Relaxation promotes production of the chemical norepinephrine in the body. Low levels of this neurotransmitter can result in depression, so to feel better, participate in activities that foster relaxation.
There are many self-care and healing measures you can use to reduce your anxiety. Unlike medications, most have few or no harmful side effects. Whichever ones you choose, remember that if you want to overcome the fears or needs beneath your anxiety, you must face them. Stop waiting for circumstances to be just right before you act. Take small steps toward reducing your anxiety. As the saying goes, nothing ventured, nothing gained. If your anxiety is still bothering you as you read this, it’s time to make a change and try something new.
As you start to see accomplishments from trying one or more of the procedures in this chapter, you’ll feel new strength and improved self-esteem. Remember to acknowledge the positive things in your life. Even when you’re anxious, make a real effort to remember some past positive experiences instead of focusing on the negative ones. Avoid catastrophic thinking. Ask yourself, “What is the worst thing that could happen in this situation?” You’ll usually find the outcome is something you can survive, even though it might not be pleasant. Once you face the unpleasant situation, rather than try to hide from it, your self-esteem will soar. You’ll be proud of yourself for taking control and conquering your fears.
Aim to stay focused. Much of your anxiety is the result of projecting yourself into future situations. Stay in the present, the here and now. That’s the only thing you can control, anyway.
Take one step at a time and give yourself permission to retry an approach. You can go back and redo steps of the approach as many times as you need to so that you’re comfortable and satisfied with the outcome.
In this chapter you’ll discover the anxiety-reducing and healing measures I’ve found most useful and effective, both personally and professionally. They’re listed alphabetically for easy reference. I suggest you read through all of them before deciding which one(s) to try first. Keep in mind that combining measures is often more powerful. For example, imagery, progressive relaxation, and self-hypnosis work well together.
Accepting Your Anxiety
Often when you try to control your anxiety or pretend it’s not there, your anxiety builds. Claim it. Let go of your need to control and try anxiety-management strategies instead. Be patient with yourself and take it one day at a time. Chart your progress by keeping track of your moments of anxiety and when they occur. Once you do that, you’ve already started to gain a sense of real control because you now have enough information to do something about it.
Act As If
Role-playing practice can help you act the way you want in upcoming anxiety-provoking situations. Find a supportive partner and practice acting the way you wish you could be. You may surprise yourself and find something within that you never knew you had. Begin with the idea that you’ll only make small changes, then try out your idea and pay attention to what happened when you tried to act differently. Remember, you don’t have to perform perfectly, you’re only practicing. Be brave and see what happens.
Ted wanted to ask Doris to marry him, but he was anxious about proposing, fearing she might reject him. He tried to tell himself she’d agree to his proposal, but it didn’t work and he still worried. Practicing role-playing with his counselor, Ted found he was able to stay calm even when his counselor didn’t react positively to his proposal. They practiced the scene several times in several different ways until Ted felt confidant he could handle Doris’s response, no matter what it was.
Accomplishment List
Before you end your day, write down the five most important things you want to accomplish the next day. Be sure to be specific. Number each in order of its importance. The next day, start working on your number-one priority. Try to complete as many as you can that day, but don’t worry if you can’t finish them all, because you will always be working on what is number one in importance to you. If you find your top priority seems too overwhelming, break it down into manageable steps, two or more high-priority goals to work on. Give yourself a pat on the back each time you accomplish one of your priorities.
Acupressure
You can use your fingers to release anxiety. Acupressure is the use of the fingertips on specific body points to release blocked energy. One of the simplest acupressure holds that can reduce anxiety is to rub the webbing between your thumb and index finger.
To prepare yourself to use light-touch acupressure, place the three middle fingers of your right or left hand on the outer aspect of your other forearm. Let your finger pads rest lightly on your other arm. Use enough pressure so you can begin to feel a pulsation coming from the fingertips. Balance the pulsation in all three fingers so that they match and are strong and even. This is the effect you will strive for in each of the areas of your body listed below.
Calm can be restored by massaging points on the body as follows:
Acupuncture
Acupuncture involves the insertion of stainless-steel needles at precise anatomic locations. The needles may be stimulated by moxibustion (the burning of the herb Artemisia vulgaris) and cupping, a suctioning of the skin through the application of small jars in which a vacuum is created. Magnets of various sizes and shapes may also be used. Your insurance company may even pay for it. Acupuncture practitioners use pulse or tongue diagnosis, and talk about your qi, or energy, and whether substances are Yin or Yang.
Sam suffered from frequent anxiety attacks that included rapid heartbeat, difficulty sleeping through the night, restlessness, and dry mouth. He tried psychotherapy but it wasn’t helping. A friend told Sam about the benefits of acupuncture and Sam tried it. He slept deeply during the first treatment. Eight treatments later, Sam reported that his psychotherapy was now going well and he was sleeping through the night.
If you’re chronically anxious, you may be too tense to relax, let alone sleep well. Acupuncture can often bring on a deep state of relaxation. Acupuncture can also help you relax enough to bring to the forefront emotional issues that are holding you back. If you decide to have acupuncture, carefully observe (and have someone else record) your moods, dreams, or unusual mental states that can occur for several days after a treatment.
Affirmations
Affirmations are positive thoughts you choose to immerse your consciousness in to produce a desired effect.
We all carry on negative dialogues with ourselves. Called “self-talk” by Dr. Albert Ellis, author of A Guide to Rational Living, much of this is left over from earlier family experiences. Affirmations provide positive messages to counteract negative messages we have received and may be inflicting on ourselves.
Louise Hay, guru of affirmations, suggests in Heal Your Body that anxiety is due to not trusting the flow and the process of life. She suggests repeating, “I love and approve of myself and I trust the process of life. I am safe.”
There are other affirmations that may also be of help to you. Choose from the list of affirmations below or devise your own positive statements. Just make sure you either say or write them twenty times a day for at least a week. It is also suggested that you write your affirmations on three-by-five cards and place them on your bathroom mirror, on your desk, in your bag or briefcase, and any places that you visit frequently.
Some affirmations to choose from include:
Affirmations Especially for Panic
Affirmations Especially for Phobias and Fears
Affirmations Especially for Intrusive Thoughts and Ritualistic Actions
Affirmations Especially for Post-Traumatic Stress
When Affirmations Don’t Come Easily
You may be able to use affirmations right away and find them useful. Or you may be like Julie and need to take a different approach.
Julie, a twenty-one-year-old college student, was having difficulty following through with her exercise regime to control her anxiety. She had heard about affirmations and asked me how to use them. I proceeded to help her find an appropriate affirmation to use. At first it seemed she was ready to develop an affirmation to exercise, but as we talked it became clear she wasn’t ready to take responsibility for exercising. That’s when we phrased the following affirmation: “I, Julie, am finding it easier and easier to accept the idea of exercising to relieve my anxiety.”
The first few weeks Julie repeated the affirmation she didn’t seem to believe what she was saying. By the second week she said, “You know, maybe exercising will help.” Julie continued saying her affirmation and carried the written form of it with her on a three-by-five card wherever she went. The following week, Julie said she had mastered the affirmation and was ready to develop an affirmation about exercising. She chose the following affirmation: “It’s getting easier and easier to exercise every day.” By the next week, she had enrolled in a yoga class and was taking line-dancing lessons.
Alexander Method
The Alexander Technique is a way to help you let go of anxiety and tension through mind/body awareness. The most important word here is let. The theory is that if you deliberately try to move a neck that’s stiff from anxiety or force anxiety-paralyzed legs to move, it won’t work. Instead, think of freeing your neck. That way, your mind sends a message to your neck muscles to let go of tension.
Try the application that follows to see if this method may be beneficial for you.
Autogenics
Autogenic Training (AT) is a systematic program you can use to relax and reduce your anxiety. You use verbal commands to effectively reduce your anxiety. AT was developed by Oskar Vogt, a famous brain physiologist in the nineteenth century. He taught individuals to put themselves into a trance to reduce tension and fatigue. The goal of AT is to normalize the physical, mental, and emotional processes that can become unbalanced by anxiety. Johannes H. Schultz, a Berlin psychiatrist, found that you can create a state very much like an hypnotic trance just by thinking of heaviness and warmth in your extremities.
AT has proven to be most effective with generalized anxiety, but it can also increase your resistance to anxiety and reduce or eliminate sleeping disorders. At least one study found that autogenic training provided relief for the majority of participants suffering from panic. AT should not be used with children under age five, or with anyone suffering from a severe mental or emotional disorder. Check with your health-care practitioner if you have a chronic disease such as diabetes, or heart conditions or high blood pressure. If you feel very anxious or restless while practicing AT or experience disquieting side effects, discontinue AT or use it under the supervision of a professional AT instructor.
Take from four to ten months to master all six exercises, using one- and half-minute sessions five to eight times a day. As you become more comfortable with AT, gradually increase the length of sessions to thirty or forty minutes twice a day. Just let what happens happen and don’t try to analyze it.
There are three AT positions:
Adjust the AT program to your own pace. Be patient and don’t move too fast; make sure you’ve mastered one exercise before moving on to the next one. If you have trouble achieving a sense of heaviness, picture heaviness, weights weighing you down, gently sinking, or whatever works for you. If you have difficulty experiencing a feeling of warmth, picture your arm lying on a warm heating pad or imagine being in a nice warm shower or bath, or sitting outside in the sunshine. If you have difficulty becoming aware of your heartbeat, hold your hand over your heart.
Weeks one to three focus on heaviness. Weeks four to seven focus on warmth. Week eight focuses on heartbeat, week nine on breathing, week ten on your solar plexus (skip this one if you have ulcers, diabetes, or any bleeding in your abdominal organs), week eleven focuses on your forehead, and week twelve focuses on individualized themes.
Week 1: Start with your right arm and repeat each statement four times. (If you’re left-handed, start with your left.)
My right arm is heavy.
My left arm is heavy.
Both of my arms are heavy.
Week 2: Repeat the following statements for 3 minutes, four to seven times a day.
My right arm is heavy.
My left arm is heavy.
Both of my arms are heavy.
My right leg is heavy.
My left leg is heavy.
Both my legs are heavy.
My arms and legs are heavy.
Week 3: Repeat the following statements for three minutes, four to seven times a day.
My right arm is heavy.
Both of my arms are heavy.
Both of my legs are heavy.
My arms and legs are heavy.
Week 4: Repeat the following statements for 5 minutes, four to seven times a day.
My right arm is heavy.
My arms and legs are heavy.
My right arm is warm.
My left arm is warm.
Both of my arms are warm.
Week 5: Repeat the following statements for 8 minutes, three to six times a day.
My right arm is heavy.
My arms and legs are heavy.
My right arm is warm.
My left arm is warm.
My right leg is warm.
Both of my legs are warm.
My arms and legs are warm.
Week 6: Repeat the following statements for 10–15 minutes, three to six times a day.
My right arm is heavy.
My arms and legs are heavy.
Both of my arms are warm.
Both of my legs are warm.
My arms and legs are warm.
My arms and legs are heavy and warm.
Week 7: Repeat the following for 10–20 minutes, three to six times a day.
My right arm is heavy.
My arms and legs are heavy.
My arms and legs are warm.
My arms and legs are heavy and warm.
Week 8: Say aloud the following statements for 10–20 minutes, three to six times a day. (If you experience any distress with this one, stop it and try again in week 11.)
My right arm is heavy.
My arms and legs are heavy and warm.
My heartbeat is calm and regular.
Week 9: Say aloud the following statements for 10–20 minutes, three to six times a day.
My right arm is heavy and warm.
My arms and legs are heavy and warm.
My heartbeat is calm and regular.
It breathes me.
Week 10: Say aloud the following statements for 10–20 minutes, three to six times a day.
My right arm is heavy and warm.
My arms and legs are heavy and warm.
My heartbeat is calm and regular.
It breathes me.
My solar plexus is warm.
Week 11: Say aloud the following statements while lying on your back for 10–20 minutes, three to six times a day.
My right arm is heavy and warm.
My arms and legs are heavy and warm.
My heartbeat is calm and regular.
It breathes me.
My solar plexus is warm.
My forehead is cool.
Week 12: Say one or more of the following statements for 10–20 minutes, three to six times a day.
My mind is quiet.
I feel serene and still.
I am at ease.
I picture and experience myself as relaxed and comfortable.
I feel quiet and serene.
I feel an inward quietness.
Breathing Awareness
Breathing is essential for life. If you’re breathing in the upper part of your chest, not allowing sufficient blood to oxygenate the lungs, brain, and other tissues, you may be adding to your anxiety.
When anxious, you are probably restricting your breathing even more, increasing muscular tension, anxiety, and irritability. Have you noticed how when you feel anxious, you tend to halt your breathing? When you start to feel anxious, deep breathing can help relax you. But there is a specific way to breathe to obtain anxiety reduction.
Relaxing breathing is deep and comes from the diaphragm or abdomen. Tense breathing occurs in the upper chest and is fast and shallow.
Become aware of how you breathe by:
To achieve abdominal breathing, begin finding a quiet environment where you won’t be disturbed. As you reduce noise and other demands on you, your mind will turn inward. Begin to notice the rhythmic rise and fall of your chest. As you focus on your breathing, you will naturally begin to breathe more slowly and deeply and your body will shift into a more relaxed mode. Gently suggest to your body that your breathing will move lower in your body, toward your middle, toward your navel.
Harvard psychologist Dr. Joan Borysenko, author of Minding the Body, Mending the Mind, is one of many mental-health professionals who believes that breathing effectively is a great way to break a cycle of anxiety. When you keep your mind and body busy with breathing, anxiety disappears.
Alternate Nostril Breathing
One way to calm the mind and reduce anxiety is through alternate nostril breathing. This type of breathing, as well as others, can rapidly reduce blood pressure. Use the directions that follow:
Breathing and Imagery
Breathing can be combined with imagery to reduce anxiety.
Breathing Retraining
Rapid, shallow breathing (hyperventilation) can bring on panic, heart palpitations, and other symptoms associated with fearful situations. In one study, individuals trained to breathe normally while being exposed to threatening environments showed a marked decrease in their fear of being in open or strange areas and of leaving the house (agoraphobia).
Based on a combined analysis of twenty-eight published studies, researchers concluded that relaxation training and controlled exposure to panic-inducing situations are two very effective psychological techniques. Breathing retraining uses these two approaches to help you prevent panic attacks.
To retrain your breathing, you must learn to feel relaxed while doing abdominal breathing and then picture upsetting situations. This builds up a history of breathing calmly while picturing an upsetting situation (your brain doesn’t know the difference between imagining an upsetting situation and experiencing one) that you can call upon and use during real-life events.
Follow the directions given below to retrain your breathing:
Identifying Overbreathing
When you’re anxious, you breathe more rapidly and shallowly. You may even have an ongoing tendency to overbreathe. This kind of breathing sets you up for hyperventilation. Look for the following signs:
Although hyperventilation is harmless, it can give you the impression you don’t have enough air to breathe, that you’re smothering or breathless. If you’re a woman, you may have been taught to hold your stomach in and your chest up. This can lead to shallow breathing and hyperventilation.
There are four things you can do to stop hyperventilation:
Chromotherapy
Chromotherapy is the use of color to heal. It has been practiced since ancient times in early Greece, China, and India. The theory behind chromotherapy is that colors of light in the visible spectrum are lower “octaves” of higher vibrational energies that affect the chakras, or energy centers, of the body. The crown chakra, located at the top of the head, is the focus of treatment in anxiety. In this case, the color to be used is violet. You can wear violet clothes, buy swatches (one foot by one foot) of violet cotton cloth and place them on painful areas, or visualize breathing in the color violet. Use the directions that follow for color breathing:
Depending on the issues you’re facing, you can also use other colors, specifically:
Coping Skills
Coping-skills training includes a combination of progressive relaxation and stress-coping self-statements that are used to replace the defeatist self-talk called forth in stressful situations. You can rehearse coping-skills procedures in your imagination to prepare for real-life events that raise your level of anxiety.
This rehearsal is important, because according to Dr. Aaron Beck, author of Cognitive Therapy of Anxiety and Phobic Disorders, we all respond to situations with a tendency to think and react in a certain way. In the cognitive therapy approach, the thought that precedes the feeling is changed to elicit more positive emotion. If you tend to be depressed, you will interpret a splash of water from a passing car during a rainstorm as convincing proof that you are a failure, there is no need in proceeding any further with the day, and you might as well go back home to bed and pull the covers over your head.
If you suffer from anxiety, you will probably interpret situations like the water splash as a personal danger or threat. If you have a tendency to obsess, you’re probably most likely to interpret the rain splash as evidence of threat of contamination. If you have social anxiety, you may start to sweat, flush, and shake, the very things you’re anxious about doing and having other people observe. If you tend to have panic attacks, you may interpret a speeding-up of your heart after being splashed as a sign of a heart attack that requires immediate medical attention.
Unfortunately, when you interpret an event as a threat, the tendency is to seek safety and avoid anxiety-provoking situations, but this only increases your anxiety because you’re apt to tell yourself, “See, this was a near miss. In the future I mustn’t be around any of these situations that make me anxious.” As a result, you are constantly anxious, not wanting to be anywhere near the feared situation. In reality, it is only by confronting the feared situation and seeing that you can survive that you will reduce your anxiety and learn to live with much less fear.
You can see how anxiety can be evoked just by your attitude. Do you enter situations thinking you’re going to be anxious and uncomfortable? With this kind of mindset you are poised to feel anxious. That’s why coping skills are so important. They can help you enter a situation believing in yourself and your ability to stay calm.
Hint: If you break your preparation for an upcoming situation into four parts, you will have more success.
The first task is to prepare: take a deep breath and begin to focus on the task. Second: interrupt any negative thoughts that come into your mind and tell yourself you can stay calm and confident. Third: pay attention to your feelings. When they start to build, begin to use positive statements to talk yourself through the situation, comments such as “I can do this. I have confidence in my ability.” And, fourth: learn to cope with feelings as they start to build by using positive comments to yourself such as “I’m anxious, but I can handle it. I’ve handled it before.” Once the situation is over, reward yourself for what you’ve accomplished. Recognize any small movement toward your goal to remain calm.
Coping thoughts can be divided into statements used for the different stages in dealing with an anxiety-provoking situation: preparation, the situation, and reinforcing success. Here are some examples.
Preparatory Stage
Use the statements that follow prior to the anxiety-provoking situation.
The Situation
Use these statements during the anxiety-provoking situation.
Reinforcing Success
Once the situation is over, use these statements to reward yourself and increase the chances you’ll stay calm in future situations.
These procedures have been shown effective for reducing general anxiety, as well as for anxiety due to interviews, public speaking, and tests. They also can help with phobias, especially fear of heights. Follow the guidelines below.
Focus on the Now
Focusing on the past or future can increase your anxiety. Stay focused on the present, and what is actually happening, not with your interpretation of what you think is happening. Focus on the outcome of what you plan to do, not on your fears or anxiety. When you let your emotions control you, the intensity of the moment can limit your options. Decide what your goal is and focus on that.
Phoebe felt anxious in public situations. She worried constantly about what other people thought of her. This created intense anxiety for her. When Phoebe’s boss told her she was going to have to speak to the employees about a new procedure, she panicked. Phoebe asked me to help her deal with this new and frightening request. I asked her to focus on just one or two of the people in the audience whom she knew and trusted. I asked her to imagine herself talking to the large group, but picture herself having eye contact with just a few people in the audience. She reported that her anxiety lessened as she pictured her friends smiling and nodding at her as she spoke. I suggested she ask her friends to sit throughout the audience, identify themselves to her before she began to speak, and to smile and nod at her throughout her presentation. Phoebe reported to me after the presentation and told me the approach we’d agreed on had worked well.
Imagery
You already have had experiences with self-generated images in dreams, daydreams, and fantasies. Most children have a well-developed sense of imaging. As they grow older, their skills may become dormant as the logical, rational (left) side of their brain is used in schoolwork and linear thought processes.
Imagery is a powerful tool for reducing anxiety. The power of this approach is derived from its right-brain source. Your right brain, which controls the left side of your body, is primarily responsible for orientation in space, body image, artistic endeavor, and recognition of faces. The right side of your brain deals with visual, holistic, intuitive, nonlinear thought. Imagery allows direct access to your subconscious and the autonomic-nervous-system functions, bypassing the left brain and its tendency to solve problem through logical reasoning. It is often logical processing that can lead to the repetitive worrying that increases anxiety. Imagery can cut through rumination to the essential core of issues and lead to effective problem solving, decreased anxiety, and increased self-confidence. Your mind doesn’t differentiate between an image of a situation and the actual experience of being in the situation, so a great deal of learning can occur during imagery. Once you picture yourself in an anxiety-provoking situation, you increase your ability to remain calm and relaxed in a similar real-life situation in the future.
Sarah, a recent college graduate, told me she was anxious about asking her boss for a raise. I suggested she try imagery to prepare for the confrontation. Sarah agreed to give it a try. I played a relaxation tape for her and asked her to signal me with her index finger when she felt relaxed. When she signaled me, I asked her to imagine herself as the director of a movie starring herself, with her boss as the supporting actor. I asked her to picture herself going to her boss’s office and to continue with the scene until she felt anxious, and then to signal me by raising her index finger. We worked back and forth like this until Sarah opened her eyes and exclaimed, “I got through the whole situation without feeling anxious.” I then asked her to continue practicing this process at home and advised her she would notice that it became easier and easier to get through the scene, and as that happened, it would be even easier to talk to her boss about a raise.
You can use this kind of imagery process yourself to reduce your anxiety about upcoming situations. Use the following guidelines to practice:
When you’re relaxed again, begin the movie at the spot a little before you felt anxious. Continue the movie until you feel uncomfortable or displeased with what occurs, and return to relaxing. Work back and forth between the movie in your mind and relaxing until you can complete the whole situation while remaining relaxed.
You can also use imagery to decrease painful or negative feelings. Follow the directions below to use imagery in this manner.
When you encounter difficulty with completing this exercise, it may be because you aren’t ready to give up your anxiety. If this is the case with you, check out the Affirmations section (above) for ways to help you get ready to give up your anxiety.
You can also use imagery during an anxiety attack. Practice at home when you are in a safe, relatively nonthreatening environment. Once you learn the technique, you can use it at work, at school, or anywhere you experience anxiety.
Immersion
When you are immersed in a pleasurable event, anxiety will recede. Take a minute or two to…
Really let yourself enjoy the experience and immerse yourself in it, forgetting everything else. Here are some more positive experiences to immerse yourself in:
Take a few minutes right now to write down activities you like to do that help relax you. Explore whether you like physical, social, emotional, creative, or intellectual activities, and when and where you like to do the activity.
Inner-Directed Movement
It may seem silly to suggest that something as simple as yawning could reduce anxiety, improve your well-being, and even revolutionize the way you feel about yourself, but inner-directed movement can do just that. Try the exercise that follows and see if inner-directed movement helps reduce your anxiety.
Journaling
Recording your thoughts and feelings is a great way to catch the negative things you think and say about yourself and others. Journaling, or journal writing, is a way to establish a permanent record of your thoughts, feelings, and situations that evoke anxiety. Journal writing has been shown to be more effective for clients with PTSD than cognitive therapy. Writing about emotions is especially useful in helping heal PTSD, but it can also be effective for other sources of anxiety.
When you journal, make an entry when you identify a painful thought. First comes the thought, and then the feeling, so if you can identify thoughts that lead to anxiety, you will be more ready to catch them, to say “cancel that thought” or perform “thought stopping” (see below).
You may wish to use the format Sarah used when she wrote about thoughts that bothered her.
|
Situation |
Automatic Thoughts |
Feelings |
|
Saturday night…at a party with my husband at his boss’s house |
“I’m going to blow this for him.” |
anxiety, panic |
|
Monday morning…my boss asks me to write a report |
“I’ll never be able to do this.” |
anxiety |
|
Have to work a double shift…can’t meet husband for dinner |
“Chad’s going to have a fit.” |
anxiety |
Massage
Getting a massage from a partner, friend, or massage therapist can be an excellent way to reduce your anxiety. There are also specific points you can massage, depending on your symptoms.
For anxiety: massage the webbing between your thumbs and index fingers.
For heart fluttering and dizziness: massage with firm pressure for just ten to twenty seconds at the following points:
Meditation
Meditation is the process of focusing your attention on one thing at a time, uncritically and totally. You can repeat a syllable, word, a group of words, aloud or silently. This is called mantra meditation. You can count your breaths aloud or silently. This is called breath-counting meditation. You can also gaze at an object without thinking about it in words. A small object is best, such as a candle, a piece of wood, a stone, or something else you think is appropriate.
To begin the process, find a quiet and relaxing spot, somewhere no one will disturb you. Sit up straight, but relaxed, in a chair, with your forefingers and thumbs touching, palms facing up. (Or, if you prefer, you can choose a moving meditation. For example, you can meditate while you walk, saying, “Right, left, right, left…”) Body and hand position are important because they act like cues to prepare you to enter the meditation process once you’ve assumed the position a few times. Just holding your hands as described and directing your breathing gradually toward your abdominal area when you start to feel anxious can often put you into a meditative state, but only if you’ve put in the requisite practice in a non-anxious state. This can come in handy when you are in a stressful work or social situation and you don’t have time to meditate, unless you can graciously excuse yourself and take a bathroom break.
No matter what type of meditation you choose, thoughts will intrude on your meditation process, but with practice, these will decrease. Be compassionate with yourself. This is a technique that you will learn if you persist. As soon as you notice your attention has strayed, gently bring it back to the word or object you are focusing on. Don’t spend even an instant on your daydreams or on berating yourself for not staying focused. Never allow meditation to become a race to the finish. Think of meditation as more like a graceful dance.
Learning to meditate is like learning to do anything. It takes time to learn a skill like meditating. Try meditating for just three or four minutes when you start. An easy way to start is to count on the exhale. This would go something like: inhale…say the word one…inhale…say the word two…and so on. Focus on feeling the breath pass through your nose or mouth. If you lose count, try, “In one, in two, in three,” and so on. Just enjoy the process and let go of any thoughts that intrude. You might even want to picture them—your thoughts—floating past you in a gentle stream. Later, when you’ve learned the process, you can meditate for four seconds or four hours.
Another easy meditation is to count your breaths while you perform a task. Choose a simple task like washing dishes, brushing your teeth, scrubbing vegetables, or making a salad or tea. Once you master this meditation, try counting breaths through more difficult tasks like cooking a meal, driving, or enduring a boring meeting.
Use the walking meditation, counting a breath each time you take a step, while you’re doing errands, cleaning the house, or walking to a potentially stressful meeting. You can also use the walking meditation when you’re out for a walk in the country.
When you’ve mastered these, you may choose to use a mantra meditation such as saying the word om or aum or amen, or blessings, or peace. If you’re religious, you can also consult with your minister, priest, rabbi or other religious leader about religious mantras to use.
If you’re an artistic person, you might do well with flame meditation. Light a candle in a darkened room. Sit a foot away from the candle and stare at it. Blow it out, and with your eyes closed, let the image of the candle come into your mind.
You can increase intimacy and closeness with another person using the “Ahhh” breath. Sit with a friend, partner, or patient. Try to match your breathing pattern exactly to your partner’s. On exhale, release your breath with an “Ahhh” sigh. This meditation promotes a strong feeling of connection and compassion. It also builds trust and can be used to enhance a relationship.
A centering meditation can help you feel more balanced and secure. Stand up straight, with your arms at your sides. Lean forward an inch or two, noticing the tension as your toes dig into the floor. Come back to center. Lean backward an inch until you sense your weight hovering over your heels. Do the same action to the right and then to the left. If you are in a situation where you feel unbalanced, try this centering meditation, but using only very subtle movements forward, back, left, and right.
If you overeat when you’re anxious, conscious eating meditation may be for you. Take a moment before you begin to eat to clear your mind by counting a few breaths, then focus your attention on picking up your fork, putting food on your fork, transporting the food to your mouth, chewing, noticing the taste, swallowing, and then returning the fork to your plate. If you prefer, concentrate instead on the sensations of the fork in your hand, the sensation of the fork in your mouth, the sensations of the food in your mouth, and so on.
If you are worried or fearful about driving, conscious driving meditation may be useful. Instead of worrying, focus your attention on getting into your car, fastening your seat belt, starting the engine, driving down the driveway, the speed of your car, road signs and road conditions. And notice the distance other cars are from you.
You can make almost any activity a meditation if you focus your attention on it—from taking a shower, to shaving, to putting on makeup or getting dressed. Try completing some of these tasks, excluding the shaving and makeup, using your nondominant hand (the left hand if you’re right-handed). This will help balance your brain as well as keep you calm.
The benefit of meditation is that it shows you that anxiety is not permanent, that it passes into and out of your body without leaving a trace. When you focus on what is happening right now, the extreme highs and lows of your emotional response to life will disappear and you will live in relative calm.
Panic Diary
If you find yourself panicking, a panic diary may be for you. Each time you have a panic attack, record it. Be sure to include what triggered it, the time of day it occurred, what you were doing at the time, the physical symptoms that accompanied the attack, what you did to cope, what thoughts passed through your head during the attack, and how you would rate the attack in intensity (from one to ten). See the example below of how Toni used her panic diary.
Panic Diary
July 20
Triggering event: My boss yelled at me at 5 P.M., just as I was leaving, claiming I lost a report, which he lost.
Setting: My boss called me into his office.
My reactions: I started to hyperventilate, my heart raced, and my body shook. I thought I was going to faint.
What I did to cope: I felt like screaming, but I counted to ten and waited.
What went through my head: This is never going to end and I’m going to have a heart attack if he doesn’t stop talking.
How I’d rate the intensity: I’d rate this a nine out of ten in intensity. It was really bad.
After Toni used this diary form for a while, she began to notice patterns in how she coped, and in what happened. Based on her evaluation, she used progressive relaxation to learn how to quiet her body and not overreact to her boss.
Paradoxical Approach
Although you may want to escape from uncomfortable feelings or fight them, you can achieve even more control by inviting the symptoms. Here are some ways to use paradoxical approaches:
Progressive Relaxation
Progressive relaxation is a simple and effective method of systematic deep-muscle relaxation. It has been widely used for many years to counteract the effects of anxiety. It has been shown in a systematic research study to work very well for panic. Progressive relaxation places emphasis on a slow, disciplined development of muscle-tension awareness, providing a powerful weapon against stress symptoms.
Follow the guidelines below and see if they work for you. It may take several tries to obtain relief. You can also purchase relaxation tapes (see the Resources section in the back of this book) or make your own (see below).
According to Dr. Herbert Benson, author of The Relaxation Response, a seminal work on anxiety, by going through groups of muscles in turn, tensing them for a few seconds, and very gradually releasing the tension, deeper than normal levels of muscle relaxation can be attained. As well as deepening physical relaxation and heightening our awareness of areas and levels of tension, this technique reliably elicits the “relaxation response” and fosters a more general state of mental and emotional calm. It may take you a few attempts to master the basic procedure, but once you do, your muscles can be relaxed very rapidly. For a greater effect, start with progressive relaxation and combine it with imagery and self-hypnosis (see below).
Making a Relaxation Tape. One of the best ways to learn to relax is to develop your own relaxation tape. Making your own tape allows you to delete segments that don’t work for you and to emphasize what is most helpful. You can also add your own music or sound, and develop your own unique approach that includes relaxation comments and coping statements, or images that you find especially peaceful and calming. When you don’t have the time or energy to perform your own relaxation procedure, just pop in your specially made tape, lie back, and listen.
Follow these guidelines:
My muscles are beginning to relax, and I can relax them even more.
I am becoming more and more relaxed.
I can stay calm and think about what I need to do. I am in control.
I can relax away my anxiety.
I breathe deeply and calmly when I feel anxious.
Whenever I feel anxious, I fill my body with peaceful light.
Anxiety can’t really hurt me; I can stay calm and it will pass.
I can stay calm and go wherever I want.
I can stay calm and breathe slowly.
I can stay calm and focused.
I can relax and feel safe.
Picturing yourself relaxed and calm can make your affirmations more powerful. You may wish to add comments such as, “I picture myself staying calm and going wherever I want.”
Find a quiet spot where no one will disturb you. Loosen your clothing. Take off your shoes. Lie down and close your eyes…Focus on your breathing. Let your breath slowly move toward your navel, the center of your body…Each time you exhale, let go of whatever it’s time to let go of…Perhaps as a color…Each time you inhale, bring in peaceful, relaxing energy…Perhaps as a different color…Feel your body becoming more and more relaxed with each breath…The next time you inhale, feel your feet filling up with peaceful, relaxing energy…Your feet are filling with peaceful, relaxing energy…The next time you inhale, fill your lower legs with peaceful, relaxing energy…Your lower legs are filling with peaceful, relaxing energy…The next time you inhale, fill your knees, front, back, and sides with peaceful, relaxing energy…Your knees are filling with peaceful, relaxing energy…The next time you inhale, fill your upper legs and thighs with peaceful, relaxing energy…Your upper legs and thighs are filling with peaceful, relaxing energy…Feel the layers of muscle in your thighs relaxing…layer…by layer…by layer…Your legs and thighs are filling with peaceful, relaxing energy…The next time you inhale, fill your buttocks with peaceful, relaxing energy…Your buttocks are filling with peaceful, relaxing energy…The next time you inhale, fill your back with peaceful, relaxing energy…Let peaceful, relaxing energy radiate out from your spine to the sides of your back as the layers of muscles in your back relax and fill with peaceful, relaxing energy…Your back is filling with peaceful, relaxing energy…Now focus on the front of your body, filling up your groin and lower abdomen with peaceful, relaxing energy…Your groin and lower abdomen are filling with peaceful, relaxing energy…Now focus on filling up your internal organs with peaceful, relaxing energy…Picture your internal organs filling up with peaceful, relaxing energy…Picture your internal organs relaxing as they spread out and take all the space available to them, filling with peaceful, relaxing energy…Picture your chest relaxing, filling up with peaceful, relaxing energy…Your shoulders are relaxing…The next time you exhale, let whatever you’re carrying on your shoulders run right across your shoulders, down your arms, and out your fingertips…Just let whatever you’re carrying on your shoulders roll right off your shoulders, down your arms, and out your fingertips…Now focus on your neck, feel your neck filling up with peaceful, relaxing energy. Your neck, front, back, and sides are filling with peaceful, relaxing energy…Let that peaceful, relaxing energy fill your jaw…Unlock your jaw and let it fill with peaceful, relaxing energy…Your tongue and teeth are relaxing, filling up with peaceful, relaxing energy…The next time you inhale, let that peaceful, relaxing energy flow into your cheeks and ears…Your cheeks and ears are filling up with peaceful, relaxing energy…Let that peaceful, relaxing energy flow through your nose, letting it relax…Let that peaceful, relaxing energy flow through your eyes, and the space behind that, and the space behind that…Your eyes are relaxing, filling up with peaceful, relaxing energy…Let your eyebrows and eyelashes relax, filling up with peaceful, relaxing energy…Let your forehead relax, filling up with peaceful, relaxing energy…Let your scalp and hair relax, filling up with peaceful relaxing energy…Let your brain relax, filling up with peaceful, relaxing energy…Take a moment to scan your body. The next time you exhale, send a wave of relaxation to any areas in your body that need to relax more…Send that wave of peaceful relaxation to your body now…The next time you exhale, you’ll find you’re a hundred times more relaxed…The next time you exhale, send another wave of relaxation to any place in your body that needs more relaxation…Your body is feeling so relaxed and peaceful now…You realize that each day, and every hour you are becoming more and more relaxed…It is getting easier and easier to relax and feel peaceful…All you have to do is breathe calmly and you will feel peaceful and relaxed…I can relax away my anxiety…I now understand that I can breathe deeply and calmly whenever I feel anxious…and peace and relaxation will be the result…Whenever I feel anxious, I know I can fill my body with peaceful light and I will feel peaceful and relaxed…I now know that anxiety can’t really hurt me…I can stay calm and it will pass…All I have to do is breathe and fill my body with peaceful, relaxing energy…I now know I can stay calm and go wherever I want to go, staying peaceful and relaxed, breathing easily and calmly, staying peaceful and relaxed…I realize I can stay calm and breathe slowly…I can stay calm and focused…I can relax and feel safe…
Quieting Response
The quieting response can help you cope with anxiety. It teaches a tension-reduction skill you can use in most situations that you can find solitude, including at home and in the workplace. This kind of relaxation training, as well as other kinds, can reduce insulin dependence, so if you are taking insulin, be sure to talk with your health-care practitioner about working together to reduce your insulin dosage. Here are the steps to take to achieve the quieting response:
Refuting Irrational Ideas
Refuting irrational ideas is another method to reduce anxiety. All of us engage in almost continuous self-talk during our waking hours. Self-talk is the internal language we use to describe and interpret the world. When our self-talk is rational, anxiety is reduced. When it’s not, anxiety is increased.
At the root of irrational thought is the idea that something is being done to you. Rational thought is based on a more neutral idea that events occur and you experience them.
According to Dr. Albert Ellis, a cognitive-behavioral theorist who developed a system to attack irrational ideas or beliefs and replace them with more realistic interpretations and self-talk, a common form of irrational self-talk is making statements that “awfulize” experience by making catastrophic, nightmarish interpretations of events—for example, interpreting a momentary chest pain as a heart attack, or a grumpy word from a boss as intent to fire, or silence as negative criticism.
The kinds of statements Ellis considers irrational are:
Dr. Ellis developed several guidelines for turning irrational thinking into rational thought. Review them whenever you notice irrational beliefs are taking over. You can also write them down and use them as affirmations.
Refuting irrational ideas is a skill that requires practice in the following nine steps:
Tom, a forty-two-year-old lawyer, worked in a law practice. He complained of having to report to one of the partners who made poor decisions and was irresponsible. He agreed to try to refute his irrational ideas so he could sleep at night and not be bothered by repetitive worries. He produced the following information.
Self-Hypnosis
Self-hypnosis is a wakeful state of deep relaxation. During hypnosis there is an alteration in the conscious level of your thinking and remembering, and an increase in your ability to focus on a particular situation. Hypnosis is also a heightened state of awareness during which you’re more open to suggestion.
You’ve probably experienced a hypnotic state while daydreaming, or concentrating intently on a task (reading a book, watching a movie or TV program, driving or completing a work project). All hypnosis (including guided hypnotherapy) is really self-hypnosis because you won’t accept a suggestion unless your really want to.
During hypnosis you choose to suspend disbelief, just as you do when you become absorbed in watching a movie or TV program. But more than that happens. When you watch a violent chase scene in a movie, your mind and body react as if you were actually participating in the scene. Your muscles tense, your heart rate increases, your stomach knots, you feel excited or afraid. Even your brain-wave patterns suggest that you are participating in an activity, although you’re just imagining yourself in the activity.
Effectiveness of Self-Hypnosis
Self-hypnosis has been clinically effective with nervous tics, tremors, chronic muscular tension, minor anxiety, and the symptoms associated with anticipatory anxiety (rapid heartbeat; cold sweaty palms; knotted stomach).
Contraindications
If you’re disoriented because of organic brain syndrome or psychosis, mentally retarded, or paranoid, hypnosis is not recommended.
Self-Hypnosis Directions
Follow the steps below to practice self-hypnosis:
Using Suggestions
When forming suggestions for yourself, make sure they are positive, direct, and given only when you feel relaxed; use the word can instead of will if commands don’t work for you; phrase suggestions in the immediate future (“Soon the drowsiness will come”), not the present (“I am drowsy”); form a helpful visual image (imagine yourself looking calm and confident) and emotion or sensation (feel the closeness and belonging you’d like if your anxiety is related to relationships); and avoid saying the word try (which implies doubt and the possibility of failure).
Use key suggestions to help you relax. Try each one and see which work for you.
Write down your suggestions, memorize them, and use a key word to remind you of them when you’re anxious. Here are some ideas:
A Ten-Minute Self-Hypnosis
Follow the steps below to put yourself into self-hypnosis.
Systematic Desensitization
Systematic desensitization is a method you can use to reduce your reaction to upcoming situations that you’re worried about. This procedure can help you construct a staircase of situations leading up to the upsetting event by breaking it down into its component steps. In this way you can make any situation more manageable. For example, if you are extremely anxious about speaking up in a conference, you might construct the steps between waking up the morning of the conference to the actual moment of speaking. The hierarchy might look something like this:
Follow the four steps below to use systematic desensitization.
Step 1. Choose an anxiety-provoking situation for which you’d like to use systematic desensitization from the list below or come up with your own. One way to choose is to rank the situations from 1 (most distressing) to 14 (least distressing).
____ saying no
____ asking others to tell me what they expect from me
____ praising others
____ telling others what I expect from them
____ taking a compliment
____ admitting a mistake
____ asking for help
____ telling others about their mistakes or limitations
____ standing up for my rights
____ disagreeing with others
____ expressing anger
____ dealing with the anger of others
____ handling a put-down or teasing
____ asking for a legitimate limit to my workload
Step 2. Choose the situation you wish to work on and construct 10 steps (see sample hierarchy above) from least anxiety-provoking (1) to most anxiety-provoking (10).
1. _________________________________________
2._________________________________________
3. _________________________________________
4._________________________________________
5._________________________________________
6. _________________________________________
7._________________________________________
8._________________________________________
9._________________________________________
10. _______________________________________
Step 3. Now think about being in step 1 of the situation you choose. Visualize the situation in your mind. If you experience no anxiety, think about the situation in step 2. If you begin to feel anxious, stop and practice deep breathing and muscle relaxation (see chapter 9). Avoid moving to the next step in the hierarchy until you feel no anxiety when thinking about the step you are focusing on. Continue up the hierarchy until you feel no anxiety when thinking about all the steps you listed.
Step 4. Begin to try this process in real-life situations. Use the same procedure described in step 3.
Thought Stopping
Thought stopping is an approach that is especially useful when nagging, repetitive thoughts make you feel anxious. Cognitive therapist Dr. Aaron Beck uses the term automatic thoughts to describe thoughts that are negative and illogical but are still believed, experienced as spontaneous, couched in terms of “should” or “ought,” or predict catastrophe or the worst possible result. Such thoughts are persistent and self-perpetuating, based on a unique way of viewing a situation; they repeat habitual themes (for example, danger) that result in tunnel vision and make it impossible to see situations in other ways. Often they are learned in childhood and conditioned by family or friends, or even the media.
There are a number of patterns of limited thinking that create anxiety and that could be reduced or even overcome by thought stopping. I’ll discuss seven of them here.
Filtering occurs when you only hear part of a message. For example, your boss tells you the report is good but that next time you ought to make it shorter. In filtering, you only hear the negative comment, blow it up out of proportion, and then think that you’re going to be fired for writing a too-long report.
Polarized thinking occurs when you see everything in black and white with no room for shades of gray or even one mistake. If you’re a perfectionist and someone criticizes you or your work, you will begin to get down on yourself and your anxiety will soar.
Mind reading is based on the false idea that you can tell what other people are thinking, especially about you. This can raise your anxiety when you interpret a cough or a raised eyebrow as a sign you’re disliked or that you did something wrong.
Overgeneralization occurs when you take one incident and assume all others are the same. You reach a conclusion based on only one case. For example, you’re overgeneralizing when one person doesn’t like your drawing and you assume no one could possibly like it. This can lead to low self-esteem and subsequent anxiety.
Magnifying can occur when you enlarge small things way beyond their true importance, especially anything that implies in any way that you’re not perfect. A small mistake becomes a fatal tragedy in your mind and your anxiety increases.
You’re catastrophizing when you get a stomachache and you’re sure it’s an ulcer requiring surgery. You read a newspaper report of someone’s death or hear about some other problem and start wondering what if that happened to you.
Personalization occurs when you compare yourself with other people and conclude your worth is questionable, or you assume everything others do or say is in reaction to you, or if you constantly test your value and come out on the short end.
See how many limited-thinking patterns you can identify in Tom’s story:
Tom came to me because he identified his wife as the source of much of his anxiety. “I keep thinking how smart and cute my wife is and that by comparison I’m a real dope. I know she loves me, but when she gets that look on her face, I know she doesn’t like me very much and I worry our marriage is over. Yesterday she told me I did a good job on the toilet handle I put in but that it sticks a little. I feel like she doesn’t appreciate one thing I do. I really worked on that handle and now I don’t want to do anything around the house anymore.
These kinds of automatic thoughts usually precede anxiety. If you’ve tried to listen for your automatic thoughts or tried to record them and have been unsuccessful, thought stopping may help you.
The first technique to try when using thought stopping is just to count the negative thoughts you have. Don’t do anything to stop them. You can get a knitting stitch-counter or golf stroke-counter and keep track of them. This will help you get some distance from your negative thoughts. Just count the thought and then say, “I release that thought. It is no longer part of me.”
Another thought-stopping method is to set a timer for twenty or thirty minutes. When you hear the timer ring, stop what you’re doing and pay attention to your thoughts. If you’re having negative thoughts about yourself or someone else, count the number and type of negative thoughts. You can write them down in a journal if you prefer, or simply picture releasing the negative thought(s), perhaps as a color.
When using thought stopping, you can also use the command “stop,” an image of the letters for the word stop, a loud noise (such as a buzzer or bell), or a negative stimulus, such as wearing a rubber band around the wrist and snapping it when the unwanted thought occurs.
Stella owned her own editing business. She worked out of her home office but occasionally had to go out to meet with clients. It was on those visits that her anxiety skyrocketed. She also reported extreme anxiety when on dates or at social occasions. I taught her several anxiety-reduction techniques, but she reported that thought stopping, especially wearing a rubber band around her wrist and snapping it when an anxiety-provoking thought occurred, worked best for her. She even taught several of her friends the technique. During one of our sessions she reported that they called me “Dr. Rubber Band.”
Thought stopping may work because (a) distraction occurs, (b) the interruption behaviors serve as a punishment and what is punished consistently is apt to be inhibited, (c) it is an assertive response and can be followed by reassuring or self-accepting comments, and (d) it interrupts the chain of negative and frightening thoughts leading to negative and frightening feelings, thus reducing anxiety.
For effective mastery, regular practice for three to seven days is needed. Other guidelines include:
For anxiety about being in a group: “I am confident in my ability to remain calm while participating in a group.”
For anxiety about being criticized: “I can listen to negative criticism, determine if it applies to me, and stay calm the whole time.”
For anxiety about turning people down: “I have the right to say no and feel good about it.”
For anxiety about making a mistake: “I am human and will make mistakes, and that’s okay.”
For anxiety about getting into an argument: “It takes two people to argue. If I remain calm, there will be no argument.”
For anxiety about going after what I want: “I deserve happiness and reward.”
Touch
Touch can be therapeutic. Without touch, babies don’t survive for long. Adults need comforting touch, too. A study published in the journal Clinical Nursing Research found that touch reduced anxiety in older adults. Touch can calm and soothe. Find a source of safe touch and ask that person for a hug when you need one.
Uncovering Core Beliefs
Core beliefs are beliefs you’ve probably held since childhood, or even longer. They are so much a part of you that you may not even know you have them. This section will help you uncover core beliefs that may be increasing your anxiety.
Here are some examples of unhealthy core beliefs:
One of the things you may notice about all these beliefs is that they are blanket statements. They are absolutes. They leave no room for in-betweens or exceptions. They are so strict, they can increase your anxiety and make change appear hopeless.
Can you alter such strong core beliefs? You can if you’re willing to follow the suggestions below to help you get to your core beliefs.
The core belief could just as well be that you have to carry the burden of unrelenting anxiety throughout life because you were molested as a youngster, that you are destined to be anxious and unhappy, that people can never be trusted, or that you’ll freak out if you have to perform a task. The core belief might have been formed in a preverbal state, and may never have been named or discussed. To begin to change core beliefs, start with affirmations (near the beginning of this chapter) that counter your negative thinking. You can also use imagery and thought stopping (also discussed above).
Worry List
Start a worry list by writing down all the things you worry about. Beside each one, write down two ways you can handle that worry. Decide which way you prefer to handle each item on your list and set a time frame. Once you get your worries out on the table and start problem-solving about how to deal with them, you’ll find it easier than you thought to stop worrying.
Summary
This chapter has presented many anxiety-reducing techniques. Choose several approaches from the following list of self-care healing measures and see how they work for you. If your anxiety is still bothersome, return to the list and choose a few more actions. Work along until you find the combination of approaches that helps you the most.