One of the most important things in working with anxiety is helping people change their relationship with their anxiety.
With any intense emotion, in some ways, it’s important to make friends with it, to tolerate it and recognise that any emotion is a form of communication with your and from yourself. It’s a signal to pay attention, to pay attention to what is this trying to tell me? What is this feeling, this emotion, this anxiety trying to tell me about myself, about my relationships, about the world?
So, I think the first piece of the work is to try making friends with it.
An often useful metaphor is: A child is laying in the bed and fears the monster under the bed. What does the parent do?
We might always think that it would be a good ideas a parent to turn the light on. Get a torch and look under the bed for the monster rather than sitting on the bed and saying tot he child, “Oh my god, the monster’s there.”
If we sit on the bed and don’t look at the monster, and we don’t say, “Hi, monster. What’s going on?” – then the monster continues to grow bigger and bigger. Yet when we turn the light on and really look at what’s there, it’s then that we can begin to manage how we’re going to deal with the monster if there’s a monster there. And if there is, how are we going to deal with that monster and communicate with it effectively?
Another way of managing anxiety is to find a message and meaning in it. I believe meaning-focused work can be helpful with many issues.
One of the dynamics that present barriers to managing anxiety has to do with focusing on the future or the past, and not being able to stay focused in the present.
If we think about worry, it’s focusing our attention on the future. If we think about rumination, it’s focusing our attention on the past. Worry and rumination both take us out of the present.
So, intervening in ways that help people ground themselves in the present moment can reduce anxiety. That way, we’re not living in the future of worrying what’s going to happen? or living, ruminating the past, playing over and over in our minds some past situation we regret.
Another metaphor that many people have heard, and is attributed to Cherokee people is the story of the two wolves.
The grandfather is telling his grandson, “There’s a war going on inside of me between two wolves. And one of the wolves is very, very evil and bad and is filled with anger and arrogance and envy and all these negative emotions. And the other wolf inside of me is really good and filled with empathy and love. And the same fight is going on inside of you, my grandson, and going on inside of everyone.”
And the grandfather pauses, and the grandson reflects for a moment and asks the grandfather, “Well, which wolf is going to win?” The grandfather pauses and says, “The wolf that you feed.”
So that idea that it’s what we feed that grows. And if we’re feeding anxiety and fear and anger, if that’s where we’re focusing our attention, then that’s what’s going to get bigger and bigger and bigger. If we feed kindness and love and self-compassion, then that’s what’s going to get bigger.
One of the things that I’ll work with clients on is what their life would look like if they fed the good wolf.
If your energy was put towards feeding the good wolf, what would that entail? What would you need to do differently to nurture and put energy towards those things?
The first one is in relationship to what I was just sharing, and it’s called the FACTS. F-A-C-T-S — Foundational Attention Centering Techniques.
The FACTS are things like meditation, breathing, and visualization. These are strategies to focus attention in different ways. And these are skills that can be learned.
Particularly for people who have a lot of anxiety, being able to ground themselves in the present, in their bodies, in their breathing, and assemble a visualisation or a mantra, is centering and meaningful to people. So, that’s one set of the core four strategies – again: the FACTS, Foundational Attention Centering Techniques.
The next cluster of techniques that I think is helpful for anxiety are the expressive-creative strategies.
We can help people identify whether it’s expressive arts— drawing, painting, finding expression for the turmoil that’s inside. Active creative activities – problem-solving in terms of inventing something or fixing something, where the attention is on using cognitive processes in the service of creativity. Creating arts as well as daily things — fixing a car, working on a car — having those kinds of outlets are creative expressive strategies. Or, physical movement — dance, sports, athletics, things where we are engaging in expression. So that’s the second.
The third is reflection exploration strategies. Another set of techniques for managing anxiety would be, as I mentioned with the other question – journaling, writing, avenues for reflection where we can take a step back and get a little observing self-activated, really ask ourselves questions about, “What am I thinking? What am I feeling?” Self-monitoring. “When do these things come up? What triggers my anxiety?” So the reflection exploration is about getting to know yourself better. Any strategy that can help you be aware of, again, the triggers, to be aware of the thoughts and feelings. That could also involve dialog, talking with someone, having a sounding board for one’s thoughts and feelings. Again, reflection. Reading, learning, reading articles, getting informed — that gives you a stimulus for reflection.
So the first three — the FACTS, the expressive-creative strategies, the reflection exploration strategies. And then the fourth is what I call healthy lifestyle and values congruent self-care.
We’re looking at four areas of turning your attention. And again, all these have a commonality of where we put out attention – turning our attention to healthy habits, healthy relationships, healthy pleasures, and a healthy world.
So, what kind of healthy habits can we develop? The healthy habits that relate to diet, nutrition, and exercise all help with anxiety management. Healthy relationships, healthy pleasures.
So how do you relate to anxiety: you can go down the list of all the ways that you respond once anxiety has come up. One of the first ways you can change your relationship is to change your initial interpretation of what it means that you’re feeling anxious.
Most people’s initial interpretation of anxiety is, something really is wrong, or something really bad is going to happen, or there’s something really wrong with me – I don’t belong here.
And one possible other interpretation is, this anxiety is arising because I care about this; I care about this person; I care about this situation.
There are other possible interpretations: this is a moment that matters, or, anxiety is arising because anxiety is how I do life. I mean, there’s a lot of different interpretations you could have. But that’s one relationship you can change: that very first thing you say to yourself about what you believe it means. You can also change your habits of behavior, which is the sort of non-avoidance; if you know that, when you feel anxious, the first thing you do is you try to escape it by avoiding the cause of the anxiety – maybe you start to work on that behavior if that happens. Maybe you notice, when that’s not possible, you try to numb what you’re feeling with a drink or with food; maybe you start to change that habit.
You can also change your relationship to your anxious self. You can have more compassion for the part of you who is anxious rather than feel like if you were the right kind of person, you wouldn’t have anxiety; there’s something wrong with you; there’s something wrong with your brain – that sort of broken brain model of anxiety. You can also develop different brakes for the anxiety.
So, what do you do when the anxiety feels like it’s spiraling out of control?
Most people’s attempts to break it are avoidance, or control coping – where people have rituals where, if they do something, they can make themselves feel better. In dysfunctional anxiety, often people are insensitive to safety or support to you – so something that you can change your relationship to is, when you’re trying to put a brake on the anxiety spiralling out of control, you can maybe think about attending to safety cues or support cues: In this moment, are you safe? Are you breathing? Who supports you? Who cares about you?
The resources that I know we’re going to talk about – that there are a lot of other things you can use as brakes to the system spiralling out of control. So those are all things that I would consider part of your relationship to anxiety.
The great thing, as we’ve been talking about, is, when you change these things, you really do change your experience of anxiety – and sometimes the anxiety goes away, sometimes it doesn’t. But you have so much more freedom and flexibility in response to the anxiety and having the choice in how you respond to your anxiety is a key art of relieving it to some degree.
Four Core Strategies to Neutralize Stress and Anxiety
Shelly Harrell, PhD, Kelly McGonigal, PhD, Rick Hanson, PhD and Ruth Buczynski, PhD