By Linda Hamilton
ANXIETY is maintained and exacerbated by avoidance, so treating anxiety inevitably means cutting out avoidance and being willing to expose yourself to things you fear.
Of course, that might seem intimidating. There is a short-term payoff to avoidance – you feel relief. Quite simply, avoidance feels good in the short-term. Facing feared situations can be difficult, so you have to be motivated.
To get motivated, ask yourself this vital question: what have you lost to anxiety?
In his book Freedom From Obsessive-Compulsive Disorder, anxiety and OCD expert Dr Jonathan Grayson talks about the importance of motivation and asks readers to fill out a ‘motivators’ form where they write down what they have lost to OCD.
The same advice is equally applicable to multiple forms of anxiety.
Why? Well, because tackling anxiety means choosing to do some hard things. Someone with OCD might need to stop engaging in checking rituals, to stop looking for reassurance, to stop avoiding places or situations that trigger unwanted intrusive thoughts, and so on.
Similarly, treating social anxiety might involve exposing yourself to feared social situations, to making small chat with strangers, to cutting out safety behaviours, resisting the temptation to ruminate about your social performance, and so on.
Someone with health anxiety might be asked to stop googling symptoms, to stop looking for reassurance, to avoiding situations that trigger health fears, and so on.
I’m not going to list every form of anxiety here – suffice to say, successful treatment invariably requires being willing to face feared situations, so you have to be motivated.
When considering what you have lost to anxiety, start with your own personal losses, ways in which your anxiety has caused you to lose out or suffer. Dr Grayson lists a number of categories to consider, including damaged or lost relationships; lost or wasted time; financial or employment losses; missed events or opportunities; feelings of guilt due to giving into anxiety; or any other categories you can think of, such as lower confidence and lower self-esteem.
Also recommended is a second form, where you list how your anxiety has hurt your loved ones. Perhaps your anxiety results in you being rigid and this impacts others; perhaps you have hurt others with your anxious demands; perhaps you argue with your partner because you ask them to continually text you when you are out with friends, or to endlessly reassure you that they wouldn’t cheat; perhaps friends get frustrated because you keep asking for reassurance; perhaps your anxiety causes you to be tense or angry with others; perhaps your anxiety contributed to a partner losing out on work or study opportunities.
If you are anxious, some of the above categories will resonate more strongly than others, or there may be various other personal examples that jump to mind.
When writing about what you have lost to anxiety, it’s important not to hurry through the exercise. Instead, be detailed about the painful parts of the loss. Instead of saying “missed out on work opportunities” or “didn’t go on holiday with friends because of anxiety” or “broke up with partner because I was afraid of getting too close”, remind yourself of the feelings you experienced around these events.
Please don’t think this exercise is some form of self-punishment – it’s not. Anxious people often beat themselves up for being anxious, but that only makes the situation worse. Indeed, low self-esteem is often the reason someone is anxious in the first place – if you feel bad about yourself, you’re much more likely to think you aren’t strong enough to cope with all kinds of situations.
No, the purpose of this exercise is to get in touch with your pain and lost hopes. Doing so is painful but necessary.
Why? Because the biggest problem with anxiety isn’t that it’s physically uncomfortable, or that you worry excessively. It’s that it shrinks your horizons and stops you from living the life you want.
When you fully appreciate what you have lost to anxiety, you’re much more likely to tackle the avoidance that fuels the problem. My next column will explore how to do just that.
Linda Hamilton is a Kinsale-based cognitive behavioural therapist.
If you would like to get in touch with her, call 086-3300807
For more information, go to www.kinsalecbt.com
