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Re-Focusing v Distracting

20/5/2019

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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!
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​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.” 
(Wells, 2007).
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​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;
​Daytime
  • Socialising
  • Exercising
  • Working/Studying
  • Housework/DIY project…
​Evening time
  • Crafting
  • Puzzles, Crosswords
  • Board games
** READING AND/TV CAN BE TOO PASSIVE, MAKING IT EASY TO RETURN TO WORRYING
​Middle-of-the-night-time.
​

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;
  • Designing your dream garden
  • Create, in your mind, a Fantasy Football Team
  • Name four countries that begin with the letter ‘A’, four countries that begin with the letter ‘B’…
  • (You get the idea!)
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.
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