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2d44f34f0c06-1 | and see if you can catch yourself in the moment you’re making the decision to
avoid. Then try to make a different choice!
STRATEGY: WHY ARE YOU AVOIDING IT?
Even dysfunctional, self-defeating behavior continues, or increases, when it’s
rewarded. People keep smoking because of the rewarding effect of the
dopamine hit. Without a serious desire to make a change, this behavior
continues in spite of the toll smoking takes on health and longevity.
It’s important to identify what is reinforcing, or strengthening, your
tendency to avoid even though you would like to stop this behavior.
•
What do you
gain
each time you avoid the situations you listed in your
notebook? Some people report feeling a sense of lightness, like they
dodged a bullet, played hooky, or got out of something truly awful.
•
Do you celebrate the reprieve as if you won a prize or accomplished
something? Who’s really winning?
•
Consider if avoidance is reinforced because it means you never have to
fully put yourself out there and risk rejection, disapproval, or failure. | anxiety.pdf |
e9eee9637060-0 | •
How else might your avoidance be reinforced?
Go
Deeper
What is Avoidance Gaining You?
Avoidance is a short-term fix that causes more and more anxiety in the
long term. Try this writing exercise to inspire motivation and focus on
longer-term, consistent relief, versus quick fixes that never last and have
negative consequences.
Write down two lists in your notebook:
1.
All the benefits of avoidance. Be very honest with yourself here;
no one else is reading this list. Write down why you avoid and the
positive feelings that come when you do. Try to emotionally
connect with the feelings—for example, the relief of pressure or
the power of managing to get out of something.
2.
All the benefits of NOT avoiding. How would you feel about
yourself—improved self-esteem, proud, less shame, strong? What
goal might you gain—greater joy, increased productivity, closer
friendships, increased work competence, increased spontaneity?
Now
compare the two lists. Which list has more in it for you for the long
term? Which list makes you feel better beyond the moment and also
helps you achieve broader goals for yourself? Set your intention now on | anxiety.pdf |
e9eee9637060-1 | what you want going forward.
Right
on Target
Behaviors that you want to reduce or change—like problematic avoidance—
are what psychologists call “target behaviors.” They are the behaviors that we
will target with our interventions. Target behaviors are often unproductive
things you continue to do, even though they’re self-defeating.
For example, Jase feared public speaking and, as a result, avoided any
kind of group meeting at work. In reality, he knew his job well and wished he
could show off his talents through public speaking. To start, we targeted
Jase’s pattern of skipping meetings. We wanted to reduce, and ultimately
eliminate, that avoidance behavior. He agreed to at least attend work meetings
but not put any initial pressure on himself to speak. Then he built up to
gradually asking a question, and eventually making longer and longer | anxiety.pdf |
4d189baa0226-0 | statements/comments to the group.
Another client, Alisha, obsessively worried that her boyfriend would
break up with her. To prevent these feelings, she sought out constant
reassurance from him that he would always be there for her. Like a drug, she
needed another and then another hit of reassurance. She wanted to feel safe
and secure in the relationship. So we targeted her tendency to seek
reassurance. She agreed to reduce requests for reassurance by 25 percent and
committed to simply riding out any resulting anxiety spike. In this way she
would not have to go cold turkey but could begin to adjust bit by bit. It
worked. Alisha started to see that she could manage, and even let go of, her
fears for longer and
longer
periods of time. And it helped Alisha’s partner feel
less burned out and more compassionate toward her.
Tackling avoidance requires pinpointing target behaviors. The table lists a
few examples of goals and how to change your behavior to reach them.
GOAL
TARGETED BEHAVIOR CHANGE
Increase social connection/closeness
with people
Initiate social outings; increase eye contact in social
situations
Increase capacity for public
speaking
Every work meeting, talk for at least three minutes: ask a | anxiety.pdf |
4d189baa0226-1 | Every work meeting, talk for at least three minutes: ask a
question, make a comment, or clarify something
Decrease need for reassurance from
partner
Learn to tolerate fears of abandonment: positive self-talk,
breathing exercises; seek reassurance but decrease it by
25 percent (three times a day instead of four, decrease
from there)
Decrease overthinking
spiral/rumination
Build awareness for rumination by breathing and being
mindful; talk to people when upset instead of dealing
with the difficulty only in your head, on your own
Be present and participate in life
No drug or alcohol use; build awareness of when you’re
spacing out or daydreaming; ask questions; be an active
listener
STRATEGY:
IDENTIFY TARGETS
Based on your goals, identify three or four target behaviors you would like to
change because they get in the way of your larger goals.
Rate how hard it will be to work on each of these behaviors. Use a 1 to 10
scale, 1 being not hard at all, and 10 being nearly impossible. | anxiety.pdf |
490337137d5a-0 | Rate how motivated you are to work on each of these behaviors. Use the same
scale.
Start with a behavior that’s not going to be too difficult to eliminate but which
is causing enough trouble to motivate you to work on it. So, using the 1 to 10
scale, consider behaviors in the 4 to 6 range for difficulty and at or above 5 on
the motivation range. Once you make progress on one target behavior,
momentum will develop, and you can work on other items as you wish.
The Great Escape
When we avoid, we work behind the scenes to dodge what we dread. We’re
planning ahead to totally eliminate contact with the trigger. Escape is
different; it manifests when we experience an acute anxiety surge in the
moment we contact the trigger. We then do whatever we have to in order to
get away from it. Imagine what you’d
do
if you touched an appliance and got
a sudden electric shock—you’d jerk your hand away immediately. You didn’t
manage to avoid the shock but you did escape it, and minimize your contact
with the unpleasant feeling.
For example, if you have a phobia of crowded spaces, you may be
perfectly fine most of the time living in a bubble that keeps you in your open- | anxiety.pdf |
490337137d5a-1 | space comfort zone. But terror can take over if for whatever reason you
miscalculate and suddenly find yourself in a crowded corner at a museum
reception. Your heartbeat jumps. Your face flushes. You shake and jitter. You
may even think you’re going to pass out or have a heart attack. Similar to a
fire alarm sounding, these panic symptoms cause you to immediately make
some excuse and flee.
As we’ve seen, an adaptive survival response in a true emergency can, for
the person with chronic anxiety, become a self-defeating pattern of avoiding
uncomfortable but nonthreatening situations. When that happens, a person
may find themselves in total escape mode for situations that are actually
benign—shopping malls, movie theaters, driving, parties, family events, work
meetings, doctor’s appointments, just to name a few. Giving in to panic and
fear through escape means no new learning can occur because you never get a
chance to discover if what you fear will actually happen.
STRATEGY:
REIN IN FIGHT-OR-FLIGHT
If a lion is attacking, jump off a high wall, run toward oncoming traffic, crash
through a sliding glass door—do whatever you must to survive. But only | anxiety.pdf |
490337137d5a-2 | rarely do most of us encounter truly life-threatening situations. In those other
circumstances, the ones that feel scary but pose no real threat, you’ll get the | anxiety.pdf |
c0db83d9159e-0 | best outcomes if you rein in your fight-or-flight response long enough for
your “upstairs brain” to kick in, so you can make an accurate risk assessment.
Here are three quick and easy strategies for decreasing the physical agitation
and arousal—shortness of breath, increased heart rate, sweating, shaking—
that accompany panic and anxiety:
1.
Take slow, deep breaths, feeling your chest rising fully. Each time you
exhale, make the exhalation a little longer than the one before.
2.
If you’re too keyed up to breathe freely, count your breaths. Counting
helps distract your brain from anxious thoughts. Count 1 when you
inhale, 2 when you exhale, and so forth up to 20. Then start again with
1. Repeat this a few times; the arousal will start to decrease.
3.
If breathing doesn’t work, place your hand on your heart. Notice the
speed. See if you
can
slow it down with your breathing. Put all your
attention into observing the beat … beat … beat … of your heart.
STRATEGY: DO WHAT YOU FEAR (a.k.a.
EXPOSURE) | anxiety.pdf |
c0db83d9159e-1 | EXPOSURE)
We reinforce escape behavior by never staying in the feared situation long
enough to see if our anxious expectations are accurate. The only way to test
your fears is to put yourself in the situation(s) that ordinarily make you want
to bolt, and see if your expectations are realistic. Initially this is going to bring
discomfort, but in the long run, it will lead to less anxiety and less escape
behavior.
1.
Get out your notebook and write down situations that typically trigger
an urge to escape.
Example:
Driving
2.
Next to each situation write what you believe would happen if you
stayed in the situation and did not escape.
Example:
“If I keep driving when I have heart palpitations and
shortness of breath, I’ll freak out and crash the car.”
3.
Rate how likely you believe each of your listed expectations is to
happen on a 1 to 10 scale (1 being not at all and 10 being extremely
likely).
4
.
Now pick a situation from your list that is moderately difficult, not
painfully difficult, but challenging enough that you feel the burn.
You’re going to intentionally put yourself into this situation to see that | anxiety.pdf |
131e218c143a-0 | you can cope better than you imagine.
5.
Start with sticking in the situation for a short time and gradually build
up from there. Remember to breathe (use the
“Rein In Fight-or-Flight”
strategy
) during this exercise. You can and will come out on the other
side of this fear.
6.
Write down your goal. (We’ll use the previous example.) Now go and
drive the car. Continue driving for 15 minutes after panic symptoms
(rapid heartbeat, shallow breathing, feeling shaky) are triggered. Use
purposeful breathing to slow down your breathing and heart rate so the
“upstairs brain” can tune in and see that you’re actually safe.
7.
After you have stuck it out, ask yourself the following:
•
Did your expectation happen? (“No.”)
•
What is the evidence that it happened or didn’t happen? (“I felt my
heart beat fast and I had shortness of breath but continued to drive for
15 minutes,” or “I did not crash the car.”)
•
What did you learn from this experience? (“I can feel anxious in my
body and still drive safely.”)
Go
Deeper
What Would Happen If? | anxiety.pdf |
131e218c143a-1 | Go
Deeper
What Would Happen If?
This short writing exercise is a way to shift your focus away from your
fear to the positive feelings and strong sense of self that will come as you
rely less on escape and more on moving forward in spite of your anxiety
or panic.
Write two stories in your notebook:
1.
The story of what you expect would happen if you intentionally
exposed yourself to something you’ve been escaping. Call to
mind your worst-case scenario—all the difficult thoughts,
feelings, or behaviors you imagine would happen if you stuck
with something that instinctively you want to move away from.
Perhaps you believe you would die, have to leave in an
ambulance, lose your mind, throw up, humiliate yourself …
whatever it is, write it down. Be as specific as possible.
2
.
The second story is your best-case scenario of what could occur
if you didn’t use escape to manage your panic. In this story, you | anxiety.pdf |
a2a8c0b09711-0 | effectively cope and manage whatever thoughts, feelings, or
behaviors arise. Despite your discomfort you stay. If you pushed
through discomfort, what would be the result? How would you
feel about yourself then? Imagine feeling good, strong, capable,
even proud.
Uncertainty
Intolerance
Remember the Magic 8-Ball from childhood? Ask the ball any question you
wish, shake it up, and poof! A triangle floating in water delivers an
unequivocal answer. If the Magic 8-Ball really worked, we probably wouldn’t
have anxiety disorders; because it would always tell us what was coming
next, we’d never have to experience uncertainty.
Research shows that people who struggle with chronic anxiety and worry
have great difficulty dealing with uncertainty—that is, situations with
unknown outcomes. Overthinking—about past events or possible future
outcomes—is a way to bridge the uncertainty gap. When we don’t know
what’s going to happen, our brain gets busy generating a bunch of
hypothetical outcomes to make us feel like we know more than we do. Take
the person going to the doctor for their yearly blood work. Before the tests,
during the appointment, and up until they receive the results, they imagine | anxiety.pdf |
a2a8c0b09711-1 | and replay the possible negative results. They even consider various treatment
plans for potential diagnoses and diseases.
The problem with this kind of worry and rumination is that anxious minds
aren’t very rational, and tend to generate possible worst-case outcomes that
aren’t very likely. So, while worrying about bad outcomes may feel soothing
in the short term, it’s actually making you more and more anxious over time.
This happens because when we can’t tolerate uncertainty, we take on more
responsibility than is reasonable
for
a given situation. A kind of superstitious
thinking creeps in, telling us that the “work” of worry is somehow keeping us
safe from the hypothetical bad things happening. Whether we think about the
blood work results every hour of every day or not, the results will be what
they are. Curiously, when the results come back indicating all is normal, there
is a self-defeating and irrational tendency to believe that all the worrying
made the difference. And then the next time uncertainty creeps in, we will be
encouraged to worry again to bridge our knowledge gap.
It’s as if we are saying, “If I don’t worry about this, then it’s my fault | anxiety.pdf |
a2a8c0b09711-2 | when the bad stuff happens.” Despite the weight of this pressure, we
persevere in our worrying, thinking it will get us somewhere when in reality
it’s only increasing our anxious state of mind. So we check our email again | anxiety.pdf |
d05800996a19-0 | and again to ensure we haven’t missed anything. We triple-check that the
stove burners are off, or that the doors are locked every time we leave the
house. We seek reassurance, asking ourselves and the people around us, “Are
you sure you still love me?” “Have I done everything I can?” “Will my child
be safe?” “Do they think poorly of me?” “Will I ever find a partner?” “Am I
healthy?” “Am I normal?” “Is everything okay??”
Living that way is exhausting, and over time it diminishes quality of life.
The idea that we have to worry or remain hypervigilant so bad things won’t
happen to us is an illusion. Bad things, including suffering and sorrow,
are
sadly part of life. It’s not your job to become certain of the uncertain. The
only real control we have is to accept reasonable uncertainty so anxiety
doesn’t rob us of joy, or of the pleasure of being fully present in this life now.
STRATEGY: MEETING NEW PEOPLE
Before entering a social situation, we can never know with 100 percent
accuracy what will happen, how we will feel, or what others may think about | anxiety.pdf |
d05800996a19-1 | us, which is why social situations often involve a lot of uncertainty anxiety.
We can get so caught up in fears over possible judgments/criticisms/slights
that we become paralyzed at the prospect of hanging out with people.
The more assertive you are, the less likely you are to fear social
interaction. This is because when you exchange eye contact, speak out, put
down boundaries, share your opinions, people see you and respect you. And,
too, speaking up is a way to clear up misconceptions and miscommunications
(both of which are inevitable in the social world) so the same distressing
social dynamics don’t continue to play out for you over and over again.
List in your notebook what your fears are before entering a specific social
situation, and next to each fear write out how you could respond and
appropriately handle the situation should it occur.
•
What rejections could occur?
Example:
“People won’t talk to me at all,” or “People will look away
and it will feel like I’m not even there.”
Response:
“I’ll volunteer to help the host,” or “I’ll make the plan and
initiate the event, so I’ll be an integral factor.”
•
What criticisms could occur?
Example: | anxiety.pdf |
d05800996a19-2 | •
What criticisms could occur?
Example:
“If I talk about my job, people will think it’s boring and that
I’m uninteresting.”
Response:
“I’ll talk a bit about my job but will highlight the positive, | anxiety.pdf |
072eb0df7819-0 | smile, and maybe even joke about it,” or “I’ll vary my conversation to
include my job but also my family or a movie I’ve seen.”
•
What things matter to you that cannot be predicted in your social
interactions that keeps you avoiding?
Example:
“I want to feel like people like me, but I fear they’ll avoid
me or won’t pay any attention to me.”
Response:
“I’ll make a point to engage people. I’ll ask questions, make
eye contact, and make them feel I’m interested in what they say so
they’ll enjoy talking to me.”
If possible, role-play with a friend or therapist where they act the part of the
critical other and you act the part of being assertive and defending yourself.
Or stand in front of a mirror and literally act out the two sides. Get used to
hearing yourself clarify
thoughts
or statements
without being defensive.
A
good formula for this is starting with something validating followed by a
clarifying statement: “I understand what you mean, but actually I don’t see it
quite the same way as you do.”
After practicing assertiveness, get out in the world and talk to people. You can
tolerate the uncertainty of not knowing what people are thinking and still | anxiety.pdf |
072eb0df7819-1 | enjoy the social experiences.
STRATEGY: BUILDING UNCERTAINTY
TOLERANCE
Learning to tolerate uncertainty, and seeing that it’s possible to live with it, is
actually much easier in the long run than overthinking possibilities and
imagining terrifying outcomes.
Here are four steps toward increasing your tolerance for uncertainty:
1.
Instead of avoiding uncertainty, seek it out.
2.
When uncertainty presents itself, courageously welcome it with open
arms: “I see you, uncertainty, and I can and I will continue to live fully
while you’re by my side.”
3.
Reduce behaviors that reinforce your belief that you can’t handle
uncertainty. If you compulsively check things, check every few days
instead of
every
day, or every five hours instead of every hour. If you
constantly seek reassurance, see if you can self-soothe through positive
self-talk, journaling, exercise, deep breathing, before you ask for
another dose of reassurance. If you’re ruminating about a what-if | anxiety.pdf |
c8ad261cd178-0 | scenario, internally label it “can’t be certain of the uncertain.”
4.
While strengthening the muscles that will let you manage uncertainty,
pay close attention to the parts of your life where you
do
have control.
For example, being present and attentive to children is one way we can
impact their future happiness. Exercising and eating well helps with
health and feeling good. Building communication skills and positive
experiences together helps a range of relationships stand the test of
time. You may not be able to predict uncertain outcomes, but those are
all things you can do to help ensure things will go well in the long run!
WRAP-
UP
•
Avoidance feels relieving in the moment but in the long run increases
anxiety.
•
The desire to avoid/escape fearful situations is part of our brain’s fight-or-
flight response.
•
The problem is when fight-or-flight is triggered without an actual threat.
•
Challenge your instinct to escape or avoid so new learning may occur.
•
Uncertainty in life is unavoidable; accepting this truth decreases anxiety. | anxiety.pdf |
52f100479ecd-0 | CH
APTER SIX
Acceptance & Approach
Making Peace with Anxiety
Anxiety serves an important function. Worry and concern enable us to tune in,
connect with others, take care of ourselves, and have empathy. Anxiety also
motivates us to set goals, take action, and pay attention to what matters. I
sometimes see people in my practice who don’t have enough anxiety. That
might sound strange, but they come in feeling unmotivated, lost, and without
purpose. Chances are, if you live with anxiety, you’re fully invested in your
life’s course. You have the drive needed to achieve an enriching and
meaningful life. The key, however, is to not squander your precious energy on
a struggle
against
anxiety.
Many of us have a sense that we aren’t living a “good” or “happy” or
“correct” life if we experience even low levels of distress. If you feel this
way, you probably
expend
a lot of energy trying to prevent the unpreventable.
Joy, love, and pleasure are magnificent aspects of life. However, in the small
print on life’s contract you’ll find that hardship, loss, suffering, setbacks, and,
yes, anxiety, are also part of the deal. | anxiety.pdf |
52f100479ecd-1 | yes, anxiety, are also part of the deal.
Instead of trying to rid yourself of things that can’t be changed, like
distress and discomfort, change your
relationship
with anxiety by accepting it.
Give up the futile struggle against your feelings and allow your anxiety to
come and go—as feelings always do.
Imagine yourself as a surfer, moving with, not against, your waves of
emotion, and accepting those waves as they come. You can’t control the
waves, but you can take them as they are, which will help you move through
life more smoothly.
Accepting anxiety doesn’t mean you’re a victim of it or that you’re giving
up and allowing it to control you. Acceptance doesn’t even mean you like
what you’re experiencing. Acceptance is the idea that it is what it is. When
you look out the window and see rain you don’t say to yourself, “It’s raining,
I have to fix this!” You also don’t say, “I’m a victim of the rain,” or “I’m
being abused by the rain,” or “It’s raining, I give up.” Perhaps you don’t love
the rain, but you pull out an umbrella, you keep moving forward, and you
know that eventually the rain will stop. | anxiety.pdf |
55cc6f3dc2e5-0 | STRATEGY:
ACCEPTANCE
Try this experiment to experience the change in perception and emotional
freedom that true acceptance brings.
For this exercise, get your notebook and also find a bandana or light cloth
you can use as a blindfold. I want you to write a few sentences while wearing
a blindfold about your understanding of the role of acceptance in managing
anxiety. You’re to write as clearly and legibly as possible, making sure to keep
the letters and words lined up, even though you won’t be able to see what
you’re writing. You can do anything you need to help you with this, except
remove the blindfold. Do your best to try to figure out a way to write as
straight as you can in spite of not being able to see.
Now do the exercise again. This time, don’t worry about writing straight and
on the lines, or making sure your letters are clear. Just write while wearing
the blindfold.
Can you feel the difference? Once you accept the blindfold, you’re liberated
from the anxiety about it.
STRATEGY: CLARIFY YOUR VALUES
Values are the things in life we cherish most, the things that give our lives
meaning. Common examples of core values include family, spirituality,
health, and
community. | anxiety.pdf |
55cc6f3dc2e5-1 | health, and
community.
Living a life that matches your core values increases
self-esteem, joy, and quality of life. The good news is, the strategies you’re
learning here will help you channel your energy away from anxious patterns
and toward the values that matter most to you, in spite of, or alongside, your
anxiety symptoms.
A good way to get in touch with your values is to imagine yourself on
your deathbed. This can be difficult, but imagining life ending can sometimes
connect us with what we want most.
•
What do you want others to know and remember about you, that you did or
didn’t do, during your life?
•
How do you want to impact the larger world?
•
How do you want others you care about to experience you?
Consider writing down what you value in each area of your life as listed in the
next section; remember, a value can be that you don’t value that particular
area. | anxiety.pdf |
ce3260af47de-0 | Relationships (romantic, friendship, family, parent, child):
Professional:
Education:
Religious/
spiritual:
Community:
Hobbies/interests:
Psychological growth:
Physical health:
STRATEGY: COMMITTED ACTION
Identify what you can do
now
to start living the kind of life you truly desire.
Any small step toward your values will improve your mood and anxiety. Get
out your notebook and map out a plan to start taking committed action toward
something you value. Here’s how:
1.
Identify value:
Example:
Psychological growth
2.
Identify goal:
Example:
Increase self-esteem
3.
Identify step to take to reach goal:
Example short-term action:
“Every day do one task that makes me
feel competent—pay the bills, make a meal, exercise, volunteer, help a
friend.”
Example
long-term action:
“Ask boss about what’s needed for a
promotion,” or “Sign up for a class.”
4.
Now take action!
Go
Deeper
Your Best Life
The story you tell yourself about who you are and what you can and
can’t do influences every aspect of your life. Although you may take
your story as fact, it is not. The accumulation of negative experiences | anxiety.pdf |
9683e2ef0f9c-0 | over time can give us a sense of ourselves that is entirely false. We are so
accustomed to our story that we don’t challenge it or recognize the ways
it blocks our growth. Your story can be changed.
•
Rewrite your story so it can support who you truly want to be.
•
In this process, consider which ideals/values you care about and want
to cultivate.
•
Write about what your best life would look like and also how you
would feel on the inside if you were actually living this life.
•
Write specific, doable, action items that will move you toward living
this life starting now, today.
Do
the Scary Thing
For many of us, it’s tempting to think the only way to emotional freedom is to
eliminate our anxiety entirely. But as we’ve seen, total anxiety elimination is
self-defeating because of anxiety’s many benefits and, of course, because it is
an impossible task. Feeling anxious from time to time is something to accept,
not struggle against.
Accepting you’re going to feel anxious at times—sometimes quite
anxious—frees up psychic space that was occupied by willing anxiety away. | anxiety.pdf |
9683e2ef0f9c-1 | This opening is a portal for achieving goals and living a meaningful life
while
anxiety is present
.
In fact, when you make room for anxiety to be present without sounding
the fire alarm, you’ll find there’s value in simply noticing where anxiety crops
up. Frequently we become anxious about things because they matter to us.
For example, when we worry about a social interaction it’s probably because
we really value having a social life. If we tremble in the face of a job
interview, it’s because professional achievement is important to us. We don’t
usually get anxious about things that are irrelevant to our lives and values.
Instead of turning on yourself when anxiety rears its head, make room for
it and for what it can teach you. Accept yourself, wholly and completely, the
positive and the negative. Approach what you’re afraid of, because
whatever
is on the other side of that fear matters to you. And that’s important, because
you
matter.
Paradoxically, fully accepting anxiety relieves anxiety. To do this,
however, you have to legitimately accept it as an inevitable part of your life.
Accepting anxiety just so it will “go away” won’t work. Tell yourself (
and | anxiety.pdf |
e34fb3575e49-0 | mean it
!), “My anxiety will forever come and go,” and “I can still be okay
and live a valuable life with anxiety.”
Maybe you’ve experienced the freedom that comes with true acceptance
in other parts of your life:
Just when you accepted you wouldn’t find love, you found it.
Just when you accepted your unsatisfactory job situation, it improved.
Just when you accepted a loss, something was gained.
Just when you accepted your flaws (or the flaws of someone else), they
stopped upsetting you.
Just when you accepted your diagnosis, you became healthier in other ways.
Acceptance brings less obsessive focus and energy spent on whatever is
troubling us. As we become less singularly focused, our lens expands to the
larger picture. We have the space to strategize, take risks, and do more to
improve our circumstance.
STRATEGY:
IMAGINE A SCENARIO
Use this visualization exercise to get in touch with what you might gain if you
push through your anxiety.
1.
Bring something to mind that matters to you but that you’ve avoided
or neglected because of anxiety and fear. Picture the details. Paint the
scene in your mind’s eye.
2. | anxiety.pdf |
e34fb3575e49-1 | scene in your mind’s eye.
2.
Try to conjure what you would feel in your body if you approached
what you are afraid of. Notice the physical cues. Can you feel your
heart rate increase or your stomach sink? Remind yourself that you’re
safe; you’re just pretending.
3.
Imagine you follow through with whatever used to frighten you into
inaction, and imagine how you would feel if you did that. What would
you gain?
Anxiety Is Not the Boss of You
Ideally, when our anxiety response is triggered, we make a swift assessment
of how dangerous the situation at hand really is. Then we’re able to either
manage the situation appropriately (“Get out of the house, there’s a fire!”) or
self-soothe (“You’re okay, take a deep breath.”), return to a calmer baseline,
and move on. When we
experience
chronic anxiety, fight-or-flight is triggered
so frequently that we are forever on guard for potential threats, and can never | anxiety.pdf |
9d29703ca53b-0 | truly relax.
Anxiety can be like a tyrant that controls us to such an extent that our true
nature fades into the background. Over time it gets harder and harder to recall
who we are and what we want, separate from anxiety, or believe there is
another way to live. Yet it’s possible to break free. You can go your own way,
do your own thing; you can be the boss of the anxiety.
Take the example of Mateo, a high school football player I worked with in
my psychotherapy practice. A gifted athlete, Mateo was nonetheless
consumed by anxiety regarding his performance on the field. Over time this
anxiety stopped him from going on the practice field at all, which only
increased his anxiety and negative feelings about himself. Not practicing
meant his skills weren’t improving. Mateo worried recruiters wouldn’t see
what he could do and all would be lost.
I suggested to him, “You know you’re really anxious right now. Your
anxiety is telling you to stay home and give up on your dream of getting a
football scholarship. You believe you have to do what the anxiety tells you.
But you don’t have to listen. You’re in charge, not the anxiety. You could go | anxiety.pdf |
9d29703ca53b-1 | to practice
while you feel anxious
.”
At first, Mateo, like many of us, remained stuck on the idea that he can’t
live with anxiety: “But I don’t want to feel anxious! I have to figure out the
anxiety first.” Then he made the connection: “Well, I guess I’m going
to
feel
anxious either way. I didn’t go to practice today and I feel even worse than
yesterday, but at least if I go to practice I haven’t lost anything else.”
And that’s it. If you make your choices
in spite of anxiety
, you’re retaking
control of yourself and your actions—you’re retaking control of your world.
Now you are free. Free to strive to become a college football player, develop
close friendships, fall in love, travel, be spontaneous, take the final tests to get
the degree, take that medical test that could save your life, speak up in the
meeting so your boss will give you that promotion, start a new business, plan
a party.
Anxiety will not disappear, but it will no longer be your tyrannical boss—
you, your true nature, will be the boss.
STRATEGY:
WATCHING YOUR THOUGHTS
Use this mindfulness exercise to better connect with the part of you—the | anxiety.pdf |
9d29703ca53b-2 | Use this mindfulness exercise to better connect with the part of you—the
observer—that is separate from your anxious feelings and thoughts.
1.
Sit quietly and comfortably. Become an observer of your thoughts and
sensations. You’re not overwhelmed by your experience and you’re not | anxiety.pdf |
dc9915ea4fb2-0 | pushing it away or judging it. Your experience just is what it is.
2
.
Notice that as each thought passes it is replaced by another … and
another … and another. Similar to lying on your back watching clouds
and labeling their varying shapes and nuances: “fuzzy cloud,” “smoke
cloud,” “bird-shaped cloud.” Watch your thoughts as they come and go
and label them: “worried thoughts,” “fear thoughts,” “planning
thoughts,” “happy thoughts.”
3.
Label your observations as they come up using the sentences below.
These sentences are ways to separate your observing self from your
emotions and thoughts:
•
“I am aware I am having the thought that ––—.”
Example:
I am bad/weak/failure …
•
“A feeling of ––— has come over me.”
Example:
sadness/dread/hurt/sorrow/joy
•
“I am experiencing the thought ––—.”
•
“I notice a narrative that tells me ––—.”
•
“I am noticing a sense of ––—.”
•
“I am noticing a body sensation of ––—.”
STRATEGY:
IN VIVO EXPOSURE
In vivo | anxiety.pdf |
dc9915ea4fb2-1 | STRATEGY:
IN VIVO EXPOSURE
In vivo
is just a fancy way of saying, “in real life,” and for our purposes, it
means you need to experience the situations you’re avoiding. Anxiety has
dictated a number of your choices and caused you to miss out. Calling up
your fears in real time, by approaching what you usually avoid, will show you
that you can work through your anxiety in the moment and get out on the
other side. What’s on the other side? A life full of experiences you value.
(When you try your first in vivo exposures, find a trusted friend to accompany
you so you have support if you start to feel overwhelmed.)
Pick something that you’ve long avoided because of anxiety. This should be
something that will be hard but that you can imagine pushing yourself to do.
Examples might be calling a friend or relative, going somewhere, speaking up
in a group, asking for something you need, telling someone something you’ve
needed to say for a long time. Take doing the task slowly. Remember, the
anxiety will be there as you push forth and that’s okay. Here’s how:
1.
Take action: Do something you avoid and fear that blocks you from | anxiety.pdf |
0fa6efdbf0bb-0 | gaining something important to you.
2.
Rein in fight-or-flight: Bring down physiological arousal by paying
attention to your breathing. Make each exhalation longer than the one
before.
3
.
Support yourself: Tell yourself, as you push forward toward your goal
and feel that surge of anxiety, “I can and I will push through. I can and
I will push through. I can and I will push through … ”
STRATEGY: HOW DID IT FEEL?
When we’re anxious, we don’t focus enough on the relief and even pleasure
we experience when we push through the anxiety and get to the other side.
Take a moment now to be aware of what good came from exposing yourself
to the situation you have previously avoided so you will be sure to do it again.
•
Do you feel any relief in your body?
•
Do you feel any pleasure or pride in knowing you did the thing?
•
Did anything good come from doing it?
•
Can you imagine doing it again or something similar?
•
Which makes you feel better about yourself, approaching your fears or
avoiding/escaping them?
Giving
Up the Struggle | anxiety.pdf |
0fa6efdbf0bb-1 | avoiding/escaping them?
Giving
Up the Struggle
It’s tempting to live life in a constant state of longing. We long to not
experience upsetting or anxious feelings. We long to win. We long to be
better. We long to be free of pain and full of pleasure. And we berate
ourselves when we don’t achieve what we long for. This mind-set can make
life an endless race to get something, and then something else, and then
something else. Deep down we believe this struggle is one day going to lead
to an end to all of our suffering, an end of wanting more, and an end to ever
feeling bad.
This belief is a fantasy that encourages anxiety to flourish. Anxiety on
some level is never going to end. Believing it can somehow be controlled or
erased becomes a barrier that prevents people from improving the quality of
their lives here and now.
Take, for example, planning a vacation. You can choose to approach the
planning with anxiety, frustration, or aggravation. You might worry that you
won’t be able to do what you want to do on the trip, that the flights will be | anxiety.pdf |
2b5158be5950-0 | horrendous, and that all the planning is taking away time from other things
you should be doing. At times you may even tell yourself, “This trip isn’t
worth all this planning, ugh, I give up!” By the time you take the trip you may
be filled with such resentment or annoyance over the planning and
packing
that nothing about the trip will quite make you happy. You return home
dissatisfied and unfulfilled. You vow to take another, better, more perfect trip
in the future.
Alternatively, you can accept the planning process—even embrace it. You
have to do it anyway, so you might as well enjoy it. You can conjure a feeling
of excitement and imagine your future pleasure as you think through what
you want to do. You can spend time looking at photos, reading articles, and
creating an agenda. When you hit setbacks, you can be flexible and think of
other ways to still get much of what you want out of the trip.
Dealing with anxiety is similar, in that there’s a choice: On the one hand,
you can forfeit the present moment and succumb to anxiety, or even self-
criticism for
feeling
anxiety. On the other hand, you can make room for a | anxiety.pdf |
2b5158be5950-1 | anxiety. On the other hand, you can make room for a
larger experience of yourself other than as just an anxious person. If you want
the latter, when setbacks hit, adjust to the new wave like that agile surfer, or
take a turn in a different direction. Do that and anxiety’s inevitable presence
will not dominate and rob you of the enriching experiences you deserve.
Go
Deeper
Exploring Your Struggle
Take some time to sit down and journal about what your struggle with
anxiety is like for you. Here are a few prompts to focus your writing:
•
Write about the ways you have attempted to fight anxiety. For
example, trying to anticipate fear/self-doubt/worry; making choices in
hopes they will keep anxiety at bay; spending time problem-solving
about things that can’t be solved; trying to make certain the
unavoidable uncertainties found in every life.
•
Many people blame themselves. Consider the ways you may have
been too hard on yourself—judgmental and self-critical—because you
feel you “shouldn’t” be struggling with anxiety.
•
Consider how many parts of days, weeks, and years have been | anxiety.pdf |
2b5158be5950-2 | consumed by anxiety. What would it be like to give up this struggle
and accept anxiety? What would you do with the gift of that free | anxiety.pdf |
36f43380ce78-0 | mental space?
•
As you write, see if you can connect with a feeling of compassion for
yourself and for what you have endured in your struggle.
STRATEGY:
INVITING DIFFICULT EMOTIONS
This strategy is a way to practice giving up the fight against your emotions.
Instead of struggling against them, you’re actually going to lean in to
whatever emotions you might be experiencing—the pleasant and the
unpleasant. Try to actually invite anxiety (and other unpleasant feelings) to
come over you.
1.
Sit comfortably in a quiet location. When anxiety appears, instead of
fighting it (“This is wrong,” “Make it stop.”), let go of control and give
up the struggle. Welcome anxiety in with open arms: “Yes, I see you,
anxiety, and there’s space for you here with me.” Meet the surges of
unease or worry with warm acceptance. You can accept your feelings
even though they cause you discomfort.
2.
You’re not attempting to change the feeling, push it away, or keep it
present. You’re aware of whatever it is,
as it is
. You’re letting go of
control in favor of awareness.
3.
As you experience the anxiety, ask yourself, “What else may be here?” | anxiety.pdf |
36f43380ce78-1 | Explore for deeper emotions that may be hiding under your anxiety.
Many anxious people have not grieved something from their past or
fully acknowledged a hardship they suffered. For example, perhaps
you’re
anxious
about your partner possibly leaving you. Dig deeper;
what is this worry connected to from your past? When do you
remember first feeling anxiety over someone leaving? Perhaps you
trace this feeling to your parents’ divorce and your dad moving out.
Now invite in that sadness or anger; see if you can notice where you
feel it in your body. Stick with the feelings.
4.
Work to uncover the root emotion to which each anxiety branch may
be attached. Oftentimes, getting at the root, where the emotion first
presented, can entirely relieve the anxious feelings. Tell the feelings
they’re welcomed here with you. Validate them as real and worthy of
your attention.
STRATEGY:
TAKE YOUR ANXIETY ALONG
FOR THE RIDE | anxiety.pdf |
36e07db5ccdb-0 | If you’re like many anxious people, fear and apprehension stop you in your
tracks. You feel as if you have to wait for anxiety to go away before you can
get on with your life. It’s actually the opposite: for your anxiety to diminish,
get on with your life
!
•
Take a moment to identify and be aware of your anxiety. Then task
yourself with an activity, errand, or outing. This doesn’t have to be an all-
day event. (You can work up to that.) Even going to the grocery store or
running a few errands while in an anxious state will do the trick.
•
Make sure you follow through completely. In other words, don’t give up
once you’re at the grocery store or after completing one errand. Remember,
you’re apt to feel anxious wherever you are, so you might as well get some
things accomplished while you’re anxious (and it might just help you to be
less anxious later).
•
Once you complete the task, see if your anxiety decreased at all as a result.
Even if it didn’t, congratulate yourself that you did what you needed to do
in spite of the anxiety. Do it again when you have an opportunity.
WRAP-
UP
• | anxiety.pdf |
36e07db5ccdb-1 | WRAP-
UP
•
Accepting that anxiety will forever come and go is liberating.
•
Stopping the struggle against anxiety creates room for an enriching life.
•
Identifying your values and larger goals will enhance your quality of life.
•
Making choices and taking action on these larger goals in spite of your
anxiety is empowering.
•
Fully accepting anxiety relieves anxiety. | anxiety.pdf |
2202d78a238c-0 | CH
APTER SEVEN
Putting the Tools to Work
Implementing anxiety techniques on a routine basis means you can
start to make choices for yourself that reflect your larger goals and
values,
in spite of anxiety
. You’re no longer only an anxious
person; you are a person who, along with anxiety, has a rich and
meaningful life. Here are ways to turn the strategies you’re
learning into consistent habits that will enrich your life for the long
term.
From
Strategies to Habits
Repeated use of these techniques in a structured, determined manner will
bring you relief far beyond managing your symptoms. Consider the
challenging task of quitting smoking. Smokers say it usually takes three
months for nicotine withdrawal symptoms to leave the body. Those three
months require deliberate effort to adopt a new learning pattern, but the
rewards clearly outweigh the effort. Three months is nothing compared to a
longer, healthier, and more satisfying life.
Similarly, take the example of Julia. Julia felt extremely anxious driving
on highways with congested lanes and higher speed limits. Each time she
drove on a highway, the same pattern of neurons fired and a panic attack soon | anxiety.pdf |
2202d78a238c-1 | ensued. Julia’s mind reeled with imagined bad outcomes. Over time, even the
thought of highway driving triggered panic. Eventually she stopped driving
on highways altogether.
In the moment, avoiding what makes us anxious feels like the fix. In the
long run, the avoidance increases anxiety. With treatment, Julia made a
commitment to overcome this anxiety. She began by visualizing herself
driving and coping well. She also practiced deep breathing to rein in the fight-
or-flight response and supportive self-talk: “I can and I will push through to
the other side.” At first the old anxiety reaction came flooding back in. She
persevered. After two weeks of visualizing, she drove on a highway again.
After two months, she was regularly behind the wheel and reported
that
her
anxiety had dropped from 10 to 5 on a scale from 1 to 10.
Julia pushed through. Not only did her symptoms improve but her quality | anxiety.pdf |
a9434496573e-0 | of life also improved. She was now able to spontaneously visit her mom and
friends. Most importantly, she felt like the independent and capable woman
she always knew herself to be.
Planning
Reconsider when you will integrate the techniques you planned in
chapter 4
into your daily routine. If you have already begun to do so, maybe your
planning is working. If you have not started to use the strategies regularly,
consider whether you’ve made a realistic plan. For example, if you commit to
practicing the various strategies for 20 minutes at the end of the day and you
aren’t following through, maybe two 10-minute sessions is a better way for
you to start.
Be flexible and open to new ways of structuring your life, but do schedule
time, ideally a little bit each day, to work on anxiety reduction.
Track Your Progress
It’s important to long-term progress that you set up a system whereby you
track, ideally on a daily basis, the strategies you’re using and the intensity of
your anxiety.
Below is an example of a quick and easy way to track progress. Each day,
check any and all
strategies
you use from
chapters 5
and
6
. Also be sure to | anxiety.pdf |
a9434496573e-1 | and
6
. 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: 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’re going to have
more days with 5s or even 4s.
STRATEGY
MON
TUES
WEDS
THURS
FRI
SAT
SUN
What Are You
Avoiding?
Why Are You Avoiding
It?
Identify Targets
✓
Rein in Fight-or-Flight
✓
Do
What You Fear
Meeting New People
✓
Building Uncertainty
Tolerance
✓ | anxiety.pdf |
ccb48ef4b62d-0 | Acceptance
Values
Committed Action
✓
Imagine a Scenario
Stop Missing Out!
Watching Your
Thoughts
✓
In Vivo Exposure
How Did It Feel?
✓
Inviting Difficult
Emotions
Take Your Anxiety
Along for the Ride
Rate Your Anxiety 1 to
10 Scale
7
3
5
2
3
6
7
Goal Setting
When the rubber meets the road, and you have to actually start implementing
your plan, self-doubt will creep in. Self-doubt is the enemy of inspiration and
change. It’s all too tempting to turn to excuses: “It’s too hard,” “It will take
forever,” “This is going to be awful.” Allow that to happen and the mental
energy required to improve will be tapped out.
You want to be released from your struggle with anxiety, which is why
you’re reading this page now. However, for many, the idea of change brings
on competing feelings. Yes, there is hope for something better but also fear
that you can’t get there. When doubt looms, remind yourself that
anxiety is
highly responsive to treatment
. People who practice these techniques on a
regular basis usually improve. The need for effort doesn’t mean results won’t
come, it just means it will require work. | anxiety.pdf |
ccb48ef4b62d-1 | come, it just means it will require work.
Take this moment to set a couple of goals for yourself based on what you
read in
chapters 5
and
6
. These
should
be overarching goals that you can
come back to repeatedly for motivation to stay the course.
Maybe you recognize all you’ve missed out on because of avoidance
behavior, and you want to stop missing out. Or perhaps you became more
clearly aware of what is meaningful and of value in your life, and you set the
goal of making space for those values, regardless of your anxiety. | anxiety.pdf |
9fdd396878ee-0 | STRATEGY OF THE DAY
Pick a few strategies from this section that you can incorporate on a daily
basis. For example, an excellent daily strategy that is quite grounding is
“Watching Your Thoughts”
. Sit quietly even for five minutes and observe
your thoughts, similar to watching clouds. Thoughts will arise, and they will
pass by—you don’t have to respond, you only have to observe them. Or sit
quietly and practice acceptance of something troubling you, or invite your
anxiety in and accept those feelings and sensations.
Another helpful strategy is
“Take Your Anxiety Along for the Ride”
. In
this case, you commit to keeping up with tasks and commitments, even when
you’re in an anxious state. You simply tell the anxiety, “Alright, I know
you’re there; you’re just going to have to come along with me today!”
STRATEGY
OF THE WEEK
Pick a few larger strategies that you can work into your routine at least three
times this week.
A good place to start and one that will immediately boost your mood and
decrease anxiety is to spend some time each week on committed action—this
could be spending time with a loved one or volunteering at a local homeless | anxiety.pdf |
9fdd396878ee-1 | shelter/animal rescue center. Taking practically any action, no matter how
small, that matches your values will inspire you and also lessen anxiety, even
if only slightly.
Go
Deeper
Create Your Weekly Strategies Calendar
Revisit the weekly strategies calendar you created in chapter 4 (
here
).
Take a moment to look over the current month. If you have not already
done so, write in work, social, and family appointments and
commitments.
People make great progress by simply committing to using one strategy
on a daily basis. This can be a simple/easy strategy, but doing it daily
encourages the habit to become gradually more automatic. Write in one
strategy from
chapters 5
and
6
that you’re willing to commit to using
every day of the month. When you realize you missed a day(s), which
will occasionally happen, just pick up where you left off. | anxiety.pdf |
7b19a3caf5ec-0 | Assess what’s coming up by digitally or manually marking red, yellow,
and green zones on your calendar. Red zones are those that are more
anxiety fueled, green are those where you expect to be fairly at ease and
feel less internal pressure, and yellow are in the middle, where you
imagine you will feel neither very anxious nor very relaxed.
Take
a step back and look at how much of your month is red and how
much is green. If there’s a predominance of red, you’re likely carrying
too much dread about your activities, which is no way to live. One of the
single best ways to improve mood is to have things to look forward to.
Can you reduce the red on your calendar and increase the green? Even a
few eliminations can make a noticeable difference.
On days or times where you anticipate anxious triggers, or see a red zone
on your calendar, write down a strategy (or strategies) that you think will
be particularly suited for that specific trigger. For example, if it’s a
dreaded social encounter, you might put on your calendar to “practice
acceptance,” or “practice being assertive in social situations.” Or if it’s | anxiety.pdf |
7b19a3caf5ec-1 | something you want to avoid but need to approach, you might practice
“imaginal exposure,” where you visualize yourself doing the thing you
want to avoid.
Check-
In
One of the reasons weekly psychotherapy is so effective for treating anxiety is
that the regular meeting serves as a cue for the brain, a reminder of the
ultimate goal—a sense of peace and well-being—and the tools needed to get
there. You can do this on your own, but do commit to checking in with
yourself on a regular basis. Use this time to note your progress and problem
solve about what you could tweak or do differently to be even more
successful. The key is to be flexible and try things differently if your anxiety
is not improving, but don’t give up. It takes flexibility and patience, but ease
and calm await.
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? | anxiety.pdf |
1d3d1c796e95-0 | 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. Remind yourself that you want
this, and you can and will do it.
STICKING
WITH IT
It takes practice to integrate new anxiety-reduction routines into your habitual
thinking and day-to-day life. Perseverance requires that you do not beat
yourself up for setbacks. Any time we make a change or learn something new,
we experience disappointments and obstacles. Use setbacks as learning tools,
teaching you what to do differently next time. Then start again.
No matter what the moment, the day, or the week is like, the key is to not give
up. You can start again at any time. Cultivate patience and compassion for
yourself. You are brave to dedicate yourself to changing your life. You will be
rewarded for your work! | anxiety.pdf |
12284c551139-0 | What
You’ll Learn in This Section
Once again, call to mind the image of a triangle with “Feelings” in
one corner, “Behavior” in another, and “Thoughts” in the third. As
we’ve seen, working in any corner of this triangle will change the
other two. In this section, we’re going to relieve your anxious,
repetitive thought patterns. Anxious thinking means you’re
frequently flooded by repetitive and intrusive thoughts. You wish
you could turn your mind off, but the catastrophic or worried
thoughts just keep coming. Feeling mentally on edge in turn fuels
anxious feelings and avoidance behaviors.
For example, imagine receiving an invitation to a friend’s
birthday party. You might immediately think something like, “No
one is going to talk to me if I go. I’ll feel awkward.” If you have
that thought often
enough,
or just believe it enough, you might end
up skipping the party, even though you like your friend and don’t
want to miss out. Or if you do go to the party, your anxious thinking
might nag at you the whole time, making it an ordeal instead of the
fun experience it should be. | anxiety.pdf |
12284c551139-1 | fun experience it should be.
The strategies in this section will help you challenge the kinds
of anxious thoughts that interfere with your quality of life. The key
thing I hope this chapter teaches you is that you can’t believe
everything you think. We’ll explore why our thoughts often need to
be challenged, and you’ll learn specific strategies that can be used
to do just that. | anxiety.pdf |
4bdc9f0393c7-0 | CH
APTER EIGHT
Thoughts vs. Reality
Don’t Believe Everything You Think
You, your resilience, and your capacity for growth are actually much stronger
than your anxious thoughts—although it probably doesn’t feel like that most
of the time. For the anxious mind, a flood of worry can rise in a matter of
minutes, sweeping you away to a place where what began as a passing
thought becomes in your head an absolute truth. If you watch your thoughts
carefully, you will catch yourself jumping to extremes and generalizations.
Imagine you get a ticket for a minor fender bender and then you have the
thought, “What if they sue me?” Anxiety quickly evolves that thought into,
“They
are
going to sue me!” Or say you get some negative feedback at work
and have the thought, “My boss sees problems with my work.” Anxiety steps
in, and the thought
becomes,
“I’m going to get fired.” Or you realize your
mom hasn’t returned your phone calls and you wonder why. Anxiety turns
wondering into, “She must have had an accident.” Or you realize your partner
hasn’t returned a text all day and you worry, “My partner doesn’t care about | anxiety.pdf |
4bdc9f0393c7-1 | me anymore,” quickly followed by, “He’s leaving me!” This pattern of taking
one small, worrisome thought to an extreme can also be initiated by a
physical sensation: “My heart is beating fast … I must be having a heart
attack!” There are all sorts of frightening, unlikely places your anxious
thoughts will take you—but only if you let them! Believe it or not, you can
intervene and slow this process down.
Imagining catastrophes and worst-case scenarios is emotionally draining
and keeps us from being fully present in the here and now. But we can learn
to sort our thoughts so that things like over-the-top speculations and black-
and-white thinking are moved to the “discard” pile, at least until you have
solid evidence that those thoughts are realistic. Start sorting helpful from
unhelpful thoughts by taking a little time (even if only a few moments) to
slow down and become aware of what you’re thinking before you react.
When we slow down, we create space to observe our thoughts and see if
they’re as realistic as they might seem initially. So the thought, “I’m going to
get fired” becomes “I’m having the thought that I’m going to get fired.” The | anxiety.pdf |
4bdc9f0393c7-2 | thought, “My girlfriend is breaking up with me” becomes “I’m having the
thought that she’s
breaking
up with me.” Taking a more curious and | anxiety.pdf |
cfdf3ff094a4-0 | observational stance makes room to challenge the accuracy of your thoughts
and weigh their usefulness to you.
STRATEGY: “THINKING ABOUT” VS.
“EXPERIENCING”
This strategy challenges your thoughts in a new way. The exercise is designed
to help you distinguish between your actual experience and your
interpretation
of what you’re experiencing. When we observe, not overthink,
we become liberated from anxiety.
1.
Bring all your attention to your heartbeat. Place a hand on your heart.
Or see if you can turn your awareness inward and actually feel the
beating within your chest.
2.
Distinguish thoughts from experience. Thoughts might be, “I can’t
find my heartbeat,” or “My heart is beating too fast,” or “I worry I
have a heart condition.” Rather than judgment or analysis of your
heartbeat, experience your heartbeat, become aware of its rhythm. How
does it feel thumping against the palm of your hand?
3.
Like finding the beat in a song, your awareness is less thought-focused
(“Did I get that lyric right?”) and more experience-focused (“Thump,
thump, thump.”).
4
.
Sense your chest rising and falling in rhythm with the sensation of | anxiety.pdf |
cfdf3ff094a4-1 | Sense your chest rising and falling in rhythm with the sensation of
your heart’s beating. See if you can notice how your heartbeat
decreases as you observe it or increases as you become caught up in
your thoughts.
STRATEGY:
RECORD YOUR THOUGHTS
Keeping a record of your thoughts is a powerful strategy for breaking out of
the anxiety spiral. Instead of those thoughts going around and around in your
head, writing is a way to examine them in a more realistic, less emotional
light. This kind of reflection puts you in control of your thoughts instead of
your thoughts controlling you. Then you’re no longer reacting to unrealistic,
over-the-top thinking that only ramps up your anxiety.
Use this exercise when you become aware you’re experiencing anxiety so
you can get better at catching your thoughts early, before they mushroom.
This strategy also helps when revisiting an anxious moment after the fact.
Identify a situation/interaction/image/thought stream that brings about
anxiety for you. | anxiety.pdf |
81442251be27-0 | •
What is/was the hardest thing about this situation?
•
What is/was your fear in this situation?
•
What is/was your imagined worst-case scenario?
•
What thoughts were running through your mind during the event or after or
even now as you revisit it?
•
Rate how much you believe each of these thoughts. (Use a 1 to 10 scale,
with 1 being you don’t believe it at all, and 10 being you believe it
completely.)
Come back to this exercise in a day or two, or even a few hours, and revisit
how much you believe these thoughts now.
When Your Thoughts Work Against You
When we’re caught up in anxious thinking, our thoughts
feel
entirely real and
accurate and so they keep us keyed up. In truth, the anxious mind isn’t so
good at differentiating the real from the unreal. In this virtual world, we feel
as anxious and frightened as we would if our fear was based on something
really happening. However, in reality, nothing terrible is going on and there
may be little, if any, chance our feared scenarios will ever happen. | anxiety.pdf |
81442251be27-1 | There are a number of biases we’re all prone to that intensify anxiety.
Familiarizing yourself with these “errors in thinking” will help you catch
exaggerated or inaccurate thought patterns. Here are a few of the more
common ones:
All-or-nothing thinking:
Things are all good or all bad; you are perfect or a
failure.
Overgeneralizing:
If something negative happens in one situation it means it
will happen in all future, similar situations.
Catastrophizing:
You look to the future with sweeping negativity and
forecast disaster instead of more realistic possibilities.
Labeling:
Applying a fixed, global label on yourself or others without
including any context. (“I’m a loser,” “I’m bad,” “I’m inadequate,” “I’m a
burden.”)
“Should”-ing and “must”-ing:
You have rigid expectations for how you
should
or
must
act, and when these unreasonable expectations aren’t met, you
forecast horrendous consequences.
Each time you successfully identify an error in thinking, your anxiety will | anxiety.pdf |
e14f59ff0bf1-0 | decrease because you’re able to see the situation at hand more realistically, or
at least entertain other possibilities.
STRATEGY: DOWNWARD ARROW
TECHNIQUE
The downward arrow technique is effective for identifying what deeper belief
you hold about yourself that is triggering—and driving—your anxious
thoughts. In cognitive behavioral therapy, core beliefs are described as your
most central thoughts about yourself and the
meaning
you ascribe to the
normal difficulties we all face. When a core belief is activated, your brain
switches into a mode in which you take in only information that supports the
belief, and disregard anything that may challenge it. This traps you in a
feedback loop of biased thoughts generated by that core belief.
When you’re caught up in negative core beliefs, it becomes difficult to
think realistically about the events in your life. Learning to identify and
challenge our core beliefs means these flawed ideas no longer make decisions
for us.
Negative core beliefs typically fall into two general categories: beliefs
associated with
helplessness
and beliefs associated with
unlovability
. See if
any of the examples below sound familiar to you.
Examples of Helpless Core Beliefs
I’m a failure. | anxiety.pdf |
e14f59ff0bf1-1 | Examples of Helpless Core Beliefs
I’m a failure.
Nothing I do will make a difference.
I’m helpless.
I’m inadequate.
I’m weak.
Examples
of Unlovable Core Beliefs
I’m unworthy. | anxiety.pdf |
db63d3e99642-0 | I’m bad.
I’m unlikable.
I’m unwanted.
I’m not good enough.
The downward arrow technique helps you look beneath the surface of your
anxious thoughts to see what’s really driving them. To find your core beliefs,
record your anxious thoughts, and then ask yourself, “If that thought were
true, what would it mean about me as a person?”
Let’s use Ava’s anxious thoughts as an example:
“I’m worried I’m not going to complete my report for work on time. I
second-guess my every move. I literally can’t stop obsessing about work even
for a few moments.”
Here is the downward arrow technique:
What does it mean about you as a person if you don’t complete the report?
“
That I’m letting my team down.”
What does it mean about you if you let your team down?
“My colleagues won’t respect me.”
What does it mean about you if your colleagues don’t respect you?
“That I failed.”
This reflects a helplessness core belief. Deep down, Ava believes she is
inadequate as a person. Likely she is underestimating her competence (more
on this later). | anxiety.pdf |
5c5f48c2bf6a-0 | Get your notebook and try the following exercise to get at your core
beliefs.
Identify a situation/interaction/image/thought stream that brings about
anxiety for you.
1.
Record the fearful/anxious thoughts you have about, or when you’re
in, the situation/interaction/image/thought stream (or revisit what you
logged for the
“Record Your Thoughts” strategy
).
2.
For each thought listed, ask yourself, “If this thought were true, what
does it mean about me as a person?”
3
.
Each time you understand what that thought means about you, write it
down.
4.
Then ask yourself the same question about new thoughts listed: “What
does it mean about me as a person if this thought is actually 100
percent accurate?” Then do the same for the next new thought.
Eventually you will funnel down to a core belief.
Let’s look at another example of the technique in action, this time with
Ahmed. When talking with others, Ahmed appears calm and collected, but
internally he is evaluating his every word. While on a date or social outing, he
believes he appears awkward. The downward arrow technique follows: | anxiety.pdf |
5c5f48c2bf6a-1 | What does it mean about you as a person if your date thinks you’re awkward?
“I messed up. I lost that opportunity.”
What does it mean about you if you messed up an opportunity with that date?
“That people will keep giving up on me.”
What does it mean about you if people keep giving up on you?
“
That I disappoint people.”
What does it mean about you if you disappoint people?
“That no one is going to want me.” | anxiety.pdf |
cce2afb1448a-0 | This reflects an unlovability core belief. Deep down, Ahmed believes no one
is going to love him.
After you use the downward arrow technique with a number of your
anxious thoughts, you will see certain core beliefs showing up repeatedly. The
next step is to start challenging these deeply rooted ideas you carry about
yourself.
STRATEGY: TEST YOUR CORE BELIEFS
In this exercise I’m going to push you out of your comfort zone so you can
see if your core beliefs are as accurate as they feel to you. I want you to
literally go out in the world and test your core beliefs—see if they actually
hold up to reality.
If you realize that at the root of your anxious thinking is a deep fear that
you’re unlovable, go out and talk to others, join a group, make a point to
spend time regularly with someone, or even ask close others if they like you.
If you recognize a core belief that you’re incompetent/helpless, go out and
take on a new but doable task: Sign up for a class,
create
something, clean
your house, organize a closet, build or fix something, read a book to
completion.
As you enter the situation, insert a different thought (even if you don’t quite | anxiety.pdf |
cce2afb1448a-1 | believe it yet!). It could be as simple as “I’m capable,” or “I can be liked.”
Be open to new information and to what you might be overlooking that
went well or differently from how you expected. Then modify your beliefs
about yourself accordingly.
Go
Deeper
Identifying Negative Thought Patterns
Developing awareness of your negative thought patterns will help you
take the steps needed to make you feel better sooner. When you become
aware that you’re experiencing anxiety, stop and take stock. Write your
answers in your notebook so you can delve into them.
•
What is a scenario that is anxiety-inducing for me, including
situations, interactions, events, and images?
Example: Every time my boss is short with me, I withdraw because I feel anxious and
worried that I’m not in good standing at work. | anxiety.pdf |
ffdc73b33d8e-0 | •
What anxious thoughts am I having (or did I have) about this
scenario?
He doesn’t like me.
He’s going to give me less work and make me unessential.
I’m going to be rendered useless at work.
•
How might my thoughts be distorted (label “errors in thinking”)?
Catastrophizing
Overgeneralizing
All-or-nothing thinking
•
What does it mean about me as a person if my most fearful thoughts
are true?
I’ll lose my job.
I’ll be embarrassed.
I won’t meet work goals.
People will know I’m incompetent.
•
What core belief was triggered?
Helplessness
•
How can I test out my core belief to see if I’m missing some
information?
The next time my boss is short with me, I won’t withdraw but instead will ask questions
about what he’s looking for to see if I’ve missed anything.
What
Are You Worried About?
Worry impacts our emotions in a big way. It influences what we do and how
we feel physically. We can come to exist in an exhausted, tense-muscled state.
This hyperarousal leads to irritability, difficulty sleeping, and eventually, even
depression. | anxiety.pdf |
ffdc73b33d8e-1 | depression.
Here’s a common example I see often in my psychology practice: A client,
Emma, had a repetitive worry that she was in danger of being kicked out of
her graduate program. Each time something went wrong with an assignment
or she received an average grade, a chain of uncontrollable thoughts would
ensue. She was afraid her professors thought she was incompetent. She
second-guessed herself in class and when she spoke out was extremely self-
conscious. Then she worried about what the other students thought of her.
Emma believed she wasn’t as intellectually competent as her peers. She
would beat herself up for always worrying: “What’s wrong with me? I’m so
crazy. I can’t stop worrying!” | anxiety.pdf |
f5daf7b85541-0 | No matter how hard Emma worked to push them away, the worried
thoughts kept swirling up, again and again. Even peaceful rest was
impossible. She would wake in the middle of the night harried by her
concerns and then be unable to fall back to sleep. Exhausted from school and
worrying, she didn’t take care of herself, eat right, or exercise regularly. As a
result, she also fretted
about
her physical health and began to think she had a
serious medical illness.
We all worry on some level, but it becomes disproportionate when it’s
persistent and uncontrollable. When this happens, we lose time to an internal,
not real-to-life focus. This hyperinternal focus is a vortex where no new
energy or perspectives are allowed in. The vortex distorts reality and creates
greater fear.
Excessive worrying is not problem-solving and is not productive. In fact,
the exhaustion and emotional depletion actually makes us less productive. We
aren’t able to concentrate, plan accordingly, and make the best use of our
energy and resources. And once again, we’re robbed of the present moment.
We typically come to recognize we’re in a vortex when the anxiety is | anxiety.pdf |
f5daf7b85541-1 | intense. At this point, it can be quite difficult to escape. The quickest solution
is to avoid this stage altogether. Developing an early warning awareness that
reacts before anxiety has reached high intensity protects us from becoming
stuck in the vortex.
STRATEGY: IDENTIFY YOUR WORRY
TRIGGERS
Even though we tend to worry about the same things day in and day out, we
persist in wasting time and energy considering each worry that pops up as if it
were
new
and deeply significant. Our worries repeat because we fail to
problem solve and cope with them appropriately. Identifying the larger issues
your worried thoughts trigger means you can switch from worried thinking to
problem-solving.
Below is a list of the more common larger issues that individual worries
tend to trigger, and example steps/actions to take to address each. Identify the
categories your worries tend to fall into and see if you can come up with a
few steps to take for each.
Financial
Actionable step:
Develop a budget; meet with financial planner
Job/school
Actionable step:
Enroll in a class; get tutor | anxiety.pdf |
f0c3593047b9-0 | Achieving goals
Actionable step:
Review expectations; are they too high, too low?
Parenting
Actionable step:
Read parenting book; take parenting class
Health of self
Actionable step:
Get yearly medical physical with blood work
Health of others
Actionable step:
Work to accept uncertainty; I can only control so much
Relationships
Actionable step:
Read relationship self-help book
Diet/
exercise
Actionable step:
Meet with nutritionist; start walking twice a week
Self-image
Actionable step:
Build self-esteem through volunteering; go to weekly psychotherapy
General safety of the world/community (politics, terrorism, environment)
Actionable step:
Volunteer for political candidate who espouses my beliefs
If mentally replaying worries made you feel better, you wouldn’t keep
hashing out the same old sets of worries. Shift your attention from specific
worried thoughts to considering how you could take an actionable step toward
improving the larger issue(s).
STRATEGY: PROBABLE VS. POSSIBLE
OUTCOMES
When we are caught in anxiety quicksand, each and every worrisome thought
may seem acute and reasonable. Stress hormones are released, anxiety builds,
and it becomes difficult to distinguish the | anxiety.pdf |
f0c3593047b9-1 | and it becomes difficult to distinguish the
probable
from the
possible
. Instead
of repeating the same concerns over and over in your head, write out the
following for each of your uneasy thoughts:
•
What is the worst possible scenario that I’m afraid of happening regarding
this thought?
•
What is the best possible scenario that I wish could happen regarding this
thought?
•
What is a realistic scenario that will likely happen regarding this thought?
You can be at peace. Slow down and train your mind to steer away from far-
reaching catastrophe and toward thoughts that represent the realistic, and most
likely, outcomes. | anxiety.pdf |
f7c65c894310-0 | STRATEGY: PRODUCTIVE VS.
UNPRODUCTIVE WORRY
Another helpful strategy when worry thoughts become triggered is to consider
how productive (useful, helpful in your life or to you) it is to worry about that
particular issue. When you recognize you’re worrying, classify worried
thoughts as productive or unproductive based on the following checklist.
Productive
□
My worry is in regard to a specific problem.
□
My worry is about something I’m going to have to deal with in the near
or immediate future.
□
I have some control over the situation’s outcome.
□
I can make a choice or decision that will solve the worry.
□
This is a new worry, something I don’t usually think about.
□
There’s an actionable step I can take to help alleviate my worry.
Unproductive
□
I’m worried about something uncertain in the future that no one knows
whether it will occur.
□
I have no control over this worry.
□
I think about possible ways to deal with the worry, but nothing feels good
enough.
□
I’m obsessively focused and can’t stop thinking about this worry.
□ | anxiety.pdf |
f7c65c894310-1 | □
This is a recurrent worry of mine.
□
There is no action I can take to solve this worry.
If your worry seems to fall more into the “unproductive” category, the next
time it pops up, remind yourself that it’s okay to live with some uncertainties.
In fact, it’s impossible
not
to. Remember to practice acceptance of things as
they are. On the other hand, if your worry is productive, make a plan for how
you want to problem solve the situation at hand. (There’s more on problem-
solving in
chapter 9
.)
Overgeneralizing and Underestimating
When we experience normal anxiety, we focus on the immediate concerns | anxiety.pdf |
303fc1decab9-0 | and challenges that no one is
immune
to, e.g., “Thanksgiving with the family
is going to be hard to get through this year.” The highly anxious mind
compounds these difficulties by extending them out across time and over a
variety of situations: “Every time I’m with my family, I get stressed out.”
Even worse, the anxious mind convinces us that we won’t be able to cope
with the thing we dread: “I can’t go to any more family functions, it’s too
upsetting.” As a result, we spin our wheels trying to prevent feared situations,
emotions, and/or interactions by avoiding people and events that don’t
actually pose a real threat. Of course, in reality, there’s only so much control
we have over the course of events, and so all this anxious energy results in us
feeling at the mercy of life, powerless, and desperate to find relief.
When we overgeneralize, we develop conclusions about ourselves, our
emotions, and what we can and can’t do based on a single experience. For
instance, Carmen found out she didn’t get her desired work promotion and
concludes: “I’ll never get promoted.” Nolan had a couple of unfulfilling dates
and concludes: “I’ll never meet the right one.” | anxiety.pdf |
303fc1decab9-1 | and concludes: “I’ll never meet the right one.”
Overgeneralizing causes you to seal the deal on your fate. In your mind,
you render your future chances of success or getting what you want at zero.
And perhaps most importantly, overgeneralizing means an end to trying. For
example, if you stop believing you will ever get promoted, you stop putting in
the extra effort at work.
If
you believe you won’t find a romantic partner, you
stop trying to engage new acquaintances or actively date.
The second component of the anxious mind is that we underestimate our
ability to cope if what we fear actually happens. We tell ourselves we can’t
possibly manage the frightening situation our mind is generating: “No way, I
wouldn’t even know what to do,” “I won’t be able to deal with that,” “That
would kill me,” “I’d go crazy.” In the face of a possible adversity, we imagine
ourselves melting into a puddle of anxious fear. This reinforces the
superstitious notion that worry itself will keep us safe: “If I worry enough, I’ll
be okay,” “If I obsess over this project, I’ll work harder,” “If I keep myself | anxiety.pdf |
303fc1decab9-2 | upset and on edge about this, I’ll be better prepared when it happens.”
This pattern can be broken. You’re capable of managing far more than
you imagine. Just because you don’t want to deal with something, or it may
be hard to deal with, doesn’t mean you can’t be effective. You have already
managed quite a bit in your life. You just do it; you push through to the other
side.
Go
Deeper | anxiety.pdf |
4bd13c16a27a-0 | Challenging Overgeneralization
Perhaps you’re recognizing some of your anxious thinking represents
overgeneralization. Nonetheless, you still can’t get the fear or thought
out of your mind. Start challenging those overgeneralizations. When you
hit a setback, ask yourself the following questions—and write your
responses down, if you can.
1.
Can you think of a time in the past when your conclusion has not
been true?
2.
Can you imagine a time or instance in the future when your
conclusion may not be true?
3.
How probable, from 0 to 100 percent, do you feel it is that the
fear you’re thinking about is going to actually happen?
4.
What do you gain by believing this thought? For example, do you
believe it keeps you safe in some way?
5.
What consequences may come from believing this thought? For
example, will you give up trying to get what you desire, allowing
a self-fulfilling prophecy to result?
STRATEGY:
SPOT OVERGENERALIZING
As we’ve seen, our worries and catastrophic thoughts often repeat. We
sometimes have new ones, but generally similar ones repeat over time and | anxiety.pdf |
4bd13c16a27a-1 | reflect the core beliefs we hold about ourselves. Open your notebook back to
the thoughts recorded earlier in this chapter.
Underline or put a checkmark by the thoughts that reflect a tendency to
overgeneralize. Clues that you might be overgeneralizing include:
•
Taking one example of something upsetting and believing that example
will occur again and again in a variety of contexts.
•
Extreme language: “This
always
happens,” “It will
never
be okay,” “No
one will
ever
like me,” “I’ll
never
win,” “I am
always
the slowest,” “I’m
the dumb one.”
•
When you hit a setback or receive negative feedback, you have thoughts
about giving up and putting less effort in to reach your goals.
STRATEGY:
STOP UNDERESTIMATING YOUR | anxiety.pdf |
6dd493355baf-0 | COMPETENCE
Try this visualization exercise:
1.
Think through one of your more upsetting thoughts or worst-case
scenarios. In your mind’s eye, play out the details of what you fear as if
it is really happening. Imagine where you are, whom you are
interacting with, or what news you’re getting.
2.
Now imagine your worst-case blocks, setbacks, or embarrassments,
but visualize yourself effectively coping with what you’re feeling or
the other feared obstacles.
3.
Instead of freaking out, giving up, or becoming painfully
uncomfortable with anxiety or fear, you stick with the situation. You
challenge yourself to find a way to effectively deal with your biggest
fear.
4.
Imagine you use a strategy (take a few deep breaths, use internal
supportive language, remind yourself of your larger goals) and it
works. You show yourself that you can cope. You find a way through
the circumstances and emerge in a more comfortable and thoughtful
place.
Practice this exercise and you will be much better equipped to deal with the
real thing.
WRAP-
UP
•
Become an observer of, not a reactor to, your thoughts.
• | anxiety.pdf |
6dd493355baf-1 | •
Keep a thought record to develop awareness of your anxious-thought
patterns.
•
Make anxious thoughts less threatening by identifying errors in thinking,
core beliefs, worry triggers, and overgeneralizations.
•
Increase your awareness for problem-solving versus unproductive worry.
•
When anxious about a future possibility, ask yourself, “Am I
underestimating my competence and/or overgeneralizing?” | anxiety.pdf |
41e756d0ec46-0 | CH
APTER NINE
Getting Unstuck from Thoughts
Changing Your Self-Talk
Anxiety increases in intensity when a person’s internal narrative is filled with
harsh judgments around good and bad, right and wrong. What we say to
ourselves influences how we think about ourselves, what we communicate to
others, and how much we believe in our competence and worth. Anxiety is
further amplified when a person’s internal narrative is overloaded with
generalizations—always, never, forever, everything, nothing. Consider which
of the following two statements is laden with greater intensity:
1.
“I suck, I’ll never get a life.”
2.
“I’m lonely and need to work on building social skills.”
The
latter is hopeful. It acknowledges the emotion but also identifies a
specific skill that could be developed to help with the feeling of loneliness.
If you’re struggling with anxiety, there’s a strong chance your internal
commentary is overly critical and harsh. But perhaps your anxious thoughts
and behaviors about situations and events have more to do with the critical
reaction you anticipate from others, and less to do with the situations
themselves. | anxiety.pdf |
41e756d0ec46-1 | themselves.
Imagine a friend who, every time you hit a setback, tells you what you did
to cause the problem and reminds you of all the times in the past you did the
same “bad” thing. That is likely how you’re treating yourself. People who
make us feel good about ourselves and comfortable being ourselves are the
ones we are most at ease with. Start relating to yourself in the way a warm,
kind friend or family member would. Changing the voice in your head to be
more self-supportive and nurturing will give you a bit of comfort—or
padding, if you will—when negative, anxious thoughts kick in.
STRATEGY: BECOME AWARE OF YOUR SELF-
TALK
How we speak to ourselves has a significant impact on anxiety. Yet we let our
anxious self-talk play out again and again on autopilot. Think about the
following
questions
regarding your self-talk so you can make the voice in | anxiety.pdf |
f0ac56778705-0 | your head more nurturing and less judgmental.
•
What is the tone of your internal dialogue? Is it loud and impatient, or is it
warm and tolerant of what’s going on with you and your immediate world?
•
When you’re upset, does your internal voice try to soothe you? Or does it
use intense/judgmental language that makes you feel worse, such as, “That
was bad,” “You suck,” “You’re never going to get this right,” “People hate
you,” “You’re a loser.”
•
Does your internal voice take away your moments of joy? When you’re
happy or feel at ease, does your voice intrude, telling you things you need
to work on, tasks that need to be accomplished, or fearful possibilities?
•
Are there certain tasks, hobbies, or people that bring out a kinder, warmer
side of you, where your internal voice seems softer, less critical? If so, these
are the things you should do more of and the types of relationships you
should cultivate. If not, experiment with different activities and people to
find those that bring out your softer side.
Cultivate your capacity for ease and calm, and encourage self-talk that is | anxiety.pdf |
f0ac56778705-1 | compassionate and forgiving. Self-compassion means showing yourself a
warm understanding of your perceived inadequacies, including
your
struggle
with anxiety. Forgiveness means voicing a kinder internal monologue when
you encounter a setback or notice your shortcomings.
STRATEGY: PINK UNICORNS
Write a few sentences about developing compassionate self-talk while not
thinking about pink unicorns. Whatever you do, stick to the task of writing
about developing a compassionate internal narrative, but make sure NOT to
think about pink unicorns. Pink unicorns should be nowhere in your mind
when you do this task. Each time you think about a pink unicorn, mark an X
in your notebook.
How did it go? Were you able to not think of pink unicorns? Probably you
were not and here’s why: Telling ourselves to not think about something has
entirely the opposite effect. This is partly why it’s so frustrating when we’re
upset and a well-meaning friend or loved one says, “Stop thinking about
that,” or “Everything is fine, stop worrying.”
Daniel Wegner, a renowned social psychologist in thought suppression at
Harvard University, asked lab participants to verbally share their thoughts | anxiety.pdf |
f0ac56778705-2 | while being sure to not call to mind the thought of a white bear. The
participants were asked to ring a bell each time they thought of a white bear.
Even though they were instructed to push away the thought, on average, they | anxiety.pdf |
983a95cf69d0-0 | brought
to mind the thought of a white bear more than once per minute.
When we suppress thoughts, we essentially tell ourselves to “stop thinking
about that!” The mind then monitors itself for each time it does think about
“that” and then brings “that” to our conscious awareness. Instead of
criticizing yourself to stop thinking or worrying about this or that, consider
challenging the thoughts that bring on anxiety.
STRATEGY: REPLACE NEGATIVE THOUGHTS
When you have a thought that keeps repeating in your internal narrative, pull
out this thought record.
1.
What triggered the thought? What were you doing or imagining when
the thought occurred to you?
Example:
Considering an invitation to a neighborhood potluck.
2.
What is the thought(s) that accompanies this trigger?
Example:
“No one will talk to me.” “I’ll feel like an outsider.” “I’ll feel
insecure.”
3.
Label the emotion(s) you feel when you have these thoughts and the
intensity of each
emotion
on a scale of 1 (less intensity) to 10 (extreme
intensity).
Example:
“Inadequate: 5, weak: 6, anxious: 9, dread: 9.”
4. | anxiety.pdf |
983a95cf69d0-1 | 4.
Is there anything that is not supportive of the thought(s) in #2?
Example:
“They invited me to the party, so someone wants me there.”
“I do make small talk with the neighbors from time to time.” “I live in
the same neighborhood, so we at least have that in common.”
5.
Can you think of a replacement thought that might be less negative but
still realistic?
Example:
“Even if people aren’t including me in every conversation, I
was invited, and I live in the same neighborhood so I’m not a total
outsider.”
6.
Revisit the feelings listed in #3. Rate each one when keeping this new
thought in mind. Recognize if the feeling(s) decreased in intensity,
even if only by a notch or two.
Example:
“Inadequate: 2, weak: 5, anxious: 7, dread: 7.”
Each time the negative thought enters your conscious awareness, | anxiety.pdf |
2e783ef9e4c5-0 | compassionately acknowledge it: “I see you, negative thinking.” Then bring
to mind a more
realistic
thought: “Well, at least they invited me.”
Problem-
Solving
In psychology, the tendency to work through negative events by replaying
them again and again in one’s mind is called
rumination
. Rumination refers
to internally focusing on anxiety/upset, as well as all the reasons, causes,
future possibilities, or risks that could occur due to this distress. An example
might be sitting alone, thinking about feeling behind your peers academically
and employment wise. Then your mind turns to worrying the situation will
never improve and imagining a future of always feeling inadequate and
professionally lacking. Next, you self-criticize about why this happened in the
first place. And then you may begin to look for ways to avoid people who
might ask questions about what you do for a living or where you went to
college.
Many people worry because they believe they are problem-solving and
engaging in a constructive process about the issues they face. Reminding
yourself of what is or could be of concern comes to be seen as a way of
avoiding denial and catastrophe. | anxiety.pdf |
2e783ef9e4c5-1 | avoiding denial and catastrophe.
In fact, rumination is essentially a passive process that leads only to more
anxious thinking. Overthinking, alone in your mind, leaves no room for other
perspectives or effective problem-solving.
Go
Deeper
Brainstorming
Take a more active, direct approach to working through your worries.
Brainstorming is a technique whereby you take the pressure off yourself
by acknowledging that there is no “correct” decision to make or a “right”
way to solve your issue.
1.
Pick an issue that you worry about on a regular basis or a new
worry that has come to mind. Write down a few sentences about
the area of concern.
2.
Now write down as many ideas as you can think of for how you
could manage the issue. Pay no mind to how outlandish or
impractical the ideas might be. There are no rules other than to let
the creative juices flow. | anxiety.pdf |
7a052ae9b7c2-0 | 3.
The goal here is to open up your process and escape repetitive
thought patterns. In fact, try to think of ridiculous solutions. This
can actually reduce the seriousness you may feel about the
particular worry. One client I worked with was struggling with
how to deal with a difficult roommate and came up with
the
thought, “Every time she annoys me I’m going to make a joke.”
At first this seemed silly to her, but the idea worked because it
decreased her tension and helped her not take the roommate so
seriously.
4.
Once you have a number of various solutions, think how each
possible solution would help or hinder the problem. Some things
will feel impossible and others will feel as if they barely help.
Pick one that is reasonably doable.
5.
Then take an actionable step; actively do something to relieve
your anxiety over this particular issue.
STRATEGY:
UN-LEARN HELPLESSNESS
Whenever you find yourself anxious or worried, notice if you’re feeling that
life and others are against you. Even if your blame is warranted, wallowing in
it is not going to help you achieve your goals or make you feel any better. | anxiety.pdf |
7a052ae9b7c2-1 | What will help you feel better is focusing on what is within your control.
Letting go of feeling at the mercy of life or circumstance creates a feeling of
safety and calmness. Here is a way to no longer face hardship with
helplessness:
1.
Pick an anxious thought or worry trigger.
2.
Recognize the thoughts that keep you in a helpless state over this
particular worry: “I’ll never find a way,” “It will always be like this.”
3.
Come up with three actionable steps you can take and that are within
your control.
4.
Take action.
For example, Layla was anxious about an upcoming wedding she had to
attend. She had lost touch with many of the folks invited to the wedding and
felt overwhelmed by worries over what they would think of her and how she
would be socially on the outside. In order to move away from wallow and
worry toward healthy control,
she
asked herself what she could do to improve
the situation. | anxiety.pdf |
403b6146a032-0 | •
Reach out to old friends before the wedding. Text, call, write a note.
Layla connected a bit before the event and even video chatted with one friend.
•
Imagine the day going the way you would like it to.
Layla visualized herself the day of the wedding being present and in the
moment. She imagined awkward encounters, or even feeling on the outside,
but in her visualization, she was able to cope and manage the situation
effectively. She visualized feeling proud of herself at the end of the event.
•
Practice deep breathing, yoga, or mindfulness meditation.
Layla practiced mindful breathing for 10 minutes a day leading up to the
event.
IMPORTANT NOTE:
An actionable item can be accepting a situation as it is and doing
nothing. Then each time the fear comes to mind, practice acceptance instead of rumination.
STRATEGY:
COST-BENEFIT ANALYSIS (OF
YOUR ANXIOUS MIND-SET)
Sometimes, clearly seeing the consequences for you of a worried mind-set
can motivate you to let go of the worry and come back to the present moment.
With this goal in mind, conduct a cost-benefit analysis of how beneficial it is | anxiety.pdf |
403b6146a032-1 | to you to continue to experience anxiety over whatever it is you’re ruminating
or obsessing on. Write out the consequences and benefits of worrying about a
specific issue.
Example:
Costs to keeping anxiety a focus
I’m removed from the present.
I feel bad.
I’m keyed up and physically ill at ease.
I’m stuck.
Benefit
to keeping anxiety a focus
I won’t be surprised if the bad thing I worry about happens. | anxiety.pdf |
d494b6c0da6c-0 | I will be vigilant, which protects me.
Decide which cost you’re most willing to accept and which option brings you
closer to your long-term goal of having more peace and less anxiety in your
life.
NOTE:
It can be quite effective to examine the costs and benefits after anxiety has lessened.
Once the intensity decreases, your brain has the bandwidth to problem solve and take on a
broader perspective.
You Are Not Your Thoughts
While visiting an amusement park with my young son, I became highly
anxious over his enthusiastic desire for me to accompany him on an old,
rickety roller coaster. As he happily pulled me into the line, worried thoughts
gripped me: “It’s rickety and old, what if it jumps the track?” “What if the
harness breaks when it goes upside down?” “What if the safety mechanisms
fail?” “What if they haven’t kept up with standards and regulations?” “What
if … What if … What if … ” Within a matter
of
minutes, I fully believed
catastrophe would strike if we rode the roller coaster. I wanted to stop us both
from taking the plunge.
Suddenly, as if waking from a trance, I saw the ride operator open the | anxiety.pdf |