Anxiety is the body’s way of preparing us for something that it perceives is a threat, or something that’s going to be hard or painful. This can be beneficial and prepare us for dangerous or life-threatening situations. However, these signals that something is wrong can get exaggerated and “stuck”, in a sense, making us feel like something scary is happening or coming when there’s no actual threat. Think of a guard dog that starts attacking the mailman or barking at your grandmother. He’s associated danger with things that aren’t actually dangerous, and when you mind does this, it puts your body in a state of stress when it doesn’t need to be. Some strong feelings come before our thinking, and some strong feelings are strengthened by and come because of our thinking. We want to become better at managing both kinds. Strong feelings that come before thinking are about managing the body, while strong feelings that come after are more about managing our thinking patterns or habits. We’ll learn how to do both to consistently chang how you respond to life and consequently, how you feel. Long-term self-care Commit to employing the following into your daily routines: · Anxiety journal: record when and under what circumstances you suffer from anxiety · Sleep: what’s the amount of sleep you need? Are you getting it? · Diet: garbage in, garbage out. Make sure your diet matches what your brain/body needs to take care of itself (fruits, vegetables, natural food, eliminate caffeine, preservatives, sugars, etc.) · Exercise: daily exercise that increases your heart rate and takes at least 20 minutes · Meditation: make sure you’re learning and practicing some form of mindfulness and meditation daily (quite time pondering, yoga, etc.) Short-term self-care · Feelings are fluid! Focus on how feelings change – think about what your feelings will be when you feel better again. It helps to write down the expected changes. For example, if you’re anxious or nervous about a coming talk or presentation, imagine what you expect your feelings will be when you start to feel better again. Thing about what the very first little sign might be that those changes in feelings are happening, such as speaking more spontaneously or beginning to smile more during the presentation. Remember, feelings are fluid and will inevitably change – simply imagine the change that will be taking place before it happens. · Chew it over and act normal! Anxiety is a survival response that can go wrong and hinder more than it helps. It senses a threat that may not be there. In order to train anxiety to be selective and monitor itself, you want to send the message that it’s not needed in the moment and can take a break. If you act in a way that you wouldn’t during a real emergency, you can help break the stress response cycle. Things you normally wouldn’t do in a real emergency include talking softly and calmly, smiling, salivating, breathing deeply (longer exhale than inhale), or have an open body posture. Doing any of these things during anxiety or panic attacks or at the beginning of stress can take the body out of anxiety by sending the message that things are okay. Something as simple as chewing gum (salivating) or even imagining chewing gum can cause this change to take place, and a combination of more than one of these things will certainly break the cycle. · Ask yourself what you’re afraid of when anxious and use “then what?” to question yourself back to things being okay. For example, if you’re anxious about a talk, ask yourself what the fear is and then ask what would happen then until there’s nothing left to be afraid of. For example, if I’m preparing for a talk and I’m anxious, I can ask what I’m afraid of. Maybe the answer is what people will think if I mess up. Then ask yourself “And what would people think if I messed up?” Well, they’d think I wasn’t prepared or wasn’t accomplished or whatever it is. Again, ask “Then what?” until there’s nothing left but life returning to normal, which isn’t scary at all. Catch the underlying assumption and chase down the logical conclusions. · Heighten Awareness of your emotions by identifying what you are feeling. Doing this can help you recognize that you are not the feelings and emotions you are experiencing. They are simply that: feelings, thoughts, and emotions. But they aren't you. If you can recognize how you are feeling, acknowledge it, and then realize they are not you, you are more able to let them go. · Breath purposefully and intentionally, slowing your breaths down to 4 seconds in then 4 seconds out (or what feels best). Clear your thoughts and when thoughts come, just notice them with a simple “hmmm” and go back to focusing on your breath. Do this for one minute several times a day, like when you’re waiting for the microwave, waiting in line or traffic, etc. Start here and work your way up to 5 and 10 minutes at a time. · Mindful awareness (focus shifting): By shifting awareness back and forth several times between what's going on in your body and what's going on around you, you learn in a physical way that you can control what aspects of your world--internal or external—you’ll notice. This gives you an internal locus of control – when you can ignore physical sensations, you can stop making the catastrophic interpretations that actually bring on panic or worry. o Close your eyes and breathe, noticing the body, how the intake of air feels, how the heart beats, what sensations you have in the gut, etc. o With your eyes still closed, purposefully shift your awareness away from your body to everything you can hear or smell or feel through your skin. · Practice Radical Acceptance: Acknowledge your present situation, whatever it is, without judging the events or criticizing yourself. Look at yourself and the situation and see it as it really is. This does not mean to condone or agree with bad behavior in others. It means to stop trying to change what’s happened by getting angry and blaming the situation. Refocus your attention on what you can do now. This will allow you to think more clearly and figure out a better way to cope with your suffering. · Do progressive muscle relaxation where you tense your muscle groups one group at a time, starting with your extremities. Go in order: hands, forearms, biceps, then feet, calves, thighs, bottom, stomach, chest, shoulders, neck, face, and head. Hold each tensely for 20 seconds, then take a deep breath and relax your muscles on the exhale. Follow with 2 more deep, cleansing breaths before you move on to the next muscle group. Repeat the entire process if necessary. When finished, pair this deeply relaxed state you’ve achieved with a color, image, and word (i.e., blue, calm surface of a lake, and the word “calm”). This strengthens associations with muscle relaxation and makes it easier to cue the sensation at will. · Don't Listen! The feeling of dread is just the emotional manifestation of physical tension. Worry is a habit with a neurobiological underpinning. Even if you aren’t particularly worried about anything, an anxiety-prone brain can create a sense of doom which then causes hypervigilance as you try to figure out what's wrong, assuming there must be something! To stop listening to that command to worry, tell yourself "It's just my anxious brain firing wrong." This is your cue: begin relaxation breathing and decrease tension by combining your decision to ignore the voice of worry with a cue for the relaxation state (like using the word “calm”). · Knowing and not showing anger: The key to relieving anxiety caused by anger is to decrease your sense of tension and stress while raising the consciousness of anger so that it can be dealt with. Simply being able to feel and admit to anger and to begin working on how to safely express it diminishes anxiety. To know you're angry doesn't require you to show you're angry. The next time you’re stricken with anxiety, immediately sit down and write as many answers as possible to this question, "If I were angry, what might I be angry about?" Restrict your answers to single words or brief phrases. · Have a little fun and act on impulse! Spending time with children, enjoying a popular comedy, spending time with a group of friends, etc. Bring examples of doing something impulsively and relearning how to have fun. Laughter is one of the best medicines for tension and anxiety. · Turning it off and clearing space. From Eugene Gendlin's Focusing method comes the concept of "clearing space" to turn off and quiet the ruminative mind. Sit quietly with eyes closed and focus on an image of an open container ready to receive every issue on your mind. Name each issue or worry and imagine putting it into the container. When no more issues come to mind, "put a lid" on the container and place it on a shelf or in some other out of the way place until you need to go back to get something from it. Once the jar is on the shelf, invite into the space left in your mind whatever is the most important current thought or feeling. Perhaps you’re at work and need to think about a work-related issue, or you need to shop and plan what you’ll buy, or you’re with friends and want to focus on what they're saying. At night, right before sleep, invite a peaceful thought to focus on while drifting off. · Thought-stopping/ thought-replacing: every time you have a thought that ruminates unnecessarily on something negative have a replacement thought that challenges the negative thought. The key is persistence – replace this negative thought every time you need to, even if it’s 1,000 times a day. Don’t quit until it’s working, because it will! · Replace worrying with planning. This includes: (1) concretely identifying a problem; (2) listing the problem-solving options; (3) picking one of the options; and (4) writing out a plan of action. You must also have learned to apply the thought-stopping/thought-replacing tools, or you’ll turn planning into endless cycles of replanning. The plan becomes part of the thought-stopping statement, "Stop! I have a plan!" · Worry well once: set 10 minutes aside to worry about a particular problem covering all possible solutions and scenarios. You’d be surprised how much you can cover in 10 minutes. Follow these steps: (1) worry through all the issues; (2) do anything that must be done at the present time; (3) set a time when it'll be necessary to think about the worry again; (4) write that time on a calendar; and (5) whenever the thought pops up again, say, "Stop! I already worried!" and divert your thoughts as quickly as possible to another activity. · Take your shoes off and concentrate on feeling the ground beneath your feet. Walk around and pay attention to what it feels like. · Get your body moving with a simple exercise that works, such as taking a walk or standing and stretching and pay attention to how every part of you feels when you’re doing this. · Distract with Activities (Go out to eat, play a game, watch a movie etc), Contributing (Help a friend, call someone to say hi, do something thoughtful), Pushing Away (Leave the situation mentally, notice the ruminating thoughts and yell NO!, refuse to think about painful situations, put the pain on the shelf for now), With other thoughts (Count to 10, count colors in a painting, count anything, do a puzzle, repeat words to a song in your mind), With other sensations (Squeeze a rubber ball very hard, listen to loud music, hold ice in your hand or mouth, take a hot or cold shower) · Self-Soothing using your FIVE SENSES: Vision: Look at pictures, make a space or room pleasing to look at, look at nature around you, browse through a store looking at things. Hearing: Listen to soothing sounds or music, sing a favorite song etc. Smell: Use a favorite soap, shampoo, perfume etc, burn a scented candle, open the window and smell the air. Taste: Eat a favorite food, treat yourself to a dessert, suck on candy, chew your favorite gum etc. Touch: Soak your feet, get a massage, sink into a comfortable chair, rock in a rocking chair, hug someone, wrap up in a blanket. · Tip the temperature of your face with cold water. Holding your breath, put your face in a bowl or tub of cold water (Keep water above 50 degrees), or hold a cold pack on your eyes and cheeks. Hold for 20 seconds (or however long is comfortable for you without causing you problems). This causes the "Dive response" to occur. Your heart rate slows down, blood flow is redirected to the brain and heart. This is helpful when you're having strong, distressing emotions. Distress Tolerance Helps 1- Heighten Awareness of your emotions by identifying what you are feeling. Doing this can help you recognize that you are not the feelings and emotions you are experiencing. They are simply that: feelings, thoughts, and emotions. But they aren't you. If you can recognize how you are feeling, acknowledge it, and then realize they are not you, you are more able to let them go. 2-Paced Breathing (pace your breathing by slowing it down): Breathe deep into your belly. Slow your pace of inhaling and exhaling way down (On average, five to six breaths per minute). Breathe out more slowly than you breathe in (for example, 5 seconds in and 7 seconds out). 3- Practice Radical Acceptance: Acknowledge your present situation, whatever it is, without judging the events or criticizing yourself. Look at yourself and the situation and see it as it really is. This does not mean to condone or agree with bad behavior in others. It means to stop trying to change what’s happened by getting angry and blaming the situation. Refocus your attention on what you can do now. This will allow you to think more clearly and figure out a better way to cope with your suffering. 4-Go for a walk 5-Paired muscle relaxation: While breathing into your belly deeply, tense your body muscles (not so much as to cause cramps or pain). Notice the tension in your body. While breathing out, say the word "relax" in your mind. Let go of the tension. Notice the difference in your body. 6-Do a containment exercise in your mind. Whatever is bothering you...whether it's a thought, image, sensation, or emotion, close your eyes and imagine yourself putting it inside some sort of container of your choosing (A safe, box, barrel etc.) to be addressed later. Imagine locking it away with the thought that you can work on it later. . And you can lock it up and fortify it however you want in your mind. Maybe you put a fictional character in charge of keeping it stored away for you etc. This isn’t an avoidance strategy, this is more a healthy distraction until you’re ready to address the problem with a trusted support person or a counselor 7-Distract with Activities (Go out to eat, play a game, watch a movie etc), Contributing (Help a friend, call someone to say hi, do something thoughtful), Pushing Away (Leave the situation mentally, notice the ruminating thoughts and yell NO!, refuse to think about painful situations, put the pain on the shelf for now), With other thoughts (Count to 10, count colors in a painting, count anything, do a puzzle, repeat words to a song in your mind), With other sensations (Squeeze a rubber ball very hard, listen to loud music, hold ice in your hand or mouth, take a hot or cold shower) 8-Self Soothing using your FIVE SENSES: Vision: Look at pictures, make a space or room pleasing to look at, look at nature around you, browse through a store looking at things. Hearing: Listen to soothing sounds or music, sing a favorite song etc. Smell: Use a favorite soap, shampoo, perfume etc, burn a scented candle, open the window and smell the air. Taste: Eat a favorite food, treat yourself to a dessert, suck on candy, chew your favorite gum etc. Touch: Soak your feet, get a massage, sink into a comfortable chair, rock in a rocking chair, hug someone, wrap up in a blanket. 9-Tip the temperature of your face with cold water. Holding your breath, put your face in a bowl or tub of cold water (Keep water above 50 degrees), or hold a cold pack on your eyes and cheeks. Hold for 20 seconds (or however long is comfortable for you without causing you problems). This causes the "Dive response" to occur. Your heart rate slows down, blood flow is redirected to the brain and heart. This is helpful when you're having strong, distressing emotions.