Set Specific Goals For Yourself

Once you have identified what it is that is missing in your life, it will be easier to see what you need to start or stop doing, to get your important needs met.

Set yourself some clear goals to work towards (these should be small and achievable) and decide on the strategies you will use to achieve them. We will be looking at specific strategies appropriate for different anxiety disorders later.

Be concrete

It is no good deciding that you want to be 'less anxious'. That's too vague. Instead, unpack what 'not being anxious' means to you. Does it mean being able to go to the party instead of turning down the invitation? Does it mean daring to fly in a plane? Does it mean trusting that your grown up children can take care of themselves instead of fruitlessly worrying about them? If you don't find this easy, try putting it this way. "If I woke up in the morning and found that I was no longer anxious, what (realistically) would I be doing that is different from what I do now?"

Be realistic

We cannot tum back the clock and save the leg that has been amputated, or keep the partner who has left, or restore the husband or wife who has died. We cannot make ourselves younger. Therefore, we must look at our current circumstances and set goals based on those - for instance, to regain or retain as much fitness as possible, to take up different challenges, to engage in social activities or to meet new people to spend time with. And, remember, we can feel young, despite our biological age.

Focus outwards

Most people who are anxious spend a great deal of their time being self-absorbed, often without realising it. They are worried about what might happen to them, what other people might think of them, whether people they love will be harmed, how they are going to cope, how they will find the strength to go on etc. So, a good place to start when making goals is to decide to do something for someone else. However, if you do a lot of that already, try doing something enjoyable for yourself, without worrying while doing it. Such a goal might be:

  • to take a walk and really look at what is around you and be in the moment as much as possible (Le. enjoy it!)
  • to have a conversation with someone, actually listen closely to what they are saying and ask them pertinent questions about what they're telling you 
  • to invite a friend or friends whom you haven't seen for ages to come to dinner and concentrate on cooking a delicious meal for you all
  • to read a chapter of a book that interests you and focus on the words and meaning
  • to take up an activity you can really engage in - such as joining a sports club, learning a new skill at a day or evening class, taking up voluntary work, etc. - and be open to getting to know new people there.

Even if you suffer panic attacks, you will be able to do such things after you have learned how to handle them. Closing down your life, so that more and more of your innate needs are left unmet, will only exacerbate your symptoms.

Gerry's panic attacks

A psychologist once worked with a young man called Gerry who had been off work for eight months because of panic attacks. His symptoms had originally begun when he was experiencing a highly stressful period of major change at work. And a relationship with a longstanding girlfriend had also ended at around the same time.

As a result, Gerry gradually started withdrawing from all of the activities he used to enjoy, such as going to the pub with his friends and playing guitar in a small group. Every time he contemplated going back to work or seeing friends in a social setting, he had another panic attack.

He was becoming isolated, depressed and now desperate. It was clear that Gerry felt highly insecure; his attention needs were not being met and he felt out of control most of the time. He had lost his most important, intimate relationship and, through his anxiety, his social and emotional connections had gradually eroded.

His status felt uncertain to him, in terms of his work, and he was no longer achieving things or challenging himself. No wonder he felt hopeless. But he wouldn't be able to help himself unless he addressed what was lacking in his life.

The psychologist soon found out that Gerry found social situations extremely daunting. He would stumble over his words and blush vividly, unless he was with people he knew well and felt safe with.

He could trace all this back to an incident at school when he was 11. His class had been set a poem to learn for homework and, the next day, Gerry was called up in front of them all to recite it. He had learned the poem but, as he looked at the sea of faces watching him expectantly, he suddenly panicked. His heart thumped, his mouth went dry and he couldn't get a word out of his mouth. The teacher drummed his fingers and looked furious. Poor Gerry was left standing there, opening and closing his mouth like a fish, while his classmates started giggling and then openly laughing. Eventually the teacher bawled at him, telling him he was incompetent and a complete disgrace and failure, before sending him to sit down.

Unsurprisingly, this event had remained live in Gerry's emotional memory. When Gerry thought about ringing his boss, he experienced the same sense of incompetence and failure (thinking his boss would criticise him for his long absence). He also panicked at the thought of the questions his colleagues might ask about why he had been off sick so long.

So, to take the emotional arousal out of the memory, Ivan used the rewind technique and then, while Gerry was calm, discussed with him what he really thought the reactions of his boss and colleagues would be. (Gerry thought his boss would probably be pleased to hear from him and that his colleagues wouldn't pry if he could make it clear he didn't want to discuss his illness.)

The psychologist then guided Gerry to visualise himself confidently making the call to his boss, chatting with his colleagues and saying, if anyone asked, "I've been really unwell but I'm fine now". He also encouraged him to visualise himself enjoying an evening out with friends. Gerry realised that, to get his life back on track, he needed to start making connection with people again, to resume pleasurable group activities and to stop thinking that he would never get another girlfriend.

When, a month later, Gerry came to see the psychologist again, he had successfully called his boss. He had also returned to work and, to his surprise, no one even asked about why he had been away so long. He had started meeting his friends again and was planning to get back to playing with his group again. What's more the blushing and stumbling over his words had completely stopped, and he now felt positive about the future.

Continued in this article: Think straight