Catriona Larkin is a Cognitive Behavioural Therapist, who works at Plus Blackrock in Dublin. Here she gives some advice for managing anxiety, stress and worries.
–The C in CBT is “cognitive” – the way that we think and take in information. It’s about how we interpret events, influenced by the beliefs that we hold about ourselves and the world. For example, if you’re a person who feels inadequate, criticism will mean a lot more to you than to someone who’s confident.
–The B is the behavioural bit, how we respond to our distress. If you feel really scared of something, your instinct might be to avoid it, or to do something to give yourself a sense of safety. However, this can reinforce your fears, or negative thinking.
–The story of how we feel and think about ourselves starts on day one, and as we grow up we develop strategies, rules to survive and get our needs met in the world. However, all too often those rules are rigid: “I must make sure I’m nice to everybody, or I’m a horrible person;” or “I must do everything perfectly or I’m a failure.”
–We all have a unique story about how we feel the way we do, but our thoughts and beliefs are not facts. Everyone has a “not good enough belief” at some strength. You need to remember that many core beliefs about yourself were formed in childhood. And the child who believed they weren’t good enough also believed other things that weren’t true, like who put presents under the Christmas tree.
–The key is understanding why we might feel, think, and even physically react, a certain way, and then to challenge our interpretations. For example, if I’m thinking, “I’m not good enough because my boss said I did something the wrong way,” that’s an inaccurate, distorted interpretation, because everybody does things wrong.
–Accept the way you are. Most of us don’t. We are the way we are through a combination of genes and experiences – experiences we have little control over. We don’t choose our parents, or where we grow up, or the pool of people to find friends from, and so on. And yet we’re so judgmental about ourselves. Practicing acceptance doesn’t mean we don’t try to change or work on things, but we do it kindly and non-judgmentally.
–Start by normalising feelings. A lot of people think that you should feel happy all the time, but nobody does. Feelings are crucial for human survival. Emotions act as signals when things are not okay, and need our attention. The problem is when they get stuck, which happens when we think and behave in unhelpful ways, particularly with anxiety.
–Anxiety is about perceived threat. If we feel anxious and fearful, our caveman brain is basically signalling “danger”. Despite evolution, our brains still only know how to deal with danger by getting ready to fight, or freeze, or flee. However, there’s no one to punch, or it’s not appropriate to run away. It’s really helpful to identify why you’re anxious, what your brain is interpreting as dangerous. For a person with social anxiety it might be about being judged negatively. For someone with OCD (obsessive compulsive disorder), it might be having to prevent harm coming to other people. Someone with health anxiety may fear there’s something wrong with them.
–Once you understand why you are anxious, examine the accuracy of the threat. People tend to overestimate the chances, and extent, of bad things happening; and to minimise their ability to cope.
Responding to thoughts
–How you respond to your thoughts is really important. If somebody with social anxiety never speaks in public, then that keeps the problem going forever. Or somebody who’s depressed may withdraw from people, because they think nobody cares about what they have to say, but that reinforces their belief, and they spiral down and down. It’s about breaking the cycle so you can think more realistically. It’s not about positive thinking. It’s not about replacing your negative thoughts. It’s about realistic thinking.
–Don’t believe everything you think. As Shakespeare’s Hamlet said: “...there is nothing either good or bad but thinking makes it so”.
–Humans have many typical thinking errors. They include catastrophising/overestimating the chances of disaster. With rigid black and white thinking, things are either good or bad; there’s no middle ground. One I come across often is jumping to conclusions, where people presume they know what’s going to happen, as if they have a crystal ball, or mind-reading, assuming they know what someone else is thinking: “I know they don’t like me.” Another big distortion is where people have a list of “shoulds”: “I should be nice to everyone,” or “I should be able to do this.” A simple tip is to change “shoulds” to “coulds”, for example, “I could be able to do this.”
–To escape those thinking patterns, first catch and name what you’re doing. We often already know the answers to correcting these errors, because it is exactly the stuff we’d say to our friends, or to people we love, who were being really negative about themselves, or “mind-reading”.
–Separating problems from worries is really helpful. A problem has to be currently happening, or within your control, versus a hypothetical worry which is not currently happening and not within your control. If you’re going on holiday in the morning and you haven’t packed, that’s an actual problem; versus sitting worrying there might be a pile-up on the M50, or the plane might crash. We have to let worries like these go. That can be very hard for some people. But we need to tolerate the stuff we don’t have control over. We have to accept that the world is uncertain.
Time to worry
–Try postponing worries. I use the analogy of putting worries into a rucksack. You carry it, and sometimes you forget it’s there. Then you can sort through what’s in the rucksack at an allocated worry time.
–Set aside time to problem solve. We go around all day with things spinning in our heads; we’re not constructively thinking things through, or deciding on a healthy response.
–Ruminating and worry are both kinds of overthinking, but worrying is about stuff that hasn’t happened yet, and ruminating is about stuff that has. You’re not going to gain or change anything by going over and over some mistake you’ve made. It just makes you feel worse. Work on bringing your attention back to the present, to what’s in front of you.
–One important technique we all need to learn is pressing the pause button, before we act or blurt things out. It doesn’t usually end well when we act in emotion. Mindfulness is all based on this idea that we don’t just react, that we choose a behaviour. The key is that pause button.
–So whether you’re being criticised at work, angry with another driver, or stressed getting the kids out to school, pause and reflect. If you don’t, you’ll react in emotion and probably shout at the kids. Name what you are feeling. And then be curious: “What’s going on that has me feeling this?” If it’s something you’re anxious about then you’re obviously perceiving danger. If it’s something you’re sad about, you’re probably perceiving loss. If you’re angry, you’re perceiving injustice. The feelings are the hints about what’s going on in your mind. Once you have an awareness, you can evaluate and choose a behaviour based on logic, rather than emotion – one less likely to get you fired, or to lose sleep over. It’s hard to do, but so useful when we get the hang of it.
–Our minds are like Velcro for negative information, but like Teflon for the positive. Many people keep gratitude logs, but try a positive data log. Every day you reflect on the things that you did well, and the positive things that happened, and what that must mean about you as a person. For example, “A friend texted. That means I’m likeable.” It’s not about positive thinking. It’s about allowing the positive information in.
Weighing up stress
–Stress is when your demands outweigh your resources. It’s like a weighing scales. Everything you have to do: getting up on time, commuting, talking to people, parenting, caring… all that stuff is on one side. When that’s really heavy, you have to balance it with resources, everything from your health, to getting exercise and enough sleep, to having a laugh. Laughing is underrated. Fun is underrated. We release so much pent-up stress with a good belly laugh. We all need to go to comedy clubs more.
–If the scales are tipping, you've got to notice and bring it back to balance or you will end up getting anxious or low, or whatever health-related issues comes with that. Look at your life and the things weighing you down. Ask which actually matter to you? Pick off those that don't, or else you've got to add to your resources to cope. It could be a walk, an hour or two of Netflix when the kids are in bed, or listening to music in the car, but it's the time when you allow yourself to breathe, and don't think about all the "shoulds" you should be doing.
