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Please note this is not an exhaustive review. It is important to seek professional guidance. While there is a prescription for treatment of anxiety we adopt as practitioners, how we get there is tailored to what we learn about you in therapy. There are tweaks that may make sense based on how you experience anxiety, your personal history, learning style and medical history.
When I think about anxiety, I try to understand the function of anxiety, how is it helping and how it is hurting. The function of anxiety relates to what is it doing for us. Is it helping you to perform? Is it overwhelming you to the point of paralysis? Is it protective? Is it motivating? Usually, we think of it in one way— debilitating. However, anxiety plays an important evolutionary and protective role that is needed (The Mind Explained: Anxiety Explained on Netflix). Without it, we wouldn’t be able to engage in protective behaviors that can be lifesaving in the face of real threats. Disorders emerge when this mechanism for protection is constantly on and we are in a constant state of alert. Anxiety becomes problematic when our bodies are in a constant state of arousal, whether threats are real, imagined or low.
One of the clinical presentations I see for anxiety is hyperfocus. When I see hyperfocus in therapy, I often refer to it as a tunnel. Some people refer to the experience as going down a “rabbit hole”. Both speak to the idea of tunneling in and only seeing one thing. This tunnel is restrictive, disorganizing, suffocating, and binding, forcing one to see only one thing—harm. While it is an attempt to gain control and protect, the process ironically generates harm leading to negative physical consequences medically (e.g. poor sleep, dysregulated appetite, high blood pressure, hypertension, increase in cortisol) and emotionally (i.e. generalized anxiety, panic disorder, depression).
Imagine you are walking through a museum. You view a painting through the hole of a rolledup paper, that looks like the inner tube of toilet paper. How much color can you take in from that hole? How much of the artist’s story are you able to see? You probably can’t see a lot. Widen the circle and you see more. You get more detail, more color, more perspective. When you are experiencing intense anxiety, the idea is to increase the amount of details at your disposal in order to see more fact-based details. Even if the one detail you are seeing through hyperfocusing is true, it is only one detail, one color. You need to see the whole picture to help you get out of the tunnel.
Help your body return to a baseline of calm through the breath. This isn’t the only tool but the idea is to help your body recalibrate to a state
of calm. There are many apps out there that help guide this practice (i.e. Calm, Breath 2 Relax, Tactical Breather). You can start by setting a timer (i.e. to a minute for starters). By the way, practice, practice, practice. It’s easier to adopt breathing practices during times of stress if you already practice it when you are not in crisis. Check out Season 1 of Netflix Series The Mind Explained : Mindfulness for an introduction to mindful practice as one on-going tool of continued wellness that benefits anxiety management among other things.
Choose to have your eyes open or your gaze averted
Put your hand on your belly and notice the rise and fall—note the
rise with inhale and the fall with exhale
Intentionally inhale through the nose and notice your belly expand
Draw the belly in and exhale, releasing the breath from your mouth
Set the timer for more time if you’re body needs it.
Notice thoughts may come up and compassionately return to — I
am inhaling; I am exhaling.
Once you feel your body is at least at a 5 on a scale of 1 to 10 of
anxiety /distress, you are not done.
Drink some water
Go to the 5 senses
(Note the last two can be tough depending on the situation. It’s okay if
you can’t get all them. The point is to reorient yourself to your immediate environment)
Once you’ve done all 5, go back and describe in detail one of the objects you just saw.
Common cognitions or thoughts that set the tunnel in motion is “what
if”. The what if this or what if that, is a thinking process that usually
tunnels us in direction of thinking that attempts to help us control the
unknown. I get it. In theory, “what if” can get us into planning mode. If we
can plan for the worse case scenarios, then go for it! However, if what
if’s are landing you in an empty tunnel to nowhere because really there
are no real answers to be generated, then you need to land with, “WHAT
IS… within your control.”
Start with the insanely simple things that are within your control.
Prompts may involve what, when, where, why, who, how… questions that
identify reasonable, manageable answers. You might also think to
yourself, what are the people, places and things that are helpful or
effective in managing this.
