Decreasing Anxiety in 7 Steps: Step 4

Before we get started with today’s lesson, let’s first take a moment to celebrate the work you’ve done so far. You’ve identified and accepted that anxiety is something that affects your life more than you would like. You’ve gone in search of ways to ease your anxiety and improve your everyday world including relationships that are often affected by anxiety. What’s more, you’ve begun doubling your efforts by taking yourself from research to reflection in preparation for action. Not only do you know that anxiety is a problem, but you’re ready to find something to do about it that might actually work for you. I’m impressed by your dedication to yourself and commitment to wellness. This may have been a process long time coming or have taken a lot of energy to get this far, but you’ve done it. I’m proud of you. You’re just the kind of client that I love working with and the kind of person I admire most.

Through reflecting on how anxiety has been showing up in your life and exploring some potential root causes, you’re now at a readiness for change stage where you’re primed to soak up information on what to do next. While I would recommend continuing your reflection practices on a regular basis, let’s add to it by helping you explore even more things that you can do for your health and well-being.

Step Four: Action

As we launch into this, please keep in mind that our goal here is to do just one thing at a time to works towards decreasing anxiety. I highly suggest starting out by picking the thing that seems most interesting and realistic to you and for your life. The following is a list and brief synopsis of some of the practices I teach to my current clients.

Tried and True Coping Strategies:

Creating a Wellness Toolbox: You’ve probably heard the phrase “creating a toolkit” or “toolbox” in reference to teaching people how to cope with various mental health struggles. Well, creating a Wellness Toolbox is the first step in a more literal interpretation of this idea. To create a Wellness Toolbox, you create a list that addresses the following ideas:

· Identify things to avoid: What kind of things tend to predispose you to being more anxious?

o Commonly, these can be triggers like: sugar, caffeine, alcohol/drugs, not getting enough sleep, eating too much or too little, and missing doses of medications or supplements

· Environment Necessities: Most folks respond well to having certain things done regularly in their work or home environment.

o This can mean regularly doing chores such as: vacuuming, sweeping, dusting, doing the dishes or laundry, and cleaning out your vehicle.

o At work this may mean: list making, taking regular breaks, spending time alone, rehydrating or eating, prioritizing or delegating tasks, asking for support from coworkers or managers, keeping the work space tidy, and tending to problems as they rise so duties don’t pile up.

· Determine what activities you normally or historically enjoy:

o Activities: what do you like to do outside? Inside? Alone? With someone else? What kind of artistic, spiritual, or physical practices or exercises revitalize you?

To learn more about creating a Wellness Toolbox which is one part of the WRAP system, explore this site and the creators of the WRAP Plan: http://mentalhealthrecovery.com/wrap-is/

They have a bookstore where the full WRAP Plan can be purchased, which includes the wellness toolbox.

Creating a Soothing Kit: While it can be undoubtedly helpful to have a written list you keep with you of activities to do to decrease stress and anxiety, I also recommend that my clients create a Soothing Kit to keep at home. To make a soothing kit, simply find or create a box or container (preferably with a lid) and fill it with things that soothe the senses and the mind. For best success, try to incorporate at least one to items to tend to each sense such as: essential oils, individually wrapped candies, words of affirmation or favorite song lyrics, lists of favorite songs to remind yourself to listen to, pictures, stuffed animals, rocks, play dough, or kinetic sand.

*Don’t forget to include a copy of the Wellness Plan you created for reminders of self care!

Mindfulness and Grounding Practices: Although this can be related to spiritual practices, for most of my clients mindfulness is not about spiritual or religious practices; rather, it’s about becoming more aware of their body in the present. After reading the psychoeducation portion of this blog series, you’ll remember that anxiety is when we aren't living actively in the present moment. Our minds are some place other than being grounded and attentive to what is going on right here and now. When we are anxious, we're living in the future. When we're rooted, centered, and focused, we are living in the now. I therefore recommend that clients who struggle with anxiety practice various mindfulness and grounding techniques to bring them out of what may be chaos in the mind to the peacefulness of the present. Here are some exercises I recommend to folks most:

· 5-4-3-2-1: Bring yourself back to the moment with this simple tool. Identify five things you can see, four you can feel, three you can smell, two you can smell, and one taste or flavor in your mouth. Repeat and focus on your favorite sense.

· Breathing: Did you know that research shows that a person’s breathing changes up to an hour before having a panic attack? Paying attention to your breathing and inviting yourself to deepen, and lengthen the breath can be extremely helpful in reducing your heart rate, blood pressure, and hormones such as adrenaline that effect your ability to think, make decisions, and move through your life. Taking even sixty seconds to consciously change your focus from your thoughts to deepening your breath can be restorative to your body functions.

· Square Breathing: For those of you who like more structure, you can practice this specific breathing technique. Looking at anything around you that’s in a square shape, and imagine yourself tracing a line around it as you breathe. Tracing on the first side, breathe in for 7 seconds until you get to the next side. Once there, hold your breath for 7 seconds as you imagine tracing along that side. When you get to the third side, slowly release your breath for seven seconds. Finally, hold your exhaled breath for a 7 seconds down the final side. Repeat several times. If you notice 7 seconds is a bit too long for your lung capacity to start, begin with something shorter like 5 seconds.

· Body Scan: Checking out of the mind and into the body can be very helpful in detaching yourself from your thoughts or feelings. Completing a body scan can be helpful in making this shift.

· Mindful Eating: Practicing eating food more slowly and mindfully can not only bring you back to the present moment, but it can also increase your enjoyment of food and aid in digestion.

Meditation: Of those with anxiety and busy minds that I’ve worked with, I’ve met a lot of people who didn’t believe meditation was a realistic option for decreasing their anxiety. Usually meditation comes with a connotation of a person who has achieved acceptance, non-attachment with the world, and has found “inner peace.” While that may be true for some people, especially those who incorporate meditation with their religion or spiritual practices, I don’t have such lofty goals or expectations for my typical client. There are many meditation techniques that people find to be helpful and user friendly that empower the practitioner to slow the mind and manage anxiety as well as other emotions. Here are a few ways to meditate:

· Walking Meditation One: While walking, let go of the thoughts and feelings that are pulling at your mind. Focus on the act of walking and with each step with either your left foot, count, “one.” When you inevitably notice that your thoughts are no longer centered on counting, simply return to counting without chastising or judging yourself.

· Walking Meditation Two: If repeating “one” so frequently doesn’t quite work for you, do the same process, but each time your left foot touches the ground, count each step up to ten. After ten, start back at one, and repeat.

· Safe Place Meditation: Rather than focusing the mind on thinking about one specific thing or trying to clear the mind entirely, another option is to create a Safe Place that you can go when you want to relax. This could be a place that literally exists or existed in the world or that you would like to visit or like to create. Imagine this place by engaging the senses: in your Safe Place, what would you hear, see, smell, feel, and taste? Who would be there? What would be there? What would be noticeably absent? How would you feel?

There are many ways a person can meditate in both traditional, and non traditional ways. There are ample videos on YouTube where a video will walk you through a “Guided Meditation” as well as apps and websites that will provide you with Guided Meditations. My favorite, that include free trials from time to time, are:

https://www.headspace.com/

https://chopra.com/

Converse: Hurt that happens in relationship is most often healed in relationship. While reflection and other solo practices are a huge part of healing work, so is sharing your experience with another trusted person. This is why people come to therapy in the first place, right? If you have a person in your life that you trust to listen to you, who you believes genuinely tries to understand you, and cares about you, I would highly suggest reaching out to them to talk. Talking with them can mean deep, meaningful conversations, or light, humor based one liners that you text back and forth. Connection is what we’re after here.

Connection is not limited to humans, either: if there’s not another human in your life that you have this relationship with, what about an animal or a plant? Many of my clients have Emotional Support Animals or at least a pet that comforts them. Others are drawn to plants and nature; if this is you, consider if there’s a plant in your house or within window gazing distance that you feel drawn to. If not, could you obtain one or plant one? Giving love to other creatures can be as important in the healing process as getting love. Talking things out in a space you know you won’t be judged for can be hugely helpful; even if you have a therapist or person in your life you can talk to regularly, you may consider adding another creature for daily comfort and conversations.

ASMR (Autonomous Sensory Meridian Response) Videos: ASMR Videos have gained popularity in recent years and their presence on YouTube channels have increased exponentially. ASMR Videos are short or long home-made videos of folks engaging in activities that may invoke “ASMR” which is when a static-like or tingling sensation starts on your scalp and moves down towards your neck. This often occurs for folks when they listen and/or watch these kinds of videos that are shot in ways to intentionally “trigger ASMR.” With teenagers and children, “slime” videos are somewhat similar and especially popular; they can spend lots of time watching others make and play with slime. For adults, videos are based more on sounds and sights such as playing with a Zen Garden, tapping or scratching objects, brushing or cutting hair, making water noises, and emphasizing hand movements, all to evoke ASMR and/or make the watcher begin to get sleepy. I have recommended ASMR videos to my clients for the past several years, and most of them have reported being able to find a particular person they enjoy watching most. Again, connection with others is important as is engaging the senses in helping to bring you back to the present moment. Following a specific YouTube Channel on ASMR can help achieve both of these goals.

The person I recommend most to clients is named Gibi and her channel includes a thorough video that explains more about ASMR and gives names of other ASMR Channels that may interest her viewers. I recommend Gibi based on her wide variety of videos, personability, validation of emotions and mental health struggles, and perhaps most importantly, practices of consent as she consistently asks for permission prior to “touching” your face in role play videos.

Find her channel here: https://www.youtube.com/channel/UCE6acMV3m35znLcf0JGNn7Q

Time to practice!

Again, I’d suggest picking out what seems most realistic and pleasurable for you to try and/or increasing the frequency of which you are already doing activities like these to manage your anxiety. Please remember that these are coping skills that do not replace the treatment goals and therapy work that we do in session together, but simply add to them. These are the things I ask people to do between sessions after teaching them the practice, on a daily or weekly basis, to decrease the ways that anxiety impacts them while they work towards overall treatment goals and symptom reduction.

To practice, I’d say set a reasonably obtainable goal for yourself per day, week, or month, and try it out. If you don’t meet that goal, assess for barriers that got in your way and reevaluate if you think it’s realistic. After making any adjustments to your plan that you feel are necessary, try again. Practicing getting the implementation just right can take some time, especially when your needs may vary week to week depending on life variables. And that’s okay! Stick with this weeks lesson for as long as you need to, and you can keep coming back to this list whenever you like. When you’re ready, you can check out next weeks blog on overcoming barriers to implementing these skills and working towards your long term goals. I’ll see you there!