Often, clients come into therapy looking for specific ways to handle their anxiety or chronic worry. I recently listened to a training session on anxiety through The Psychotherapy Networker, and I want to share some points that I found especially useful in my therapeutic work.
David Burns, a psychologist who specializes in anxiety, spoke about his experience treating clients with chronic worry. When clients first come into Burns’ office, he uses a particular method that enhances other techniques he is using. He calls this method Paradoxical Agenda Setting. He asks his clients, “Suppose there were a magic button and if you press it, you will walk out of here cured of your anxiety – all your fears will disappear, you will be euphoric. What are the good reasons not to push the button? Are you afraid of a good outcome? Are you afraid something terrible would happen if you did get cured from your anxiety? Are you afraid you will be unsafe?” He uses a cost-benefit analysis to examine what the advantages and disadvantages are of recovering from anxiety. Burns then becomes the voice of resistance, allowing clients to explore the advantages of letting go of anxiety. After this, he emphasizes to his clients the importance of confronting their fears, and challenging the thoughts that are holding these fears in place.
What you can do: If you are looking to confront your fears, you can ask yourself Burns’ questions to explore what is holding you back from letting go of your anxiety. You can also explore these questions with your therapist, who can help you look at all sides of feeling better – the ways you are ready to let go of anxiety, and also what might feel incredibly scary about facing these fears.
Margaret Wehrenberg is a psychologist who specializes in anxiety treatment and is the author of “The 10 Best-Ever Anxiety Management Techniques.” In her training, she offers practical tools to help manage anxiety. She has found that her strategies help clients with unpleasant anxiety symptoms, including:
- The physical arousal of anxiety, such as the feeling of terror or panic.
- The “wired” feelings of tension that lead to being “stressed out,” or having a sense of doom or dread.
- The torment of rumination – being unable to stop thinking upsetting thoughts.
Similar to Burns, Wehrenberg explores with her clients how they are trying to manage their fear, and how they are avoiding what they are afraid of. She explains that the more you avoid your fear, the less opportunity you give yourself to feel your anxious symptoms and to learn that the situation is actually safe. Therefore, avoidance can feel like it is working and can be reinforcing.
Wehrenberg explains to her clients how fear is triggered by the amygdala, a structure in the brain that registers what is not safe within the environment. The amygdala can be enlarged in those who have panic disorder or social anxiety, allowing people to become overly reactive or sensitive to what is actually a safe situation. She explains how much easier it is for people to talk themselves down and use relaxation strategies if they understand and remind themselves that they are not truly at risk, but that their amygdala is being overly responsive. Wehrenberg emphasizes how the brain can actually change through therapy by shifting your experience (relaxation, breathing, working with thoughts) when you do face what you have previously been afraid of and have been avoiding.
For people who are experiencing anxiety, Wehrenberg encourages them to take care of their bodies first:
- Eat well.
- Avoid alcohol, drugs, nicotine and excessive caffeine.
- Exercise regularly.
- Get into better sleep habits.
Wehrenberg acknowledges that these self-care tips might be simple, but if neglected, could offset any progress made with other anxiety management strategies.
Check out my next blog to learn some other practical strategies to reduce anxiety.