1. Anxiety is often
driven by anticipation. Try not to indulge thoughts about what could
happen. Allow your thoughts to focus on what you are doing now or where you are
now. Stay out of the past and out of the future. If you "stay in the
now," your anxiety level will come down. If you are anticipating upset,
planning your escape, checking your watch or thinking about past
"failures," your anxiety level will go up. Focus on your immediate
surroundings to help you stay in the present, (e.g., colors, textures, the
details of a conversation, etc.). Tell yourself: "Stay in the
here-and-now." "Keep your feet on the floor." "Keep your
mind where your body is." "What am I doing now? What do I need to do
now?" "I'll deal with that when the time comes."
2. Accept your
"first feelings" of anxiety. Don't try to fight off, control
or ignore these initial feelings. You cannot make them go away and trying to do
so will only make your anxiety get worse. Rate your anxiety from 1 (none) to 10
(panic) and observe that it fluctuates up and down. If you find yourself rushing,
slow down. Tell yourself: "Accept--don't fight." "I can be
anxious and still do this." "I will accept this anxiety and continue
doing what I must." "It is okay to be anxious. It is okay not to feel
in control."
3. Don't add
"second fear." This is the fear associated with your
anxiety, like the fear of dying, fainting, going crazy, losing control or
embarrassing yourself. It often starts with sudden thoughts like "What
if...?"/"Suppose...?"/"If I don't get out of here soon, I'm
going to..." If you tell yourself you are in danger, your body will
dutifully react as if you really are in danger and it will scare you more.
Sometimes thoughts are so automatic or feelings follow them so quickly that you
won't see the connections, but look for them. In time, you will become more
skilled at seeing and interrupting such connections. Tell youself: "It's
just what-ifing!" "I've felt like this before and the worst didn't
happen." "I'm not going to (die, faint, go crazy, etc.). This is still
just anxiety." "This is very uncomfortable, but it is not
dangerous."
4. Accept panic when it
happens. If you are having a panic attack, label it as such and remind
yourself that it is self-limiting. That is, it will pass shortly on its own if
you don't add second fear, don't fight it or don't try to make it go away. Try
to bring on a panic attack or try to make your symptoms worse. This is the
paradox: You can't do either by willing it. Truly trying to do so is a move
toward acceptance and will help the feeling pass. Try to make your symptoms
worse: If your heart is beating fast, make it beat faster. If your legs are
weak and shaky, make them feel weaker and shakier. If your hands are sweating,
make them sweat more. Tell yourself: "If I'm going to have a panic attack,
let's go ahead and have it right here and now." "It is an adrenalin
surge. It will pass--just accept." "Even with panic, I can do what I
need to do." "What I resist persists."
5. Strive not to escape
or avoid. To do so only reinforces the idea that there is something
genuinely dangerous about your feelings. Always stop and consider your options,
rather than making decisions based only on how you feel. Remember that it is
not the place, but rather your catastrophic thought that makes you anxious.
Each time you face your fears and accept your feelings is a step forward. Each
time you escape or avoid is one less opportunity to take a step forward. If
something you are avoiding seems too big, try to break it up into steps you can
do. Remember that your recovery lies in the places, situations and anxious
feelings you have fearfully avoided. Tell yourself: "It's not the place,
it's the thought." "I can be here (or do this) even with panic."
"I will not run or avoid--that only causes more problems." "Face
the fear and the fear will disappear." In general, be willing to
have symptoms and be willing to do the opposite of what the symptoms demand of
you.
6. Practice
diaphragmatic breathing but take smaller breaths. To practice, lie on
your back, with one hand on your chest and one hand on your belly. Observe the
movement of your two hands as you breathe regularly. Now try to focus your
breathing in your belly so that hand moves while the one on your chest stays
virtually still. Allow your breathing to be calm and rhythmic rather than
hurried or forced. As you breathe in this manner, allow relaxation to flow into
your muscles throughout your body. Instead of "taking deep breaths"
as commonly advised, try to take smaller breaths--you will still get enough
oxygen and it will help to counteract the symptoms of hyperventilation that can
compound panic. Once you have developed some skill with this method of
breathing, try it in other positions, such as sitting or walking. Try it while
you're in a conversation with someone. Eventually, practice your abdominal
breathing skills when you feel anxious. Although such breathing skills usually
help anxiety, the goal of such breathing is not to get rid of your
symptoms. Such breathing activates the part of your nervous system that
counteracts panic, may directly reduce any symptoms due to hyperventilation,
gives you something to do rather than catastrophize or flee, and encourages
willing acceptance of symptoms. Tell yourself: "Breathe low and
slow." "Small breaths." "Breathe and accept."
7. Practice and be
patient. Remember that recovery lies in changing your relationship
with your anxiety and panic symptoms rather than in making them go away. Oddly,
you have to be entirely willing to have them before they can begin to subside.
Consider your options for practice every day. Be committed to recovery, but
don't be rigid and perfectionistic. It's okay not to be perfect. Give yourself
credit for small successes--don't diminish them with thoughts like "Yes,
but I used to..." or "So what, anybody can..." There will be
times when you feel you are no better--you may even fear that you are getting
worse. Remind yourself to be patient and not to be too harsh in your judgments
at any given point in time. Strive for a sense of perspective about progress
over time. Recovery is accomplished in thousands of small steps, one step at a
time. Do not try to control things outside yourself that are beyond your
control. Nothing in your future is prevented by worry. Tell yourself: "It
took time to get this way. It will take time to recover." "Each time
I face the fear, I learn that I can see it through by accepting the
anxiety." "It's okay to make mistakes. I'll just try not to make the
same mistakes repeatedly." "I do not have to judge my progress by how
bad I feel today." "I can recover just as others before me have
recovered." "The more willing I am to have symptoms, the more the
symptoms will subside and the more I'll get my life back."
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