Introduction to Overcoming Anxiety. If you struggle with anxiety and you’ve learned a lot of tools or strategies that are supposed to help you manage your anxiety but when you use them they don’t work as well as you think they’re supposed to, today’s episode is for you. As a therapist, the most common reason I see people struggle to manage their anxiety effectively is because they have not been taught how to know which tools to use for which types of anxiety. In fact, most of the people I work with don’t even know there are different types of anxiety other than very general definitions like anxiety versus social anxiety versus panic attacks versus phobias.

 

Four Different Forms

 

There are actually four different forms, at least in my opinion, this is my model, that your anxiety can take, and each form requires a different subset of anxiety management tools in order to be effectively treated or contained.My Name Is Dr. Scott

 

My name is Dr. Scott. I’m a licensed objective psychologist. I’m the owner of the Northstar Psychological Center, and I’m the author of the book “For When Everything Is Burning.” My passion is helping people who are really, really stuck with their mental health.

 

I Specialize in People

 

I am usually like a fourth or fifth or sixth therapist somebody sees, and I specialize in people who have not gotten better, or at least not gotten as better as they wanted to, with more standard treatment approaches. I like to really dig deep with people, get into the super fine details of things, and figure out why these things are not working the way they’re supposed to. In the case of anxiety, as I said before, its usually because they are not properly matching the skills to the type of anxiety.

 

 Subtypes of Anxiety

 

So let’s start by defining those four tames of anxiety, then I’ll run through the skills that help the most with each subtype. The first type of anxiety is narrative anxiety. Narrative anxiety is the type of anxiety that presents as thoughts or words or a conversation that you have with yourself in your own mind.

 

What I Call Narrative Anxiety

 

If someone conveys , “Why are you anxious?” Well, “I have a job record and I’m afraid that I’m going to make a fool out of myself and not know how to answer the questions correctly.” So anxiety that takes that form is what I call retold  anxiety. The second type of anxiety is visual anxiety.

 

Physical Anxiety

 

The third type of anxiety is physical anxiety, and this is the anxiety that you really just feel intensely in your body. Sometimes when we’re really anxious, we experience physiological sensations like racing heart, shortness of breath, sweating, shaking, dizziness, lightheadedness, muscle tension, numbness, even all kinds of things can happen to our bodies, nausea, indigestion.

 

Visible  Symptoms of Anxiety

 

These are all really common with anxiety, and sometimes we experience those solid symptoms of anxiety in the absence of narrative or visual anxiety. A lot of times these all go together. Many times you’ll experience every type of anxiety all at the same time to some degree, but you’ll often find that one is primary, and sometimes you’ll experience one completely in isolation from everything else.

 

You Don’t Even Know Why

 

Sometimes you’ll get these physical symptoms of anxiety and you don’t even know why. There’s not like a specific thought or a specific thing you’re picturing, you just get this tense, wound up, nervous, anxious, on-edge feeling in your body. It’s almost more physical than it is emotional, and you can’t even necessarily articulate to another person why it’s there, but it’s there.

 

It Happens

 

And if you have an experience that probably sounds really weird, like how can you be so anxious and not even have a specific thing that you’re anxious about, but believe me, you can. I mean, it happens. It happens to many, many people, billions of people, pretty frequently, and there isn’t always something you can put your finger on and say, “I am this way because of this,” especially if a person has a chronic anxiety disorder.

 

Constant Feeling of Unease

 

There really does not have to be any type of stimuli at all to create this just constant feeling of unease and doom and dread. I

Narrative Anxiety Tools

 

Narrative anxiety tools. Narrative anxiety management is most effectively challenged by narrative thought challenges. 

Challenging Our Thoughts

 

There are many, many different ways you can do this. Ill give a couple brief examples today, and I have some other content on this as well. When were trying to challenge our thoughts, what were essentially doing is were taking this idea that we have, again going back to the example, “I’m going to say something stupid in this job interview, make a fool out of myself, and not get offered the job,” you’re essentially looking at how well does the evidence you have in your life support that idea.

 

One of the Things Our Anxiety Does

 

This is one of the things our anxiety does. It takes these rare events and kind of makes us believe that they’re just super common and that they’re inevitable and going to happen all the time, and they tend to ignore things like statistics. For example, if you’ve had twelve job interviews and only one of them really went bad, you can kind of talk yourself down from that and literally just say that to yourself, like I’ve done reasonably well at least in eleven out of the twelve job interviews that I’ve had.

 

Exaggerating the Negative

 

So the idea that this one’s going to go horribly isn’t super well supported by the actual experiences I’ve had in my real life. Is this me really exaggerating my fears and exaggerating the negative? So here you are really having a dialogue, a conversation with yourself, trying to talk yourself down from this idea that you’re really stuck on.

 

I Know This Subject Matter Well

 

Or you might say to yourself, well, in general I think I have pretty good people skills, or I have a lot of experience in the area that this job is interviewing me for, so the idea that I’m just going to have no idea what to say or say something completely inaccurate really is very unlikely because I know this subject matter well.

 

Those Are the Types of Tools

 

Now again, that’s just an example, right? Obviously I made some things up there, and there’s a lot of assumptions in that example, but those are the types of tools that you want to use to challenge narrative anxiety. Now the thing is, I know a lot of therapists who teach thought challenges like all the time for all anxiety, but what if you have primarily physical anxiety?

 

A Very Effective Tool

 

So if you try to use this strategy with other types of anxiety, it’s really not going to do much. It might do literally nothing. You might not even be able to do it because it does not interact with the form your anxiety is taking, but if you’re experiencing narrative anxiety, then this is often going to be a very effective tool for you to use.

 

Neutral Visualization

 

So you may have heard about visualization activities for anxiety, right, whether that’s visualizing something like a safe place, visualizing something good happening. I’m actually not a huge fan of those, I’m just naming some common ones. I actually like to do what’s called neutral visualization, meaning that rather than imagining some like a fantasy escape world or imagining some best-case scenario happening, which might be just as unrealistic as the worst-case scenario, just try to visualize like a normal version of whatever your stressor is.

It Can Backfire

I actually can give you an example of that. When I was about twenty-six years old in my masters program, I took a job teaching two sections of Introduction to Psychology, and I had a lot of anxiety about that.

I Went Too Far

And I realized that that was unrealistic, and I realized I needed to challenge my anxiety, but I went too far. I did too positive of a visualization, and I pictured myself giving some life-changing lecture or lesson and getting a standing ovation at the end and having a bunch of people come up to me and they’re like, “I want to be a psych major now.”

Picture It Being Average

So I like neutral visualizations, which basically picture it being average. If you have to give a presentation or some kind of public speaking engagement, just picture it being fine, like normal. If you’re going to fly in an airplane, don’t picture yourself winning the lottery on the airplane or meeting your dream partner.

Those Are More Plausible

Just picture the airplane taking off, flying, landing, and just being normal. The main reason is that those are more plausible. When your brain is projecting a really negative image or movie in your mind and you try to make it really positive, it’s either going to reject it or you’re going to accept it but then it’s not actually going to play out that way.

Physical Anxiety Techniques and Tips

 

So the third type of anxiety is physical. Physical anxiety techniques and tips. I bet you have figured out the pattern by now, and you probably already know that Im about to tell you that the best way to challenge physical anxiety is with physical coping tools.

Unless Your Anxiety Is Visual

But when you try to use visualization activities for non-visual forms of anxiety, that’s basically what you’re doing. “Oh, you have anxiety, look at this pretty picture, you’ll feel better.” Not really, unless your anxiety is visual, then you probably will.

Switch Your Nervous System

 

So we want to use techniques like deep breathing, progressive muscle relaxation, things that are going to actually switch your nervous system from sympathetic, which is the fight-or-flight response, to parasympathetic, which is your rest-and-digest mode.

 

Preparing for Danger

 

So your body is getting wound up and tight and ready for some kind of threat to materialize, right, for you to have to literally defend yourself from something or run away from something, and you can’t really talk yourself out of that because it’s a hardwired, instinctive survival response.

The Only One That’s Consciously Controllable

But one of all the changes that happen in your body when you’re really anxious, just to review, there’s rapid shallow breathing, increased heart rate, sweating, shaking. 

You Breathe Automatically

 

You breathe vitally , but you can carefully  change the way you’re breathing just by thinking about it. You can’t do that with any other nervous system function. You cannot just think about having a lower heart rate and lower it.

Direct Conscious Control

You cannot just think about re-engaging your digestive system and have it just happen. There are things you can do indirectly to affect those nervous system functions, but the only nervous system function that you have direct conscious control over is your breath.

Your Body Doesn’t Speak English

Now the funny thing is if you actually say those words to yourself when you’re experiencing a physical anxiety response, they won’t do anything because your body doesn’t speak English, but if you translate those ideas into slow, deep breaths, then your body will relax because you are actually telling it, “We are all right. This isn’t what it looks like.”

Tense Them Beyond the Point

What you can do, though, is you can tighten them or tense them beyond the point they’re already at, and what that does is it simulates engagement of a fight-or-flight response. In other words, it tricks your body into thinking that, yeah, there was something dangerous and we got away from it or defended ourselves from it, and we’re okay now, because it actually uses the muscle tension that you’ve built up.

Clench and Relax

So just to give you a super brief example of progressive muscle relaxation, you can even just do it with your hands. If you have a lot of tension in your hands, you just clench them even further, like make fists for about five seconds, and you should be able to really feel that, right, and then you let go.

A Sense of Maybe Relaxation or Peace

You actually feel like you’ve used them for something, because you have, and with that tiredness comes almost like a heaviness, and with that heaviness comes a sense of maybe relaxation or peace, and you’re now starting to counteract that physiological anxiety that you were experiencing before.

You Can Do That With Literally Any Body Part

Now that was just an example, hands, right? You can do that with literally any body part. Just tense and relax. You can do it with your whole body if you want, if you have time, and that can be a really powerful tool to work through your physical anxiety.

The Trickiest One by Far

So that fourth subtype of anxiety I mentioned is the trickiest one by far. Its that general anxiety, and it’s tricky because managing general anxiety approaches and insights, its almost like refusing to take a form.