If you struggle to cope with anxiety, I guarantee you have developed patterns of avoidance to minimize feelings of distress. The current prevalence of trigger warnings accompanying TV shows, live performances, and social media posts may make avoidance appear to be an appropriate strategy. But protecting yourself from potential triggering content or situations will only heighten your anxiety, make it harder to tolerate in the long run, and seriously affect your enjoyment of life.
I am not suggesting a head-first plunge from the high board into the deep end of the anxiety pool as a means of overcoming trauma or unpleasant feelings. You can start at the shallow end, dip a toe in, and then ease in slowly, if the gradual approach suits you better. Ultimately, though, you have to get wet.
Minimizing avoidance is the rationale behind Exposure and Response-Prevention treatment, the primary evidence-based behavioral treatment for OCD and other anxiety-driven syndromes. There is even a protocol called Prolonged Exposure used to treat PTSD symptoms stemming from serious traumatic events such as combat. Any type of exposure treatment involves seeking out triggers and learning to tolerate the discomfort they provoke (or, in the case of Prolonged Exposure for PTSD, reliving the trauma over and over by visualizing it repeatedly).
For debilitating anxiety or trauma, you should undertake exposure exercises only with the support and guidance of a qualified professional. But if you see yourself opting out of situations that simply make you uncomfortable, such as social events, driving, or even shopping at a different grocery store, you can find opportunities to push yourself toward the discomfort every day.
Whenever I catch myself finding excuses not to engage in an activity that makes me nervous, I try to practice what I preach and do it anyway.
In the fall I organized a group of neighbors to play Pickleball. We were all beginners, equally clumsy and clueless, and it was fun. But then an injury sidelined me. I didn’t play again for four months, until a few weeks ago, when I was invited to join a group of regular players. Most of them play daily. They are at a level far above mine, and they are very competitive.
Despite considerable trepidation, I forced myself to go. I was embarrassed by my lack of skill and felt myself transported back to middle school, when I was the last to be picked for the team in whatever sport we were playing. I am not exaggerating when I say I felt close to tears.
I really wanted to make an excuse never to return. Which is exactly why I forced myself to go back the next week, and then again a few days later.
I am still the weakest link but my skills have improved. More important, I am proud I didn’t let my feelings of awkwardness and discomfort get the better of me. I may or may not keep playing with the group, but if I choose to stop or look for other, less intense Pickleball partners, I can be confident I am not letting anxiety drive my decision.
So get out there. Force yourself to do whatever your anxious brain is telling you to avoid. Don’t let it boss you around. You will be glad you pushed back and stopped letting anxiety control you.
My newly rescued terrier Dewey is, in almost all ways, an excellent dog. He’s energetic, inquisitive, friendly, and affectionate. But when we’re out walking and he spies another dog, he turns into a whirling, barking Tasmanian Devil. Luckily he weighs only eighteen pounds—any bigger and he’d knock me off my feet. Still, the prospect of a surprise canine encounter made me dread our daily outings.
So I signed up for a Distracted Dog class. I already had been working on undoing some of the bad habits Dewey had acquired over the seven years of his life before coming to us. He’s learning how to wait for his food, lie down instead of jumping up and begging, and walk on a leash without pulling. The challenge now is to keep his attention on me in more stressful situations.
Before the first day of class, our instructor asked us to send her a hierarchy of our dog’s top five distractions, much like the hierarchy of anxiety triggers used in CBT for exposure and response prevention. At the top of Dewey’s list was “seeing another dog approach while on a walk.”
In treating anxiety, I help people stop avoiding and start approaching what they most fear. I needed to apply the same mindset to changing my dog’s (and my own) reactions to the stimuli that send him into a frenzied display of doggie frustration.
So, instead of anxiously scanning the environment for other dogs in order to do an about face before Dewey spots them, I’ve started looking for ways to practice building his self-control. As a result, I’ve observed a dramatic change in my own (if not yet Dewey’s) emotional reaction. I’m excited instead of tense when I see neighbors out walking their dogs. I now interpret a potential trigger not as a threat to steer clear of but as an opportunity to seek out.
If I were drawing only from my personal experience, my method wouldn’t carry much weight. But the results of several research studies support my anecdotal evidence. Saying, “I feel excited” instead of attributing physical arousal to anxiety—a technique called “anxious reappraisal”—can improve singing, test-taking, and public speaking performance by putting people in an “opportunity mindset” even though the physiological markers of anxiety such as increased heart rate and cortisol levels remain elevated.
In fact, you don’t even need to tell yourself you’re excited; just believing that anxiety can improve rather than impair performance helped test takers score higher on the GRE. It’s a trick actors often use to cope with stage fright. Those who are successful don’t necessarily feel less nervous. But they’re able to view the fluttering of their hearts and rumbling of their stomachs as feelings that give energy to their performance.
Confronting anxiety is hard. You can’t make progress unless you’re willing to face the situations you fear. But changing the way you think about arousal might make it a little easier to rise to the challenge.
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