Adapted from Wehrenberg, M. (2005). Psychotherapy Networker, Sept/Oct, 47-59. ****
Method 1: Manage the body.
Taking care of your body by eating right, avoiding alcohol, nicotine, sugar, and caffeine, and exercising is a strikingly ordinary “prescription,” but not doing these things can undermine the effectiveness of other anxiety techniques.
A tip to remember for female clients who experience a resurgence of symptoms in spite of the fact that they’re managing their body is to consider hormonal changes. Pregnancy, postpartum changes, hysterectomy, and interruptions in cycles may contribute to anxiety. Shifts in thyroid function also contribute to shifts in anxiety. They can occur at any age, and predominate in female clients.
The simple rule - manage the body -must remain a first priority when managing anxiety.
Method 2: Breath.
Diaphragmatic breathing can be highly effective for warding off anxiety. The technique is simply to breathe deeply once faced with a stressor. People who think this is not helpful often fail to try it, or quit trying the technique after a brief time of relief.
Deep breathing will slow down or stop a stress response, but the technique must be attempted to work. To get into the practice, try doing conscious, deep breathing for about one minute at a time, 10 to fifteen times a day, every time you are waiting for something – the water to boil, the phone to ring, a doctor’s appointment, the line to move at the bank. This will eventually help you to associate breathing with many of the surrounding activities. This way, you are more likely to actually remember to breathe when anxiety spikes.
Method 3: Mindful awareness.
A wonderful technique, this simple “mindful awareness” exercise has two simple steps, repeated several times:
- Close your eyes and breathe, notice your body, how the intake of air feels, how the heart beats, what sensations you have in the gut, etc.
- With your eyes still closed, purpose-fully shift your awareness away from your body to everything you can hear or smell or feel through your skin.
By shifting awareness back and forth several times between what’s going on in your body and what’s going on around you, you learn in a physical way that you can control what aspects of your world - internal or external - you’ll notice. This gives you an internal locus of control, showing you that when you can ignore physical sensations, you can stop making the catastrophic interpretations that actually bring on panic or worry.
Method 4: Don’t listen when worry calls your name.
Few realize that the feeling of dread is just the emotional manifestation of physical tension. This “Don’t Listen” method decreases this tension by combining a decision to ignore the voice of worry with a cue for the relaxation state. You must first learn that worry is a habit with a neurobiological underpinning. Even when a person isn’t particularly worried about anything, an anxiety-prone brain can create a sense of doom, which then causes hyper-vigilance as the person tries to figure out what’s wrong.
A technique is to pay attention to the order of events: You will quickly recognize that the sensation of dread occurred before the conscious thought of worry. It is relieving to realize that dread is just a physical function of the brain sometimes, without a legitimate cause to worry. The dread can then serve as a cue to exercise deep breathing to relax, instead of getting wrapped up in unnecessary worry.
Method 5: Knowing, not showing, anger.
Many of us have learned to fear the feeling of anger because of past experiences - recalling the terrifying rage of a parent, or having been severely condemned for showing any anger ourselves. These experiences make the very feeling of anger a trigger for anxiety, thereby making it likely that our angry feelings become unconscious.
To undo the anxiety provoking feeling of unconscious anger, follow this technique. Make yourself journal on this question: “If I were angry, what might I be angry about?” Restrict your answers to single words or brief phrases. Because the question is hypothetical, it makes it easier to reveal unknown sources of anger. Without fail, this exercise has helped anxious clients begin to get insight into the connection between their anger and their anxiety, which can lessen the angry feelings that build into anxiety.
Method 6: Have a little fun.
Laughing is a great way to increase good feelings and discharge tension. The problem for anxious people is that they take life so seriously that they stop creating fun in their lives, and they stop experiencing life’s humorous moments. Everything becomes a potential problem, rather than a way to feel joy or delight.
A couple of ways to get more playful is to spend time with younger children or go with a benign “impulse” that has no greater agenda. Over time, listening to your inner wishes can help you feel a reservoir of pleasure in life, and it is great practice for giving yourself time to find fun.
Method 7: Turning it off.
It can be quite difficult to turn off the mind of a worrier. Imagine the mile-a-minute super-salesman, for example. He has remarkable drive and also a capacity to fret. His mind travels from one possible problem to another like a pinball that never comes to rest. Even as he goes to bed, his last conscious awareness at night is a worry.
The concept of “clearing space” can help turn off and quiet the ruminative mind. Sit quietly with your eyes closed and focus on an image of an open container. Then see and name each issue or worry, and imagine putting it into the container. When no more issues come to mind, mentally “put a lid” on the container and place it somewhere that you can return to. After this step, you have free space in your mind to consider the one most important issue that needs attention. For example, if in the evening, you can invite peaceful thoughts of relaxation. Only after the container is put away and space is cleared, can the mind have a chance to rest or calm down.
Method 8: Persistent interruption of rumination.
Worrying has a life of its own, consistently interfering with every other thought on the mind. A common technique for interrupting chronic worry is the thought-stopping technique. In thought-stopping, negative thoughts are neutralized by visualizing a bright red stop sign and hearing yourself yell “STOP!” in your head.
The key to this technique, however, is persistence. Most people quickly pick up the thought-stopping technique itself, but they’re always shocked by how rumination can subvert all their good efforts, and by how persistently they have to keep at it to succeed. It is important to do the technique every time you catch yourself worrying, even if it is 100 times a day or more!
Method 9: Worry well, but only once.
Some worries just have to be faced head-on. For example, what if you were going to receive serious medical news in a few weeks? In cases like this, worrying about the issues the right way can help eliminate secondary, unnecessary worrying.
Here’s how that works.
- You must worry through all the issues
- Do anything that must be done at the present time
- Set a time when it’ll be necessary to think about the worry again
- Write that time on a calendar
- Whenever the thought pops up again say, “Stop! I already worried!” and divert the thoughts as quickly as possible to another activity.
Method 10: Learn to plan instead of worry.
When we have a worry, we always try to get rid of it by seeking assurances that are unrealistic. The worried mind believes that if it finds the right kind of solution to the problem - the right piece of information or the best reassurance - then it will be rid of worry once and for all. In reality, however, a ruminating brain will simply find some flaw in the most fail-safe reassurance and set us off on the track of seeking an even better one!
One good way to get out of the reassurance trap is to use the fundamentals of planning. This simple skill can make a big difference in calming a worried mind. Here are the steps for making a plan:
- Concretely identify a problem
- List the problem-solving options
- Pick one of the options
- Write out a plan of action
You must use the thought-stopping technique during this process, or planning can turn into an endless cycle of re-planning.
Once the plan is complete, it will be reassuring for a while. However, the worried mind will start the cycle of seeking reassurance inevitably. In response to this, you must remind yourself that you have already made a plan and do not need to worry any longer about this issue.