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What you think affects what you feel. Think about something that makes you happy, you feel happy. Think about something that makes you sad, you feel sad. Think anxious thoughts you feel anxious. Your anxiety is under your control, you just may be thinking thoughts that make it worse.
Anxiety is a normal part of being human. It is the flight branch of fight and flight. When faced with perceived danger we quickly assess if we are strong enough to fight and win. If so we may activate anger, approaching the danger with the intention to get it to change.
If we do not think we are strong enough to win, we run. The problem is that fear can be subtle and insidious, activating our flight response before we even know it. We may think thoughts so automatically and instantaneously we may not even be aware we thought them. All we experience is the anxiety telling us to get away.
What you think affects what you feel. Change your thoughts, you change anxiety.
Here is a simple four step way to reduce your anxiety: the four R’s.
First R, Recognize you are anxious and don’t avoid it. Does your heart beat faster, do you get a funny feeling in your stomach? Do you get the cold sweats, or do your muscles tense up? These are actually elegantly designed biological domain responses to get away. Blood is diverted to your muscles so you can run. To do this your heart has to beat faster. That blood has to come from somewhere so it is diverted from the gut because there is no point digesting lunch if you are about to be lunch. That’s where that sick feeling comes from. And blood is diverted from the skin, cooling you down so you don’t overheat in case you have to run far to get away, the cold sweats.
Recognize these feelings and think, “I know what this is. It’s my anxiety!” Recognition is a thinking function so you have already begun to shift your brain into the Pre-frontal cortex, the bastion of rational thought which you will use to manage your limbic anxiety.
The biggest mistake people make when they feel anxious is to try and avoid it. They distract themselves. That’s exactly what anxiety is designed to do: flight. Unfortunately, when you do this you teach your brain you are not strong enough to deal with anxiety so you have to avoid it. If you don’t think you are strong enough what do you think happens to anxiety? It gets worse because what you think affects what you feel. So do the first R: Recognize and think, I know what that is, that’s my anxiety.
Second R, Rate. Rate your anxiety between 1 and 10. Notice I don’t say zero. Human beings are never at a zero. We are always at a low grade anxiety called vigilance: We are aware of our surroundings. It’s about survival.
Rating is also a thinking function. Rate your anxiety right now between 1 and 10. My guess is, unless you are in a panic, you are not a 10. This leads directly to the third R which takes us back into the limbic system, the part that is responsible for memory.
The third R, Remember. Anxiety is like a wave: It goes up but always comes down. Always. You just proved it! If you think your anxiety will never go away what do you think happens? It gets worse because what you think affects what you feel. This anxiety is under your control, and always has been. You’ve just been thinking thoughts to make it worse. How cool is that? If you think anxiety is out of your control you are going to be more anxious. But when you recognize it has always been in your control, what do you think happens? You get less anxious because what you think affects what you feel.
Now you get to the Fourth R, Reflect. What was I thinking to begin with that made me feel anxious? This is the hardest part of the four R’s because it may be difficult to identify anxiety provoking thoughts. Why? Because those thoughts are designed to make you avoid something, in this case the very thought that is making you anxious. For every thought that increases anxiety you can construct an opposite one to decrease anxiety every time! You just have to create them, and then practice them. This fourth R, Reflect, combines limbic memories with PFC rational thought, shifting the locus of brain control to what you think.
It is crucial that you do the four R’s in order to manage your anxiety to put your PFC in charge.
I had a patient who was afraid of dying. “Dr. Shrand,” he would say to me, “You know I’m going to die. I know I’m going to die. What’s the opposite thought to that?”
I said to him, “As long as you’re thinking about it you’re not dead.” Every time he thought about dying it reminded him he was alive. The thoughts would still pop into his head but he would follow the four R’s in order. Over time, he got so good at recognizing, rating, and remembering that the reflection became almost automatic, and he would think a thought that reduced his anxiety every time. Just knowing the anxiety was under his control made him feel less anxious.
What you think affects what you feel. It's an I-M thing.
The I-M Approach
