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26fc3a68562a-0 | Copyright
© 2019 by Althea Press, Emeryville, California
No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any
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except as permitted under Sections 107 or 108 of the 1976 United States Copyright Act, without
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professional person should be sought. Neither the Publisher nor the author shall be liable for | anxiety.pdf |
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Althea Press is not associated with any product or vendor mentioned in this book.
Interior and
Cover | anxiety.pdf |
26fc3a68562a-2 | Interior and
Cover
Designer: Jamison Spittler
Editor: Camille Hayes
Production Editor: Erum Khan
Author photo
© Stacy Vaeth Photography
ISBN: Print 978-1-64152-208-3 | eBook 978-1-64152-209-0 | anxiety.pdf |
dfb7c0107b56-0 | peace
for all | anxiety.pdf |
12f9e08aa4f3-0 | Contents
Quick-
Start Guide
Chapter
One: Is Anxiety Running Your Life?
Section
I: Feelings
Chapter
Two: Your Emotions
Chapter
Three: Your Body & Physical Sensations
Chapter
Four: Putting the Tools to Work
Section
II: Behavior
Chapter
Five: Avoidance & Escape
Chapter
Six: Acceptance & Approach
Chapter
Seven: Putting the Tools to Work
Section
III: Thoughts
Chapter
Eight: Thoughts vs. Reality
Chapter
Nine: Getting Unstuck from Thoughts
Chapter
Ten: Putting the Tools to Work
Section
IV: Staying on Track
Chapter
Eleven: The Road Ahead
Chapter
Twelve: Building Your Support Network
Resources
References
About the Author | anxiety.pdf |
eb93858be3c9-0 | Quick-
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 I’ve
divided them up here based on which type of symptom they target. This
Quick-Start Guide will navigate you straight to the set of strategies that will
help you deal with acute symptom flare-ups and anxiety-producing situations.
Section I:
Feelings
Turn to the strategies starting
here
if you’re feeling strong emotional or
physical symptoms of anxiety.
•
Anger/irritability
•
Sadness
•
Hopelessness/despair
•
Insomnia
•
Mood swings
•
Racing heart
•
Shortness of breath
•
Dizziness
•
Stomach upset
Section
II:
Behavior
Turn
here
if your anxiety is making you behave in ways that you don’t like or
that are causing you problems.
Section II
will be helpful when your anxiety
causes you to:
•
Avoid activities you used to enjoy
•
Avoid certain people
•
Frequently cancel plans
• | anxiety.pdf |
eb93858be3c9-1 | 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 store | anxiety.pdf |
0e6985a3d4a1-0 | •
Behave uncharacteristically in anxiety-provoking situations, e.g., you don’t
approach or talk to your friends when you’re at a party
Section III:
Thoughts
Starting
here
, you’ll find strategies to help diminish the inaccurate or
unhelpful thinking that preoccupies the mind when you’re caught up in
anxiety. These thought-focused strategies will help if you’re experiencing:
•
Chronic worry
•
Repetitive or racing thoughts
•
Catastrophic (worst-case scenario) thinking
•
Self-defeating thoughts (e.g., “I suck at this, so I might as well give up.”)
•
Irrational beliefs (e.g., “If I don’t drive back home to check the oven, my
house will burn down.”)
Welcome
Everyone feels anxious at some point! 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 common:
1. | anxiety.pdf |
0e6985a3d4a1-1 | typically have two things in common:
1.
A part of them, no matter how small, believes they can get better.
2.
They learn, and put to work, effective anxiety-reducing strategies.
Simply opening this book and reading this far shows that some part of you
believes your anxious symptoms can get better. And if you’re willing to
engage with this material and give serious thought to the impact anxiety has
on your life, there’s a part of you that
wants
to get better. Take heart; 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 there’s still quite a bit we don’t 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 of | anxiety.pdf |
3c1d6e5916a6-0 | feeling as if the waves in the ocean are pulling them under and they have to
fight for dear life, they realize they can float—even 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 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 (CBT), acceptance and commitment therapy
(ACT, pronounced like the word
act
), and mindfulness practices.
It’s 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 you’re 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 you’ll see sections titled “Go Deeper,” which
are suggestions on how to
take
the strategies to the next level. (You’ll need a
notebook or journal for these.) The “Go Deeper” strategies are optional, but
they are a great way to maximize your results. | anxiety.pdf |
3c1d6e5916a6-1 | they are a great way to maximize your results.
A NOTE TO READERS:
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
you’re learning and how your new skills can help you better cope with
anxiety. The more you practice and write about the strategies, the faster
they’ll 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 how/when 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 go—even if you
can set aside only a few minutes. The point is, give some thought to how
you’re going to integrate this book into your routine.
If
you’re in the middle of an acute symptom flare-up, I encourage you to
go directly to the relevant section. So, for example, if you’re consumed by
worried or intrusive thinking, start with | anxiety.pdf |
3c1d6e5916a6-2 | worried or intrusive thinking, start with
section III, “Thoughts”
. If your
anxiety is causing you to avoid important events or people, you may want to
start with
section II, “Behavior”
. If you’re struggling with your feelings or
physical health, start with
section I
.
To reach longer-term goals of sustained peace of mind and inner calm, | anxiety.pdf |
71444573dc7a-0 | consider breaking the material down into small, doable steps so you
eventually work through the entire book, at the pace that suits your life. | anxiety.pdf |
26af98bed095-0 | CH
APTER ONE
Is Anxiety Running Your Life?
Why We Struggle with Anxiety
A snake on a hiking trail, or a gun in your face, or any direct threat to your
well-being will trigger your fight-or-flight 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 full-throttle physical response to the danger. These
changes come together in an instant, to create a singular focus on
survival
.
When anxiety is appropriate—as in the case of the snake or the gun—this
physiological response is normal, because it prepares us to respond to the
potential threat.
Even
when the perceived danger
isn’t
life-threatening, 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 | anxiety.pdf |
26af98bed095-1 | on practice exams. The fear of failure can energize and focus him for the hard
work ahead. Or a person 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 person’s fight-or-flight response is
triggered by cues that are not threatening at all—either 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 they’re 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 person’s career will be limited or ended by what is, at its core, an
irrational fear.
Anxiety | anxiety.pdf |
26af98bed095-2 | irrational fear.
Anxiety
isn’t just a problem of overreacting to things happening around | anxiety.pdf |
9cd8991bfb63-0 | us; our anxiety response can be triggered by things that exist only in our
minds. This happens when we worry about and anticipate what-ifs and worst-
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 they’ve known for a long time.
If you’re 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 you’re 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 in-the-moment fear
of risk in your immediate environment. Anxiety is
maladaptive
when it
becomes a chronic state of tension, worry, and/or 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 | anxiety.pdf |
9cd8991bfb63-1 | problematic anxiety.
FEAR
ANXIETY
Fear is present-focused and generally rational
in that it’s responding to a threatening situation
or event.
Anxiety is future-focused and can easily
become irrational because it is untethered from
real events. Your imagination continually calls
up what-if scenarios.
You’re in the here and now. There is a fire in
the house, and you’re 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 loss; medical diagnosis; illness
of a loved one; threat of being physically
harmed; wanting to do well on a specific task,
such as a speech or an exam; wanting to make
a good impression on new acquaintances.
For the most part, anxiety isn’t created by the
outside world; it’s created by your mind. You
worry about possibilities that may or may not
happen, such as: “What if they don’t like me?”
“What if the plane crashes?” “What if I can’t
leave the movie theater?” “What if they hate
me?” “What if I have a panic attack?” “What | anxiety.pdf |
9cd8991bfb63-2 | me?” “What if I have a panic attack?” “What
if I make a fool of myself?”
What
We Can Do About It
The Anxiety and Depression Association of America estimates that 40 million | anxiety.pdf |
60b279ad9d1c-0 | people suffer from anxiety disorders, which are the most common issues that
bring people to therapy. Thanks to decades of research, 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 long-term 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 proven-effective 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 (not necessarily liking!)
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 self-perpetuating cycle that creates
more anxiety. We’ll use cognitive behavioral therapy to examine and change
your thoughts. Strategies from acceptance and commitment therapy will
help | anxiety.pdf |
60b279ad9d1c-1 | 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 to accept that we all suffer sometimes, you’ll find there’s
more room for you to separate from your battle with anxiety. Through
practicing the mindfulness strategies throughout each chapter, you’ll 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 there’s 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 | anxiety.pdf |
60b279ad9d1c-2 | think and behave. A real-life example of this would be if you
decided
you
wanted to change your habit of snacking right before bed. Perhaps you’ve
eaten chips or crackers before bed for years, and you decide to substitute | anxiety.pdf |
186ee07390bf-0 | sliced vegetables. The plan is solid and you’re ready to go. However, you’re
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 (which continually fires the
same neuronal pathway), the new experience becomes a part of your brain’s
system on a chemical level. This phenomenon is called neuronal plasticity, or
sometimes brain plasticity.
SELF-
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 self-defeating 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, let’s | anxiety.pdf |
186ee07390bf-1 | plan to cultivate your capacity to believe that freedom from anxiety is
possible.
1.
When I’m told some way of thinking or behaving will help my
anxiety, I zone out, think nothing can help, or that this person doesn’t
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 don’t 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.
I’d 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 you’re making in believing in yourself. In time, you will look
back and feel both surprised and proud of your growth. | anxiety.pdf |
2be60cb34381-0 | WRAP-
UP
•
Anxiety is a normal bodily response to threat.
•
Feeling fearful about something in your immediate environment is
adaptive.
•
Imagining what-if situations that may or may not come to pass is
maladaptive.
•
Anxiety responds to treatment; 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 this! | anxiety.pdf |
f09751969c31-0 | What
You’ll Learn in this Section
Imagine a triangle with “Feelings” in one corner, “Behavior” in
another, and “Thoughts” 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 emotions—like learning strategies to calm your
fear and anxiety in social situations—then you will likely change
your thoughts (“When I calm my anxiety, I can contribute to the
conversation and people will like me”) and your behavior (you stop
avoiding social activities). Simply put, if you’re 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 (sadness, anger, mood swings, helplessness) and physical
(shortness of breath, heart palpitations, insomnia). You’ll learn
better ways of dealing with your feelings and how to overcome
avoiding or pushing your emotions away. We will also see how the
stress of anxiety can lead to unpleasant physical side effects, such | anxiety.pdf |
f09751969c31-1 | 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. | anxiety.pdf |
87abe2c8b773-0 | CH
APTER TWO
Your Emotions
Are You Suppressing Your Emotions?
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 don’t 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. (The average risk is
12 percent.) I distinctly remember thinking, “This can’t be happening; 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-ifs. What I wasn’t doing
was 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 | anxiety.pdf |
87abe2c8b773-1 | become. This self-defeating process is a learned habit that actually worsens
anxiety over time, in part because it reinforces anxious thoughts and anxiety-
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 we’re anxious about. When we, despite
our best efforts, drop our guard even for a moment, the pushed-away
emotions come flooding in and we again anxiously push them away. On this
merry-go-round the original negative emotion goes unaddressed and we
remain ill at ease and hypervigilant.
STRATEGY:
CHECK-IN
How Do You Feel Right Now?
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 you’re feeling means you can address
the real issue and feel better. When you’re upset or aware you’re experiencing | anxiety.pdf |
3e67002e704e-0 | anxiety, use the following chart to help you label the deeper feeling(s) that
may be underneath your anxiety.
EMOTIONS
PHYSICAL/BODILY
SENSATIONS
LABELS TO
DESCRIBE
YOUR
EXPERIENCE
ACTION
URGES
EVOLUTIONARY
SIGNIFICANCE
LOVE
Calm body, relaxed
muscles, sense of peace
and well-being
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
Feel-good 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 | anxiety.pdf |
3e67002e704e-1 | 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 self-protect
through physical
force, self-assertion,
or boundary setting.
SADNESS
Desire to remain still,
feeling of lethargy and
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 problem-
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
(fear of losing a
relationship), being
in high-
alert/vigilant/survival
Urge to be
vigilant,
replay
events in
one’s mind,
predict
future
events,
desire to
control the
Anxiety triggers | anxiety.pdf |
3e67002e704e-2 | predict
future
events,
desire to
control the
Anxiety triggers
adrenaline, which
puts the body into
high alert, primed
for action and
protection. | anxiety.pdf |
9d36d984010f-0 | mode
threat, flee,
or be busy
GUILT
Stomachache, aching
muscles, feeling that you
can’t be physically at
ease
Feeling like a “bad”
person, feeling
destructive, feeling
you should be
punished
Urge to
make
amends, to
be a
“better”
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 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.
STRATEGY:
EXPRESSING YOURSELF
When you’re 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 | anxiety.pdf |
9d36d984010f-1 | their feelings for 50 minutes, and they leave feeling significantly better. Many
often say, “That’s too easy. How can merely talking make such a difference?”
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 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 don’t know that well may help you feel
more accepted and less anxious.
Go
Deeper
Express Yourself | anxiety.pdf |
1dea3849bc26-0 | As 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 isn’t a
writing test so don’t worry about your writing style, spelling, or
punctuation. Simply ask yourself the following questions:
•
How old were you when you first remember feeling this emotion?
•
What was the situation? Was that situation at all similar to what
you’re going through now?
•
Did you express what you were feeling to anyone?
•
Did anyone comfort you or help you make sense of your feelings?
See if in your writing you can comfort yourself now through self-
compassion and self-acceptance. Tell yourself, “It’s okay to feel this
(your specific emotion).” 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.
What’s
Underneath Anxiety?
When we don’t express negative experiences, they become internalized—we
try to problem solve the upset in an internal vacuum, which results in | anxiety.pdf |
1dea3849bc26-1 | overthinking and a sense that we can’t 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 one’s medical expenses, funeral, and the what-ifs 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 (working
through negative events by mentally replaying them again and again).
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 didn’t 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 | anxiety.pdf |
1dea3849bc26-2 | avoidance only increases the loss she has not fully experienced
emotionally,
and so she clings more tightly to her unhealthy eating patterns. | anxiety.pdf |
5f54c1c33dc1-0 | If you’re a chronically anxious person, you’re 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. Let’s take a
look at how to start doing just that.
STRATEGY: EXPLORING ANGER
If you struggle with anxiety, the moment you feel an ember of anger brewing,
you likely blink it away. Anger is adaptive, evolution’s way of motivating us
to protect ourselves through boundary setting and self-assertion.
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
anxious-spiral default, ask yourself, “What feeling might I be resisting
right now?” and “What might I be missing?” and “Is anger present?”
2.
For 10 minutes, without taking any action, without distracting yourself
with your worries, and without self-criticism, tolerate your anger being
present.
3
. | anxiety.pdf |
5f54c1c33dc1-1 | present.
3
.
Breathe in and out, simply letting yourself be aware of the anger.
NOTE:
Becoming aware of anger doesn’t mean 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
self-defeating.
STRATEGY: 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, you’ll have the advantage, and you’ll
start to learn that you can actually tolerate feeling sad and that it isn’t 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 awareness; remember moments
when you felt sadness.
Consider
when sadness was present but was | anxiety.pdf |
5f54c1c33dc1-2 | 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 in | anxiety.pdf |
b01b9507d80a-0 | your body? Do you feel tenderness in your stomach, behind your eyes,
a feeling of fragility or vulnerability? 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, “I 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 Feelings?
We minimize our very real and normal emotions by telling ourselves, “It’s
bad that I feel this way,” or “My negative emotions mean I’m weak,” or
“What’s wrong with me that I feel this way?” or “I’m such a loser because
I’m always upset,” or “No one will ever love me because my emotions are out | anxiety.pdf |
b01b9507d80a-1 | 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 first place.
Telling yourself you’re a weak loser for a feeling you can’t 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 “get
over it” and that she was “too sensitive.” Eventually, whenever she felt hurt,
lonely, overwhelmed, or full of self-doubt, she learned to tell herself the same
things: “What’s wrong with you?” and “Get over it, no one cares!” and “Why
can’t you be cool and keep your feelings together like everyone else?” 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 can’t 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 | anxiety.pdf |
b01b9507d80a-2 | strategies are
designed
to help you let go of judgment and allow your feelings
to surface.
STRATEGY: 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 anger— | anxiety.pdf |
c47e9dd673b3-0 | whether memories from your childhood and/or adult experiences.
Write down in your notebook four or five specific words you associate with
anger. Do you understand why you associate these words with anger? Where
did the judgments come from? Were they ideas you got from observing others
or things you were told when you experienced anger? Are your associations
with anger mostly negative? If so, why?
Which word holds the strongest association with anger for you? Now, reflect
on its
opposite.
Can you think of ways this opposite word might be associated
with anger, too?
For example, for many, anger brings up words such as “out of control” and
“destructive.” Opposites of this include “constructive” or “useful.”
Expressing anger is
constructive
and
useful
when done in a respectful way
that allows us to set boundaries and take care of ourselves.
STRATEGY:
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. | anxiety.pdf |
c47e9dd673b3-1 | you become.
Whatever the loss may be, it’s 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 you really
felt?
•
Instead of feeling your sadness, did you go into an anxiety spiral?
•
What stopped you from allowing yourself to be purely sad?
•
What kind of judgments might you have been making about your sadness?
•
Did avoiding the sadness help or hurt you in the long run?
Letting
Go of Judgment (short meditation)
It’s 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 moment-to-moment, ever-changing emotions.
Sit quietly and comfortably. Close your eyes. Bring your breath to your | anxiety.pdf |
4dd1a323462f-0 | conscious 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 label: “chest tight,”
“anxious,” “worried,” or “calm,” and “at ease.” If your inner observer
becomes aware of your mind making judgments, simply label it “judging” or
“thinking.” 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.
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, we’re left feeling defeated.
Feeling that we must have made a terrible mistake somewhere along the way
(why else would we be feeling so bad?), we spin our wheels doing whatever | anxiety.pdf |
4dd1a323462f-1 | we believe necessary to avoid, push away, or somehow “fix” the upset.
We all experience negative emotions, including anxiety. No one is
immune. Even people without full-on anxiety disorders go through anxious
spikes; it’s 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 doesn’t mean you want them or that
you’re resigning yourself to a lifetime of emotional pain. Acceptance doesn’t
mean feeling you’re the victim of your pain and that your pain controls you.
Acceptance doesn’t mean you necessarily like what you’re experiencing.
Acceptance is the idea: “It is what it is.”
The metaphor of the Chinese finger trap used in acceptance and
commitment therapy clearly shows how struggling against the 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—wham—suddenly and unexpectedly your | anxiety.pdf |
4dd1a323462f-2 | fingers are trapped. Trying to become unstuck, the inexperienced immediately
attempt to pull their fingers out. The harder they pull, the tighter the tube | anxiety.pdf |
b6ec7512fd48-0 | becomes, evoking fear and even a little panic. The solution: 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 crisis-state existence leaves us with an emotional blind spot. After
all, if you’re 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 reconstruction—a literal
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 don’t want, how we feel about the people
we are close to, and what we need to work on within ourselves. Acceptance | anxiety.pdf |
b6ec7512fd48-1 | 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 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 emotions? Did they cry or get angry? Or
did they seem to have a tight lid on their emotions and rarely
expressed frustration or sadness?
• | anxiety.pdf |
b6ec7512fd48-2 | expressed frustration or sadness?
•
Do you think you need to appear in control of emotions all of the time | anxiety.pdf |
1e2965a2e7ab-0 | or do you feel completely out of control and so try to clamp down as
much as possible?
•
Can you recall any expressions from caregivers, coaches, or teachers
telling you that you are “too sensitive,” “overly needy,” or “too
emotional”?
•
Did your family or caregivers describe you as being very
independent/mature as a child? Did you hear a constant “good girl” or
“good boy”? Did you feel as if you couldn’t be a kid with them? Did
you feel there was limited space for you to be you emotionally?
•
Consider your memories of joy and happiness in your household as
you grew up. Do you recall your caregivers laughing among
themselves? Did they notice and label your happiness? Or was joy
squelched?
•
When upsetting things happened to you as a child, did you feel as if
you could talk to your parents openly? Or did you feel your caregivers
would judge your upset or overly pressure you to “fix it” in some
way? Did you not confide in them at all?
Identify the link between the type of emotional support you were given
in childhood and how accepting you are now of your emotional | anxiety.pdf |
1e2965a2e7ab-1 | 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.
STRATEGY:
PRACTICING ACCEPTANCE
Although it can be hard to accept painful emotions—to not avoid or push
them away—the consequences that come from
not
doing so far outweigh the
pain of facing whatever it is you’re 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 #1 feeling you tend to avoid that brings the most consequences to you—
sadness, anger, anxiety, guilt, shame, frustration, joy.
Consider the results of avoiding this emotion. Has it increased your anxiety?
Caused you to siphon off large amounts of emotional energy in vain? Or has
avoiding this emotion blocked joy and contentment?
STRATEGY: SITTING WITH DIFFICULT | anxiety.pdf |
17552b3dd4fa-0 | EMOTIONS
It is likely you have avoided negative emotions because you’re afraid of
feeling them or you don’t know how to feel them. Here is a way to do just
that, and it takes only 10 minutes:
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, “Welcome, I’m glad you’re here.” See if you can
observe the feeling, almost as if you are looking down on a physical
thing separate from yourself.
4.
Internally note: “I notice a feeling of ––— coming over me.” Tell
yourself, “I am making room for you,” or “I 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. It’s okay to feel this anxiety. It makes sense | anxiety.pdf |
17552b3dd4fa-1 | because you’re afraid of this emotion and I’m 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 your time is up, move forward and let go of this experience.
WRAP-
UP
•
All emotions are a normal (and helpful) 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. | anxiety.pdf |
ce3d81118a07-0 | 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 anxiety-reduction 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
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 “all” they have is anxiety. For example, for a long time Cole | anxiety.pdf |
ce3d81118a07-1 | 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.
STRATEGY: 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 you—lying
down or sitting up, eyes open or closed. As you do this, let go of | anxiety.pdf |
653aeb04dd3f-0 | judgment. You are simply observing yourself in the here and now.
2
.
Each time you breathe out, feel 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 ease:
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.
STRATEGY: 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 can’t sleep at night or to downshift into relaxation before bed.
Lie down or sit comfortably. In turn, tense each muscle in your body (face, | anxiety.pdf |
653aeb04dd3f-1 | shoulders, hands, arms, stomach, buttocks, legs, feet) 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 this exercise a few times. Notice your body loosen and gradually
become more at ease.
Anxiety’s Physical Symptoms
The body’s 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 neuronal | anxiety.pdf |
7ef73f588502-0 | pathway. 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 and/or worsen physical pain symptoms.
The
body’s biological response to stress can also significantly impact our
cardiovascular, digestive, respiratory, and endocrine systems. In a large meta-
analysis examining over 20 studies and about 250,000 individuals, researchers
found that anxiety was associated with a 26 percent increased risk of coronary
heart disease and a 48 percent increased risk of death due to a cardiac-related
incident.
The stomach and bowel are directly impacted by the body’s fight-or-flight
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 (COPD). Fear and worry | anxiety.pdf |
7ef73f588502-1 | 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 well-being.
STRATEGY:
WHAT STORIES ARE YOU
TELLING?
There is a back-and-forth interplay between anxiety and medical illness. The
story you tell yourself about your medical symptom(s) and how it impacts
you physically is the variable we’re going to focus on here. Let’s begin with
an example:
My client Sierra endured uncomfortable bouts of gastroesophageal reflux
disease (GERD). 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 of | anxiety.pdf |
2db817859b9b-0 | gastroenterologists 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 stress-reducing strategies to use each time her anxiety was
triggered. She still experienced GERD but reported that the intensity of her
symptoms 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 | anxiety.pdf |
2db817859b9b-1 | 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 anxiety-reduction 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 (or physical symptom) is not entirely out of my
hands; I must persevere in living a less-anxious life.
•
Stress-relieving 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 self-
care.
Go
Deeper
What Else Could You Think About? | anxiety.pdf |
8ed0ebc34cd3-0 | Obsessive thinking is a way to avoid facing deeper emotions. Perhaps we
worry we can’t manage the painful emotions, or 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 victim; 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 self-aware, 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 | anxiety.pdf |
8ed0ebc34cd3-1 | daily, exercised regularly, ate a healthy diet, and
worked on breathing and positive self-talk. 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 topic:
If you did not fill your conscious mind with thinking about your medical
condition or physical symptoms, the causes, the worries, the what-ifs,
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 submission; it’s a way to take different steps to protect yourself
than the ones you’ve already taken.
STRATEGY:
TAKING CARE OF YOUR
PHYSICAL HEALTH
It’s 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 whole | anxiety.pdf |
847b64930577-0 | picture 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 with your doctor, make three columns in your notebook:
1.
Your specific medical issue(s)
Example:
High blood pressure
2.
How you’re going to address it medically
Example:
Take high blood pressure medication
3.
How you’re going to address it in terms of anxiety intervention
Example:
Become aware of anxiety triggers; practice mindful
breathing 15 minutes a day; exercise four days a week; positive self-
talk (“Better managing of my anxiety will improve my physical
health”)
The
Mind-Body 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 | anxiety.pdf |
847b64930577-1 | 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 medical/physical
challenges.
The mind-body 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.
STRATEGY: SLEEP
Sleep is restorative in all respects: mood, cognitive functioning, energy, and
health. Unfortunately, when we’re anxious we do not reap these benefits
because anxiety typically interferes with sleep. People who struggle with
anxiety wake up to intrusive worries during the night, can’t fall asleep, or
wake up too early. | anxiety.pdf |
cf40cb01c841-0 | Creating
a nightly sleep routine places cues in the brain. When practiced
regularly, the cues remind us that it’s 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.
There’s a middle gear: relaxation. Here’s 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 (ideally the same time each night),
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 exercise: meditate through deep breathing, visualize
relaxing imagery, practice progressive muscle relaxation.
•
Lie down comfortably and read fiction or something light.
• | anxiety.pdf |
cf40cb01c841-1 | Lie down comfortably and read fiction or something light.
•
Turn off your lights when you feel sleepy and your eyes start closing.
•
When you can’t sleep, don’t think, “Why can’t I sleep?!” Tell yourself,
“It’s okay if I don’t fall asleep, at least I’m resting.” If waking up
continues, try progressive muscle relaxation with the lights off.
•
Don’t worry about the time on the clock. The goal is to relax even if you
can’t sleep.
•
Wake up at the same time each morning.
•
If you didn’t sleep well the night before,
don’t
take a nap or go to bed at an
earlier time; stick with the same routine.
IMPORTANT NOTE:
Worry often appears at night because we have been so busy during the
day we haven’t been able to emotionally connect with ourselves so all the things we haven’t
thought about crash in once the lights are out. To counteract this, set aside 30 minutes each day
for what I call “total worry time.” Take out your notebook and put all your worries on the page:
Consider how you’re feeling, what needs to get done, and what worries you about the days or | anxiety.pdf |
cf40cb01c841-2 | weeks ahead. Then when the lights are out, your brain won’t have to remind you of everything
you haven’t thought about earlier.
STRATEGY:
EXERCISE | anxiety.pdf |
67524d373883-0 | Anxious 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 stress, increase your self-esteem, improve
your sleep, and improve your physical and emotional functioning. Feeling
good about yourself means you’re more likely to cope well because you
believe in your ability to do so.
Exercise also increases endorphins, the body’s natural painkiller, and
decreases the stress hormone cortisol. It’s worth it! And if 30 minutes feels
like too much too quickly, keep in mind that research is showing that even a
20-minute 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 is—no goal is too small; any
physical movement is better than none. However, each time you exercise, your | anxiety.pdf |
67524d373883-1 | mood will improve and your anxiety will decrease, so consider doing
something on a daily basis.
When experiencing acute anxiety, employ the “10-minute remedy.” If you’re
anxious and you vigorously exercise for 10
minutes—
a brisk walk, jogging,
bouncing on a trampoline, jumping jacks—your anxiety will decrease almost
immediately. Lifting 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 10-minute remedy is a quick hit for anxiety.
STRATEGY: 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 anxiety:
Water:
Our body needs water to function, and if it isn’t functioning properly, | anxiety.pdf |
67524d373883-2 | mood will suffer. Make sure you’re 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 brain’s attention to | anxiety.pdf |
b332ad657977-0 | the cold sensation, and reduce your anxiety.
Caffeine:
It’s astounding how many people who struggle with anxiety also
drink a lot of caffeinated beverages.
Make
no mistake: Caffeine increases
anxiety. Decreasing or eliminating caffeine and other stimulants from your
diet will immediately lessen the intensity of your anxiety. Consider removing
all caffeine from your diet, and if that’s too hard, halve it and work down
from there.
Nicotine and alcohol:
Both nicotine and alcohol have short-term 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.
Nutrients:
If you have any vitamin deficiencies (check with your physician),
you may benefit from taking specific supplements, such as vitamin D or a
daily multivitamin.
Go
Deeper
Goal Setting for Exercise & Sleep (1-Week
Program)
In order to make a long-term 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 | anxiety.pdf |
b332ad657977-1 | week. It doesn’t necessarily have to be at the same time each day but
remember: 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 that’s important
to you.
Then, each day do aerobic exercise for at least 30 minutes. Jog, speed
walk, bike, hike, play a vigorous sport (soccer, basketball, tag with your
kids), 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
don’t 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 life—simply
by dedicating 30 minutes each day. Bonus: The release of endorphins
and other rewarding hormones will help you feel good about yourself. | anxiety.pdf |
2012a0a50df5-0 | As we’ve seen, good sleep hygiene is perhaps the most impactful way to
improve mood and anxiety. A regular nightly wind-down 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 wind-down habit. It’s 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 cope? Have you experienced even slightly less physical
tension/anxiety this week? Could you continue this for another week?
Everyday
Body Awareness
When we’re 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 short-circuit anxious thinking by shifting our
attention to our physical sensations.
Try this: 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 | anxiety.pdf |
2012a0a50df5-1 | 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 anxious-thought spiral, observe your physical
sensations—tight chest, tense shoulders, racing heartbeat, whatever they are
—and give them your full attention, breathing in and out. As you
acknowledge it (“I see you” or “There you are”), it will likely change to a
different sensation. Recognize these sensations are communicating how alive
you are in this moment.
STRATEGY: 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 time—walking to 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 ground? How do your arms feel as you move? | anxiety.pdf |
3524e31f322e-0 | Try to feel the earth from within your body. What is that sensation like? Does
the sole of your foot on the ground feel heavy? Can you make it soft?
Explore each of your senses. Notice what you feel on your skin; is the air hot
or cool? Do you smell anything as you inhale and exhale?
Simply observe any sounds you hear. Notice what you see. You are here in this
moment; 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 inhale? How
many as you exhale? 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
rush; all that matters in this moment is to be aware of your body as it glides
through space.
WRAP-
UP
•
Anxiety impacts the body and the body impacts anxiety.
•
Learn to identify and observe (without judgment) where anxiety manifests
in your body.
• | anxiety.pdf |
3524e31f322e-1 | 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 anxious-thinking spirals. | anxiety.pdf |
dc6fd65e3d44-0 | CH
APTER FOUR
Putting the Tools to Work
Your intention is set. Anxiety will no longer rule your life. Now you
know it’s within your reach to experience a peaceful emotional life
and to feel physically at ease. The techniques you’re 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. Here’s how to start taking the
techniques to the next level through building longer-term habits and
goals.
From
Strategies to Habits
The great pioneering neuropsychologist Donald Hebb observed, “neurons 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 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 “stop sign ahead.” You realize as
you approach that it’s actually an advertisement on a red circle, but your
initial perception told you it would be a stop sign, so you had already started | anxiety.pdf |
dc6fd65e3d44-1 | 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 won’t 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 payout! To
cultivate the ease and calm you want, stick with the strategies and put in
steady, consistent effort.
Planning
Take a wide-angle look at how your life is organized so you can begin to | anxiety.pdf |
8e9e992d30e6-0 | think through how and when you will integrate the techniques into your day-
to-day routine.
Outside of your responsibilities—work, school, volunteering, childcare,
social life, family obligations—what do you do for yourself? When you do
have downtime, how do you currently spend it? 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 (looking at your
notebook can help) and identify which techniques you want to start with. How
often? What times or days of the week are best? You don’t have to try every
technique; 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 “neurons that fire together wire
together” process.
Track Your Progress
Tracking progress works for many things, like losing weight or saving money.
And tracking works with anxiety reduction, too. It’s essential to long-term | anxiety.pdf |
8e9e992d30e6-1 | progress that you set up a system where you track on a daily basis the
strategies
you’re using, and the intensity of your anxiety. Here’s 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 this:
STRATEGY
MON
TUES
WEDS
THURS
FRI
SAT
SUN
How Do You Feel
Right Now?
✓
Express Yourself
Exploring Anger
✓
Exploring Sadness
✓
Judging Anger
Judging Sadness
Let Go of Judgment
(Meditation)
✓
Practice Acceptance
✓ | anxiety.pdf |
b4f75cc2093a-0 | Sitting with Difficult
Emotions (Meditation)
Body Scan
Progressive Muscle
Relaxation
What Stories Are You
Telling?
✓
Take Care of Medical
Health
Practice Good Sleep
Hygiene
✓
Exercise
Nutrition
Mindful Movement
(Walking Meditation)
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 ourselves that we don’t have the
time it takes to make a change. If you’re reading this book, you spend time
worried and anxious, yet you don’t 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 daily/weekly 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 | anxiety.pdf |
b4f75cc2093a-1 | deliberate steps to do so. You might worry that you won’t be successful. It’s
sometimes easier, particularly in the beginning, to say, “I can’t do it,” or “I
don’t need this.” If you hear yourself saying these things, it might be because
you’re afraid of failure. If so, dig deep; 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 yourself; tell trusted friends or family and | anxiety.pdf |
741b73c11ec9-0 | get their
support.
Sharing a bit about your struggle and how you’re working
on getting better will make your goal more real and increase your likelihood
of success. And 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 self-sabotage 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, and/or 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 | anxiety.pdf |
741b73c11ec9-1 | 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 time; choose one reasonably
achievable for 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
“What Stories Are You Telling?” strategy
.
Go
Deeper
Create Your Weekly “Anti-Anxiety Calendar”
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
we’re trying to cultivate on a daily basis. Write in one strategy from the | anxiety.pdf |
2e362f824990-0 | chapters in this section that you’re 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 anxious? Or are there specific
commitments that always trigger your anxiety?
Get
ahead of your anxiety by identifying strategies to use before you
encounter anxiety-provoking situations, and write down a strategy that
you think will be particularly suited for that specific trigger. For
example, if you’re going to have a pressure-filled meeting at work, you
might write on your calendar “express your feelings through writing”
when you get home that evening. Or if you’re anticipating being
annoyed with a friend or family member, you might practice “exploring
anger” before the visit so you’ll be more aware of and better able to
manage your irritation.
Check-
In
It’s 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 you’re
improving/changing.
When you check in, you can assess what’s going well and what you might | anxiety.pdf |
2e362f824990-1 | 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 Do?
Start by reflecting on how you’re 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 goals?
•
How about your weekly goals?
•
Based on the 1 to 10 scale, are you noticing any symptom improvement?
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 weren’t as
successful as you’d like, try things differently. Look for other 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. | anxiety.pdf |
dd9a28d1c6fd-0 | 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 self-defeat future progress.
For example, Hannah started therapy not being able to get a moment’s 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 self-critical spiral. Suddenly thinking she had made no
progress at all, she would abandon the strategies that 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 | anxiety.pdf |
dd9a28d1c6fd-1 | 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. | anxiety.pdf |
f242f51fedb9-0 | What
You’ll Learn in This Section
Imagine again the triangle with “Feelings” written in one corner,
“Behavior” in another, and “Thoughts” 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 patterns:
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 costs; one of the most serious costs is that they actually
increase anxiety over time.
This
section is designed to help reduce your anxiety-driven
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 (“Hey, elevators aren’t so scary after all”) and | anxiety.pdf |
f242f51fedb9-1 | your feelings (over time, you won’t experience as much fear when
you take an elevator).
Responding to anxiety with avoidance/escape behavior makes
your world smaller and smaller. Eventually you may lose tolerance
for even day-to-day, basic interactions. As we explore strategies to
tackle avoidance/escape behavior, we’ll focus on specific self-
defeating habits, doing what you fear, accepting anxiety, and
increasing your tolerance for uncertainty. | anxiety.pdf |
47087b1b05e3-0 | 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 the most of the sunshine. You’re 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, you’re 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 ice-cold water. You’re
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 head: “Should I jump in? Or not?”
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 self-consciousness and | anxiety.pdf |
47087b1b05e3-1 | 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 fear: We avoid by indecision, 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 reprieve—“I’m dreading facing my boss today … ah, I’m
going to call in sick … what a relief to not have to deal with that jerk!” The
temporary relief reinforces the tendency to avoid. But the reprieve is almost
always short-lived. New anxiety creeps in and takes over. What felt like the
sweet taste of freedom becomes bitter with self-critical thoughts about the
consequences your avoidance may bring. What will your boss think of you for
not showing up? What if you get fired? How will you pay your bills? Are
your colleagues criticizing you for not coming in? | anxiety.pdf |
47087b1b05e3-2 | your colleagues criticizing you for not coming in?
Far from relaxing and enjoying a day off, you’re spinning back and forth
in your mind. Eventually all that anxiety keeps you stuck in avoidance; you
don’t go to work not only that day, but also the next day and
perhaps
even the | anxiety.pdf |
6bccdb245aa5-0 | next. Now you likely have actual negative consequences to face.
Avoidance feels protective in the short term, but in the longer term
generates real peril and more anxiety than ever. It’s worth keeping in mind
that the fundamental problem is not the anxiety, but how you respond to it.
Hardwired to Avoid
The fight-or-flight response is produced by an area of the brain often called
the “reptilian brain” due to its primitive nature. The reptilian brain evolved
very early and relies on an unsophisticated operating system; within
milliseconds we flee (avoid/escape) a perceived threat or freeze in place,
before we even process the apparent danger. From an evolutionary
perspective, this instant all-or-nothing response is effective because, after all,
we don’t want to waste precious time on details when we encounter a real
physical threat.
On the other hand, the reptilian response doesn’t 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 situation—like a performance review
with a boss you don’t like—isn’t an immediate threat to you. But your | anxiety.pdf |
6bccdb245aa5-1 | reptilian brain doesn’t know this, and may react to your fear with a fight-or-
flight response that’s unhelpful in a professional setting.
In
other words, the fight-or-flight response can be triggered even when
real danger doesn’t lurk. Once the information regarding the perception of
danger makes its way to our more evolved “upstairs brain,” we’re 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 weren’t actually such a big deal.
By avoiding the things or situations that trigger you, you’re 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 (more on this in | anxiety.pdf |
6bccdb245aa5-2 | chapter 8
). Let’s look at how to start changing your tendency to avoid. | anxiety.pdf |
2d44f34f0c06-0 | STRATEGY:
WHAT ARE YOU AVOIDING?
As we’ve seen, avoidance and escape only beget more avoidance. The
avoidance loop continues because it’s a habit that becomes unconscious. A
helpful step is to consciously identify what you’re avoiding so you are no
longer doing it on autopilot.
Take a moment to reflect on your patterns of avoidance. What do you
avoid that only causes you problems in the long run? Here are clues that
suggest you’re ducking something that matters or has meaning to you:
•
Saying you will do something but then not following through.
•
Procrastination: delaying a task until tomorrow … then the next day … and
the next.
•
Making rationalizations, justifications, and excuses for why you can’t do
something. (“My alarm clock didn’t wake me up.”)
•
Wasting energy/time 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 don’t feel well physically
and that’s why you can’t do something.
Make
a list in your notebook of what you avoid. Keep this focus top of mind, | anxiety.pdf |
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