In Search of a Comprehensive Anxiety-Management Tool
Updated: Dec 31, 2020
Every counselor has their go-to tools and strategies that they share with clients, and when it comes to managing anxiety, there’s no shortage of acronyms and techniques. There’s R.I.D.E. (Recognize, Involve, Distract, End) the anxiety wave, S.T.O.P. (Stop, Take a breath, Observe, Proceed mindfully), I.M.P.R.O.V.E. (Imagery, Meaning, Prayer, Relaxation, One thing in the moment, Vacation, Encouragement), grounding, breathing, meditating, progressive muscle relaxation, smelling a candle (though this last one often sounds to me like putting band aid on a volcano).
These methods have some or all of what I consider vital components for an anxiety management tool:
An action to engage with or distract from the anxiety
Nevertheless, I felt like there are some important components missing from the main players:
Engaging with the anxiety, questioning where it’s coming from. Identifying the source of the anxiety isn’t always possible, but when it is, the knowledge of that source can be a huge relief. For example, if I didn’t sleep well the night before, being able to point to a sleep deficit as a contributing factor of my anxiety will likely allow me to tolerate it better.
The option to problem-solve. Some anxiety-evoking situations are best dealt with through direct action. For example, if someone’s partner said something that activated an old attachment wound (evoking anxiety), they might be best off having a frank and calm conversation with their partner to clarify what they meant.
A combination of consecutive steps and options. Anxiety management tools seem to be a set of steps to take (like S.T.O.P), a variety of options to pick from (like I.M.P.R.O.V.E.), or a single action (like meditation). I wanted something that would start out as steps to take and end with a set of options to choose from.
In thinking about all I wanted in a simple, easy-to-remember anxiety management tool, it quickly became clear to me that an acronym wouldn’t cut it. To combine all of the qualities I wanted (non-judgmental acceptance, mindfulness, problem-solving, engaging with the anxiety, steps and options), I decided on a flow chart.
I’d like to point out that this chart contains nothing new or original. It all comes directly from Dialectical Behavior Therapy (DBT), Cognitive Behavior Therapy (CBT), and Acceptance and Commitment Therapy (ACT). This is taking existing ideas and packaging them in a way that makes the most sense to me.
As I made this flow chart, I found it challenging to keep it simple. There are so many different skills in DBT, CBT, and ACT that I could have included. But I wanted to keep it simple, accessible to a wide audience, and broad. Even so, I started out with 6 items in the flow chart and ended up with 9.
There are also considerations to make depending on the type of anxiety (social anxiety, hypervigilance, and panic just to name a few). Maybe I will make a much more complicated version of this flowchart sometime with all of these things taken into consideration.
But for now, here are explanations for some of the flow chart items that haven’t been discussed already:
Coping Statements: Say positive and truthful things to yourself that will help you push through the anxiety. Pick or come up with a brief statement and repeat it to yourself like a mantra. This can be done in conjunction with deep breathing. Here are some examples* and more ideas here:
This feeling is uncomfortable, but I can accept it.
Fighting and resisting this isn’t going to help, so I’ll just let it pass.
I’ve survived this before and I will survive it this time too.
These are just thoughts, not reality.
Distress Tolerance: These skills can be a first line of defense – what you might do if the anxiety or panic is so strong that it’s interfering with your ability to think. They can also be the last thing to try if problem-solving isn’t applicable to the situation and if the coping skills aren’t cutting it.
Grounding: These skills are especially useful if your anxiety causes you to dissociate (common in PTSD and other reactions to trauma). Grounding is a way to bring you into the present moment, and there are endless ways to do this. Here are a few examples and a link to more ideas:
Identify 5 things you can see, 4 you can feel or touch, 3 you can hear, 2 you can smell, and 1 you can taste
Focus on your breathing, counting the seconds that you breathe in and breathe out
Look around you and name as many colors as you can that you see
Self-Soothe: Use your five main senses (sight, sound, smell, taste, and touch) to engage in the outside world in a relaxing and comforting way. Pet a critter, take a bath, look at Pinterest, slowly and mindfully eat a favorite food. Yes, you could even smell a candle. Here are some more ideas.
Distract: Engage in whatever healthy activity you find enjoyable to distract from the anxiety. Watch Netflix or Youtube, play a video game, listen to music, talk to a friend, make art, craft something, cook or bake food. Just make sure that distraction isn’t the only anxiety-management skill you hone.
*Coping statements taken from Bourne, E. J. (2015). The Anxiety and Phobia Workbook (6th edition). New Harbinger Publications, Inc: Oakland, CA.