WHO treats you and HOW he treats you is as important as WHAT's being treated
People who struggle with anxiety need a special kind of person to help them. This person understands how the intellectual brilliance of an anxious mind makes it think, imagine, predict and project. He understands how the characteristics of this kind of anxious thinking is tied to deeply held values.
But he also knows how the anxious person's need for certainty, congruence and perfectionism distorts his reality. So it is the job of this person to train the sufferer in differentiating between when/which thoughts to listen and respond to and when/which not to.
The supporting person also understands the sensitive temperament of the sufferer and resulting biological symptoms that can be mistaken for fear. These symptoms stemming from the emotional brain are painful enough to hijack the rational, higher brain.
Finally, the supporting person knows how trauma, chronic stress, painful memories and past conditioning cause the Stress Response to be perpetually active in the body of the sufferer, making it even harder to break the anxiety loop.
I have not an ounce of doubt in my mind that it HAS to be someone who has experienced anxiety themselves AND cured it.
Unless you have experienced anxiety, you simply do not know anxiety.
Textbooks can tell you what anxiety feels like, but they can't make you feel it. And you need to have felt it before you can dole out any advice on how to overcome it.
Practical training, doing research, internships and having your own counseling practice can give you a tons of exposure to anxiety patients, but unless you have experienced a panic attack, you have no way of understanding how horrifying it can be. You have no way of understanding how "change your thinking and face your fears" are impossible to follow in a state of panic.
IF YOU HAVE ANXIETY and are looking for qualified support, seek it from someone who has experienced anxiety AND then gone on to cure it. This someone does not have to be a therapist, but who knows the ins-and-outs of anxiety, the anxious mind and the anxious person.
However, insist on finding someone who has cured his anxiety. Not someone “who knows it, but hasn't cured it”.
Avoid people, forums, chat rooms and meeting groups that connect with each other to find healing by mainly expressing the horrors of anxiety.
Consciously, you will listen compassionately, will find comfort in your shared histories and experiences and find the validation you have craved forever.
But at a subconscious level, such narrations can be extremely triggering. You have to be careful. If you haven't resolved your own anxiety, you are very likely to be triggered by seeing how everyone else is suffering too. You are more likely to interpret this as proof that anxiety indeed is incurable, what your mind has always suspected.
But it is not true. Anxiety IS curable. There are people who have recovered . And that should be your goal too.
For that you need to be in the energy of people who walk, talk and live recovery. They talk about cure, relief, recovery, tools, strategies and their journey in arriving here.
If you prefer a therapist, find someone who is a trained expert in anxiety and sensitivity. Better still, if this professional has experienced anxiety in his own life, then recovered from it, and now reached a point of helping others.
Avoid therapists and professionals who say things like “there is no cure, and it is lifelong." These claims snatch away hope and possibilities, and they are simply not true.
- Acceptance and Commitment Therapy
- Dialectical Behavior Therapy
- Positive Psychology
Mindfulness is the practice of bringing your attention to the present moment, non-judgmentally and non-strivingly. This sounds like the worst possible suggestion to an anxiety sufferer. When the present moment is consumed with fear, why would I want to bring further attention to it?
This is not what mindfulness is asking you to do. Instead, it is asking you to use the same mind to observe the "other" part of the mind that tells you that "it" is consumed with fear.
In anxiety, the sufferer is entirely "fused"/merged with anxious thoughts. For him, a "what if" scenario isn't a "what if" anymore; it's a "it is" scenario. Unless you are able to create some space or "wiggle room" between you and your automatic thoughts, you will be fully merged with your anxiety.
Mindfulness helps you create that space. When you get into the practice of using mindfulness to "watch"/ "observe" your thoughts from a distance, it becomes easier to identify the distortions without merging with them. Consequently, you are more equipped to choose different and better behavioral options.
Mindfulness is practiced non-judgmentally and non-strivingly. These are qualities/skills that anxiety sufferers have tremendous initial difficulty with, because of their strong conditioning towards perfectionism, control and instant gratification. But since mindfulness can be done in no other way, with practice, the sufferer starts gaining exposure to what exactly "acceptance" and "allowing" (of imperfections) really means. And how critical they are if you want to move towards a good life.
When you get better at allowing your present moment to be exactly what it is - warts and all - without falling into the viscous trap created by fear, anger, perfectionism and control, then paradoxically and counter intuitively, you experience less fear, worry and anger.
There are many benefits of mindfulness, but the greatest one seems to be the regaining of faith and confidence in your own mind.
Anxiety sufferers have lost that faith along the way because it seems to them that all their mind is capable of creating is a vision of doom and destruction. But when the sufferer starts witnessing how he has the ability to use the same mind (wisely) to watch how his mind works in anxiety, he gets to question which part of his mind is the "real" him. The one creating doom or the one watching how the other creates it? The question triggers hope.
Mindfulness can be done in many ways. Mindfulness meditation is one of them.
ACT is a mindfulness-based behavior therapy whose core goals are "acceptance" of your present moment and "commitment" to values and goals.
In ACT, we are not particularly concerned with the reality of having distorted thoughts and painful symptoms. But what we are terribly concerned with is how to accept the sum total of the present moment and still move towards a value-based life.
Acceptance of anxiety, or the circumstances that make up your anxiety, is not easy. But it is absolutely necessary to gain the psychological flexibility needed to commit to actions and behaviors that will move you towards your values and goals.
ACT is broken down into 6 process areas, each of which influences your ability to commit to a value-based future by accepting your present day anxiety: contact with the present moment; defusion; acceptance; values; committed action; self-as-context.
The greatest contribution of ACT is that it implores sufferers to consider alternative ways of defining anxiety, and eventually themselves and their lives.
DBT is a cognitive-behavior therapy that trains the individual on embracing "dialectics", that is, the existence of two opposing positions. In the case of anxiety, it means - Accept your anxiety (thoughts, symptoms, sensations, the past) but still work to Change your anxiety (through behavior).
DBT works by helping the client build and practice skills to help himself. In that sense, DBT rejects the absolute notion that mental disorders are inherent or genetically wired since birth and that as a result, the individual's behavior will remain forever compromised, or out of his control.
Instead, DBT believes that behavior simply is the result of putting appropriate skills to work that further your life towards your goals.
DBT teaches these skills through 4 modules:
- Mindfulness Skills- Radically accept ALL of your present moment anxiety
- Distress Tolerance Skills - What to do when distress (symptoms/sensations) arises once you make a wise choice to "radically accept" instead of surrender to old distortions
- Emotional Regulation Skills - How to change emotions, especially fear and anger, through cognitive restructuring
- Interpersonal Effectiveness Skills - How to ask for what you want, and how to establish/exercise personal boundaries without compromising yourself or your relationships
Not everything is wrong with you. Even in the throes of anxiety. Your addiction to black-n-white thinking and your high standards of perfectionism make you blinded to your gifts, your strengths, your qualities and your unique contributions.
Positive Psychology is a branch of psychology which teaches you how to see more of the positives and less of the negatives. In yourself. In others.
It then implores you to keep your focus on building on the positives while accepting, but still committing to changing the negatives.
I used to be very suspicious of Positive Psychology. I thought that it tries to "whitewash" your otherwise honest albeit painful inner life, thoughts, dialogues and experiences. For that reason, I found it to be fake, invalidating and hence ineffectual.
I misunderstood it.
If you want to recover from anxiety, all you want is relief from painful symptoms. If your symptoms arise from fear, anger, despair or guilt, maybe it's time to hunt for sources that will compete with these emotions? What are those? They are gratitude, hope, empathy, flow, motivation and giving.
If you decide to look for these, you will find them in yourself, despite everything you have been through. You just need some training and practice in how to make place for positive feeling states in your life, without insulting your pain and suffering.
It is possible. It is necessary. We cannot go far in our anxiety treatment if we refuse to investigate emotions opposite to fear and anger. Positive Psychology keeps reminding us to do that.
In the end this is what you are trying to answer in every single anxiety episode:
Anxiety strikes! Now what?
1. What is the first thing I should do?
When you feel anxious, mindfulness is the first tool you will use to create a space between you and your thoughts.
Pause, create that space, watch your thoughts.
You are not the thoughts, you are the one watching them non-judgmentally.
When there is room between the two, you will be able to calmly identify the "why's" and "how's" and "when's" of your problems. Your distortions come to the surface.
But because you do this non-judgmentally with the purpose of breaking the anxiety loop you're habitually stuck in, you will remain calm.
Mindfulness allows you to create a distinction between you and your mind. You get to see from a distance that the world you have assumed as handed over to you is more a construction of your own thoughts.
2. What should I do to deal with the content of my thoughts?
Acceptance and Commitment Therapy suggests that using our mind as a problem-solving tool to 'solve' psychological pain leads us into the traps that create suffering. There is a distinction between pain and suffering. No one can rid pain, but we can control our levels of suffering.
You can attest to this from your own experiences that as a rule, the more we try to rid painful thoughts, memories, impulses and urges, the stronger they become. ACT tells us that we never needed to fight this battle to live a meaningful life.
How do we move forward despite the mucky thoughts going on inside of us?
ACT gives us tools and exercises showing us how to hold thoughts lightly, not as a trick to manipulate them, but as a value-driven decision to no longer waste our mental health (and our life) barking up the wrong trees.
It's possible to move forward despite the thunderstorm.
Where do you move to?
3.What should I behave like to cure my anxiety?
Acceptance and Commitment Therapy shows us this as well.
It solves answers to the final questions "What should I do?" We make these decisions independently, individually. We align them with the values we want our lives to follow.
Anxiety sufferers struggle with too much choice. Because of the way our brains are wired (quite brilliantly), we can automatically envision the joys and pitfalls of each of the many, many possibilities our mind spits out.
How do we choose? ACT grounds us in our own values, and even to us, those are more or less constant. Thus, the behavioral decisions we make to commit to our values are grounded in our own honest truth. Unlike before, the decisions now become easy to make.
4. What should I do to deal with the symptoms of anxiety from a triggered amygdala?
Mindfulness and body-based therapies like Dialectical Behavior Therapy give us tools to tolerate distress the way we never could before. These are learned skills. With knowledge and practice, we can regulate the most difficult emotions like fear and anger in wise, functional ways that break the anxiety loop.
Having a panic attack? What have you always done about that? Doctor, hospital, google research, talking to friends and family? Felt better? No? Felt worse? Yes?
Assuming you know about the amygdala, what you really need to do is to shake off the symptoms by facing the symptoms. Means what? Know that it's your amygdala and use that built-up, volcanic flight-fight energy to get some cardio in the gym.
This is one example of a DBT skill.
5. Why does it all suck?
It doesn't. Interpret the moments of your life in honest but flexible ways.
Not everything is wrong with you and your life. Even when anxiety is a big, big part of it.
The same OCD that keeps me stuck thinking about someone's hurtful comments is the same OCD that makes me play a song on repeat mode for 2 days.
I no longer fight away and curse my OCD. The obsessive music behavior has saved my life. Music is something that helps me regulate my emotions in healthy ways. I no longer want to change that OCD itch to press that "repeat" button until my fingers bleed. With the other stuff, ACT helps me deal with it.
Positive Psychology makes me see this. Even within my anxiety, I have good, bad and a lot of grey.
You are not all black. You are some white, some black, and a lot of shades of grey. Your anxiety condition is not all of you. It is one part of you. Are you able to see that? If not, you need the training.
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