Do you spend the night before work worrying about what the next day will bring?The vast majority of people who come to my therapy practice seeking help with anxiety do not have any form of mental illness – in the sense that they are not suffering from any kind of serious disorder in their behaviour or thinking. A lot of them would not even recognise themselves as being anxious. They are usually not exactly sure what is wrong, but they know something is not right. They have become overwhelmed and their pre-existing coping mechanisms are not working or are certainly not sufficient anymore. They are struggling and they don’t know where to start to turn things around.
When life is going well, everything can seem easy. All the different aspects of our lives just seem to slot into place and little managing is needed. How often do we experience this, however? Most of the time, we are dealing with the worries and stresses of life. So, how aware are we of exactly what we are dealing with? Do we understand how our anxiety works or what causes us the most difficulty? How conscious are we of what we are saying to ourselves? How deliberate is what we are doing to tackle the issues? How do we know if what we are doing is helping or making things worse?
As we touched on in the previous chapter, there are three central aims to this book:
1. It will set out how anxiety and worry work. This will enable you to gain awareness around what areas are causing the most difficulties.
2. It will enable you to break down your problems into manageable, bite-size pieces and lower the sense of being overwhelmed.
3. It will offer advice and tools to help you tackle the areas that are causing difficulty.
Note that we’re not talking about ridding our lives of worry here – we can all expect to be dealing with varying levels of worry throughout our lifetime. Before we progress any further, let’s explore this idea of ‘worry levels’ a little more.
The reservoir
It can be helpful to view our anxiety as the water in a large reservoir. The reservoir is our capacity – emotional, physical and psychological – to cope with whatever life throws at us, and the water is the amount of anxiety we are experiencing at any one time. So, the lower the water level, the calmer and more in control we are. As the water rises, we start to become agitated and life becomes more difficult. As the reservoir gets more and more full, we start to lose control. And when the reservoir is full, we are overwhelmed. Our coping mechanisms are no longer working. Minor things that would not have bothered us when our reservoirs were half-full now cause serious stress. We begin to doubt ourselves and how we ever coped at all: ‘What is wrong with me? Why am I not able to deal with the smallest things?’
So, how do we manage the reservoir to ensure that the level of the water – our anxiety – remains as low as possible? Where do we even begin?
If we don’t know what fills it up, how do we prevent it from overflowing?
We can’t just tackle ‘anxiety’. We have to know exactly what we are dealing with. There are many tributaries – anxieties from different sources – feeding into the reservoir. Our goal is to discover where they are and then to cut them off, or at least ease the flow.
This is the essence of anxiety management: becoming conscious of all the areas in our lives where we are most vulnerable to anxiety. Breaking down the problem into multiple, manageable pieces each with practical solutions, and slowly working through the issues. This method will not only bring us back from crisis but will also enable us to maintain a controllable level of anxiety going forward. We need to be able to realise that the reservoir is filling, and not just react when it is already full.
However, no matter how good we become at managing our anxiety, sometimes it just rains. These are the times when things happen outside our control – serious illness, the death of a loved one, a tragic accident. These will contribute greatly to the reservoir and there is not much we can do to stop them happening. At times like these, we need to be managing all our other anxieties as well as we can. We need to keep the levels of our reservoirs as low as possible in order to be best placed to tackle adversity, because if we maintain a low level generally we can better cope when the levels are raised by stress. We do not want to be already overwhelmed when life hits us hard.
It is probably a good time to set expectations here. When it comes to anxiety, we will regularly talk about ‘managing’, and rarely about ‘overcoming’. Whilst we may be able to overcome certain specific fears in our lives – for example, a fear of flying or spiders – anxiety is something that will always be with us to some degree.
As humans, we have evolved to where we are today because of anxiety; it has kept us alert and safe. And whilst we may not be able (or want) to turn it off, we can certainly learn how to turn it down. The focus when we are tackling anxiety should be on integrating tools into our lives to help us recognise and address our anxious thoughts and behaviours when they are not working in our best interests.
So, while the reservoir may never be empty, if we can maintain it at a level that we find tolerable, we are much better placed to move forward and tackle whatever life throws at us.
Throughout this book, we will endeavour to uncover as many tributaries to the reservoir as possible. We will look at some of the major sources of difficulty and stress in our lives, including work, relationships, our online lives, and other specific areas of worry and social anxiety.
When we are trying to figure out what we are anxious about, it will be important to look at an issue a little more deeply than we normally would. For example, if work is a major source of anxiety, it is vitally important to identify what it is about the working environment that causes such difficulty. It is more than likely not just one thing – and, even if it is, that one thing can probably be broken down into multiple aspects.
Anxiety can be sneaky. It can have us believe we are not actually anxious at all. There may be several things we have low-level anxiety about, but nothing that is causing us to take too much notice. We go about our daily lives, doing the various things that keep our moods in check and enable us to believe we are in control. This can go on for years. But all the while, anxiety is bubbling away underneath the surface. We are able to keep it at bay through distraction and various escape mechanisms, and these just become a way of life. We avoid facing our anxieties head-on, because we are not aware of what it is exactly.
Looking again at work as an example, what exactly is driving your anxiety in this area of your life?
Do you spend the night before work worrying about what the next day will bring?
Is your Sunday lost to a sense of impending doom at the prospect of the week ahead?
Do you tend to overestimate the problem – and underestimate your ability to cope?
Do you have difficulties saying ‘no’? Does this cause you to take on more than you have time for?
Do you constantly fear getting in trouble or being found out? Are you able to admit when you do not know something?
Do you need constant validation from others to feel you are doing a good job?
Do you look back on every interaction, and play it over in your head, focusing on the bits where you feel you made a fool of yourself or said something stupid?
Has anxiety got to such a level that you cannot start a task and constantly procrastinate, letting your workload build up and become unmanageable?
Do you see yourself as an adult? If not, how do you see yourself? What is it like working in an adult world when you do not see yourself as one?
From the above questions, you can see that there are many sources of anxiety within one ‘problem’.
We are all different in terms of what triggers our worries. However, when we become aware of exactly what we are dealing with, we can start to develop practical steps to address our fears.
If anxiety is something we have to deal with on a regular basis, then we can be pretty sure it seeps into all areas of our lives. Similar questions to those above could have be asked about our relationships, social situations, our futures and how we see them panning out, or any other aspect of our lives. The same issues that may jump out for us in our working environment may also affect other areas. For example, if we find it hard to say ‘no’ in work, and become resentful or feel taken advantage of, it is not a huge leap to assume this could also happen with a partner or with friends or family members. If we are anxious around social interaction in the office, it’s likely that we will also struggle socially to some degree on a night out.
Becoming aware of all the issues in our lives that we have to recognise and deal with may seem daunting at first, but the beauty of it is that, with just a small shift in focus, we can begin to tackle something that has probably seemed out of our reach for a long time.
The tributaries that feed into our reservoirs may be many, but when we figure out what they are, we can begin to get some sense of control over them.
There are many different strands of anxiety, each with its own characteristics and triggers, but what they all have in common is how they make our bodies react.
Anxiety is the body’s response to situations that we interpret as threatening, and our very distant ancestors would have relied on this response to escape from or fight off wild animals. These days, however, we very rarely need the adrenalin of anxiety to help us in life-threatening situations. Today, much of the anxiety we feel on a day-to-day basis is not physically life-threatening, but has been created in our own minds through worry. It’s always future-based, and we are usually imagining bad things that could happen to us or around us. Very different situations – such as the Sunday night before a busy week at work, an upcoming social situation where we might perceive potential judgement from others or a busy bus where we can feel panic coming on – will activate the same response in our bodies that our ancestors used to keep them safe from danger.
As we go about our daily routines, our minds and bodies may be awash with activity, but we are often oblivious to this. If we were asked what we were thinking or feeling an hour ago, we might not be able to say exactly – but that doesn’t mean it hasn’t affected us. We can be watching TV or absently flicking through social media sites, but our minds are whirling away, generating anxiety-inducing thoughts and our bodies respond in kind, with a physical reaction to the threat of the story we are telling ourselves.
Are you always aware of what you are saying to yourself or what bodily sensations you can feel? Are you even aware of what is going on in your body right now?
As an experiment, let’s have a quick body scan to see if we can feel anything. Put down this book for two minutes, close your eyes and slowly move your focus from your toes, up through your feet, ankles, shins, knees, thighs, and so on, until you reach the top of your head. As you move your focus up your body, rest for five seconds on every major area.
Did you feel anything that you were not aware of two minutes ago? Is your stomach tight? Are your fingers tingling? Is your heart beating fast? Do you have a pain in your head? Can you feel a twitch anywhere? Is there any soreness across your shoulders? Might you be holding your hands more tightly than you thought? Are you grinding your teeth?
In order to tackle anxiety effectively, it is just as important to know how your body responds to stress as it is to know what you are saying to yourself. The ‘threat system’ – or as it is more commonly known, ‘fight or flight’ – is our bodies’ mechanism to prepare us to stand our ground and get ready to fight or, if we don’t fancy our chances, to get the hell out of there. Either way, we need to be ready to move. All animals have evolved to react this way to brief and acute distress – something that can be seen in action on the birdfeeder in any back garden. If you watch a small bird landing to eat, it doesn’t kick back, pop some peanuts and admire its surroundings. It is hyper-alert, constantly scanning the air and ground, and, at the first sign of any movement, it will fly off. Anxiety is keeping that bird alive.
So, how does the fight-or-flight response play out for us?
Basically, your body prepares itself to address the threat by turning up its emergency functions and turning down the non-emergency ones.
Below are some of the main sensations you can feel when the threat system is activated:
Your heartbeat quickens in order to pump more blood to your muscles.
Your breathing becomes shallow and faster to take in more oxygen.
You may feel dizzy, light-headed or short of breath, as you do not use the extra oxygen you have drawn in.
As blood is drawn from your digestive system to feed your muscles, you can feel nauseous, as if you have ‘butterflies’ in your stomach.
As your body looks to drop excess liquids, your bladder relaxes and you may feel the need to go to the toilet.
With more blood being diverted to your muscles, your hands may begin to feel cold.
As you prepare to fight or run, your muscles become tense.
If you are in a fight for your life or are being chased by a predator, you need to be able to cool down so that you can react as effectively as possible – in order to do this, you may begin to perspire.
The combined effect of breathing through your mouth and fluids being redirected to priority areas can leave you with a dry mouth.
As your vision narrows and your thoughts quicken to hone in on the threat, you can feel disorientated and as if your mind is racing.
If you do not use the adrenalin being generated to run or fight, your body may begin to shake uncontrollably, as the energy that has been generated has nowhere to go.
We all have a similar threat system, but each of us can experience it more intensely in certain parts of our bodies. When I am nervous, I might feel it more in my stomach, whereas you may be more conscious of a faster heart rate or dizziness, or a feeling of being disconnected from reality. Some people will feel cold or need to use the bathroom more, whilst others will shake uncontrollably or get a tingling sensation in their hands. We may be aware of several of the symptoms at the same time. What is important is that you figure out which recurring sensations you get when you feel anxious, with a view to building awareness and tolerance for the physical symptoms of anxiety.
Much of what we experience as stress can be caused by misreading what is going on in our bodies during this fight-or-flight response. As explained, this has evolved to jolt us abruptly into action in situations of acute emergency, so it is not going to feel comfortable. Unfortunately, a lot of times when it kicks off, there is no danger present and so we are just left in our bedrooms with our bodies screaming, ‘run!’ or ‘fight!’, but with nothing to run from and nothing to fight. Without understanding what is happening to us physically, we may feel that something is wrong and that we are in danger of having a heart attack, fainting or vomiting and so, sometimes, these bodily sensations will actually intensify our anxiety. We sit there, sensing danger, and, if we don’t know what is going on, we may feel as if we have lost the plot completely – it’s a very frightening experience.
If this level of anxiety strikes randomly, but on a regular basis, it can leave us feeling out of control, as if we can no longer trust our own bodies. We may begin to be constantly on the alert for these physical symptoms of anxiety and this, in turn, can make us even more anxious. If we go out for a run and our heart starts to beat more quickly and our breathing becomes quick and shallow, this similarity with the symptoms of anxiety can actually cause us to feel anxious, sometimes to the point where we no longer want to do physical exercise. It is not the exercise – it is the misreading of our bodies that is the problem.
Our aim needs to be to get to a place where, although uncomfortable, we can start seeing these sensations for what they are – just our bodies’ way of signalling that we are anxious. In the moment, they are not dangerous. We need to use them as an early-warning system to let us know to bring our focus away from whatever it is we are doing and give our bodies and our thoughts a little attention. Depending on the type of thoughts we find, we can choose to respond to them in different ways – and this is something we will be exploring in detail in Chapter 6 – but, in the first instance, we need to acknowledge that we are anxious because we are then in a better position to take action.
So, while the triggers of anxiety may be different for each of us, the physical threat system that is fired into action by the body is the same. Knowing what is happening physically, and that it is not dangerous in that moment, will help us calm ourselves when we are feeling anxious and will mean we are more able to address what is actually going on, rather than being at the mercy of our bodies’ emergency responses.
Thoughts
If you are at all familiar with your own anxiety, you will know that your thoughts are often your worst enemy. Constantly dealing with the noise of worry or negativity can be exhausting, but how we deal with our thoughts can make all the difference. We will look at this in more detail in Chapters 4 and 6, but for now we need to learn when to engage with our thoughts and when to let go. Sometimes, we need to bring our thoughts into focus and address them; other times we want to be aware of them, but not allow ourselves to get caught up in them.
To start this process, we do need to know what we are saying to ourselves. I fully appreciate that some people are all too painfully aware of their constant, intrusive thoughts, but this is why we need to make the distinction between the two types of thoughts and decide the best course of action – engage or let go.
Sometimes, examining what is going on in your head and body is the last thing you want to do. Why would you want to take a closer look when you may not like what you find? Unfortunately, however, this is exactly what you need to do. Armed with the information you’ll discover, you can do two things. Firstly, you can begin to gain control over how you interact with your thoughts and, secondly, you can learn to use your body as an early-warning system for anxiety, rather than having both your body and mind unwittingly working against you.
Avoiding our fears
While our ancestors’ anxiety responses may have been focused on survival, we obviously don’t have to worry about the same things today. There is probably a supermarket close by. Predators are not behind every bush. Modern medicine means our health is as good as it can be.
We are, however, hardwired for anxiety, and can always find things to worry about. Whatever our fears – and they are different for everyone – it is safe to assume that they didn’t spring up overnight. Most of our anxieties build over time. If we avoid social interactions, they become more daunting. If we develop a fear of flying, the longer we go without taking a flight, the more the fear grows.
Anxiety is both a blessing and a curse. Without it, we would not survive. However, with uncontrolled or misplaced anxiety, we can be left feeling stuck, isolated, fearful and helpless.
If we ignore or hide from our fears, they will come and find us. This is true of any fear we continually try to avoid. The more we turn away, the bigger the issue becomes, and the smaller we become in its shadow. It doesn’t go away. It can’t go away. We are shackled to it.
This thing that we are so afraid of now follows us everywhere, and we dare not turn around. And so, the fear grows ever more powerful.
Avoidance
If we spend our lives avoiding the things that would enable us to grow, we end up in a space that is sheltered but limiting. It is comforting but keeps us stuck. It robs us of our potential, and persuades us to stay small, preferring a sense of security over adventure.
We seek to avoid and escape our fears, and the uncomfortable feelings of anxiety that come with them. We immerse ourselves in work or eat to change our mood or spend hours playing video games or looking at porn or we go shopping all the time and spend all our money, or we surround ourselves with people and distractions or we stay up all night watching TV shows or drinking – the list is endless. But everything here serves a purpose and that is to help us avoid feeling what we do not want to feel – in this case, anxiety. The only way to start taking back control is to cast off the need for comfort and distraction, and begin to look out into the world.
Tackling any anxiety is about actively confronting our fears. This doesn’t mean suddenly just deciding, ‘Right, I have to do everything I’m afraid of right now.’ It generally involves a more gradual process, firstly determining what level of fear we can tolerate and then voluntarily – and continually – tackling challenges so that we are always living just outside our comfort zones. No one else can do this for us, and it is only through direct experience that we can move forward. As we spend less time avoiding our fears and start to confront reality more, we slowly gain strength. We prove to ourselves that we are stronger than we might have thought.
Awareness and action
When the realisation dawns on us that we have a problem in a certain area, it can be difficult to admit it to ourselves, let alone to other people. This awareness can, however, spur us to take action and finally address something that we have been avoiding or ignoring for a long time. We may have hit a low ebb and have been forced to acknowledge that we need to change or we may have had some sort of realisation that there is a better way to live. No matter how we came to this place, when we are ready to do something about it, this is a precious time.
It can be difficult to address a problem properly when we don’t know exactly what is wrong or what the best action to take is. So, there is an initial figuring-out period. We may talk to others close to us, seek out mentors, do some research online, read books or decide to find professional help. There is so much information available now that, in theory, it needn’t take us too long to find the first kernel of wisdom that will set us on our path.
When we discover a source that brings us greater awareness of what we are dealing with, it can become intoxicating. There is nothing like hearing or reading about someone else’s experiences that mirror our own, given in words we can understand but have had difficulty articulating ourselves. It is as if that person is speaking about us and directly to us. However, it is crucial at this precious time of willingness to change that we do not get lost in the awareness part of the journey, particularly in this online age where so much information is so easily accessible to us.
The more we find out about ourselves, the more we become hungry for further knowledge. Everyone we talk to will have another suggestion about a great book to read or podcast to listen to. Every YouTube clip that inspires us will have a list of recommended clips for us to watch, and we may find these just as powerful and relevant to our situation. All the while, the initial crisis that caused us to start looking inward becomes a little more distant, and we become calmer, causing the precious window for real change in our own lives to become smaller.
The problem with awareness is that, without action, it can eventually become just another thing to beat ourselves up with. If we have worked out what is wrong with us or that how we are acting is making our lives a misery, and we do nothing about it, the awareness will become nothing more than another reminder of our inadequacies. There comes a stage, pretty soon into the journey of discovery, where action is needed. We must not wait till we feel ready or we have learned all we can about ourselves, we have to get out and start doing.
We must decide reasonably quickly when we have enough understanding of our weaknesses, and put one foot forward in an attempt to address them. The worst that can happen in this instance is that we learn something else about ourselves – something we could probably not learn in a book!
Find a ‘go-to’ ally
When starting out, we need to settle on one person who we feel will be able to support us – someone who has experience in the area and knows how to help us move forward. This person can be a professional, someone online who is an expert in the subject or a friend who has been through something similar and is a few steps further down the road to sorting themselves out.
Do not keep flitting from person to person amongst the very many people out there who are offering help. If you do, this, in itself, can become a distraction, taking your attention away from the real issue at hand. What you need most at this point is effective focus. Aside from this, no one can possibly assimilate in a productive way all the information that is available out there!
We need to figure out what is wrong. What are we currently doing that is not helping – or that is actually making things worse – and what steps do we need to take to start making headway? The handiest place to begin may simply be to stop doing some things that are exacerbating the situation. Then, we can begin – in a gradual, methodical way – to address the fears that we have been avoiding.
Opportunity, curiosity and compassion: reframing anxiety
Anxiety can keep us stuck or it can spur us on. When we come across something that frightens us, do we turn away and hide or do we see it as an opportunity to grow? The fear has obviously highlighted something we are lacking, a skill we do not yet possess or an area of ourselves that we need to explore and develop. We now have a choice about which road we take. Do we look for safety and comfort or do we do something different and try to take steps towards our fears?
It would be so beneficial if we could approach this work with a slightly different mindset. Instead of seeing anxiety as something to push away, can we begin to see it as a perfect opportunity to grow stronger and braver, and to give us some mental retraining? Instead of being annoyed and exacerbated when something triggers anxiety in us, can we be curious and interested as if we were discovering something novel and important about ourselves?
If anxiety is a problem and we are looking to change, then life will give us ample opportunity. When we become aware of what drives our anxiety, we will encounter it frequently. Well, we will encounter it frequently regardless, but, when the awareness is there, we have a choice about how we interact with it. If we decide to meet our fears head-on and see them as an opportunity to move forward, we will be better prepared and more able to tackle whatever anxiety it is we face. If we ignore the need to overcome our fears, then, when we meet them, we will act out of defence and withdrawal, and will be so much more poorly equipped to handle the situation.
Curiosity is a powerful tool. When we gain awareness around an area that was unclear to us, we can begin to see how it pops up in various aspects of our lives. Let’s say we figure out that people-pleasing is a big problem for us. When people are not obviously happy with us, this causes us some degree of discomfort. When we know this, we will begin to notice it in all our dealings with other people. If we find it annoying or we begin to feel helpless, then it is much harder to see this as an opportunity. If we can approach it with curiosity and start to think more along the lines of, Oh, there it is again – that’s interesting or I didn’t realise it was such a big deal for me or that it has seeped into so many areas of my life, then we will be much more open to doing something about it.
Compassion
Learning to tackle your fears will not be easy, especially in the beginning. It would really help, therefore, if you could be on your own side during the process. This may seem like a given, but, in reality, it rarely is. If anxiety is a problem in your life, it would not be a shock to discover that you are also unduly hard on yourself. Having self-compassion can feel unnatural or alien at times, especially if you have spent a lifetime criticising your every decision and downplaying or ignoring your every accomplishment. Instead of deriding yourself, highlighting your flaws and everything that went wrong, can you build in self-compassion? Can you acknowledge how difficult this is and allow yourself to advance slowly and cautiously? If you cannot get to a place of compassion, can you at least stop paying so much attention to the hyper-critical voice in your head?
Self-compassion is a key component to tackling anxiety in the present and managing it going forward. Anxiety is no walk in the park. If we are castigating ourselves for feeling nervous or showing no empathy for times when we really struggle, then it will only make things harder. If a friend or family member came to us with a story of their anxiety, we would probably listen intently and have all the understanding in the world. We just need to find a small piece of that for ourselves.
Finding our motivation
Figuring out why we want to get our anxiety under control is just as important as finding out how to do it.
Let’s consider another aspect of self-care – why do we look after our teeth? The answer is because, if we don’t, they will fall out, and look and smell awful. How do we look after them? By brushing and flossing every day, and going to the dentist for regular check-ups. We take this as a given. We can see the consequences of not looking after our teeth and those around us will let us know fairly quickly if we are failing! We’re not thrilled about going to the dentist, but we do it and every day we clean our teeth without thinking about it. It’s just part of our daily routine.
We have a really good ‘why’, which makes the ‘how’ part acceptable.
We need to find our motivation for change when it comes to our anxiety. Turning towards our fears is not fun, even if the rewards are many. But think about what anxiety and worry currently take from your life in the day-to-day choices you make. It may not seem like much but, over time, unmanaged anxiety will take its toll.
What way is anxiety affecting your life? Is it damaging your career or your relationships? What effect does it have on the people around you? What does it stop you doing? Is it detrimental to your sleep, your attention, concentration, mood and self-esteem? Is it affecting how you see the world or is it making your world smaller?
How would things look if you were more in control of your anxiety? What would you be doing that you are not doing currently? How would you be interacting with others? Would you have different goals? The road to managing your anxiety involves facing your fears, challenging your habitual ways of thinking and an acceptance of where you are now. You will also experience the joy that comes with pushing through a fear, the pain of occasional regression and the satisfaction of seeing gradual, long-term progress.
Is remaining in the fog of anxiety, unsure of what is wrong, constantly fire-fighting, using insufficient coping mechanisms and spiralling into a low mood when you become overwhelmed really a better solution?
When we find our ‘why’, then another great step is to see ourselves as a continual work-in-progress, rather than thinking that, one day, we will be cured or fixed. We will get better and our lives will get easier as we manage our minds and our anxiety, but there will always be difficulties to deal with and we are always going to need to keep on top of our thoughts.
What is the alternative? We can read all the self-help books we want, but if we are not putting things into practice and taking action, we will not get the results we are craving. We can read every night for a year about how to push aside our anxious thoughts and face our fears, but until we start pushing and facing, then it will be for nothing.
It may seem scary, but as we look out into the world, we only need to take small steps to begin. Enough small steps will add up to a minimum of progress. Over time, this will add up to huge change.