Strategies for Managing Anxiety
Metacognitive therapy (a form of CBT) tackles the clients ‘positive beliefs about worrying’ (“I think worrying is a useful thing to do!”), as well as their ‘negative beliefs about worrying’ (“I am afraid that I can’t control it… What’s going to happen to me if I can’t?... What if I have a nervous breakdown?!”). It is recommended that those (very frightening) negative beliefs are fully dealt with first, moving the client to a better understanding of their anxiety and its manageability. This part of therapy may be challenging, and may take some time, but will be well worth the effort!
Having done this, the therapist next explores, with the client, their previous attempts at controlling their worry/anxiety. Distraction is a favourite! On the surface, distraction seems like a good strategy and, to a degree, it does work. Perhaps the greatest issue with distraction, as a strategy for managing anxiety, is when it comes from a place of fear. If one is fearful of their anxiety, and fearful of not being able to control their thinking, then attempts to ‘Suppress’, ‘Block’, or ‘Distract’ from those thoughts/emotions, will be of little real benefit – and may even reinforce their sense of danger.
The term ‘Re-Focusing’ can be useful here, to help the client modify this coping strategy into one that will be more beneficial. Re-Focusing, like Distracting, is about deliberately choosing to not engage with one’s distressing thoughts/emotions. Unlike Distracting, though, the client is encouraged to; first acknowledge their worrying and/or anxiety, accept it as manageable, and only then, deliberately ‘ignore and re-focus’.
“The antithesis of controlling worries, or using hypervigilant threat monitoring, and trying to reason with worry, is passive ‘letting go’ of the activity.”
Taking the time to generate a comprehensive list of ‘Re-Focus Activities’, with the client, can help to reinforce this helpful strategy. It might also help to group the activities into the following categories;
For many clients who struggle with anxiety, the night-time can be very difficult (mostly because they have no distractions!). ‘Mental Re-Focus Activities’ can be of some assistance here;
References and Recommended Reading
Dugas, M. J. & Robichaud, M. (2007). Cognitive-Behavioural Treatment for Generalised Anxiety Disorder: From Science to Practice. New York: Routledge.
Meares, K. & Freeston, M. (2015). Overcoming Worry and Generalised Anxiety Disorder: A self-help guide using Cognitive Behavioural Techniques. London: Robinson.
Wells, A. (2007). Cognitive Therapy of Anxiety Disorders. England: Wiley
Wilkinson, A., Meares, K. & Freeston, M. (2011). CBT for Worry & Generalised Anxiety Disorder. London: Sage.