Anxiety and Worry Workbook; Part 3

April 08, 2020

Anxiety and Worry Workbook; Part 3

Re-Re Book

(Book Review and Resume)

What book I've read?

What statement I highlighted?

What the lesson I learned from the book?

Here I write down that all.

To be honest, I planned to write this part until Chapter 9, but then I realize, it's too long, so I cut it down just until Chapter 8. Well, actually, Chapter 9 to Chapter 11 is a specialized therapy for panic attack, social anxiety, and worry. Then, after a long thinking, I deciding to exclude this three last part, to avoiding the self-diagnosed and to invite you who have an anxiety problem to come to the professional such as psychologist or psychiatrist ✌

Chapter 7 – Courageously Facing Fear

Webster’s dictionary defines courage as “mental or moral strength to venture, persevere, and withstand sanger, fear, or difficulty.”

Perhaps you’ve forgotten that you were once courageous, able to face the difficulties and uncertainties of life. But the good news is that you’re still courageous, whether you recognize it or not. Anxiety cannot be eliminate courage; it can camouflage it or override it, but it cannot eliminate it.

Life has a way of presenting us with challenges we didn’t invite.

Our goal is to help you tap into your enduring strength and to use that to face your anxiety courageously.

If you feel uncomfortable writing down instances of your own courage, keep in mind that no one needs to see this list besides you. If you really can’t think of yourself as ever having been courageous, try asking a close friend, partner, parent, or family member.

It’s important to remind yourself of the strength and courage you’ve exhibited in everyday life challenges unrelated to your core fear and to realize you can use this resilience to courageously face your anxious concerns and overcome their debilitating effects.

The trouble with escape and avoidance is that, while they may lead to an immediate reduction in anxious feelings and symptoms, they come at high price. Over the long term, escape and avoidance are powerful contributors to the persistence of your anxiety. The reinforce your exaggerated thoughts of threat and danger and your belief that you’re helpless to deal with the anxiety-provoking situation.

In literally hundreds of research studies over the last 50 years, psychologist and psychiatrists have shown that the best antidote for fear and anxiety is repeated, systematic exposure to the feared situation. Exposure can be defined as systematic, repeated, and prolonged presentation of external objects, situations, or stimuli, or internally generated thoughts, images, or memories, that are avoided because they provoke anxiety.

Exposure is mustering your courage and climbing out of your comfort zone.

Exposure be thought of as a form of “desensitization” in which repeated exposure to fear triggers and the accompanying anxiety help you learn to see these situations more realistically and thus increase your tolerance for anxiety.

Misunderstanding about exposure should be questioned and evaluated just like any other belief about anxiety so that you can give yourself the best chance of success with systematic, repeated, and prolonged exposure to fear triggers – a highly effective therapeutic strategy for eliminating fear and anxiety.

First you have to lay some groundwork to prepare and plan for exposure exercises. Then you actually have to go out into your daily routine and do the exercises.

It’s also important that you fully realize what to expect when you start an exposure treatment program. Don’t expect it to be easy or painless! It will involve moderate to intense levels of anxiety, and you will want to “run.” It will take courage and determination to face your fears and persist with the exposure tasks. You may want to turn back to the old habit of “run and hide.” But if you persist – if you summon the courage you’ve shown in past situations – you will achieve significant success over your anxiety with exposure.

Five steps needed to construct an effective exposure plan:

Develop a written, systematic, step-by-step exposure plan that takes you through a hierarchy of anxiety triggers to address a particular core fear.
Identify and evaluate faulty thinking about exposure so you start unencumbered by doubt and harmful preconceived notions.
Plan to start with a moderate goal and work your way up gradually
Commit to daily exposure practice.
Come up with a plan for coping with anxiety without resorting to false safety-seeking measures.

A written exposure plan maximizes the effectiveness of this interventions and ensure that it does note make you more rather than less anxious.

Step 1: Develop an Exposure Plan

You begin your exposure plan by breaking down your fear triggers into dozen or more graduated steps and then arranging these steps from least to most anxiety provoking. Probably each of these triggers was described in general terms, so you will need to break them down into more specific descriptions. Make sure you include enough detail about what you must do in each situation to generate anxiety. Remember, the goal of exposure to anxiety triggers is to make you feel anxious. If you do an exercise without feeling anxious, the exposure will not be therapeutic. Also beside each exposure triggers, rate the situation from 0 to 100 on the amount of anxiety you expect to feel.

Make a list of all situations, objects, physical sensations, thoughts, or memories that trigger anything from mild to intense anxiety. Provide enough detail so you know what to do to elicit anxiety when you engage in exposure and rate the expected level of anxiety associated with each step.

Identifying exaggerated thoughts of threat and helplessness, critically evaluating them, and then replacing them with an alternative, more balanced perspective is an important therapeutic tool for managing your anxiety level during exposure.

Step 2: Target Anxious Thinking

Deal with the anxious thinking and you’ll reduce your anxiety during exposure.

Step 3: Plan to Start Moderately and Resolve to Pace Yourself

It’s important to do exposure in a graduated fashion, starting your exposure somewhere in the middle of the hierarchy you’ve made. If you start too low in the hierarchy, you waste a lot of time doing things that cause only mild anxiety. If you start too high, you’ll feel overwhelmed with intense anxiety. Remember, the goal of exposure is to generate moderate anxiety so you can experience the anxiety decreasing over time with repeated practice. In the process you learn that situation is not dangerous and you’re not helpless.

Also be sure to stick with one task and do it over and over until you can do it with only slight feeling of anxiety.

Exposure is like running a marathon: pacing is everything! If you start with a task that rpvpkes moderate anxiety and still find the exposure too overwhelming, drop back to a less intense task and work on it. If the exposure is too easy, proceed up the hierarchy until you do a task that is moderately challenging.

Step 4: Commit to Practice, Practice, and More Practice

Successful exposure is like physical exercise: practice is critical! The more exposure you do, the better the outcome. You should aim to do some exposure every day, especially at the beginning. Also make sure you do at least 30 minutes of exposure each time. The number-one reason that exposure treatment fails in anxiety is that people do too little exposure. The problem with brief and occasional exposure is it can have a reverse effect. Occasional or brief exposures can actually INTENSIFY your anxiety. You are more likely to feel overwhelmed with brief exposure (5 to 15 minutes). It will reinforce your faulty anxious beliefs that the situation is highly threatening and that you are helpless to deal with your anxiety. You’ll end up discounting what you’ve written on your normalization card and conclude that the best strategy is to return to avoiding the situation.

The success of exposure depends on its “dosage.” Do the same exposure task over and over for at least 30 minutes until you can do the task with only slight feeling of apprehension.

Step 5: Develop a Coping Strategy

The whole point of exposure is to generate anxiety and then let it decline naturally. So you will be anxious during exposure. Having a list of coping strategies that you can call on will help you get through it. The goal is to ensure that you remain in the exposure situation without engaging in escape or safety behaviour that would interfere with the natural decline in anxiety. The following are some constructive coping strategies you can use to deal with anxiety and sustain exposure to the anxious situation.

Modify anxious thinking. Remember, modifying your thoughts of danger and helplessness will lower your anxiety level.
Focus on physical symptoms. Rather than deny these symptoms, accept them, embrace them, and practice experiencing them as normal heightened physical arousal.
Find evidence of safety. Consciously and deliberately look around your exposure environment and pick out evidence that the environment is safe.
Control your breathing.
Initiate relaxation. You can try out this coping strategies, but never use it to avoid feeling anxious.
Visualize mastery. Imagining yourself successfully doing the exposure can boost your confidence and positive expectations about task.
Increase physical activity. Never use physical activity to avoid anxiety or exposure task.

If for some reason a particular coping strategy dramatically reduces your anxiety level, stop using it. That’s a good sign that you’re using it to escape anxiety or to seek safety. Remember, the whole point of exposure is to let the anxiety decline naturally.

Develop a list of coping strategies you can use to help you remain in the exposure situation until anxiety has declined naturally, but remember that the purpose of coping is to make anxiety more tolerable and not to eliminate it entirely.

In their 1985 treatment manual for cognitive therapy of anxiety disorder, Beck and Emery proposed a five-step AWARE strategy to deal with anxiety. This strategy is particularly helpful for coping with the elevated levels of anxiety that occur during exposure.

Accept anxiety. Instead of fighting against anxiety, agree to receive it; welcome it as part of the exposure experience.
Watch your anxiety. Separate yourself from the anxiety and observe it like you were standing on the sidelines and watching a parade parch by.
Act with the anxiety. Normalize the exposure situation and act as if you were not anxious.
Repeat the steps. Repeat steps 1-3 until your anxiety decreases to a milder more acceptable level.
Expect the best. Don’t be surprised by anxiety. Learn to expect that you will experience anxiety in exposure situations. Correct any false expectations that anxiety can be utterly defeated for all time. Instead replace this with the goal of strengthening your ability to tolerate anxiety. In this way you take control of anxiety rather than letting it control you.

Behavioral experiments are structured, planned tasks designed to collect evidence for and against an anxious belief about threat or danger and personal vulnerability.

Behavioral experiments are an especially effective way to enhance exposure because exposure therapy is thought to work by correcting maladaptive fear beliefs and help the person relearn that fearful situations are actually safe.

Don’t procrastinate – start your exposure program today! Most people with anxiety find the anticipation more anxiety-provoking than the actual task. It will probably be less difficult than you expect.

Exposure is hard work, and it’s easy to get discouraged. If you’re tempted to conclude that exposure is not for you, keep in mind that numerous research studies have shown that exposure is probably the most effective and quickest remedy for anxiety.

It takes courage to engage in exposure to your fears. Identify your problems with exposure, revise your exposure plan, and then return to your daily practice sessions.

To maximizes the effectiveness of exposure, refrain from all efforts to control or eliminate anxiety. Identify your false safety-seeking responses and work on eliminating them from your exposure exercises.

Chapter 8 – Let’s Talk Strategy

Why you need plan?

Maintain goal direction. Having a treatment plan will help ensure that you’re working toward hose goal.
Keeps you focused.
Promotes a systematic, organized approach.
Sustains commitment.
Enables evaluation.

Step 1: Target Anxiety Symptoms

Breaking down your anxiety into individual symptoms – specific anxiety triggers, anxious thoughts about threat and danger, and coping responses – is an essential step because it enables you to target exactly what need to be changed to reduce anxiety.

Step 2: List Intervention Exercises

Planning your treatment involves knowing how you’re going to work on each anxiety symptom.

Step 3: Create a Self-Help Schedule

Develop a weekly schedule for working on your anxiety. Be clear on what you are working on, when, where, and for how long. To overcome anxiety, you need to be committed to your plan.

Be creative in thinking how you can fit times to work on your anxiety into your busy day. Remember, the more work you do on anxiety, the quicker and better the results. Procrastination and neglect are the enemies of anxiety reduction!

Step 4: Record the Outcome

At the end of each week, evaluate the success of the intervention exercises you’ve done so you know what is and is not working for you and can make adjustments in your cognitive therapy program.

The best way to maintain your gains is to know the signs that your anxiety is getting out of hand and you need to signed into specialized cognitive therapy:

Avoidance creeps back. You start avoiding some of the anxiety triggers from past.
You become less tolerant of feeling anxious. You’re more bothered by feeling anxious and begin taking steps to avoid anxious feelings and symptoms.
Worry increases. You are thinking more about anxiety and find yourself increasingly worried about the possibility of becoming anxious.
Your belief in threat and catastrophe returns. You find yourself more accepting of the automatic thoughts of danger, catastrophe, and the worst-case scenario.
Safety seeking increases. You resume taking antianxiety medication or engage in other activities to exert greater control over anxiety.
Anxiety interferes in your life more. You notice that you’re isolating yourself more or you’re having trouble sleeping or concentrating at work. You may feel more depressed or irritable. Anxiety is creeping back into your life and eating away at your quality of living.