This is Part 4 of our series of articles on anxiety.

In the previous article, Anxiety, Part 3, we talked about the three components of anxiety: Thoughts, physical sensations, and behaviours.

We also learned that each component affects the other two.

In this section, we'll see how we can deal with each of those components.

1. Overcoming Anxious Thinking

The first step is to actually start being aware of your thinking. Some people find it easy to do, while others initially struggle to identify their thoughts.

Start paying attention to the thoughts that cross your mind in situations that make you anxious. Whenever possible, record those thoughts.

Sometimes, it's easier to start with situations where you are only mildly anxious, and gradually work up to identifying the thoughts in more anxiety-producing situations.

After you have a good understanding of the anxious thoughts that you repeatedly experience, try to examine how true they are.

Ask yourself these questions with regard to your anxious thoughts:

• What is the evidence that this thought is true?

• What is the evidence that this thought is not true?

• Have you had this thought before? How often?

• What is the likelihood of whatever you worry about happening in the future?

• Is it a guess or a fact?

• Is it a hassle or a horror?

• What is the worst possible outcome?

• What is the best outcome?

• What is the most likely outcome?

• What would my non-anxious friend say about it?

Try to separate the evidence and the reality from the way you feel. Sometimes, we make an error believing that if we have a bad feeling, it means that things will be bad.

It may be useful to have a friend help you evaluate the evidence for and against your thought.

After the thorough evaluation of the thought, write down an alternative realistic statement that better reflects the reality. This statement does not have to be positive; it just has to be based on facts.

2. Addressing Anxiety-Induced Physical Sensations

Two techniques that best address the physical sensations of anxiety are:

• Progressive Muscle Tension and Relaxation

• Abdominal Breathing

It is important to practice those techniques at times when you are not anxious. Often, when people rely on these techniques to get rid of anxiety, they start perceiving anxiety as dangerous and something they can handle.

Schedule about 15 minutes a couple of times a day to do those exercises. For example, in the morning and before bed.

Progressive Muscle Tension and Relaxation

This is a special way of tensing and relaxing your muscles.

Why can't we just relax the muscles? Why is it necessary to tense them first?

Sometimes, if we try to relax the muscles without tensing them first, it is difficult to achieve real relaxation. When stressed, we tend to forget how relaxed muscles feel! Therefore, start from one group of muscles and tense them for about five seconds. Then, release and relax for about fifteen seconds.

• For example, start with your right hand. Make a fist and hold for five seconds. Release for fifteen seconds.

• Now, tense the entire right arm for 5 seconds. Release for fifteen seconds.

• Then, repeat on the left side.

• The same with the foot, lower leg, upper leg, and then the entire leg.

• Repeat on the other side.

• After, tense and relax the buttocks, stomach, chest, shoulders, neck, mouth, eyes, and face.

Some important tips:

• Only practice this in a non-anxious state.

• Each time you release the muscles and relax, concentrate on the difference between the tense state and the relaxed state. This is very important and will eventually help you quickly achieve a relaxed state, as you will know the exact feeling of it.

• As you progress, you can tense and relax both arms, then both legs, then the torso, and then the face.

• As you progress even further, you will be able to just relax without tensing the muscle first. But don't rush there. It will take a lot of practice first.

• A benefit of this exercise is that you'll start to notice the first signs of tension as you go about your day, which will allow you to address it early on.

Abdominal Breathing

To practice Abdominal Breathing, lie down on your back and put one hand on the abdomen and another on your chest. Try to breathe in a way where the air travels all the way down toward your tummy. Your goal is for the hand on your abdomen to move up and down, and the hand on your chest remain still.

Now, try to inhale to a count of four, then hold your breath for about two counts, and then exhale to a count of four. Then, pause for another count of two.

As you practice, you can work toward making your exhalation longer than the inhalation:

• Inhale for a count of four

• Hold your breath for a count of two

• Exhale for a count of six

• Pause for a count of two

Please note that the goal of those techniques is not to avoid being anxious!

Remember, anxiety is our friend and we don't want to get rid of it. We also don't want to see it as dangerous and desperately try to avoid feeling anxious.

Instead, these are effective techniques to help you feel calmer during the day (and who doesn't need that!), and also to take the edge off of the anxiety in difficult situations so that you can cope with them more effectively.

3. Changing Behaviours

This is a major part of addressing anxiety and it deserves a separate chapter. Please read on to learn about The Discovery of Oz the Terrible in Part 5.

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Anna Prudovski is a Psychologist and the Clinical Director of Turning Point Psychological Services. She has a special interest in treating anxiety disorders and OCD, as well as working with parents.

Anna lives with her husband and children in Vaughan, Ontario. When she is not treating patients, supervising clinicians, teaching CBT, and attending professional workshops, Anna enjoys practicing yoga, going on hikes with her family, traveling, studying Ayurveda, and spending time with friends. Her favorite pastime is reading.

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