In today's fast-paced world, most people experience anxiety. Whether your anxiety is in a 'normal' range - and 'normal' is always subjective - or extreme enough to be categorized as an anxiety disorder, anxiety is prevalent in our society.
This blog post offers a few practical suggestions for managing your anxiety, based upon my extensive clinical experience working with anxiety disorders, as well as literature influences from colleagues of mine who are also specialists in this field.
1) Recognize the rhythms of your anxiety and take a 'time-out' when you first notice your anxiety starting to build
There are many signals of an anxious over-reaction, ranging from cognitive (typical maladaptive anxious thoughts or worries) to emotional (e.g. fear) to somatic (certain sensations in the body, such as heart racing or stomach clenching). When you first notice your signals, give yourself permission to take a time-out from what you are doing and reset. Now in terms of determining the best reset for you...
2) Know your personality style
Are you someone who is comfortable sitting in a quiet room and closing your eyes? Or are you someone who is high-energy and prefers movement?
Although diaphragmatic breathing is a staple of many traditions (such as meditation and self-hypnosis), for some people this feels too 'passive.' Go with what fits your personality. For active types, I encourage more kinesthetic based anxiety discharging techniques. For example, consider a technique which encourages muscle variation, such as progressive muscle relaxation or a fist clench (and release). These types of techniques involve clenching/tensing and releasing/relaxing - it is the alternation of these two states which can be both empowering and relaxing. Another type of kinesthetic anxiety management technique involves rhythm. For example, consider foot tapping or hand clapping to a musical beat that you enjoy. In fact, calling a song to mind is a helpful way of shifting your focus away from the anxiety. Should you be so inclined, there are also more formal kinesthetic practices, such as yoga, mindful yoga, and active-alert hypnosis.
3) Utilize multiple senses in your anxiety management practice
Why just breathe when you can imagine your stomach as a balloon filling on the in-breath and emptying on the out-breath? Or better yet, imagining a balloon that changes color with alternation of breath? For the fist-clench, imagine a ball of liquid that intensifies as the fist tightens and runs loose with color as the fist releases and fingers unfurl. The creative possibilities are endless. Employing multiple senses heightens your sensory involvement in your own self care and coping.
4) Get grounded
An important staple of any kind of relaxation practice is connecting yourself with an object that is inert, stable, and symbolically secure.... like the floor or ground. I always tell my clients that the floor isn't going anywhere (unless maybe you live in an earthquake zone... in which case there might be other more helpful types of imagery!) I also find that the symbolism of your feet on the floor is incredibly grounding and soothing. It signals "hey, I'm right here, and I'm not going anywhere (unless I want to)." Another applicable image is one of a tree with roots that are anchoring and nourishing. Getting centered often involves concentrating on the comfortable and pleasant sensations in your feet on the floor, such as heaviness and/or warmth.
5) Focus on the undeniable positive truths in your present moment-to-moment experience... and keep it simple
While practicing your anxiety management skills (e.g. coping/relaxing techniques), what positive truths about your experience do you observe? Well, odds are that you are breathing in and out, no? There is a good chance your hands might be by your side, or in your lap, or holding one another, correct? Or you're sitting in a chair or a couch, right (or if you are active, you are moving in some kind of predictable way, such as swaying your arms from side to side or moving your feet/legs one in front of the other)? Allow yourself to concentrate on these positive, pleasant and undeniable moment-to-moment sensory experiences. And if you find it helpful, repeat them to yourself - such as "I'm breathing in and out... my feet are on the floor... my hands are by my side." These kind of statements are very soothing. I initially tend to emphasize these rather than reassurances about the future (e.g. 'everything will be alright') which are more difficult to empirically prove and may be connected to anxious fears.
6) Mindful self-statements
When you become more comfortable with your practice of anxiety management, try adding some mindfulness-based statements, such as: "I am aware of ___" / "I breathe through __" / "I release __" If this language doesn't feel right for you, substitute statements that do. There is no magical formula.
These six basic tips are a great start for managing your anxiety. There are also many great resources out there, from websites to books. In particular, I'd like to recommend a book from a colleague of mine in the American Society of Clinical Hypnosis, Dr. Carolyn Daitch. The book is called Anxiety Disorders: The Go-To Guide, and it is published by Norton, and available at most retail outlets and Amazon. Dr. Daitch and another colleague, Dr. Elgan Baker, have been influential in training me and countless other professionals in working with anxiety disorders. I am grateful for their wisdom.
Eric Spiegel, PhD, is a licensed psychologist in private practice with offices in Bryn Mawr, PA and Philadelphia, PA. He specializes in the treatment of anxiety disorders, relationship issues, and trauma. He is co-author of the 2013 book Attachment in Group Psychotherapy, published by the American Psychological Association. In 2012, he was recognized by the American Society of Clinical Hypnosis (ASCH) with the Early Career Achievement Award. He is certified by ASCH as an Approved Consultant in clinical hypnosis. In addition to clinical hypnosis, he also incorporates mindfulness meditation in his clinical work. Dr. Spiegel has taught undergraduate and graduate psychology courses at Drexel University, James Madison University, Lafayette College, and the University of Maryland. He has also presented locally, nationally, and internationally on topics such as anxiety disorders, trauma, attachment theory, group therapy, and hypnosis. Most recently, he co-authored a chapter on hypnotherapy for anxiety disorders in adolescents in the book Therapeutic Hypnosis with Children and Adolescents.