Approaches and Techniques

In this post I will cover several approaches to help you manage anxiety.  As discussed in the previous post, the first step to managing anxiety is to simply notice and name it.  You cannot address that which you turn away from, and it is common to turn away from anxiety because it is unpleasant and because some consider it to be a sign of moral weakness.

In order to manage your anxiety it is important to identify the pattern(s) it takes.  How does it manifest itself?  What tends to precede and follow it?  Does it follow a typical course once it begins?  Does it fit a pattern which is associated with a diagnosis such as generalized anxiety disorder, panic disorder or social anxiety disorder?  How does it differ depending on your life circumstances?  There is power in simply noticing and naming a problem because it is the first step toward addressing it.  You cannot change that which you cannot identify or acknowledge.

Once you have identified the pattern(s) of your anxiety, the next step is to notice how you talk to yourself in general about things that provoke anxiety.  It is common for people with anxiety to talk to themselves in a negative way, layering pessimistic (even catastrophic, “what-if”) thoughts on top of self judgment for being anxious.  It is important to break this habit and instead to be as compassionate with yourself as you can.  It is also important to speak to yourself as kindly, constructively and positively as possible.  The way we talk to ourselves influences our state of mind as well as our physiology.  Learn to notice when your thoughts are telling you that something is worse than it really is and train yourself to be more realistic and compassionate instead of pessimistic and critical.  You don’t have to believe everything that you think.

You may be thinking to yourself that it is easier said than done to just start thinking positively and kindly.  This is true.  You probably developed your thinking habits over a substantial period of time and it will take some time and concerted effort on your part to change them, but it is possible.

Let me give you some suggestions for how to start to train your brain to talk to yourself well.  You start by monitoring your own thoughts, in particular the ones which are anxiety provoking.  There are three basic distortions which contribute to anxiety: over-estimating the likelihood of a negative outcome, over-estimating the severity of a negative outcome and under-estimating your ability to cope with a negative outcome.

Look for examples of each of these distortions as well as of instances of self judgment in your thinking.  Write them down.  Then cross them out and replace those words with words that are more realistic and kind.  The more consistently and systematically you do this the more habitual it will become to think realistically and with kindness toward yourself.

When you write the counter statements, it is helpful to write them in the positive, to keep them in the present tense and in the first person and to have them be statements that you can actually believe.  In time you won’t have to write the negative thoughts down because you will learn to mentally intercept and counter the types of thoughts which needlessly provoke anxiety before they have an opportunity to do so.  It just takes practice and repetition to learn more constructive ways of thinking.  When you have gotten to the point that you can catch yourself in the midst of anxiety provoking negative self talk use the following shorthand to correct yourself: notice and name, reframe and counter.

The next strategy corresponds to the step referred to as attending and befriending.  When you notice that you are anxious, find your way to some place that is quiet and calm.  Tune into how the anxiety feels in your body even though this seems counter-intuitive.  Where and how do you experience the anxiety in your body?  Try not to fight against it because doing so just adds another layer on top of the anxiety.  Rather, just be with it and note that there is a you who is noticing it (in other words notice that you are not the anxiety, you are the one who is able to observe it). This subtle distinction helps to give you a significant distance from the anxiety, so that you are not completely identified with it.

When it gets too overwhelming to attend to the anxiety switch to noticing your breath instead.  Deliberately breath deeply and fully from your abdomen.  It is difficult to be tense and to breath from your abdomen at the same time.  When you feel that you can, go back to noticing how the anxiety feels in your body.  Has it shifted in any way?  If so, notice how.  Pay particular attention to how you can tell that the anxiety is dissipating in your body.  Keep shifting between paying attention to how the anxiety is experienced in your body and then breathing deeply and slowly from your abdomen until the anxiety subsides or at least lessens.

The next strategy is related to the step referred to as acting out and reaching in.  This is where you take concrete steps to approach (as opposed to avoid) the things that make you anxious.  Make a list of the things that you are avoiding doing because they make you anxious.  Prioritize the list.  Break the items on the list down into very small steps.  Give yourself a very simple goal to accomplish — something extremely manageable from the list.  It doesn’t have to be a whole item, it can be just a small step or two toward one of the items.  Once you have accomplished some part of something check it off the list so that you can see that you have made some progress.  Make a commitment to yourself to keep working away at your list on some sort of a regular basis.  Each time you accomplish something, check it off the list and give yourself credit.  If you can’t bring yourself to accomplish something from the list, you can start by imagining yourself accomplishing it until the idea of actually doing it is no longer overwhelming.

Stay tuned for the next post in this series which will be about the brain and the neurobiology of anxiety.

 

Anxiety Series Part Three: Approaches and Techniques

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