Anxiety can feel paralyzing. It can keep us from doing the things we love. It can keep us from pursuing our goals. It can keep us from enjoying our lives. Yet anxiety need not be a roadblock. “Even if you have a genetic tendency for anxiety, or you have been anxious for a long time, it is still possible to make changes,” writes Renee Mill.
In her new book, The Anxiety Management Manual: A Therapist Guide for an Effective 10-Session CBT Treatment Program, Mill harnesses a powerful yet succinct treatment program complete with a 4-step procedure to effectively begin the process of stimulating the brain circuitry that results in a feeling of calm.
“Anxiety has nothing to do with your personality or your star sign. It is the result of activity of the neurons in your primitive brain. When you learn to stop your primitive brain from working so much, and train your smart brain to use helpful neuronal circuits instead, your anxiety will reduce,” writes Mill.
The first step is to believe in the process. Turning anxiety around takes practice, diligence, and a commitment to the process, even if it feels unnatural.
Anxiety is an innate response to feelings threatened. However, it is also rooted in our thoughts about the events in our lives and often exists under our cognitive radar.
Mill writes, “Like most of us, you are not aware of what you are thinking when you become stressed. The majority of your thoughts occur automatically and at the subliminal level. This prevents you from being able to link your thoughts to your stress.”
The EBB-Flow model of CBT, Mill tells us, contends that events incite beliefs, which then lead to behaviors that exacerbate our fears.
An important shift in learning to control anxiety is what Mill calls the “working down” process. She asks clients to choose helpful thoughts — “There is no right or wrong” or “I choose to put this event into perspective” — feel soothing emotions, behave constructively by compartmentalizing, thinking about solutions, breaking the work into parts, acting with self-discipline, and, lastly, utilizing calming strategies such as breathing deeply, exercising, and practicing mindfulness.
One helpful tool Mill offers to contain particularly challenging situations is called the “Reality Check Ruler.” Here, she asks clients to choose a number between one and ten, where one is not at all life-threatening and 10 is life-threatening, to rate their current situation.
She writes, “The ruler allows you to test out whether or not, in fact, your body is responding realistically.”
Unraveling anxiety also involves separating facts from fears, as quite often irrational thoughts lead to irrational and ongoing anxiety. By putting conclusions about events on hold, Mills contends, we can also practice putting anxiety on hold until we have evidence that there is reason to worry.
Catching our pessimistic thinking, especially when it becomes pervasive and permanent, is another important step. What we can do instead is choose the “total view” of the situation, which includes all other events relevant to the situation.
Mill writes, “When you have an issue in your life, it will be beneficial for you to stand back and look at your life as a whole.”
While not denying that there may be pain or stress in your life, this exercise helps to put things in perspective and not allow one negative event to contaminate the whole picture.
As we often forget about those situations when we predicted worse outcomes than what occurred, Mills suggests that we write down times when we thought things wouldn’t get better but they actually did.
Mills writes, “This will build up a memory bank that you can draw on in the future. There will come a time when you will feel hopeless again. When this happens, dip into this memory bank to reassure yourself that the situation will prove to be temporary and will not stay the same.”
Similarly, it is helpful to recognize growth in the way anxiety is handled. By separating out what we would have done in the past from the way we are responding now and labeling the positive traits that were utilized in the process, we effectively motivate ourselves to continue practicing.
“Every single situation in life is an opportunity to learn something new. Sometimes it is a practical lesson like planning your travel time better. But often, the lesson pertains to personal growth. In fact, in some really difficult situations where external change is impossible, internal growth is the only place progress is possible,” writes Mill.
The Anxiety Management Manual is a practical tool designed to be used in the moment to change the thoughts and behavior that accompany anxiety, and in doing so, move from a life of fear and anxiety to one of growth, resilience, and fulfillment.
The Anxiety Management Manual: A Therapist Guide for an Effective 10-Session CBT Treatment Program
Australian Academic Press Group, December 2017
Softcover, 278 pages