How to Treat Anxiety by Learning and Using Coping Self Statements.
The many and various situations in which we all find ourselves usually bear a resemblance to situations in the past in one or more important ways. The thoughts and feelings that are triggered by a particular life situation are the result of both your unconscious and conscious interpretation of the situation. This interpretation is usually based upon habitual, automatic thinking patterns. The key to changing this type of learned habit pattern and treating anxiety, lies in the fact that thoughts are really silent sentences that you say to yourself. Because your emotions are partially controlled by your conscious interpretation of the situation, statements that are able to calm you down when you feel anxious and worried or afraid also help you to reinterpret the situation so that it is less frightening. Psychologists refer to these types of statements as coping self statements and they form part of the cognitive behavioural therapy method which is used to treat anxiety. These coping self statements are statements that you say to yourself, which then enable you to cope with a given anxiety provoking situation more effectively.
As an exercise, try considering the last event or life situation that you were in that resulted in anxiety. Try to remember the thoughts that were going through your mind at the time. If you take time to think about it for a while, you will probably remember that the statements of thoughts that you repeated to yourself are the same as the ones that you say to yourself in many similar anxiety provoking situations. In addition they are probably statements that actually increase your level of anxiety. It is as if your particular set of negative statements have been recorded and and are being repeated over and over inside your head. Whilst the actual, specific things that people say to themselves vary depending on the person and the type of anxiety provoking situation problem that they find themselves in, there are common themes. Here are examples of negative self-talk which are reported by anxious people to psychologists. These include the following:
- I can’t stand this
- This is dreadful
- Why is this happening?
- I can’t take this again
- This is terrible
- Is this situation ever going to end
- I am so stupid, why can’t our even cope with this simple problem
- I’m not doing this right
- This is so stupid
- I think I’m dying
- I can’t breathe
- I’m never going to get better
- I can’t do this
- I shouldn’t be feeling this way
- I shouldn’t be acting this way
- I can’t make it through this
Reducing the frequency and intensity of this type of negative self talk is a vital key to reducing anxiety. One way to do this, is to repeat positive coping self statements when you find yourself becoming anxious or worried. Initially this may only have a slight effect. However with practice it is possible to create a set of positive self coping statements or messages that eventually replace the old negative anxiety provoking messages. Gradually over time, as you repeat these messages you will find that you gain confidence that they are true. Specific coping self statements for each of the basic types of anxiety related disorders are listed below.
An important means to overcoming your symptoms, is using the self coping statements to challenge worries and fears. This enables you to stay focused on the task at hand. It is important to remember to use the worry reducing skills and concentrate on the problem and problem-solving rather than on your inadequacies or worries.
How to treat panic disorder with self coping statements.
It is important to note that panic disorder starts to develop when unpleasant symptoms are experienced and the symptoms are misinterpreted by the panic sufferer. Panic disorder is then maintained by a combination of conditioned response anxiety, internalisation (constantly monitoring your bodies for symptoms of anxiety), negative anticipation and the negative habit pattern of repeating false statements about the meaning of the body sensations that are noticed by the panic attacks sufferer. Two false statements that play a key role in maintaining panic disorder are: firstly the statement “anxiety is dangerous” and secondly “I won’t be able to function properly if I become panicky”. The actual truth is that, anxiety is not dangerous, it is just a very unpleasant bodily sensation. Likewise a person with a panic and disorder will find a way to get to a safe personal area when a panic attack is experienced. There are a number of coping self statements that psychologists use to treat panic disorder in their patients. Examples of these are:
- What I am feeling is just an unpleasant body sensation. It is not dangerous I don’t have to let it stop me. I can continue to function even know I don’t like the feelings that I am experiencing.
- Anxiety is not dangerous – just unpleasant and uncomfortable. I have survived and come through anxious feelings like this, and worse before.
- The scary thoughts that I have about my symptoms are not true – anxiety is an unpleasant nuisance and nothing more.
- I can be anxious and still function effectively. I just need to stay focused on the task at hand and ignore the anxiety symptoms.
- There is no need to fight the anxious feelings that I am experiencing. Even though I know it is unpleasant, it is just an effect from the adrenaline levels surging in my body and will pass.
- I must monitor my breathing, then focus on and describe what is going on around me. It is important to external lies and distract myself.
- My present symptoms are just a form of conditioned response. My symptoms will become less as I desensitise myself.
- The symptoms are now taking place because I reacting like a “Pavlov dog”- instead of salivating though, I get anxious and panicky when certain “bells” ring. This conditioned response is normal and will fade over time.
- My body may be reacting very strongly right now, but it doesn’t really matter. This panic attack is just an old habit pattern that will pass in time.
Overcoming the obsessive thoughts of obsessive compulsive disorder (OCD).
Jeffrey M. Schwartz, M.D., who is an associate research professor of psychiatry at the UCLA School of Medicine has developed an extremely effective four step program for treating the obsessive thoughts which occur in obsessive compulsive disorder (OCD).
This treatment plan involves the following four steps: relabel, reattribute, refocus and revalue.
Step one: Relabel
This step involves recognising that when an obsessive thought takes place, it is caused by a problem within your brain and thoughts. While this problem is often described by psychiatrists as a chemical imbalance, it may also involve other aspects of the brain structure. In some ways it is similar to a patient who has a tic. The tic is harmless but occasionally it causes muscles to contract when they are not meant to. In a similar way, thoughts sometimes come into your mind that have no basis in reality. This is something that surveys have found occurs in about 80 to 90% of the population and is most likely due to automatic associations produced within the brain. For example whilst driving along you see a bus and a thought about an accident involving a bus and the car that you saw on the television news, may flash into your mind. You may even imagine what it would be like if the bus drove into you. In patients with OCD these normal random and irrational associations are much stronger and are seen as real possibilities. The brain of OCD sufferers quickly becomes overly sensitised to them, so that they trigger increasing levels of anxiety when they take place. The more an OCD sufferer gives in to the compulsive ritual, which is used to calm the anxiety that is caused by the obsessional thought, the more the brain’s sensitivity to the imagined and perceived threat is increased.
Re-labelling is an effective way of dealing with these biologically driven thoughts. When these obsessional thoughts occur, psychologists advise that you re-label them as obsessions and compulsions. To give an example, Michael experienced obsessive thoughts about bacteria (germs), which he relieved by repeatedly washing his hands. This is a common obsession. When the thought occurred that he had just touched something that was contaminated with bacteria he would begin saying to himself: “my hands are not really contaminated it is just my obsession with germs and washing my hands”. When he felt compelled to wash his hands he would say to himself: “I don’t really need to wash my hands now, I am having a compulsive urge to perform the compulsion of washing my hands”. The same approach can be used with any other obsession or compulsion such as: ordering, checking or counting.
Step two: Reattribute
This second step which is used to treat OCD is usually carried out along with the first step. When you reattribute, you remind yourself that, the powerful and intense urge to perform a ritual in order to treat the anxiety, is being driven by a part of your brain which is not functioning properly. Because of this malfunction, at least in the short term, there is nothing that you can do to make the urges and the thoughts disappear. The key message is to remember that you don’t have to act on the thoughts and urges. You tell yourself that they are false messages generated by a part of your brain because you have a condition called OCD. Because you cannot make the thoughts go away, the best option is to carry out another behaviour. Trying to make the thoughts go away only increases the worry and stress and this in turn makes the OCD urges worse. If you act on the urge then this may provide temporary relief, but it also strengthens and enhances the faulty response, which in turn leads to the urge becoming even stronger when the obsession occurs again. Refusing to act on the urge actually has the effect of changing the way the brain functions and causes false neural channels to be weakened. Over time the feelings and urges become weaker.
Michael in treatment by a psychologist would be given the following advice: He would be advised to follow the statements given in the first step with statements such as: “The compulsion that I’m feeling, to wash my hands, is coming from the OCD. I do not have to act on it”. Or: “It is not me, but my OCD that is causing me to think, feel and respond in this way”.
Step three: Refocus
The third step, refocusing, is the process of moving or shifting your attention to something else. This may only be for a few minutes, while you delay responding to the urges which are generated by the obsessions and compulsions. When treating OCD, psychologists find that refocusing is usually the most difficult part of this four step program. Refocusing takes considerable effort and initially may result in a high level of mental discomfort. However it is important to persist with this step, in order to treat your OCD. Refocusing is the only way to change the way that the brain is functioning, and in the long run it will reduce the pain and discomfort that OCD sufferers experience.
Delaying the response for a set period of time is a good way to enable refocusing. When treating OCD psychologists recommend that you begin by delaying acting on a compulsion for a set period of time, such as 15 min. If this seems too long, then you may choose a shorter period of time to start with such as 5 or 10 min. During this delaying time, you need to find something constructive or pleasurable to focus on that is not related to the obsession or compulsion. Examples include: carrying out a task for work, engaging in a hobby, playing a computer game, watching television, or taking a walk. The vital key when using refocusing to treat OCD is to never perform a compulsion without some delay.
When the time period that you have set has passed, then re-assessed the urge. Psychologists advise that you should note whether there has been any change in the intensity of the urge during this time period. Even if there is only a small reduction in intensity, it gives an OCD sufferer the courage to wait longer. Over a period of time, you will find that the longer you wait, the greater reduction in intensity of the urge.
If you find that an urge becomes so overwhelmingly strong that you have to perform a compulsion, then be compassionate and kind with yourself. Remind yourself, that using the four step plan to change your thoughts and feelings and treat the OCD will take time. During the times when you do happen to give into an urge and carry out the compulsion after a time delay, then be certain to re-label the behaviour. For examples you may say to yourself: “I have not gone back to check whether the door is locked because I forgot to lock it, I am checking it because I have given in to my OCD. The OCD may have won on this occasion but next time I will wait longer”.
Step four: Revalue
The revaluing step is a long-term goal that flows from an accumulated benefit of the first three steps. When treating OCD with this plan, as time passes, you learn to put less and less importance on obsessive thoughts or urges that occur. OCD thoughts may be annoying and unpleasant but are not important. Two factors that help in this process are learning to anticipate and also accept obsessive thoughts and urges.
By “anticipate”, psychologists mean that OCD sufferers are ready and prepared for a obsessive thoughts and urges to take place again and again, because they understand that these thoughts and urges are driven by faulty brain functioning. As you come to expect that your OCD symptoms will recur, then the OCD symptoms no longer surprised you.
Acceptance is an important stage in the treatment of OCD, and refers to the development of a calm attitude towards the obsessions. Psychologist sometimes compare this to when an annoying car alarm goes off. When an annoying car alarm goes off you can choose to dwell on how terrible it is, to listen to the dreadful noise, or you can choose to ignore the alarm and focus on other activities by using distraction. In a similar way an OCD sufferer can come to acccept that this is just the way they were born. Just as some individuals are born with physical problems, such as asthma, an OCD sufferer has a brain that sometimes malfunctions, and makes obsessions and compulsions. If you find that you are putting yourself down because you have obsessive thoughts or carry out a compulsive ritual, it is important to remind yourself that these are simply due to a faulty brain function, and that you are working and learning to find a way round them. It also is important, and helps to remind yourself, that with treatment and time, the obsessions and compulsions will eventually lesson in intensity as you follow and practice these four steps.
Using coping self statements to treat post-traumatic stress disorder (PTSD).
Psychologists report that post-traumatic stress disorder (PTSD) sufferers often think that their symptoms are a sign of weakness. It is important to make the point that everyone will experience some post-traumatic stress disorder symptoms when traumatised. Psychologists teach that one of the most powerful statements for countering these feelings and treating PTSD, is to remind yourself and say, when the feelings happen that: “I am a normal person who has been unlucky enough to be in an abnormal situation”.
Flashbacks are common in PTSD. An excellent statement to use when flashbacks happen is: “My mind is simply taking snapshots of the incidents and attempting to make sense out of something that is actually senseless”. If PTSD sufferers find that sensations or images of the trauma are intense then they are taught in treatment to remind themselves that the frightening episode is over and that they are now safe. For example, Maxine who was involved in a terrifying and traumatic car accident would tell herself: “The accident is over. It happened in the past and I am now completely safe. I am simply sitting in my car and driving normally. I am safe. I am just experiencing feelings from the past. These are just conditioned responses triggered by the accident. They have nothing to do with what is happening in the present”. In treating PTSD the statements given in the section above on panic disorder may also be useful.
Treating specific phobias with self coping statements.
Psychologists find when they treat specific phobias, that the coping self statements which are listed above in the section on panic disorder also are effective for individuals with specific phobias. It is also important as well to create and develop coping self statements that address the specific fearful thoughts that are associated with the specific phobia.
For example Sophie, who had developed a fear of water as a result of teasing by friends at school, who told her that the local pond contained piranhas,was treated by her psychologist and taught to use the following statements which she found useful: “There are no pirhanas in the water. My fear is simply a conditioned response caused by the teasing that took place when I was a child. The water is safe and nothing dreadful will happen if I stepped into the swimming pool”.
Treating social phobia with self coping statements.
The central worry underlying social phobia is the belief that other individuals are watching you and judging you in a critical way. To treat social phobia successfully, the vital key is to challenge these types of thoughts and to realise that things in the adult world are very different from when you were young. The vast majority of adults who are present around you, are far too busy thinking about their own lives and problems, to spend much time or energy thinking about you. In addition, most of the adults that you meet will treat you with the same kindness that you extend to others. If you do happen to make a mistake or say or do something stupid, it’s just not that important to them. It is unfortunate that many sufferers from social phobia, react to people as if they are still in in school. When in school children do tend to be very concerned with their status within the social group, and indeed can be very cruel to each other. Whilst there are a small number of adults who still unfortunately react in this way, they are in the minority and most adults have grown up and treat people in a mature manner.
How to treat generalised anxiety disorder (GAD) with self coping statements.
To successfully treat GAD, psychologists have found that the following four step analysis is very effective.
In addition to using this four step analysis technique, it is important to remind yourself that your predictions very rarely come true. When you worry, your reasoning is based on emotion rather than fact.
The PanicAway Method is an extremely effective and proven way of curing nervousness. PanicAway is more than just a way of relieving nervousness. It is a proven cure for panic.