• Alexis Cate, LCSW, CCTP, CASAC-T

Understanding & Conquering Anxiety

"I can't do this."

"How can this be happening to me?"

"I'll never make it through."

These thoughts have likely crossed your mind at one point in your life.

Whether it's recovering from a break up, going on a job interview, or trying to tackle a conflict with your best friend; #anxiety may creep in and do one of two things 1) foster avoidance from addressing the problems at hand, or 2) make it seem as if the problem is the scariest thing you've ever dealt with.

So how do we understand this process?

According to the American Psychological Association (2019), "Anxiety is an emotion characterized by feelings of tension, worried thoughts, and physical changes like increased blood pressure. People with anxiety disorders usually have recurring intrusive thoughts or concerns. They may avoid certain situations out of worry. They may also have physical symptoms such as sweating, trembling, dizziness or a rapid heartbeat."

There are a few points of this definition that I think are worth exploring further. The first being recurring intrusive thoughts. Have you ever had a fly stuck in your office, bedroom, or kitchen, and no matter what you just cannot seem to get rid of it? Despite not seeing it, you just know that it is there and it's irritating? That is just like intrusive thinking. No matter what you do, the thoughts are all consuming, hard to get rid of, and just down right annoying. You could be out with friends or enjoying time with your child and even though everything really IS okay, your thoughts are working against you. They are plaguing you with the idea that you're not wanted, that you are unloved. For some , intrusive thoughts can be so debilitating that they avoid socialization all together.

That brings us to our second point. #Avoidance. Nothing fuels anxiety more than giving in to it an AVOIDING your life. Avoidance is easily explained with respect to phobias. Do you hate the doctor for a check up or going to the dentist for a cleaning? Most of us feels some level of fear associated with these professionals, often because going to them means we will be poked and prodded a bit. Additionally, because there is always this underlying question of, am I actually, physically, okay? I've worked with many individuals who absolutely refuse to go to the doctor when they have some kind of discomfort or pain, because they fear the absolutely worst thing is about to happen or is going on with them. Side note* If you suffer from anxiety, please do not google any physical symptoms you may have, WebMD is not your friend!

Now, what do we do about it?

All that being said, there are a multitude of treatment options for someone suffering from anxiety. For some, psychotropics medications, as described by Dr. Dillon Browne (2018), are a go to as a means of taking the edge off that anxiety creates. For others, #psychotherapy, specifically Cognitive Behavioral interventions, are the key to fostering self-management.

For our purposes here, I feel it is important to provide you with my preferred take home techniques that I use with my patients in their sessions.

Step One: In order to conquer our anxious state, we first need to be able to identify how it is manifesting. Therapist Aid, LLC (2018) has a great user friendly worksheet that provides an overview of the possible errors in our thinking. I find it becomes a lot easier to take back control of our thoughts when we can identify and label the errors in them.

Step Two: Taking back control, literally means to take the thoughts and #challenge them! There is a Socratic questioning exercise I love to do with my patients. It's starts by asking:

"Is there evidence for this thought?" Now I like to break down the word evidence a little bit. Evidence meaning something factual and tangible.

For example, I was working with a gentleman a few years ago, who could not stop himself from fortune telling (refer to the worksheet above for more details). He would always convince himself that if he wanted or aspired to something, it would never happen, so why bother? One instance of this was asking for a raise at his present job. He had been working at this job for three years, was highlighted multiple times for his achievements on the job, and never even received a raise despite having finished his Masters Degree. With all that, he believed wholeheartedly, "I shouldn't ask for a raise, they'll deny me anyway, or worse, fire me."

So, we began our Socratic line of questioning.

I asked him for the evidence. He stumbled a moment, and after a few minutes of contemplation, revealed, "Well...there is none really."

Then I asked him if there was any evidence CONTRARY to his believe that he would be denied or fired. Another pause. "Well, I have been cited for my exemplary work. I did get my Master's Degree while on the job which improves my resume and employ-ability in my field."

We went further, "Are you looking at this situation from an emotional stance without having all the evidence at hand?" He laughed, "I guess this would be a good time to say that it's nerves and worry talking, isn't it?"

One of my favorite questions to follow up with is if you were to look at this from a more positive angel, how would things be different? I love this question because it can be so hard for us to answer, and that is where growth really comes to fruition, pushing oneself beyond their comfort zone.

We took a whole session processing this question. He felt that positive thinking only sets one up for disappointment. After the push and pull, he went out on limb and gave me a chance on this one. Ultimately, he decided if he was to be more positive than he would be able to ask for his raise with confidence and that confidence would propel him to feel that he was deserving of the raise after all, and thus, why wouldn't they give it to him?

Once more, would this whole thing matter, really matter in a year, five years, or even ten years from now? "Well, no. If they gave me the raise great, but if they didn't than I'd either stick it out a little longer or pursue work at another company, being assured I'd make a salary I feel more comfortable with since it'd be discussed during the hiring process."

Alas, the power of Socratic Questioning (and yes, he did get the raise)!

Step Three: Anxiety often offsets our #equilibrium. The best way to get ourselves back is to practice mindfulness through a grounding exercise. Jon Kabat-Zinn (2016), scientist, author, and widely recognized father of contemporary mindfulness, defines mindfulness simply as “paying attention in a particular way: on purpose, in the present moment and non-judgmentally.” I feel grounding techniques help up to find our footing, quite literally.

One technique I have found particularly helpful is engaging our 5 senses. What I love about this is you can do it anywhere, anytime! Initially, you settle in to a comfortable seated position in a chair, preferably, so your feet can be placed flat on the ground. Your hands placed gently on your lap. Take a deep breath in, 1-2-3-4, pause, and a big sigh out 4-3-2-1 (now I mean, I want to here some passion behind that exhale). First, engage your eyes, what are five things you can see. Then your hands, what are four things you can touch. What are then three things you hear? Moving to smell, what are two things or smell, or, two smells that bring a smile to your face? Lastly, what is one thing you taste, or, the last good thing you tasted? Maybe it was your morning coffee, or a buttered croissant. There you have it, you are grounded with your 5 senses and in the present (#mindful).

Ideally, with these three steps you'll find anxiety to be something you can manage, not something that takes over.

Now go on and be empowered

Alexis Cate, LCSW, 2019

Disclaimer: I recommend if you are suffering from anxiety or any mental health disorder to always consult your doctor or a mental health practitioner. The above article may not benefit you and thus it is always important to seek help in real time!

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