“The greatest weapon against stress is our ability to choose one thought over another” -William James
One afternoon I was hyperventilating while trying to locate an office building in downtown Detroit. “What if” scenarios ran through my head at light speed as my breath seemed to slip away. It was a panic attack. Much of my adolescence and early 20's were spent in excessive worry. It wasn't until a co-worker expressed concern after this incident that I began to realize the way I was thinking wasn't working.
Over 40 million Americans are affected by an anxiety disorder, making it the most prevalent diagnosis in the U.S. It also costs $42 billion each year in medical costs*, not including total cost of lost productivity, unpaid time off, sick days, child care, etc. However, there is hope. Anxiety is also the most treatable and treated diagnoses with one-third of sufferers receiving some form of treatment. Usually A mixture of medication and behavioral therapy is the best combination to overcome anxiety.
With that in mind, here are a few techniques that can be applied today that will help lighten the tension hold of anxiety.
1. Write Out A Control List. First, it’s important to identify what exactly is making you anxious. Is it a fear of public places? A fear of of judgement or rejection? A fear of death, injury, trust, love, losing your home, your job, the apocalypse? Whatever it is, write it down. Next, divide the list into two columns. In the first column, write down the fears you have control over. Be honest here, do you really have control over the apocalypse, when you die, or what other people think? Most likely, no. In the second column, make a list of the things you do have control over.
The first column provides a list of aspects that cannot be controlled, and therefore worrying about them has no effect. The second column is a list of growth areas. A to-do list. Try focusing energy on the second column. Ask, “what can I do about this today?” If you’re afraid of losing your job, start applying for other position or have a discussion with your boss about your performance. I’ve found with clients that eight out of ten times their anxieties are either imagined or in vain.
2. Develop Awareness. Mindfulness meditation is simply the act of sitting in one place and focusing on a physical aspect of yourself, usually our breath, while remaining passively aware of our thoughts. Focusing on oxygen entering and leaving the body physically slows down the nervous system, which allows our minds to settle. If we try to control our minds in order to settle them, it will only disrupt it further. However, if we leave our thoughts be it will naturally settle like the ripples in a pond. If that sounds too far out, then take time to sit and simply observe the happenings around you. Try not to judge, but rather accept them as if observing the stars or a blowing field. This can be done anywhere at anytime.
2. Practice Your A-B-Cs. An important part of mindfulness is becoming aware of how our thoughts and behaviors affect how we feel. Anxious behavior is often a learned reaction to particular conditions and events. A useful tool is the A-B-C model used in Cognitive-Behavioral Therapy (CBT) to analyze and alter troubling behavior. Below is a breakdown of how this works:
A- Activating stimulus, event, action or condition (i.e. a crowded room)
B- Behavior or belief about the stimulus, event, action or condition (i.e. “This is overwhelming,” “I am going to embarrass myself,” sweating hands, shortness of breath)
C- Consequence of belief/behavior (i.e. leaving the room, isolation, avoiding crowded spaces)
Understanding this sequence allows us to become aware of the cause-effect relationship between certain situations and how we react to them. Likewise, breaking our beliefs and behavior down in this manner allows us to pick apart the aspects we have control over, which mainly falls under the ‘B” category. Though we may not have control over how crowded rooms may be, we are able to control our beliefs and reactions to them.
4. Face Your Fears...Gradually. After identifying what anxieties you have control over, set aside time to write out the A-B-Cs of the situation. This time can also be used to practice gradual exposure** to the event or condition triggering your anxiety. For example, overcoming a fear of crowded spaces can appear difficult at the outset. Our reaction to the situation seems instantaneous and overwhelming. However, by breaking the situation into more manageable steps, we can slowly overcome our fear of them.
Here is a breakdown schedule used for overcoming fear of public spaces (social anxiety):
Step1: Visualize a crowded room while remaining aware of how your body reacts and the thoughts going through your head
Step 2: Look at a photo of a crowded room, again, remaining mindful of the way you react
Step 3: Watch a video of people enjoying themselves in a crowd
Step 4: Observe a crowd from a distance, such as a park or farmer’s market
Step 5: Enter a crowded area for 10 minutes
Step 6: Enter a crowded area for 20 minutes
Step 7: Enter a crowded area for 20 minutes and speak with somebody
Step 8: Enter a crowded room and reman for 1 hour
This process should take place slowly, with each step occurring over a span of days or weeks. During the process, write down your beliefs and feelings about each step (ex. “Walking into the grocery store was terrifying”). Then, replace this belief with a more positive one (ex. “Walking in the store was OK, and I did not get hurt or embarass myself). Continue this process until the fear no longer impedes on your ability to function in the situation.
Hope For Healing
By accepting what we cannot control, practicing mindfulness and modifying our beliefs, we can relieve the hold anxiety has on our life. These techniques are backed by decades of research and have helped myself and my clients overcome their fears. Anxiety is self perpetuating, which means we add fuel to the fire. Becoming more aware of how we organize our life and what thoughts we choose is a crucial step. Remember, if you’re suffering from severe anxiety, there is hope. Explore resources in your area and seek help if anxiety is interfering with work or home.
*For more info about anxiety check out the Anxiety and Depression Association of America
**For more info about gradual exposure therapy click here.