Your anxiety in specific situations is perfectly understandable if you are aware of the thoughts or beliefs that fuel it.
Social Anxiety
“She’ll laugh at me if I talk to her… I’ll be devastated”
Panic Disorder
“It’s dangerous to have a panic attack”
OCD
“If I have a violent thought, I’m likely to act it out”
Phobia
“Flying is dangerous”
Anyone who has such thoughts is likely to be anxious in certain situations. Therefore these can make an anxiety disorder worse. So what do you do?
You could try positive thinking. There was a Saturday Night Live character, Stuart Smalley, who would look at his reflection and tell himself, “I’m good enough, smart enough, and darn it, people like me!” The problem is that you’re not buying it…and it might not be true. You’ve heard of the expression, “You can call poop a rose, but it still stinks.” If you believe that life has stuck you with a pile of poop, no amount of calling it a rose will sweeten the smell.
So, if positive thinking is not the answer, what is?
You could try Adaptive Thinking. Pessimists, as you probably have heard, view a glass of water as half-empty; the optimist views it as half-full. The Adaptive Thinker observes an eight-ounce glass with four-ounces of fluid in it. It’s hard to disagree with observable, measurable reality.
Adaptive Thinking is another name for a Cognitive Restructuring, a technique invented by Dr. Aaron Beck, a pioneer in the field of cognitive therapy. Basically, it involves taking a painful or scary thought or belief and looking at it in a more realistic or helpful way. Since it is typically your scary thoughts and beliefs that trigger your anxiety, changing those is likely to improve your anxiety disorder.
Sometimes, it is helpful to write (or type into a word processer) your anxious thought and then pick it apart in a structured way. The goal is to create a new Adaptive Thought utilizing a “Thought Record”. I have my own format for this that I like to use with my clients, though there are other formats that are equally good.
Here’s how you do it:
Step 1
Record your automatic thought or belief that triggers your emotional discomfort.
Examples- “I am unlovable…I am likely to pass out, die, or go insane from a panic attack…flying is incredible dangerous…Everyone thinks I am a loser…If I don’t monitor my thoughts for violent content, I am likely going to snap and hurt someone…I probably have HIV that the doctors have missed…If I don’t ace this test then my career plans are ruined!”
Tip- If you have a difficult time identifying your uncomfortable thought/s then try to imagine you are in your anxious situation (or wait until you are actually in it). Bringing up the anxiety in the moment tends to make the scary thoughts much more noticeable. Then, while you are anxious, write down all the fears you are having. You should then have a list of your “hot thoughts” for you to work with.
Record the emotion triggered by the thought (typically anxiety, sadness, anger, or a combination)
Record how much you believe the thought from zero to one-hundred percent
Step 2
Analyze
Ask yourself a series of thought provoking questions designed to make you think differently about your automatic thoughts and beliefs. Record your answers.
Here are some examples. Note- they do not all apply to every type of thought. Select those questions that are relevant to your thought.
- What are your Thinking Traps (AKA cognitive distortions)?
- What is the objective evidence for and against your thought (note- “Because it feels like it is NOT evidence”)? How would a judge rule based on the evidence? Why?
- If you do not believe your thought 100%, why not?
- Are you so sure of your thought that you would bet a million dollars? Why not?
- Would other people agree with your thought? Why not?
- Would you hold other people to that standard? Why not?
- Would you think the same thing about (enter name of someone you love) if he or she had that thought? Why not?
- What are the advantages and disadvantages to keeping this thought?
- What are some other possible ways of looking at the situation?
- Do other people share responsibility?
- If it were true, would it be possible to cope or even accept the situation and make your life as good as possible anyway?
Step 3
Take the information obtained on Step 4 and generate a new, more adaptive thought.
Record the emotion triggered by the new thought (typically anxiety, sadness, anger, or a combination)
Record how much you believe the new thought from zero to one-hundred percent
Adaptive Thinking can be a powerful method of anxiety management. It is best when used in conjunction with exposure with response prevention therapy (ERP).
Caution is recommended when using Adaptive Thinking for treating OCD. One of the primary goals of OCD treatment is to enhance your ability to tolerate and accept uncertainty. If you use Adaptive Thinking to try to become 100% certain that your fears will not come true, then you may be playing into Anxiety’s hands (perhaps making Adaptive Thinking into just another OCD ritual). Therefore seeking the guidance of an OCD treatment specialist may be warranted.
For further reading on using Adaptive Thinking (AKA cognitive restructuring) try Mind Over Mood: Changing the way you feel by changing the way you think, by Dennis Greenberger and Christine Padesky, Robert Leahy’s book entitled The Worry Cure, or Feeling Good: The New Mood Therapy Revised and Updated by David Burns
Eric Goodman, Ph.D.
Case Example
“Bobby” is a twenty year-old college student who has social phobia and is terrified to take the public speaking course needed to graduate.
My Thought: If I mess up during a speech, the other students will laugh at me and I’ll never be able to show my face in class again and I’ll never get over it!
Emotion/s: anxious, worried, helpless
- What are your Thinking Traps (AKA cognitive distortions)? Catastrophizing, fortune telling, emotional reasoning
- What is the objective evidence for and against your thought (note- “Because it feels like it is NOT evidence”)? How would a judge rule based on the evidence? Why?
- Evidence Supporting My Thought:
- When I was in 3rd grade some classmates laughed at me when I gave a presentation
- People can be mean
- Rejection really bothers me
- Evidence Against My Thought:
- In 3rd grade only some of the kids laughed…and they laughed at other kids too
- When I gave a presentation in my psychology class, I was nervous but it went ok
- I don’t think about the time in 3rd grade very much—I’m over it
- Even if I get laughed at, I can still force myself to go back
- Even though people can be mean, most are not
- If you do not believe your thought one hundred percent, why not? I haven’t gotten laughed at in a long time. It may not happen even though I am terrified it will.
- Are you so sure of your thought that you would bet me a million dollars? Why not? No, there is a good chance I will lose.
- Would other people agree with your thought? Why not? No. People have told me that I did fine when I presented in the past, some have even complemented me (though I thought they were just being polite).
- Would you hold other people to that standard? I’m ok when other people make mistakes when presenting. They don’t have to be perfect, but I feel I have to be.
- Would you think the same thing about (enter name of someone you love) if he or she had that thought? I’d tell them that it is normal to worry before a presentation and that they will do fine. Besides, half the class is napping or texting during presentations anyway.
- What are the advantages and disadvantages to keeping this thought?
Advantages: If I worry, I might prepare harder. If I keep this thought and I do get laughed at it won’t catch me by surprise.
Disadvantages: I tend to waste a lot of time over preparing. I’ll be miserable. I’ll feel anxious and maybe depressed. I’ll worry every time I have to do this and it will interfere with my career and social goals.
- What are some other possible ways of looking at the situation? I might do fine. People may not laugh. The people who pay attention actually may want to hear what I have to say and not care if I am not a polished presenter.
- Do other people share responsibility? I would never laugh at someone making a mistake during a presentation. If others do then they are behaving badly. If I get laughed at it says more about their failings than my own.
- If it were true, would it be possible to cope or even accept the situation and make your life as good as possible anyway? I have dealt with worse things in life. I could cope and live with it. I won’t see those people again after the semester is out anyway.
My Adaptive Thought: Even though I worry that people will reject me if I mess up, it is unlikely to happen. If it did happen, I wouldn’t like it, but I could certainly cope. I have gotten over worse in the past so I could likely handle this.
Emotion/s: Relieved, hopeful
I believe this Adaptive Thought 90%.