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Copyright 2019 by Althea Press Emeryville California No part of this publication may be reproduced stored in a retrieval system or transmitted in any form or by any means electronic mechanical photocopying recording scanning or otherwise except as permitted under Sections 107 or 108 of the 1976 United States Copyright Act without the prior written permission of the Publisher Requests to the Publisher for permission should be addressed to the Permissions Department Althea Press 6005 Shellmound Street Suite 175 Emeryville CA 94608 Limit of of The Publisher and the author make no representations or warranties with respect to the accuracy or completeness of the contents of this work and specifically disclaim all warranties including without limitation warranties of fitness for a particular purpose No warranty may be created or extended by sales or promotional materials The advice and strategies contained herein may not be suitable for every situation This work is sold with the understanding that the Publisher is not engaged in rendering medical legal or other professional advice or services If professional assistance is required the services of a competent professional person should be sought Neither the Publisher nor the author shall be liable for damages arising herefrom The | [
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Stacy Vaeth Photography Print eBook for allContents Start Guide Chapter Is Anxiety Running Your Section Feelings Chapter Your Emotions Chapter Your Body Physical Sensations Chapter Putting the Tools to Work Section Behavior Chapter Avoidance Escape Chapter Acceptance Approach Chapter Putting the Tools to Work Section Thoughts Chapter Thoughts vs Reality Chapter Getting Unstuck from Thoughts Chapter Putting the Tools to Work Section Staying on Track Chapter The Road Ahead Chapter Building Your Support Network Resources References About the Start Guide This book provides a variety of strategies and techniques that have proven effective at reducing anxiety and its most troubling symptoms Any of the strategies you choose to practice will help your anxiety overall but divided them up here based on which type of symptom they target This Guide will navigate you straight to the set of strategies that will help you deal with acute symptom and situations Section Feelings Turn to the strategies starting here if feeling strong emotional or physical symptoms of anxiety Sadness Insomnia Mood swings Racing heart Shortness of breath Dizziness Stomach upset Section Behavior Turn here if your anxiety is making you behave in ways that you like or that are causing you problems Section | [
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II will be helpful when your anxiety causes you Avoid activities you used to enjoy Avoid certain people Frequently cancel plans Call in sick to avoid stressful events like presentations Feel unable to do routine things like drive or go to the Behave uncharacteristically in situations e g you approach or talk to your friends when at a party Section Thoughts Starting here find strategies to help diminish the inaccurate or unhelpful thinking that preoccupies the mind when caught up in anxiety These strategies will help if Chronic worry Repetitive or racing thoughts Catastrophic thinking thoughts g suck at this so I might as well give up Irrational beliefs g I drive back home to check the oven my house will burn down Welcome Everyone feels anxious at some I have worked with anxious clients for the past 15 years in my practice as a clinical psychologist Some come to me believing that their anxious feelings can improve Others enter therapy reluctantly mostly convinced that nothing will ever reduce their panic symptoms avoidance behavior or worried thoughts People who improve typically have two things in 1 A part of them no matter how small believes they can get better 2 | [
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They learn and put to work effective strategies Simply opening this book and reading this far shows that some part of you believes your anxious symptoms can get better And if willing to engage with this material and give serious thought to the impact anxiety has on your life a part of you that wants to get better Take you already have all you need to start managing your anxiety symptoms and living a happier more fulfilling life How to Use This Book Psychology is a young science and still quite a bit we know However we do know how to treat anxiety Most people who consistently use the psychological tools in this book will find relief My clients who use these methods tell me that although they are still aware of their worried thoughts those thoughts no longer have the same power over them So instead offeeling as if the waves in the ocean are pulling them under and they have to fight for dear life they realize they can in a stormy sea They ride out the tempest by using their tools and knowing that the waves will eventually subside and the sea will be calm again The | [
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strategies in this book are simple to implement They are all evidence based meaning research has proven their effectiveness They come from cognitive behavioral therapy acceptance and commitment therapy pronounced like the word act and mindfulness practices not necessary to go through the book from start to finish in order to improve You likely have not experienced the whole range of possible anxiety symptoms described here so you may choose to skip some sections depending on what experiencing Although this is not a workbook it is full of practical strategies and instructions for how to implement them In each of the nine main chapters see sections titled Deeper which are suggestions on how to take the strategies to the next level need a notebook or journal for these The strategies are optional but they are a great way to maximize your results A NOTE TO The clients in the examples used throughout the book are composites and the names are fictional to protect anonymity Getting Started Keep a notebook or journal handy so you can jot down your thoughts about the strategies as you try them out Your notes will help you reflect on what learning and how your new | [
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skills can help you better cope with anxiety The more you practice and write about the strategies the faster become automatic responses to your anxiety triggers Once you have your notebook and are ready to start take a moment to think about your schedule Consider you want to work on this material and when you can best fit it into your general routine To really get up to speed with your new skills daily practice is the way to if you can set aside only a few minutes The point is give some thought to how going to integrate this book into your routine If in the middle of an acute symptom I encourage you to go directly to the relevant section So for example if consumed by worried or intrusive thinking start with section III If your anxiety is causing you to avoid important events or people you may want to start with section II If struggling with your feelings or physical health start with section I To reach goals of sustained peace of mind and inner calm consider breaking the material down into small doable steps so you eventually work through the entire book at the pace that | [
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suits your life CH APTER ONE Is Anxiety Running Your Why We Struggle with Anxiety A snake on a hiking trail or a gun in your face or any direct threat to your will trigger your response When this happens the sympathetic nervous system releases a cascade of hormones in particular adrenaline and epinephrine These stress hormones very rapidly cause a series of changes in your body including increased blood pressure and heart rate slowed digestion tunnel vision shaking and increased muscle tension All this prepares you for a physical response to the danger These changes come together in an instant to create a singular focus on survival When anxiety is in the case of the snake or the physiological response is normal because it prepares us to respond to the potential threat Even when the perceived danger anxiety can still be helpful For example a student might need to achieve a certain score on a test in order to be accepted to medical school His anxiety motivates him to study take a test prep course and spend considerable time on practice exams The fear of failure can energize and focus him for the hard work ahead Or a person | [
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driving on a busy highway suddenly experiences increased heart rate and blood flow when she sees someone screech to a halt in the lane next to her The immediate increase in heart rate prepares her for action so she can steer toward safety if she needs to These kinds of anxiety responses may not be saving our lives but they are adaptive and keep things running smoothly Anxiety becomes a problem when a response is triggered by cues that are not threatening at physically or otherwise For instance the person who obsessively worries about their health even though tests have ruled out a medical condition This person is unable to be present with the people around them because constantly preoccupied by what might or might not be going on medically Or take the person who fears using public bathrooms and eventually avoids all business travel in order to not have to confront this fear If travel is necessary for work this career will be limited or ended by what is at its core an irrational fear Anxiety just a problem of overreacting to things happening our anxiety response can be triggered by things that exist only in our minds This | [
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happens when we worry about and anticipate and case scenarios which may never come to be Consider the person who feels insecure and frets relentlessly about the possibility of doing something wrong socially and being embarrassed Eventually their social world becomes smaller and smaller They may no longer go to social events and may even stop opening up to people known for a long time If holding this book you likely struggle with anxiety in some way But you may still have questions about whether or not anxiety is a problem for you or about how serious a problem it is There are some general ways to assess if dealing with problematic anxiety or just the normal fears that arise in life from time to time Anxiety is adaptive when it comes in response to an fear of risk in your immediate environment Anxiety is maladaptive when it becomes a chronic state of tension worry avoidance behavior all of which negatively impacts your life and functioning The table below describes the differences between normal fear and problematic anxiety FEAR ANXIETY Fear is and generally rational in that responding to a threatening situation or event Anxiety is and can easily become | [
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irrational because it is untethered from real events Your imagination continually calls up scenarios in the here and now There is a fire in the house and figuring out how to put it out Once the fire is out your fear subsides You feel worry and discomfort even though you are not in immediate danger No clear threat is present and there is no clear way to solve the concern Fear comes from real threats in the outside world e g job medical illness of a loved threat of being physically wanting to do well on a specific task such as a speech or an wanting to make a good impression on new acquaintances For the most part anxiety created by the outside created by your mind You worry about possibilities that may or may not happen such if they like if the plane if I leave the movie if they hate if I have a panic if I make a fool of What We Can Do About It The Anxiety and Depression Association of America estimates that 40 millionpeople suffer from anxiety disorders which are the most common issues that bring people to therapy Thanks to decades of research | [
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we know a good deal about how to treat them In fact anxiety symptoms of all kinds are very responsive to treatment offering anxiety sufferers relief This book gives you access to some of the same tools I use in my practice to help people struggling with all types of anxiety symptoms The techniques in this book are taken mainly from three scientifically tested and interventions As a clinician and also as someone who struggles with anxiety I have personally found relief using these specific approaches and so have my clients I believe you will too What research and experience have shown me is that a combined approach of examining your thoughts accepting necessarily anxiety as a part of your life and learning to be more present in the here and now are the essential keys to reducing anxiety and living a more peaceful life Having anxious thoughts becomes a cycle that creates more anxiety use cognitive behavioral therapy to examine and change your thoughts Strategies from acceptance and commitment therapy will help you behave in a manner and ultimately live a life that matches your core values and desires regardless of your mood or anxious symptoms As you grow | [
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to accept that we all suffer sometimes find more room for you to separate from your battle with anxiety Through practicing the mindfulness strategies throughout each chapter be more easily able to bring your thoughts back to the here and now As you learn ways to observe and distance yourself even if only slightly from your anxious experiences you will be less overwhelmed and more able to experience joy and pleasure in your life now Habits and Neuroplasticity Struggling with anxiety can be so demoralizing that we give up Similar to traits like height or eye color people who struggle with anxiety can start to believe that they were born anxious and nothing they can do about it However the reality is that changes in our environment along with learning new skills have a significant impact on anxiety and can lessen anxious symptoms over time Neuroscience shows that neuronal growth and structural changes in the brain occur as the result of new experiences and also as the result of how you think and behave A example of this would be if you decided you wanted to change your habit of snacking right before bed Perhaps eaten chips or crackers before | [
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bed for years and you decide to substitutesliced vegetables The plan is solid and ready to go However unlikely to be successful in changing this habit if you substitute your chips for veggies only once a week or every couple of weeks On the other hand if you consistently eat sliced veggies every night of the week or even just most nights of the week your brain will adjust and the new habit will take hold When you repeat a new behavior enough continually fires the same neuronal the new experience becomes a part of your system on a chemical level This phenomenon is called neuronal plasticity or sometimes brain plasticity ASSESSMENT Tap Your Growth Potential People just like you with similar symptoms and levels of anxiety have triumphed over anxiety largely because they believed they could Recognize if you send yourself messages such as telling yourself no amount of work will lessen your symptoms Just having these thoughts can hinder your progress Take this assessment to see how much you believe in your ability to grow and have the internal peace you deserve and desire If you answer yes often plan to cultivate your capacity to believe that freedom | [
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from anxiety is possible 1 When told some way of thinking or behaving will help my anxiety I zone out think nothing can help or that this person get it 2 If I have to work hard at something I feel like something is wrong with me 3 I want to stay just as I am but I am unhappy where I am 4 I believe the anxious aspects of my personality that bother me are changeable through learning and new experience 5 Most of what I do is to survive and get through the day and less about what I want 6 rather stay stuck in anxiety than learn new ways of coping As you work your way through the strategies in this book you will likely start to believe in your ability to grow Revisit this assessment from time to time to see the progress making in believing in yourself In time you will look back and feel both surprised and proud of your growth UP Anxiety is a normal bodily response to threat Feeling fearful about something in your immediate environment is adaptive Imagining situations that may or may not come to pass is maladaptive Anxiety responds | [
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to you can and will get better The brain is able to grow and change structurally as the result of new experiences over time Believing that reducing anxiety is in your control and hard work will pay off makes all the difference You can do Learn in this Section Imagine a triangle with in one corner in another and in the third These represent the three main paths to change which lead to relief from a wide range of anxiety symptoms This book is divided into these three main sections too A change in one corner of the triangle will affect the other two If you change your learning strategies to calm your fear and anxiety in social you will likely change your thoughts I calm my anxiety I can contribute to the conversation and people will like and your behavior stop avoiding social Simply put if trying to effect change you can start with any corner of the triangle In this first section we will look at your anxious feelings both emotional anger mood swings and physical of breath heart palpitations learn better ways of dealing with your feelings and how to overcome avoiding or pushing your emotions away | [
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We will also see how the stress of anxiety can lead to unpleasant physical side effects such as digestion problems racing heart and chronic headaches Together we will uncover what lurks underneath your anxiety which may be the most important factor when life is disrupted by anxiety CH APTER TWO Your Emotions Are You Suppressing Your A few years back I took a genetic test to determine if I was at heightened risk for developing certain cancers I did this at the urging of my doctor who rightfully promoted prevention over treatment This thinking made sound sense to me and given that I have a family history of cancer I believed I would get the reassurance of longevity I was shocked when I was told I had an 80 percent lifetime risk of developing breast cancer average risk is 12 percent I distinctly remember thinking be there must be a mistake in the test The information was too overwhelming for me to process emotionally so I pushed it away As a result I became obsessively focused on negative thoughts about other aspects of my life I was unable to sleep most nights overwhelmed by worries and What I doing was | [
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acknowledging my profound sadness and grief Once I started to get in touch with the vulnerability I felt the anxiety became easier to manage The more we avoid or push away our emotions the more anxious we become This process is a learned habit that actually worsens anxiety over time in part because it reinforces anxious thoughts and driven behavior This happens because to keep the unwanted emotion at bay we have to continually work at avoidance Over time keeping up this avoidance becomes something else anxious about When we despite our best efforts drop our guard even for a moment the emotions come flooding in and we again anxiously push them away On this the original negative emotion goes unaddressed and we remain ill at ease and hypervigilant How Do You Feel Right As you learn to better identify your feelings you will gain greater emotional control This means you will be less prone to intense emotional reactions such as panic attacks emotional meltdowns blowups crying spells and worried thinking Plus knowing what feeling means you can address the real issue and feel better When upset or aware experiencinganxiety use the following chart to help you label the deeper | [
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that may be underneath your anxiety EMOTIONS SENSATIONS LABELS TO DESCRIBE YOUR EXPERIENCE ACTION URGES EVOLUTIONARY SIGNIFICANCE LOVE Calm body relaxed muscles sense of peace and Sense of comfort safety comfort with another passion sexual longing Desire to be with the person to bond with the other to make sure the other is okay Love bonds couples children families and tribes It is the glue that connects people PLEASURE hormones released increased energy lack of physical pain excited body Delight joy vivaciousness contentment mastery feeling lost in the moment not thinking about the future or the past Urge to smile laugh talk more with others and reveal more about yourself Pleasure is a tonic for negative emotions and motivates us to do certain things in order to experience more pleasure ANGER Tense body clenched jaw tightened muscles increased body temperature feeling of pressure behind the eyes Feeling unfairly treated or disrespected by others or the world as a whole outrage rage feeling the self is not valued Urge to be aggressive or harm another urge to yell or throw something Anger cues the body to through physical force or boundary setting SADNESS Desire to remain still feeling of lethargy and | [
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lack of energy difficulty getting your body to move Loss grief hopelessness rejection feeling defeated or unwanted feeling bad about the self Urge to cry or sit still in one place lack of motivation urge to dwell on what you did to cause the loss Sadness is protective in that it allows the self to mark time while grief and solving can take place ANXIETY Stress hormones released in the brain muscle tension restlessness increased heartbeat sweating shortness of breath stomachache Being worried or fearful feeling threatened by something in the environment or within a relationship of losing a being in Urge to be vigilant replay events in mind predict future events desire to control the Anxiety triggers adrenaline which puts the body into high alert primed for action and protection mode threat flee or be busy GUILT Stomachache aching muscles feeling that you be physically at ease Feeling like a person feeling destructive feeling you should be punished Urge to make amends to be a person to berate oneself Guilt keeps people in line with societal laws and norms designed for protecting people SHAME Burning sensation on face cheeks flushing stomach sinking Embarrassment humiliation exposure as a fraud fearing | [
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a flaw will be revealed to another or the public Urge to flee the situation to become invisible and hide oneself Shame signifies social status in a group and keeps people in accordance with group expectations EXPRESSING YOURSELF When feeling strong emotions finding a way to express those feelings can go a long way toward helping you move through them There are countless benefits in talking about our feelings with another person For example I see it over and over again in my practice that a person comes into a therapy session feeling upset or anxious They allow themselves to talk about their feelings for 50 minutes and they leave feeling significantly better Many often say too easy How can merely talking make such a The answer is that the act of talking labeling and expressing moves emotional information from your emotional brain to your frontal lobe which helps you better understand yourself and feel more in control of your emotions which makes you feel better Choose a person with whom you can discuss your feelings Try to look the person in the eyes while expressing yourself because maintaining eye contact with a supportive connection will further soothe your nervous | [
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system Emotional relief can come by talking with others with whom you have very little intimacy or contact such as a therapist or support group Even talking online with someone you know that well may help you feel more accepted and less anxious Go Deeper Express YourselfAs you explore the feelings table and begin talking about your feelings write down in your notebook the emotions that seem to come up for you the most Record one or two of these primary emotions This a writing test so worry about your writing style spelling or punctuation Simply ask yourself the following How old were you when you first remember feeling this What was the Was that situation at all similar to what going through Did you express what you were feeling to Did anyone comfort you or help you make sense of your See if in your writing you can comfort yourself now through compassion and Tell yourself okay to feel this specific See if you can let yourself believe that part of the problem is never having allowed yourself to reflect on and accept your deeper emotional experiences Underneath When we express negative experiences they become try to problem solve | [
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the upset in an internal vacuum which results in overthinking and a sense that we turn our mind off Without a release valve all those negative doomsday thoughts just keep bouncing around inside our heads Take the example of Zander a typical patient in my psychotherapy practice who is grief struck by the death of a loved one Instead of expressing his feelings and allowing himself to be openly sad he suppresses his pain Seemingly out of nowhere Zander finds himself obsessing about the details of the loved medical expenses funeral and the now that the loved one is deceased Over time his world becomes smaller and smaller He is afraid to go out and spends most of his time at home ruminating through negative events by mentally replaying them again and Another example is Valentina who after her divorce blocks the normal feelings of anger loss and sadness and instead becomes obsessively focused on her weight She replays in her mind what she did or eat that day plans her next meal imagines herself larger or smaller In this way she occupies her mind to avoid confronting the hurt and upset of the divorce The avoidance only increases the | [
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loss she has not fully experienced emotionally and so she clings more tightly to her unhealthy eating patterns If a chronically anxious person likely in a habit of suppressing your negative emotions You may be aware of your anxiety but unwilling to explore what might be under or driving the anxiety As uncomfortable as the anxiety feels it can still feel easier than managing more threatening emotions such as anger or sadness or shame or guilt take a look at how to start doing just that EXPLORING ANGER If you struggle with anxiety the moment you feel an ember of anger brewing you likely blink it away Anger is adaptive way of motivating us to protect ourselves through boundary setting and 1 Build awareness of anger Notice when your body gets tight your jaw tenses or your heart rate increases Instead of going to your automatic default ask yourself feeling might I be resisting right and might I be and anger 2 For 10 minutes without taking any action without distracting yourself with your worries and without tolerate your anger being present 3 Breathe in and out simply letting yourself be aware of the anger Becoming aware of anger mean | [
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you need to react to it One client I worked with recognized that when she was starting to become angry her jaw clenched up Recognizing this anger signal helped her know when she was angry long before it became intense enough to be EXPLORING SADNESS Many of us will go lots of other places first even to rage rather than willingly feel the vulnerability of sadness This short meditation is a safe way to feel an uncomfortable emotion by inviting it in rather than feeling overwhelmed by it By meeting sadness on your terms have the advantage and start to learn that you can actually tolerate feeling sad and that it such a threat to you after all 1 Sit comfortably or lie down on your back Close your eyes Allow the tension in your body to release as you breathe in and out 2 Invite sadness into your conscious remember moments when you felt sadness Consider when sadness was present but was overlooked and unattended to Review your relationships experiences achievements and various circumstances through the lens of sadness 3 Now be a gentle curious observer Where is the sadness located inyour Do you feel tenderness in your stomach | [
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behind your eyes a feeling of fragility or Maybe you can observe an urge to cry or to retreat Perhaps your heart feels tense or heavy 4 Recognize when a voice in your head pulls you away Gently direct your attention back to your sad feelings 5 Your suffering only wants to know that you see it and that you no longer have to hide and suppress it Repeat internally see you sadness I feel you I am side by side with you 6 Feel the sadness as you breathe in Release the sadness as you breathe out Notice the feeling as it comes in and how observing it allows it to become less intense How Do You Feel About Your We minimize our very real and normal emotions by telling ourselves bad that I feel this way or negative emotions mean weak or wrong with me that I feel this or such a loser because always upset or one will ever love me because my emotions are out of control When we negatively judge our emotions we experience double the emotional pain On top of the original hurt or upset we feel worthless for having the feeling in the | [
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first place Telling yourself a weak loser for a feeling you help but experience is a particularly harsh torment Take for example Tanisha a client from my practice When Tanisha became overwhelmed by sadness or anger as a child her parents would immediately dismiss her coldly telling her to over and that she was sensitive Eventually whenever she felt hurt lonely overwhelmed or full of she learned to tell herself the same wrong with and over it no one and you be cool and keep your feelings together like everyone By the time she was an adult Tanisha had layers of unaddressed negative emotions that came out in the form of crushing panic attacks We eliminate anger and sadness but we can control how open and kind we are to ourselves when we experience these feelings The next strategies are designed to help you let go of judgment and allow your feelings to surface JUDGING ANGER By changing your anger associations or judgments you can be at ease with the emotion Take a moment to consider what you associate with memories from your childhood adult experiences Write down in your notebook four or five specific words you associate with anger | [
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Do you understand why you associate these words with Where did the judgments come Were they ideas you got from observing others or things you were told when you experienced Are your associations with anger mostly If so Which word holds the strongest association with anger for Now reflect on its opposite Can you think of ways this opposite word might be associated with anger For example for many anger brings up words such as of and Opposites of this include or Expressing anger is constructive and useful when done in a respectful way that allows us to set boundaries and take care of ourselves JUDGING SADNESS Sadness is a feeling that comes about due to grief rejection feeling defeated unwanted or unloved Typically each of these instances brings on a sense of loss The longer the sadness goes unaddressed the more and more anxious you become Whatever the loss may be always okay to acknowledge your sadness about having missed out on something or losing something very dear Bring to mind three or four specific occasions when you pushed away the feeling of loss grief failure or rejection Were you honest with yourself or with others about how sad | [
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you really Instead of feeling your sadness did you go into an anxiety What stopped you from allowing yourself to be purely What kind of judgments might you have been making about your Did avoiding the sadness help or hurt you in the long Letting Go of Judgment important that you practice observing your emotions without having to immediately push them away Use this short meditation to gain perspective and space from your emotions Sit quietly and comfortably Close your eyes Bring your breath to yourconscious attention by noticing your chest rising and falling Meet whatever emotion or feeling arises in your mind with your inner observer Your inner observer carries no judgment Your inner observer places no pressure on you to act on your emotions It merely notes what you are experiencing For example your inner observer might verbally tight or and ease If your inner observer becomes aware of your mind making judgments simply label it or Notice how when you observe and label the feeling state passes and then you observe and label the next feeling state Nothing you observe is right or wrong Your emotional experience needs your calm accepting awareness nothing more and nothing less | [
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Turning Toward Difficult Emotions Our culture floods us with the message that happiness and success depend on never experiencing suffering or painful emotions Of course we all feel negative emotions at times and when we do left feeling defeated Feeling that we must have made a terrible mistake somewhere along the way else would we be feeling so we spin our wheels doing whatever we believe necessary to avoid push away or somehow the upset We all experience negative emotions including anxiety No one is immune Even people without anxiety disorders go through anxious just part of life Bringing acceptance to your emotional world means giving up the fight against suffering and pain so you may be free in spite of it And too it means recognizing and believing that experiencing negative emotions is normal Accepting situations and experiences mean you want them or that resigning yourself to a lifetime of emotional pain Acceptance mean feeling the victim of your pain and that your pain controls you Acceptance mean you necessarily like what experiencing Acceptance is the is what it is The metaphor of the Chinese finger trap used in acceptance and commitment therapy clearly shows how struggling against the | [
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experience of difficult emotions only increases negative emotion The Chinese finger trap is a small woven cylinder that children often enjoy You place a finger in each end of the cylinder pull and unexpectedly your fingers are trapped Trying to become unstuck the inexperienced immediately attempt to pull their fingers out The harder they pull the tighter the tubebecomes evoking fear and even a little panic The Push the fingers toward the center of the tube The tube becomes slightly bigger and then it is easy to wiggle the fingers out When we continually push away and avoid our experiences we become increasingly afraid of the negative Over time we stop knowing our feelings altogether Even pleasant experiences like joy become blocked We are no longer present but instead live in a survival state waiting for the next shoe to drop This existence leaves us with an emotional blind spot After all if completely focused on bailing water out of a sinking boat you might not notice the life preserver at your side In my case spending time processing and ultimately accepting my genetic cancer risk as a reality led to the decision to undergo an elective mastectomy with literal | [
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life preserver that I was unable to see or even consider until I accepted my situation as it was Our emotions provide valuable information and guidance They tell us what we want out of life what we want how we feel about the people we are close to and what we need to work on within ourselves Acceptance allows us to play the game of life with the full deck of cards Go Deeper Understanding What We Learned Early On Most of us learn how to cope with our feelings while growing up We model ourselves based on what our parents did what they told us about how to handle negative feelings or how they interacted with us when we were upset These messages can play out over a lifetime and go unchallenged For example Juan a client I worked with came to see that whenever he was upset his parents told him he was fine and not to worry Although well meant this only increased his upset because he had no outlet to talk through what was bothering him so he could problem solve the situation and find true relief Take some time to think through what may be | [
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helpful or unhelpful in what you learned growing up about managing your emotions In your notebook write about any or all of these prompts that resonate with you Did your caregivers express Did they cry or get Or did they seem to have a tight lid on their emotions and rarely expressed frustration or Do you think you need to appear in control of emotions all of the timeor do you feel completely out of control and so try to clamp down as much as Can you recall any expressions from caregivers coaches or teachers telling you that you are sensitive needy or Did your family or caregivers describe you as being very as a Did you hear a constant or Did you feel as if you be a kid with Did you feel there was limited space for you to be you Consider your memories of joy and happiness in your household as you grew up Do you recall your caregivers laughing among Did they notice and label your Or was joy When upsetting things happened to you as a child did you feel as if you could talk to your parents Or did you feel your caregivers would | [
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judge your upset or overly pressure you to in some Did you not confide in them at Identify the link between the type of emotional support you were given in childhood and how accepting you are now of your emotional experiences Start changing the way you support yourself emotionally so you can be more unconditionally accepting of whatever you feel PRACTICING ACCEPTANCE Although it can be hard to accept painful not avoid or push them consequences that come from not doing so far outweigh the pain of facing whatever it is really feeling Come up with several examples in your life where your lack of acceptance of your feelings has only caused you more negative emotion or wheel spinning As you reflect on these examples be honest with yourself and acknowledge the feeling you tend to avoid that brings the most consequences to sadness anger anxiety guilt shame frustration joy Consider the results of avoiding this emotion Has it increased your Caused you to siphon off large amounts of emotional energy in Or has avoiding this emotion blocked joy and SITTING WITH DIFFICULTEMOTIONS It is likely you have avoided negative emotions because afraid of feeling them or you know how | [
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to feel them Here is a way to do just that and it takes only 10 1 Set a timer for 10 minutes Bring to your conscious awareness an emotion you tend to avoid or suppress Try to conjure it up so you can feel it right now 2 Observe where in your body you experience the upset or discomfort Recognize how it feels See if you can literally visualize the feeling as you experience it in your body Instead of fighting the feeling welcome it in 3 Whisper out loud glad here See if you can observe the feeling almost as if you are looking down on a physical thing separate from yourself 4 Internally notice a feeling of coming over me Tell yourself am making room for you or can feel this feeling and also be okay 5 Notice the anxiety that drifts over you as you allow yourself to face a feeling you always avoid okay to feel this anxiety It makes sense because afraid of this emotion and asking you to feel it You can be afraid and still invite the emotion in Show yourself you can enter into the feeling and still be okay When | [
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your time is up move forward and let go of this experience UP All emotions are a normal part of human experience Pushing away negative feelings increases anxious thinking Regularly identifying your feelings will decrease anxiety Expressing your feelings will decrease anxiety Accepting your emotional world will decrease anxiety You can experience negative feelings and still be okay CH APTER THREE Your Body Physical Sensations Anxiety and the Body Cole struggled with debilitating physical symptoms including lack of appetite racing heart an inability to concentrate feeling internally keyed up and insomnia with racing thoughts These distressing symptoms were all he could talk about because they were so unnerving Cole understandably felt as if his body was betraying him and that no amount of work would solve this Anxiety regularly shows itself with physical symptoms At some point sometimes after years of experiencing such symptoms the dam breaks and the body will no longer be ignored For Cole this meant such intense heart palpitations that he would become dizzy and pass out Other people might react in a different way like succumbing to acute exhaustion or no longer being able to drive because of severe back spasms or being unable to | [
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concentrate because of persistent headaches For symptoms like this anxiety treatment begins once medical causes are ruled out When I see clients like Cole in my psychology practice they are usually surprised that they have is anxiety For example for a long time Cole believed that eventually a specific physical ailment would be identified as the root of his very real suffering Anxiety impacts the brain and the brain impacts anxiety In other words emotions influence our physical functioning and our physical functioning influences our emotional states Improving our overall physical functioning and body awareness can make all the difference Cole eventually became more at ease by learning to observe his physical sensations and taking better physical care of himself BODY SCAN Anxiety inhabits your body The trick is to start tuning in so you can more quickly recognize the physical signals The goal of this exercise is to develop awareness for where you carry your anxiety 1 Pick a position or posture that is most comfortable for down or sitting up eyes open or closed As you do this let go ofjudgment You are simply observing yourself in the here and now 2 Each time you breathe out feel | [
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your body relax as it releases tension Recognize when your attention shifts and gently direct it back to your body awareness 3 One by one focus on each segment of your body opening up to whatever is present in that moment Name the body part and imagine you are breathing into it Observe areas of tension strain pain or Head Neck Shoulders Arms Hands Chest Back Stomach Thighs Calves Feet As you come out of this exercise make a mental note of where anxiety tends to rest in your body so you can tune in to that spot more quickly PROGRESSIVE MUSCLE RELAXATION When you notice a spike in anxiety and your body feels tense take 5 to 10 minutes for a progressive muscle relaxation This strategy also helps when you sleep at night or to downshift into relaxation before bed Lie down or sit comfortably In turn tense each muscle in your body shoulders hands arms stomach buttocks legs while breathing in for a count of 5 and then release the muscle while breathing out for a count of 5 While doing so pay close attention to the contrast between your experience of muscle tension and muscle relaxation Repeat | [
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this exercise a few times Notice your body loosen and gradually become more at ease Physical Symptoms The stress system combined with heredity and environmental experiences over time can set the stage for a variety of chronic medical conditions Persistent exposure to stress through psychological trauma grief and loss life transitions habitual worry and chronic perfectionism can cripple the adrenal system The adrenal glands overwork to manage the ongoing stress and then eventually give way and underwork The result creates a roller coaster of anxiety spikes followed by exhaustion Exhaustion can lead to a variety of medical diagnoses Anxiety is also linked with the release of stress hormones and chemicals that over time can worsen medical conditions For example research is showing that stress and chronic pain are likely linked to the same neuronalpathway Nerve pain increases the expression of the neurotransmitter PACAP which is the same neurotransmitter the brain releases in reaction to stress In other words stress can bring on worsen physical pain symptoms The biological response to stress can also significantly impact our cardiovascular digestive respiratory and endocrine systems In a large analysis examining over 20 studies and about 250 000 individuals researchers found that anxiety was | [
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associated with a 26 percent increased risk of coronary heart disease and a 48 percent increased risk of death due to a incident The stomach and bowel are directly impacted by the response Over time nerves that manage digestion can become reactive causing unpredictable abdominal discomfort such as irritable bowel and upset stomach Although the symptoms are not life threatening they significantly impact quality of life and can be quite difficult to manage In addition people are more vulnerable to stomach ulcers when the stress hormone cortisol is released on a chronic basis Anxiety is often present in people with respiratory disease particularly asthma and Chronic Obstructive Pulmonary Disease Fear and worry impact breathing making these illnesses all the more distressing The stress reaction due to anxiety is also linked with migraines rheumatoid arthritis hyperthyroidism diabetes and autoimmune illnesses Unfortunately anxiety is often not considered a significant factor when treating these complicated and often debilitating symptoms If anxiety is overlooked medical symptoms may become worse Knowing which of your symptoms are anxiety related and managing them will improve your overall physical functioning and psychological WHAT STORIES ARE YOU There is a interplay between anxiety and medical illness The story you | [
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tell yourself about your medical and how it impacts you physically is the variable going to focus on here begin with an My client Sierra endured uncomfortable bouts of gastroesophageal reflux disease The symptoms were so painful that she was frequently distracted from work and family responsibilities slept upright at night and so slept poorly and despite medication had a perpetual burning sensation in her chest By the time Sierra entered therapy she had seen a number ofgastroenterologists without gaining relief When I talked to her about the relationship between stress anxiety and medical conditions she was exasperated and felt that I was minimizing her genuine physical illness After some conversation Sierra softened her view although she was unable to believe that her GERD symptoms could be helped by anything other than a medical fix We persevered She started practicing mindfulness changed her diet and studied the relationship between stress and physical health Eventually she became aware that her GERD although very real and painful often flared after she experienced a stressful event Armed with this knowledge she developed strategies to use each time her anxiety was triggered She still experienced GERD but reported that the intensity of her symptoms | [
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halved As a result her symptoms had less of an impact on her life Your perception of your ability to manage and control your medical condition makes a difference Managing anxiety and stress better will not take away your medical condition but it will enhance your quality of life Reflect on the following statements and say them out loud a number of times The more you say them the less you will feel at the mercy of your physical symptoms I believe I have some control over my physical symptoms I believe if my physical symptoms were to improve it would be due in part to strategies The way I think about my physical state impacts my symptoms Exercise will likely improve my physical symptoms My current quality of life could improve My medical diagnosis physical is not entirely out of my I must persevere in living a life strategies and taking good care of my physical self will help me feel better physically Working to believe these statements will motivate you toward healthy care Go Deeper What Else Could You Think thinking is a way to avoid facing deeper emotions Perhaps we worry we manage the painful emotions or | [
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perhaps we fear they will overwhelm us One client Jack told me if he did not think about his medical condition so regularly he would begin to feel a tremendous sense of helplessness and vulnerability He felt ineffective and powerless if he was not preoccupied with his health Hyperfocusing on his body and medical care was a way to not feel like a a way to take charge With his obsessive thinking Jack felt like he was doing something This was difficult to experience and express but once Jack understood his real fear we could productively work on helping him feel less vulnerable One way we did this was by looking at what he could control about his medical diagnosis and then using acceptance strategies to deal with the rest Jack became more noticing when his anxiety was triggered He did more to quickly identify the sources of his anxious thoughts He practiced mindfulness daily exercised regularly ate a healthy diet and worked on breathing and positive The rest he turned over to his medical team and the universe Take a few minutes to reflect and journal in your notebook about the following If you did not fill your conscious | [
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mind with thinking about your medical condition or physical symptoms the causes the worries the and fears that go along with it what would you be thinking about instead Explore what you may be avoiding or missing by engaging in your obsessive thinking Then see if you can talk yourself through those deeper emotions and find a way to accept them Remember acceptance is not a way to take different steps to protect yourself than the ones already taken TAKING CARE OF YOUR PHYSICAL HEALTH important to know exactly what your medical situation is otherwise the mind is free to imagine all sorts of alarming scenarios And appropriate medical intervention is essential If you have not done so already consider making an appointment with a medical doctor who considers the wholepicture of physical and emotional health Tell your doctor about your physical symptoms and also your struggle with anxiety Ask your doctor for a medical physical with blood work as well as a full thyroid panel test Thyroid imbalances impact anxiety and need appropriate medication Also make sure your doctor checks your vitamin D level Vitamin D deficiency can impact mood and energy level After you talk through the results | [
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with your doctor make three columns in your 1 Your specific medical High blood pressure 2 How going to address it medically Take high blood pressure medication 3 How going to address it in terms of anxiety intervention Become aware of anxiety practice mindful breathing 15 minutes a exercise four days a positive talk managing of my anxiety will improve my physical The Connection I want you to remember the last time you were genuinely frightened When it happened you probably experienced an increase in your heart rate change in your breathing pattern or became sweaty shaky or jittery These physical symptoms may have then reinforced your original fearful thoughts The mind and the body constantly communicate If your mind is filled with a sense of emotional peace you are much better equipped to handle challenges The connection is empowering because your anxiety symptoms will likely improve or even disappear simply by taking good consistent care of yourself Healthy sleep exercise and nutrition habits usually swiftly improve anxiety symptoms SLEEP Sleep is restorative in all mood cognitive functioning energy and health Unfortunately when anxious we do not reap these benefits because anxiety typically interferes with sleep People who struggle with | [
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anxiety wake up to intrusive worries during the night fall asleep or wake up too early Creating a nightly sleep routine places cues in the brain When practiced regularly the cues remind us that time to start unwinding The key is to follow the routine consistently so you become accustomed to the cues Eventually you will need only to start your routine to feel more at ease and even sleepy Many expect to go from alert to asleep with no downshift in between a middle relaxation an example of a good nightly routine that will help you get into a relaxed sleepy state Work to develop one of your own or use this one One hour before your desired bedtime the same time each start your routine Unplug from technology Dock your phone tablet or computer away from your bedroom Take a warm bath or shower Change into sleep clothes Drink a warm decaffeinated beverage such as chamomile tea Do a relaxation meditate through deep breathing visualize relaxing imagery practice progressive muscle relaxation Lie down comfortably and read fiction or something light Turn off your lights when you feel sleepy and your eyes start closing When you sleep think I | [
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Tell yourself okay if I fall asleep at least resting If waking up continues try progressive muscle relaxation with the lights off worry about the time on the clock The goal is to relax even if you sleep Wake up at the same time each morning If you sleep well the night before take a nap or go to bed at an earlier stick with the same routine IMPORTANT Worry often appears at night because we have been so busy during the day we been able to emotionally connect with ourselves so all the things we thought about crash in once the lights are out To counteract this set aside 30 minutes each day for what I call worry time Take out your notebook and put all your worries on the Consider how feeling what needs to get done and what worries you about the days or weeks ahead Then when the lights are out your brain have to remind you of everything you thought about earlier EXERCISEAnxious energy needs a release or it will continue to run amok Adding regular exercise into your life will pay off Thirty minutes of aerobic exercise five days a week will lessen your | [
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stress increase your improve your sleep and improve your physical and emotional functioning Feeling good about yourself means more likely to cope well because you believe in your ability to do so Exercise also increases endorphins the natural painkiller and decreases the stress hormone cortisol worth And if 30 minutes feels like too much too quickly keep in mind that research is showing that even a vigorous walk improves cognitive functioning and mood Make a realistic exercise goal Pick something you enjoy doing so you will continue to do it For example walk every day for 15 to 20 minutes Then after two weeks increase the amount of time or increase to a light jog Be sure to check with your medical doctor that exercise is safe for your physical condition Write down now what your exercise goal goal is too any physical movement is better than none However each time you exercise your mood will improve and your anxiety will decrease so consider doing something on a daily basis When experiencing acute anxiety employ the remedy If anxious and you vigorously exercise for 10 a brisk walk jogging bouncing on a trampoline jumping anxiety will decrease almost immediately Lifting | [
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heavy objects or weights for a short time can also relieve anxiety and tension Endorphins are released and you will feel naturally at ease It will wear off but the remedy is a quick hit for anxiety NUTRITION Start looking at food as not only one of the great pleasures in life but also as a natural means to improving your emotional functioning The goal is to eat a varied diet with plenty of fruits and vegetables Rid your pantry of all processed foods and sugar Adding a variety of nutrients and decreasing sugar helps the body regulate insulin and hormone levels which directly impact mood anxiety and energy levels A few specific tips about diet and Our body needs water to function and if it functioning properly mood will suffer Make sure drinking 8 to 10 glasses of water daily When experiencing an acute bout of anxiety pour yourself a tall icy glass of water This will quickly change your physiology turn the attention tothe cold sensation and reduce your anxiety astounding how many people who struggle with anxiety also drink a lot of caffeinated beverages Make no Caffeine increases anxiety Decreasing or eliminating caffeine and other stimulants from | [
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your diet will immediately lessen the intensity of your anxiety Consider removing all caffeine from your diet and if too hard halve it and work down from there Nicotine and Both nicotine and alcohol have rewarding effects on the brain but increase anxiety in the long term If you drink or smoke regularly take a break and see how you feel For some people this change alone cures their anxiety overload If you have any vitamin deficiencies with your you may benefit from taking specific supplements such as vitamin D or a daily multivitamin Go Deeper Goal Setting for Exercise Sleep In order to make a impact on your anxiety and give yourself an emotional boost consider centering your goals this week on regular exercise and sleep hygiene Think now about how you can fit in 30 minutes of exercise each day this week It necessarily have to be at the same time each day but Consistency makes it easier to stick with a routine Taking care of yourself needs to be a higher priority in your life so you might have to give something up or put to the side something important to you Then each day do aerobic | [
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exercise for at least 30 minutes Jog speed walk bike hike play a vigorous sport basketball tag with your take an exercise class Force yourself to do some kind of activity every day no matter what else is going on in your life Even when you want to do it remind yourself little in life pays off as much as an investment in exercise You will improve your physical health your emotional health and probably live a longer more fulfilled by dedicating 30 minutes each day The release of endorphins and other rewarding hormones will help you feel good about yourself As seen good sleep hygiene is perhaps the most impactful way to improve mood and anxiety A regular nightly ritual cues the brain to calm and switch into sleep mode Make that a goal starting with a regular bedtime Identify which sleep aid techniques discussed previously you will incorporate into your habit essential to do the routine consistently and at roughly the same time each night After a week journal about how you feel physically and emotionally compared to last week Do you feel any more positive about your ability to Have you experienced even slightly less physical this | [
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Could you continue this for another Everyday Body Awareness When anxious one worried thought replaces another and another This can keep us so stuck that even a few moments away from anxiety feels impossible but it is possible to anxious thinking by shifting our attention to our physical sensations Try Imagine looking at the sky and focusing intently on one small black cloud Now pull back your perspective so you take in the entire sky horizon to horizon From that perspective the black cloud loses its significance In the same way switching your attention from your anxious thoughts to the physical sensations created by those thoughts can alter your perspective When you experience an spiral observe your physical chest tense shoulders racing heartbeat whatever they are give them your full attention breathing in and out As you acknowledge it see or you it will likely change to a different sensation Recognize these sensations are communicating how alive you are in this moment MINDFUL MOVEMENT Use the simple act of mindful walking to ground yourself into the here and now and to let go of or decrease the intensity of obsessive thinking You can do this anywhere and at any to | [
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your car walking around the grocery store walking around your neighborhood or walking to work While walking focus less on your thinking self and more on your physical experience For example what does your foot feel like as you lift it and lower it to the How do your arms feel as you to feel the earth from within your body What is that sensation Does the sole of your foot on the ground feel Can you make it Explore each of your senses Notice what you feel on your is the air hot or Do you smell anything as you inhale and Simply observe any sounds you hear Notice what you see You are here in this feel your presence and your alert state of mind With each step mindfully breathe in and breathe out Count your steps as you inhale and as you exhale How many steps does it take as you How many as you Keep your attention on the steps and your breathing Each time you become aware of your mind drifting gently bring your attention back to observing what it feels like in your body to walk There is no all that matters in this | [
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moment is to be aware of your body as it glides through space UP Anxiety impacts the body and the body impacts anxiety Learn to identify and observe where anxiety manifests in your body Anxiety is associated with a variety of medical conditions Healthy sleep nutrition and exercise habits typically improve anxious symptoms Practicing body awareness exercises helps reduce spirals CH APTER FOUR Putting the Tools to Work Your intention is set Anxiety will no longer rule your life Now you know within your reach to experience a peaceful emotional life and to feel physically at ease The techniques learning in this book can reduce anxiety on the spot in the moment that it arises Repeated use of the strategies will give you consistent sustainable symptom reduction how to start taking the techniques to the next level through building habits and goals From Strategies to Habits The great pioneering neuropsychologist Donald Hebb observed that fire together wire together Whether it be learning a new language or responding to an abusive parent repeated experiences over time trigger the same patterns of neuronal activity At some point only a tiny cue will trigger that pattern of activity and you can expect the | [
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same events to occur that have always occurred in the past For example when you see a red circle in the distance your brain automatically registers sign ahead You realize as you approach that actually an advertisement on a red circle but your initial perception told you it would be a stop sign so you had already started downshifting or easing your foot off the gas Because old patterns of neuronal activity fire quickly and before we have time to consciously think changing automatic habits can feel hard It takes about 90 days to build a new habit This is roughly enough time to rewire a bit of your brain It does take discipline and effort at the beginning but with practice the new coping strategies become a natural part of your functioning and routine Eventually you even have to think about what to do to reduce your anxiety You will automatically have a more peaceful way of being with yourself and coping with the world This is the To cultivate the ease and calm you want stick with the strategies and put in steady consistent effort Planning Take a look at how your life is organized so you can | [
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begin tothink through how and when you will integrate the techniques into your routine Outside of your school volunteering childcare social life family do you do for When you do have downtime how do you currently spend People with anxiety often feel as if their downtime is unpredictable that they are at the mercy of others their schedules or their anxiety Stop this pattern by looking at the big picture of your life Look for opportunities where you can deliberately schedule periods of time to work on your anxiety strategies Review what you learned in the last two chapters at your notebook can and identify which techniques you want to start with How What times or days of the week are You have to try every start with two or three that particularly resonate with you Try to do your anxiety work at the same time or times each day A consistent time gives the brain a cue that will speed the that fire together wire process Track Your Progress Tracking progress works for many things like losing weight or saving money And tracking works with anxiety reduction too essential to progress that you set up a system where you | [
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track on a daily basis the strategies using and the intensity of your anxiety an example of a quick and easy way to track progress Each day check any and all strategies you use from chapters 2 and 3 Also be sure to rate your anxiety for the day using a 1 to 10 scale with 1 being entirely relaxed and 10 being full anxiety meltdown For example you could create a table like STRATEGY MON TUES WEDS THURS FRI SAT SUN How Do You Feel Right Express Yourself Exploring Anger Exploring Sadness Judging Anger Judging Sadness Let Go of Judgment Practice Acceptance with Difficult Emotions Body Scan Progressive Muscle Relaxation What Stories Are You Take Care of Medical Health Practice Good Sleep Hygiene Exercise Nutrition Mindful Movement Rate Your Anxiety 1 to 10 Scale 6 7 2 5 3 5 8 The 1 to 10 scale is a way to look back and see your progress At first you may have quite a few 8s or even 10s but ideally over the course of a month you are going to have more days with 5s or even 4s Goal Setting One way we sabotage our goals is by telling | [
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ourselves that we have the time it takes to make a change If reading this book you spend time worried and anxious yet you spend quality time making the changes that will nurture your mental health Take a moment now to make a goal to tackle your anxiety by doing anxiety strategies on a basis You may feel vulnerable acknowledging to yourself and the people close to you that you want to improve your anxiety and that you are going to take deliberate steps to do so You might worry that you be successful sometimes easier particularly in the beginning to say do it or need this If you hear yourself saying these things it might be because afraid of failure If so dig believe in your ability to change You can and will find relief from anxiety provided you learn to believe in yourself When it comes to your anxiety you likely try to deal with it all on your own This is hard Try expressing tell trusted friends or family andget their support Sharing a bit about your struggle and how working on getting better will make your goal more real and increase your likelihood of success And | [
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it will boost your ability to believe in yourself Joining an anxiety support group in your community or meeting with a therapist will also help keep you on task Another way people is by asking too much of themselves too soon Start with smaller goals and build from there Even a little bit of something different creates the scaffolding for more and more growth Your belief in your ability and your motivation to improve will strengthen each time you are successful and each time you check off implementing a strategy on your calendar STRATEGY OF THE DAY Pick a strategy from this section that resonated with you and work that strategy into your schedule on a daily basis this week Helpful daily strategies include practicing acceptance letting go of judgment mindful breathing Before you implement the strategy visualize yourself doing it For example visualize yourself getting up a little earlier and practicing mindful breathing for 10 minutes After visualizing practice the strategy in real time each morning STRATEGY OF THE WEEK Pick another strategy that you can work into your calendar at least three times this week This does not need to take a long choose one reasonably achievable for | [
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you For example this week commit to brisk walking or light jogging for 20 minutes three times or schedule a full medical physical with your doctor or complete the Stories Are You strategy Go Deeper Create Your Weekly Purchase a weekly or monthly planner or use your digital calendar on your tablet or phone Then look over the current month If you have not already done so write in any work social and family commitments and appointments Habit formation comes faster when we teach our brains the behaviors trying to cultivate on a daily basis Write in one strategy from thechapters in this section that willing to employ every day of the next month Now think about when your anxious moments might be during the coming month Are there specific days of the week or times of the day that you anticipate being particularly Or are there specific commitments that always trigger your Get ahead of your anxiety by identifying strategies to use before you encounter situations and write down a strategy that you think will be particularly suited for that specific trigger For example if going to have a meeting at work you might write on your calendar your | [
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feelings through when you get home that evening Or if anticipating being annoyed with a friend or family member you might practice before the visit so be more aware of and better able to manage your irritation In all too easy for the brain to slip back into old habitual patterns One extremely effective way to prevent backsliding is to make a regular practice of checking in with yourself and consider the ways When you check in you can assess going well and what you might have lost sight of on your path to a peaceful life And you can recommit to persevering Rewiring the brain takes practice and time How Did You Start by reflecting on how doing every couple of days Then as you notice your symptoms improving check in once a week and then eventually monthly How successful were you with your daily How about your weekly Based on the 1 to 10 scale are you noticing any symptom Improvement may be subtle at first but any reduction in the intensity of your anxiety even going from an 8 to a 7 is an improvement If you as successful as like try things differently Look for other | [
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ways to fit in the strategies and be honest about what is blocking you from making more progress Remind yourself that you want this and you can and will do it STICKING WITH IT Whatever you do please please be sure to recognize and celebrate your successes I have worked with many people who make major progress but once the progress is made they minimize or dismiss it When that happens they future progress For example Hannah started therapy not being able to get a respite from panic feeling on edge and muscle tension She was so consumed by her constant worries that she could not be present let alone enjoy her life She made the decision to take charge and became gradually more at ease emotionally and physically Hannah integrated various techniques into her daily routine and her symptoms improved She started working again enjoying sporting events and spending time with friends Sometimes she would have a reoccurrence of panic and find herself in a familiar trance where her entire focus was riveted to worries piling up It also threw her into a spiral Suddenly thinking she had made no progress at all she would abandon the strategies that | [
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had brought her relief Progress is not a straight line Setbacks are part of any growth and change process Anyone who has raised a child can recall a baby finally sleeping through the night for a few solid weeks You think those sleepless nights are behind you then ugh the baby starts waking again Nevertheless the typical pattern is for setbacks to become fewer and fewer over time Eventually the new behavior becomes routine Every couple of weeks reflect on where you started Remind yourself of what your life was like then and how that anxious life motivated you to adopt a program to improve Freedom from anxiety is here for you Open up to the ease and calm that is within your reach You are worth the investment What Learn in This Section Imagine again the triangle with written in one corner in another and in the third Any change in one corner of the triangle will impact the other two That insight is at the core of all the strategies in this book In this section we are going to focus on your anxious behaviors and how we can change them Anxiety generally results in two main behavior | [
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avoidance and escape These two patterns of behavior allow us to limit or even totally eliminate our contact with whatever makes us feel anxious Reducing contact with anxiety triggers makes us feel better temporarily But avoidance and escape patterns come with hidden one of the most serious costs is that they actually increase anxiety over time This section is designed to help reduce your behaviors Because of the interconnectedness of those three points on the triangle this will in turn also help reduce anxious thoughts and feelings For example if you commit to taking the elevator every day even when your anxiety tells you to avoid it you will change your thoughts elevators so scary after and your feelings time you experience as much fear when you take an Responding to anxiety with behavior makes your world smaller and smaller Eventually you may lose tolerance for even basic interactions As we explore strategies to tackle behavior focus on specific defeating habits doing what you fear accepting anxiety and increasing your tolerance for uncertainty CH APTER FIVE Avoidance Escape The Avoidance Paradox Imagine standing in front of a beautiful pool on a sunny day The pool is full of swimmers making | [
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the most of the sunshine in your suit and poised on the edge of the water looking as if you are ready to dive in and join them But in reality frozen with indecision Yes part of you wants to jump in You want to make the most of life and enjoy connection with others At the same time a big part of you dreads the shock of the water stuck You see others enjoying the pool laughing and frolicking freely You however stand on the side You feel alone You feel different You pace You sit down You start to imagine people are staring at you and your anxiety increases You go back and forth in your I jump Or You nurture your initial impulse to avoid the cold water with more avoidance As a result your fear grows stronger Finally you decide to sit out the pool experience You feel instant relief but feelings of and isolation soon arise Your decision to avoid limits your enjoyment your spontaneity and your social life because your fear has taken control The swimming pool is a simple example but there are many ways we avoid what we We avoid by indecision | [
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by not showing up by not following through on commitments by distracting ourselves with meaningless activities by making excuses and rationalizations No longer avoiding what you fear means paying attention to how you feel not just at the moment you avoid but over the longer term Sure avoidance brings a temporary dreading facing my boss today ah going to call in sick what a relief to not have to deal with that The temporary relief reinforces the tendency to avoid But the reprieve is almost always New anxiety creeps in and takes over What felt like the sweet taste of freedom becomes bitter with thoughts about the consequences your avoidance may bring What will your boss think of you for not showing What if you get How will you pay your Are your colleagues criticizing you for not coming Far from relaxing and enjoying a day off spinning back and forth in your mind Eventually all that anxiety keeps you stuck in you go to work not only that day but also the next day and perhaps even thenext Now you likely have actual negative consequences to face Avoidance feels protective in the short term but in the longer term | [
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generates real peril and more anxiety than ever worth keeping in mind that the fundamental problem is not the anxiety but how you respond to it Hardwired to Avoid The response is produced by an area of the brain often called the due to its primitive nature The reptilian brain evolved very early and relies on an unsophisticated operating within milliseconds we flee a perceived threat or freeze in place before we even process the apparent danger From an evolutionary perspective this instant response is effective because after all we want to waste precious time on details when we encounter a real physical threat On the other hand the reptilian response work so well at helping us figure out how to address problems that provoke anxiety but are not actually threatening And in modern life that describes most of the problems we encounter Even a genuinely scary a performance review with a boss you an immediate threat to you But your reptilian brain know this and may react to your fear with a flight response unhelpful in a professional setting In other words the response can be triggered even when real danger lurk Once the information regarding the perception of | [
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danger makes its way to our more evolved brain able to rationally determine what level of risk the threat truly poses as well as problem solve and act strategically But we have to give that information a chance to get there without getting stuck in the response generated by our reptilian brain When Avoidance Becomes the Problem Ask yourself if you reflexively avoid or overreact to things that pose no real danger to you Things that had you paused and considered more carefully you might have realized actually such a big deal By avoiding the things or situations that trigger you essentially deciding that they are too much for you to manage when in reality you could deal with them This diminishing ability to believe in yourself only increases future avoidance Among other misleading thoughts your anxious mind probably seriously underestimates your capabilities on this in chapter 8 look at how to start changing your tendency to avoid WHAT ARE YOU As seen avoidance and escape only beget more avoidance The avoidance loop continues because a habit that becomes unconscious A helpful step is to consciously identify what avoiding so you are no longer doing it on autopilot Take a | [
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moment to reflect on your patterns of avoidance What do you avoid that only causes you problems in the long Here are clues that suggest ducking something that matters or has meaning to Saying you will do something but then not following through delaying a task until tomorrow then the next day and the next Making rationalizations justifications and excuses for why you do something alarm clock wake me up Wasting on trivial thoughts tasks and interactions as a way to distract you from what you should or need to be doing Frequently telling others or yourself that you feel well physically and why you do something Make a list in your notebook of what you avoid Keep this focus top of mind and see if you can catch yourself in the moment making the decision to avoid Then try to make a different WHY ARE YOU AVOIDING Even dysfunctional behavior continues or increases when rewarded People keep smoking because of the rewarding effect of the dopamine hit Without a serious desire to make a change this behavior continues in spite of the toll smoking takes on health and longevity important to identify what is reinforcing or strengthening your tendency | [
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to avoid even though you would like to stop this behavior What do you gain each time you avoid the situations you listed in your Some people report feeling a sense of lightness like they dodged a bullet played hooky or got out of something truly awful Do you celebrate the reprieve as if you won a prize or accomplished really Consider if avoidance is reinforced because it means you never have to fully put yourself out there and risk rejection disapproval or failure How else might your avoidance be Go Deeper What is Avoidance Gaining Avoidance is a fix that causes more and more anxiety in the long term Try this writing exercise to inspire motivation and focus on consistent relief versus quick fixes that never last and have negative consequences Write down two lists in your 1 All the benefits of avoidance Be very honest with yourself no one else is reading this list Write down why you avoid and the positive feelings that come when you do Try to emotionally connect with the example the relief of pressure or the power of managing to get out of something 2 All the benefits of NOT avoiding How would | [
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you feel about proud less shame What goal might you joy increased productivity closer friendships increased work competence increased Now compare the two lists Which list has more in it for you for the long Which list makes you feel better beyond the moment and also helps you achieve broader goals for Set your intention now on what you want going forward Right on Target Behaviors that you want to reduce or problematic are what psychologists call behaviors They are the behaviors that we will target with our interventions Target behaviors are often unproductive things you continue to do even though For example Jase feared public speaking and as a result avoided any kind of group meeting at work In reality he knew his job well and wished he could show off his talents through public speaking To start we targeted pattern of skipping meetings We wanted to reduce and ultimately eliminate that avoidance behavior He agreed to at least attend work meetings but not put any initial pressure on himself to speak Then he built up to gradually asking a question and eventually making longer and to the group Another client Alisha obsessively worried that her boyfriend would break | [
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up with her To prevent these feelings she sought out constant reassurance from him that he would always be there for her Like a drug she needed another and then another hit of reassurance She wanted to feel safe and secure in the relationship So we targeted her tendency to seek reassurance She agreed to reduce requests for reassurance by 25 percent and committed to simply riding out any resulting anxiety spike In this way she would not have to go cold turkey but could begin to adjust bit by bit It worked Alisha started to see that she could manage and even let go of her fears for longer and longer periods of time And it helped partner feel less burned out and more compassionate toward her Tackling avoidance requires pinpointing target behaviors The table lists a few examples of goals and how to change your behavior to reach them GOAL TARGETED BEHAVIOR CHANGE Increase social with people Initiate social increase eye contact in social situations Increase capacity for public speaking Every work meeting talk for at least three ask a question make a comment or clarify something Decrease need for reassurance from partner Learn to tolerate fears of | [
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positive breathing seek reassurance but decrease it by 25 percent times a day instead of four decrease from Decrease overthinking Build awareness for rumination by breathing and being talk to people when upset instead of dealing with the difficulty only in your head on your own Be present and participate in life No drug or alcohol build awareness of when spacing out or ask be an active listener IDENTIFY TARGETS Based on your goals identify three or four target behaviors you would like to change because they get in the way of your larger goals Rate how hard it will be to work on each of these behaviors Use a 1 to 10 scale 1 being not hard at all and 10 being nearly impossible Rate how motivated you are to work on each of these behaviors Use the same scale Start with a behavior not going to be too difficult to eliminate but which is causing enough trouble to motivate you to work on it So using the 1 to 10 scale consider behaviors in the 4 to 6 range for difficulty and at or above 5 on the motivation range Once you make progress on one target behavior | [
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momentum will develop and you can work on other items as you wish The Great Escape When we avoid we work behind the scenes to dodge what we dread planning ahead to totally eliminate contact with the trigger Escape is it manifests when we experience an acute anxiety surge in the moment we contact the trigger We then do whatever we have to in order to get away from it Imagine what do if you touched an appliance and got a sudden electric jerk your hand away immediately You manage to avoid the shock but you did escape it and minimize your contact with the unpleasant feeling For example if you have a phobia of crowded spaces you may be perfectly fine most of the time living in a bubble that keeps you in your space comfort zone But terror can take over if for whatever reason you miscalculate and suddenly find yourself in a crowded corner at a museum reception Your heartbeat jumps Your face flushes You shake and jitter You may even think going to pass out or have a heart attack Similar to a fire alarm sounding these panic symptoms cause you to immediately make some excuse | [
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and flee As seen an adaptive survival response in a true emergency can for the person with chronic anxiety become a pattern of avoiding uncomfortable but nonthreatening situations When that happens a person may find themselves in total escape mode for situations that are actually malls movie theaters driving parties family events work meetings appointments just to name a few Giving in to panic and fear through escape means no new learning can occur because you never get a chance to discover if what you fear will actually happen REIN IN If a lion is attacking jump off a high wall run toward oncoming traffic crash through a sliding glass whatever you must to survive But only rarely do most of us encounter truly situations In those other circumstances the ones that feel scary but pose no real threat get thebest outcomes if you rein in your response long enough for your to kick in so you can make an accurate risk assessment Here are three quick and easy strategies for decreasing the physical agitation and of breath increased heart rate sweating that accompany panic and 1 Take slow deep breaths feeling your chest rising fully Each time you exhale | [
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make the exhalation a little longer than the one before 2 If too keyed up to breathe freely count your breaths Counting helps distract your brain from anxious thoughts Count 1 when you inhale 2 when you exhale and so forth up to 20 Then start again with 1 Repeat this a few the arousal will start to decrease 3 If breathing work place your hand on your heart Notice the speed See if you can slow it down with your breathing Put all your attention into observing the beat beat beat of your heart DO WHAT YOU FEAR k a We reinforce escape behavior by never staying in the feared situation long enough to see if our anxious expectations are accurate The only way to test your fears is to put yourself in the that ordinarily make you want to bolt and see if your expectations are realistic Initially this is going to bring discomfort but in the long run it will lead to less anxiety and less escape behavior 1 Get out your notebook and write down situations that typically trigger an urge to escape Driving 2 Next to each situation write what you believe would happen if | [
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you stayed in the situation and did not escape I keep driving when I have heart palpitations and shortness of breath freak out and crash the car 3 Rate how likely you believe each of your listed expectations is to happen on a 1 to 10 scale being not at all and 10 being extremely 4 Now pick a situation from your list that is moderately difficult not painfully difficult but challenging enough that you feel the burn going to intentionally put yourself into this situation to see thatyou can cope better than you imagine 5 Start with sticking in the situation for a short time and gradually build up from there Remember to breathe the In strategy during this exercise You can and will come out on the other side of this fear 6 Write down your goal use the previous example Now go and drive the car Continue driving for 15 minutes after panic symptoms heartbeat shallow breathing feeling are triggered Use purposeful breathing to slow down your breathing and heart rate so the can tune in and see that actually safe 7 After you have stuck it out ask yourself the Did your expectation What is the | [
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evidence that it happened or felt my heart beat fast and I had shortness of breath but continued to drive for 15 minutes or did not crash the car What did you learn from this can feel anxious in my body and still drive safely Go Deeper What Would Happen This short writing exercise is a way to shift your focus away from your fear to the positive feelings and strong sense of self that will come as you rely less on escape and more on moving forward in spite of your anxiety or panic Write two stories in your 1 The story of what you expect would happen if you intentionally exposed yourself to something been escaping Call to mind your the difficult thoughts feelings or behaviors you imagine would happen if you stuck with something that instinctively you want to move away from Perhaps you believe you would die have to leave in an ambulance lose your mind throw up humiliate yourself whatever it is write it down Be as specific as possible 2 The second story is your scenario of what could occur if you use escape to manage your panic In this story youeffectively cope and | [
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manage whatever thoughts feelings or behaviors arise Despite your discomfort you stay If you pushed through discomfort what would be the How would you feel about yourself Imagine feeling good strong capable even proud Uncertainty Intolerance Remember the Magic from Ask the ball any question you wish shake it up and A triangle floating in water delivers an unequivocal answer If the Magic really worked we probably have anxiety because it would always tell us what was coming next never have to experience uncertainty Research shows that people who struggle with chronic anxiety and worry have great difficulty dealing with is situations with unknown outcomes past events or possible future a way to bridge the uncertainty gap When we know going to happen our brain gets busy generating a bunch of hypothetical outcomes to make us feel like we know more than we do Take the person going to the doctor for their yearly blood work Before the tests during the appointment and up until they receive the results they imagine and replay the possible negative results They even consider various treatment plans for potential diagnoses and diseases The problem with this kind of worry and rumination is that anxious | [
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minds very rational and tend to generate possible outcomes that very likely So while worrying about bad outcomes may feel soothing in the short term actually making you more and more anxious over time This happens because when we tolerate uncertainty we take on more responsibility than is reasonable for a given situation A kind of superstitious thinking creeps in telling us that the of worry is somehow keeping us safe from the hypothetical bad things happening Whether we think about the blood work results every hour of every day or not the results will be what they are Curiously when the results come back indicating all is normal there is a and irrational tendency to believe that all the worrying made the difference And then the next time uncertainty creeps in we will be encouraged to worry again to bridge our knowledge gap as if we are saying I worry about this then my fault when the bad stuff happens Despite the weight of this pressure we persevere in our worrying thinking it will get us somewhere when in reality only increasing our anxious state of mind So we check our email againand again to ensure we missed anything | [
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We that the stove burners are off or that the doors are locked every time we leave the house We seek reassurance asking ourselves and the people around us you sure you still love I done everything I my child be they think poorly of I ever find a I I everything Living that way is exhausting and over time it diminishes quality of life The idea that we have to worry or remain hypervigilant so bad things happen to us is an illusion Bad things including suffering and sorrow are sadly part of life not your job to become certain of the uncertain The only real control we have is to accept reasonable uncertainty so anxiety rob us of joy or of the pleasure of being fully present in this life now MEETING NEW PEOPLE Before entering a social situation we can never know with 100 percent accuracy what will happen how we will feel or what others may think about us which is why social situations often involve a lot of uncertainty anxiety We can get so caught up in fears over possible that we become paralyzed at the prospect of hanging out with people The more assertive | [
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you are the less likely you are to fear social interaction This is because when you exchange eye contact speak out put down boundaries share your opinions people see you and respect you And too speaking up is a way to clear up misconceptions and miscommunications of which are inevitable in the social so the same distressing social dynamics continue to play out for you over and over again List in your notebook what your fears are before entering a specific social situation and next to each fear write out how you could respond and appropriately handle the situation should it occur What rejections could talk to me at all or will look away and it will feel like not even there volunteer to help the host or make the plan and initiate the event so be an integral factor What criticisms could I talk about my job people will think boring and that uninteresting talk a bit about my job but will highlight the positive smile and maybe even joke about it or vary my conversation to include my job but also my family or a movie seen What things matter to you that cannot be predicted in your | [
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social interactions that keeps you want to feel like people like me but I fear avoid me or pay any attention to me make a point to engage people ask questions make eye contact and make them feel interested in what they say so enjoy talking to me If possible with a friend or therapist where they act the part of the critical other and you act the part of being assertive and defending yourself Or stand in front of a mirror and literally act out the two sides Get used to hearing yourself clarify thoughts or statements without being defensive A good formula for this is starting with something validating followed by a clarifying understand what you mean but actually I see it quite the same way as you do After practicing assertiveness get out in the world and talk to people You can tolerate the uncertainty of not knowing what people are thinking and still enjoy the social experiences BUILDING UNCERTAINTY TOLERANCE Learning to tolerate uncertainty and seeing that possible to live with it is actually much easier in the long run than overthinking possibilities and imagining terrifying outcomes Here are four steps toward increasing your tolerance for | [
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1 Instead of avoiding uncertainty seek it out 2 When uncertainty presents itself courageously welcome it with open see you uncertainty and I can and I will continue to live fully while by my side 3 Reduce behaviors that reinforce your belief that you handle uncertainty If you compulsively check things check every few days instead of every day or every five hours instead of every hour If you constantly seek reassurance see if you can through positive journaling exercise deep breathing before you ask for another dose of reassurance If ruminating about a internally label it be certain of the uncertain 4 While strengthening the muscles that will let you manage uncertainty pay close attention to the parts of your life where you do have control For example being present and attentive to children is one way we can impact their future happiness Exercising and eating well helps with health and feeling good Building communication skills and positive experiences together helps a range of relationships stand the test of time You may not be able to predict uncertain outcomes but those are all things you can do to help ensure things will go well in the long UP Avoidance | [
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feels relieving in the moment but in the long run increases anxiety The desire to fearful situations is part of our flight response The problem is when is triggered without an actual threat Challenge your instinct to escape or avoid so new learning may occur Uncertainty in life is accepting this truth decreases anxiety CH APTER SIX Acceptance Approach Making Peace with Anxiety Anxiety serves an important function Worry and concern enable us to tune in connect with others take care of ourselves and have empathy Anxiety also motivates us to set goals take action and pay attention to what matters I sometimes see people in my practice who have enough anxiety That might sound strange but they come in feeling unmotivated lost and without purpose Chances are if you live with anxiety fully invested in your course You have the drive needed to achieve an enriching and meaningful life The key however is to not squander your precious energy on a struggle against anxiety Many of us have a sense that we living a or or life if we experience even low levels of distress If you feel this way you probably expend a lot of energy trying to | [
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prevent the unpreventable Joy love and pleasure are magnificent aspects of life However in the small print on contract find that hardship loss suffering setbacks and yes anxiety are also part of the deal Instead of trying to rid yourself of things that be changed like distress and discomfort change your relationship with anxiety by accepting it Give up the futile struggle against your feelings and allow your anxiety to come and feelings always do Imagine yourself as a surfer moving with not against your waves of emotion and accepting those waves as they come You control the waves but you can take them as they are which will help you move through life more smoothly Accepting anxiety mean a victim of it or that giving up and allowing it to control you Acceptance even mean you like what experiencing Acceptance is the idea that it is what it is When you look out the window and see rain you say to yourself raining I have to fix You also say a victim of the rain or being abused by the rain or raining I give up Perhaps you love the rain but you pull out an umbrella you keep | [
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moving forward and you know that eventually the rain will stop ACCEPTANCE Try this experiment to experience the change in perception and emotional freedom that true acceptance brings For this exercise get your notebook and also find a bandana or light cloth you can use as a blindfold I want you to write a few sentences while wearing a blindfold about your understanding of the role of acceptance in managing anxiety to write as clearly and legibly as possible making sure to keep the letters and words lined up even though you be able to see what writing You can do anything you need to help you with this except remove the blindfold Do your best to try to figure out a way to write as straight as you can in spite of not being able to see Now do the exercise again This time worry about writing straight and on the lines or making sure your letters are clear Just write while wearing the blindfold Can you feel the Once you accept the blindfold liberated from the anxiety about it CLARIFY YOUR VALUES Values are the things in life we cherish most the things that give our lives meaning | [
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Common examples of core values include family spirituality health and community Living a life that matches your core values increases joy and quality of life The good news is the strategies learning here will help you channel your energy away from anxious patterns and toward the values that matter most to you in spite of or alongside your anxiety symptoms A good way to get in touch with your values is to imagine yourself on your deathbed This can be difficult but imagining life ending can sometimes connect us with what we want most What do you want others to know and remember about you that you did or do during your How do you want to impact the larger How do you want others you care about to experience Consider writing down what you value in each area of your life as listed in the next remember a value can be that you value that particular area Relationships friendship family parent Psychological Physical COMMITTED ACTION Identify what you can do now to start living the kind of life you truly desire Any small step toward your values will improve your mood and anxiety Get out your notebook and map | [
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out a plan to start taking committed action toward something you value 1 Identify Psychological growth 2 Identify Increase 3 Identify step to take to reach Example day do one task that makes me feel the bills make a meal exercise volunteer help a friend Example boss about needed for a promotion or up for a class 4 Now take Go Deeper Your Best Life The story you tell yourself about who you are and what you can and do influences every aspect of your life Although you may take your story as fact it is not The accumulation of negative experiencesover time can give us a sense of ourselves that is entirely false We are so accustomed to our story that we challenge it or recognize the ways it blocks our growth Your story can be changed Rewrite your story so it can support who you truly want to be In this process consider which you care about and want to cultivate Write about what your best life would look like and also how you would feel on the inside if you were actually living this life Write specific doable action items that will move you toward living this | [
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life starting now today Do the Scary Thing For many of us tempting to think the only way to emotional freedom is to eliminate our anxiety entirely But as seen total anxiety elimination is because of many benefits and of course because it is an impossible task Feeling anxious from time to time is something to accept not struggle against Accepting going to feel anxious at quite up psychic space that was occupied by willing anxiety away This opening is a portal for achieving goals and living a meaningful life while anxiety is present In fact when you make room for anxiety to be present without sounding the fire alarm find value in simply noticing where anxiety crops up Frequently we become anxious about things because they matter to us For example when we worry about a social interaction probably because we really value having a social life If we tremble in the face of a job interview because professional achievement is important to us We usually get anxious about things that are irrelevant to our lives and values Instead of turning on yourself when anxiety rears its head make room for it and for what it can teach you | [
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Accept yourself wholly and completely the positive and the negative Approach what afraid of because whatever is on the other side of that fear matters to you And important because you matter Paradoxically fully accepting anxiety relieves anxiety To do this however you have to legitimately accept it as an inevitable part of your life Accepting anxiety just so it will work Tell yourself andmean it anxiety will forever come and go and can still be okay and live a valuable life with anxiety Maybe experienced the freedom that comes with true acceptance in other parts of your Just when you accepted you find love you found it Just when you accepted your unsatisfactory job situation it improved Just when you accepted a loss something was gained Just when you accepted your flaws the flaws of someone they stopped upsetting you Just when you accepted your diagnosis you became healthier in other ways Acceptance brings less obsessive focus and energy spent on whatever is troubling us As we become less singularly focused our lens expands to the larger picture We have the space to strategize take risks and do more to improve our circumstance IMAGINE A SCENARIO Use this visualization | [
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exercise to get in touch with what you might gain if you push through your anxiety 1 Bring something to mind that matters to you but that avoided or neglected because of anxiety and fear Picture the details Paint the scene in your eye 2 Try to conjure what you would feel in your body if you approached what you are afraid of Notice the physical cues Can you feel your heart rate increase or your stomach Remind yourself that just pretending 3 Imagine you follow through with whatever used to frighten you into inaction and imagine how you would feel if you did that What would you Anxiety Is Not the Boss of You Ideally when our anxiety response is triggered we make a swift assessment of how dangerous the situation at hand really is Then able to either manage the situation appropriately out of the house a or okay take a deep breath return to a calmer baseline and move on When we experience chronic anxiety is triggered so frequently that we are forever on guard for potential threats and can nevertruly relax Anxiety can be like a tyrant that controls us to such an extent that our | [
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true nature fades into the background Over time it gets harder and harder to recall who we are and what we want separate from anxiety or believe there is another way to live Yet possible to break free You can go your own way do your own you can be the boss of the anxiety Take the example of Mateo a high school football player I worked with in my psychotherapy practice A gifted athlete Mateo was nonetheless consumed by anxiety regarding his performance on the field Over time this anxiety stopped him from going on the practice field at all which only increased his anxiety and negative feelings about himself Not practicing meant his skills improving Mateo worried recruiters see what he could do and all would be lost I suggested to him know really anxious right now Your anxiety is telling you to stay home and give up on your dream of getting a football scholarship You believe you have to do what the anxiety tells you But you have to listen in charge not the anxiety You could go to practice while you feel anxious At first Mateo like many of us remained stuck on the idea | [
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that he live with I want to feel I have to figure out the anxiety first Then he made the I guess going to feel anxious either way I go to practice today and I feel even worse than yesterday but at least if I go to practice I lost anything else And it If you make your choices in spite of anxiety retaking control of yourself and your retaking control of your world Now you are free Free to strive to become a college football player develop close friendships fall in love travel be spontaneous take the final tests to get the degree take that medical test that could save your life speak up in the meeting so your boss will give you that promotion start a new business plan a party Anxiety will not disappear but it will no longer be your tyrannical you your true nature will be the boss WATCHING YOUR THOUGHTS Use this mindfulness exercise to better connect with the part of is separate from your anxious feelings and thoughts 1 Sit quietly and comfortably Become an observer of your thoughts and sensations not overwhelmed by your experience and notpushing it away or judging it | [
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Your experience just is what it is 2 Notice that as each thought passes it is replaced by another and another and another Similar to lying on your back watching clouds and labeling their varying shapes and cloud cloud cloud Watch your thoughts as they come and go and label thoughts thoughts thoughts thoughts 3 Label your observations as they come up using the sentences below These sentences are ways to separate your observing self from your emotions and am aware I am having the thought that I am feeling of has come over me am experiencing the thought notice a narrative that tells me am noticing a sense of am noticing a body sensation of IN VIVO EXPOSURE In vivo is just a fancy way of saying real life and for our purposes it means you need to experience the situations avoiding Anxiety has dictated a number of your choices and caused you to miss out Calling up your fears in real time by approaching what you usually avoid will show you that you can work through your anxiety in the moment and get out on the other side on the other A life full of experiences you value | [
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you try your first in vivo exposures find a trusted friend to accompany you so you have support if you start to feel overwhelmed Pick something that long avoided because of anxiety This should be something that will be hard but that you can imagine pushing yourself to do Examples might be calling a friend or relative going somewhere speaking up in a group asking for something you need telling someone something needed to say for a long time Take doing the task slowly Remember the anxiety will be there as you push forth and okay 1 Take Do something you avoid and fear that blocks you fromgaining something important to you 2 Rein in Bring down physiological arousal by paying attention to your breathing Make each exhalation longer than the one before 3 Support Tell yourself as you push forward toward your goal and feel that surge of anxiety can and I will push through I can and I will push through I can and I will push through HOW DID IT When anxious we focus enough on the relief and even pleasure we experience when we push through the anxiety and get to the other side Take a | [
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moment now to be aware of what good came from exposing yourself to the situation you have previously avoided so you will be sure to do it again Do you feel any relief in your Do you feel any pleasure or pride in knowing you did the Did anything good come from doing Can you imagine doing it again or something Which makes you feel better about yourself approaching your fears or Giving Up the Struggle tempting to live life in a constant state of longing We long to not experience upsetting or anxious feelings We long to win We long to be better We long to be free of pain and full of pleasure And we berate ourselves when we achieve what we long for This can make life an endless race to get something and then something else and then something else Deep down we believe this struggle is one day going to lead to an end to all of our suffering an end of wanting more and an end to ever feeling bad This belief is a fantasy that encourages anxiety to flourish Anxiety on some level is never going to end Believing it can somehow be | [
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controlled or erased becomes a barrier that prevents people from improving the quality of their lives here and now Take for example planning a vacation You can choose to approach the planning with anxiety frustration or aggravation You might worry that you be able to do what you want to do on the trip that the flights will behorrendous and that all the planning is taking away time from other things you should be doing At times you may even tell yourself trip worth all this planning ugh I give By the time you take the trip you may be filled with such resentment or annoyance over the planning and packing that nothing about the trip will quite make you happy You return home dissatisfied and unfulfilled You vow to take another better more perfect trip in the future Alternatively you can accept the planning embrace it You have to do it anyway so you might as well enjoy it You can conjure a feeling of excitement and imagine your future pleasure as you think through what you want to do You can spend time looking at photos reading articles and creating an agenda When you hit setbacks you can | [
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be flexible and think of other ways to still get much of what you want out of the trip Dealing with anxiety is similar in that a On the one hand you can forfeit the present moment and succumb to anxiety or even criticism for feeling anxiety On the other hand you can make room for a larger experience of yourself other than as just an anxious person If you want the latter when setbacks hit adjust to the new wave like that agile surfer or take a turn in a different direction Do that and inevitable presence will not dominate and rob you of the enriching experiences you deserve Go Deeper Exploring Your Struggle Take some time to sit down and journal about what your struggle with anxiety is like for you Here are a few prompts to focus your Write about the ways you have attempted to fight anxiety For example trying to anticipate making choices in hopes they will keep anxiety at spending time about things that be trying to make certain the unavoidable uncertainties found in every life Many people blame themselves Consider the ways you may have been too hard on and you feel you | [
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be struggling with anxiety Consider how many parts of days weeks and years have been consumed by anxiety What would it be like to give up this struggle and accept What would you do with the gift of that freemental As you write see if you can connect with a feeling of compassion for yourself and for what you have endured in your struggle INVITING DIFFICULT EMOTIONS This strategy is a way to practice giving up the fight against your emotions Instead of struggling against them actually going to lean in to whatever emotions you might be pleasant and the unpleasant Try to actually invite anxiety other unpleasant to come over you 1 Sit comfortably in a quiet location When anxiety appears instead of fighting it is wrong it stop let go of control and give up the struggle Welcome anxiety in with open I see you anxiety and space for you here with me Meet the surges of unease or worry with warm acceptance You can accept your feelings even though they cause you discomfort 2 not attempting to change the feeling push it away or keep it present aware of whatever it is as it is letting go | [
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