in	mind,	consider	your	goals	for	anxiety	management:
•

What	made	you	pick	up	this	book?
•

What	do	you	want	to	achieve?
•

How	do	you	want	to	feel	on	the	inside?
•

How	do	you	wish	you	could	cope	with	anxious	thoughts?
People

often	get	to	this	point	and	then	start	to	doubt	themselves,	or	talk
themselves	out	of	their	goals	because	they	fear	it	will	be	too	hard	to
accomplish,	or	they’re	not	strong	enough	to	meet	challenging	tasks,	or	they
will	fail	in	the	end.	Remember,	people	like	you	all	over	the	world	have
struggled	with	anxiety	and	have	gotten	better.	It’s	not	that	they	never	feel
anxious	again,	but	they	find	methods	to	cope	in	healthy	ways	and	stay	present
in	their	lives.	Anxiety	is	treatable,	perhaps	more	so	than	any	other	mental
health	problem,	and	people	get	better	by	consistently	applying	new	ways	of
thinking	and	coping.
Setting	a	goal	and	sticking	to	it	is	akin	to	spotting	and	then	reaching	a
buoy	while	treading	water	in	the	ocean.	Each	buoy	leads	to	another	and
another	and	before	you	know	it,	you	see	the	shore	on	the	horizon.	Putting	the
effort	in	and	reaching	for	goals	will	almost	instantaneously	help	you	believe


in	yourself,	increase	your	self-esteem,	and	make	your	anxiety	seem	less
daunting.
STRATEGY	OF	THE	DAY
Pick	a	few	strategies	from	this	section	that	you	can	incorporate	on	a	daily
basis,	or	a	different	specific	focus	each	day.	One	example	would	be	to	label	a
day	“Positive	Self-Talk	Day,”	where	you’re	mindful	of	your	internal	narrative,
or	“Identify	Errors	in	Thinking	Day,”	where
you

commit	to	focusing	on	what
exaggerated	or	irrational	thought	patterns	may	be	making	you	feel	anxious.
Another	helpful	strategy	is	to
“Become	an	Observer”

of	your	thoughts	each
day.	If	only	for	five	minutes,	commit	to	watching	your	thoughts	go	by	without
becoming	attached	or	actively	pushing	them	away.
STRATEGY	OF	THE	WEEK
Pick	a	few	overarching	or	general	strategies	that	you	can	work	into	your
weekly	routine	at	least	three	times	this	week.	They	don’t	need	to	take	a
prolonged	period	of	time,	just	something	reasonably	achievable	for	you	in	the
context	of	your	life.	For	example,	you	could	incorporate	the	idea	of
“Un-
Learn	Helplessness”

,	where	you	commit	to	taking	one	reasonable,	actionable


step	to	combat	what	is	making	you	anxious.	Or	commit	to	a	hypothesis	test
and	use	it	to	challenge	at	least	one	of	your	anxious	beliefs.
Go

Deeper
Create	Your	Weekly	Strategies	Calendar
Revisit	your	weekly	strategies	calendar	you	created	in	chapters	4	(
here

)
and	7	(
here

).	Take	a	moment	to	look	over	the	current	month.	If	you	have
not	already	done	so,	write	in	work,	social,	and	family	commitments	and
appointments.
Habit	formation	comes	faster	when	we	teach	our	brain	new	strategies
and	techniques	on	a	daily	basis.	Also,	anxiety	is	reduced	when	we	have	a
solid	plan	and	stick	to	it.	Write	in	one	strategy	from
chapters	8

and
9

that
you’re	willing	to	employ	every	day	of	the	month.
Assess	what	is	coming	up	by	digitally	or	manually	marking	red,	yellow,
and	green	zones	on	your	calendar.	Red	zones	are	those	that	are	more
anxiety	charged,	green	are	those	where	you	expect	to	be	fairly	at	ease
and	feel	less	internal	pressure,	and	yellow	are	neutral	where	you	imagine
you	will	feel	neither	very	anxious	nor	very	relaxed.
Take	a	step	back	and	consider	which	red	zones	might	trigger	anxious
thinking	for	you.	On	days	or
times


thinking	for	you.	On	days	or
times

where	you	anticipate	anxious	thinking
or	see	a	red	zone,	write	down	a	strategy	(or	strategies)	that	you	think	will
be	particularly	suited	for	that	specific	trigger.	For	example,	if	you’re
anticipating	a	few	events	that	will	cause	you	to	ruminate	or	overthink,
consider	keeping	a	thought	record	that	week.	Also,	if	you’re	dreading	an
encounter,	consider	if	you’re	underestimating	your	competence	and
filtering	out	your	abilities	and	strengths	that	can	help	you	through	the
difficult	situation.
Check-

In
For	the	kind	of	change	that	really	lasts	for	the	long	term,	it’s	important	to
check	in	with	yourself	and	see	how	you’re	progressing.	Otherwise,	you	may
fall	back	into	those	same	old	anxious	habits.	Checking	in	is	a	way	to	stay
focused	on	your	goals	and	to	notice	which	strategies	are	working	or	which
you	may	want	to	add	or	change.
Check	in	with	yourself	to	take	stock	of	what’s	going	well	and	also	what
you’ve	lost	sight	of	on	your	path	to	a	peaceful	life.	And	as	you	also	take	stock


of	your	setbacks,	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.	Swap	out	the	strategies	you’ve
been	using	for	others,	and	be	honest	about	what’s	blocking	you	from	making
more	progress.	Remind	yourself	that	you	want	this,	and	you	can	and	will	have
peace	of	mind	and	a	meaningful	life.
STICKING

WITH	IT
Any	time	we	make	a	change	or	learn	something	new,	we	experience
disappointments	and	obstacles.	When	you	hit	setbacks,	take	a	moment	to
consider	what	negative	thoughts	or	beliefs	you	have	about	your	ability	to	get
better	and	start	new	techniques.


better	and	start	new	techniques.
For	example,	you	might	have	the	thought,	“Doing	these	exercises	will
improve	my	anxiety,”	and	simultaneously	think,	“These	exercises	are	hard,	so
I	probably	won’t	get	anywhere.”	Consider	incorporating	more	realistic
thoughts.	For	example,	“Other	people	have	done	this	and	made	themselves
better,	so	maybe	I	could	change,”	or	“I	don’t	have	to	implement	the	strategies
all	the	time	or	be	perfect	at	it	to	improve.”
Each	day	you’re	one	step	closer	to	your	goal	of	emotional	freedom.	Don’t
give	up.	You	will	come	out	on	the	other	side	of	your	anxiety.	What’s	on	the
other	side?	Ease	within	your
body

and	your	mind.	The	kind	of	ease	that	will
enable	you	to	steadily	push	out	of	your	comfort	zone	so	you	no	longer	miss
out	on	all	life	has	to	offer.	You	can	and	will	achieve,	connect,	and	live	a	fully
present	life.
Reading	about	the	strategies	means	you’re	no	longer	resigning	yourself	to	an
anxious	life.	This	change	alone,	of	giving	yourself	new	ways	of	thinking	and
managing	your	anxiety,	perhaps	more	than	any	other,	will	deliver	the	peace


and	calm	you	deserve.	Now	keep	going.	Don’t	give	up;	you’ve	already	come
so	far.


What

You’ll	Learn	in	This	Section
Recognize	that	you	do	have	the	ability	to	manage	your	anxiety	and
experience	the	kind	of	ease	and	calm	you	want.	This	confidence
doesn’t	have	to	come	all	at	once.	However,	it’s	something	we’re	all
capable	of	building,	and	this	section	addresses	how	to	stick	with	the
strategies	for	the	long	term.	One	element	is	learning	to	celebrate
your	successes.	Recognition	of	progress,	even	when	it	comes	in
very	small	increments,	fuels	your	ability	to	be	persistent,	and
persistence	is	the	path	to	new	learning.	We	will	also	look	at	how	to
sidestep	the	negativity	bias,	nip	anxiety	in	the	bud,	and	clarify
which	strategies	you	want	to	maintain	throughout	your	life.	And	we
will	explore	ways	to	accelerate	your	progress	on	the	anxiety-
reduction	path—including	building	your	support	network,
psychotherapy,	and	medication.


CH

APTER	ELEVEN
The	Road	Ahead
Long-Term	Outlook
It	is	estimated	that	one	in	five	adults	in	the	United	States	meets	the	diagnostic
criteria	for	an	anxiety	disorder.	As	prevalent	as	anxiety	is,	it	is	also	highly
responsive	to	treatment.	But	how	can	we	tell	who	will	get	better	and	who
won’t?	Well,	I	see	it	consistently	in	my	practice,	and	research	backs	this	up:
When	people	adopt	these	three	“beliefs”	they	typically	are	able	to	learn,
sooner	rather	than	later,	to	manage	their	anxiety	symptoms.
1.

Believe	you	need	to	change:

Doing	the	same	things	you’ve	always
done	keeps	you	stuck.	Open	yourself	up	to	new	ways	of	thinking	and
behaving	and	you’ll	start	changing.
2.

Believe	in	the	strategies:

Self-doubt	and	second-guessing	the	process
is	only	a	distraction	from	building	the	new	habits	that	will	take	you
away	from	anxiety	and	toward	greater	calm.	The	strategies	in	this	book
are	all	evidence	based,
which

means	research	has	proven	their
effectiveness.	The	strategies	work,	they	really	do!
3.

Believe	in	your	ability	to	grow:

As	we’ve	seen,	people	just	like	you


As	we’ve	seen,	people	just	like	you
all	over	the	world	experience	anxious	patterns	yet	find	sustained	peace
of	mind,	so	why	couldn’t	this	be	you?	Believe	in	yourself,	and	you	will
gain	control	over	your	anxiety.
Your	Biggest	Victories	So	Far
Take	a	moment	to	remember	what	emotions	and	habits	were	ruling	you	before
you	read	this	book.	Now,	like	playing	back	a	reel	of	sports	highlights,	look	at
your	greatest	victories	so	far.	Perhaps	you	couldn’t	connect	with	your	other
emotions,	except	for	anxiety,	and	now	you’re	no	longer	afraid	to	look	under
the	anxiety	and	understand	what	you’re	really	feeling.	Or	perhaps	you’ve
found	ways	to	relax	your	body	and	not	feel	as	physically	keyed	up.
Maybe	you’ve	stopped	avoiding	something,	or	a	few	things,	that	have
long	caused	you	fear	and	apprehension.	Maybe	the	concept	of	acceptance,
that	anxiety	is	a	part	of	human	experience,	has	opened	up	space	so	there’s	a
“you”	now	separate	from	being	anxious.
Or	maybe	you’ve	found	ways	to	become	unstuck	from	or	challenge	your


fearful	and	anxious-thought	patterns.	You	may	even	have	moments	now
where	you’re	able	to	observe	your	thoughts	or	feelings	without	becoming
overwhelmed	by	them.
If

you’re	thinking	about	your	struggle	differently,	if	you’re	engaging	new
ways	of	thinking	or	behaving,	consider	yourself	victorious.	Now	keep	on
doing	what’s	working.
Your	Biggest	Challenges	So	Far
What	have	been	your	biggest	challenges	so	far?	Perhaps	you	continue	to
struggle	and	have	not	yet	seen	any	noticeable	benefit.	Or	perhaps	the
improvements	feel	too	small	and	not	impactful	enough.
It	can	feel	impossible	to	keep	believing	in	yourself	and	your	treatment
approach	when	you’re	not	noticing	any	measurable	change.	Take	a	firm	look
at	the	facts.
•

Are	you	following	the	strategies?
•

Do	you	believe	the	strategies	will	work?
•

Do	you	believe	in	yourself	and	your	ability	to	improve	and	live	the	life	you
deeply	desire?
Also,	consider	if	there	are	specific	strategies,	or	even	entire	sections	of	the
book,	that	you	find	particularly	challenging.	Reflect	on	what	has	been	the
hardest	for	you	to	accept,	to	take	in,	and	to	change.	Consider	whether	you


might	benefit	from	additional	support	to	help	you	with	the	rougher	patches
(more	on	therapy	and	medication	in
chapter	12

).	Give	yourself	compassion
for	going	toward	what’s	difficult,	and	for	not	giving	up.
The

Road	to	Progress	Isn’t	Always	Straight
Change	doesn’t	unfold	in	a	straight	line,	although	we	often	believe	it	should,
which	is	why	when	we	confront	setbacks	we	become	self-critical	and	start	to
doubt	ourselves.	This	kind	of	thinking	sabotages	progress	and	contributes	to
us	giving	up	entirely.
The	reality	is	that	setbacks	and	failures	along	the	path	to	change	are
inevitable	for	everyone.	Our	brains	have	the	miraculous	ability	to	rewire,	to
grow,	to	change;	however,	our	brains	also	cling	to	what’s	become	habit.	This
contradictory	tension	means	change	does	not	come	immediately	or	without
effort.	Sustained	change,	the	kind	that	really	makes	a	difference,	takes	time
and	consistency.
Each	time	you	hit	a	roadblock,	instead	of	self-criticism	and	self-defeat,


consider	the	roadblock	a	signal	of	your	growth	and	progress.	After	all,	if	you
were	still	stuck	doing	what	you’ve	always	been	doing,	you	wouldn’t	have
come	across	a	roadblock.	When	progress	on	the	anxiety-reduction	trail	stalls,
or	even	halts	completely,	it	means	you’ve	likely	progressed,	more	than	you
imagined,	and	that’s	why	the	setback	bothers	you.	Setbacks	are	part	of	your
brain’s	adjustment	process.	Keep	persisting,	don’t	give	up,	and	return	to	the
strategies	again	and	again.	It	will	pay	off.
Go

Deeper
Gratitude
Recognizing	what	we’re	thankful	for	increases	well-being,	contentment,
and	peace	of	mind.	The	negativity	bias,	as	we’ve	seen,	is	wired	into	our
brain	as	a	survival	mechanism.	We	tend	to	dwell	on,	relive,	and	attempt
to	problem	solve	the	negative	more	than	the	positive.	When	this	process
isn’t	buffered	by	joy	or	contentment,	we	become	more	anxious.
We	can	counter	the	negativity	bias	easily	and	in	only	a	few	minutes	a
day.	Adopt	a	daily	practice	of	identifying	two	or	three	things	that	you
appreciate.	You	can	write	these	in	your	notebook	or	internally	reflect	on
them.	What’s	important	is	to	bring	conscious	and	deliberate	attention	to


what	is	going	well,	or	at	least	okay,	in	your	life	or	what	you	feel
positively	about	within	yourself.
Building

Your	New	Habits
Once	you’ve	been	successful	with	a	strategy,	take	it	to	the	next	level.	Practice
the	strategies	on	multiple	occasions	across	a	variety	of	settings.
For	example,	if	you	fear	eating	out	in	public,	don’t	decide	to	just	go	to	the
same	restaurant	with	the	same	friend	over	and	over.	Instead,	challenge
yourself	to	go	to	a	variety	of	restaurants	and	with	a	variety	of	people.	It’s
great	to	become	comfortable	knowing	that	you’re	no	longer	going	to	have	a
panic	attack	in	your	local	movie	theater,	but	consider	branching	out	to	other
theaters	in	nearby	towns	or	even	going	to	a	play	or	a	concert.	Or	if	you’re
working	on	obsessive	thinking,	don’t	just	work	on	it	when	you’re	at	your
place	of	employment.	Work	to	be	mindful,	an	observer,	when	home	alone,
when	driving,	even	when	interacting	with	others.	Practice	the	strategies	across
a	variety	of	situations/people	and	you’ll	eventually	start	using	them
instinctively.
The	more	you	act	the	way	you	wish	you	could	act,	and	do	the	things	you


used	to	avoid,	and	think	in	the	ways	that	bring	peace	of	mind,	the	quicker	new
habits	will	form	and	then,	before	you	know	it,	they’ll	become	automatic.
Exercise:	Catch	Anxiety	Early
Catch	anxiety	early,	before	it’s	left	the	barn,	so	to	speak,	and	you’ll	stop	it	in
its	tracks	before	it	becomes	too	intense	to	pull	back.	A	way	to	start	catching
anxiety
early

is	to	develop	a	quick	and	easy	habit	of	checking	in	with
yourself.	So	instead	of	rushing	from	task	to	task,	person	to	person—
intentionally	STOP.	Take	time	to	be	mindful	of	your	ongoing	experience.
Here’s	how:
•

At	the	end	of	the	day	when	you	arrive	home,	STOP	before	entering.	Reflect
for	a	few	moments;	check	in	with	yourself.
•

When	you	end	one	encounter,	STOP.	What’s	going	on	in	your	body,	your
mind?	What	sensations	do	you	notice?
•

When	you	finish	a	task,	STOP.	Reflect	on	what	tinges	or	shifts	might	be
happening	mentally	or	physically	for	you.	Literally	say	to	yourself,	“I	want
to	see	you.	What’s	going	on	in	there?”
Tune-Ups	and	Check-Ins
As	you	move	along	your	anxiety-recovery	path,	you	may	find	there	are


stretches	of	time	when	you’re	no	longer	deliberately	thinking	about	the
strategies.	You	may	feel	that	you’re	“in	the	zone,”	able	to	effortlessly	manage
life’s	hardships.
Still,	even	with	progress,	it’s	easy	for	us	to	go	back	to	old	ways	of
thinking	and	acting.	Consider	placing	sticky	notes	in	key	locations	(car,
bedroom	mirror)	or	reminders	on	your	digital	calendar	of	the	strategies	that
are	working	well	for	you	so	you	keep	them	top	of	mind	and	use	them	even
when	you	may	not	feel	like	you	need
them.

Also,	set	a	reminder	on	your
calendar	once	or	twice	a	month	to	review	the	material	in	this	book	and	what
you’ve	written	in	your	notebook	(even	if	you	think	you	don’t	need	to!).
Goal	Setting
Each	time	you	reach	a	goal,	consider	the	strategies	that	got	you	there	and	if
it’s	possible	to	expand	those	strategies	to	reach	even	larger	goals.	For
example,	perhaps	you	implemented	“total	worry	time”	(
here

)	and	it	worked.
Now	that	you’ve	discovered	its	effectiveness,	consider	making	it	a	goal	to	do
this	strategy	on	a	daily	basis.	Or	if	you	recognize	that
“Watching	Your
Thoughts”

works	when	under	stress,	consider	implementing	this	strategy


works	when	under	stress,	consider	implementing	this	strategy
every	day	while	driving	to	work,	with	or	without	stress.


Once	your	overall	anxiety	level	decreases,	you’ll	likely	find	that	you	think
about	your	goals	in	new	ways	and	find	deeper,	more	meaningful,	ways	to
impact	your	life.	And	as	your	well-being	increases,	the	overall	picture	of	the
path	forward	will	no	longer	bring	dread	but	instead	pleasure	and	optimism.
You	have	much	to	look	forward	to!
Exercise:

What’s	the	Big	Picture?
Refocus	on	the	bigger	picture	in	which	overall	strategies	are	important	to	you
in	maintaining	your	less-anxious	life.	These	are	the	strategies	that	either
worked	well	for	you,	or	are	linked	to	something	you	care	about,	like	an	active
social	life.	Here’s	a	list	of	some	of	the	things	my	clients	keep	in	mind.	Make	a
list	of	your	own.
•

Physical	exercise
•

Daily	mindfulness
•

Physical	health
•

Live	your	best	life
•

Acceptance
•

Challenge	your	thoughts
•

Exposure
•

Make	space	for	yourself	separate	from	your	anxious	thoughts


CH

APTER	TWELVE
Building	Your	Support	Network
Human	connection	relieves	anxiety.	Looking	another	person	in	the
eye	and	sharing	our	vulnerable	moments,	aspirations,	and	setbacks
soothes	our	nervous	systems.	If	you’ve	been	caught	in	anxiety’s	grip
for	some	time,	you	may	not	have	had	the	mental	space	to	sustain
close	family	or	friendship	ties.	One-on-one	meetings	with	a
therapist	or	group	therapy	are	ways	to	start	garnering	some	in-
person	support.	Online	anxiety-reduction	tools	also	can	be	helpful.
Sharing	your	goals,	progress,	and	setbacks	with	others	offers	a
sturdy	brace	that	will	give	you	encouragement	and	perspective	as
you	find	your	way.
Finding

a	Therapist
Be	Calm

is	for	you	to	use	on	your	own,	or	with	a	therapist	if	you	have	one.
You	can	find	relief	on	your	own	if	you’re	persistent	and	stay	with	it.	However,
you	will	want	to	participate	in	psychotherapy	if	you’d	like	to	accelerate	the
learning	process,	deepen	your	self-awareness,	if	you	have	little	social	support,
or	if	you’ve	implemented	the	strategies	and	are	not	feeling	much	relief	or
progress.
Psychotherapy	in	a	sense	is	a	mini	laboratory	where	you	can	try	out	your


new	skills	with	another	human	in	real	time.	Unlike	your	“real”	life,	the
therapeutic	life	is	safe	and	confidential,	and	the	therapist	has	no	connection
with	your	outside	relationships	or	broader	life.
Often,	working	with	a	therapist	can	be	tremendously	effective	in
understanding	yourself	and	in	developing	a	support	network	outside	of
therapy.	The	past,	in	particular	unprocessed	grief	and	trauma,	has	a	significant
impact	on	the	persistence	of	anxiety	symptoms.	Consider	weekly
psychotherapy	to	help	you	work	through	past	trauma	and	loss	that	may	be
impacting	your	ability	to	feel	sustained	relief	from	anxiety.
As	we’ve	seen,	anxiety	frequently	masks	other	negative	emotions	that	you
may	be	unaware	of	or	have	not	yet	processed.	Talking	with	a	therapist	can
help	you	uncover	those	negative	emotions	and	identify	what’s	causing	them.
Very	typically,	anxiety	lifts	when	you	enter	therapy	and	start	the	process	of


exploring	your	deeper	emotions	and	issues.	You	may	be	faced	with
other
complicated	emotions,	but	awareness	of	them	will	significantly	accelerate	the
recovery	process.
Medication
In	some	cases,	medication	along	with	psychotherapy	is	the	best	approach	for
anxiety	reduction.	This	should	be	considered	only	after	using	the	strategies	in
this	book	on	a	consistent	basis	and	meeting	with	a	licensed	mental	health
therapist	or	clinical	psychologist.	If	you	and	your	therapist	believe	medication
could	be	helpful,	set	up	an	appointment	with	a	psychiatrist.	Psychiatrists	have
specific	training	in	how	drugs	impact	emotions	and	behavior.
If	you	decide	to	try	medication,	be	wary	of	benzodiazepines	and
prescription	painkillers	(including	Xanax,	Ativan,	and
Clonazepam/Klonopin).	Benzodiazepines	and	sedatives	work	right	away	to
bring	down	anxiety,	which	provides	relief	in	the	moment,	but	over	time	it’s
easy	to	become	dependent	on	them.	Also,	if	you	use	sedating	medication	you
will	be	unmotivated	to	implement	the	strategies	and	your	brain	will	be	less
able	to	retain	the	new	ways	of	dealing	with	anxiety.	And	there	is	a	rebound
effect	when	benzodiazepines	and	painkillers	wear	off.	Anxiety	typically


comes	roaring	back	in,	even	stronger,	and	then	you’ll	feel	the	immediate	need
for	more	of	the	drug.
Selective	serotonin	reuptake	inhibitors	(SSRIs)	and	serotonin-
norepinephrine	reuptake	inhibitors	(SNRIs)	are	generally	more	effective	for
anxiety	reduction	over
the

longer	term.	However,	it’s	essential	that	you
undergo	a	full	assessment	with	a	psychiatrist	for	an	accurate	diagnosis	and
appropriate	medication	regime.
Getting	Referrals
Accessing	support,	whether	with	a	psychologist,	a	psychiatrist,	or	a	support
group,	is	a	way	to	enhance	your	recovery	process	as	you	move	toward	your
goal	of	anxiety	reduction.	Often,	a	good	place	to	start	is	with	your	general
practitioner.	Talk	to	your	medical	doctor	about	your	symptoms	and	see	if	they
can	refer	you	to	a	psychotherapist	or	clinical	psychologist.
Online	search	engines	can	also	be	quite	helpful	in	getting	a	referral.	The
Anxiety	and	Depression	Association	of	America	website	has	a	“Find	a
Therapist”	link	that	will	connect	you	with	licensed	mental	health	providers	in
your	geographical	area	who	specialize	in	the	treatment	of	anxiety.	Some	of
the	listed	mental	health	professionals	also	provide	telemental	services	(online
therapy)	through	video	conferencing,	phone,	or	email.


therapy)	through	video	conferencing,	phone,	or	email.
The	Social	Anxiety	Institute	website	also	provides	a	referral	list	of


treatment	providers	as	well	as	other	resources	for	lessening	social	anxiety.
The	American	Psychological	Association,	a	professional	organization	for
psychologists,	has	an	online	tool	to	find	a	psychologist	near	you,	as	does
Psychology	Today

where	you	can	read	various	therapists’	profiles	to	see	who
might	be	a	good	fit.
When

searching	for	a	therapist	to	help	you	with	anxiety	symptoms,	look
for	those	who	are	licensed	mental	health	providers	or	licensed	clinical
psychologists	who	specialize	in	cognitive	behavioral	therapy,	mindfulness,
and/or	acceptance	and	commitment	therapy.	As	we’ve	seen,	these	approaches
are	well	researched	and	have	shown	to	be	effective	in	the	treatment	of	anxiety
disorders.
Online	Support
Working	on	the	strategies	in	a	vacuum	with	no	outside	influence	will	not	be	as
effective	as	if	you	share	what	you’re	doing	with	the	outside	world.	Whether
you	talk	with	trusted	friends	or	family	or	seek	online	support	makes	little
difference.	However,	finding	a	way	to	connect	with	others	who	also	struggle
can	help	you	feel	more	normal	and	keep	the	material	fresh	in	your	mind.
The	National	Alliance	on	Mental	Illness	(NAMI)	is	one	of	the	leading
mental	health	organizations	in	the	United	States.	NAMI	supports,	advocates,


and	educates	on	behalf	of	the	mentally	ill	and	their	families.	The	NAMI
website	offers	support	regarding	a	range	of	mental	health	experiences,	as	well
as	what	it	is	like	to	live	with	the	stigma	of	mental	illness.
The	Anxiety	and	Depression	Association	of	America	has	an	online
anxiety	and	depression	support	group	where	you	can	connect	with	people	all
over	the	world	who	cope	with	anxiety.	You	can	join	this	group	anonymously
through	the	online	app	or	through	subscribing.
One

positive	step	to	take	is	to
sign	up	and	simply	peruse	ongoing	conversations	to	help	you	feel	connected
to	others	struggling	with	similar	symptoms.	Over	time,	you	may	become	more
and	more	comfortable	initiating	your	own	discussions.
The	National	Suicide	Prevention	Lifeline	(1-800-273-8255)	provides	free
confidential	support,	24	hours	a	day,	seven	days	a	week	for	people	in	crisis
and	in	need	of	immediate	intervention.
Support	Groups
Group	therapy	is	extremely	effective	in	lessening	anxiety	symptoms.	In	fact,
for	some	people,	group	therapy	is	more	impactful	than	individual	therapy.
Group	therapy	works	because	it	challenges	our	ideas	that	we’re	alone	in	our
suffering	and	are	somehow	“bad”	or	“less	than”	others	as	a	result.	This


experience	reduces	shame	and	isolation	and	also	helps	with	the	idea	of
accepting	anxiety	while	you	continue	to	live	your	life.
Communicating	and	connecting	in	a	group	therapy	setting	often	helps
people	develop	self-awareness	around	their	role(s)	in	social	relationships.
While	in	the	group,	a	person	may	act	out	a	role	that	they	use	to	manage	their
anxiety	in	real	life,	i.e.,	overly	friendly,	withdrawn,	very	inquisitive,
constantly	talking,	dismissive.	Group	members	typically	reflect	on	the	roles
they	notice	and	provide	one	another	with	feedback.	Because	group	therapy	is
not	real	life	and	is	confidential,	it	feels	safe	for	people	to
process

such
feedback.	As	a	result,	they	become	more	flexible	or	even	adopt	other	roles	in
the	group	that	will	eventually	extend	to	their	real-life	relationships.
In	addition,	when	we’re	in	an	anxious	state,	adrenaline	can	take	over.	It
can	be	hard	to	know	what	we	feel	deep	down,	let	alone	find	the	words	to
express	what	we’re	feeling.	Yet,	anxiety	typically	decreases	when	we’re	able
to	talk	with	others.	Group	therapy	is	a	type	of	exposure	in	that	you’ll	probably
feel	anxious	at	moments.	At	the	same	time,	it’s	a	nonthreatening	place	for	you
to	become	more	skillful	at	knowing	what	you’re	feeling,	when	you’re	feeling


it,	and	becoming	comfortable	expressing	it.
Finding	a	Group
If	you	decide	that	group	therapy	is	a	treatment	approach	you’d	like	to	try,	and
you	have	an	individual	therapist,	consider	asking	your	therapist	if	they	know
of	a	group	that	would	be	a	good	fit	for	you.	Alternatively,	there	is	a	“Find	a
Support	Group”	feature	on	the	Anxiety	and	Depression	Association	of
America	website	as	well	as	the
Psychology	Today

website.
Keep	in	mind	there	are	two	common	types	of	group	therapies.	“Process-
oriented”	groups	are	led	by	a	therapist,	but	generally	the	therapist	lets	the
group	members	steer	the	discussion.	Process	groups	are	about	the	group
members’	experiences	of	what	they’re	observing,	feeling,	or	want	to	discuss.
“

Psychoeducational”	groups	also	are	led	by	a	therapist	but	the	therapist
takes	on	an	instructor	role.	Psychoeducational	groups	are	helpful	when	you’re
looking	to	gain	specific	skills	in	some	area	of	your	life	or	functioning.	In	this
case	an	anxiety	psychoeducational	group	might	discuss	coping	skills	and
strategies.
Starting	a	Group
As	we’ve	seen,	anxiety	is	an	extremely	prevalent	issue	for	many	people.	If
you’re	looking	for	an	anxiety	therapy	group	in	your	local	area	and	can’t	find


If	you	decide	to	start	a	group,	think	carefully	about	how	you	wish	to
structure	it,	what	kinds	of	members	you’re	targeting	for	the	group	(only
anxiety,	anxiety	and	other	mood	issues,	relationship	issues),	and	who	will	be
the	leader.	Consider	if	you	want	this	to	be	a	process-oriented	or	more	of	an
information-sharing	group.	It’s	also	important	to	think	through	group	therapy
rules.	It’s	typically	helpful	not	to	have	a	group	with	family	members	or	people
who	know	one	another	very	well	because	it	reduces	anonymity	and	the
comfort	that	comes	from	anonymity.	Confidentiality	among	group	members	is
key	to	feeling	safe	and	open,	which	is	what	helps	people	grow.
Staying

the	Course
Like	many	things	in	life,	success	in	your	pursuit	of	anxiety	reduction	and
internal	peace	takes	patience,	adaptability,	and	perseverance.	Of	course,
anxiety	is	unpleasant	and	you’d	like	it	to	stop	as	quickly	as	possible.
However,	habits	take	practice	to	form	and	they	take	practice	to	break.
Compassionately	remind	yourself	that	there’s	nothing	wrong	with	you	if	you
feel	that	your	recovery	isn’t	moving	as	fast	as	you’d	like.	And	just	because
it’s	taking	time	doesn’t	mean	you	won’t	get	better.
Allow	yourself	to	adjust	the	strategies	for	your	personal	brand	of	anxiety


symptoms.	One	strategy	may	work	for	a	while,	but	it’s	important	to	try	new
ones	so	you	stay	challenged	and	keep	growing.	As	your	symptoms	improve,
the	anxiety	will	likely	change	and	present	itself	differently.	You	will	need	to
adjust	and	bring	new	skills	into	your	repertoire.	If	the	strategies	aren’t
working	or	are	going	only	so	far,	then	consider	individual	psychotherapy	or
group	therapy.	Some	people	do	both.	If	therapy	doesn’t	work	on	its	own,
consider	combining	psychotherapy	and	medication.
And,	most	importantly,	whatever	you	do,	don’t	give	up!	Allow	yourself	to
pick	the	work	back	up	again	and	again.	Believe	in	the	process.	Your	work	will
pay	off	in	the	form	of	a	brighter	future.


Resources
Online
Anxiety	and	Depression	Association	of	America	(
adaa.org

)
Social	Anxiety	Institute	(
socialanxietyinstitute.org

)
American	Psychological	Association	(
apa.org

)
National	Alliance	on	Mental	Illness	(
nami.org

)
National	Suicide	Prevention	Lifeline	(1-800-273-8255)
Headspace:

Meditation	app
Calm:

Meditation	and	sleep	app
Further	Reading
Antony,	M.	M.	and	Swinson,	R.	P.	(2009).
When	Perfect	Isn’t	Good	Enough:
Strategies	for	Coping	with	Perfectionism

.	Oakland,	CA:	New	Harbinger.
Bourne,	E.	J.	(2015).
The	Anxiety	and	Phobia	Workbook

(6th	ed.).	Oakland,
CA:	New	Harbinger.
Carbonell,	D.	A.	(2016).
The	Worry	Trick:	How	Your	Brain	Tricks	You	into
Expecting	the	Worst	and	What	You	Can	Do	About	It

.	Oakland,	CA:	New
Harbinger.
Collard,	P.	(2014).
Little	Book	of	Mindfulness:	10	Minutes	a	Day	to	Less
Stress,	More	Peace

.	Colorado:	Gaia.
Hanh,

Thich	Nhat.	(1999).


Hanh,

Thich	Nhat.	(1999).
The	Miracle	of	Mindfulness:	An	Introduction	to	the
Practice	of	Meditation

.	Boston:	Beacon	Press.
Hayes,	S.	C.	(2005).
Get	Out	of	Your	Mind	and	Into	Your	Life:	The	New
Acceptance	and	Commitment	Therapy

.	Oakland,	CA:	New	Harbinger.
Knaus,	W.	J.	(2014).
The	Cognitive	Behavioral	Workbook	for	Anxiety:	A	Step-
By-Step	Program

(2nd	ed.).	Oakland,	CA:	New	Harbinger.
Pittman,	C.	M.	and	Karle,	E.	M.	(2015).
Rewire	Your	Anxious	Brain:	How	to
Use	the	Neuroscience	of	Fear	to	End	Anxiety,	Panic,	and	Worry

.	Oakland,
CA:	New	Harbinger.


References
Baltazar,	N.	C.,	Shutts,	K.,	and	Kinzler,	K.	D.	(2012).	“Children	Show
Heightened	Memory	for	Threatening	Social	Actions.”
Journal	of
Experimental	Child	Psychology

,	112(1):	102–10.
Boswell,	J.	F.,	Thompson-Hollands,	J.,	Farchione,	T.	J.,	and	Barlow,	D.	H.
(2014).	“Intolerance	of	Uncertainty:	A	Common	Factor	in	the	Treatment	of
Emotional	Disorders.”
Journal	of	Clinical	Psychology

,	69(6):	630–45.
Craske,	M.	G.,	Treanor,	M.,	Conway,	C.,	Zbozinek,	T.,	and	Vervliet,	B.
(2014).	“Maximizing	Exposure	Therapy:	An	Inhibitory	Learning	Approach.”
Behaviour	Research	and	Therapy

,	58:	10–23.
Culpepper,	L.	(2009).	“Generalized	Anxiety	Disorder	and	Medical	Illness.”
Journal	of	Clinical	Psychiatry

,	70,	20–24.
Jackson,	M.	C.,	Wu,	C.	Y.,	Linden,	D.	E.,	and	Raymond,	J.	E.	(2009).
“Enhanced	Visual	Short-Term	Memory	for	Angry	Faces.”
Journal	of
Experimental	Psychology:	Human	Perception	and	Performance

,	35(2):	363–
74.


,	35(2):	363–
74.
Jakubovski,	E.	and	Bloch,	M.	H.	(2016).	“Anxiety	Disorder-Specific
Predictors	of	Treatment	Outcome	in	the	Coordinated	Anxiety	Learning	and
Management	(CALM)	Trial.”
Psychiatry	Quarterly

,	87(3):	445–64.
Katon,	W.	J.,	Richardson,	L.,	Lozano,	P.,	and	McCauley,	E.	(2004).	“The
Relationship	of	Asthma	and	Anxiety	Disorders.”
Psychosomatic	Medicine

,
66(3):	349–55.
McCallie,

M.	S.,	Blum,	C.	M.,	and	Hood,	C.	J.	(2006).	“Progressive	Muscle
Relaxation.”
Journal	of	Human	Behavior	in	the	Social	Environment

,	13(3):
51–66.
Missig,	G.,	Mei,	L.,	Vizzard,	M.	A.,	et	al.	(2017).	“Parabrachial	PACAP
Activation	of	Amygdala	Endosomal	ERK	Signaling	Regulates	the	Emotional
Component	of	Pain.”
Biological	Psychiatry

,	81(8):	671–82.
Roest,	A.	M.,	Martens,	E.	J.,	de	Jonge	P.,	and	Denollet,	J.	(2010).	“Anxiety
and	Risk	of	Incident	Coronary	Heart	Disease:	A	Meta-Analysis.”
Journal	of


Journal	of
American	College	of	Cardiology

,	Jun	29;	56(1):	38–46.
Wegner,	D.	M.,	Schneider,	D.	J.,	Carter,	S.	R.,	and	White,	T.	L.	(1987).
“Paradoxical	Effects	of	Thought	Suppression.”
Journal	of	Personality	and
Social	Psychology

,	53(1):	5–13.


Willgoss,	T.	G.	and	Yohannes,	A.	M.	(2013).	“Anxiety	Disorders	in	Patients
with	COPD:	A	Systematic	Review.”
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,	58(5):	858–66.


About

the	Author
Jill	P.	Weber,	PhD,	is	a	clinical	psychologist	in	private	practice	in	Washington,
D.C.	She	is	also	a	psychology	author	and	a	speaker.	Dr.	Weber	works	with
teenagers,	individuals,	and	couples	managing	varying	degrees	of	anxiety	from
panic	attacks,	generalized	anxiety,	and	life	stress.	Dr.	Weber	uses	a	combined
approach	of	cognitive	behavioral	therapy,	mindfulness,	and	acceptance
techniques	when	working	with	anxiety	symptoms.	She	writes	a	blog	for
Psychology	Today

and	has	appeared	as	a	psychology	expert	in	various	media
outlets	including
USA	Today,	Washington	Post

,
Nightline

,
U.S.	News	&
World	Report,

and	CNN.	Dr.	Weber	is	the	author	of
Having	Sex,	Wanting
Intimacy:	Why	Women	Settle	for	One-Sided	Relationships

and	the
Relationship	Formula	series	including	the	titles
Breaking	Up	and	Divorce	5
Steps,	Building	Self-Esteem	5	Steps,	Toxic	Love	5	Steps,

and
Getting	Close	to
Others	5	Steps

.	For	more	information,	see
www.DrJillWeber.com.