Anxiety – Thought-Provoking

In this series of five emails and posts, we’ve looked at what anxiety is, how we need to prepare for anxiety-provoking moments by taking time for quiet reflection, how to deal with unwanted feelings in the moment and to cope better, and how changes in the choices we make in our lives can help with reducing anxiety and improving our health in general. In this final part, we’ll look at ways we can change the way we think about the challenges we face, and how we make sense of our reaction to them.

A highly-effective method for managing anxiety is the cognitive-behavioural approach. The ideas behind cognitive-behavioural therapy (CBT)(as well as coaching) are that:

• The way we interpret and assess information (think and feel) affects what we do (our behaviour).
• Anxiety and depression promote negative thinking.
• Identifying and changing negative thinking can relieve anxiety.

In my second post – ‘Be Prepared!” – I pointed that the stressed brain is overcome with emotional thinking and that we lose the ability to think logically and rationally. Instead we distort our thoughts in a number of ways, all of which serve some purpose in promoting a fight-flight-freeze response. If we are already on edge and worried about something bad happening, our brain maintains a hypervigilant stance by looking out for evidence that confirms our worst fears. If there’s a problem, it’s not trivial but massive and will cause the end of the world as we know it. Or so our emotional-thinking brain will have us believe.

CBT works by having us take the time to identify these unhelpful (by perfectly natural – there’s nothing ‘wrong’ with us for having them) thoughts that reduce our quality of life, examine the evidence for holding them to be true, and reframing them into something more positive (i.e. helpful, realistic).

Let’s start with ‘thinking errors’, of which there are around 13, all intended to help speed up a response to a perceived threat (or to a perceived opportunity – it works both ways, just that one comes with unpleasant emotions and the other with pleasant ones):

1. 1. All-or-nothing thinking. Also known as ‘black or white thinking’. Seeing results, outcomes or personal competence in absolute terms.

“I’ll never be good at this!”

1. 2. Labelling. Globally rating ourselves a failure or incompetent.

“I’m rubbish at presenting.” “I failed my exam; I’m a total idiot.”

1. 3. Focusing on the negative (a form of filtering). Filtering evidence and paying disproportionate attention to negative facets.

“I’ve made a number of mistakes.”

1. 4. Discounting the positive (a form of filtering). Filtering evidence and paying little attention to positive facets.

“I was lucky to have passed that exam.”

1. 5. Fortune-telling. Predicting outcomes that are not in your control.

“I know I’ll be made redundant next week.”

1. 6. Mind-reading. Making decisions about what you think others are thinking about you.

“They think I’m incompetent.” “If I don’t work overtime, I’ll get sacked.”

1. 7. Magnification (‘awfulising’ or ‘catastrophising’). Blowing things out of proportion.

“The whole presentation was a fiasco because of that error!”

1. 8. Minimisation. Reducing the significance of the part one plays in a situation.

“It must have been an easy exam, as I got a good mark.”

1. 9. Emotive judgement (emotional reasoning). Mistaking feelings and physical sensations for facts.

“I feel so nervous; I know this pitch will go wrong.”

1. 10. Blame/personalization. Unfairly blaming others or oneself.

“If only others had checked the slides first…” “It was all my fault.”

1. 11. Demandingness. Peppering your narrative with rigid or inflexible thoughts about yourself or others.

“I must perform well.” “He should have done better.”

1. 12. Imposter Syndrome or Phoneyism. Believing that one is incompetent and will soon be found out.

“Even if I perform well, they’ll find out I’m not up to the job.”

1. 13. ‘I can’t stand it’. Reducing our tolerance to frustrating or stressful situations by telling ourselves that we can’t take any more.

“I can’t put up with this any longer!”

For each of these Thinking Errors you can ask yourself ‘where’s the evidence to support that thought?’ or ‘how do you know?’ Speaking to yourself using your first name has also been shown to reduce emotionality, as if you are an objective third party able to ask neutral questions (just avoid doing it out aloud in the office or on public transport!). Thoughts are not facts.

Another technique in CBT is to reframe how we see a situation. Imagine that you are stressed and anxious after giving a presentation which didn’t go as perfectly as you had wanted it to (see Thinking Error number 11 above). Your emotional-thinking, survival brain might that it was all a waste of time and a disaster (all-or-nothing thinking, labelling). And yet, through that experience, you have gained vital knowledge of what needs to change for a success to follow. Failing wasn’t such a failure after all: something useful and positive has come from it after all.

Through adversity comes education…but only if you’re calm enough to be able to reflect on it!