by Jill Weber
When it comes to your anxiety, you likely try to deal with it all on your own. This is hard. Try expressing yourself; tell trusted friends or family and get their support. Sharing a bit about your struggle and how you’re working on getting better will make your goal more real and increase your likelihood of success. And it will boost your ability to believe in yourself. Joining an anxiety support group in your community or meeting with a therapist will also help keep you on task.
Another way people self-sabotage is by asking too much of themselves too soon. Start with smaller goals and build from there. Even a little bit of something different creates the scaffolding for more and more growth. Your belief in your ability and your motivation to improve will strengthen each time you are successful and each time you check off implementing a strategy on your calendar.
STRATEGY OF THE DAY
Pick a strategy from this section that resonated with you, and work that strategy into your schedule on a daily basis this week. Helpful daily strategies include practicing acceptance, letting go of judgment, and/or mindful breathing. Before you implement the strategy, visualize yourself doing it. For example, visualize yourself getting up a little earlier and practicing mindful breathing for 10 minutes. After visualizing, practice the strategy in real time each morning.
STRATEGY OF THE WEEK
Pick another strategy that you can work into your calendar at least three times this week. This does not need to take a long time; choose one reasonably achievable for you. For example, this week, commit to brisk walking or light jogging for 20 minutes three times, or schedule a full medical physical with your doctor, or complete the “What Stories Are You Telling?” strategy.
Go Deeper
Create Your Weekly “Anti-Anxiety Calendar”
Purchase a weekly or monthly planner or use your digital calendar on your tablet or phone. Then look over the current month. If you have not already done so, write in any work, social, and family commitments and appointments.
Habit formation comes faster when we teach our brains the behaviors we’re trying to cultivate on a daily basis. Write in one strategy from the chapters in this section that you’re willing to employ every day of the next month.
Now think about when your anxious moments might be during the coming month. Are there specific days of the week or times of the day that you anticipate being particularly anxious? Or are there specific commitments that always trigger your anxiety?
Get ahead of your anxiety by identifying strategies to use before you encounter anxiety-provoking situations, and write down a strategy that you think will be particularly suited for that specific trigger. For example, if you’re going to have a pressure-filled meeting at work, you might write on your calendar “express your feelings through writing” when you get home that evening. Or if you’re anticipating being annoyed with a friend or family member, you might practice “exploring anger” before the visit so you’ll be more aware of and better able to manage your irritation.
Check-In
It’s all too easy for the brain to slip back into old habitual patterns. One extremely effective way to prevent backsliding is to make a regular practice of checking in with yourself and consider the ways you’re improving/changing.
When you check in, you can assess what’s going well and what you might have lost sight of on your path to a peaceful life. And you can recommit to persevering. Rewiring the brain takes practice and time.
How Did You Do?
Start by reflecting on how you’re doing every couple of days. Then, as you notice your symptoms improving, check in once a week and then eventually monthly.
•How successful were you with your daily goals?
•How about your weekly goals?
•Based on the 1 to 10 scale, are you noticing any symptom improvement?
Improvement may be subtle at first, but any reduction in the intensity of your anxiety, even going from an 8 to a 7, is an improvement. If you weren’t as successful as you’d like, try things differently. Look for other ways to fit in the strategies and be honest about what is blocking you from making more progress. Remind yourself that you want this, and you can and will do it.
STICKING WITH IT
Whatever you do, please, please be sure to recognize and celebrate your successes. I have worked with many people who make major progress, but once the progress is made they minimize or dismiss it. When that happens, they self-defeat future progress.
For example, Hannah started therapy not being able to get a moment’s respite from panic, feeling on edge, and muscle tension. She was so consumed by her constant worries that she could not be present, let alone enjoy her life. She made the decision to take charge and became gradually more at ease emotionally and physically. Hannah integrated various techniques into her daily routine and her symptoms improved. She started working again, enjoying sporting events, and spending time with friends.
Sometimes she would have a reoccurrence of panic and find herself in a familiar trance where her entire focus was riveted to worries piling up. It also threw her into a self-critical spiral. Suddenly thinking she had made no progress at all, she would abandon the strategies that had brought her relief.
Progress is not a straight line. Setbacks are part of any growth and change process. Anyone who has raised a child can recall a baby finally sleeping through the night for a few solid weeks. You think those sleepless nights are behind you, then, ugh, the baby starts waking again.
Nevertheless, the typical pattern is for setbacks to become fewer and fewer over time. Eventually the new behavior becomes routine.
Every couple of weeks, reflect on where you started. Remind yourself of what your life was like then and how that anxious life motivated you to adopt a program to improve. Freedom from anxiety is here for you. Open up to the ease and calm that is within your reach. You are worth the investment.
What You’ll Learn in This Section
Imagine again the triangle with “Feelings” written in one corner, “Behavior” in another, and “Thoughts” in the third. Any change in one corner of the triangle will impact the other two. That insight is at the core of all the strategies in this book. In this section, we are going to focus on your anxious behaviors and how we can change them. Anxiety generally results in two main behavior patterns: avoidance and escape. These two patterns of behavior allow us to limit, or even totally eliminate, our contact with whatever makes us feel anxious. Reducing contact with anxiety triggers makes us feel better temporarily. But avoidance and escape patterns come with hidden costs; one of the most serious costs is that they actually increase anxiety over time.
This section is designed to help reduce your anxiety-driven behaviors. Because of the interconnectedness of those three points on the triangle, this will, in turn, also help reduce anxious thoughts and feelings. For example, if you commit to taking the elevator every day even when your anxiety tells you to avoid it, you will change your thoughts (“Hey, elevators aren’t so scary after all”) and your feelings (over time, you won’t experience as much fear when you take an elevator).
Responding to anxiety with avoidance/escape behavior makes your world smaller and smaller. Eventually you may lose tolerance for even day-to-day, basic interactions. As we explore strategies to tackle avoidance/escape behavior, we’ll focus on specific self-defeating habits, doing what you fear, accepting anxiety, and increasing your tolerance for uncertainty.
CHAPTER FIVE
Avoidance & Escape
The Avoidance Paradox
Imagine standing in front of a beautiful pool on a sunny day. The pool is full of swimmers making the most of the sunshine. You’re in your suit and poised on the edge of the water, looking as if you are ready to dive in and join them. But in reality, you’re frozen with indecision. Yes, part of you wants to jump in. You want to make the most of life and enjoy connection with others. At the same time, a big part of you dreads the shock of the ice-cold water. You’re stuck. You see others enjoying the pool, lau
ghing and frolicking freely. You, however, stand on the side. You feel alone. You feel different. You pace. You sit down. You start to imagine people are staring at you, and your anxiety increases. You go back and forth in your head: “Should I jump in? Or not?” You nurture your initial impulse to avoid the cold water with more avoidance. As a result, your fear grows stronger. Finally, you decide to sit out the pool experience. You feel instant relief, but feelings of self-consciousness and isolation soon arise. Your decision to avoid limits your enjoyment, your spontaneity, and your social life, because your fear has taken control.
The swimming pool is a simple example, but there are many ways we avoid what we fear: We avoid by indecision, by not showing up, by not following through on commitments, by distracting ourselves with meaningless activities, by making excuses and rationalizations.
No longer avoiding what you fear means paying attention to how you feel, not just at the moment you avoid, but over the longer term. Sure, avoidance brings a temporary reprieve—“I’m dreading facing my boss today . . . ah, I’m going to call in sick . . . what a relief to not have to deal with that jerk!” The temporary relief reinforces the tendency to avoid. But the reprieve is almost always short-lived. New anxiety creeps in and takes over. What felt like the sweet taste of freedom becomes bitter with self-critical thoughts about the consequences your avoidance may bring. What will your boss think of you for not showing up? What if you get fired? How will you pay your bills? Are your colleagues criticizing you for not coming in?
Far from relaxing and enjoying a day off, you’re spinning back and forth in your mind. Eventually all that anxiety keeps you stuck in avoidance; you don’t go to work not only that day, but also the next day and perhaps even the next. Now you likely have actual negative consequences to face.
Avoidance feels protective in the short term, but in the longer term generates real peril and more anxiety than ever. It’s worth keeping in mind that the fundamental problem is not the anxiety, but how you respond to it.
Hardwired to Avoid
The fight-or-flight response is produced by an area of the brain often called the “reptilian brain” due to its primitive nature. The reptilian brain evolved very early and relies on an unsophisticated operating system; within milliseconds we flee (avoid/escape) a perceived threat or freeze in place, before we even process the apparent danger. From an evolutionary perspective, this instant all-or-nothing response is effective because, after all, we don’t want to waste precious time on details when we encounter a real physical threat.
On the other hand, the reptilian response doesn’t work so well at helping us figure out how to address problems that provoke anxiety but are not actually threatening. And in modern life, that describes most of the problems we encounter. Even a genuinely scary situation—like a performance review with a boss you don’t like—isn’t an immediate threat to you. But your reptilian brain doesn’t know this, and may react to your fear with a fight-or-flight response that’s unhelpful in a professional setting.
In other words, the fight-or-flight response can be triggered even when real danger doesn’t lurk. Once the information regarding the perception of danger makes its way to our more evolved “upstairs brain,” we’re able to rationally determine what level of risk the threat truly poses, as well as problem solve and act strategically. But we have to give that information a chance to get there, without getting stuck in the response generated by our reptilian brain.
When Avoidance Becomes the Problem
Ask yourself if you reflexively avoid or overreact to things that pose no real danger to you. Things that, had you paused and considered more carefully, you might have realized weren’t actually such a big deal.
By avoiding the things or situations that trigger you, you’re essentially deciding that they are too much for you to manage, when in reality you could deal with them. This diminishing ability to believe in yourself only increases future avoidance. Among other misleading thoughts, your anxious mind probably seriously underestimates your capabilities (more on this in chapter 8). Let’s look at how to start changing your tendency to avoid.
STRATEGY: WHAT ARE YOU AVOIDING?
As we’ve seen, avoidance and escape only beget more avoidance. The avoidance loop continues because it’s a habit that becomes unconscious. A helpful step is to consciously identify what you’re avoiding so you are no longer doing it on autopilot.
Take a moment to reflect on your patterns of avoidance. What do you avoid that only causes you problems in the long run? Here are clues that suggest you’re ducking something that matters or has meaning to you:
•Saying you will do something but then not following through.
•Procrastination: delaying a task until tomorrow . . . then the next day . . . and the next.
•Making rationalizations, justifications, and excuses for why you can’t do something. (“My alarm clock didn’t wake me up.”)
•Wasting energy/time on trivial thoughts, tasks, and interactions as a way to distract you from what you should or need to be doing.
•Frequently telling others, or yourself, that you don’t feel well physically and that’s why you can’t do something.
Make a list in your notebook of what you avoid. Keep this focus top of mind, 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.
•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 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 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 question, make a comment, or clarify something
