Cluster One: Physical Arousal
Distressing Physical Arousal – sympathetic arousal causes the heart thumping, pulse-racing, dizzy, tingly, shortness of breath physical symptoms, that can come out of the blue and are intolerable when not understood. Even high levels of anxiety can cause physical tension in the jaw, neck and back as well as an emotional somatic feeling of doom or dread in the pit of the stomach, which will set off a mental search for what might be causing it.
Method 1: Manage the body.
- Eat right
- Avoid alcohol, nicotine, sugar and caffeine
- On going self care
- Consider hormonal changes
Method 2: Breathe
Breathing will slow down or stop the stress response
Do the conscious, deep breathing for about 1 minute at a time, 10-15 times per day every time you are waiting for something eg., the phone to ring, an appointment, the kettle to boil, waiting in a line etc.
Method 3: Mindful Awareness
Close your eyes and breathe; noticing the body, how the intake of air feels, how the heart beats, what sensations you can feel in the gut etc
- With eyes still closed, purposefully shift your awareness away from your body to everything you can hear or smell or feel through your skin
- Shift awareness back and forth from your body to what’s going on around you
You will learn in a physical way that you can control what aspects of the world – internal or external –you’ll notice, giving you an internal locus of control and learning that when you can ignore physical sensations, you can
stop making the catastrophic interpretations that bring on panic or worry. It allows you to feel more in control and mindful of the present.
Cluster Two: Tension, Stress and Dread
Many people with anxiety search frantically for the reasons behind their symptoms in the hope that they can ‘solve’ whatever problem it is, But since much of their heightened tension isn’t about a real problem, they are wasting their time running around an inner maze of perpetual worry. Even if the tension stems from psychological or other causes, there are ways to eliminate the symptoms of worry.
These methods are most helpful for diminishing chronic tension.
Method 4: Don’t listen when worry calls your name
This feeling of dread and tension comprises a state of low grade fear, which can also cause other physical symptoms, like headache, temporomandibular joint pain and ulcers. The feeling of dread is just the emotional manifestation of physical tension.
You must first learn that worry is a habit with a neurobiological underpinning. Then apply relaxation to counteract the tension that is building up.
This ‘Don’t Listen’ method decreases the tension by combining a decision to ignore the voice of worry with a cue for the relaxation state.
To stop listening to the command to worry, you can say to yourself: “Its just my anxious brain firing wrong”. This is the cue to begin relaxation breathing which will stop the physical sensations of dread that trigger the radar.
Method 5: Knowing, Not Showing, Anger
When you fear anger because of past experience, the very feeling of anger, even though it remains unconscious, can produce anxiety To know you’re angry doesn’t require you to show you’re angry.
A simple technique: Next time you feel stricken with anxiety, you should sit down and write as many answers as possible to this question, “If I were angry, what might I be angry about?” Restrict answers to single words or brief phrases.
This may open the door to get some insight into the connection between your anger and your anxiety.
Method 6: Have a Little Fun
Laughing is a great way to increase good feelings and discharge tension. Getting in touch with fun and play isn’t easy for the serious, tense worrier.
A therapy goal could be simply to relearn what you had fun doing in the past and prescribe yourself some fun.
Cluster Three: The Mental Anguish of Rumination
These methods deal with the difficult problem of a brain that won’t stop thinking about distressing thoughts or where worry suffocates your mental and emotional life. These worries hum along in the background, generating tension or sick feelings, destroying concentration and diminishing the capacity to pay attention to the good things in life.
Therapy does not need to focus on any specific worry, but rather on the act of worrying itself – the following methods are the most effective in eliminating rumination.
Method 7: Turning it Off
If a ruminating brain is like an engine stuck in gear and overheating, then slowing or stopping it gives it a chance to cool off. The goal of ‘turning it off’ is to give the ruminative mind a chance to rest and calm down.
Sit quietly with eyes closed and focus on an image of an open container ready to receive every issue on your mind. See and 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 you have the container on the shelf, you invite into the space that is left in your mind whatever is the most important current thought or feeling.
At night, right before sleep, invite a peaceful thought to focus on while drifting off.
Method 8: Persistent Interruption of Rumination
Ruminative worry has a life of its own, consistently interfering with every other thought in your mind. The key to changing this pattern is to be persistent with your attempts to use thought stopping and thought replacement. Its important to attempt to interrupt the pattern every time you catch yourself ruminating – you’ve spent a long time establishing this pattern and it will take persistence to wear it down.
Thought stopping – use the command “Stop” and/or a visual image to remind yourself that you are going into an old habit. The command serves as a punishment and a distractor.
Thought replacement – substitute a reassuring, assertive or self-accepting statement after you have managed to stop the thought. You may need to develop a set of these statements that you can look at or recall from memory.
Method 9: Worry Well, but Only Once
Some worries just have to be faced head-on, and worrying about them the right way can help eliminate secondary, unnecessary worrying. When you feel that your worries are out of control try this next method:
- Worry through all the issues within a time limit of 10-20 mins and cover all the bases
- Do anything that must be done at the present timeSet a time when it’ll be necessary to think about the worry again
- Write that time on a calendar
- Whenever the thought pops up again say, “Stop! I already worried” and divert your thoughts as quickly as possible to another activity – you may need to make a list of these possible diversions beforehand.
Method 10: Learn to Plan Instead of Worry
A big difference between planning and worrying is that a good plan doesn’t need constant review. An anxious brain, however, will reconsider a plan over and over to be sure it’s the right plan. This is all just ruminating worry disguising itself as making a plan and then seeking constant reassurance.
It is important to learn the fundamentals of planning as it can make a big difference in calming a ruminative mind. These include:
- Concretely identifying the problem
- Listing the problem solving options
- Picking one of the options
- Writing out a plan of action
To be successful in this approach, you must also have learned to apply the thought-stopping/thought-replacing tools or you can turn planning into endless cycles of replanning.
Once a plan has been made you can use the fact that you have the plan as a concrete reassurance to prevent the round-robin of ruminative replanning. The plan becomes part of the thought-stopping statement, “Stop! I have a plan!” It also helps the endless reassurance-seeking, because it provides written solutions even to problems the ruminator considers hopelessly complex.