by Jill Weber
•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
•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.
CHAPTER 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 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 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 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 ✓
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.
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.
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 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.
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sp; 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.
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 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?
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!
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.
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.
CHAPTER 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 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 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 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 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.
•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.)
