Over 18% of our population struggles with anxiety. And yet, only 1/3 of those who struggle with anxiety seek treatment. You can recover from anxiety! It's highly treatable and most people, with help, are able to kick anxiety to the curb.
One way to challenge anxiety is by identifying the anxious thinking. (This is the C-cognitive in cognitive behavioral therapy.) This can be tricky, often people don’t even recognize how their thoughts influence their emotions. People are aware of their anxiety, but when I ask what they were thinking about when their anxiety spiked, they don’t have an answer. They will tell me that the spike ‘just happened.’ This is almost never the case, there is almost always some thought, usually many thoughts, which precede the anxiety spike. Automatic negative thoughts happen so quickly and are so normal in people with anxiety that it takes some practice to be able to identify then.
Here’s an example of how automatic negative thinking works and how tricky it can be to identify.
Stan reports that he woke up feeling great. On his way to work, he realizes that he is suddenly feeling really anxious. Initially, he says that nothing triggered the anxiety, it was just there. With some probing, he might realize that he is anticipating a really stressful day at work. He woke up with a to-do list running through his head. After a few more questions, he’ll realize that some of his thoughts were:
“I’ll never get through the day. I have a presentation today and I’m not ready for it. I’m going to look like an idiot. I never do well speaking in front of people. My boss will be there and he’ll realize just how incompetent I am. He’ll probably fire me after this.”
Of course Stan was feeling anxious, who wouldn’t be with those thoughts running through his head!
So how do we change these automatic negative thoughts? The first step is to learn to identify them. To start with, it is helpful to start charting levels of anxiety. I find that using a scale to rate levels of anxiety throughout the day helps people become more aware of their anxiety and what might be causing it.
Identify how many times a day you want to chart your level of anxiety. I’d suggest charting at least 6 times a day. If you find it hard to remember, set alarms on your phone to prompt you or pick a part of your routine (breakfast, lunch, dinner, bedtime etc.). During the day, rate your level of anxiety from 0-10. Let’s say 0 is no anxiety at all, life is awesome and 10 is having a panic attack which lands you in the emergency room because you think you are having a heart attack. These numbers will be specific to you of course, your 10 might be less extreme, so long as it is the extreme edge of your anxiety, it works.
After a week or so, most people are pretty aware of their anxiety levels and better able to identify when it spikes and possibly some of the triggers causing the increase in anxiety. Don’t worry if it takes you longer to become more aware of your anxiety. This is a highly individualized process, there is no right or wrong.
Once you are able to identify when your anxiety increases, it’s time to start looking for those automatic negative thoughts. Again, this will require some writing. It’s important to stop what you are doing and really examine what is going on inside. Ask yourself where, who, when and what. Where are you? Who else is around? What time of day is it? What are you doing? And of course, what are your thoughts.
I can’t emphasize enough the need to write all of this down in the moment. So many people assume they will remember when they are feeling anxious or what is going on in the moment. Our memories are faulty and we can’t identify triggers or thoughts reliably unless we put these things on paper to examine later.
Identifying the thoughts might be difficult at first. Don’t give up! It might start with a general, “I just feel like something bad is going to happen.” Slow down and really look at what is going on.
Remember Stan, he initially reported that he was driving to work and just started feeling anxious for no reason. When he learns to slow down and really examine his thoughts, he realize that he is worried about work and his upcoming presentation. This can be a difficult step to take on your own.
Once you are able to identify your automatic negative thoughts, it's time to start challenging them. Let's look at Ashely, a college student. She has a test coming up and she is so filled with anxiety that it's hard to sit down and study.
Ashley has practice recognizing her anxiety and identifying the negative thoughts. Ashley can write down all her negative thoughts on one side of her paper. If Ashley can really examine her thoughts, she can challenge most of them. Here's an example
Fear thought-I'm going to fail this test
Challenge-I've been doing really well in this class and I've done well on all my other assignments. There's no reason for me to fail.
Fear thought-If I fail this test, I'll get a bad grade. If I get a bad grade, I won't be able to get a good job.
Challenge-One test in a class that I'm doing well in, won't ruin the rest of my life.
You get the idea. Sometimes it can be really hard to slow your thinking down long enough to identify your thoughts. Sometimes you've had these negative beliefs for so long that they feel real to you. No worries, that's why a therapist with a good background in cognitive behavioral therapy can help.
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