by Liz Miller | Anxiety
Anxiety Tends to Snowball. Try this Counseling Hack for Less Anxiety
Did you know that anxiety breeds more anxiety? I’ll bet if you suffer from anxiety, you already know that. You start out worrying about one thing, and the next thing you know, your mind is chewing away at everything you’ve worried about that day—or that week, month, year, or just about ever.
Or, maybe it starts with the physical feelings of anxiety, and you’re not even sure where they came from. But, now your mind starts throwing stressful reasons for your anxiety at you from every direction.
The trouble is, once anxious thoughts snowball into scores of worries, it gets very hard to know what to do to ease that anxiety. You need a way to break it down into manageable chunks so that you can use some tools to calm yourself down.
If snowballing, compounded anxiety sounds familiar, try this three step counseling hack for less anxiety and more clarity.
Borrow a Tool from Couples Counseling to Handle Anxiety Differently
When a conversation starts with criticism, contempt, or accusation, it is not likely to end well. According to a six year study of 124 couples (by Dr. John Gottman of the Gottman Institute for Couples Counseling), the first three minutes of a difficult conversation are key to both the outcome of that discussion, and marital success as the years unfold.
But, what about the way we talk to ourselves as individuals? When you are experiencing anxiety, do you beat yourself up, say self-critical things, overreact because the problems seem so big, or put yourself down for how you feel or for your reactions? And, does that help you calm down? Of course not!
Just as couples can learn to have more effective conversations by starting them differently, you can also be more effective with yourself by creating healthier self-conversations about your worries.
So, borrow this counseling hack that was designed for use in discussion with others to reduce interpersonal defensiveness, blaming, and shaming—but apply it to your own thought process. It’s called the Gentle Start Up.
Try The Gentle Start-Up: a Couples Counseling Hack that Works Well for Individuals, Too!
It can be hard to sort out the tangled ball of emotions, thoughts, and possible actions we might take when we’re stressed, sad, or anxious. However, until we are clear on what’s really going on with ourselves, it is pretty hard to know what we need in upsetting circumstances.
Just as we need to sort through our emotions and needs before a couples conversation is going to be very effective, we need to do that for our own encounters with stress, too. If we don’t, we react and are at risk for hurting those around us, making poor decisions for ourselves, or generally freaking out (to use a clinical term).
The following three questions are part of what the Gottman’s call The Gentle Start-Up for couples. But, the questions are very clarifying for individuals, too.
Ask yourself three questions: “What am I feeling? What’s it really about? And, what do I need?”
What are you feeling?
Yep, here it is. This is a counseling blog, so we’re going to talk about feelings—as in, emotions. This can be a little trickier than we realize when we’re upset. “Wait a minute,” you say! “I’m upset, how hard is that to figure out?!” Well, what kind of upset are you?
Depending on who’s research you look at, there are somewhere between five and 10 main emotions. I call them “umbrella emotions” because the ways we really describe how we feel are all the words that fall under these overarching five:
Joy, Anger, Sadness, Fear, and Shame. For example:
Joyful (ecstatic, happy, excited, glad, peaceful, pleased, content, grateful, etc.)
Angry (enraged, peeved, irritated, frustrated, irked, annoyed, pissed off, etc.)
Sad (bummed, down, blue, disappointed, devastated, lonely, etc.)
Fear (anxious, worried, concerned, uptight, petrified, etc.)
Shame (embarrassed, ashamed, guilty, etc.)
You’ll notice that these are pure feelings. They are the actual feelings and emotions you are having in the moment. Accurately describing your own feelings almost never begins with, “I feel that you…” or “I feel that it…” At that point, you’re usually about to give your opinion, rather than your emotion.
Focus on how you feel, and don’t be surprised if you identify more than one! It is really common to have a confusing mix of emotions, or to think you’re having one emotion, when maybe that one is really masking another.
For example, it’s common to have both fear and anger at the same time. Maybe what you are sure is pure anger (“I can’t believe they were late again; didn’t they know how important this was to me?”) is masking a deeper feeling of fear (“I’m getting worried that I’m not important to them anymore; I’m afraid maybe I don’t matter”).
Once you’ve identified what your own emotions are, you’ll decide what they’re really about.
What are your feelings really about?
This is where you get to move out of emotions and into your head. Let’s use a different example. You’re in your car, on your way to a lunch date. Someone in front of you is doing 5 mph under, you’ve missed the light, and it looks like you’re going to be late. You know you’re feeling frustrated. So, what are you frustrated about? (I know, I know, you’re torqued that no one knows how to drive.) But, beyond that:
Are you frustrated because a tourist is going slowly, looking for street signs, and you haven’t had a vacation in two years?
Are you frustrated because your boss ignored your need to leave the office on time…again?
Are you frustrated because you’ve made a commitment to your partner that you’re going to be more punctual, but you lapsed into old habits and procrastinated this time?
You get the idea. This is the step where you sort out what your emotions are really about. Why is this important? Because you can’t fix a problem until you know what it is.
This brings us to the last step. Identifying what you really need.
What do you need in order to take care of what’s really bothering you?
Finally, we get where this is all headed. After you are clear on what’s going on internally, and what the real cause is, you are in a position to decide what you need: what you need to ask for, or what you need to do for yourself.
This is where a little self-knowledge and practice come in handy, but don’t worry if you’re not sure what you need at first. Slow down, and think about it. For example, do you know what you need when you are sad, as opposed to when you are angry? When you’re burned out at work, versus feeling powerless in your relationship?
When I’m anxious, I need to be gentle with myself, do some body-based relaxation and rhythmic breathing, reach out to talk to someone who cares about me, or reframe my thoughts to bring some balance back into my expectations. I sometimes need to cocoon, have a hot shower, or remind myself that I won’t always feel anxious.
But, when I’m angry, I need something different. It helps if I get outside and take a walk, expend some energy, and give myself some space to sort through what’s at the heart of my irritation. Sometimes it helps to discuss it with a trusted friend who can help me see things clearly rather than seeing red.
In addition to knowing what you need related to your feelings, you can also learn what you need for different problem areas.
Do you need to plan a three day weekend retreat and evaluate your job satisfaction? Or, do you need to buck up and finally have that talk with your spouse about what’s been on your mind? Do you know when you need to retreat, versus needing to act or speak up?
If you’re not sure, yet, don’t worry. This process takes time, but the more you use it, the more quickly you’ll know what you need in the face of certain emotions or issues.
Wrapping Up: Use the Gentle Start-Up to Reduce Anxiety and Gain Clarity
Knowing what you’re feeling and why you’re feeling that way is a great first step toward making a wise decision about what to do next, or what needs to change. Untangling your feelings, thoughts, and needs isn’t always easy. But, one nice thing about this exercise is that the more you do it, the easier the questions are to answer. As you get used to separating your feelings from the reasons for them, you can develop a wider range of ways to get your needs met.
Then, whether you are meeting your own needs, or asking others for what you need, you increase the chances that you’ll feel better, faster.
Reference:
Carrere, S., and Gottman, J.M., (1999). Predicting Divorce among Newlyweds from the First Three Minutes of a Marital Conflict Discussion, Family Process, Vol. 38(3), 293-301
by Liz Miller | Anxiety, Trauma
Lots of people can relate to being anxious, and wonder if they have anxiety or PTSD.
Sometimes the feelings are mild: slightly elevated heart rate or blood pressure, some discomfort in social settings, or too many thoughts to get back to sleep easily. Other times, experiences of anxiety are really debilitating: panic attacks that make the heart race and leave a person feeling like they are having a heart attack, or physical symptoms resulting from obsessive worry about all the “what ifs” involved with an upcoming event.
There are many types of anxiety. Social anxiety, generalized anxiety, acute stress disorder, and phobias all fall under the “anxiety disorder” umbrella, among others. But, up until 2013, so did Posttraumatic Stress Disorder (PTSD). And, with quite a lot of overlap in symptoms whether it’s anxiety or PTSD, it can be hard to distinguish the variety of anxiety disorders from PTSD, which the newest edition of the Diagnostic and Statistical Manual of Mental Disorders now calls a “trauma and stressor-related disorder.”
So, what is trauma?
It would be so much simpler if we could just identify which stressful experiences are “traumas,” and which aren’t. The trouble is that trauma isn’t in the event itself. It’s in each person’s experience of the event—even an event that happened to someone else, but was witnessed—and how his or her brain and nervous system perceive and process the threat.
You might not necessarily tie a traumatic event to your anxious thoughts and feelings, or even realize you experienced “trauma.” You might think you just feel bad. You might want help for your persistent nervousness or tools to manage the unexplained panic that comes “out of nowhere.” You may be frustrated by how out of control you feel when you’re stressed.
There is some complex neurobiology at work in a brain that perceives an event as traumatic. But, when most people think about anxiety and trauma, they think about their experiences. Let’s look at those.
How Do Anxiety and PTSD Compare?
There are clear symptomatic similarities. Anxiety and PTSD affect sleep and energy. They both impact disposition and mood. They both fuel a need to be alert and exhaustingly on guard. Both conditions generate fear and worry surrounding non-imminent threats.
For the most part, typical anxiety is often generated without an actual precipitating situation. Thoughts present in anxiety disorders do not necessarily relate to past events, and no real circumstance needs to drive the upset. The worry and fear are real, but the cause is often based on unsupported assumptions.
On the other hand, PTSD’s symptoms are driven by a significantly different force than other anxiety types. Suffering occurs because frightful circumstances are not imagined. Something frightful actually happened, and in fact, a person with PTSD experiences the symptoms as if the event was happening again and again.
While anxiety symptoms and PTSD symptoms can overlap, PTSD is always related to traumatic and stressful past events.
You might ask, “Isn’t social anxiety sometimes linked to stressful past social situations, for example?” Sometimes, but it’s much more usual that anxieties are not specifically related to a certain past event. For example, the stressful thoughts suffered by someone with Obsessive-Compulsive Disorder are not usually provoked by past experiences.
But, PTSD is always related to specific past events. It might be a one-time event in adulthood, like a horrific car accident. It could be a series of events over a period of time like many combat veterans experience. Or, it might be the ongoing developmental or complex traumatic stress experienced in childhood or later developmental years. Whatever the event(s), traumatic stress disorders have their roots in past events, and they can produce many symptoms in a sufferer’s current life.
PTSD is much more than fear and worry related to the frightening circumstance.
Enduring something so frightening or terrible that our very existence is threatened—or perceived to have been threatened— has the power to change not only perceptions, but the nervous system itself.
In fact, trauma survivors are distinctly and uniquely affected as the nervous system adapts to what it perceives as a more dangerous world in the aftermath of trauma. It is an inability to release oneself from the emotional, mental, and bodily sensations that accompanied that experience. It’s like the traumatic event or events are still happening. The brain and nervous system find ways to compensate for the perception of danger, and distinct symptoms result.
Let’s compare common symptoms of anxiety unrelated to trauma and common PTSD symptoms.
Anxiety Symptoms
- Fatigue and restlessness
- Hypervigilance
- Irritability
- Excessive, persistent worry
- Intrusive, fearful thoughts
- Difficulty with sleeping, digestion, and tension
- Reduced concentration
- Racing heart, sense of doom
Although many of these are also associated with PTSD, Traumatic Stress Symptoms Fall into Four Categories, and Include:
- Re-experiencing symptoms, such as nightmares and dissociative flashbacks, or intense distress related to triggers some parts of the event, and/or having bodily sensations specifically associated with the traumatic event.
- Avoidance symptoms, such as avoiding any people, places, actions, words or objects related to the event, and feeling detached, “spaced out,” or emotionally numb.
- Negative thoughts and mood, including difficulty remembering important parts of the event(s), ongoing negative moods and trouble having positive experiences.
- Arousal symptoms such as irritability, angry outbursts, recklessness, self-destructive actions, watchfulness or edginess, feeling easily startled, poor concentration, sleep problems.
While some anxiety symptoms and PTSD symptoms clearly overlap, the difference is that with anxiety, the intrusive thoughts, persistent worry, and other difficulties are generally not tied to a specific or past event, whereas in PTSD, they are.
PTSD impairs your ability to recover from overwhelming events, or to establish healthy thought patterns and relationships. It deserves to be set apart from standard anxiety disorders for good reason. To recover is possible, but the care of a well-trained therapist using safe, effective, research-based methods can be crucial.
How about you? Are you anxious and unsure why?
Do you need help distinguishing the way you feel now from what you endured in the past? Or, are you unsure if your current symptoms are related to anxiety or PTSD? Getting answers to these questions and gently working it out with a compassionate, skilled trauma therapist can make all the difference.
by Liz Miller | Anxiety
This isn’t going to be a blog post on “Three Tips for College Anxiety.” Believe me, I know test anxiety and other symptoms are real, and if you are experiencing them, you need real strategies. That’s why in my counseling practice we start with specific tools for alleviating anxiety as soon as possible. But, what if some aspects of college anxiety are different?
Anxiety In College Can Be Rough
If you’re a college student, maybe you can relate. You finish a test or turn in a term paper. Whew! Relief. Then, whether it’s a few days later, or just a few minutes, that sense of pressured anxiety settles right back down on you. It’s more or less always there. It’s the next test, the next semester, and the biggie…Your Future.
You know there’s a lot you have to get figured out. The pressure takes many forms: choosing a major, alleviating your parents’ concerns, or wondering how your degree will pay off your student loans. Whatever form the pressure takes, it always seems to be there. If you’re the student, I don’t have to describe the feeling for you. If you’re the parent of a stressed out college student, you might be wondering how to help.
When I was an anxious freshman at Washington State, my own dad said, “You’ve got the next four years to figure it out.” He was trying to encourage me! But, a lot of my friends and I had picked up a similar message: I’ll graduate high school and go to college, where I’ll have to figure everything out. Then I can start my life.
College Is Real Life
It’s easy to see why we sometimes view college as an interim to pass through on our way to real life. It is literally structured as a series of requirements to complete (classes, assignments, tests). There are also bigger hurdles: picking a major, finishing degree requirements. You have to make some choices (to figure it out), but once you have, you can check off the to-do’s. Still, other things are less clear: how to create a career from a degree, where to work, all the stuff.
Hmmm. Sounds a little like the rest of life: specific tasks (opening your business every morning, doing your quarterly taxes) within an unknown future (will I get married, will I succeed in my career, can I support my aging parents?). The point is that college is real life. Maybe two to eight years of it! It’s not just something to complete before your real life starts. So, learning how to handle your college anxiety might just be the most important “graduation requirement” you fulfill, the most important thing to figure out.
Enjoy Life Before Graduation to Enjoy Life After Graduation
Students who develop healthy stress management in college are well prepared to enjoy life after the diploma, whatever it brings. That’s why I love helping anxious college students get a handle on anxiety, forgive themselves for imperfection, and enjoy life before they’ve got it all figured out. From there, a student can ask, “What do I want my life to be about? What will my compass be no matter what I major in?” From there, sustained motivation for work and passion for life can grow beyond anxiety. Hoping for a confident outlook on life doesn’t have to wait for graduation.
I counsel students from Washington State University and the University of Idaho in Moscow. Learn more.