This page will address four counseling techniques for worry control; relaxation, accurate risk assessment, worry exposure, and worry behavior prevention.
A quick relaxation technique involves combining a verbal suggestion with abdominal breathing.
First take a comfortable position then release as much tension as possible, and focus on your belly as it moves in and out. Make breathes slow and rythmic, and with each inhale and exhale release tension.
With each inhale, say the word "breath in" and as you exhale, say the word "relax" while letting go of tension throughout your body.
Continue for five minutes.
The cue-controlled method teaches your body to associate the word "relax" with the feeling of relaxation associated with belly breathing. Remember that this style of breathing should move your abdomen in and out, like a baby breathes, deep and full.
Relaxation follows that breathing style. After you have practiced this technique for awhile, and the association between the word and the feeling is strong, saying the word "relax" will bring the physiology of relaxation, and tightness or tension will reduce or disappear on use of the cue word. Remember, practice is what makes this happen.
Not intense or perfect practice but REGULAR practice.
With great thanks to Mathew McKay, Ph.D., Martha Davis, Ph.D., and Patrick Fanning, authors of "Thoughts and Feelings-Taking Control of Your Moods and Your Life".
If worry is a problem for you, you probably have not learned the skill and art of risk assessment. While no one can escape risk, we can make an effort to determine which risks can be avoided, which can be prepared for, and those you simply do not have to prepare for.
People who worry a lot overestimate risk, which happens because of some combination of experience and belief, how much weight they give their worry, and my beliefs about the function of worry.
Experience-There are two ways our experience plays into worry. If something bad happened to me once, then I can worry about a repetition, and if something bad has not happened to me, then I can worry that the odds have now increased in favor of something bad happening.
Belief-There are two ways deeply held, and UNEXAMINED beliefs can make worry worse. I may believe that worry has predictive powers or preventive powers. Both beliefs are examples of magical thinking, since I can neither prevent nor predict events of my life. I can however, influence or even control my interpretation of those events, seeing them as opportunities or disasters.
The use of expercience and belief in these ways soon makes worry more of a problem the feared experience itself.
Catastraphizing is the process of creating the worst possible outcome imaginable, and then whirling that thought around in your head way more than necessary.
The antidote? Make an accurate risk assessment, and remember that people cope with even the most serious disasters. We forget that we have family and friends who will help us.
Use a risk assessment form, and write out the worst possible outcome associated with your worry.
Next, write down the automatic thoughts that typically come up.
Next, rate your anxiety when considering this worst-case scenario.
Next, on a scale of 0 to 100, rate the probability of this event happening.
The next four questions deal with catastrophic thinking. Assuming that the worst did happen, predict the consequences you most fear.
Now spend some time planning what you would tell yourself and what you would do if the worst case consequence did happen.
When you have a clear picture of possible coping strategies, make a revised prediction of the consequences.
After these predictions, re-rate your anxiety and see if it has lessoned.
The next two questions address the issue of overestimation.
List the evidence against the worst case scenario happening. Figure the odds as realistically as you can. Then list all the alternative outcomes you can think of.
Finally re-rate your anxiety and the probability of the event.
Hopefully, both your anxiety and the probabilities of the event happening have been reduced.
Repeat this process whenever confronted by a significant worry, or when a worry returns more than once.
The writing will help you change old patterns of thinking.
When practicing worry exposure, you expose yourself to minor worries first, giving yourself 30 minutes to experience them, and then gradually moving into distressing worries.
Gradually, you learn to take on your major worries with little or no anxiety.
Worry exposure is similar to flooding, a technique that "floods" your imagination with fearful images until you grow tired of them.
Given enough time and focused attention, the most upsetting material can become boring, reducing the intensity of the upset the next time you experience it.
This "boring" effect doesn't happen on its own because you do not spend enough time dwelling on only the worst possible outcome.
When you do "free form" worrying, without a structure, you try to distract yourself, argue with yourself, escape into another topic, perform ritual checking or avoiding behaviors, gaining none of the benefits of structured worry exposure.
Worry exposure works well also because it concentrates your worrying time. When you know that you will be worrying intensely during your daily exposure session, it's easier to clear your mind or worry the rest of the day.
Worry exposure consists of eight simple steps.
1. List your worries. This would include worries about success and failure, holding relationships together, your performance at work, physical danger, health, making mistakes, rejection, shame, over past events, and so on.
2. Rank Your Worries. Make a list of your worries, placing the least anxiety-provoking item at the top, and your most anxiety inducing worry at the bottom.
3. Relax. Make yourself comfortable, breathe deeply, and begin cue controlled relaxation.
4. Visualize a worry. Vividly imagine a worry from your list. Imagine the worst case scenario happening over and over again, experiencing all the sensations of it, as if you were in it, rather than observing it.
Sustain this experience for 25 minutes. Don't stop for anxiety or boredom. As you are experiencing this internal image, occasionally jot down the intensity of your feelings.
Imaging alternative outcomes. Allow yourself to visualize aternative, less stressful outcomes. It is important to have spent a full 25 minutes imagining the worst possible outcome.
Spend just five minutes on the less stressful alternative.
Re-rate your anxiety from 0-100. After five minutes of alternative outcomes, and note the intensity of your anxiety, which should be lower.
Repeat these steps. Keep working this process until your peak anxiety with this item from your stress list is 25 or less on the intensity scale.
Then repeat the process with the next item on your list. Try to do one from your list, working through all these steps once per day. If you can tolerate it, try several worries from your list each day, until you have worked all the way through your hierarchy.
You might find your self postponing worry until your next "worry session," or when this worry comes up, you might think that you have worried this into the ground already, why worry anymore?
When you were a Little League star, did you always wear the same pair of socks in order to perpetuate a hitting streak?
Do you "knock on wood" or not drive past a cemetary in order to prevent the inevitable?
Close examination will show that these ritual or preventive behaviors are actually perpetuating your worry and have no power to prevent bad things from happening.
You can prevent worry behavior by following these simple steps.
A. Record Your Worry Behavior.
Write out the things you do to prevent disaster you worry about from happening.
B. Pick the Easiest Behavior to Stop and Predict Consequences of Stopping It. (If I usually make way too much food for a party, the worst case scenario is running out of food halfway through the party).
C. Stop the Easiest Behavior and/or Replace It With a New Behavior.
This is the hard part. In order to find out if your prediction will come true, you would actually have to run the experiment. Resolve to refrain from the worry behavior the next time it comes up.
If your worry behavior involves an avoidance of something, to reduce the worry, begin to do the avoided behavior.
If the 'easiest behavior' is still hard to stop, create a hierarchy of replacement behaviors that allows you to taper off from your worry behavior.
If you are worried about a spelling error in your typing, leave one error deliberately, for example.
D. Assess Your Anxiety Before and After.
When you felt like performing your old behavior and did not, how anxious were you?
Also assess the consequences of your new behavior. What actually happened as a result of your new or reduced behavior? Did your worst case scenario happen?
E. Now repeat these steps with the next easiest behavior to stop.
Next chapter is Thought Stopping. See you there.
Using programs like Lumosity and Mind Sparke Brain Fitness Pro make worry reduction much simpler. Both programs have free trials.
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