As a Clinical Psychologist, I have worked with a large number of clients who are struggling with anxiety disorders. Anxiety struggles can be overwhelming, frustrating, and persistent. They can often affect various areas of life, such as work, relationships, productivity, and relaxation. That said, professional therapy has been shown to be effective in treating this condition. Not all anxiety disorders are the same, so I make sure to conduct a thorough and ongoing assessment with all of my clients to attempt to identify the nature of the struggle. Anxiety disorders can vary and, according to the Big Book of Mental Health Disorders (DSM-V), include some of the following conditions:
- Social Anxiety: Often related to excessive fears in the context of interacting or connecting with others.
- Panic Attacks: Sharp and distressing episodes of anxiety and overwhelm.
- Agoraphobia: Difficulty, if not inability, to leave one’s home or feeling confined to certain geographical locations due to a flooding of emotion.
- Generalized Anxiety Disorders: An ongoing and persistent anxiety that does not remit of its own accord, often for prolonged periods of time.
Oftentimes, these conditions can overlap with each other, and diagnosis is largely helpful in getting an idea of what the condition entails, so that proper treatment can be provided. In working with Anxiety disorders, my theoretical orientation is oriented around Cognitive Behavioral Therapy (CBT). This treatment involves a bit of education regarding the framework and skills behind this therapy. Learning how to better recognize dysfunctional thoughts, exaggerated emotional states, and unhelpful behaviors is a large part of this approach. The recognition of each of these areas is a key part of this therapy. Once the property is categorized, then the individual is likely to be able to reflect and work to intervene on their struggles at the proper time.
- Anxious Thoughts: “I’ll never be able to get all this done,” “I have to do this right, everybody is depending on me,” “What will everybody think? I’m just going to look stupid.”
- Anxious Feelings: Tense, Overwhelmed, Worried, Apprehensive, Embarrassed
- Anxious Behaviors: Avoiding, Perfectionism, Insomnia, Compulsivity, Loss of Productivity, Isolation.
The techniques of CBT will help an individual to recognize their individual dysfunctional patterns and help to offer new skills and perspectives to help alleviate these feelings. As a Psychologist, some of the CBT tactics that I routinely implement with my clients include the following:
- Thought Records: Thought records are basically taking the skill of journaling and adding some structure and theory to them. A simple version of a thought record is to write on one half of a piece of paper your “anxious voice” and what it is trying to tell you about yourself or your circumstances. After some writing, the second time, this content can be reread and edited by the “calm, confident voice.” This means dissecting the previous anxious ideas and attempting to reprogram the mind with new thoughts that more accurately, if not positively, reflect on your circumstances and capacities.
- Relaxation Techniques: Often, when the body becomes so accustomed to being tense, wound up, or stressed, a person can start to address this with concrete and intentional relaxation techniques. These often include focusing on breathing, mental imagery, or body scans. One of my favorite meditation techniques actually involves just finding a few minutes to lie on the ground and focus on how gravity is holding you grounded and steady to the earth.
- Appropriate Risk Taking: Anxiety can try to send you a message that the world is a scarier place than it really is. Many people reinforce anxiety with an excessively fearful approach to the challenges that they face. The CBT approach to risk-taking is to be able to evaluate the risk and find a level that feels appropriate but challenging. Then, oftentimes, it is working to the catastrophic thoughts that can flood the brain, telling you that nothing will ever work out again. Appropriate risk taking means taking a chance; you may or may not be successful, but you will be able to do your best and give credit for your efforts, whether they work out or not.
- Behavioral Experiments: Ultimately, challenging distorted thoughts and emotions will likely lead to Behavioral Experiments. Rather than being stuck in overthinking and rumination that can go on seemingly infinitely, you can challenge yourself to ask questions, push the limits, and see what else might be possible. By definition, experiments do not always work, but the point is to get out of apathy and feeling frozen and gain some momentum by focusing on the action that best serves your interests.
- Time Management: Though this point may seem a bit dry, oftentimes focusing on concrete time management can lead to a significant amount of focus and relief. A simple but powerful approach to managing feeling overwhelmed is to make a list of all the things that are pummeling your mind, stand back from that list, and work on just one item that makes the most sense from a priority perspective. Many times, a concrete and incremental approach can help build momentum and feelings of competence.
Overall, every client I’ve ever worked with has had their own unique struggles that require skilled focus on understanding the nature of their struggles as well as what is going to work best for them. No case of anxiety is exactly like another, and I attempt to tailor my approach to find what is most effective for each person in alleviating their worries. If you feel that you might be struggling with anxiety, click on this link, send me a message and we can schedule a free 15-minute phone consultation where I can get more information about your situation and tell you more about how I might be able to help.
All the Best, Dr. Chad K. Cox, PsyD
Licensed Psychologist PSY23320
San Diego, CA