Don't Just Cope: Changing Your Relationship With Anxiety.

Anxiety is a normative experience that we share  with each other and it becomes problematic when it impacts our day-to-day function or we develop anticipatory worry of its reemergence. Anxiety is the brain’s interpretation of perceived threat in the absence of danger. The physiological changes we experience (e.g., increased heart rate, sweating, racing thoughts, numbness in extremities) when running from a bear are never thought of as an anxious response. They may be initiated by fear but are bloody necessary!

This need changes, however, when the same damaging symptoms arise before a public presentation, or networking opportunity. In these circumstances we are not actually in danger, but our brains get stuck in a loop between our physical symptoms and cognitive appraisals. This emotional reasoning, “If I feel bad it must be because there is reason to be” is commonly experienced by individuals who struggle with anxiety disorders. For example, individuals with social anxiety use their body’s physiology as cues for their social success or failure (e.g., “Sweating, blushing, and stomach knots are ‘proof’ I’m screwing this up!”).

Effective therapies (i.e., CBT, Exposure Response Prevention, Mindfulness, & Acceptance and Commitment Therapy) help individuals shift their relationship with their anxiety by challenging distorted thinking and breaking the anxiety brain-body loop through behavioral techniques. Methods to help individuals cope can sometimes be problematic. When utilizing coping skills, individuals continue to perceive their anxiety symptoms as dangerous and run the risk of temporary relief.

Although immediate symptom reduction can be seductive, it produces continued intolerance for distress - the major contributor to anxiety disorders. Treatment should focus on increasing a person’s  tolerance for distressing feeling and separating feelings of anxiety from themselves. The feelings of panic will never be pleasurable, but tips to make them manageable and ultimately less significant do exist.

5 Tips for Shifting Your Relationship with Anxiety

1. Think about and discuss your anxiety as a separate entity. For example, “My anxiety wants me to cancel my plans. My anxiety is telling me i’m making a fool of myself.” This helps individuals identify their experience without judgement.
2. Name it. When talking about your anxiety as separate from yourself it can be very helpful to call it something else. Some clients find vilifying their anxiety helps by calling it “Nazi” “Voldemort”  “bully” or “AOJ: Antithesis of joy,” while others use comical names to reduce its power, such as “bunny” or “Goofy.”
3. Plan for the worst and expect the worst. Most individual’s anxiety is centered around the anticipation of something. Anxiety can be predictable and often is. Don’t be surprised and demoralized by it showing its face. Expect it. It is empowering to enumerate your expected symptoms before an event and chuckle to yourself when your anxiety shows up with its predictable symptoms to freak you out.
4. Track the time. A helpful strategy is to make a mental or written note of the precise time you notice its appearance. Anxiety physiologically can not last for long, although it feels like it’s forever. Tracking the time provides real evidence of the limited nature of acute distress.
5. Bring it on. Avoidance is the fuel that maintains anxiety. Seeking out anxious experiences on purpose teaches the brain these experiences are not dangerous. With regular practice, the once predictable anxiety fades away when it loses its power.

Written by Kevin Ashworth, MA, LPC. Kevin is a licensed therapist and co-founder of NW Anxiety Institute in Portland, Oregon. He specializes in CBT and ERP treatments of anxiety disorders in children and adults.