by Jill Weber
Check-In
For the kind of change that really lasts for the long term, it’s important to check in with yourself and see how you’re progressing. Otherwise, you may fall back into those same old anxious habits. Checking in is a way to stay focused on your goals and to notice which strategies are working or which you may want to add or change.
Check in with yourself to take stock of what’s going well and also what you’ve lost sight of on your path to a peaceful life. And as you also take stock of your setbacks, recommit to persevering. Rewiring the brain takes practice and time.
How Did You Do?
Start by reflecting on how you’re doing every couple of days. Then as you notice your symptoms improving, check in once a week and then eventually monthly.
•How successful were you with your daily goals?
•How about your weekly goals?
•Based on the 1 to 10 scale, are you noticing any symptom improvement?
Improvement may be subtle at first, but any reduction in the intensity of your anxiety, even going from an 8 to a 7, is an improvement. If you weren’t as successful as you’d like, try things differently. Swap out the strategies you’ve been using for others, and be honest about what’s blocking you from making more progress. Remind yourself that you want this, and you can and will have peace of mind and a meaningful life.
STICKING WITH IT
Any time we make a change or learn something new, we experience disappointments and obstacles. When you hit setbacks, take a moment to consider what negative thoughts or beliefs you have about your ability to get better and start new techniques.
For example, you might have the thought, “Doing these exercises will improve my anxiety,” and simultaneously think, “These exercises are hard, so I probably won’t get anywhere.” Consider incorporating more realistic thoughts. For example, “Other people have done this and made themselves better, so maybe I could change,” or “I don’t have to implement the strategies all the time or be perfect at it to improve.”
Each day you’re one step closer to your goal of emotional freedom. Don’t give up. You will come out on the other side of your anxiety. What’s on the other side? Ease within your body and your mind. The kind of ease that will enable you to steadily push out of your comfort zone so you no longer miss out on all life has to offer. You can and will achieve, connect, and live a fully present life.
Reading about the strategies means you’re no longer resigning yourself to an anxious life. This change alone, of giving yourself new ways of thinking and managing your anxiety, perhaps more than any other, will deliver the peace and calm you deserve. Now keep going. Don’t give up; you’ve already come so far.
What You’ll Learn in This Section
Recognize that you do have the ability to manage your anxiety and experience the kind of ease and calm you want. This confidence doesn’t have to come all at once. However, it’s something we’re all capable of building, and this section addresses how to stick with the strategies for the long term. One element is learning to celebrate your successes. Recognition of progress, even when it comes in very small increments, fuels your ability to be persistent, and persistence is the path to new learning. We will also look at how to sidestep the negativity bias, nip anxiety in the bud, and clarify which strategies you want to maintain throughout your life. And we will explore ways to accelerate your progress on the anxiety-reduction path—including building your support network, psychotherapy, and medication.
CHAPTER ELEVEN
The Road Ahead
Long-Term Outlook
It is estimated that one in five adults in the United States meets the diagnostic criteria for an anxiety disorder. As prevalent as anxiety is, it is also highly responsive to treatment. But how can we tell who will get better and who won’t? Well, I see it consistently in my practice, and research backs this up: When people adopt these three “beliefs” they typically are able to learn, sooner rather than later, to manage their anxiety symptoms.
1.Believe you need to change: Doing the same things you’ve always done keeps you stuck. Open yourself up to new ways of thinking and behaving and you’ll start changing.
2.Believe in the strategies: Self-doubt and second-guessing the process is only a distraction from building the new habits that will take you away from anxiety and toward greater calm. The strategies in this book are all evidence based, which means research has proven their effectiveness. The strategies work, they really do!
3.Believe in your ability to grow: As we’ve seen, people just like you all over the world experience anxious patterns yet find sustained peace of mind, so why couldn’t this be you? Believe in yourself, and you will gain control over your anxiety.
Your Biggest Victories So Far
Take a moment to remember what emotions and habits were ruling you before you read this book. Now, like playing back a reel of sports highlights, look at your greatest victories so far. Perhaps you couldn’t connect with your other emotions, except for anxiety, and now you’re no longer afraid to look under the anxiety and understand what you’re really feeling. Or perhaps you’ve found ways to relax your body and not feel as physically keyed up.
Maybe you’ve stopped avoiding something, or a few things, that have long caused you fear and apprehension. Maybe the concept of acceptance, that anxiety is a part of human experience, has opened up space so there’s a “you” now separate from being anxious.
Or maybe you’ve found ways to become unstuck from or challenge your fearful and anxious-thought patterns. You may even have moments now where you’re able to observe your thoughts or feelings without becoming overwhelmed by them.
If you’re thinking about your struggle differently, if you’re engaging new ways of thinking or behaving, consider yourself victorious. Now keep on doing what’s working.
Your Biggest Challenges So Far
What have been your biggest challenges so far? Perhaps you continue to struggle and have not yet seen any noticeable benefit. Or perhaps the improvements feel too small and not impactful enough.
It can feel impossible to keep believing in yourself and your treatment approach when you’re not noticing any measurable change. Take a firm look at the facts.
•Are you following the strategies?
•Do you believe the strategies will work?
•Do you believe in yourself and your ability to improve and live the life you deeply desire?
Also, consider if there are specific strategies, or even entire sections of the book, that you find particularly challenging. Reflect on what has been the hardest for you to accept, to take in, and to change. Consider whether you might benefit from additional support to help you with the rougher patches (more on therapy and medication in chapter 12). Give yourself compassion for going toward what’s difficult, and for not giving up.
The Road to Progress Isn’t Always Straight
Change doesn’t unfold in a straight line, although we often believe it should, which is why when we confront setbacks we become self-critical and start to doubt ourselves. This kind of thinking sabotages progress and contributes to us giving up entirely.
The reality is that setbacks and failures along the path to change are inevitable for everyone. Our brains have the miraculous ability to rewire, to grow, to change; however, our brains also cling to what’s become habit. This contradictory tension means change does not come immediately or without effort. Sustained change, the kind that really makes a difference, takes time and consistency.
Each time you hit a roadblock, instead of self-criticism and self-defeat, consider the roadblock a signal of your growth and progress. After all, if you were still stuck doing what you’ve always been doing, you wouldn’t have come across a roadblock. When progress on the anxiety-reduction trail stalls, or even halts completely, it means you’ve likely progressed, more than you imagined, and that’s why the setback bothers you. Setbacks are part of your brain’s adjustment process. Keep persisting, don’t give up, and
return to the strategies again and again. It will pay off.
Go Deeper
Gratitude
Recognizing what we’re thankful for increases well-being, contentment, and peace of mind. The negativity bias, as we’ve seen, is wired into our brain as a survival mechanism. We tend to dwell on, relive, and attempt to problem solve the negative more than the positive. When this process isn’t buffered by joy or contentment, we become more anxious.
We can counter the negativity bias easily and in only a few minutes a day. Adopt a daily practice of identifying two or three things that you appreciate. You can write these in your notebook or internally reflect on them. What’s important is to bring conscious and deliberate attention to what is going well, or at least okay, in your life or what you feel positively about within yourself.
Building Your New Habits
Once you’ve been successful with a strategy, take it to the next level. Practice the strategies on multiple occasions across a variety of settings.
For example, if you fear eating out in public, don’t decide to just go to the same restaurant with the same friend over and over. Instead, challenge yourself to go to a variety of restaurants and with a variety of people. It’s great to become comfortable knowing that you’re no longer going to have a panic attack in your local movie theater, but consider branching out to other theaters in nearby towns or even going to a play or a concert. Or if you’re working on obsessive thinking, don’t just work on it when you’re at your place of employment. Work to be mindful, an observer, when home alone, when driving, even when interacting with others. Practice the strategies across a variety of situations/people and you’ll eventually start using them instinctively.
The more you act the way you wish you could act, and do the things you used to avoid, and think in the ways that bring peace of mind, the quicker new habits will form and then, before you know it, they’ll become automatic.
Exercise: Catch Anxiety Early
Catch anxiety early, before it’s left the barn, so to speak, and you’ll stop it in its tracks before it becomes too intense to pull back. A way to start catching anxiety early is to develop a quick and easy habit of checking in with yourself. So instead of rushing from task to task, person to person—intentionally STOP. Take time to be mindful of your ongoing experience. Here’s how:
•At the end of the day when you arrive home, STOP before entering. Reflect for a few moments; check in with yourself.
•When you end one encounter, STOP. What’s going on in your body, your mind? What sensations do you notice?
•When you finish a task, STOP. Reflect on what tinges or shifts might be happening mentally or physically for you. Literally say to yourself, “I want to see you. What’s going on in there?”
Tune-Ups and Check-Ins
As you move along your anxiety-recovery path, you may find there are stretches of time when you’re no longer deliberately thinking about the strategies. You may feel that you’re “in the zone,” able to effortlessly manage life’s hardships.
Still, even with progress, it’s easy for us to go back to old ways of thinking and acting. Consider placing sticky notes in key locations (car, bedroom mirror) or reminders on your digital calendar of the strategies that are working well for you so you keep them top of mind and use them even when you may not feel like you need them. Also, set a reminder on your calendar once or twice a month to review the material in this book and what you’ve written in your notebook (even if you think you don’t need to!).
Goal Setting
Each time you reach a goal, consider the strategies that got you there and if it’s possible to expand those strategies to reach even larger goals. For example, perhaps you implemented “total worry time” (here) and it worked. Now that you’ve discovered its effectiveness, consider making it a goal to do this strategy on a daily basis. Or if you recognize that “Watching Your Thoughts” works when under stress, consider implementing this strategy every day while driving to work, with or without stress.
Once your overall anxiety level decreases, you’ll likely find that you think about your goals in new ways and find deeper, more meaningful, ways to impact your life. And as your well-being increases, the overall picture of the path forward will no longer bring dread but instead pleasure and optimism. You have much to look forward to!
Exercise: What’s the Big Picture?
Refocus on the bigger picture in which overall strategies are important to you in maintaining your less-anxious life. These are the strategies that either worked well for you, or are linked to something you care about, like an active social life. Here’s a list of some of the things my clients keep in mind. Make a list of your own.
•Physical exercise
•Daily mindfulness
•Physical health
•Live your best life
•Acceptance
•Challenge your thoughts
•Exposure
•Make space for yourself separate from your anxious thoughts
CHAPTER TWELVE
Building Your Support Network
Human connection relieves anxiety. Looking another person in the eye and sharing our vulnerable moments, aspirations, and setbacks soothes our nervous systems. If you’ve been caught in anxiety’s grip for some time, you may not have had the mental space to sustain close family or friendship ties. One-on-one meetings with a therapist or group therapy are ways to start garnering some in-person support. Online anxiety-reduction tools also can be helpful. Sharing your goals, progress, and setbacks with others offers a sturdy brace that will give you encouragement and perspective as you find your way.
Finding a Therapist
Be Calm is for you to use on your own, or with a therapist if you have one. You can find relief on your own if you’re persistent and stay with it. However, you will want to participate in psychotherapy if you’d like to accelerate the learning process, deepen your self-awareness, if you have little social support, or if you’ve implemented the strategies and are not feeling much relief or progress.
Psychotherapy in a sense is a mini laboratory where you can try out your new skills with another human in real time. Unlike your “real” life, the therapeutic life is safe and confidential, and the therapist has no connection with your outside relationships or broader life.
Often, working with a therapist can be tremendously effective in understanding yourself and in developing a support network outside of therapy. The past, in particular unprocessed grief and trauma, has a significant impact on the persistence of anxiety symptoms. Consider weekly psychotherapy to help you work through past trauma and loss that may be impacting your ability to feel sustained relief from anxiety.
As we’ve seen, anxiety frequently masks other negative emotions that you may be unaware of or have not yet processed. Talking with a therapist can help you uncover those negative emotions and identify what’s causing them. Very typically, anxiety lifts when you enter therapy and start the process of exploring your deeper emotions and issues. You may be faced with other complicated emotions, but awareness of them will significantly accelerate the recovery process.
Medication
In some cases, medication along with psychotherapy is the best approach for anxiety reduction. This should be considered only after using the strategies in this book on a consistent basis and meeting with a licensed mental health therapist or clinical psychologist. If you and your therapist believe medication could be helpful, set up an appointment with a psychiatrist. Psychiatrists have specific training in how drugs impact emotions and behavior.
If you decide to try medication, be wary of benzodiazepines and prescription painkillers (including Xanax, Ativan, and Clonazepam/Klonopin). Benzodiazepines and sedatives work right away to bring down anxiety, which provides relief in the moment, but over time it’s easy to become dependent on them. Also, if you use sedating medication you will be unmotivated to implement the strategies and your brain will be less able to retain the new ways of dea
ling with anxiety. And there is a rebound effect when benzodiazepines and painkillers wear off. Anxiety typically comes roaring back in, even stronger, and then you’ll feel the immediate need for more of the drug.
Selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) are generally more effective for anxiety reduction over the longer term. However, it’s essential that you undergo a full assessment with a psychiatrist for an accurate diagnosis and appropriate medication regime.
Getting Referrals
Accessing support, whether with a psychologist, a psychiatrist, or a support group, is a way to enhance your recovery process as you move toward your goal of anxiety reduction. Often, a good place to start is with your general practitioner. Talk to your medical doctor about your symptoms and see if they can refer you to a psychotherapist or clinical psychologist.
Online search engines can also be quite helpful in getting a referral. The Anxiety and Depression Association of America website has a “Find a Therapist” link that will connect you with licensed mental health providers in your geographical area who specialize in the treatment of anxiety. Some of the listed mental health professionals also provide telemental services (online therapy) through video conferencing, phone, or email.
The Social Anxiety Institute website also provides a referral list of treatment providers as well as other resources for lessening social anxiety. The American Psychological Association, a professional organization for psychologists, has an online tool to find a psychologist near you, as does Psychology Today where you can read various therapists’ profiles to see who might be a good fit.
