Noticing Automatic Thoughts

Have you heard the term “automatic thought”? Its presence can be quiet but powerful. Sometimes people tell me “I have no thought at all! I’m just on the train and BAM! I’m flooded with nothing but fear. No thought. Just emotion. Unbearable emotion.”

Such a common experience.

Here’s the thing. Dig a little deeper. Slow it down. Check in with a curiosity. Often there is an automatic thought that either precipitates or follows the emotion in some chicken and egg sequence. You don’t need to figure out the order; they likely influence each other. For example…

“I’m trapped” [thought] —> anxiety [emotion]—> “I can’t bear to feel this way” [thought]—-> heightened anxiety [emotion]—> “This feeling will make me freak out, flail around, and people will think I’m crazy” [thought]  —> heightened anxiety [emotion]

Take a breath. You don’t need to make the anxiety go away. You really don’t. Take a breath to give yourself space to ask “What is the thought”? Identify the actual words. Write them down. Notice them. Shift your stance from being entirely enveloped by the whole experience to being an observer. Watching it. Noting thoughts that might be amplifying the intensity of the emotion. Or just keeping the emotion company.

Even if you already know what the thought is, check in at the time it arises because it’s this shift in stance when you’re activated that begins to shift the system. You may decide to challenge the thought (“What’s the actual evidence that I physically flail when I feel intense anxiety?”) or you may decide just to notice the thought without giving it undue attention (“Oh, ya, I know this thought. I’ll let it pop up and run its course.”) or you may decide to play with the thought by embracing it and even taunting it (“Welcome back Oh Familiar Panic Thought… You Can’t Hurt Me….Bring It!!!”). Consider using a thought record…. there are lots of apps that let you do this on your phone. Or visit this site to download old school but effective forms.

Thoughts are just thoughts, and learning to change your relation to them can have a significant impact. But you first have to train yourself to notice them. Give it a shot.

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Showing Care to Someone with Cancer

I often write about managing anxiety. This is a little different. People often don’t know what to do when someone they care about gets diagnosed with a terminal illness. They get paralyzed with fear. This post, written by a man with stage 4 cancer, beautifully describes some ideas to consider. There’s a lot of wisdom in his experience and advice.

Drinking: What to do

Many people use alcohol to regulate anxiety, or any emotion really….boredom, stress, anger, sadness. Sometimes it “works” in the short run: it loosens you up to talk to people at a party; it gives temporary relief from ruminating about the problems at work; it lets you forget for a few minutes that you’re unhappy.

 

wine

But sometimes it gets out of hand, leading to fights with loved ones, physical problems, disruptions at work. AA is the most famous approach to addressing this problem, and, based on Hollywood movies, you might think it’s the only way. Although AA certainly works for some, there are other strategies that have evidence to back up their efficacy. These include harm reduction and moderation management. Abstinence is not the only way. AA is not the only way.

 

The tools in these other approaches include specific cognitive and behavioral strategies that can help: detailed tracking (with an app like DrinkControl or coins you move from one pocket to another), identifying cues and triggers, planned alternatives in bars (water between drinks, putting the drink down between sips, etc etc), building and maintaining motivation, surfing urges, identifying and managing interfering thoughts… so many more tools. This is an area that thankfully has been researched quite a bit. There is help out there.  

Want some group help with this? Smart Recovery is one option if you want to meet with others also working to cut down.

Or check out these helpful books, including ways to assess whether non-abstinence approaches make sense for your individual case:

Feel unsure? It’s so very normal to experience ambivalence. Start where you are. Maybe just track this week. Or write down the pros and cons of reducing your drinking. Or read this to consider some ideas. You don’t have to solve it all today. Just take a step.  

Radical Acceptance

 

Pain differs from suffering. We all endure pain. Of course we don’t like it…it genuinely hurts! What often exacerbates pain, though, is the fight against it.  For example “I shouldn’t feel this way!” or “There’s something wrong with me for being anxious” or “Why am I like this?!” or the physical bracing oneself against the feelings. All of this contributes to suffering. It’s uncomfortable enough to contend with pain, now you have to contend with BOTH pain AND suffering!

Radical acceptance is an alternative response to pain. It’s intentionally acknowledging what is, rather than using that energy and attention to wish for what is not. Fighting agony doesn’t make it go away; it makes it worse. So try acceptance as a first step. Acceptance is not condoning a thing, or pretending you like it. It’s simply acknowledging what is. So instead of “I shouldn’t be anxious!” try on “This is anxiety. This is fast heart beat. This is fear in my body. This is adrenaline.” Simple, non objective awareness of what is, in that moment. Reality. Pause there. See if that changes the experience for you at all. Even just a smidge.

This often gives people a little space to move forward differently. With a different, more effective stance. To gently shift attention to something worth their attention (hey, there’s a tree there, or my breath, or my kids). To approach something daring even though anxiety might come along too. To make all sorts of intentional choices that aren’t getting lost in the paralysis that often results from judgment and suffering.  Try it.

Social Anxiety, Some Tips

Social anxiety is so very common, and natural. People are social animals, and so if you get nervous, it may just mean that connecting with others matters to you. When you reach out, it feels risky. We’re hard wired to feel anxiety when we confront risk. So part of your task, if you’re wanting to do something different here, is to accept social anxiety as OK. Don’t let it change your behavior, don’t let it stop you from diving in to social situations.  Let it be background noise.

Here’s another tip. Notice where you put the priority of your attention.

Folks who struggle a lot with social anxiety often shift their attention during interpersonal interactions from the social task to the self. Self-focused attention includes focus on arousal, sensations, perceived appearance, emotion (e.g., “Do I feel anxious?”), private self  (e.g., “How am I doing?”), public self (e.g., “How do others see me?”). There are other options. Attention on the task is attention towards the behavior that’s required for the specific situation, e.g., the words being spoken. Attention on the environment is focus on the aspects of the environment not necessary for the task, e.g., the curtains in a effort to distract.

The most useful place to gently shift your attention to is the task itself. Here’s why self focused attention is so problematic. First, attention is a limited resource. Second, we all assume what we see in our minds is reality (oops), and therefore exactly what others see. So you are not only diverting attention away from the place that would serve you, but you are bringing it to a place that can exacerbate your perception of your poor performance. In your mind, you look foolish or boring, so you assume that’s what others see too. Or you notice physiological sensations and therefore assume that’s the main focus of what others see too.   Trouble. Shift to the task. Gently.

 

Practice now. Play with different scenarios… give a mini speech –it’s OK that you’re by yourself—and play it 3 different ways: attention on self (How do I appear??), then attention on environment (curtains!), then attention on task. What effects do you notice?

 

Karaoke & Excitement

If anxiety holds you back from doing something, watch this video for one idea on how to effectively frame those sensations.  Then come back.

I love the specific suggestion to think of it as excitement– the physical experience really is the same, and the label is legitimate. In addition, the underlying message here is that you need not get rid of (or even decrease!!) those sensations. Once you get in the habit of not making this goal so very central, anxiety genuinely grows quieter. And experiences get more comfortable. But, in the meantime, who needs calm when you’ve got excitement!!

I also like this strategy as an attention diffuser. Yes, there is anxiety. And your default is a laser focus on that and that alone. But remind yourself there is also excitement.  There is also karaoke. There is also adventure. There is also friends. There is also  …..etc. There are many aspects to attend to. Broaden your attention because that laser focus on anxiety misleads you into thinking that is all that experience has to offer.

Happy singing.

A Tool for Anxiety: Train Your Interpretation

If you hear a loud noise in the middle of the night, a vase crashing, what do you think happened? Do you think burglar? Or cat? One interpretation leads to one emotion (fear) while the other makes another (irritation, or relief if you started with “burglar”) more likely.

Many situations in life are ambiguous, and your interpretations or appraisals impact the feelings that arise.

Many studies have demonstrated that people who struggle with anxiety have a cognitive bias or a tendency to interpret events negatively. That not only effects feelings, but often  behavior too. Imagine seeing someone at a party and she looks away. If you interpret that moment as “She thinks I’m boring and doesn’t want to talk” you may walk away and miss the opportunity to make a connection. If, on the other hand, you consider “She might be shy” or “She hasn’t spotted me yet” you might feel more neutral and be more likely to move toward her to initiate a conversation.

There are many ways to work with these pesky thoughts that arise. One is through Cognitive Bias Modification programs. One I highly recommend comes out of the University of Virginia’s Psychology Program. They’re testing a new version that is informed by the 10 years of research that’s gone into this approach so far.

Check it out here.

The Guest House

This being human is a guest house.
Every morning a new arrival.

A joy, a depression, a meanness,
Some momentary awareness comes
as an unexpected visitor.

Welcome and entertain them all!
Even if they’re a crowd of sorrows,
who violently sweep your house
empty of its furniture,

still treat each guest honorably.
He may be clearing you out
for some new delight.

The dark thought, the shame, the malice.
Meet them at the door laughing,
and invite them in.

Be grateful for whoever comes
because each has been sent
as a guide from beyond.

~Rumi

I tend not to quote poetry. But this one resonates.

Many of us spend a lot of energy trying to force uncomfortable thoughts and feelings out. What would happen if you treated each one as a guest? Even anxiety? What if, rather than trying desperately to push it out, lock the door, make it go away immediately, you instead noticed its presence, said hello, and allowed it just to visit for a moment. What would happen if you let go of the struggle?

Guests come and go.

For some, this is an outrageous idea. Anxiety is painful. Why invite it in??? One reason is that anxiety and other uncomfortable thoughts and feelings are inevitable. They’re showing up whether you like it or not, whether they were invited or not. Another reason is that pushing away often amplifies distress. So now you have to contend with both the initial discomfort as well as the tension and suffering inherent in resisting something that would likely float in and out, if left alone.

How to get more skilled at disengaging from this struggle? Cognitive defusion exercises help. For example, next time you notice an uncomfortable thought or feeling, pause and say “Welcome.” Seriously. Imagine yourself handing that thought or feeling a cocktail or a cup of tea. It’s a guest.

You can also practice building that capacity with daily meditation, even very brief ones. This site offers many free guided meditations worth a listen.

Clean Versus Muddy Emotions

I’m guessing this isn’t news, but being human includes having feelings. All of them. Including anxiety. Emotions serve a purpose. Feel anxious before a job interview? Of course you do. It’s normal, and sends your body the signal “This is something I care about. Prepare.” Get nervous before interacting with new people? Connecting with others is meaningful to you, and your body is letting you know. These are clean emotions, feelings that are natural, human, and worth accepting in order to live a value driven life.

Humans are drawn to challenge, to risky things, and our bodies are designed to produce anxiety when risky things are around. So accept and embrace these emotions.

But I bet you’re thinking “But I feel too much anxiety, way more than most.”  Well, this is possible, and we’ll get to what creates more anxiety in a moment. But also consider you do not know what others feel. I encourage you to resist judging people’s insides by their outsides. You just can’t tell.

 

Back to what makes anxiety manageable versus overwhelming, clean versus muddy. Clean emotions can be intensely felt, but if left alone, they tend to be fleeting. They deliver their message and then either dissipate or come and go. Muddy emotions, on the other hand, can feel sticky and overwhelming. For example, you might muddy your emotions by judging yourself for having that feeling, telling yourself there’s something wrong with you, or to stop feeling anxiety, you shouldn’t feel anxiety. Now you’ve got not only the clean emotion to contend with, you’ve also got the muddiness that makes the anxiety bigger and frankly more confusing. Muddiness also happens when you start drifting your attention to other time periods. So it’s clean if you’re noticing the anxiety in the context of the here and now– e.g., I’m nervous about talking with this person I’m attracted to. It’s muddy if you start time traveling– e.g., I’m always going to look like a social moron or this is just like that time I talked to that girl freshman year and she shot be down and laughed because I was sweating up a storm.

What to do instead? Well, first step is to notice it in the moment. Get curious about the details of these experiences, the thoughts and the feelings. Track it in writing. Use a thought record. Then get curious about the emotions. Categorize the clean parts, the muddy parts. Just bring your awareness to it at first. Then start practicing acceptance of clean emotions, literally say “hello, welcome” when you notice them. If you let them be there, they tend to pass on their own. And catch that moment when clean turns muddy and bring your attention to something in the present rather than feed those muddy emotions.

 

 

 

 

 

 

 

 

Mindfulness & Meditation for Anxiety

When I suggest mindfulness or meditation, I often hear from folks: “My mind wanders too much, it’s not relaxing.” Or “It was great, I focused on my breath the whole time, my mind went blank.”

Feeling relaxed and super focused sounds very pleasant. It also isn’t going to happen every time. And I’m glad for that! Because there’s a larger aim, a more important one, at least for my purposes in helping people who struggle with anxiety. Let’s come back to that.

For now, after reading this paragraph, take a moment to close or lower your eyes and pay attention to your breath. Don’t try to change it, just notice it. Pay attention to the air entering the nostrils, or what it feels like in the back of your throat or filling up your belly. Notice the pace, and the pause between the inhale and the exhale. Just be curious about the physical details. Go ahead and try that for a couple minutes.

Did the mind wander? Yes? OK! That’s what it’s  there for, to generate thought. It’s really OK.

Now try again, and each time the mind wanders, just notice that, say to yourself “wandering” and gently, softly, quietly return your attention to your breath. It will wander again. If it wanders 100 times, shift 100 times. This moment of awareness followed by gentle shifting is the skill I’m most interested in. If you cultivate that, under less challenging conditions like sitting at your dining room table or on the meditation pillow, you will have a skill that is awfully handy when your mind does its thing off the meditating pillow. Because it will.

Cultivating mindfulness, especially for people who struggle with anxiety, is helpful, in part, because when the mind launches into a frenzy of catastrophic thinking or worry or intrusive thought, it can be useful to gently pause in awareness, with a compassionate “ah, there’s that thought” followed by a soft return to the present. A gentle shift.  Maybe to your breath, or maybe the sounds, or your kid right in front of you, or the task you’re trying to complete. The present. And meditation gives you practice with that gentle shifting.

Headspace is a good app for guided meditations. Another I like is Insight Timer, because I prefer non guided, just the breath. Whichever you choose, give it a shot this week, even just 10 minutes a day, and see what you notice.