For example, CBT applied to body dysmorphic syndrome proceeds by challenging the beliefs that patients have about their own attractiveness. But what if you are, as you believe, truly unattractive (as most men seem to be)? And what if lack of physical attractiveness has a major impact on most aspects of your life (as seems to be the case for both sexes)?
Assuming both of those are true, CBT isn't be about denying that. The next step would be to ask "why is that bad?" and "exactly how bad is it?" Eventually, if you do it in a precise structured manner, you'll find some irrational thoughts hidden away somewhere (for example, "if I'm physically unattractive I'll never find romantic love" may be one irrational thought, which is easily countered by pointing out that lots of unattractive people are married).
The act of writing it down and following a structured approach is also really important. Even if you know a thought is irrational, it helps to write down all of the reasons it's irrational. I don't know why, but the act of writing it down seems to be important even for things you already "know" in order to believe them on a gut level and actually start to feel better.
All of this is described in the Feeling Good Handbook, which you should be able to find a free pdf of if you can't afford it.
I started going out with a fantastic girl a couple of weeks ago. Everything is great, except that whenever I've sent her a text message or email requesting something and haven't received a response yet, I experience significant dysphoric anxiety, fearing that her response will be not just "no" but "no and I don't want to date you any more". This is due to brain chemistry or personal history, take your pick—either seems like a possible explanation to me. But there's certainly no evidence supporting the idea that this is likely to happen, nor is the anxiety helping me prevent it or helping me in any other way.
Does anyone have evidence-based advice, or pointers to same, on dealing with this kind of issue? It is the only splotch on what have otherwise been the best two weeks of my life.