(Burns, 1996-2000) Dr. Frances M. Christian, a clinical social worker and cognitive therapist at the Medical College of Virginia in Richmond, says, "Thoughts and beliefs have a lot to do with how people feel and behave. Early in life, people develop core beliefs about themselves and other people and about how the world operates." Cognitive behavioral therapy has been very thoroughly researched. In study after study, it has been shown to be as effective as drugs in treating both depression and anxiety. In particular, cognitive behavioral therapy has been shown to be better than drugs in avoiding treatment failures and in preventing relapse after the end of treatment. A cognitive therapist directs a patient's attention to "automatic" thoughts, the things people say to themselves, that result in unpleasant feelings. (Stopa, 2000) For example, someone prone to anxiety attacks might automatically think, "I'm going to mess up," when taking an exam, participating in a school event or being interviewed for a job. After failing such a task, the person might conclude, again automatically, "I'm a loser." In therapy, the person is helped to recognize delusions in thought, which include exaggerating the sense of threat, anticipating disaster as the outcome, and over generalizing from one negative experience and ignoring times when things went well. Finally, once the damaging automatic thoughts are recognized, the person is helped to examine how realistic they are, and they consider alternative explanations, then imagine other outcomes and realize that the symptoms of anxiety are not the prelude to a heart attack or some other medical disaster. (Stopa, 2000) This same approach is practiced for depression. The difference in the therapeutic approach versus medicating is dramatic, and the relief people feel is immediate. Instead of dwelling on the negative, which the other therapists sometimes do, they acquire therapeutic tools the depressed can apply on his or her own, in case they may find themselves slipping into old patterns of thought or behavior.