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Anxiety

How to Calm Anxiety: Reduce Stress in 8 Steps

Calm your anxiety using CBT, ACT, and mindfulness.

Zimmytws/Shutterstock
Source: Zimmytws/Shutterstock

Aaron Beck, the father of cognitive therapy and possibly the most influential psychologist of all time, may have been the first to discover how to disempower our negative thoughts and beliefs. I cannot think of something more vital at this turbulent moment in history. You may have read articles alleging that the National Science Foundation (NSF), an independent federal agency, discovered that humans have anywhere from 12,000-60,000 thoughts per day, 85% of which were negative. Let me enlighten you: This is a myth that's been carelessly disseminated throughout the internet without a semblance of validity, nor a citation. The NSF allocates U.S. government money to various researchers. They do not conduct research; they fund research.

Now that you have less of an unnecessarily gloomy outlook on the inner workings of human cognition, we'll move on to my main point. You cannot believe or accept everything you read, hear, and, most importantly, think. It's always wise to verify, challenge, dispute and even create distance between "you" and "your thoughts," especially anxious ones. It's my personal belief that you and your thoughts are two very separate entities, but I'll save the involved philosophical theories for another post.

Accept That Thought Suppression Doesn't Work

Before I tell you what does work, allow me to inform you about what doesn't. Thought suppression is the desperate and might I add, remarkably fruitless attempt to avoid, control, or subdue thoughts that cause distress. We've all been there. We frantically try to push these distressing thoughts out of our minds through distraction or force. For example, when an intrusive anxiety-producing thought of embarrassment, failure, or rejection inconveniently pops up, we immediately try to "make it go away." We even try to force ourselves to "just stop thinking about it."

I hate to be the bearer of bad news, but these desperate attempts do nothing more than increase intrusive thoughts' frequency and occurrence. Let's practice what we preach and verify the claim. If someone were to repeatedly tell you, "you cannot think about a big pink elephant," what would pop up your mind?

Cognitive Distancing

Now let's talk about what does work. Beck calls the ability to get "unstuck" from your thoughts "cognitive distancing." Acceptance and Commitment Therapy (ACT), an evidence-based therapy that encourages people to embrace their feelings using acceptance and mindfulness, calls it "defusion." "Fusing" is personally identifying with unhelpful and unproductive negative thoughts, beliefs, expectations, or judgments about ourselves. When we can disidentify, we can "defuse." In simple terms, we reduce the thoughts' believability and decrease reactivity by mindfully observing our thoughts without judgment or conclusion. We can look at thoughts rather than from thoughts.

Ask yourself this simple question: Is it the negative thought that causes stress, frustration, and anxiety, or is it your validation, endorsement, or "fusion" with that thought that causes distress? As Helen Keller once said, "No one can make you feel inferior without your consent." Please note that the objective of defusion is not to remove the negative thoughts altogether. Part of this exercise will be accepting that negative thoughts will always be there while recognizing that you can change your relationship and reaction to them.

An 8-step ACT and CBT exercise to break the hold of anxious thoughts

CBT and ACT have undergone the gold standard of clinical trials: Randomized Clinical Trials or RCTs. In a 2016 study, both ACT and CBT were highly deemed highly effective in the treatment of anxiety. The goal of this exercise is to reduce reactivity to thought content, disidentify from your anxious internal experience, and break the anxiety loop.

1. Adjust the way you think about your anxious thoughts and allow them to be there. Steven Hayes, the creator of Acceptance and Commitment Therapy, created a metaphor to help depict the effects of thought suppression and its association with suffering.

When we're stuck in quicksand, the immediate instinct is to struggle and fight to get out. However, when in quicksand, the more you struggle, the deeper you sink. What you resist, persists! If we would stop struggling and still ourselves, we would stop sinking. Allowing distressing thoughts and feelings is more effective than if we fight and struggle.

2. Identify the Negative Automatic Thoughts (NATS) and beliefs. Ask yourself, what am I reacting to? Stop, take a few slow breaths and observe your thoughts for a moment. These are streams of consciousness that we're not always aware of, so it's best to slow down and tune in. Negative automatic thoughts and beliefs can sound like, "What if I mess up and make a fool of myself?" "I'm a failure," "I never do things right," "I've always been like this," "I'll never change," "I should be able to deal with this," "They're not responding because they're mad," "It's too hard," "I'm too scared," and "I can't do this."

3. Do these NATS fall under any common thinking errors?

By identifying thinking errors or cognitive distortions listed below, we are empowered to stop making erroneous conclusions. Once you read through the thinking errors, ask yourself which category your NAT falls into?

  • Dichotomous thinking: Things are seen regarding two mutually exclusive categories with no shades of gray in between.
  • Overgeneralization: Taking isolated cases and using them to make sweeping generalizations.
  • Selective abstraction: Focusing exclusively on particular, usually negative or upsetting, aspects of something while ignoring the rest.
  • Disqualifying the positive: Positive experiences that conflict with the individual's negative views are discounted.
  • Mind reading: Assuming the thoughts and intentions of others.
  • Fortune telling: Predicting how things will turn out before they happen.
  • Minimization: Positive characteristics or experiences are treated as real but insignificant.
  • Catastrophizing: Focusing on the worst possible outcome, however unlikely, or thinking that a situation is unbearable or impossible when it is just uncomfortable.
  • Emotional reasoning: Making decisions and arguments based on how you feel rather than objective reality.
  • "Should" statements: Concentrating on what you think "should" or "ought to be" rather than the actual situation you are faced with or having rigid rules which you always apply no matter the circumstances.
  • Personalization, blame, or attribution: Assuming you are completely or directly responsible for a negative outcome.

4. Incorporate mindfulness and call out the NAT. Once you've identified the NAT and thinking error, employ this mindfulness technique. Mindfulness has different conceptualizations in Eastern and Western society, so for the sake of this exercise, we'll use John Kabat Zin's definition "the awareness that arises from paying attention, on purpose, in the present moment and non-judgmentally." This mindful process creates space and separation between you and your thoughts:

  • "I'm having the thought…"
  • "I notice myself having the thought that I'm…"
  • "Ah, here's the old "________" story again."

5. Use Guided Imagery to swat the NATS away. A 2018 study found that Nature-Based Guided Imagery "are effective anxiety management interventions that have the added benefit of being cost-effective and easily accessible." Guided imagery is also a great way to change your perception of your anxious thoughts and your ability to disempower them. Listen to this ACT YouTube video below. Disclaimer: Please do not listen to this while driving or operating heavy machinery.

6. Combat NATs with humor. Remember that one of the best ways to take power away from an anxious thought is to laugh at it! Don't take the NATs so seriously. Say the NAT in slow motion, a funny voice, or turn the NAT into a song (ex. use the "deck the halls" tune), hear the NAT as an echo, as a sports commentator, scramble up the words in the sentence, or say the sentence backward. Now rate the credibility of the NAT from 1-10 (10 being the most). Did you notice a sense of distance from the thought? More importantly, did you laugh?

7. Give your negative internal critic a name. Hayes once wrote in a TED article, "Research has shown that naming your mind — give it a name other than the one you call yourself — helps us to disagree with our internal voice. Why? Because if your mind has a different name, it is different from "you." Choose a name for your anxious inner critic (a funny one, if possible) and introduce yourself. P.S. It's probably best to do this in your head or the privacy of your home.

8. Express gratitude and appreciation toy or mind. Finally, being in an adversarial relationship with yourself will surely only increase the frequency of anxious and unwanted thoughts. Neuroscientist Dr. Joe Dispenza once wrote on a social media post, "Instead of putting all of your focus on suppressing the experience, aim to uncover its message." What is the anxious thought's message for me? What is it trying to tell me? I'll add, "How is it trying to help?" These questions will help to quell some of the fear and anxiety. Then thank your mind for trying to help you and accept that it's not your enemy. We all have a built-in fight or flight system programmed to alert us of potential risks or danger. It's merely trying to do its job, and sometimes it, like all of us, can make mistakes.

  • "Thank you, fear, but I can handle this."
  • "That's not really helpful, but thanks anyway!"
  • "I can see how you're trying to help me; I appreciate it."

If the above was not helpful here's another ACT metaphor from a UK self-help website that may change your perspective about feeding into anxiety-provoking thoughts:

When we visit an online store, we tend to know what we are looking for. We know our budget, the item we want, the color, the size, how quickly we need it, and so on. There may be hundreds of items advertised on the page, but we do not put every item we see into our shopping cart and buy them all. That would be ridiculous.

However, we do tend to buy into each thought in our mind’s online shop, especially those thoughts that fit with the thinking habits we’ve gotten into. If only we could treat them the same way as the online store! Do I need to buy this thought, right now? Can I afford it? Is it going to be helpful? Is it really true?

Be Well,

Dr. K

If you or a loved one are struggling with anxiety, contact the Substance Abuse and Mental Health Services Administration (SAMHSA) website or the National Helpline at 1-800-662-4357.

References

Beck AT, Rush AJ, Shaw BF, Emery G. Cognitive therapy of depression. New York, NY: Guilford Press; 1979.

Hayes SC, Strosahl KD, Wilson KG, editors. Acceptance and commitment therapy: An experiential approach to behavior change. New York, NY: Guilford Press; 1999.

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