by Margaret
Wehrenberg
"I don't think I want to live if I
have to go on feeling like this." I hear this remark all too
often from anxiety sufferers. They say it matter-of-factly or
dramatically, but they all feel the same way: if anxiety symptoms are
going to rule their lives, then their lives don't seem worth
living.
What is it about anxiety that's so horrific that
otherwise high-functioning people are frantic to escape it? The
sensations of doom or dread or panic felt by sufferers are truly
overwhelming--the very same sensations, in fact, that a person would
feel if the worst really were happening. Too often, these, literally,
dread-full, sickening sensations drive clients to the instant relief
of medication, which is readily available and considered by many
insurance companies to be the first line of treatment. And what good
doctor would suggest skipping the meds when a suffering patient can
get symptomatic relief quickly?
But what clients don't know
when they start taking meds is the unacknowledged cost of relying
solely on pills: they'll never learn some basic methods that can
control or eliminate their symptoms without meds. They never develop
the tools for managing the anxiety that, in all likelihood, will turn
up again whenever they feel undue stress or go through significant
life changes. What they should be told is that the right
psychotherapy, which teaches them to control their own anxiety, will
offer relief from anxiety in a matter of weeks--about the same amount
of time it takes for an SSRI to become effective.
Of course,
therapists know that eliminating symptomatology isn't the same as
eliminating etiology. Underlying psychological causes or triggers for
anxiety, such as those stemming from trauma, aren't the target of
management techniques; they require longer-term psychotherapy.
However, anxiety-management techniques can offer relief, and offer it
very speedily.
The unpleasant
symptoms most likely to be helped by medication are the very ones
that the 10 best-ever anxiety-management techniques are intended to
correct. They fall into three typical clusters:
- the physical
arousal that constitutes the terror of panic;
- the "wired"
feelings of tension that correlate with being "stressed out"
and can include pit-of-the-stomach doom;
- the mental
anguish of rumination--a brain that won't stop thinking distressing
thoughts.
A therapist armed
with methods for addressing these clusters can offer her anxious
client the promise of relief for a lifetime, if she knows which of
these "10 best" techniques work for which symptoms, and how
to use them.
Cluster One:
Distressing Physical Arousal
Panic is the
physical arousal that sends many clients running for Xanax.
Sympathetic arousal causes the heart-thumping, pulse-racing, dizzy,
tingly, shortness-of-breath physical symptoms that can come from out
of the blue, and are intolerable when not understood. Even high
levels of acute anxiety that aren't as intense as outright panic
attacks can constitute very painful states of arousal. Physical
symptoms of anxiety include constant heightened 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. The feeling of doom will
always set off a mental search for what might be causing it.
Bad as these
symptoms are, there are methods that, when followed regularly as
lifelong habits, offer tremendous relief.
Method
1: Manage the Body.
Telling
anxiety-prone clients to take care of their bodies by eating right,
avoiding alcohol, nicotine, sugar, and caffeine, and exercising is a
strikingly ordinary "prescription," but not doing these
things can undermine the effectiveness of other antianxiety
techniques. During the summer before Ellie went off to college, for
example, she'd almost eliminated her anxiety by practicing deep, calm
breathing and learning to stop her catastrophic thinking. She'd even
been able to stop taking the antianxiety medication she'd used for
years. But two months after starting college, her panic attacks came
roaring back with a vengeance. She came back to see me, but
quickly let me know that she was going to call her psychiatrist for
another Xanax prescription. I suggested that, before she made the
call, she spend a couple of weeks keeping a "panic profile"--a
journal recording when and under what circumstances she suffered from
panic attacks.
A couple of weeks
later, she came to my office smiling broadly. "I figured it
out," she said, grinning as she showed me her panic profile.
She'd traced her panic attacks to days after she drank heavily and
smoked cigarettes--neither of which had she done over the summer
while living in her parents' house. Also, her caffeine use had risen
dramatically while at school--to help her wake up for classes after
partying at night--and her diet had devolved to pizza and doughnuts.
She really didn't want to give up these habits, but keeping the
journal had reminded her that her anxiety symptoms are physical, and
that calming her body had defused her panic triggers once before.
Taking care again to eliminate CATS (caffeine, alcohol, tobacco,
sugar + Nutrasweet), Ellie got back on track without returning to
meds. The simple rule--manage the body--must remain a first priority
throughout treatment for anxiety. Ellie had a major relapse when she
let go of routine self-care.
Therapists who
remember that humans have bodies as well as minds are much likelier
to inquire routinely about ongoing self-care, including sleep and
exercise. They're also more willing to help clients overcome their
reluctance to follow a self-care routine. A tip to remember for
female clients who experience a resurgence of symptoms in spite of
the fact that they're managing their body is to consider hormonal
changes. Pregnancy, postpartum changes, hysterectomy, and
interruptions in cycles may contribute to anxiety. The slow process
of menopause, which may begin over a wide range of ages, is another
factor to consider. Shifts in thyroid function also contribute to
shifts in anxiety. They can occur at any age, and predominate in
female clients. Therapists need to be particularly alert to what
might be going on in the body when a client who was previously doing
well starts having trouble.
Method
2:
Breathe.
Ellie
and I next reviewed her use of diaphragmatic breathing to ward off
the panic. As it turned out, she'd forgotten how helpful breathing
had been when we first started working together, and had quit doing
it. Now, not only did she suffer again from panic, but she thought it
was too powerful to be relieved merely by breathing deeply. She'd
begun to panic just thinking about feeling panic. I've often found
that when clients say that breathing "doesn't work," it's
because they haven't learned to do it correctly. Or once having
learned it, they've given it up when they felt better, believing that
they no longer needed to do it. By the time they feel anxiety
returning, they're convinced that something so simple can't possibly
be really effective. Therefore, it's important for therapists to
emphasize and reemphasize that breathing will slow down or stop the
stress response, if the client will just do it.
The
biggest block to making breathing truly helpful is the time it takes
to practice it until it becomes an ingrained habit. Most relaxation
books teach clients to practice breathing once a day for 10 minutes,
but I've never found a client who actually learned how to do it from
this one, daily, concentrated dose. I don't teach clients to breathe
for lengthy periods until they've practiced it for very short periods
many times a day. I ask them to do the conscious, deep breathing for
about one minute at a time, 10 to 15 times per day, every time they
find themselves waiting for something--the water to boil, the phone
to ring, their doctor's appointment, the line to move at the bank.
This will eventually help them associate breathing with all of their
surroundings and activities. This way, they're more likely to
actually remember to breathe when anxiety spikes. Ellie needed a
review session in breathing to help her get back on track.
Method
3: Mindful Awareness.
Since the return
of her panic attacks, Ellie had also begun to fear that she'd always
be afraid. "After all," she said, "I thought I was
cured when I went back to school, and now look at me! I'm constantly
worried I'll have another panic attack." She'd started to give
catastrophic interpretations to every small, physical
sensation--essentially creating panic out of ephemeral and
unimportant changes in her physical state. A slight chill or a
momentary flutter in her stomach was all she needed to start
hyperventilating in fear that panic was on its way, which, of course,
brought it on. She needed to stop the catastrophic thinking and
divert her attention away from her body.
Like most anxious
people when they worry, Ellie was thinking about the future and
wasn't in the moment. She felt controlled by her body, which required
her to be on the lookout for signs of panic. She'd never considered
that she could manage her body--and prevent panic--by controlling
what she did or didn't pay attention to. But, in fact, by changing
her focus, she could diminish the likelihood of another panic attack.
A wonderful technique, this simple "mindful awareness"
exercise has two simple steps, repeated several times.
1. Clients close
their eyes and breathe, noticing the body, how the intake of air
feels, how the heart beats, what sensations they have in the gut,
etc.
2. With their
eyes still closed, clients purposefully shift their awareness away
from their bodies to everything they can hear or smell or feel
through their skin.
By shifting
awareness back and forth several times between what's going on in
their bodies and what's going on around them, clients learn in a
physical way that they can control what aspects of their
world--internal or external--they'll notice. This gives them an
internal locus of control, showing them, as Ellie learned, that when
they can ignore physical sensations, they can stop making the
catastrophic interpretations that actually bring on panic or worry.
It's a simple technique, which allows them to feel more in control as
they stay mindful of the present.
Cluster
Two: Tension, Stress, and Dread
Many
clients with generalized anxiety disorder (GAD) experience high
levels of tension that are physically uncomfortable and compel
them to search frantically for the reasons behind their anxiety.
They hope they can "solve" whatever problem seems to be
causing anxiety and thus relieve its symptoms. But since much of
their heightened tension isn't about a real problem, they simply
waste time running around their inner maze of self-perpetuating
worry. And even if their tension does stem from psychological or
neurobiological causes, there are ways to eliminate the symptoms
of chronic worry before addressing those dimensions. The following
methods are most helpful for diminishing chronic tension.
Method
4: Don't
Listen When Worry Calls Your Name.
Colleen
feared I'd think she was crazy when she said, "It's as
if my anxiety has a voice. It calls to me, 'Worry now,' even when
there's nothing on my mind. Then I have to go looking for what's
wrong." And she was very good at finding something wrong to
worry about. An executive who had a lot of irons in the fire, she
had no shortage of projects that needed her supervision. On any
day, she could worry about whether a report had been correct, or
projected figures were accurate, or a contract would generate
income for her firm. In describing the voice of worry, she was
describing that physical, pit-of-the-stomach sense of doom that
comes on for no reason, and then compels an explanation for why
it's there. This feeling of dread and tension, experienced by most
GAD clients, actually comprises a state of low-grade fear, which
can also cause other physical symptoms, like headache,
temporo-mandibular joint (TMJ) pain, and ulcers.
Few
realize that the feeling of dread is just the emotional
manifestation of physical tension. This "Don't Listen"
method decreases this tension by combining a decision to ignore
the voice of worry with a cue for the relaxation state. Early in
treatment, GAD clients learn progressive muscle relaxation to get
relief. I always teach them how to cue up relaxation several times
throughout the day by drawing a breath and remembering how they
feel at the end of the relaxation exercise. We usually pair that
deeply relaxed state with a color, image, and word to strengthen
associations with muscle relaxation and make it easier to cue the
sensation at will.
We
then use that ability to relax to counteract the voice of worry.
Clients must first learn that worry is a habit with a
neurobiological underpinning. Even when a person isn't
particularly worried about anything, an anxiety-prone brain can
create a sense of doom, which then causes hypervigilance as the
person tries to figure out what's wrong. Colleen smiled with
recognition when I said that, when she was in this state, it was
as though her brain had gone into radar mode, scanning her
horizons for problems to defend against. I asked her to pay
attention to the order of events, and she quickly recognized that
the dread occurred before she consciously had a worry. "But,"
she announced, "I always find something that could be causing
the doom, so I guess I had a good reason to worry without
realizing it."
She
believed the doom/dread must have a legitimate cause, and was
relieved to learn that her need to find the cause (when there
really wasn't one) stemmed from a brain function. This
cause-seeking part of her brain, triggered by changes in her
physiology that made her feel dread, in effect, called out, "Worry
now!"
To
stop listening to that command to worry, I suggested that she say
to herself, "It's just my anxious brain firing wrong."
This would be the cue for her to begin relaxation breathing, which
would stop the physical sensations of dread that trigger the
radar. |
Method 5:
Knowing, Not Showing, Anger.
Anger can be so
anxiety-provoking that a client may not allow himself to know he's
angry. I often find that clients with GAD have an undetected fear of
being angry. Bob was a case in point. He had such a tight grin that
his smile was nearly a grimace, and his headaches, tight face
muscles, and chronic TMJ problems all suggested he was biting back
words that could get him into trouble. There were many arenas of his
life in which he felt burdened, such as losing out on a promotion and
his wife's chronic inability to spend within their budget, but he
genuinely believed he was "putting a good face" on his
problems. As with other anxious clients, the acute anxiety was
compelling enough to command the therapy time, and it would have been
possible to ignore the anger connection. However, as long as anger
stays untreated, the anxious client's symptoms will stay in place.
When a client
fears anger because of past experience--when she remembers the
terrifying rage of a parent, or was severely condemned for showing
any anger herself--the very feeling of anger, even though it remains
unconscious, can produce anxiety. The key to relieving this kind of
anxiety is to decrease the client's sense of tension and stress,
while raising the consciousness of anger so that it can be dealt with
in therapy. I've found that simply being able to feel and admit to
anger in sessions, and to begin working on how to safely express it,
diminishes anxiety. I tell clients, "To know you're angry
doesn't require you to show you're angry."
The technique is
simple. I instruct clients that the next time they're stricken with
anxiety, they should immediately sit down and write as many answers
as possible to this specific question, "If I were angry, what
might I be angry about?"Â I tell them to restrict their
answers to single words or brief phrases. The hypothetical nature of
the question is a key feature, because it doesn't make them feel
committed to the idea that they're angry. They may destroy the list
or bring it in for discussion, but I ask them to at least tell me
their reactions to writing this list. Without fail, this exercise has
helped some of my anxious clients begin to get insight into the
connection between their anger and their anxiety, which opens the
door to deeper levels of psychotherapy that can resolve long-standing
anger issues.
Method 6: Have
a Little Fun.
Laughing is a
great way to increase good feelings and discharge tension. The
problem for anxious clients is that they take life so seriously that
they stop creating fun in their lives, and they stop
experiencing life's humorous moments. Everything becomes a potential
problem, rather than a way to feel joy or delight.
Margaret was a
witty woman, whose humor was self-deprecating. A high-level executive
who typically worked 12- to 14-hour days, she'd stopped laughing or
planning fun weekends about two promotions back. Her husband rarely
saw her on weeknights, and on Saturday and Sunday, she typically told
him she was just "going to run over to the office for a little
while"--anywhere from 3 to 7 hours. When I asked her to make a
list of what she did for fun, she was stymied. Other than having a
drink with friends after work, her list of enjoyable activities was
almost nonexistent.
Getting in touch
with fun and play isn't easy for the serious, tense worrier. I've
often found, however, that playing with a child will get a person
laughing, so I asked her to spend some time with her young nieces.
She agreed, and noticed that she felt more relaxed after being with
them for an afternoon. Then I asked her to watch for any impulse to
do something "just because," without any particular agenda
in mind. When I saw her next, she seemed transformed. She said, "I
had an impulse to stop for an ice-cream cone, so I just went out and
got it. I don't know when the last time was that I felt like doing
something and just did it--no worries about whether everyone else had
a cone or whether I should wait till later. It was fun!" Over
time, listening to her inner wishes helped Margaret feel that there
was a reservoir of pleasure in life that she'd been denying herself,
and she began to experiment with giving herself the time to find it.
But Margaret
needed to rediscover what she liked after years of ignoring pleasure.
For a time, our therapy goal was simply to relearn what she had fun
doing. Fun-starved clients sometimes need a "prescription,"
like "Take two hours of comedy club and mix with a special
friend, once a week" or "Plan one weekend out of town with
your husband every two months." Not surprisingly, tightly wired
workaholics initially need to make fun a serious goal of treatment,
something to be pursued with some of the same doggedness they put
into work. But once they actually find themselves laughing
and enjoying themselves, they become less tightly wired, less dogged,
and more carefree. Laughter itself is one of the best "medications"
of all for tension and anxiety.
Cluster Three:
The Mental Anguish of Rumination
The final methods
are those that deal with the difficult problem of a brain that won't
stop thinking about distressing thoughts. Worries predominate in
social phobia, GAD, and other kinds of anxiety, and continual
rumination can create nausea and tension, destroying every good thing
in life. A metaphor drawn from nature for this kind of worry would be
kudzu, the nearly unkillable plant that proliferates wildly,
suffocating every other form of life, just as continual worry
suffocates clients' mental and emotional lives.
I don't believe
rumination is caused by deep-seated conflict in the way anger-anxiety
might be; I think it's almost entirely a neurobiologically driven
feature of anxiety. What clients usually worry about--often ordinary,
day-to-day concerns--is less important than the omnipresence of the
worry. Their brains keep the worry humming along in the background,
generating tension or sick feelings, destroying concentration, and
diminishing the capacity to pay attention to the good things in life.
Seeking reassurance or trying to solve the problem they're worrying
about becomes their sole mental activity, obscuring the landscape of
their lives. Nor can ruminators ever get enough reassurance to stop
worrying altogether. If one worry is resolved, another pops right
up--there's always a fresh "worry du jour."
Therapy with
these clients shouldn't focus on any specific worry, but rather on
the act of worrying itself. 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 more rumination is interrupted, the less
likely it'll be to continue. The following methods are the most
effective in eliminating rumination.
Method
7: Turning It Off.
Peter's
rumination was the bane of his existence. A mile-a-minute
supersalesman with remarkable drive, he had a capacity to fret that
could wear out a less energetic person. His mind traveled from one
possible problem to another like a pinball that never comes to rest.
Ruminating worry preoccupied him so much that he couldn't enjoy being
with his children or relax before going to sleep--his last conscious
awareness at night was of worry.
In therapy, he
had a hard time focusing on just one issue at a time; one worry
just reminded him of another and another after that. Before
addressing the psychological underpinnings of worry in his life, we
needed to find a way for Peter to cool down his brain and halt the
steady flow of rumination for a while.
From Eugene
Gendlin's Focusing method, I've borrowed the concept of "clearing
space" to turn off and quiet the ruminative mind. I ask the
client to sit quietly with eyes closed and focus on an image of an
open container ready to receive every issue on his or her mind. She's
then instructed to see and name each issue or worry, and imagine
putting it into the container. When no more issues come to mind, I
suggest that the client mentally "put a lid" on the
container and place it on a shelf or in some other out of the way
place until she needs to go back to get something from it. Once the
jar is on the shelf, the client invites into the space left in her
mind whatever is the most important current thought or feeling.
Perhaps she's at the office and needs to think about a work-related
issue, or she needs to shop and should plan what she'll buy, or she's
with friends and wants to focus on what they're saying. At night,
right before sleep, the client is asked to invite a peaceful thought
to focus on while drifting off.
Peter is a man
who prefers tangible tools to metaphorical ones, so when he was at
home, I suggested that instead of using imagery, he make a written
list of the issues he couldn't turn off and put the list in a desk
drawer to wait for him overnight, or even place it in his freezer to
help him "chill out." Any tangible technique is fine, such
as Al Anon's idea of a "God Box" to hold slips of paper,
each with a worry written down that the client is turning over to
God. The goal of "turning it off" is to give the ruminative
mind a chance to rest and calm down.
Method 8:
Persistent Interruption of Rumination.
Ruminative worry
has a life of its own, consistently interfering with every other
thought in your client's mind. Thought-stopping/ thought-replacing is
the most effective cognitive-therapy technique for interrupting
chronic rumination, but I find the key to making it work is
persistence . Clients very quickly pick up on the technique itself,
but they're always shocked by how rumination can subvert all their
good efforts, and by how persistently they have to keep at it to
succeed. I've had clients come back and say the technique didn't
work, because they'd tried it 20 to 30 times in a day and they still
were ruminating. I tell them that they must do it every time they
catch themselves ruminating, even if it is 1,000 times a day or more!
That's what I mean by persistence.
Darla is a good
example. She was a self-described worrywart before she got cancer,
but after her diagnosis, her anxiety zoomed out of control. Although
treatment was successful and she'd been in remission for some time,
she still had constant, negative, racing thoughts about whether her
cancer would recur. A really hard worker in therapy, she did every
method I suggested, and was ready to use thought-stopping to
interrupt her ruminations about cancer. "Remember," I told
her, "winning this game is about persistence. Do the
thought-stopping exercise every single time you find yourself
worrying, no matter how many times you have to do it."
At the next
session, she reported her success--she really had radically cut back
the amount of worrying she was doing. But it worked only because I'd
warned her about how persistent she'd have to be. "When you told
me I'd have to thought-stop every time, even if it was 1,000 times a
day," she said, "I thought you were kidding. If you hadn't
warned me, I'd have given up in despair after about 100 times,
thinking it would never work for me. Since you said 1,000, I figured
I'd better stay the course. After a couple of days, it got markedly
better." Rumination is persistent, and the only way to beat it
at its own game, so to speak, is to be even more persisten
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.
Connie knew that her next medical results were going to tell the
story of whether she needed surgery. Although there's always a
level of legitimate worry about any medical problem, some medical
conditions, like high thyroid, create anxiety symptomatology.
Connie's medical problems weren't causing the anxiety symptoms,
but her anxiety about her condition was getting in the way of her
medical recovery. She called the doctor's office repeatedly, until
the doctor said she'd fire Connie if she got one more phone call
before the test results came in.
Connie
was out of control with worry, so we tried out a method that
actually had her worry, but worry well--and only once. Here's how
that works. The client must: (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 her
thoughts as quickly as possible to another activity.
Connie
and I set a 10-minute time limit on our worry session, and then
together thought through all the possible ramifications of a
positive test result. She covered things such as "Who'll
watch the cat while I'm in the hospital?" "Will I have
to miss too many days of work?" "Will I need a ride
home?" We covered everything from the mundane to the serious,
if unlikely, "What if I die while in surgery?"
It's
critical to this method to cover all the bases, but 10 minutes,
surprisingly, is an adequate amount of time in which to do that.
At the end of the worry period, Connie agreed that she had no
other worries related to the surgery, so we set a time at which
she thought she'd need to think about the problem again. We agreed
that the next time she should let the possibility of surgery cross
her mind was when the doctor's office called. Until that moment,
any thought would be counterproductive. She wrote in her PDA that
she could worry again at 4 p.m. on Tuesday afternoon, by which
time the results would be in and the doctor had promised to call.
If she hadn't heard at that point, then she could start worrying
and call the doctor's office.
Having
worried well, we moved to the "Only Once" part of the
method. She then practiced, "Stop It! I already worried!"
and we made a list she could carry around with her that enumerated
some distractions to use. While this may sound trite, her brain
believed her when she said she'd already worried, because it was
true. |
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.
Clients
who ruminate about a worry always try to get rid of it by seeking the
reassurance that it's unfounded. They believe that if they get the
right kind of solution to their problem--the right piece of
information or the best reassurance--they'll then be rid of the worry
once and for all. They want to be absolutely sure, for example, that
a minor mistake they made at work won't result in their being fired.
In reality, however, a ruminating brain will simply find some flaw in
the most fail-safe reassurance and set the client off on the track of
seeking an even better one.
One
good way to get out of the reassurance trap is to use the
fundamentals of planning. This simple but often overlooked skill can
make a big difference in calming a ruminative mind. I teach people
how to replace worrying with planning. For most, 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. To be successful with this approach, clients must also
have learned to apply the thought-stopping/thought-replacing tools,
or they'll turn planning into endless cycles of replanning.
After
they make a plan, ruminating clients will feel better for a few
minutes and then start "reviewing the plan"--a standard
mental trick of their anxiety disorder. The rumination makes them
feel overwhelmed, which triggers their desire for reassurance. But
when they've actually made the plan, they can use the fact that they
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 stop
endless reassurance-seeking, because it provides written solutions
even to problems the ruminator considered hopelessly complex.
For
example, if Connie, who'd worried well about surgery, found out she
did have to have the surgery, she could write out the plan to get
ready. The new plan would cover all the issues she'd identified in
her worry session, from finding a catsitter to writing a living will.
She'd put completion dates in for each step and cross off the items
as she did them until the day of the surgery. Then, each time she
needed reassurance, the concrete evidence that she had a good plan
would enable her to go on to some other thought or activity.
While
these techniques aren't complicated or technically difficult to
teach, they do require patience and determination from both
therapist and client. For best results, they also demand clinical
knowledge of how and why they work, and with what sorts of issues;
they can't simply be used as all-purpose applications, good for
anybody in any circumstance.
But
the rewards of teaching people how to use these deceptively
simple, undramatic, and ungimmicky methods are great. While
clients in this culture have been indoctrinated to want and expect
instantaneous relief from their discomfort at the pop of a pill,
we can show them we have something better to offer. We can give
people a lasting sense of their own power and competence by
helping them learn to work actively with their own symptoms, to
conquer anxiety through their own efforts--and do this in a
nonmanipulative, respectful, engaging way. People like learning
that they have some control over their feelings; it gives them
more self-confidence to know they're not the slaves of
physiological arousal or runaway mental patterns. And what we
teach them is like playing the piano or riding a bicycle: they own
it for life; it becomes a part of their human repertoire. What
medication can make that claim?
Margaret
Wehrenberg, Psy.D., has been in private practice as a psychologist
and addictions counselor for more than 20 years. She also
specializes in trauma and anxiety, working with adolescents and
adults. She's the cofounder of the Reflex Delay Institute, and the
author of Stress Solutions: Effective Strategies to Eliminate Your
Stress. Contact: drmw116@aol.com. Letters to the Editor about this
article may be e-mailed to letters@psychnetworker.org. |
Love is an enemy of fear. So is gratitude. “Be anxious for nothing but in all things, by prayer and supplication WITH THANKSGIVING, let your requests be made known to God; and the PEACE of God that surpasses understanding will keep your hearts and minds in Christ Jesus.” I think it may be impossible to be thankful and fearful simultaneously. Here’s a formula that has helped many of my clients deal with fear/anxiety:
Face, don’t Flee, and
Float, don’t Fight.
You can’t get away from something going on inside your own skin: so don’t try. Turn toward it in the power of His Spirit and watch it shrink away from you.
The fight against fear is a manifestation of the fear itself. When we “Float” in our Faith in Christ, fear evaporates or passes like an emotional wave passing through our heart. We are always left standing on the firm, unshakable foundation of God-with-us.
