It is no exaggeration to say that anxiety is rampant. People have been talking abut the "Age of Anxiety" since at least the 1940's. Yet, our time, right now, feels like the one that might finally split. If we were to sit still and take a collective peek inside-- if that 3am voice got to just talk--- the list would be daunting. Employment, mortgages and other bills, health, affording necessities, where this country is going, COVID, raising kids, having relationships, and more. The list goes on, is real, and can be so scary.
And anxiety feels awful. When clinicians assess anxiety, we ask about what it feels like in the body and in the brain. Body sensations can be anything from an endlessly tight jaw and back to the pounding, squeezed heart feeling during a panic attack. Anxiety is a bodily response, so the toll on the body can be exhausting. Anxiety also happens in the brain: spiraling rumination loops, getting "stuck" on fear, starting to see the world as a negative place, starting to assume the worst. The cumulative effect of chronic anxiety starts to re-shape a person, and that person can even start changing the entire pattern and rhythm of their life to avoid these feelings.
I work a lot with anxiety complaints in my private practice, and I teach college students CBT-based and DBT-based skills courses mostly to help them with anxiety. We go over breathwork, relaxation, mindfulness, generating positives, doing self-care, and challenging unhelpful thoughts (catastrophizing, magnifying, etc). These are all incredibly helpful skills and are mandatory for anyone struggling with anxiety.. However, I've learned that there is one crucial learning needed to start feeling better: don't do anxiety all the time. It is critical to catch yourself doing anxiety all the time, and to stop that momentum.
You might think turning off anxiety would be built-in and automatic. It would seem to make sense that people would instinctively love the chance to come up for air. Yet, this is not what tends to happen. More often than not, the tendency is to burrow down, retreat inside yourself, and revert to just trudging on until anxiety-provoking life stops happening to us.
This mechanism makes sense when you look at it. Our anxiety equipment was originally designed to keep us safe in a world that was much more naturally balanced between threat and joy. And this equipment worked well in that world: the anxiety response would fire, would push us to take action, and the threat would resolve.
We don't live in that world. The threats in our world are increasingly chronic. College students are neither inaccurate nor dramatic when they worry if in four years they will have done enough to begin a decent life. Families are neither hyperbolic nor histrionic when they wonder every week if the recession wheel will land on the year they have big expenses or would like to retire. Anyone who finds themselves with a seemingly endless background-worry pushing at them has a very good point.
Our equipment was not well-designed for the chronic nature of this type of anxiety. Without training and coaching, the instinctive response tends to be "survive." In trauma work, we talk a lot about what happens to someone experiencing trauma over the long-term: they have to put most of their resources into surviving, and never really have enough left over to do begin thriving. Chronic anxiety does this in a way too. A person in chronic-anxiety-survival mode starts to break up their life into unhealthy chunks: try-not-to-think-or-feel-too-much-and-just-keep-going... okay, now TV, weekend, vacation. Repeat.
This won't work. The key is to learn that the central idea of surviving chronic anxiety is, itself, a fallacy. It's a body/brain trick, or more like a glitch in the anxiety response equipment. It's hard to believe this in the moment, I know. So often clients really resist the idea of stepping out of anxiety temporarily. People suffering from anxiety are almost always going to believe instead that it needs to be survived, and that they then need an all-good period of time, and that they can hopefully, at some point, construct a stress-free life. However, these are the people who end up doing anxiety all the time. They do anxiety for days, weeks, and months on end, and it is making them miserable.
Here's why I want you to consider a new way:
First: the idea of "anxiety offsets" doesn't work. The weekends, if you are lucky enough to have them, are only 48 hours. Vacations typically last a week. School breaks are 1/6th the length of a semester. And so on. It's crucial not to wait until the dust settles to attend to your anxiety.
Second: anxiety is physiologically cumulative. Anxiety spikes cortisol and adrenaline, tightens muscles to the point of fatigue, makes breathing chronically shallow, and impacts sleep. We're not able to sustain this way of being for days on end.
Third: anxiety is emotionally cumulative. Chronic anxiety begins to shape a person's view of self, others, and the world, and begins to chip away at the ability to take perspective. This is a formula for depression, and the formula is potent.
Here's how to do something different:
1) "The 3 C's." The fundamental skills of CBT are often encapsulated as The 3 C's: Catch it, Challenge it, Change it. In other words, notice what you're trying to change; interrupt the momentum of what is happening; create a new, more helpful response. Here's how this would work for our anxiety problem:
- Build a description of signs and flags to look for that tell you you're in a chronically anxious
state.
- Catch yourself when you're in that state, or heading towards it.
- Challenge whatever resistance to slowing down might come up. An inner voice might tell
you to just keep on trudging in survival mode. Another might tell you it feels uncomfortable to
notice your anxiety. You might try to convince yourself, "I don't have time for this!" It is crucial
to challenge these instincts.
- Replace those instinctive thoughts with pro-relaxation thoughts. Be your own ally here. Make
sure to tell yourself it is time to reduce this anxiety, that it is is a priority, and that you can do
it.
2) Schedule mindful check-ins. Step 1 is meant to take place in the moment, when you pick up on your flags and signs. However, we can miss these. And, we can avoid doing this work when we have a full schedule, or just want to go home for the day. I have my clients schedule a mindful check-in of their current state at least twice a day: before lunch, and before dinner.
3) Find a way to measure your current state. When you're checking in, try to rate and describe your initial state. Clients often use a 1-10 scale. This is important, so you can start building a better sense of what anxious feels like, what less anxious feels like, and to see if your relaxation is effective.
4) Slow things down. The best ways to slow things down are sitting still and breathing out slowly. Please remember that both can take time, especially when you are stirred up. And that time can feel really uncomfortable initially. However, if you can hang in for at least 5 minutes, you'll notice your system starting to return to a calmer state. The very best way to help it is to exhale slowly. This is important! When clients get coached to breathe, they are often coached to "take deep breaths." Don't. Take a natural inhale, pause, and then control the exhale in a slow, graceful manner. I coach clients to "breathe out slowly, gracefully, like a gentle wave rolling itself out." I also tell clients to remember that, "the breathe tells the body and brain that it is time to slow down."
5) Soothe yourself. Once you've slowed things down for 5 minutes, you'll be ready for another 5 minutes of soothing. I like the idea of soothing so much better than "mindfulness" or "deep breathing." "Soothing" connotes gentleness, being loving, taking good care of yourself. This is what we are going for here. People can self-soothe in all sorts of ways. Two popular ways: imagery (sitting on your favorite beach, etc) and using any of the five senses. If the smell, sound, or feel of something is very soothing to you, use it.
6) Shape your perspective. This is the last step for a reason. Have you ever tried to "be positive" when you're really stressed? It often doesn't work. What tends to happen is that you just start having arguments in your head between a voice telling you to be fine and another voice reminding you things aren't fine. We do slowing and soothing first, so that the brain has time to switch away from anxiety. Now you have more access to thinking and self-coaching. Now you can shape your perspective. Use that slowed, soothed state to remind yourself that calmer feels better; that you can make it and will be okay; and that you are a self-compassionate person doing the best you can.
Try this, for one week, and see how you feel. Really challenge yourself to be the kind of person who pushes back against chronic anxiety. Say "no" to all-the-time anxiety. Think of it as rebalancing throughout the day. Experiment, and see how you feel.
Thanks for reading! I welcome questions, feedback, and further conversation: matt@mattbrennanlcsw.com. Interested in working together? Let's talk more. You can find my contact details at my main contact page.