A Six-Part Approach to Managing Anxiety

Woman looking anxiousMost of us experience anxiety at different times in life; it’s when it takes over our quality of life that that it becomes a problem. But what is anxiety, and do you experience it?

There two different types of anxiety: external and internal.

External anxiety comes from outside events that produce an internal reaction inside us. Examples include sitting in traffic jams and worrying about being late, or perhaps an argument with a spouse.

Internal anxiety is when a person internally generates anxiety with an internal thought.

Thinking, “What if my boyfriend doesn’t like what I said and he leaves me, and then I’m all alone and I can’t take care of myself and I break down?”

We think the worst, and then our thoughts become a generator of this biochemical reaction in our bodies. A moment of anxiety automatically sends an alarm system to our brains. In this case, the anxiety is all in the mind, and it manifests into a physical reaction. When this happens, we start to question the physical symptoms.

The fuzzy, anxious feeling won’t hurt you. It’s only an adrenaline response. But when you focus on the fear, you may create more cortisol and adrenaline, which will create more body symptoms and more confusion. When adrenaline hits the lymbic system of the brain, we feel intense terror. The thinking part of our brain reacts, and we start to question how we feel and we want to fix it.

Start by making a list of situations that make you uncomfortable and you find yourself wanting to avoid. Here are some possible examples:

  • shopping in stores
  • bridges
  • standing in lines
  • socializing with people
  • talking in front of an audience
  • being alone

Now write down the body sensations you could experience during an anxiety episode.

Here are more examples:

  • racing heart
  • feelings of confusion or bewilderment
  • insomnia or sleeping too much
  • feelings of fatigue and depression
  • feelings of helplessness
  • muscle tension
  • headaches
  • strange or scary thoughts

Now that you’ve thought about what makes you most anxious and how you react, don’t worry—you are not crazy, and you are not alone.

Anxiety can be caused by the following:

  • obsessively anticipating
  • thoughts that create body symptoms
  • feeling fear of losing control
  • projecting into the past and worrying about the future

The following is a six-part approach to helping manage anxiety:

  1. Recognize that you are feeling anxious and accept feelings as a sign that something is bothering you.
  2. Try to figure out what is really bothering you. Is it some kind of conflict you don’t want to deal with? Is it a scary thought? Is it a ridiculous expectation you have of yourself. Did you eat chocolate or drink caffeine last night?
  3. Give yourself permission to feel anxious about whatever it is that is bothering you.
  4. Use compassion and self-talk to move past anxiety. It will be ok. You can go about your business until it passes.
  5. Get busy. Do something productive with all the energy.
  6. Try to see a little humor in the way you feel and laugh at yourself a little. For example, if you don’t like confronting someone, say to yourself, “I don’t like confronting people. That is a normal, OK reaction to have.”

Being aware of what is causing your anxiety is the first step. Once you find out what is bothering you, you can use the six-part approach above to help cope with and diminish your symptoms. Remember, anxiety is often caused by a physical reaction to our thoughts. If one can stop and take time to recognize the thoughts and where they are coming from, one can then learn to do self-talk and understand that there are healthy ways to manage anxiety.

© Copyright 2014 GoodTherapy.org. All rights reserved. Permission to publish granted by Joanna Engelman LMSW, MA, therapist in New York City, New York

The preceding article was solely written by the author named above. Any views and opinions expressed are not necessarily shared by GoodTherapy.org. Questions or concerns about the preceding article can be directed to the author or posted as a comment below.

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  • gemma

    gemma

    May 31st, 2014 at 6:12 AM

    So driving over a bridge that spans a huge body of water always freaks me out, to the point where I will intentionally drive miles out of my way to avoid that scenario if I know that this is on my route. How then would I be able to stop and do this willingly and then write down how it makes my body feel? I would have to somehow overcome some of the anxiety that I already have to even be able to try this little experiment because if not I am afraid that I would have a panic attack even attempting to do it.

  • Ollie

    Ollie

    June 2nd, 2014 at 3:48 AM

    I get it that you wnat to give yourself permission to feel what you are feeling but is it always a good thing to allow yourself to feel the anxiety? Do you think that in some ways this validates what you are feeling and helps you continue believing that this is an appropriate response when things are uncomfortable?
    I am not saying that you don’t deserve to feel or experience, but I think that there are always better ways to handle these responses if possible.

  • Kate

    Kate

    June 2nd, 2014 at 9:18 AM

    Ollie all feelings are valid. Good and not so good ones- being able to manage, feel and ‘be with’ these feelings is the aim. Even the uncomfortable ones. By fighting or denying the feelings of anxiety you cause your brain to believe that there really must be something terrible about to happen if you need to fight feeling it! It exacerbates the feeling of anxiety and increases all the physical symptoms- viscious circle… By accepting the anxiety it becomes less of a monster – you learn to understand it and how you manage it. No one will ever be without anxiety and in fact we wouldn’t last long if we didn’t feel it! It’s what keeps us safe- ie we don’t stand near the edge of the cliff in case we fall off, anxiety over being late for work helps us keep our job… Etc it’s about being able to accept that you will be anxious sometimes and that’s ok. When anxiety becomes an problem counselling can really help as to what the root of it is, and learning techniques to manage and control anxiety symptoms like relaxation techniques, breathing techniques and de-catastrophising can be of great benefit.

  • Brad

    Brad

    June 6th, 2014 at 3:49 PM

    Giving yourself permission is not the same as encouraging yourself to feel anxious. What people tend to do with emotions that hurt them is to resist or avoid those emotions. Even though many do this in response to anxiety, avoidance and resistance don’t work to solve the problem.

    Most people don’t realize that emotions that hurt us are just another kind of problem to solve. Have any of us ever solved a problem by avoiding it? Have any of us ever felt less anxious by fighting our anxiety when we feel it?

    It’s by accepting and allowing ourselves to feel what we feel that we take the emotional energy out of the negative feeling, especially anxiety, providing us with better perspective and allowing us to see more clearly and thus make better choices for ourselves.

    Some of this may seem counter-intuitive, but it can breed surprising results.

  • Jayma

    Jayma

    June 2nd, 2014 at 3:09 PM

    IT’s not the external things that worry me, it is those things that are more on the inside of me that tend to cause the most anxiety. I am forever beating up on myself and wondering why I couldn’t do better, be better, do more etcetc. It gets to be such a chore to tune it all out that that alone makes me anxious too. It is a horrible cycle of beating myself up and letting myself down and although I don’t want that as a part of my life anymore it gets more and more difficult to tune thsoe things out when they are speaking loud and clear. Sometimes I think that the external things would be so much easier to handle because you can drive a different way, avoid another person, but it is awfully hard to escape those things in your head/

  • lisa

    lisa

    January 5th, 2015 at 9:43 PM

    Hi Jayma, our situation sounds very similar. Ive often wanted to get away from me, even find my self saying outloud ‘for God’s sake shut up lisa’. I have a wonderful friend who always makes me happy and feel loved, liked even. We have a saying wen we think we’re a winge and no good company, , ‘let me be the judge’. She points out all good things about me, which usually makes me feel a little worse if you know what i mean. However it does make me look at me through, although bias, her eyes. I do my best try my hardest, …Most of the time lol. And i can think of worse situations relationships health matters the list is endless. Again this triggers self pitty as people are delt worse and cope?. Hurt no matter how what why or when, if it hurts its real its justified, its yours. Just try and learn by it or leave it behind. Chin up

  • ruby s

    ruby s

    June 5th, 2014 at 3:35 PM

    I am going to really try to focus on the first one, in that when I see that I am anxious I want to simply sit back and say ok so I am worried about something instead of allowing all of that anxiety overwhelm and consume me. Notice I said that this is one I will try to work on because i know that it is not my strong suit.
    As soon as I feel the annxiety building that is when I will typically start to go just a little bit crazy on the inside and worry about even more and more things as they get tangled in that web of worry and concer. I think that if I could simply let some of that go then I would be in a much better place. I know that it will be a process but I at least that by the end of summer I have a little bit of progress to report. Fingers crossed!

  • suzana

    suzana

    June 7th, 2014 at 1:59 AM

    Jayma, How you describe your thoughts suggests that you don’t think much of yourself. Sounds as if you can never be good enough. This can be due to all sorts of experiences but simply it sounds as if you are out of step with yourself. Perhaps consider taking time out to be with yourself in a deeper way: through relaxation, meditation or yoga for example. Find suitable and experienced teachers who know what they are doing.
    Let’s also not forget that we live in a competitive world and this has influenced much of our tender growing years as well as our adult ones. The default for many can be ‘not good enough’ when in reality you are a beautiful human being but there is so much that has gotten in the way of you recognising that. Learning to love oneself just as one is can be a long journey. It can require us to seek out our inner nurturing parent, accepting, letting go of identifying … stilling the mind – an ageless task – all the more critical perhaps at this time of our development as humans and with our world in crisis.

  • lisa

    lisa

    January 5th, 2015 at 9:46 PM

    Hi suzana, nail on the head. Self battling even with lots of love around you are the hardest evilest and loneliest though.

  • Betsy S.

    Betsy S.

    June 17th, 2014 at 1:42 PM

    One thing the author doesn’t talk about it automatic triggers, which often defy logic, as often as not, have nothing to do with what’s happening, and can completely scare you into a state of panic, extreme discomfort, and despair.

    At times like this, “trying to figure out why you’re feeling the way you’re feeling,” is meaningless. It can also feel demeaning and dismissive.

    The truth is, once your central nervous system is in full-on, physical, freak-out mode, no amount of “understanding,” affirmations, or distraction may help much. When you’re in “overwhelm,” my suggestion is to call someone who will keep you company, and be a calming presence until the adrenaline levels in your body naturally diminish–as they will.

    What I tell clients is that sometimes we can’t really make ourselves feel much better, but we can ALWAYS make ourselves feel worse. People who are anxious know exactly what this means. My advice is to do things that are neutral or good for you, even if they don’t bring immediate relief. And not to continue doing anything you know makes you feel even worse. On that list are things like:
    -going online to “research” your condition–which usually means finding something or someone online who will convince you that you have a brain tumor, or are having a heart attack, etc.
    -sitting in the dark freaking out about your physical symptoms, and your grim hope of relieving them anytime soon
    -making countless doctors’ appointments with every crazy alternative healer you can think of
    -drinking or taking more medication than prescribed or recommended
    -staying in bed

    On my list of alternatives to self-destructive ruminating:
    -reading something soothing or interesting about how people like you get well (The Depression Cure, Hope and Help for Your Nerves are two examples)
    -forcing yourself to get aerobic exercise (which will burn off adrenaline).

    There are lots more, but dinner calls. Good luck!

  • Andy H

    Andy H

    July 28th, 2014 at 8:08 PM

    while I concur with much of what you said, I have a few reflections. First, most of the examples of body sensations you give are not in fact body sensations.for example, feelings of confusion and bewilderment are not body sensations. You might ask, when you feel confused and bewildered, what do you feel in the body. You are looking for some kind of discomfort. Pain, queasiness, tightness, emptiness, as you mentioned, racing heart…
    instead of trying to figure out what makes you anxious, bring all your attention to the body sensation,get receptive, and talking directly with the sensation, ask, name body sensation, what have you come to share, what’s making you anxious, where are you beginning,.?
    this has the advantage of acknowledging that the body sensation has its own consciousness which is anxious. You as witness are just having an experience of anxiety.
    in my experience, the body sensation has a narrative to share about where the anxiety crystallized and what it needs in order not to feel anxious anymore.
    finally,using kinesiology diagnosticly,the most powerful interventions for anxiety are typically acupressure. Most common is Emotional Freedom Technique and tapas acupressure technique.
    very interested in any reflections. Thanks, Andy H

  • Teresa

    Teresa

    September 20th, 2014 at 7:17 AM

    My individual experience of anxiety has been physiological. I think because I used my anxiety as a motivational tool. I would decide to distort what I was feeling and why into something that would be a more profitable concern, then be super motivated to make the positive outcome to happen instead. I had no idea this practice would still give me crippling chest pain and real danger of still dying with a healthy heart! I haven’t mastered it totally, but acknowledging my base, foundational thoughts and saying out loud , what I dared never to say , to a trusted friend and/or therapist has released me and allowed me live in the moment and “choose” whether I am going to let some worry take my joy of living away.

  • Kalamazoo

    Kalamazoo

    October 13th, 2014 at 12:29 PM

    I can have panic attacks thinking about what might happen in certain situations (such as: my son gets arrested or killed due to risky behavior) and I have a complete paralysis of chest wall and truly can’t speak ,breathe, or move -it’s the most terrifying thing I’ve ever felt ! It’s also a real painful experience! I’m now afraid of being panicky if that makes sense ? How can I get through one if these episodes ? My husband called 911 when he witnessed this and I was checked out at ER with instructions to see a dr if happens again

  • Deb

    Deb

    January 5th, 2015 at 11:49 AM

    K-zoo .. From East Lansing .. I do the same thing . I imagine the worst that could happen. My sister calls it ” awfulizing ” . I make things awful ! I do . So then some awful things did happen and I made it through the awful times .. Divorce , my Moms death , my27 ur old son had an injury that changed his life . Guess what . I survived , I rose to the occasion. I started to believe in myself . I also started meditation . Guided meditation for empowerment . It works ! Oprah and Deepak also have a series of CD’s called miraculous relationships that I bought and listen to over and over . I did it all while becoming disabled myself and thinkng I could never recover . Some days I still let it rule me but then I get my meditaions back out and I become strong . Sending you personal power Kalamazoo !

  • lisa

    lisa

    January 5th, 2015 at 9:27 PM

    The 2 types of influence mentioned, internal and external. This i didn’t know about, yet i emideatly understood what is meant. This I feel is because I experience both and each fuel the other just as powerful and effective as the first. This has lead to my 4 days solid of sleep then flip of a coin and im now on day 3 awake right through, then there is The super highs and wrenching lows, indecisive unsure questioning own mind thoughts and feelings. Why can’t I share the energy and fatigue equally like other people. I flog myself to shear exhaustion with nothing to show for my efforts but missed time memories and life with my kids my friends my family. Yet the tasks i am facing day to day are what cause the panic and low feelings if I complete the job or task it pleases me with a sense of achievement, and yet somehow i hurt dissapoint or let someone important to me down. I know this to be true as they are happy to inform me. So i suppose if I have a question, it would be… How do i assess control deal with the outside bothering the inside so much.

  • tds

    tds

    May 29th, 2016 at 3:57 PM

    This article gave me anxiety! The bullet points, the picture at the beginning…The six part approach… really? When I’m in a panic attack there is no way I can implement a Six Part approach to get out of it….one word sentences are about all I can do.

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