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.

Minor Social Errors Happen All the Time

People who struggle with social anxiety often spend their energy trying not to make social mistakes.

For all of us, though, minor social errors happen all the time and major social errors are rare. Folks with social anxiety disorder often ignore that distinction and merge the two in their minds. They think errors ought to be avoided, period.

This causes trouble in so many ways. Here’s a sample:

  1. Vigilance for errors is distracting. Attention is a limited resource, so being on the lookout for errors prevents you from engaging fully in the interaction.
  2. Because errors happen all the time, you will spot an error. That will then narrow your focus more (doh!), increase your anxiety (doh!), unnecessarily diminish your confidence in your social capabilities (doh!), and will take you further from actual engagement in that interaction (shoot!).
  3. All that hyperfocus on and perceived importance of errors means you’ll remember the errors as the salient features of that interaction. That mistakenly builds your case for yourself as socially incompetent, which feeds into this cycle where you excessively fear making mistakes.
  4. If you fear making errors, which are inevitable, you’ll be more likely to avoid. And avoidance, though natural, is the enemy. It feeds anxiety, and takes you out of living a rich life.  

Do not waste your time trying hard to not make any social errors. Embrace them, feel the momentary cringe, and keep moving.

What are examples of minor social errors? My 8 year old daughter and I played the game of tracking them one afternoon. Here’s the honest to goodness list of what happened over 2 hours during our walk to and dinner with friends at a local restaurant:

  1. I waved to a stranger in a car, thinking the driver was my friend. She was not.
  2. I said hello to the waiter as we entered. He walked right by because presumably he didn’t hear my hello.
  3. While waiting, I responded to someone’s question chatting behind me, thinking she was talking to us. She wasn’t.
  4. They were talking loudly compared to others there.
  5. My friend accidentally let a curse word slip out in front of the kids.
  6. She then forgot someone’s name who was in the restaurant… who she had dated.
  7. Someone introduced himself to me despite having met me before.
  8. My friend’s daughter farted.

I challenge you to practice acceptance of social errors in your own life. If you’re up for it, play the game for part of a day… every time you notice an error, smile a bit. Change your attitude toward making errors so you don’t waste energy later trying desperately to avoid them. They make you human. 

 

Thoughts on Thoughts and Popcorn

Let’s talkPopcorn about two distinct types of troubling thoughts.

Some thoughts just pop into the mind. I call them popcorn. Bam! Suddenly an idea arrives and it’s vivid. “Ugh, that was so foolish!” or “That gross thing might have touched my hand!” or “What if they fire me?”  That type of thought can feel unpleasant, I know. And it happens to all of us. It’s not in our control. In fact, efforts to control this tend to backfire. Daniel Wegner did all kinds of fun research demonstrating the more you try to control thoughts (about white bears, in his original example), the more they rebound or come back with a vengeance.  

But then there’s what happens after that quick, popping thought, when we unadvisedly flesh out that initial thought, and turn it into a story we actively create. We’re adding more details, playing it out, giving it more attention. For example, following the initial “That was foolish!”, we might add “She probably noticed how anxious I was…did she look at me kind of sideways? Ugh, yes, she thinks I’m awkward. I am awkward! She won’t want to be around me anymore, why would she? I’m so incompetent, this always happens, people think I’m lame, and can’t hold a normal conversation … why aren’t I normal?…” and so on and so on… 

Tune in to see if you can spot the difference in your own experience. Pop versus fleshing it out.

That first type of thought, the popcorn thought, is harmless and unavoidable. Learn to notice it. Label it. Accept it for what it is “Oh, Popcorn. Hello.”

And then practice spotting the “fleshing it out” thoughts. When you catch this happening, gently label that urge, smile a little because practice is awesome, and then attend to something that matters. Like your breath. Seriously, it keeps you alive. Or the person in front of you. Focus the priority of your attention outward. Not in your head. Choose to disengage from fleshing out thoughts that are not helpful and instead choose to engage your attention in the real world.

Happy practicing.