Free Yourself from Anxiety (14 page)

In this section, we are going to put your Anxiety on trial. Because it lives inside your head it can be difficult to examine it as if it were a separate entity, but that is what cognitive work is all about.

We are going to examine the ways Anxiety works inside your mind and affects your thought processes. Take your time reading this section, it contains a lot of ideas and you’ll want to get your head round each one before you do the exercises that relate to it. And while you’re working through this section, remember to press on with your lifestyle changes from Part One and the exposure work from Part Two.

As you read about each type of anxious thinking, examine your own thought processes to see which you do, and don’t do. It can be quite hard at first to identify your thoughts – sometimes just a single word or image may flash though your mind so quickly that you are barely aware of it. You may not even see them as thoughts, instead you may identify them as feelings or physical sensations.

It can also be difficult to identify the external trigger that sets off the thoughts. Catching a glimpse of the cooker may set off thoughts about checking the gas, or walking towards a restaurant may set off the thoughts that lead to a panic attack, but the first thing you may normally be aware of is the adrenalin surge of Anxiety.

So keep a record for a week in your notebook – several times a day, examine your thoughts and write them down. If you have a bad Anxiety
day, take extra trouble with this, but try to calm yourself before you pick up the notebook. Each time you make a note of your thoughts also mention the situation and the intensity of any feelings you had, both physical and emotional. Here’s an example for someone with spider phobia:

Situation
:
leafing through magazine, saw photo of large spider.

Emotion
:
surge of fear, 6/10, feeling sweaty and shaky.

Thought
:
it’s real, no it isn’t it’s a photo, but it might be, we could get spiders that big in this country and they might be poisonous.

When you’ve done this for a week, look back over your records and examine each thought. Ask yourself how much you believe it to be true, and how important that is.

Examination:
thinking about it, I don’t truly believe that we are going to get poisonous spiders in this country. I can see that it’s not important enough to concern myself about.

Of course doing this once probably won’t stop Anxiety in its tracks. In all of the following exercises that work with your thoughts, you will need to keep repeating them until you find your thoughts changing.

If you have OCD you may feel that you already spend too much time with your thoughts, but if you work on your thoughts in the ways that we suggest, you will start to have a different relationship with them. Instead of believing the thoughts you will come to understand that they are generated by your Anxiety. All Anxiety is driven by the thoughts that go round and round in your head, but with OCD there is an extra element because the thoughts link in to beliefs, usually about preventing harm. There are various ways that this manifests itself, for instance:

Any one of us can have thoughts like these from time to time. If you’re cooking chicken for guests you might think about being careful to cook it right through to guard against food poisoning, or if you’re getting irritated with a naughty child you might have a thought about giving them a good hard smack.

Research has shown that most of us are able to have these thoughts without getting upset or obsessed with them – we don’t attach any importance to them. Someone with OCD is likely to attach enormous importance to thoughts of this type. The thought becomes mixed up with the dreaded consequence, something like ‘if I don’t cook this chicken right through then everyone will get food poisoning and it’ll be my fault and they might need to go to hospital, they might even die and then I’d have killed someone’ or ‘I could easily smack this child if I’m not careful I will do it and if I don’t watch myself I might really hurt them’.

If your thoughts run away with you like this it’s only a small step to feeling as if you have really done the bad thing and are a bad person as a result. The next step happens when you tell yourself that you have to cancel out the bad thought, and stop it having a harmful effect – you might do this by having another type of thought, or by doing a ritualistic compulsion.

So, now that you know how to examine your own thoughts, let the trial commence
.

People with Anxiety tend to make assumptions based on their intense feelings of panic and fear. In Part Two you saw how this can lead to anxious behaviours such as escape, avoidance or rituals. Behind those behaviours are anxious thoughts and a tendency to think the worst about bodily sensations, leading to the idea that not doing rituals will cause harm to befall another person or the idea that panic must be a heart attack.

There are three ways that Anxiety helps this process:

Write down in your notebook which of these your Anxiety is guilty of – it may be all of them, or just one. When you are doing your exposure work, you can mentally challenge your Anxiety by asking:

Anxious thought patterns are a way of maintaining Anxiety, but they can be changed just as anxious behaviours can be changed. Let’s look at three very common ones:

This means watching yourself all the time for alarming bodily sensations. You’ll be on the look-out for danger and will be over-sensitive and detect it long before it really exists. If you have a phobia, you’ll be on the alert for any hint of the feared object or situation. If you have OCD you’ll constantly find new things that need cleaning or checking.

Anxiety is so unpleasant and distressing that people will do anything to avoid it. If you’ve had a panic attack in a crowded bus, you will associate crowded buses with panic and start to dread getting on the bus if it looks full. If you were overwhelmed with fear when you tried to stop your rituals, then you’ll be terrified of cutting them down in future. At this point you are afraid of feeling your fear just as much as the initial trigger for your problem – this is fear of fear.

Anxiety tells you bad things are going to happen and lo and behold, they do. But was it inevitable? Let’s look at the example of someone with social phobia. They enter a social situation feeling dreadfully
self-conscious
, and focusing on their own feelings. Perhaps they feel unable to make eye contact, and lurk unhappily on the edge of the proceedings. Their body language tells other people to leave them alone and they go home confirmed in their belief that nobody likes them.

Write down in your notebook how your anxious thought processes affect you.

If you are
scanning
, then you are probably distracted and unable to focus on your daily life.

Fear of fear
leads to avoidance and is the chief maintenance factor for panic, agoraphobia and social phobia.

Self-fulfilling prophesies
will lead you to give up trying to recover, because you think the world doesn’t hold anything worthwhile for you.

Scanning and fear of fear will both reduce as you persevere with your lifestyle changes and exposure work. With self-fulfilling prophecies you can set goals that include risking them coming true, because you’ll also include the risk that they won’t come true at all.

There are many ways of describing the complicated entity that is each individual’s personality. Introvert or Extrovert? Optimist or Pessimist? Inner directed or Other directed? One way that helps with understanding Anxiety is to think of your overall personality as being made up of a number of smaller personalities, rather like a large box of assorted sweets. Perhaps when you are at work you are organised and efficient, while at home you are relaxed and caring. Or you may be very sociable with the people you meet at your local sports club, but quite withdrawn if you find yourself in a fancy restaurant.

These smaller personalities are called sub-personalities and they are all equally important to making up the unique being that is you, and in a healthy person they all have their uses and balance each other out. However, if you have Anxiety it’s likely that one or more of the four
sub-personalities
described below has got out of hand and has become far too dominant.

Worrying is part of the human ability to look into the future and make decisions based on the likelihood of something happening – worrying that it looks like rain will cause you to take an umbrella for instance. Also you can look into the past – worrying that you made a bad job of something will cause you to try harder the next time.

However, if your Worrier becomes too dominant you’re likely to start assuming that something will always go wrong. You’ll always be on the lookout for trouble. A Worrier’s typical thoughts start ‘What if …’ ‘What
if I pass out?’ ‘What if there are germs on my hands?’ ‘What if my helper abandons me?’

Being able to criticise yourself is a useful skill and helps you improve your performance. How smug and self-satisfied we’d all be if we didn’t have a critic inside us.

But a Critic who has started to run wild will lead to you being preoccupied with what other people think about you. You’ll always judge yourself in the worst way and never give yourself the benefit of the doubt. A Critic’s typical thoughts are ‘I’m so stupid,’ or ‘I’m such a failure.’

Victim is a fairly negative word and yet we all have bad times that we know weren’t our fault. Recognising when we’ve been victimised helps us to deal with the bad experience, and reminds us to nurture ourselves when it’s over.

This is fine but it’s not helpful if your dominant mindset is that of the Victim. You’ll feel helpless and hopeless, and unable to take responsibility for yourself or to control your life. A Victim’s thought patterns are along the lines of ‘I can’t manage it’ ‘What’s the point of trying?’ ‘What’s the use?’.

The desire to improve is one of the bedrocks of human progress, and there are times when a perfectionist streak will lead us to achievements that we never thought were possible.

But, rather like the Critic, a dominant Perfectionist will tell you that you’ll never be good enough. Your sense of self-worth will depend on your
achievements, your status, or simply on being liked, and yet you’ll never feel that you’ve got enough of any of these. Perfectionist thoughts tend to include commands such as ‘I must do better’, ‘I should have done X’ ‘I ought to do Y’.

Read through the four personality types and decide which ones your Anxiety has enlisted to help. Make a list of all the thoughts that your anxious sub-personalities throw at you. Decide which one is the most important and use the examples below to start the process of putting it back in its place.

The way to deal with the negative thoughts that your anxious
sub-personalities
are constantly throwing at you is to find a way to put the ball back in their court. This is called countering. Work your way through your list of thoughts and devise an answer to each one. Here are some examples of thoughts and counters:

What if I make a fool of myself?
So what? I can cope with being a fool if it helps me get better
.

What if I have a heart attack?
All my tests are negative and I really need to do my exposure work
.

I’m a useless parent.
I’m the best parent I can be
.

Other people don’t get in this mess.
They must do – they wouldn’t run helplines just for me
.

I’ve never been good at anything.
I’m good at being me and that’s all I need
.

It’s all my parents’ fault.
I’m an adult, I’ll take responsibility now
.

What’s the point of trying, I’ll never get better.
If I don’t try, I’ll never know
.

I’ll never find someone to love me.
I’ll start with loving myself
.

I ought to have got over this by now.
Who says? It takes as long as it takes
.

I shouldn’t need to ask for help with the kids.
Superwoman is a myth. I’m human
.

I must deal with this on my own.
It’s OK to ask for help
.

As you can see, the counters are all positive statements. Your brain will take them on board much more easily if they are expressed that way, so don’t use negatives For example, when countering ‘I’m a useless parent’ don’t say ‘I’m not a useless parent’ – the words ‘useless parent’ are still there nagging at you so take them right out and say boldly ‘I’m the best parent I can be.’

For combating ‘should’ statements, try being more polite to yourself – as if you were talking to another person. Instead of ‘I should …’ try saying ‘it would be nice if …’. Don’t get bogged down when you use counters – counter each thought once, and then move on.