“I was looking forward to the party and I liked everyone there, but afterward I felt so down. I couldn’t stop worrying about what I’d said that sounded stupid, or if I hurt someone’s feelings. But I can’t possibly have social anxiety. I love socializing! I have plenty of friends.”

I’ve heard a version of that story many times—people in therapy experiencing what they call shyness, self-criticism, or loneliness in social situations. When I suggest this might fit the category of social anxiety, they’re shocked. They picture a person who huddles in the corner at a party or tries to be invisible in work meetings, never speaking above a whisper. The reality is social anxiety could affect anyone around you, from the bubbly girl in your class who is secretly praying she won’t be called on by the teacher, to the take-charge guy in the office who goes home exhausted from the strain of interacting with others all day.

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It’s true one model of social anxiety is the extreme: a loner who fears any contact with other people. This person might be diagnosed with “social anxiety disorder,” a clinical term which involves a high degree of distress, significant interference with daily functioning, and often panic attacks. It’s more common to have a less severe version of the condition, which wouldn’t be labeled a disorder—it’s just a major, sometimes daily, challenge.

Social anxiety can show up in many ways, such as not wanting to be the center of attention or dreading walking into a room of strangers. The unifying factor for everyone who struggles with it is a persistent fear they are being judged critically. It’s a sense any interaction could be fraught with danger, where we run the risk of messing up and being seen in a negative light. In this way, it can turn occasions that ought to be pleasant—like parties, weddings, or holidays—into torturous ordeals.

Below are some common misconceptions about social anxiety, along with more detailed information about the ways this condition can present itself.

1. Everyone with social anxiety is an introvert.

Believe it or not, you can be confident or personable and have social anxiety. You can know you’re basically a likable person and still worry everything you say is wrong. This is because social anxiety isn’t about your overall view of yourself but rather the conviction you are being judged and are bound to fail.

It can be surprising to discover someone who is outgoing and successful also frets over how they come across. The condition is distressing whether it’s obvious (hiding in the back of the room at a wedding) or subtle (telling a story to a group, but grinding your nails into your palms under the table). Sometimes struggling in secret is harder because people don’t believe you have the condition or discount how much you’re suffering, or don’t know they need to offer you more support.

2. If you have social anxiety, you can’t be good at public speaking.

Many socially anxious people are quite good at giving lectures or heading up meetings. In fact, many actors, who make their living speaking in front of others, struggle with social anxiety. This is because giving a speech or reading a script is a learnable, practicable skill, and one that offers fewer opportunities to mess up than impromptu socializing does. Many worriers plan far in advance and rehearse multiple times, so that a presentation becomes more like a memorization activity, or a performance, than a nightmare scenario.

Public speaking has the additional benefit of allowing the speaker to feel in control of the room. Since the belief is everyone is always watching and judging, it can feel relieving to enter a situation where that element is assumed and can to some extent be prepared for.

3. If you have social anxiety, you feel it most of the time.

The condition can affect you only in certain settings, or only some of the time. Some of the people I work with in therapy feel confused when they attend two social events but struggle through only one of them. “Why can I deal sometimes but not all the time?” they wonder. Luckily, we can examine the difficult times to explore what makes them worse.

Usually, what seems baffling at first soon yields important truths. Each of us has elements that make us more anxious based on past experiences (such as the time we fell during a school dance), messages we’ve heard (a parent reminding us we’d put on weight), or societal norms (a fear nice girls are never loud and boisterous). When we can uncover our personal triggers, they become easier to soothe.

Like any other anxiety, this one can itself become the source of angst. Sometimes people aren’t really anxious about the social event—they’re more anxious they might feel anxiety, and the fear of what might happen overcomes them.

4. Social anxiety affects you only during social interactions.

Some people worry incessantly before a gathering, but once it starts, they’re in the moment and feel less concerned. Others don’t dread the office holiday party and enjoy it while it lasts, but the next morning face self-recrimination. Social anxiety doesn’t have a timeline, though it typically affects the same person in the same way during each occurrence. In other words, once a pre-worrier, always a pre-worrier. It’s not uncommon to be engrossed in a conversation and truly enjoying it, only later to recall the conversation as tormented or littered with your blunders.

Like any other anxiety, this one can itself become the source of angst. Sometimes people aren’t really anxious about the social event—they’re more anxious they might feel anxiety, and the fear of what might happen overcomes them. In these cases, it’s important to remember all the times the anxiety doesn’t exist and reinforce the idea it isn’t in control.

5. If you have social anxiety, you don’t feel it with people you’re close to.

It’s a little like the Phillip Lopate satiric poem, which begins: “We who are your closest friends feel the time has come to tell you that every Thursday we have been meeting as a group to devise ways to keep you in perpetual uncertainty frustration discontent and torture …” The condition convinces people that others could be misinterpreting them, teasing them, secretly thinking negatively, leaving them out, rejecting them, or talking behind their back. This is sometimes only with strangers, but it can seep into any relationship.

For some people, it’s the closest friendships and romances that cause them to feel the most vulnerable and exposed. Some partners get frustrated they aren’t being trusted to be kind and understanding. But social anxiety isn’t usually a result of real rejection; it’s a perceived threat of eventual rejection.

Treating Social Anxiety

Because social anxiety is so individualized, and runs the spectrum from severely impairing to hidden but distressing, there is no one-size-fits-all treatment. The best course of action to soothe these difficult emotions is to get a deeper understanding of where and when they may have started, what triggers them, and possible tools to calm them.

Perhaps more than any other issue, social anxiety is helped by therapy, whether one-on-one or in a group setting. This is because so much of the condition is based in shame or the feeling one is basically lacking. Having the support of another person who can give objective feedback is invaluable. To learn to be vulnerable and real with one safe person, or a group who really gets it, is one of the best ways to attack social anxiety and replace it with what the anxious person so dearly needs: a realistic and secure sense of self.

Dear GoodTherapy.org,

For years now, I’ve had a problem with grinding my teeth, and it only seems to be getting worse. I think it might be hereditary because my mom says she grinds her teeth, too. It used to only happen at night, but lately it’s almost constant, and I have to consciously stop myself from clenching my jaw even during normal daily tasks (like writing this letter, for example).

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I know things like biting cheeks and the skin on your lips can be linked to anxiety or other mental health issues. Is it the same with grinding teeth or jaw clenching? So far, amazingly, my dentist says my teeth haven’t been affected too much—but they always still try to sell me on expensive mouth guards. I’ve tried store-bought mouth guards and had a retainer for a while, but obviously they’re not really stopping the jaw tension even if they’re protecting my teeth. Sometimes I fall asleep biting my tongue and wake up with really pronounced indents from my molars. And I think sometimes the tension is related to how stressful my dreams are. But I don’t always remember my dreams, so I can’t say for sure.

Anyway, do you have any suggestions for things I can try? I wake up with a dull headache from this nearly every morning, and I’d really like to stop popping painkillers. I do think I have a more-stressful-than-average life, but honestly I prefer staying busy, and I don’t think my stress level is likely to change. Besides, I know people who lead lives with far more responsibilities and stress who don’t have this issue. Any ideas? —Ground Down

Dear Ground Down,

You’re not alone in this! Many people grind or clench their teeth, often in their sleep but also often in the daytime as well. Fortunately, there are many things you can try to help yourself overcome this issue and prevent more significant damage as a result of teeth grinding. I will provide some suggestions of things you can do, but first I’ll share a little more information about grinding teeth, how and why it happens and persists, and the role of anxiety in clenching or grinding teeth.

Clenching or grinding teeth without awareness, also known as bruxism, affects many (the incidence at any one time is around 10% of the population) and can range in severity from mild (no physical evidence of consequences) to severe. More notable effects of grinding or clenching include facial pain, tired jaw muscles or the development of jaw disorders, sensitive or damaged teeth, damage to tongue or inside of mouth walls, headaches, or earaches. It has been found to happen more frequently during periods of high stress, though it can become habitual and happen regardless of stress level. It also appears to have a hereditary link and happens more frequently in women than men.

Teeth Grinding and Anxiety

Does this mean you have anxiety? It’s hard to accurately assess that without information that can only be gleaned by talking to you in person. I recommend making an appointment with a therapist near you to discuss the issues you may be experiencing.

Certainly, grinding or clenching teeth can be one manifestation of holding tension and responding to stress, and many individuals who experience anxiety (and depression) do also grind their teeth. Grinding teeth does not necessarily mean you are experiencing anxiety (or depression), however. That said, one way to treat this is by using many of the same behavioral techniques you might use to help manage anxiety.

How Can Teeth Grinding Be Treated?

The first step in overcoming grinding or clenching teeth is to become aware of the issue. How did you discover you were doing this? Have you experienced headaches or tightness in your facial muscles? Has your dentist remarked about damaged teeth or suspect you might be grinding or clenching? Are you hearing from your partner that you are grinding teeth in your sleep? Ask yourself questions about the frequency and nature of this behavior. When are you grinding or clenching your teeth? Are you doing other activities at the same time (e.g., sleeping or working)? Do you notice you are feeling stressed when you are clenching your teeth? You may want to keep a journal for a period of time to track this behavior and when it occurs. This information can inform your strategies to help overcome these behaviors.

Essentially, a pattern has developed over time. For example, you have trained yourself to engage in teeth clenching if you automatically start clenching your jaw when doing things like typing on your keyboard or stepping out into the winter cold. Now is the time to break this habit, before you notice more significant consequences. 

Essentially, a pattern has developed over time. For example, you have trained yourself to engage in teeth clenching if you automatically start clenching your jaw when doing things like typing on your keyboard or stepping out into the winter cold. Now is the time to break this habit, before you notice more significant consequences.

Be aware of your mouth position. Believe it or not, there is a correct way to position your jaw. With your lips closed, you want to keep a gap between your top and bottom jaw, which can he assisted by placing the tip of your tongue just behind your front teeth on top. This may take some practice and regularly checking in to modify your habit of how you typically position your mouth. If, as you are reading this, you notice you are clenching your jaw, start to make a change. Begin by opening your mouth as if you are about scream, which is a great stretch for these muscles, followed by adopting the correct mouth position. This correct position will likely reduce tension in the jaw.

Implementing Relaxation Is Key

How do you know whether you are holding tension in your body? It is not always obvious. One thing to do is to scan your body for tension. Deliberately think about every muscle group in your body. Are muscles in your back or shoulders holding tension? Muscles in your jaw? Take a deep breath in and exhale. Let go of the tension where you notice you are holding it. Various relaxation techniques, centered on mindful breathing, can be especially effective. You may want to end every day by scanning your body for tension. You may want to do some yoga stretches. Additionally, try placing a warm washcloth on the muscles of your jaw to relax them before bedtime.

There are some suggested “don’ts” as well. Because this is a habit, be mindful of nonfood items you may “chew” on. Chewing pencils, straws, toothpicks, etc. may increase your tendency to engage in that behavior when you are not aware of it. Be aware of your chewing all around. Also, some experts would recommend reducing caffeine, nicotine, or alcohol before bed.

Other strategies to consider are what your dentist has been suggesting to you. If relaxation strategies and retraining your behavioral patterns are not the approach you would like to try, many individuals do utilize bite plates and find that custom plates are useful. If you are reluctant to try this approach, first try the behavioral strategies suggested above.

Knowing potential damages or consequences can be enough to motivate many to try to make a change. It sounds like you are quite motivated to overcome this on your own. Good luck!

Kind regards,

Marni Amsellem, PhD

Agoraphobia, which involves a fear of leaving the house, driving on freeways or other roads, being in lines or in the open, and similar situations, is a condition that provokes anxiety and panic attacks.

The uniquely debilitating characteristic of agoraphobia is that it is a self-perpetuating condition, often referred to as an “emotional and physical cage.” It effectively prevents the person experiencing it from doing the things that may bring healing—like taking a walk, taking a trip, etc.—because of the severity of the potential panic attacks when the person moves behind the boundaries of comfort.

The physiological symptoms of a panic attack can include the inability to breathe, a feeling of physical paralysis, blurred vision, or dizziness to the point of fainting when the person moves beyond these perceived boundaries.

If you struggle with agoraphobia, what can you do to help yourself overcome it?

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Recovery involves interventions on three fronts: (1) facing the panic, (2) implementing coping skills, and (3) addressing the underlying issues.

Facing the Panic

There is a catch-22 in recovery from agoraphobia: you must learn to endure the panic attacks in order to stop having them. This involves finding a goal that is bigger than your anxieties and that is worth enduring the extreme discomfort, like being able to go to dinner with your family, taking a vacation, etc. Think of this as your motivation to heal yourself. Please be assured that in following these strategies, the attacks are likely to become less frequent and less severe in time, eventually disappearing altogether.

As with any recovery process, it helps to locate yourself within your problems, envision yourself outside of them, and develop step-by-step strategies to make the transition.

To start the recovery process, think of yourself as being trapped inside a barbed-wire enclosure; your freedom resides on the outside of this enclosure. The idea is the barbed wire represents your panic attacks, the emotional and physical cage of your self-perceived “boundaries.” In essence, you need to climb over the barbed-wire fence to freedom—and this requires facing the barbs, or the panic attacks, in order to overcome their power.

Repetition is necessary in order to heal. Every day, it is important to take yourself on a trip to face your panic, endure your panic, and ultimately, overcome your panic.

Another useful metaphor to visualize is to think of yourself as a prisoner creating an escape plan. You will need to develop strategies for escaping your prison. It is like falling down a well and having to crawl back up over the jagged rocks to escape. As a prisoner with an escape plan, you know the journey will be a tough one, full of booby traps and pitfalls, but that your freedom lies beyond.

Please know progress will be slow but steady, and that sometimes you will stretch your boundaries, but sometimes they will feel like they are shrinking around you. But don’t be discouraged—this is all part of the process of healing.

To begin, set a small goal. Think of an activity you would like to try to participate in. An example is taking a trip to the library. If your destination is the library, you will have to endure the panic attack of driving or getting on the bus in order to travel there. However, once you arrive, if it is something you truly wanted to do and enjoy, your panic will likely subside, and you will likely feel better after you return home again.

Repetition is necessary in order to heal. Every day, it is important to take yourself on a trip to face your panic, endure your panic, and ultimately, overcome your panic.

Implementing Coping Skills

Coping skills may help you in the moment. Here are some tried strategies you can implement as the need arises. The point is to distract your mind from the anxiety.

Strategy 1: Counting

• In your mind, count to 11. Then count backward to two. Then count up to 12. Then backward to three, etc.
• Count items of certain things in the room by category; for instance, count everything you see that is orange. You can do this with a variety of categories.

Strategy 2: Locate Patterns

• Write lists or patterns on a piece of paper.
• Fold a piece of paper systematically.

Strategy 3: Accept Your Panic Attacks

• Do not “stoke” your panic by being afraid to have an attack; this will likely only prolong the attack.
• Learn to endure and accept the attacks. As you do this, they may become less severe and frequent.
• Realize “that which you resist, persists.”

Addressing Underlying Issues

A pivotal quality of agoraphobia to be aware of, one that may help you in your recovery, is the concept the condition provides a type of “reflection” for you. If you can see there are some situations in your life that exacerbate your panic attacks, you can look at these situations as indicators of areas in your life that need to be addressed.

Seeking therapy is highly recommended, but in lieu of or in addition to therapy, it is most important for you to be self-aware of the connections between situations, events, and your panic attacks. These issues can be related to job, family, or other dynamics that might normally produce minor stress symptoms.

As part of the process of becoming self-aware, it is a good idea to keep a journal, one that records not only when you have attacks, but what happened in your life around the time you had the attack. What were you feeling? What feelings or memories did it trigger? As you work through these issues, in addition to progressively enduring your attacks, you may find your freedom once again.

Dear GoodTherapy.org,

I’m afraid of everything. I seriously mean everything. Spiders, clowns, heights, germs, dying, dogs, small spaces, large crowds, undercooked meats, darkness, terrorist attacks, natural disasters … I could go on. These irrational fears have been affecting my life for as long as I can remember, and I never seem to get over them. If anything, I only find new things I’m afraid of.

I did a ton of research to find a place to live that was least risky—no hurricanes, no tornadoes, unlikely earthquakes, the least number of bugs, etc. I’ve insulated myself as much as humanly possible. I’m still miserable and afraid.

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Only a small number of these fears actually have roots in personal experiences. For instance, I was once bitten by a large dog, which explains my fear of dogs. But I have never been traumatized by a clown, never been caught in a violent attack, never experienced a natural disaster. I never had a negative experience in an elevator, but I have a panic attack almost every time I step foot in one.

Why do these things bother me so much? Is it possible to “cure” fears that have no basis in personal history? I want to live more freely and feel better about normal things and occurrences that should, at most, evoke minimal discomfort. Please help! —Dread Locked

Dear Dread Locked,

You write that you are scared of everything and there is no reason for most of your fears. I disagree. I think you do have reasons, even if you may not be fully aware of them, and these reasons can be worked with.

Sure, if you’ve been bitten by a dog, it makes logical sense you’d be afraid of dogs—there’s a reason for the saying “once bitten, twice shy,” after all. But you don’t have to have been in an elevator, necessarily, to be afraid of elevators—claustrophobia (fear of being trapped in small places) and agoraphobia (fear of situations that might cause panic and feelings of helplessness) are both pretty common.

Some of the other fears you describe—fear of spiders (arachnophobia), fear of heights (acrophobia), fear of germs (mysophobia), fear of clowns (coulrophobia), fear of dying (thanatophobia), and fear of earthquakes (seismophobia)—are prevalent enough to have their own names, too.

You ask whether there is a cure. That’s a strong word, and while nothing is guaranteed, I feel confident in saying therapy can help you understand your fears better, which in turn may help you manage them in more effective and productive ways.

It’s telling to me that you describe your fears as irrational. If you look at these fears, you no doubt recognize they are about things and events that do sometimes happen or present problems in human experience, but remember: the brain is wired to protect itself. Consider your fear of dying, for instance. Would you agree most people fear death on some level? Fundamentally, fear of death is protective, as it is our brain telling us to make decisions that are in the best interests of its preservation. Your brain is in fact being rational, not irrational, when it tells you to, say, keep your distance from the edge of the cliff, or to slow down, or to not eat those two-week-old leftovers. (Thanks, brain!)

Some of these fears can also go along with emotional experiences—claustrophobia, for example, can be linked to early experiences. You may not have been stuck in an elevator at any point, but you may have a history of being stuck or trapped in other, perhaps figurative, more emotional ways. As a result, seeking and finding safety may have become paramount in your life. Based on the extent of your fears and the lengths to which you go to avoid feeling fearful, I imagine that being vulnerable—as we all are in one way or another—is not something that sits especially well with you.

Can you do anything about being fearful? Well, yes. I think your best bet would be to seek a therapist who specializes in helping people with anxiety, fear, and worry. Starting therapy can be scary too, of course, but working with someone who is grounded, accepting, and knowledgeable about how to help people in your situation is a fine step toward learning how to handle your feelings.

You say you’ve “insulated” yourself as much as “humanly possible,” but you are still afraid and “miserable.” Clearly, the actions you’ve taken to protect yourself, while well-intentioned, aren’t working for you. You yearn for some relief. You ask whether there is a cure. That’s a strong word, and while nothing is guaranteed, I feel confident in saying therapy can help you understand your fears better, which in turn may help you manage them in more effective and productive ways.

I salute you for identifying an issue that is blocking you. You’ve taken a fine first step by writing in and explaining your situation. I wish you well as you take the next step in addressing your fears by partnering with a qualified mental health professional.

Take care,

Lynn

If you struggle with anxiety, regardless of whether you’ve been given an official diagnosis, one of the most powerful things you can do is to construct a toolbox of skills and strategies to implement when those thoughts of worry and stress—and their accompanying physiological responses—take hold.

Here are 12 things you may want to include in your toolbox:

1. Journaling. You don’t have to subscribe to any rules in connection with your journal. Write to relieve your stress and let go of the anxiety you feel. Write and rip, share or don’t, draw or scribble. Externalize your thoughts and feel the relief of having emptied them onto paper.
2. Music. Assemble various playlists so you have the kind of music you seek when you need it, whether it be soothing songs or those that will energize you if you’re feeling “stuck.”
3. Creative outlets. Funnel your anxiety into painting, drawing, dancing, writing, sculpting, playing music, singing, decorating, sewing, knitting, photographing, cooking, etc. A creative endeavor can be a healthy outlet for angst and a means of expressing feelings that might cause further suffering if ignored or suppressed. [fat_widget_anxiety_right]
4. Breaks. Stepping outside to get a breath of fresh air, getting a drink of water, or fixing yourself a cup of tea, having a healthy snack, or reading for a few minutes can all serve as brief diversions to recharge your battery and offer you a bit of calm.
5. Relaxation skills and breathing exercises. You can download guided exercises or use an app (calm.com and headspace.com are commonly used by people I work with in the therapy room). Just a few minutes of focusing on your breath—consciously breathing in for five seconds and then out for five seconds—can be all you need to bring your anxiety level down a notch or two. Be sure to practice these exercises on a regular basis so they come more naturally to you when you need them (before bed can be an ideal time to do this).
6. Imagery and visualization. Imagine an upcoming anxiety-producing event going as smoothly as possible. Be sure to engage as many of your senses as possible. You can also visualize a safe, soothing place such as a waterfall, the beach, or a mountaintop, again plugging into the sights, sounds, smells, tastes, and touches the scene might invoke. These skills, too, will serve you best if they are well practiced.
7. Rehearsing. Rehearsing can help you anticipate, and plan for, “what-ifs” so you feel better prepared. You can role play with others to help diffuse your fear and apprehension and strategize with regard to how to handle potential hurdles in a productive way.
   Combat your negative inner dialogue and perfectionism by letting go of the need to be perfect, and becoming okay with things being just “okay.”
8. A support network. Who are the people you can talk to and go to for support? Examples might be a parent, sibling, spouse, friend, coach, teacher, religious leader, coworker, mentor, or therapist. Awareness of who is in your network of support can enable you to feel less isolated and alone. Compile your network’s names and numbers so you have them handy when you want to reach out. Be sure to let those people know just how important they are to you.
9. Positive self-talk. Combat your negative inner dialogue and perfectionism by letting go of the need to be perfect, and becoming okay with things being just “okay.” As you tune in to the negative messages you feed yourself, formulate more appropriate, realistic ones to combat them. Nourish yourself with encouragement and the kinds of messages you’d offer your best friend in the same situation.
10. Exercise. Funnel your stress and anxiety into physical activity. Give that excess energy and adrenaline a place to work rather than allowing it to manifest in a racing heart or sweating while sitting still.
11. A list of your accomplishments and thoughts of gratitude. Focus on what you’ve done well, no matter how big or small, as well as on what is going right in the world around you. This can serve to create a big shift in your thoughts. Instead of putting your attention on what might go wrong, which steeps your brain and body in fear, enable positive thoughts and moments to produce as their byproduct other positive thoughts and moments. Success breeds success.
12. The ability to ask for help. Seeking out appropriate resources when you don’t have all the answers is a wonderful skill worth developing. It helps you feel supported, and you don’t have to remain stuck if you’re unsure which direction to turn.

The most interesting thing about constructing an anxiety toolbox is that, in doing so, many people see their anxiety markedly decrease overall. This is because they now feel equipped, ready to face their anxiety more effectively when stress, upset, or overwhelm attempt to take over.

What will you put in your toolbox?

For many, anxiety is the enemy. It can make you feel nervous and afraid and can prevent you from taking actions that will move you forward in life. People often look at anxiety as something they need to get rid of or prevent, but what if that isn’t the case? Would your relationship to anxiety change if you could look at is as a friend rather than an enemy?

Anxiety itself may not be the problem; not knowing what to do with it may be the main issue. Anxiety is the body’s natural response to stress. If you can accept that some anxiety is inevitable, you may be able to learn how to work with it instead of against it.

Here are seven creative ways to turn anxiety into productivity.

1. Use the Adrenaline

Anxiety gives you adrenaline. Stimulants such as caffeine and nicotine can cause physical symptoms similar to anxiety symptoms in the body by increasing heart rate and constricting the blood vessels. Coffee is a popular productivity booster for this reason. If you’re feeling anxious about an upcoming project, speech, or other task, try utilizing the extra energy to help improve performance and increase productivity.

Many sports psychologists and coaches generally want their athletes to be a little anxious rather than relaxed right before a game. Researchers say there is a “sweet spot”—a moderate amount of anxiety that actually helps people perform better by keeping them on their toes. Studies have shown learning increases when stress hormones are slightly elevated. The Yerkes-Dodson curve—originally developed by Harvard psychologists Robert Yerkes and John Dodson in 1908—illustrates how arousal enhances performance up to a certain point, but too much anxiety may hinder performance.

2. Reframe Your Anxiety

Anxiety is not always a negative thing. Telling yourself anxiety is bad and trying to avoid it may end up making the problem worse. Rather than saying “I’m so nervous,” try saying “I’m so excited” instead.

Anxiety is the body’s natural response to stress. If you can accept that some anxiety is inevitable, you may be able to learn how to work with it instead of against it.A research study conducted at Harvard Business School found saying “I am excited” out loud can improve performance. In order to increase anxiety levels during the study, Dr. Alison Woods Brooks told students their persuasive speeches would be recorded. Before delivering the speech, students were instructed to say “I am excited” or “I am calm” out loud to themselves.

Those who said “I am excited” gave longer speeches that were more competent, relaxed, and persuasive than those who said “I am calm.”

Because anxiety and excitement are both emotional states characterized by high arousal, Dr. Woods suggests it may be easier to reframe symptoms of anxiety as excitement rather than trying to be calm. When you’re feeling anxious, you often focus on potential threats. In these situations, it is more productive to try to reframe the situation and focus on potential opportunities instead of threats.

3. Accept that Anxiety May Be Inevitable

Some situations or tasks may always give you some amount of anxiety. Rather than trying to avoid these tasks or diminish the emotion, it may be best just to accept the feeling as part of the experience.

The more you view anxiety as routine and normal, the less power it can have over you. Even successful people experience fear. They just choose to find a way to persevere in spite of it. Try to remember that anxiety and fear are natural reactions. If you’re able to, choose to focus on the task in front of you rather than the fear related to it.

4. Channel the Anxiety into Motivation

[fat_widget_anxiety_left]Find your anxiety sweet spot and channel it into motivation. Research shows most people have an anxiety sweet spot where they have enough anxiety to feel alert, but not enough to feel debilitated. In this state, anxiety can be an excellent motivator. For example, if you’re worried about theft, you might lock your doors. If you’re concerned about your health, you might visit a doctor. Whatever the worry, the surrounding anxiety can often push you to do something about it.

Anxiety often results from some sort of apprehension about the future. Perhaps you’re worrying about the outcome of something you really care about. Remind yourself why it matters to you in the first place, and let that drive you forward. Anxiety has the ability to make you more alert, focused, and productive, and you have the ability to use that to your advantage.

5. Distinguish Productive Worry from Unproductive Worry

Anxiety can be either productive or unproductive. Unproductive anxiety usually amounts to worrying about things that are out of your control and may lead to an anxiety attack. If you can’t do anything to change the situation, you might be wasting your time and energy by worrying about it.

On the contrary, productive anxiety generally amounts to worry about things you do have the power to change. If you are worried about a presentation you have to give to your boss, you can acknowledge your anxiety and take the steps necessary to help you be best prepared for the presentation.

6. Decatastrophize Your Anxiety

Anxiety often stems from fear. Try to decatastrophize your anxiety by asking yourself what it is you are truly afraid of.

What is the worst possible outcome, and what are the odds of that actually occurring? When you realize even the worst outcome isn’t as bad as it may seem in your head, your anxiety may start to decrease.

7. Practice Centering

Centering is a pre-performance technique originally designed by sports psychologist Dr. Robert Nideffer in the 1970s. Centering is a 7-step process that can help you quiet the mind, focus, and gain poise.

• Step 1: Choose a focal point. Select a focal point that is below eye level to minimize distractions.

• Step 2: Set a clear intention. Your intention is your goal. What task are you planning on doing in spite of your anxiety? Whether it is a performance, work task, or creative project, clearly state your intention in positive language.

• Step 3: Breathe mindfully. Use diaphragmatic breathing to calm the body and deactivate the body’s fight or flight response.

• Step 4: Scan and release tension. When you engage in more negative thinking, the muscles in the body have a tendency to tighten. Scan the body slowly for tension, relaxing the muscles one by one.

• Step 5: Find your center. In many Eastern philosophies and traditions, it is believed the body has a specific location where the center of a person’s energy rests. By finding your center, you may begin to feel more grounded, calm, and self-assured.

• Step 6: Visualize success. Visualize yourself accomplishing your intended goal. Activate the right brain by imagining what it would look like, feel like, and smell like to achieve your desired results.

• Step 7: Direct your energy appropriately. By the time you reach the last step, you are more likely to be calm enough to channel the energy appropriately. Rather than trying to rid yourself of the anxiety completely, you can use it as inspiration.

Anxiety can be both normal and healthy in small amounts. If it becomes debilitating and is negatively impacting your life, a qualified therapist may be able to help you learn how to deal with anxiety.

References:

1. Beck, M. (2012, June 18). Anxiety can bring out the best: researchers prescribe just enough stress to ace life’s tests; too little is lazy. Wall Street Journal. Retrieved from http://www.wsj.com/articles/SB10001424052702303836404577474451463041994
2. Kageyama, N. How to make performance anxiety an asset instead of a liability. Bulletproof Musician. Retrieved from http://www.bulletproofmusician.com/how-to-make-performance-anxiety-an-asset-instead-of-a-liability/
3. MacGill, M. (2013, December 28). ‘Work with anxiety’ rather than seek calm to improve performance. Medical News Today. Retrieved from http://www.medicalnewstoday.com/articles/270641.php
4. Nisen, M. (2013, February 19). How productive people turn anxiety and fear into an advantage. Business Insider. Retrieved from http://www.businessinsider.com/how-productive-people-turn-anxiety-and-fear-into-an-advantage-2013-2
5. Porter, J. (2014, October 21). How to turn your anxiety into a productivity booster. Fast Company. Retrieved from http://www.fastcompany.com/3037338/how-to-be-a-success-at-everything/how-to-turn-your-anxiety-into-a-productivity-booster

Do you often dread parties, anxiously fearing awkward conversations that expose the contents of your mind for all to see?

Do you cringe at the thought of meeting people?

Around others, do you find yourself spinning with worry about what they think of you or how you measure up?

These are just a few of the manifestations of social anxiety.

Social anxiety can be a paralyzing, frustrating, and chaotic experience. It’s a very out-of-control feeling that can leave you very torn: torn between the human need to be social and connected to others and the feeling of wanting to run away and hide from what feels like an oppressive, all-consuming monster. It can feel as though you have no clothes and no skin—as if people can see right inside you.

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And when you’re alone again, away from the social scene, you may notice your immediate relief being slowly replaced by feelings of isolation, disappointment with yourself, and hopelessness.

Social anxiety can derive from many sources: early traumatic experiences, generalized anxiety expressing itself in particular ways, and a more sensitive disposition interacting with a highly stimulating world, among others.

In the paragraphs that follow, I want to address one aspect of social anxiety and offer some tips for how to think about and work with it. Specifically, I want to discuss how social anxiety can be a reflection of what is happening for you on the inside.

Social Anxiety as an Internal Mirror Image

If you struggle with social anxiety, you may be projecting onto the outside world what you feel inside, perhaps partially or entirely unconsciously. Inside, you may feel the (self-fulfilling) constellation of thoughts and feelings you notice in social settings:

Social anxiety can derive from many sources: early traumatic experiences, generalized anxiety expressing itself in particular ways, and a more sensitive disposition interacting with a highly stimulating world, among others.

• Anxious anticipation of socializing or being with people, about being judged or exposed, or just having to deal with awkward conversations.
• Heightened anxiety (maybe manifesting in sweaty palms, pale skin, or rapid heartbeat) in a social setting, particularly if you feel what you anticipated you’d feel: anxiety, feeling judged, awkwardness, and the feeling you don’t belong.
• Often what goes along with this, even when things are going OK, is a running inner commentary of comparison: how everyone else is NOT anxious, just you. How everyone else is able to connect and has so much to say and is so articulate, just not you.
• Depending on how difficult it gets, you may want to run, but first have to devise the best escape route in order to not attract attention.

These thoughts and feelings may echo how you felt as a child in your family of origin. If so, you may have internalized them, and now replay them in social settings of one type or another.

Specifically, as a child, you may have felt alone, anxious, and not quite adequate in relation to your family. Especially if there was anxiety, insecurity, or self-criticism in the family system, and no one was really aware of or dealing with it, you may have internalized it and made it your own.

Attending to Your Inner World

In order to reduce social anxiety, especially if the family scene I described resonates for you, it’s important to attend to your inner world in a consistent way. Here are five steps you can take:

1. In a journal, draw a line down the center. On the left, write “Family Environment” and on the right, “Social Anxiety.”
2. Spend some time thinking about your family environment. Look for any similarities you experience in your social anxiety and your childhood. Specifically, was there a lot of criticism? Anxiety? Did you feel judged? Insecure? Write your observations down in the left-hand column.
3. Track the thoughts and feelings you notice in social settings. (This is a great exercise because it distracts from your anxious thoughts and gives you an immediate tool to work with your anxiety.) Write down any repetitive thoughts and feelings you experience in the right-hand column.
4. Take some time and compare and contrast. You might be surprised how much you learn about how your past affects your present experience. Write down any insights and, especially, feel whatever feelings arise.
5. When feeling social anxiety, breathe into your belly consistently. Reassure yourself. Tell yourself that, most likely, everyone in the room is anxious in one way or another.

These are some great initial steps that may open your eyes to how your inner world, especially memories and emotion, affects your present-day experience. For more in-depth work and permanent change, psychotherapy is an excellent way to work with social anxiety because you can, in real time, observe and share your anxious thoughts with a trained professional who can help you navigate the memories and hurts that keep you from having a more satisfying social life.

While new parents frequently seek the “right way” to parent, there is no one rule book. Rather, there are many, often contradictory, guides to parenting. The lack of certainty about how to raise and care for a child can create intense anxiety for a new parent. Some learn, soon enough, that they will figure out how to be good enough parents. Others never lose an overwhelming anxiety that each decision could have life-or-death consequences. The communication of high levels of parental anxiety frequently results in children whose anxiety controls, limits, and shapes their relationships to the world.

Anxiety is an internal state that is communicated in a variety of ways. The anxious mother holding her baby can unconsciously communicate her inner agitation through her body tension and facial expressions. The young child may sense a parent’s anxiety in the parent’s frantic behavior or speech.

Eventually the child becomes old enough to be the recipient of clear expressions of anxiety in the parent’s verbal communications. The child can experience the parent’s anxiety when told, “No, honey, you’re not old enough for play dates,” or, “I don’t care if your friends can stay out until 9. It’s not safe out there,” or in the parent’s intake of anxious breath every time the child goes down the slide or falls and bruises a knee.

Repeated exposure to parental expressions of anxiety teaches children to expect that they will be vulnerable in a risky world. These lessons are not simply intellectual. They are emotional communications which often have an unconscious component: the lesson to be learned is transmitted and received unconsciously. It is a very powerful communication.

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The Inability to Self-Soothe

When parental anxiety is communicated, consciously or unconsciously, the child’s defenses are put on high alert. If parents are overwhelmed by their own anxieties and can’t soothe themselves, it can be difficult to calm and reassure their children. Without an experience of being calmed as infants, children may not develop an ability to self-soothe. They may develop anxiety, which paradoxically functions as a signal that they are in protective mode. It’s as if the anxiety is evidence of vigilance toward pending danger and thus has a calming influence.

It would be risky to let go of this essential feeling by using rational thoughts to challenge the basis of the anxiety. Instead, anxiety can be put on temporary hold with behavioral distractions that anesthetize against anxiety but don’t alleviate the feelings.

The Intergenerational Transmission of Anxiety

Kate initially came to see me two years ago because she was unhappy with her work life. She is a painter with a master’s degree in fine arts working as an administrator in an art gallery. She was doing little painting, hated her work, and felt clueless about what she wanted to do with herself professionally. She was married with a 17-year-old daughter.

Through our work, we learned about Kate’s lack of belief in her ability to be a good painter and her intense anxiety about showing her work publicly. She described a history of feeling tortured when she painted and had anxiety attacks when she had to submit work to her professors. She acknowledged that even though she won several prizes for her art and was considered very talented by the faculty, “Putting my work out there feels like I’m walking naked in the streets where everyone can see my private parts.” She never was able to initiate the showing of her work and became filled with dread the few times she was persuaded to allow her work to be seen in public.

Talking in therapy helped Kate to paint more at her small studio at home. She began to allow herself to enjoy the experience after she learned to slow down her anxious feelings and use her thoughts to calm herself. But she was clear that she thought it best to leave painting to her personal enjoyment and figure out what else she could do with her life. As we began to look further at Kate’s history, her narrative revealed her to be a person with intense anxiety about almost everything in her life:

“I’ve always had terrible separation anxiety. I went away to college, but it was less than two hours from home. I drank a lot and smoked pot from late middle school until midway through college. I over-ate, I still do. I know I’ve used these things to get rid of my feelings. I think when I started to paint and could get into a kind of Zen place and not worry about any audience, it calmed me down. That’s what probably helped with my drinking and pot smoking. But as soon as my painting was up for judgment, I would freak out. Sometimes I would skip classes or feel sick and go home for days.”

I asked how her parents dealt with her anxiety and her homecoming. Laughing ruefully, she told me, “They didn’t have a clue what to do. I made them, especially my mother, very anxious. She always seemed so agitated when I was conflicted and anxious. It was as if she didn’t want to address my issues because she didn’t know what to do, and that made her a ball of anxiety. I would feel so helpless and angry, and I think she did, too. I soon learned not to come home when I was upset. That only made things worse.”

Then Kate went silent and became tearful. I waited as she slowly began to speak. “You know, I’ve talked mostly about me and my work life in my therapy with you,” she said. “I know that my anxious mother is not news to either of us and how much that has influenced me. But I’ve been ashamed to bring up the fact I’m just like her. My daughter Erica just turned 19. She’s finishing her freshman year in college …”

Repeated exposure to parental expressions of anxiety teaches the child to expect that he or she will be vulnerable in a risky world. These lessons are not simply intellectual. They are emotional communications which often have an unconscious component: the lesson to be learned is transmitted and received unconsciously. It is a very powerful communication.

Kate paused, then started to sob and shake. “I see what’s happening,” she said. “Erica is just like me—a ball of anxiety. She calls home a lot to talk to me, not her father. I know she can feel how anxious I am about her being away at school. I don’t know if she’s calling to reassure me that she’s OK or to check in to see if I’m OK. … I’m an awful mother. I know I don’t help her and only make her more anxious. The problem is I really am scared for her. I didn’t give her the tools to take care of her feelings. Like me, she doesn’t know how to use her thoughts to find ways to counteract her anxious feelings. Worse is when she tells me her anxious feelings, I feel like the best I can do is not share my anxious feelings with her. I feel totally at a loss to offer any useful, thoughtful, soothing response.”

I was familiar with the phenomenon Kate was describing: the intergenerational transmission of anxiety. Like her mother and now her daughter, Kate’s anxiety always lurks at the edge of her emotional life. It is on call to alert her to danger and can be summoned consciously and unconsciously to send out the signal to a loved one that he or she, too, must be vigilant. What else can a good mother do? How can she not warn her child of impending danger? Kate’s mother couldn’t contain her dread and needed Kate to feel it so she could become part of the team to defend against harm. Kate needed to be sure that Erica would be able to function in the world and protect herself from all the dreadful possibilities she was at risk of encountering. While often unconscious, it is a relief for an anxious mother to know that her child is on alert and aware of the many possible threats to her well-being.

Unlike her mother, Kate had become aware of the disadvantages of being unable to manage anxiety. Her recognition that Erica’s anxiety was intensified in the presence of her own strongly contributed to her wish to disrupt this harmful intergenerational cycle. Talking with me helped her use the rational thought that “if I soothe myself and lessen my own anxiety, I will be better able to help Erica with hers.” She was determined not to perpetuate the cycle of anxiety.

Kate has begun to talk with Erica about what she has learned about the intergenerational transmission of anxiety. They have had some honest and painful discussions about the ways they each make the other anxious and have needed the other to mirror their anxiety so they could feel better. Erica has decided to begin her own therapy, and Kate continues to work with me on becoming more comfortable with all her feelings and the feelings she evokes in others. She is slowly developing a greater tolerance for her negative feelings and the negative responses she has been protecting herself from for so many years. When she experiences the anxieties of her mother and daughter, she has started to think thoughts that help her to remind herself that she is a separate person with her own feelings. She can say to herself, “I’m not the same as you. I see you are anxious and scared, but I don’t have to be. These anxieties are not rational, and I don’t have to be in that irrational-feeling space.”

This is hard work for Kate, but the strong wish for her daughter to be free from the same anxiety that has debilitated her is strong motivation for Kate to continue her struggle for change.

Note: To protect privacy, names in the preceding article have been changed and the dialogues described are a composite.

Having a mental health issue can be very isolating. You may feel like no one understands the pain and despair you experience. Because of this, you might keep your condition to yourself, confiding in no one. This is not uncommon.

The stigma surrounding mental health doesn’t help. Many people are hesitant to open up about their struggles out of concern for being judged and thus go to great lengths to hide their conditions from coworkers, friends, even family members.

People with depression and anxiety, among other issues, often isolate because of lack of energy or because they are unsure how to get support. Being open about a mental health condition constitutes taking a risk, which can feel scary. Not everyone may be supportive, some people don’t know how to help, and some people in your life may choose to remain ignorant.

A mental health condition has nothing to do with what kind of person you are. It doesn’t mean you overreact to things, that you’re “just” feeling down, that you’re incompetent, that you’re weak, or that you’re “crazy.” Just as people who struggle with a physical health issue need and deserve support, people with a mental health issue need and deserve the same.

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Contacting a therapist is a great step in the right direction, of course, as a professional is best positioned to help you understand the factors contributing to what you’re feeling and can point you toward helpful resources. He or she can’t replicate the compassion and empathy of close friends or family members, however.

So how can you find the support you need? Here are five considerations to help you get what you need when you need it most.

1. Learn as much as you can about your condition so you can explain to others what you experience. Many people’s only source of information about mental health is what is portrayed in the media, which more often than not is inaccurate or even demeaning. But if you can describe what it’s like to live with bipolar, for example, you can inform others and help them understand how they can best support you. By educating yourself, you can educate others.
2. Identify someone you think might be a support to you. Whether a friend or family member, this should be a person you trust, who has displayed compassionate tendencies in the past. Again, not everyone will understand, want to understand, or be able to help.
3. Think about what you hope to get out of the conversation you will have with this person. Are you looking for someone to vent to (“Work was so rough today that I spent 30 minutes in the bathroom crying”), or would you like help solving a problem (“I’m so anxious that I need help getting to the grocery store”)? Be specific about what you need and why you need it: “I’m feeling really stressed right now and could really use someone to talk to,” or, “My depression is making it hard for me to get out of bed each day and take care of my house and family. Do you have any suggestions?” Practice asking for what you need.
4. Recognize that some people may be better at supporting you than others. The first person you confide in may not understand. Keep sharing until you’ve found the person or people who can support you. If someone you asked for help cannot follow through, understand that it’s not something you’re doing wrong. They may be dealing with their own struggles and simply not have enough energy or wisdom to help you with yours.
5. Don’t rely on just one person. Try to build a support network, one person at a time. This way, if one friend or your partner can’t talk right away, there are others you can reach out to.

It should not go unacknowledged that, for some people, finding support is exceedingly difficult. People whose pool of family and trusted friends is limited or nonexistent may feel like they have no one to turn to. However, there is always someone who not only will listen but wants to listen—whether it’s a therapist, a pastor or church member, or someone who volunteers for a crisis line. There is always support. The key is summoning the strength to ask for it, something everyone must do at one time or another.

Mental health conditions are very common, so keep sharing; chances are, sooner or later someone you confide in will have dealt with their own struggles. You shouldn’t have to go it alone. Each time you are open about your condition, you decrease the stigma and ignorance surrounding mental health issues. Little by little, we can change the world.

This is a picture of a child experiencing selective mutism—children who speak to certain people in certain situations (most commonly immediate family members inside the home) but are otherwise silent.

For parents of children with selective mutism, life can be frustrating. They are often led down a path of incorrect diagnoses, including autism, language disorders, or oppositional defiant disorder. Some are given no diagnosis at all and are reassured by well-meaning doctors, teachers, family members, and friends that their child is “just shy” and “will grow out of it.”

The reality is that children with selective mutism do not grow out of the anxiety that prevents them from speaking. They are typically diagnosed between the ages of 3 and 6 and, without treatment, spend their childhood and adolescence struggling to answer teachers’ questions, talk to peers, and get help when they are hurt. This can sometimes result in academic underachievement, social isolation, and low self-esteem.

[fat_widget_right]The good news is that effective treatments for selective mutism exist. The first step is an assessment by a qualified psychologist or mental health practitioner. Learning more about the condition can also help improve the quality of life for both the child and parents. To help facilitate that important step, here are 10 dos and don’ts for parents of children with selective mutism:

1. DO Understand That Selective Mutism Is Not a ‘Choice’

When children do not speak despite having language skills at home, it can seem like an act of defiance. Children might act silly, become aggressive, growl, freeze, or appear to simply ignore whoever is speaking to them. It is important for parents to recognize that these behaviors are based in anxiety, not oppositionality.

2. DO Lay off the Questioning

For children with selective mutism, speaking is hard. When you see your child clamming up, lay off the questions. Pushing them to speak will only increase their anxiety and reduce the likelihood that they will be able to talk.

3. DO Describe and Praise Their Behaviors

When you see your child becoming anxious in a speaking situation, you can take the pressure off by simply describing what you see your child doing and praising their efforts to participate in activities, whether verbally or nonverbally.

4. DO Give Your Child Time to Speak

Often, adults ask children questions in a rapid-fire format with little breathing room in between. Children experiencing selective mutism often have a delay before speech, so always wait at least five seconds after you ask a child with selective mutism a question to give them a chance to answer.

5. DO Notice Your Own Reaction to Your Child’s Silence

When a parent sees their child freeze or hide when asked a question, it will likely be that parent’s natural, caring response to speak for the child. This may reduce both a parent and child’s anxiety, but it can also prevent the child from overcoming mutism.

6. DON’T Offer Rewards for Something Your Child Can’t Do

Since mutism is not a choice, but rather an inability to speak driven by anxiety, asking your child to speak in exchange for a reward is like offering your artistic spouse a million dollars to complete a calculus question. It comes from a place of kindness, but is rarely helpful.

7. DON’T Try to Understand the ‘Rules’ of a Child with Selective Mutism

Children with selective mutism may speak to one teacher but not the other, their grandmother but not their grandfather, one of four aunts, and so on. Children with selective mutism divide the world into those people, places, and activities in which they speak and those in which they do not. These boundaries are rigid, and trying to understand the why behind your child’s rules may only cause frustration.

8. DON’T Expect ‘Please’ and ‘Thank You’

I applaud those parents who are unwilling to accept that their child should suffer in silence and encourage all parents to persevere in their search for treatment in the face of being repeatedly told, “Your child is just shy.”Courtesies such as please, thank you, hello, and goodbye may be some of the most difficult words a child with selective mutism will learn to say. Unfortunately, they are also the words parents often push for the hardest because they don’t want their child to be perceived as being rude. The reality is that these children are anxious, not rude, and most will grow up to be thoughtful, polite adults.

9. DON’T Criticize Your Child

This one seems obvious, but criticism can hide in seemingly innocuous phrases. “You spoke so well last week. What’s going on this week?” or “Look how your brother is talking, can you try to be like him?” may not sound overtly critical to parents, but are often experienced as critical by children.

10. DON’T Give Up

Many children with selective mutism never receive appropriate treatment. Many parents who seek help for their children report their own struggles with selective mutism throughout their lives. I applaud those parents who are unwilling to accept that their child should suffer in silence and encourage all parents to persevere in their search for treatment in the face of being repeatedly told, “Your child is just shy.”

Acknowledgement: Adapted from the work of Dr. Steven Kurtz.

References:

1. American Psychiatric Association. (2013). Selective mutism. Diagnostic and statistical manual of mental disorders (pp. 195-197) (5^th). Arlington, VA: American Psychiatric Publishing.
2. Stanley, C. (n.d.). The top ten myths about selective mutism. Selective Mutism Group. Retrieved from http://www.selectivemutism.org/resources/library/SM%20General%20Information/Top%20Ten%20Myths%20about%20SM.pdf

’Tis the season for ghosts and goblins and creepy crawlies real and imagined … so I want to talk about one of the human mind’s scariest inventions, one nearly all of us believe in from time to time.

The bubble.

As in, “I’m just waiting for this bubble to burst.”

What, exactly, is the bubble? For many, it represents a happy time in life, a time when things are going well or some relief from a problem has been realized, a too-good-to-be-true moment or relationship. But it comes with a nagging feeling, a sense that it will all come crashing down at some point. People are uneasily content inside their bubbles; believing it could burst at any moment creates anxiety, fear, and worry. They fret themselves into pretzels and struggle to appreciate good fortune because they are so preoccupied with the possibility it will end.

I’ve seen people finally meet the partners of their dreams, only to walk around terrified that their new love is too perfect, the relationship too easy. They find themselves “waiting for the other shoe to drop.” I’ve seen mothers with healthy, beautiful families who, on the one hand, talk about how much they love motherhood and how thankful they are but, on the other, are so terrified their kids will get sick or injured that they spend most of their time researching symptoms online and seeking reassurances from doctors’ offices.

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At first glance, these two examples might seem to have nothing in common—a type of self-esteem issue and a form of hypochondria—but both are signs that a scary-feeling bubble of sorts has taken over and prevented each person from fully enjoying what they have.

There are many interesting things to discover about each person’s unique bubble. For someone in a new relationship, we can talk about the joys of the “honeymoon” phase and how important it is for lasting connection. We can talk about the person’s belief that he or she is not worthy of a good relationship. For the mom with an overly involved parenting style, we can connect to her sense of responsibility and her deep love and desire to protect her children. We can gently poke at the bubble and remind these folks that, like all creatures, they deserve good things in their lives and don’t have to “pay” for them with bad fortune later.

Indeed, bad fortune does come to some of us some of the time, but the bubble doesn’t prepare us. We might look back and say, “Oh, I knew my luck would run out” or “The relationship was bound to fail at some point,” but the bubble didn’t help matters. It’s imaginary. We invented it out of thin air.

More importantly, the bubble doesn’t protect us from anything. It just causes us stress. The bubble is our safeguard against all that we fear: as long as we put ourselves in this happy bubble over here, but feel impending doom (or at least some alternative, negative reality) over there, we can stay in a fantasy.

Yes, terrible things may happen from time to time, but this anxious mind-set—the bubble—does not keep terrible things at bay. Creating a doom-filled scenario for the future does not protect our happy state right now.

There is no bubble. All of these feelings and states and phases in our lives are just part of our lives.

We have grown accustomed to the idea that there is a “honeymoon” phase at the beginning of relationships and that it’s not a bubble that bursts. It is a stage that we can be grateful for, one that graduates to something else. Similarly, we should get used to the fact there will be times of health, connection, and success without expecting “payback” down the road. Just because something wonderful is happening in our lives doesn’t mean it must be followed by something terrible.

Yes, terrible things may happen from time to time, but this anxious mind-set—the bubble—does not keep terrible things at bay. Creating a doom-filled scenario for the future does not protect our happy state right now.

The best we can do when things are going well, when we have healthy children or a flourishing relationship, is to stay mindful of what we have and enjoy it. Spend more time flourishing, enjoying your good health, and cultivating happy things. This is the cornerstone of a solution-focused mind-set.

Here are some ways I help people in therapy through their bubble mind-sets:

• Use anxiety as a reminder to feel gratitude. When you think, “Nobody’s gotten sick yet this winter, so a bad flu must be on its way,” use this as a reminder to feel grateful for the health your family has enjoyed so far, and to keep doing what’s working to keep you all healthy. Try hard to translate what’s working into actual behaviors.
• When the bubble tells you that this can’t last, counter it. Identify the ways it’s trying to make you nervous, then challenge it by saying, “Nothing lasts forever, so I’m going to enjoy what I have right now. Being worried about when it will end isn’t going to help me cope in the future and will make it harder to enjoy this time.”
• Spread your confidence and gratitude to others. When you hear someone expecting the good in their life to end, counter it. Point out that nobody deserves bad fortune, and encourage the person to enjoy what they are experiencing as long as they can.
• Seek therapy and support when bad events do happen. Perhaps the worst thing about the bubble mind-set is it allows for bad fortune to feel like it makes sense. If we believe we are in a bubble that can be popped by bad luck, a wrong move, or negligence, it may always seem like we are doomed. Partnering with a counselor can help challenge this line of thinking and get to work on solving the actual problem: the bad event itself.

Remember, bubbles are every bit as imaginary as ghosts and goblins. Happy Halloween!

It never fails: When August rolls around, parents begin calling the office. They are calling about their child, who made so much progress toward the end of the previous spring that we reduced or eliminated sessions. But as soon as the back-to-school supplies show up in stores, sleep patterns are disrupted, instances of acting out increase, and general chaos begins.

The children I see in my office often don’t realize why they are feeling so dysregulated. They blame situations with friends, their siblings, and their parents to externalize the cause for their behavior. Sometimes parents don’t even recognize the cause of increased anxiety. As I start asking questions to try to dig toward the cause of the change, I’ll hear tell-tale signals that school anxiety is building beneath the surface. “She’s crossing off the days on the calendar until school begins,” or “He asked if he could send an email to last year’s teacher.”

[fat_widget_right]Other children are very aware that their anxiety is related to school, and they process it outwardly. Every day, they express concerns about not knowing their new teacher, dread the amount of homework they are going to have, or worry that they might miss the bus on the first day of school. The caretakers of these children may quickly become overwhelmed because usually they can give no answer other than, “We’ll find out when school begins.”

What can parents do to help their anxious children transition to the new school year? How can children who don’t recognize how much a new beginning worries them begin to accept and embrace the new adventures that each school year brings?

1. A change in behavior prior to or following a major transition could be related to anxiety.

When a child begins to fight more frequently with a sibling or talk back to parents, take a step back and ask what may be going on in that child’s life. Beginning a new school year is a major unknown for a child, even if the child has attended that school previously. Getting used to new teachers, new classmates, and new routines can be daunting, even for a child who doesn’t experience anxiety. Imagine starting a new job. Your worries about a new boss, different coworkers, and changing responsibilities are likely to be very similar to your child’s concerns about the coming school year.

2. Recognize psychosomatic symptoms as possible signs of anxiety.

If your child begins complaining about stomachaches, headaches, or any other maladies, realize that this may be a signal they are experiencing anxiety. If a child is anxious, they may truly have a headache, but consider finding ways to relieve the anxiety instead of only treating the headache medically, as this is likely to have more long-term benefit. Mindful breathing or guided visualization can be great tools to help alleviate this type of stress.

3. Confront the conversation directly.

Parents often want to keep the peace in the days leading up to the first day of a new school year. However, prepping your child for the upcoming change and talking about the transition can be beneficial. Ask what types of school supplies your child wants, have the child visualize an ideal classroom, and encourage the child to discuss ways to react in case things don’t go exactly as planned. By bringing up the conversation gently, parents have the opportunity to encourage verbalization and reassure their child of their ability to handle the situation.

4. Try not to allow avoidance.

Ask what types of school supplies she or she wants, what a perfect classroom would be like, and what their plan is if things don’t go exactly as they would like. By bringing up the conversation gently, parents have the opportunity to encourage verbalization and reassure their child that they can handle the situation.The primary thing anxiety drives a person to do is avoid the anxiety-provoking situation. When your child says, “I don’t want to go shopping for school supplies,” break it into smaller segments, such as only going to pick out a backpack. Leave the rest for another day. By encouraging your child to push through anxiety, you help build the belief they can succeed during this transition.

5. Ask the school for help.

Talk to the teacher. Talk to the counselor. Give them a heads-up about what your child is experiencing. They may have a plan in place or ideas to try to help acclimate your child to the new school year before it begins. If your school hosts a “meet the teacher” or “back-to-school night,” you may choose to request a separate time that your child can drop off supplies and meet the new instructor.

6. Use guided visualization.

Take the time to write out a script with your child about how the first day will go, from the time the child wakes up to the return home. Focus only on the positive aspects of the day. At bedtime each night, either read the script to your child or have the child read the script, imagining every portion of the day in detail. When your child arrives at the situations in the script that tend to trigger anxiety, encourage mindful breathing for self-regulation and help the child visualize how to handle those obstacles while at school.

Generally, students settle into a routine within the first few weeks of school, and their anxiety subsides. However, if you notice that your child is still experiencing trouble after the first part of the school year, reach out to your school or to a professional counselor who can help you and your child learn more in-depth coping skills to handle these intense experiences.