Overcoming Anxiety

Having looked in detail at what happens to us when we become anxious, we can now get down to the business of tackling anxiety. The first 15 sections of Part 2 will teach you vital skills for dealing with it. These are crucial not just for overcoming generalised anxiety, but for reducing vulnerability to the other forms too.

We will also be looking individually at what you can do to handle specific forms of anxiety. But as post-traumatic stress and most phobias are best treated by therapists, and can in fact be completely cured, we will cover them separately in Part 3.

So, to recap quickly, there are three elements to any anxiety disorder. These are:

  • physiological (tension, inability to relax, disturbed sleep, etc.) 
  • emotional (imagining catastrophe, sense of apprehension, anticipatory fear, etc.)
  • cognitive (negative thoughts, poor concentration, etc.).

Throughout the following articles, we will help you to deal with all of them.

Learn how to relax

The first thing anyone who suffers from anxiety needs to do is learn a reliable, pleasant way to relax. Of course, if you suffer from anxiety, relaxing - or being able to calm yourself at vital moments - is probably the very thing that you find hardest to do. But the ability to calm down, relax, or mentally and physically take time out (whatever you choose to call it) is an absolutely key weapon in the arsenal you are now going to assemble to tackle your over-anxiety and recapture your mental equilibrium.

Relaxing is important not just because high anxiety is a horrible, exhausting and often frightening feeling, but because, when you are anxious, you are highly emotionally aroused and, as we have seen, in that state - however hard you try - you cannot think straight. The emotional brain strong-arms its way centre stage, pushing the rational part of your brain out into the wings or off-stage altogether, leaving you at the mercy of primitive, emotional, black-or-white thinking such as: ''I'll die if I have to do that!" ''I'm having a heart attack!" ''I'll never be good enough!" It is these types of thoughts that crank up our emotional temperature and send anxiety soaring.

As we have already observed, we all need access to anxious feelings to keep us alert to dangers and to motivate us to take on new challenges. But, to deal with unproductive, self-defeating anxiety, we also need our sense of perspective back, so that we can look at the whole picture; if we are highly emotionally aroused, we can't even begin to do that.

Calming anxious people down - and teaching them how to do it for themselves - is a priority in a first psychology therapy session. Most people find this an enormously helpful - and enjoyable - experience. It is like being given permission to let go of all that agonising and ruminating, checking and worrying, so that you can just appreciate being in your own body for a moment, often for the first time in a long while.

You may be feeling doubtful that you will ever be able to relax again, but we have never come across anyone who couldn't be helped to relax at least for a little while, even those who were utterly convinced that it couldn't be done, or were actively resistant. However, we don't force people to relax 'our way'. What works is to find the way that does the magic for you. And there will be one. For your body will be yearning for relief from the highly unnatural state of unrelenting stress you may unwittingly be subjecting yourself to. Ten or 15 or 30 minutes' calm is a wonderful gift to give yourself. It will show you, through the very experience of changes you can induce in your own body, that things can be different; you can make changes happen.

Once you know what true relaxation feels like (many people tell us that they had quite forgotten), you will soon become able to relax yourself quickly whenever you need to. (It's like coming into money and being able to afford to take a mini-break whenever you need to 'recharge your batteries'.) This is a brilliantly effective way of preventing anxiety from escalating into a panic attack or a fearful thought from leading to a compulsive activity - it leaves you access to the full power of your thinking brain, so that you can put your situa-tion into perspective and defuse it on the spot.

A few ways to relax quickly

Here are a few easy and effective methods you can use to induce relaxation - choose one you like or try them all out, and then practise the one you like best for 10 minutes at least twice a day. If you are unable to relax by yourself at the beginning, it could help if you see a therapist so that they can do a guided relaxation with you. Psychologists sometimes tape such sessions, so that clients can replay the tape and induce a relaxed state whenever they want to. Alternatively, you might like to ask someone to read the steps to you for the first few times, so that you can focus on relaxing.

1. The 7/11 method

Many people find that the easiest way to relax is to concentrate on their own breathing, so we suggest you try this method first. (If paying attention to your breathing makes you more anxious, however, move on to the second method, and come back to this one when you feel ready.)

  • Settle yourself comfortably in a place where you won't be disturbed. Make sure your clothes are loose.
  • Sit or lie comfortably with your hands side by side in your lap, or your arms by your side, and your legs uncrossed.
  • Close your eyes.
  • Now concentrate on becoming aware of your feet on the floor, your legs and arms where they are resting and your head against the cushion, pillow or chair back.
  • Keep your shoulders down and take in a really deep breath - it can be helpful to put your hand on your tummy to feel it inflating like a balloon, as this lets you know that you're doing it right.
  • Then make each out-breath last longer than your in-breath. (This is important because the out-breath stimulates the body's natural relaxation response. By changing your pattern of breathing in this way, your body automatically begins to relax.) A good way to do this is to breathe in to the count of 7, then breathe out gently and more slowly to the count of 11. If you cannot breathe out for that long, hold your breath for the remainder of the time while you keep counting to 11 and then breathe in again. Alternatively, try breathing in to the count of 3 and out, more slowly, to the count of 5. Keep your shoulders down and take in a really deep breath - it can be helpful to put your hand on your tummy to feel it inflating like a balloon, as this lets you know that you're doing it right.
  • Do this about 10 to 20 times, knowing that you will relax more with each breath.
  • Concentrate on the counting (try not to let your mind wander off; if it does, just gently bring it back) and feel the welcome sense of calm, gradually flowing in.
  • Try and be aware of how much less tense you feel, just by relaxing your breathing and blocking out your over-busy thoughts.

This 7/11 (or 3/5) technique is good for instant relaxation too. Just do it a few times, wherever you are, if you feel tearful or that a panic attack is coming on or you are getting so wound up that you can't make a simple decision. No one will know you are doing it, so there is no embarrassment to fear.

2. The clenched fist method

Another good way to relax is through the following simple method, derived from yoga. (However, only use this if you don't have any problems with your hands, such as arthritis.)

  • Settle yourself comfortably and then make your hands into the tightest fists possible. (If you have exceptionally long fingernails, just clasp both hands tightly together, interlocking the fingers.)
  • Look at your fists carefully as you squeeze them harder and harder, being aware of the whiteness of your knuckles, the feeling of your nails against your palms, the pressure of your thumbs against your forefingers and the rigidity of your wrists. Notice too the tension moving up your arms to your elbows and shoulders.
  • Keep squeezing your fists like this and concentrate on the physical sensations for a moment or two. To help you concentrate, close your eyes.
  • Then, with all your concentration focused on the change that develops between tension and relaxation, allow your fingers and hands to slowly unwind.
  • Still with your eyes closed, feel the enjoyable sensation of relaxation spreading quite naturally through your fingers and up along your arms as the tension drains away. You may find it takes the form of whatever your body needs - coolness if you tend to be too hot or warmth if you tend to feel too cold - or else you might just feel a pleasant tingling sensation.
  • Whatever form it takes, let the relaxing sensation spread through your body, relaxing your brow, your cheek muscles, your jaw, your shoulders, chest and so on, down to your toes. 
  • Keep your focus on the falling away of stress and the calming differences you can sense in your body, perhaps imagining it draining away from your feet and disappear-ing into the floor.
  • You can keep repeating this for as long as you like, while you enjoy noticing the calming changes that occur throughout your body. As your body relaxes, so does your mind.
3. The whole body method

This highly effective method is also derived from yoga and achieves relaxation in a similar way.

  • Work gradually through the main muscles of your body, tensing each in turn for a count of 10 and then relaxing them. As in the previous technique, this works on the simple mechanical principle that, if you tense muscles and then relax them, your muscles are always more relaxed afterwards than before you tensed them.
  • Try starting with your feet, move up to your calf muscles, then your knees, your thighs, your tummy muscles and so on.

Create a 'safe and special place'

You can make relaxing an even more pleasant and rewarding experience by using the time with your eyes closed to waft yourself away mentally to some pleasant imaginary place, or to a real place that you love to go to. People often choose to imagine themselves walking on empty beaches by the sea, or in the mountains, or by a stream, or sitting in their own gardens. Children might choose their bedrooms or to imagine themselves in outer space. You can make the scene whatever you want it to be. If you are more relaxed when there are other people around, incorporate their presence into your imaginings too.

Perhaps you relax through a physical activity, such as playing football or squash, dancing, cycling or walking in the park, in which case visualise yourself enjoying that activity. Wherever you choose to be and whatever you choose to do there, concentrate on making the occasion as real as it can be. Really try to see the colours of the sandy beach, or the flowers or football shirts. Hear the sounds - the gentle whoosh of rippling waves, the rustling of leaves, the voices of the players. Feel the textures; smell the smells. (You may well find that you are 'better' at visualisation than at hearing the sounds or smelling the smells, or better at the sounds or smells than visualisation: this really doesn't matter as we all tend to have one sense that is more dominant than the others; just focus on whatever comes easiest.)

Imagine your chosen scene in detail, so that you can make it your very own' special, safe place', one you will always be able to call to mind and enjoy when relaxed - or to use to help you to relax, when you need to very quickly. 

Deliberately try to calm yourself down in one of these ways, whenever you start becoming over-whelmed with feelings. Just as you can't contract and relax a muscle at the same time, so you can't be anxious when you are in a relaxed state. When you are calm and free from pressing thoughts, even for a short period, you have access to the rational part of your brain and can more clearly recognise and question any black-and-white thinking.

Practise 'mindfulness'

People who suffer from anxiety don't tend to spend much time 'in the moment', absorbed in what they are doing: they are more likely to do things absent mindedly, while they fret about something in the past or worry about the future.

Creating 'mindfulness', a teclmique for turning off busy thoughts, which derives from Buddhist meditative practices, is a powerful antidote to that. It can be hard to do at first, just because it is so contrary to our usual way of going about things, but perseverance pays. Try it for yourself, by following these simple steps:

  • Decide to give your complete attention to a simple task you are familiar and comfortable with. For instance, if you are weeding the garden, be aware of all the movements you make, as you make them, one after another. Be aware of the flowers and weeds you are working with, their textures and colours. Let your focus be entirely on the activity you are engaged in and what you are seeing and sensing, but don't think about what you are doing.
  • If a thought intrudes, whether it concerns what you are doing (for instance, "I'm getting tired", "I'm bored" or "I don't like those flowers") or concerns other matters or worries, just be aware you are having the thought, then gently let it go and bring yourself back to the task in hand. Your aim is to experience, not to think or make judgements or have opinions.
  • Whatever your chosen activity, whether it's cooking, eating, dusting, brushing your teeth, changing a tyre, savouring a cup of coffee or anything else, follow the same pattern: be aware of every action you are taking, moment by moment, and the associated textures, colours, sounds and/or smells that you are conscious of as you work.

Taking a little time to practise periods of 'mindfulness' like this will give you a welcome break from the interminable thoughts and worries that fuel anxiety and help to keep your arousal levels down.

Continued in this article: Get a good night's sleep