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What To Do When Feeling Anxious


Introduction


First things first. I’ll start by suggesting useful things to try anytime you find yourself anxious. Then I’ll outline the main features of Exposure Therapy - a Cognitive Behavioural Therapy (CBT) used particularly to treat phobias (fears of specific things or places). No matter what type of anxiety ails you it’s worth time to identify the triggers of your anxiety and how the anxiety finds expression in your body.


When Anxiety Strikes


· STOP! Pause; take a few breaths deep into the stomach; close your mouth and breathe only through your nose; count to 5 on the inhale, pause and count to 7 on the exhale.


· Orientation: Bring yourself into the here and now by doing a brief orientation of your surroundings. Look around you and note the main features of the room. Listen to the sounds around you. Touch some objects in the room. Ground your feet against the floor and your back against the chair.


· Question yourself:

o What am I reacting to? What is it that I think is going to happen here?

o What's the worst (and best) that could happen? What's most likely to happen? Am I getting things out of proportion? Am I overestimating the danger? Am I underestimating my ability to cope? Am I putting more pressure on myself? Is there another way of looking at this? Is this fact or opinion?

o How important is this really? How important will it be in 6 month’s time?

o Am I mind-reading what others might be thinking? Am I believing I can predict the future?

o What advice would I give someone else in this situation?

o What would be the consequences of responding the way I usually do? Is there another way of dealing with this? What would be the most helpful and effective action to take? (for me, for the situation, for others) What do I want or need from this person or situation? What do they want or need from me? Is there a compromise?


· Visualise yourself coping in the situation you feel anxious about. See the situation to a successful completion.


Exposure Therapy


In Exposure therapy, counsellors create a safe environment in which individuals ‘expose’ themselves to the things they fear and avoid. Over time, if clients continue to expose themselves to the feared objects, activities or situations, in a way that is safe for them, their fear gradually reduces and their avoidance gradually decreases to the point where the problem eventually disappears.


The therapist helps the client construct an exposure fear hierarchy, in which feared objects, activities or situations are ranked according to difficulty. They begin by exposing themselves to the smallest fear on the exposure fear hierarchy and gradually progress by exposing themselves to greater and greater fearful situations. So someone who has a fear of public spaces could be asked to stay in a supermarket for one minute more than as many minutes as they can normally comfortably bear. Slowly over a number of weeks they will asked to gradually build up the time that they can spend in a supermarket to the point where they are free and relaxed at any time to go to a supermarket.


The exposure exercise can be combined with relaxation exercises to make the anxiety feel more manageable and to associate the feared objects, activities or situations with relaxation. So before going into the supermarket, the client plays a five minute guided mediation tape which guides the client to imagine feeling relaxed and really enjoying the experience of shopping.


Triggers


What or when are the times when you are more likely to get anxious? If you can see the patterns, then maybe you can do something about those situations, and do something different. Certain places? Certain people? Then you should probably stop going to these places or seeing these people. Anytime? See certain things? Hear certain things? Then you should think about these times, these sightings and these sounds and devise practical ways to counteract them.


Physical Sensations of Anxiety


The body keeps the score. The ups and downs of our lives are imprinted in our bodies. The effects of our anxiety too are imprinted in some or various parts of the body. Learning to identify where we store these physical sensations is a great help to reducing the symptoms of anxiety. Anxious clients talk of ‘butterflies in their stomach’, ‘a weight on their shoulder’, tension in their forehead, over heating of their body. The mere conscious awareness of these tensions and reactions helps to start taking the edge off the anxiety.


A great way to develop bodily awareness is by practicing mindfulness. As we learn to tune into the sensations of the body, we become more grounded, more relaxed in our own skin and gain more control over anxiety. Learning to be mindful of our body and learning from the messages of our bodily sensations not only can help us with our anxiety but can bring a deep healing to our psyches.


Last but by no means least, a great way to counteract some of the adverse effects of the body’s anxious adrenaline response is by using it up healthily in physical exercise particularly the form of exercise you enjoy the most. Go for a walk, run or cycle, or do some gardening or housework. Yoga has been shown to be a particularly good exercise for anxious people to practice and complements the practice of mindfulness.