Anxiety in children and adults
Information about anxiety:
Anxiety is the most common problem for children and adults. Fear or worry at normal levels and frequency are helpful and adaptive because some situations are really dangerous. Worry can be a way of preparing for a situation. When that fear interferes with normal functioning, it may be that an anxiety disorder exists.
Sometimes the ‘fear sensor/alarm’ can become too sensitive so that safe things seem scary, and
lead to reacting too quickly or too intensely and/or worries can be for too many things and too much
of the time. This can really disrupt daily life.
Avoiding things/situations that cause nervousness or worry is a temporary solution because it actually leads to MORE nervousness and worry over time (but feels better in the short term). Therefore, facing fears and worries (exposure) is the key to reducing them by finding out they are not so terrible and can be handled (e.g., A fear of talking in public? Elevators? Try it out and find out!).
Information about the Cognitive Triangle:
Thoughts, feelings, and behavior are connected. Thoughts drive feelings even if the person is unaware of the thoughts. Avoidance (a behavior) can temporarily lower distress (a feeling) but reinforces unhelpful thoughts (X is dangerous). Avoidance can also result in people missing out on “good things.”
Information about treatment (CBT):
• Treatment is short (8-20 sessions), active (practice/homework), and works!
• It teaches ways to lower anxious feelings, promote helpful thoughts, and face up to fears and
worries so they diminish. Clients learn tools that can be used anytime.
• After hard work, clients feel calmer, more in control, less distracted, and more focused.
These skills are important for helping the client do exposure/facing fears (e.g. “I can try exposure b/c I know I can calm down”) and for empowering them so that they can personally change emotional states (“I can change how I feel. My feelings don’t rule me.”).
Relaxation: Progressive Muscle Relaxation or tense/relax exercise, yoga, meditation, visualization,
exercise to learn to calm body tension or stress.
Secret calming (controlled breathing): Slow belly breathing to calm down in the moment.
Distraction (planned avoidance of negative thoughts by engaging in other activities): Listening to music, playing ball or a game, reading, engaging in an enjoyable hobby or activity.
Mindfulness (learning to accept and tolerate distressing emotions instead of fighting them): Sitting with
a feeling, like a wave that washes over, knowing it won’t last forever and is tolerable; mindful walking or eating (e.g., melting M&M in mouth while concentrating on it). Focus on “now sensations”.
KEY COMPONENT: Exposure [Facing fears and worries, not avoiding them]
Create a list of feared situations or types of worries, then rank least to most feared.
Imaginal exposure: Thinking about and imagining feared memories, situations, objects, and worries,
and learning to tolerate the feelings and body sensations.
In-vivo exposure: Facing feared situations/things in real life that FEEL scary or unsafe, but are actually safe (e.g., being in the dark in one’s room, being away from parents, talking in front of class)
Try to come up with alternative thoughts to the fearful ones that keep coming to you and creating anxiety.
Examine the accuracy of your thoughts – where is the evidence? Are your thoughts helpful or unhelpful? Ask yourself what you would tell a best friend if they were having the same cary, fearful thoughts. This can add perspective and help you to distance yourself from inaccurate thinking.
Anxiety often comes from us overestimating the threat (eg. rejection, failure, abandonment, heart break) and underestimating our ability to cope. As a result, we avoid the threat. The only problem with this is that you never get to test out what would happen in reality.
Face your fears and confront the threat.