Webb Therapy Uncategorized Effective strategies and techniques for moderate to intense anxiety:

Effective strategies and techniques for moderate to intense anxiety:

Managing moderate to intense anxiety often involves a combination of techniques that address both the mind and body. Here are some effective strategies:

1. Breathing Exercises: Practice slow, deep breathing to calm your nervous system. For example, inhale for a count of four, hold for four, and exhale for four.

2. Progressive Muscle Relaxation: Tense and then relax each muscle group in your body, starting from your toes and working upward.

3. Grounding Techniques: Use the 5-4-3-2-1 method to focus on your senses—identify 5 things you see, 4 you feel, 3 you hear, 2 you smell, and 1 you taste.

4. Mindfulness and Meditation: Engage in mindfulness practices to stay present and reduce anxious thoughts. Apps like Headspace or Calm can be helpful.

5. Physical Activity: Exercise, even a short walk, can release endorphins and reduce anxiety levels.

6. Cognitive Behavioural Techniques: Challenge negative thoughts by questioning their validity and replacing them with more balanced perspectives.

7. Healthy Lifestyle Choices: Maintain a consistent sleep schedule, eat nutritious meals, and limit caffeine and alcohol intake.

8. Journaling: Write down your thoughts and feelings to process them and identify triggers.

9. Social Support: Talk to trusted friends, family, or support groups to share your experiences and gain perspective.

10. Professional Help: If anxiety persists, consider seeking therapy or counselling. Techniques like Cognitive Behavioural Therapy (CBT) or medication prescribed by a professional can be highly effective.

When traditional strategies don’t seem effective for managing intense, chronic anxiety, there are additional approaches you can explore:

a. Therapeutic Modalities:

Acceptance and Commitment Therapy (ACT): Focuses on accepting anxious thoughts rather than fighting them, while committing to actions aligned with your values.

Dialectical Behavior Therapy (DBT): Combines mindfulness with skills for emotional regulation and distress tolerance.

Eye Movement Desensitisation and Reprocessing (EMDR): Often used for trauma-related anxiety, it helps reprocess distressing memories.

b. Medication:

Anti-anxiety medications or antidepressants may be prescribed by a psychiatrist. These can help manage symptoms when therapy alone isn’t sufficient.

c. Lifestyle Adjustments:

Explore dietary changes, such as reducing sugar and processed foods, which can impact mood and anxiety levels.

Incorporate consistent physical activity tailored to your preferences.

d. Support Groups:

Joining a group for individuals with anxiety can provide a sense of community and shared understanding.

e. Intensive Programs:

Consider enrolling in an intensive outpatient program (IOP) or residential treatment program for anxiety, which offers structured and comprehensive care.

f. Emerging Treatments:

Research into treatments like ketamine therapy or transcranial magnetic stimulation (TMS) shows promise for treatment-resistant anxiety.

g. Alternative Therapies:

Practices like acupuncture, yoga, or tai chi can promote relaxation and reduce anxiety.

Biofeedback and neurofeedback can help you gain control over physiological responses to stress. They are techniques that help individuals gain control over certain physiological and mental processes. Here’s a breakdown:

i. Biofeedback is a mind-body therapy that uses sensors to monitor physiological functions like heart rate, muscle tension, breathing, or skin temperature. The goal is to provide real-time feedback to help individuals learn how to regulate these functions consciously. For example:

Heart Rate Variability Biofeedback: Helps manage stress by teaching control over heart rate.

Muscle Tension Biofeedback: Useful for conditions like chronic pain or tension headaches.

By practicing biofeedback, people can develop skills to manage stress, anxiety, and other health conditions2.

ii. Neurofeedback, a specialised form of biofeedback, focuses on brain activity. It uses electroencephalography (EEG) to monitor brainwaves and provides feedback to help individuals regulate their brain function. For instance:

It can help with conditions like ADHD, anxiety, depression, and PTSD.

During a session, individuals might watch visual cues or listen to sounds that reflect their brainwave activity, learning to adjust their mental state for better focus or relaxation4.

Both techniques are non-invasive and can be effective tools for improving mental and physical well-being.

IMPORTANT NOTE: It’s necessary to consult with a mental health professional or medical doctor to tailor these options to your specific needs.

Related Post

Problematic Thinking Styles (continued)Problematic Thinking Styles (continued)

Hello readers! A few of the cognitive styles below were mentioned in my last post. As humans, we have a tendency to forget things so a bit of revision can be useful.

Many people have cognitive processes that result in overall unhelpful thinking styles that they tend to apply globally across situations and which may result in emotional distress (such as depression or anxiety) or unhelpful behaviours (such as anger or avoidance). Some of the most problematic thinking styles are listed in the extract below.


Mental Filter: This thinking styles involves a “filtering in” and “filtering out” process – a sort of “tunnel vision”, focusing on only one part of a situation and ignoring the rest. Usually this means looking at the negative parts of a situation and forgetting the positive parts, and the whole picture is coloured by what may be a single negative detail.


Jumping to Conclusions: I’m sure you’ve heard people say on television, “Don’t jump to conclusions” or “The truth is we just don’t know yet”. We jump to conclusions when we assume that we know what someone else is thinking (mind reading) and when we make predictions about what is going to happen in the future (predictive thinking).


Personalisation: This involves blaming yourself for everything that goes wrong or could go wrong, even when you may only be partly responsible or not responsible at all. You might be taking 100% responsibility for the occurrence of external events.


Catastrophising: Catastrophising occurs when we “blow things out of proportion” and we view the situation as terrible, awful, dreadful, and horrible, even though the reality is that the problem itself is quite small. A helpful restructuring of this cognition is to ask yourself if the situation will still be awful, terrible, or dreadful in a month. There may be ongoing consequences or stress involved if you lose a job or a relationship ends, so validate the experience you are having but also take a look at the big picture. What’s the worst that could happen? Why is the worst so “bad”? And if you are being realistic about the issue, reach out for some help if you can.


Black & White Thinking: This thinking style involves seeing only one extreme or the other. You are either wrong or right, good or bad and so on. There are no in-betweens or shades of grey.


Should-ing and Must-ing: Sometimes by saying “I should…” or “I must…” you can put unreasonable demands or pressure on yourself and others. Although these statements are not always unhelpful (e.g. “I should not get drunk and drive home”), they can sometimes create unrealistic expectations.


Overgeneralisation: When we overgeneralise, we take one instance in the past or present, and impose it on all current or future situations. If we say “You always…” or “Everyone…”, or “I never…” then we are probably overgeneralising.


Labelling: We label ourselves and others when we make global statements based on behaviour in specific situations. We might use this label even though there are many more examples that aren’t consistent with that label.


Emotional Reasoning: This thinking style involves basing your view of situations or yourself on the way you are feeling. For example, the only evidence that something bad is going to happen is that you feel like something bad is going to happen. I live with anxiety and it can be debilitating at times. I use my “wiser thinking” or “rational thinking” to evaluate whether I am operating from an emotional mindset. You might ask yourself: “What’s the evidence?”, “Does the past necessarily predict the future?”, “Am I angry or fearful right now because that might be clouding my judgement?”. It can be helpful to talk to someone who isn’t caught in your emotional headspace, or perhaps wait for the emotion to subside to think about the situation again.


Magnification and Minimisation: In this thinking style, you magnify the positive attributes of other people and minimise your own positive attributes. It’s as though you’re explaining away your own positive characteristics.

(CCI, 2008)

Self-sabotage is self-sabotaging. Why would anyone do this?Self-sabotage is self-sabotaging. Why would anyone do this?

As I always like to say, there are as many reasons why people self-sabotage as there are people. A common theme is to protect the self from failure, feeling things we don’t want to feel, and to control our experiences.

One of the hidden culprits behind self-sabotage is the need for perfection and control. Self-sabotage has a strange way of helping us maintain the illusion that if only we had put in more effort or had better circumstances, everything would have worked out as it should. Social psychologists call this counter-intuitive strategy of regulating self-esteem ‘self-handicapping.’ It’s very seductive to engage in self-sabotage because the hidden payoff is high. It’s often easier to be a perfect whole rather than a real part. It’s a short-term solution that sidesteps the more arduous but ultimately more fulfilling work of individuation and self-realization. It takes risk, patience, suffering, and ultimately wisdom to come to the place where you can let go of self-sabotage and learn how to be real.

Behaviour is said to be self-sabotaging when it creates problems in daily life and interferes with long-standing goals. The most common self-sabotaging behaviors include procrastination, self-medication with alcohol and other drugs, comfort eating, and forms of self-injury such as cutting.

Self-sabotage originates in the internal critic we all have, the side that has been internalized by the undermining and negative voices we’ve encountered in our lives. This critic and ‘internal sabotuer,’ functions to keep the person from risking being hurt, shamed, or traumatized in the ways they had been in the past. While it keeps the individual safe, it does so at a very high cost, foreclosing the possibility of new, creative, and three-dimensional experiences. Like an addiction, self-sabotage insidiously lulls and deludes us into thinking that it has the answer. In fact, it is the problem masquerading as the solution. Nothing stops self-sabotage faster in its tracks than shining this particular light on it. Consciousness is true power. We need to let go of our illusions of omnipotence and perfection and see that it is only when we are real and imperfect that we can create a true work of art. Then and only then we can enjoy the gifts of being Real.

– Michael Alcée, Ph.D., Relational therapist/ Clinical psychologistArt: Bawa Manjit, Acrobat

Self-Sabotage | Psychology Today Australia

AIPC (2021). Busting Common Myths About Anger. Issue 355 // Institute Inbrief. Retrieved June 17, 2021.AIPC (2021). Busting Common Myths About Anger. Issue 355 // Institute Inbrief. Retrieved June 17, 2021.

All human beings experience anger at least occasionally. It’s a natural emotion helping us recognise that we or someone or something we care about has been violated or treated badly. When we feel threatened or our goals are thwarted, anger is a coping mechanism that enables us to act decisively, especially in situations where there is little time to reason things out. It can motivate problem-solving, goal-achievement, and the removing of threats. It serves a protective function and is not always a problem (Lowth, 2018; Stosny, 2020; Zega, 2009).

But anger is a complex emotion, and all too often manifests maladaptively in clients’ lives, when they perceive excessive need for protection, protect the “wrong” things, or use anger to thwart their longer-term best interests. The result is problem anger.

Perhaps because it is so multi-faceted, misperceptions about anger abound, and the question arises: how shall we regard anger? How do we advise the client to think about it? Folk wisdom often would say that the best thing to do is just let it all out, but is it? Clients complain that they cannot control it, that the tendency to be easily angered is inherited, but again, is there evidence for that? Here are common myths people tend to hold about anger, and factual statements following them that you can use to clarify for the client why learning to deal with problem anger is time well spent.

Myth 1: “Anger is inherited.”

This is the client that may try to claim that their father was short-tempered and they have inherited that trait from him, so there is nothing they can do. Such a stance implies an attitude that the expression of anger is a fixed, unalterable set of behaviours. Research shows, however, that expression of anger is learned, so if we have – say, through exposure to aggressive influential others, such as parents – learned to be violent in our expressions, we can also learn healthier, more appropriate, pro-social ways of dealing with it.

Myth 2: “Anger and aggression are the same thing.”

Fact: Nope. Anger is a felt emotional state. Aggression is a behaviour, sometimes carried out in response to anger, but not the same as it. A person can be angry, yet use healthy methods of expression without resorting to violence, threats, or other aggression. Anger does not always lead to aggression. In fact, some experts claim that most daily anger is not followed by aggression. When it does result in aggression the “I3 Model” (pronounced “I cubed”) is deemed responsible. This suggests that aggression emerges as a function of three interacting factors, which all begin with “I”:

Instigation, an event which instils an urge to aggress as a result of, say, being addressed rudely or learning that one’s partner has had an affair (or a relatively “minor” event, such as being cut off in traffic);

Impellance, meaning a force that increases the urge to act in response to an instigating stimulus. These could be strong hormonal releases or a belief system which says that the instigating event should not be tolerated, or even a sociocultural norm which demands that instigating stimuli be responded to immediately and harshly (such as punching back someone who has hit you);

Inhibition, referring to forces that typically work to counter aggression, such as cultural norms, awareness of negative consequences, or perspective-taking or empathy (Kassinove & Tafrate, 2019).

Myth 3: “Other people make me angry.”

Fact: How often in common parlance do we say things like, “He made me so angry!” or “You make me so mad I could kill you!”? Even though we may occasionally speak about people causing emotions other than anger, it is far more frequent to hear such statements in regard to anger. We can choose whether or not we let someone else’s behaviour make us happy, sad, or something else, but we often think and talk about it as if anger is caused directly by others. With the undiscerning listener, an angry person thus gets to use anger as an excuse for unacceptable behaviour. Ultimately, it is not the other person’s behaviour that causes our anger, and in fact, it’s not even their intention, though that may influence our behaviour. Being precise, we must acknowledge that it is our interpretation of their intention, expressed in their behaviour/language, which is causative.

Myth 4: “I shouldn’t hold anger in; it’s better to let it out” (either by venting or catharsis).

Fact: If by “holding it in” someone means that they suppress anger, it’s true; ignoring it won’t make it go away and squashing it down is not a healthy choice. Neither, however, is venting. Blowing up in an aggressive tirade only fuels the fire, reinforcing the problem anger. Ditto the use of pillow-punching or other means of catharsis; this may come as a surprise to therapists trained a few years ago, when catharsis was an anger management technique in good standing. Now researchers have found that, even though we feel better in the moment after hitting something, our brain notices, subtly changing its wiring. Then the next time we are angry it softly whispers, “Hit something; you’ll feel better”. The time after that, the wiring is stronger in the brain towards a hitting catharsis, and the angry-brain-voice speaks a little louder. Continuing in this vein means that eventually, we could decide to hit something more alive than a pillow. Rather than either angry venting or catharsis is the use of skills to manage the angry impulse.

Myth 5: “Anger, aggression, and intimidation help me to earn respect and get what I want.”

Fact: People may be afraid of a bully, but they don’t respect those who cannot control themselves or deal with opposing viewpoints. Communicating respectfully is a far superior way to get (most) people to listen and accommodate one’s needs. While the momentary power that comes with successful intimidation may feel heady in the moment, it does not help build the healthy relationships that most people coming to counselling yearn to have.

Myth 6: Anger affects only a certain category of people.

Fact: Anger is a universal emotion that affects everyone. It does not discriminate against people of any particular age, nationality, race, ethnicity, socioeconomic status, education, or religion. It is tempting for some people in the educated middle classes to believe that anger is more prevalent among the poor, or those who are less educated or lacking in social skills. Reality does not bear this out, although the expressions of anger do vary among different social groups. Remember, anger is just an emotion, one which does not make people “good” or “bad” for having it.

Myth 7: “I can’t help myself. Anger isn’t something you can control.”

We don’t always get to control the situations of our lives, and some of them may trigger our anger. In fact, it’s also agreed by experts that we don’t (in the short-term) control whether we have angry feelings or not; they just come – although there are longer-term ways to work with clients that see them less easily provoked, and therefore less prone to have the experience of anger. What we do have the short-term choice to control is how we express that anger. Continuing in sessions with you (the therapist) for the purpose of learning how to better handle anger means having more choices of response, even in highly provocative situations.

Myth 8: “When I’m angry I will say what I really mean.”

Fact: This is rarely true. Uncontrolled angry expressions are more about gaining control of or hurting others, not saying what a person’s deepest truth is. 

Myth 9: “By not saying what I’m thinking in the moment, I’m being dishonest and will be even angrier later.”

Fact: There is a strong pull to “speak our mind” when angry. But it is at this time that a person’s judgment is most severely flawed. To speak from anger is to allow the impulsive part of the brain to overrule the rational part. Better for relationships, career, and pretty much everything else to wait until that reasoning part can regain control.

Myth 10: “Men are angrier than women.”

Fact: The sexes experience the same amount of anger, says research; they just express it differently. Men often use aggressive tactics and expressions, whereas women (often constrained culturally) more frequently choose indirect means of expression, such as found in passive-aggressive tactics. This could mean getting back at someone by talking negatively about them or cutting them out of their lives (categories adapted from: Therapist Aid LLC, 2016; Segal & Smith, 2018; Morin, 2015; Morrow, n.d.; Better Relationships, 2021; Gallagher, 2001).

Thought for reflection

Anger has many facets to it, and we have introduced some information here that may seem either startling or counterintuitive. As you think back over the myths we just debunked, which aspect has surprised you the most? Do you have any sense of why that might be? One woman, for example, was very surprised to hear that “men are angrier than women” was only considered a myth; it turned out that in her family, women “never got angry” (we hypothesise that perhaps they were socialised to not show anger), and the men got angry all the time (perhaps more allowed in that woman’s family/culture). In what ways, if at all, might your views about anger have shaped how you behave? How you respond to others? 

And here’s the ultimate question if you share this material with a client: what are their responses to the above questions? How might hearing these myths help them seek more adaptive ways to deal with problem anger? 

The upcoming Mental Health Academy course, “Helping Clients Deal with Problem Anger” draws from numerous therapies and neuroscience to help clinicians and clients collaboratively create a program to address each client’s unique challenges with this universal human emotion.

References:

  1. Better Relationships. (2021). Common myths about anger. Anglicare Southern Queensland. Retrieved on 13 April, 2021, from: Website.
  2. Gallagher, E. (2001). Anger. eddiegallagher.com.au. Retrieved on 13 April, 2021, from: Website.
  3. Kassinove, H., & Tafrate, R.C. (2019). The practitioner’s guide to anger management: Customizable interventions, treatments, and tools for clients with problem anger. Oakland, CA: New Harbinger Publications, Inc. 
  4. Lowth, M. (2018). Anger management. Patient. Retrieved on 7 April, 2021, from: Website.
  5. Morin, A. (2015). 7 myths about anger and why they’re wrong. Psychology Today. Retrieved on 13 April, 2021, from: Website.
  6. Morrow, A. (n.d.). Anger myths. Stress and Anger Management Institute. Retrieved on 13 April, 2021, from: Website.
  7. Segal, J., & Smith, M. (2018). Anger management: Tips and techniques for getting anger under control. Helpguide.org. Retrieved on 9 April, 2021, from: Website.    
  8. Stosny, S. (2020). Beyond anger management. Psychology Today. Retrieved on 9 April, 2021, from: Website.
  9. Therapist Aid, LLC. (2016). Anger warning signs. Therapist Aid LLC. Retrieved on 7 April, 2021, from: Website.
  10. Zega, K. (2009). Holistic Psychotherapy (159). Retrieved on 7 April, 2021, from: Website.