Be Calm
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1.When I’m told some way of thinking or behaving will help my anxiety, I zone out, think nothing can help, or that this person doesn’t get it.
2.If I have to work hard at something, I feel like something is wrong with me.
3.I want to stay just as I am, but I am unhappy where I am.
4.I don’t believe the anxious aspects of my personality that bother me are changeable through learning and new experience.
5.Most of what I do is to survive and get through the day and less about what I want.
6.I’d rather stay stuck in anxiety than learn new ways of coping.
As you work your way through the strategies in this book you will likely start to believe in your ability to grow. Revisit this assessment from time to time to see the progress you’re making in believing in yourself. In time, you will look back and feel both surprised and proud of your growth.
WRAP-UP
•Anxiety is a normal bodily response to threat.
•Feeling fearful about something in your immediate environment is adaptive.
•Imagining what-if situations that may or may not come to pass is maladaptive.
•Anxiety responds to treatment; you can and will get better.
•The brain is able to grow and change structurally as the result of new experiences over time.
•Believing that reducing anxiety is in your control and hard work will pay off makes all the difference. You can do this!
What You’ll Learn in this Section
Imagine a triangle with “Feelings” in one corner, “Behavior” in another, and “Thoughts” in the third. These represent the three main paths to change, which lead to relief from a wide range of anxiety symptoms. This book is divided into these three main sections, too.
A change in one corner of the triangle will affect the other two. If you change your emotions—like learning strategies to calm your fear and anxiety in social situations—then you will likely change your thoughts (“When I calm my anxiety, I can contribute to the conversation and people will like me”) and your behavior (you stop avoiding social activities). Simply put, if you’re trying to effect change, you can start with any corner of the triangle.
In this first section, we will look at your anxious feelings, both emotional (sadness, anger, mood swings, helplessness) and physical (shortness of breath, heart palpitations, insomnia). You’ll learn better ways of dealing with your feelings and how to overcome avoiding or pushing your emotions away. We will also see how the stress of anxiety can lead to unpleasant physical side effects, such as digestion problems, racing heart, and chronic headaches. Together we will uncover what lurks underneath your anxiety, which may be the most important factor when life is disrupted by anxiety.
CHAPTER TWO
Your Emotions
Are You Suppressing Your Emotions?
A few years back I took a genetic test to determine if I was at heightened risk for developing certain cancers. I did this at the urging of my doctor, who rightfully promoted prevention over treatment. This thinking made sound sense to me, and given that I don’t have a family history of cancer, I believed I would get the reassurance of longevity. I was shocked when I was told I had an 80 percent lifetime risk of developing breast cancer. (The average risk is 12 percent.) I distinctly remember thinking, “This can’t be happening; there must be a mistake in the test.” The information was too overwhelming for me to process emotionally so I pushed it away. As a result, I became obsessively focused on negative thoughts about other aspects of my life. I was unable to sleep most nights, overwhelmed by worries and what-ifs. What I wasn’t doing was acknowledging my profound sadness and grief. Once I started to get in touch with the vulnerability I felt, the anxiety became easier to manage.
The more we avoid or push away our emotions, the more anxious we become. This self-defeating process is a learned habit that actually worsens anxiety over time, in part because it reinforces anxious thoughts and anxiety-driven behavior. This happens because to keep the unwanted emotion at bay, we have to continually work at avoidance. Over time, keeping up this avoidance becomes something else we’re anxious about. When we, despite our best efforts, drop our guard even for a moment, the pushed-away emotions come flooding in and we again anxiously push them away. On this merry-go-round the original negative emotion goes unaddressed and we remain ill at ease and hypervigilant.
STRATEGY: CHECK-IN
How Do You Feel Right Now?
As you learn to better identify your feelings you will gain greater emotional control. This means you will be less prone to intense emotional reactions, such as panic attacks, emotional meltdowns, blowups, crying spells, and worried thinking. Plus, knowing what you’re feeling means you can address the real issue and feel better. When you’re upset or aware you’re experiencing anxiety, use the following chart to help you label the deeper feeling(s) that may be underneath your anxiety.
EMOTIONS PHYSICAL/BODILY SENSATIONS LABELS TO DESCRIBE YOUR EXPERIENCE ACTION URGES EVOLUTIONARY SIGNIFICANCE
LOVE Calm body, relaxed muscles, sense of peace and well-being Sense of comfort, safety, comfort with another, passion, sexual longing Desire to be with the person, to bond with the other, to make sure the other is okay Love bonds couples, children, families, and tribes. It is the glue that connects people.
PLEASURE Feel-good hormones released, increased energy, lack of physical pain, excited body Delight, joy, vivaciousness, contentment, mastery, feeling lost in the moment, not thinking about the future or the past Urge to smile, laugh, talk more with others, and reveal more about yourself Pleasure is a tonic for negative emotions and motivates us to do certain things in order to experience more pleasure.
ANGER Tense body, clenched jaw, tightened muscles, increased body temperature, feeling of pressure behind the eyes Feeling unfairly treated or disrespected by others or the world as a whole, outrage, rage, feeling the self is not valued Urge to be aggressive or harm another, urge to yell or throw something Anger cues the body to self-protect through physical force, self-assertion, or boundary setting.
SADNESS Desire to remain still, feeling of lethargy and lack of energy, difficulty getting your body to move Loss, grief, hopelessness, rejection, feeling defeated or unwanted, feeling bad about the self Urge to cry or sit still in one place, lack of motivation, urge to dwell on what you did to cause the loss Sadness is protective in that it allows the self to mark time while grief and problem-solving can take place.
ANXIETY Stress hormones released in the brain, muscle tension, restlessness, increased heartbeat, sweating, shortness of breath, stomachache Being worried or fearful, feeling threatened by something in the environment or within a relationship (fear of losing a relationship), being in high-alert/vigilant/survival mode Urge to be vigilant, replay events in one’s mind, predict future events, desire to control the threat, flee, or be busy Anxiety triggers adrenaline, which puts the body into high alert, primed for action and protection.
GUILT Stomachache, aching muscles, feeling that you can’t be physically at ease Feeling like a “bad” person, feeling destructive, feeling you should be punished Urge to make amends, to be a “better” person, to berate oneself Guilt keeps people in line with societal laws and norms designed for protecting people.
SHAME Burning sensation on face, cheeks flushing, stomach sinking Embarrassment, humiliation, exposure as a fraud, fearing a flaw will be revealed to another or the public Urge to flee the situation, to become invisible and hide oneself Shame signifies social status in a group and keeps people in accordance with group expectations.
STRATEGY: EXPRESSING YOURSELF
When you’re feeling strong emotions, finding a way to express those feelings can go a long way toward helping you move through them. There are countless benefits in talking about our feelings with another person. For example, I see it over and over again in my practice that a person comes into a therapy session feeling upset or anxious. They allow themselves to talk about their feelings for 50 minutes, an
d they leave feeling significantly better. Many often say, “That’s too easy. How can merely talking make such a difference?” The answer is that the act of talking, labeling, and expressing moves emotional information from your emotional brain to your frontal lobe, which helps you better understand yourself and feel more in control of your emotions, which makes you feel better.
Choose a person with whom you can discuss your feelings. Try to look the person in the eyes while expressing yourself, because maintaining eye contact with a supportive connection will further soothe your nervous system.
Emotional relief can come by talking with others with whom you have very little intimacy or contact, such as a therapist or support group. Even talking online with someone you don’t know that well may help you feel more accepted and less anxious.
Go Deeper
Express Yourself
As you explore the feelings table and begin talking about your feelings, write down in your notebook the emotions that seem to come up for you the most. Record one or two of these primary emotions. This isn’t a writing test so don’t worry about your writing style, spelling, or punctuation. Simply ask yourself the following questions:
•How old were you when you first remember feeling this emotion?
•What was the situation? Was that situation at all similar to what you’re going through now?
•Did you express what you were feeling to anyone?
•Did anyone comfort you or help you make sense of your feelings?
See if in your writing you can comfort yourself now through self-compassion and self-acceptance. Tell yourself, “It’s okay to feel this (your specific emotion).” See if you can let yourself believe that part of the problem is never having allowed yourself to reflect on and accept your deeper emotional experiences.
What’s Underneath Anxiety?
When we don’t express negative experiences, they become internalized—we try to problem solve the upset in an internal vacuum, which results in overthinking and a sense that we can’t turn our mind off. Without a release valve, all those negative, doomsday thoughts just keep bouncing around inside our heads.
Take the example of Zander, a typical patient in my psychotherapy practice, who is grief struck by the death of a loved one. Instead of expressing his feelings and allowing himself to be openly sad, he suppresses his pain. Seemingly out of nowhere Zander finds himself obsessing about the details of the loved one’s medical expenses, funeral, and the what-ifs now that the loved one is deceased. Over time, his world becomes smaller and smaller. He is afraid to go out and spends most of his time at home ruminating (working through negative events by mentally replaying them again and again).
Another example is Valentina, who after her divorce, blocks the normal feelings of anger, loss, and sadness and instead becomes obsessively focused on her weight. She replays in her mind what she did or didn’t eat that day, plans her next meal, imagines herself larger or smaller. In this way she occupies her mind to avoid confronting the hurt and upset of the divorce. The avoidance only increases the loss she has not fully experienced emotionally, and so she clings more tightly to her unhealthy eating patterns.
If you’re a chronically anxious person, you’re likely in a habit of suppressing your negative emotions. You may be aware of your anxiety but unwilling to explore what might be under, or driving, the anxiety. As uncomfortable as the anxiety feels, it can still feel easier than managing more threatening emotions, such as anger or sadness or shame or guilt. Let’s take a look at how to start doing just that.
STRATEGY: EXPLORING ANGER
If you struggle with anxiety, the moment you feel an ember of anger brewing, you likely blink it away. Anger is adaptive, evolution’s way of motivating us to protect ourselves through boundary setting and self-assertion.
1.Build awareness of anger. Notice when your body gets tight, your jaw tenses, or your heart rate increases. Instead of going to your automatic anxious-spiral default, ask yourself, “What feeling might I be resisting right now?” and “What might I be missing?” and “Is anger present?”
2.For 10 minutes, without taking any action, without distracting yourself with your worries, and without self-criticism, tolerate your anger being present.
3.Breathe in and out, simply letting yourself be aware of the anger.
NOTE: Becoming aware of anger doesn’t mean you need to react to it. One client I worked with recognized that when she was starting to become angry her jaw clenched up. Recognizing this anger signal helped her know when she was angry long before it became intense enough to be self-defeating.
STRATEGY: EXPLORING SADNESS
Many of us will go lots of other places first, even to rage, rather than willingly feel the vulnerability of sadness. This short meditation is a safe way to feel an uncomfortable emotion, by inviting it in rather than feeling overwhelmed by it. By meeting sadness on your terms, you’ll have the advantage, and you’ll start to learn that you can actually tolerate feeling sad and that it isn’t such a threat to you after all.
1.Sit comfortably or lie down on your back. Close your eyes. Allow the tension in your body to release as you breathe in and out.
2.Invite sadness into your conscious awareness; remember moments when you felt sadness. Consider when sadness was present but was overlooked and unattended to. Review your relationships, experiences, achievements, and various circumstances through the lens of sadness.
3.Now be a gentle, curious observer. Where is the sadness located in your body? Do you feel tenderness in your stomach, behind your eyes, a feeling of fragility or vulnerability? Maybe you can observe an urge to cry or to retreat. Perhaps your heart feels tense or heavy.
4.Recognize when a voice in your head pulls you away. Gently direct your attention back to your sad feelings.
5.Your suffering only wants to know that you see it and that you no longer have to hide and suppress it. Repeat internally, “I see you, sadness. I feel you. I am side by side with you.”
6.Feel the sadness as you breathe in. Release the sadness as you breathe out. Notice the feeling as it comes in and how observing it allows it to become less intense.
How Do You Feel About Your Feelings?
We minimize our very real and normal emotions by telling ourselves, “It’s bad that I feel this way,” or “My negative emotions mean I’m weak,” or “What’s wrong with me that I feel this way?” or “I’m such a loser because I’m always upset,” or “No one will ever love me because my emotions are out of control.” When we negatively judge our emotions, we experience double the emotional pain. On top of the original hurt or upset, we feel worthless for having the feeling in the first place.
Telling yourself you’re a weak loser for a feeling you can’t help but experience is a particularly harsh torment. Take, for example, Tanisha, a client from my practice. When Tanisha became overwhelmed by sadness or anger as a child, her parents would immediately dismiss her, coldly telling her to “get over it” and that she was “too sensitive.” Eventually, whenever she felt hurt, lonely, overwhelmed, or full of self-doubt, she learned to tell herself the same things: “What’s wrong with you?” and “Get over it, no one cares!” and “Why can’t you be cool and keep your feelings together like everyone else?” By the time she was an adult, Tanisha had layers of unaddressed negative emotions that came out in the form of crushing panic attacks.
We can’t eliminate anger and sadness, but we can control how open and kind we are to ourselves when we experience these feelings. The next strategies are designed to help you let go of judgment and allow your feelings to surface.
STRATEGY: JUDGING ANGER
By changing your anger associations, or judgments, you can be at ease with the emotion. Take a moment to consider what you associate with anger—whether memories from your childhood and/or adult experiences.
Write down in your notebook four or five specific words you associate with anger. Do you understand why you associate these words with anger? Where did the judgments
come from? Were they ideas you got from observing others or things you were told when you experienced anger? Are your associations with anger mostly negative? If so, why?
Which word holds the strongest association with anger for you? Now, reflect on its opposite. Can you think of ways this opposite word might be associated with anger, too?
For example, for many, anger brings up words such as “out of control” and “destructive.” Opposites of this include “constructive” or “useful.” Expressing anger is constructive and useful when done in a respectful way that allows us to set boundaries and take care of ourselves.
STRATEGY: JUDGING SADNESS
Sadness is a feeling that comes about due to grief, rejection, feeling defeated, unwanted, or unloved. Typically, each of these instances brings on a sense of loss. The longer the sadness goes unaddressed, the more and more anxious you become.
Whatever the loss may be, it’s always okay to acknowledge your sadness about having missed out on something or losing something very dear.
Bring to mind three or four specific occasions when you pushed away the feeling of loss, grief, failure, or rejection.
•Were you honest with yourself or with others about how sad you really felt?
•Instead of feeling your sadness, did you go into an anxiety spiral?
•What stopped you from allowing yourself to be purely sad?
•What kind of judgments might you have been making about your sadness?
•Did avoiding the sadness help or hurt you in the long run?
Letting Go of Judgment (short meditation)
It’s important that you practice observing your emotions without having to immediately push them away. Use this short meditation to gain perspective and space from your moment-to-moment, ever-changing emotions.