Read Free Yourself from Anxiety Online
Authors: Emma Fletcher
‘My coping skills are positive self-talk and I believe that you can achieve most things if you’ll tolerate the discomfort.’
A
NDREA
‘As for coping skills, when I trained in hypnotherapy I was very drawn to the idea of a gentle touch on the right earlobe to remind you to be calm, but I have to say it’s never worked for me!’
A
NDREW
‘My most important coping skills are breathing and visualisation. I used to use physical props such as a bottle of water or some ice cubes at home, mints, boiled sweets and a little hard ball to squeeze and relieve my tension. I gave them all up gradually. The mints were the last to go as I used to get a very dry mouth (I had sugar-free mints so that I didn’t get a sugar rush).’
J
ULIE
‘My main coping skills are relaxation, and meditation, which stops the internal chatter.’
P
EN
‘My coping skills are: controlling my breathing, regular exercise, music (I put on headphones and block out anxious thoughts), making myself socialize even when I feel I can’t be bothered and asking for support from friends.’
S
ARAH
‘My main coping skill was using my bike – you can always escape and come back quicker.’
W
ENDY
After reading this section you should understand how to do exposure work to change your Anxiety driven behaviour in small, manageable steps. You have established your long-term goals, and your medium-term goals, and broken one of those down into a series of small, repeatable steps, like a ladder.
You know that recovery entails accepting change and facing risks in a controlled way. You know that you need to feel some Anxiety while doing exposure, but not enough to overwhelm you.
You’ve thought about how the people around you are involved in your Anxiety, and affected by it, and you’ve decided whether to use a helper during your exposure sessions.
Use your notebook to keep records of your exposure work, scoring your Anxiety on a scale of 0–10.
You’ve learnt a little more about healthy breathing. You know about coping skills and you’ve put a reward system in place. Use the checklist below to make sure you have everything ready, and then start your exposure work.
CHECKLIST
Long term goal(s):
| Five medium-term goals in order of difficulty: 1. | |
| | 2. |
| | 3. |
| | 4. |
| | 5. |
Ladder leading to easiest medium term goal:
Helper YES/NO
Coping skills:
Reward system:
‘I had a phobia of thunderstorms and especially the noise they make which started when I was very young, after a bad experience. I had reached a point where I could travel to my family in France but I never went in the summer, because they live in the mountains where they have spectacular thunderstorms at night in hot summers. I missed all the family get togethers that were always in the summer. I started work in February, to be ready to travel in July. In England we don’t have many thunder-storms so I got a tape of a thunderstorm from First Steps to Freedom.
I couldn’t listen to it, even looking at it terrified me. Playing the tape became a goal. I tried visualising myself playing the tape and being calm, but for once this didn’t work for me. I asked my mentor to be on the phone while I listened to the tape. The first time we were on the phone for 3 hours. First he talked me through relaxation, then I pressed play and let the tape run at very very low volume while he kept talking to me. Slowly I put the volume up. I was getting more and more agitated but we did get the volume very high and the thunder sounded very real – this triggered a massive panic attack and we had to stop. We had sessions twice a week for three weeks until I could tolerate the tape at full volume for 10 minutes.
The next stage was for me to listen to the tape on my own, knowing that I could phone him. At first I could only take three or four minutes but I gradually got it up to the full 20 minutes. I kept it loud so we had to shout but I did learn to stay with the situation. After a month I could listen to the whole tape without phoning him.
The next stage was to recreate lightning. I got three friends to come round with their cameras. We made the room dark and they took flash photos while a fourth friend managed the tape, so that after every flash I heard a peal of thunder. At first I had to call my mentor on the phone to get through it – we did it about four times before I was OK. The flashes didn’t frighten me as much as the noise.
After that we tried it at night, outside in the rain, with the tape player the cameras, and my mobile phone. We did it a few times and I could cope without phoning. I repeated the exposure once a week till I went to France in July and there was only one small thunderstorm.’
‘My therapist gave me a notebook in which she’d already put the headings: Time, Date, Situation, Ritual, Alarm level beforehand, Time Spent or Number of Repetitions, Alarm level afterwards and Thoughts.
One of my rituals was when I was leaving the house, looking at the door whilst locking it, checking it was closed, and feeling anxiety that it really was closed. 8 is a comfort number for me so I used to check it 2 by 8 times, and I had to go through the count without blinking. Once I started recording it over the next few days it got much worse and I was up to checking 8 by 8 times. I saw the therapist again and I felt raw and angry from having to open myself up so much and show her the notebook. However by discussing it with me she was able to put a more logical slant on it.
After two or three weeks I realised it was decreasing – I wanted to reduce it in the notebook and I didn’t want to cheat, it had to be real. It was like I was in a play and I had to play the part well. I also tried to make my thoughts more positive so that I could write down more positive thoughts.
It was difficult to put my feelings into words and that sent my anxiety up. Once I started to reduce it I was cautious about admitting I was doing well – if you’re successful then you’re running the risk of a setback, and there’s a feeling that you’re not worthy of success.
The turning point came when I realised that the therapist had the confidence that I would make progress. I made really good improvement, I could still improve but the vast majority of the time it isn’t a problem and I can live my life quite comfortably.’
When you set up a recovery programme you aim to work steadily, curbing your impatience and taking one step at a time. And yet recovering from Anxiety is not a smooth, steady process. You will have good days and bad days, times when anything seems possible and times when nothing goes right.
Everybody’s recovery moves at a different pace, and to a different rhythm. You may start wonderfully, going off like a rocket, and then grind to a halt. You may find it impossible to get started and feel quite despairing, and then suddenly everything falls into place. Some goals may take weeks to crack, others you may manage on the first attempt.
Whatever your particular experience, you can be as sure as eggs are eggs, there will be difficulties at some point, so you might as well have an understanding of how to deal with them.
Whatever you do, don’t give up. Don’t let yourself slide back into the hopeless black hole. You’ve started to work towards recovery and however tough things get, you can find a way to keep going.
A plateau occurs when you’ve had some success with exposure, but then reach a point when you don’t seem to be able to get any further.
Setbacks are bound to be more worrying, but virtually everybody has
them. Think of anything else you’ve undertaken and you’ll see that it’s inevitable – whether you were trying to play the piano, make cakes, get qualified or fit a new kitchen there were bound to be times when you felt like you were going backwards.
It is much more realistic to expect setbacks and plan for them, rather than assume that your recovery is going to go without a hitch or two along the way. That way, you will be prepared for them and have more confidence that you can stay on the ladder, even if you have to take a step or two back.
For both plateaux and setbacks there are various things you can try:
Did you attempt too much and tire yourself? Is it time to take a break? If you suspect that you simply need some time out from recovery work, then by all means take it. Give yourself a week without attempting any new goals. Use the time to repeat well-established goals, and to look after yourself with good diet, rest and exercise. When you are ready to start work on your recovery again, take it a little more slowly.
Remind yourself how far you’ve come by reading your diary from the beginning. You’ll almost certainly have forgotten how bad things were, and how much progress you have made. Take note of any other problems you’ve had, and how you overcame them. When you read the pages that record a setback, don’t despair. Instead try to work out if there were any special circumstances that might have caused the setback.
If you’ve been part of a local recovery group, or a telephone group, make contact with someone you met on the group and talk it through with
them. Or phone one of the helplines and talk it through with a volunteer. They speak to hundreds of people every week and they know how common plateaux and setbacks are. They also know that both can be overcome.
Have you set two of the rungs on the ladder too far apart, and is that why your progress has stalled? Can you see a way of putting another step in between? Or did you try to take too big a step, and instead of moving up, you lost your footing and slipped back down?
Look at the ladder you are currently working on and see if you can climb it a different way. For instance, someone who couldn’t progress with their dental phobia because of the long gaps between appointments volunteered as a driver for elderly people – the regular visits to the surgery helped them to be much more relaxed there. Someone who suffered a setback when reducing the number of times they checked their cooker changed to the goal of restricting the amount of time they spent checking – later they were able to return to the original goal.
Above all, don’t give up. It may be that exposure work has taken you as far as it can. Maybe it’s time to start cognitive work.
‘You … ought to take the approach that a setback is a sign that you are getting better and learn from it to move forwards again. After all, you pulled through it before so there is no reason why you shouldn’t pull through it again this time.’
J
ULIE
‘Your physical and mental abilities are not damaged by your anxiety illness and you will always be capable of coping with an emergency.’
M
ARGARET
‘I feel like I was living in a different world to everyone else. It frustrates me to see other people making the same mistakes I did.’
T
ERESA
Picture a scene at the Old Bailey. Look, in the dock there’s Anxiety, there’s the judge, wearing a wig, and an interested crowd in the public seats. What does your Anxiety look like? Male or female? Big or small? Defiant or cowering? Blustering bully, or evil shadow?
Anyway, here come the witnesses for the prosecution.
‘Anxiety stopped me going to my best friend’s wedding.’
‘Anxiety made me wash my hands till the skin was red raw.’
‘Anxiety kept me on the couch day after day.’
‘Anxiety made me helpless and hopeless.’
‘Anxiety ruined my life.’
The judge looks stern. What can Anxiety possibly say in defence?
‘Your Honour, I only did it to keep them safe, and they wanted to be safe, didn’t they? Yes I did keep them at home, or in one room even, and I did stop them doing all sorts of things and I did make them do other things, but supposing something dreadful had happened? What if that wedding was a nightmare of panic and they ruined it by rushing out of the church in the middle of the ceremony? Supposing those hands had germs on them and someone got sick and it was all their fault for not washing their hands enough? And if you feel so tired and weak, isn’t the couch the best place to be? Oh Your Honour, I didn’t ruin their lives, life is so full of danger and woe and all sorts of terrible things, I only did my best to keep them safe and if I may say so Your Honour, you’re looking a bit peaky, maybe you’d better go for a lie down, it wouldn’t do to pass out in the middle of the court now would it?’
The prosecution lawyer isn’t having any of it. He, or she, points a stern finger at Anxiety.
‘You did all these things for your own malicious purposes. You enjoy the power it gives you over these innocent people. I ask the jury to return a verdict of GUILTY!’
‘Anxiety, that familiar and much dreaded Bully, played havoc with my nerves all day, reminding me of how hard everything used to be.’
J
ULIE
‘A reference on television, radio or an article in a newspaper about a person being deliberately injured or killed would send me into a nightmare of conjecture. Simple tasks like helping put on a school tie would trigger off my imaginings of strangulation and panic would engulf my whole being.’
M
ARGARET