by Jill Weber
When searching for a therapist to help you with anxiety symptoms, look for those who are licensed mental health providers or licensed clinical psychologists who specialize in cognitive behavioral therapy, mindfulness, and/or acceptance and commitment therapy. As we’ve seen, these approaches are well researched and have shown to be effective in the treatment of anxiety disorders.
Online Support
Working on the strategies in a vacuum with no outside influence will not be as effective as if you share what you’re doing with the outside world. Whether you talk with trusted friends or family or seek online support makes little difference. However, finding a way to connect with others who also struggle can help you feel more normal and keep the material fresh in your mind.
The National Alliance on Mental Illness (NAMI) is one of the leading mental health organizations in the United States. NAMI supports, advocates, and educates on behalf of the mentally ill and their families. The NAMI website offers support regarding a range of mental health experiences, as well as what it is like to live with the stigma of mental illness.
The Anxiety and Depression Association of America has an online anxiety and depression support group where you can connect with people all over the world who cope with anxiety. You can join this group anonymously through the online app or through subscribing. One positive step to take is to sign up and simply peruse ongoing conversations to help you feel connected to others struggling with similar symptoms. Over time, you may become more and more comfortable initiating your own discussions.
The National Suicide Prevention Lifeline (1-800-273-8255) provides free confidential support, 24 hours a day, seven days a week for people in crisis and in need of immediate intervention.
Support Groups
Group therapy is extremely effective in lessening anxiety symptoms. In fact, for some people, group therapy is more impactful than individual therapy. Group therapy works because it challenges our ideas that we’re alone in our suffering and are somehow “bad” or “less than” others as a result. This experience reduces shame and isolation and also helps with the idea of accepting anxiety while you continue to live your life.
Communicating and connecting in a group therapy setting often helps people develop self-awareness around their role(s) in social relationships. While in the group, a person may act out a role that they use to manage their anxiety in real life, i.e., overly friendly, withdrawn, very inquisitive, constantly talking, dismissive. Group members typically reflect on the roles they notice and provide one another with feedback. Because group therapy is not real life and is confidential, it feels safe for people to process such feedback. As a result, they become more flexible or even adopt other roles in the group that will eventually extend to their real-life relationships.
In addition, when we’re in an anxious state, adrenaline can take over. It can be hard to know what we feel deep down, let alone find the words to express what we’re feeling. Yet, anxiety typically decreases when we’re able to talk with others. Group therapy is a type of exposure in that you’ll probably feel anxious at moments. At the same time, it’s a nonthreatening place for you to become more skillful at knowing what you’re feeling, when you’re feeling it, and becoming comfortable expressing it.
Finding a Group
If you decide that group therapy is a treatment approach you’d like to try, and you have an individual therapist, consider asking your therapist if they know of a group that would be a good fit for you. Alternatively, there is a “Find a Support Group” feature on the Anxiety and Depression Association of America website as well as the Psychology Today website.
Keep in mind there are two common types of group therapies. “Process-oriented” groups are led by a therapist, but generally the therapist lets the group members steer the discussion. Process groups are about the group members’ experiences of what they’re observing, feeling, or want to discuss.
“Psychoeducational” groups also are led by a therapist but the therapist takes on an instructor role. Psychoeducational groups are helpful when you’re looking to gain specific skills in some area of your life or functioning. In this case an anxiety psychoeducational group might discuss coping skills and strategies.
Starting a Group
As we’ve seen, anxiety is an extremely prevalent issue for many people. If you’re looking for an anxiety therapy group in your local area and can’t find one, chances are others are, too.
If you decide to start a group, think carefully about how you wish to structure it, what kinds of members you’re targeting for the group (only anxiety, anxiety and other mood issues, relationship issues), and who will be the leader. Consider if you want this to be a process-oriented or more of an information-sharing group. It’s also important to think through group therapy rules. It’s typically helpful not to have a group with family members or people who know one another very well because it reduces anonymity and the comfort that comes from anonymity. Confidentiality among group members is key to feeling safe and open, which is what helps people grow.
Staying the Course
Like many things in life, success in your pursuit of anxiety reduction and internal peace takes patience, adaptability, and perseverance. Of course, anxiety is unpleasant and you’d like it to stop as quickly as possible. However, habits take practice to form and they take practice to break. Compassionately remind yourself that there’s nothing wrong with you if you feel that your recovery isn’t moving as fast as you’d like. And just because it’s taking time doesn’t mean you won’t get better.
Allow yourself to adjust the strategies for your personal brand of anxiety symptoms. One strategy may work for a while, but it’s important to try new ones so you stay challenged and keep growing. As your symptoms improve, the anxiety will likely change and present itself differently. You will need to adjust and bring new skills into your repertoire. If the strategies aren’t working or are going only so far, then consider individual psychotherapy or group therapy. Some people do both. If therapy doesn’t work on its own, consider combining psychotherapy and medication.
And, most importantly, whatever you do, don’t give up! Allow yourself to pick the work back up again and again. Believe in the process. Your work will pay off in the form of a brighter future.
Resources
Online
Anxiety and Depression Association of America (adaa.org)
Social Anxiety Institute (socialanxietyinstitute.org)
American Psychological Association (apa.org)
National Alliance on Mental Illness (nami.org)
National Suicide Prevention Lifeline (1-800-273-8255)
Headspace: Meditation app
Calm: Meditation and sleep app
Further Reading
Antony, M. M. and Swinson, R. P. (2009). When Perfect Isn’t Good Enough: Strategies for Coping with Perfectionism. Oakland, CA: New Harbinger.
Bourne, E. J. (2015). The Anxiety and Phobia Workbook (6th ed.). Oakland, CA: New Harbinger.
Carbonell, D. A. (2016). The Worry Trick: How Your Brain Tricks You into Expecting the Worst and What You Can Do About It. Oakland, CA: New Harbinger.
Collard, P. (2014). Little Book of Mindfulness: 10 Minutes a Day to Less Stress, More Peace. Colorado: Gaia.
Hanh, Thich Nhat. (1999). The Miracle of Mindfulness: An Introduction to the Practice of Meditation. Boston: Beacon Press.
Hayes, S. C. (2005). Get Out of Your Mind and Into Your Life: The New Acceptance and Commitment Therapy. Oakland, CA: New Harbinger.
Knaus, W. J. (2014). The Cognitive Behavioral Workbook for Anxiety: A Step-By-Step Program (2nd ed.). Oakland, CA: New Harbinger.
Pittman, C. M. and Karle, E. M. (2015). Rewire Your Anxious Brain: How to Use the Neuroscience of Fear to End Anxiety, Panic, and Worry. Oakland, CA: New Harbinger.
References
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Boswell, J. F., Thompson-Hollands, J., Farchione, T. J., and Barlow, D. H. (2014). “Intolerance of Uncertainty: A Common Factor in the Treatment of Emotional Disorders.” Journal of Clinical Psychology, 69(6): 630–45.
Craske, M. G., Treanor, M., Conway, C., Zbozinek, T., and Vervliet, B. (2014). “Maximizing Exposure Therapy: An Inhibitory Learning Approach.” Behaviour Research and Therapy, 58: 10–23.
Culpepper, L. (2009). “Generalized Anxiety Disorder and Medical Illness.” Journal of Clinical Psychiatry, 70, 20–24.
Jackson, M. C., Wu, C. Y., Linden, D. E., and Raymond, J. E. (2009). “Enhanced Visual Short-Term Memory for Angry Faces.” Journal of Experimental Psychology: Human Perception and Performance, 35(2): 363–74.
Jakubovski, E. and Bloch, M. H. (2016). “Anxiety Disorder-Specific Predictors of Treatment Outcome in the Coordinated Anxiety Learning and Management (CALM) Trial.” Psychiatry Quarterly, 87(3): 445–64.
Katon, W. J., Richardson, L., Lozano, P., and McCauley, E. (2004). “The Relationship of Asthma and Anxiety Disorders.” Psychosomatic Medicine, 66(3): 349–55.
McCallie, M. S., Blum, C. M., and Hood, C. J. (2006). “Progressive Muscle Relaxation.” Journal of Human Behavior in the Social Environment, 13(3): 51–66.
Missig, G., Mei, L., Vizzard, M. A., et al. (2017). “Parabrachial PACAP Activation of Amygdala Endosomal ERK Signaling Regulates the Emotional Component of Pain.” Biological Psychiatry, 81(8): 671–82.
Roest, A. M., Martens, E. J., de Jonge P., and Denollet, J. (2010). “Anxiety and Risk of Incident Coronary Heart Disease: A Meta-Analysis.” Journal of American College of Cardiology, Jun 29; 56(1): 38–46.
Wegner, D. M., Schneider, D. J., Carter, S. R., and White, T. L. (1987). “Paradoxical Effects of Thought Suppression.” Journal of Personality and Social Psychology, 53(1): 5–13.
Willgoss, T. G. and Yohannes, A. M. (2013). “Anxiety Disorders in Patients with COPD: A Systematic Review.” Respiratory Care, 58(5): 858–66.
About the Author
Jill P. Weber, PhD, is a clinical psychologist in private practice in Washington, D.C. She is also a psychology author and a speaker. Dr. Weber works with teenagers, individuals, and couples managing varying degrees of anxiety from panic attacks, generalized anxiety, and life stress. Dr. Weber uses a combined approach of cognitive behavioral therapy, mindfulness, and acceptance techniques when working with anxiety symptoms. She writes a blog for Psychology Today and has appeared as a psychology expert in various media outlets including USA Today, Washington Post, Nightline, U.S. News & World Report, and CNN. Dr. Weber is the author of Having Sex, Wanting Intimacy: Why Women Settle for One-Sided Relationships and the Relationship Formula series including the titles Breaking Up and Divorce 5 Steps, Building Self-Esteem 5 Steps, Toxic Love 5 Steps, and Getting Close to Others 5 Steps. For more information, see www.DrJillWeber.com.