Words of Advice for “Worriers”

If you are a “worrier” then you grapple with something called negative self-talk.  You become overwhelmed because you have a little voice in your head that tells you that you “can’t” manage things in your life or that there are things you need that you “shouldn’t”.  In order to gain any sense of mastery you need to silence, or at least suppress, that voice. 

There are multiple steps to this process.  First, you need to recognize when you begin to play the “can’t” or “shouldn’t” soundtrack in your head and put a stop to it.  Some people do this through visualization.  You can imagine a big red stop sign, a board where these thoughts are being erased or a remote control where you can change the channel.  Other people do this through the cultivation of what I like to call “the angel on the other shoulder”.  This involves the development of a stronger, more rational voice, which contradicts the negative talk.  You may simply begin to cultivate that voice by having it question your inner negative thoughts.  Sometimes when you feel as though you can’t do something, questioning why you can’t is enough to help you gain perspective.  However sometimes that voice needs to be forceful and insist that you can handle whatever comes your way. 

Once that negative inner voice is stopped in its tracks you can begin to create a new narrative for yourself to help you gain a different perspective.  What are all the things you have achieved even when you thought you couldn’t?  Use past experience to help yourself gain new perspective on the situation and calm down.  You need to find a way to tell yourself that you can handle whatever comes your way.  Sometimes it helps to step outside yourself for a moment.  If a friend was having a similar issue what words of encouragement would you offer them?  Now give those words to yourself!  You deserve at least as much support from yourself as you would give to a friend. 

The final step is to remember to offer yourself a mental high five when you are through your negative experience.  Validating that you were capable and that things turned out alright will help you recall positivity in similar future experiences.  If the task at hand is longer term, remember to praise yourself as every milestone passes and you handle it effectively. 

Like any intervention aimed at using the elasticity of your brain to change your thinking, changing this habit requires lots of practice.  Your brain is capable of muscle memory and you have been training it to worry.  It’s time to train it to get rid of those irrational thoughts so that you can let go of the worry and engage in your life. 

Managing Feelings of Impending Doom

When people embark on a therapeutic journey to combat panic attacks and generalized anxiety one of the toughest issues to overcome is the feeling of impending doom.  Often as people improve and start to feel hopeful, they find themselves waiting for the other shoe to drop.  This feeling drastically inhibits their ability to truly feel happy and healthy.  Like most other anxiety behaviors, the tendency to be fearful of the unknown future is generally an ingrained pattern that has developed over an extensive period of time.  This means that the development and incorporation of new behaviors will also take time to take effect. 

I often talk to my clients about the idea of change as a continuum.  My favorite metaphor to use to describe this continuum is the alphabet.  Just as when you are reciting the alphabet you would not go directly from A to Z, when you are making changes in your thinking and behaviors you cannot go from worrying to not worrying.  There is a whole alphabet of letters, or steps in the healing process, in between.  Often we are so focused on our goals that we fail to recognize the steps we must take along the way. 

The first step on the journey of gaining mastery over feelings of impending doom is recognizing that these feelings are usually self-imposed.  These worry feelings are a reaction to your need for control in your life.  For so long, trying to control things and planning for the worst case scenario have allowed you to feel in control of your life.  This was an illusion.  Truly being in control of your life comes from trusting that you have the ability to adapt to and manage any situation.  It is not realistic to believe that bad things will not happen.  They will.

However, negative events have a lot less power in your life if you feel prepared and capable of handling them.  You need to practice telling yourself often that you are capable of handling problems that may come up and that you are stronger than you think.  Reflect on difficult situations that you have handled well to solidify that thought in your mind.  When the next bad event occurs, focus on what you did well in the situation instead of all the things you did wrong.  Remember change is a continuum and, while you may not immediately be able to handle problems in your life the way you would like to all of the time, effectively handling these problems part of the time is a step in the right direction.  Validate every movement in the right direction and build on it.  Before you know it you will hopefully be free from impending doom.

Letting Go of Regret

So many people seem to struggle with regrets about their lives.  On any given week in my office I will encounter someone struggling with a decision they have made for their life that they know was wrong for them, yet they made it anyway.  Regret about the decisions we “should” have made are at the foundation of our guilt and shame.  While I do not believe that it is possible to live a life completely devoid of regrets, it is possible to live one without the debilitating guilt and shame associated with those regrets. 

Throughout my years of practice I have come to realize that while it is easy for people to say (with all good intentions) that you will never do something (i.e., drugs, an affair, etc.) that they will regret, the reality is typically much more complicated.  People do not just wake up one day and decide to make destructive decisions that ruin their lives.  Those decisions usually result from the culmination of complicated situations and many minute decisions that lead them to a place where they thought they would never be.  If it was just a matter of making amends for poor decision making, I do not believe that so many people would harbor guilt and shame.  Instead, the hurt and shame often derives from the realization that the poor decision has caused pain to others in your life for whom you care.  It becomes difficult to reconcile the good person you believe that you are with the person who hurt others in a way of which you never imagined you were capable.  The truth is that good people sometimes make bad decisions when they lose perspective and we have all been there in some way, and to some degree, in our lifetimes.  Whether it is a matter of something we said that we wish we could take back or developing a problem with addiction, we all have regrets.

The question becomes: how do we move past these feelings of shame and guilt caused by our actions?  My answer is forgiveness.  Moving past shame and guilt comes from forgiving yourself.  You must acknowledge your own humanity and forgive yourself for being fallible.  I have been providing therapy long enough to know that regret is a loop that will continue to play over and over in your mind until you let it go.  So change the way that you talk to yourself about it.  Acknowledge your mistakes and take responsibility for them.  Make amends.  Learn from them and move forward.  You cannot change the past, all you can do is honor those that you have hurt by not repeating the same mistake.  When you do finally get to a better spot in your life, accept that we are made up of the sum of all of our experiences.  Therefore, every negative experience in which you’ve been involved has contributed to the good person you are today.  Whether an experience teaches you an important life lesson or provides you a new perspective on yourself or relationships, it changes you in some way.  Own it, but don’t let it control the sum of who you are.  Be patient with yourself as it may take weeks or months of forgiving yourself regularly when it comes up before positive effects are noticed.  Repeated refocusing of your energy toward the future is the best way to move past it and shed the guilt and shame that you are experiencing.  Ultimately, life will throw difficulties in your path and you will be more adept at traversing them without guilt and regret holding you back.  Use these experiences to make you a better person and you can turn that regretful decision into a tool for personal growth.

Self-Care Without the Guilt

Our daily lives are busy and, for most people, busy is an understatement.  We are constantly juggling the competing demands in our life.  I regularly treat patients who come to me struggling to find a work-life balance.  They are overwhelmed and many are guilt-ridden.  They express feelings that due to all these competing demands on their time, they do nothing truly well.  When I ask them about the things in their lives that are most important, I am not surprised to hear that these are the same things to which they dedicate the least amount of their time and energy. 

My initial suggestion typically involves making more time for these things of primary importance in order to emotionally recharge.  This suggestion is often met with a bevy of commitments or obstacles in their lives that make it impossible or inconvenient for them to carve out more time for recharging.  Yet they continue to have guilt that they miss their children’s soccer games or are too tired to spend much time with their significant other.  They put off developing the hobby that they love or spending time with friends.  So I ask them to make a list of the things that prevent them in a week from being present where they would really like to be.  Then I hit them with a hard truth: the things that prevent them from taking that break to have fun time will always be there, even when they are dead and gone.  There will always be laundry, house cleaning, and work.  So maybe everything doesn’t have to get done.  This is why we prioritize our lives and if we make recharging ourselves a priority, we will feel better, sleep better, think better, and will be significantly more efficient when we set out to do the things that are necessary evils.

It is not surprising that as people adapt to the idea of putting themselves higher on the priority list, guilt rears its ugly head.  This is where self-talk comes into the equation.  Guilt is a by-product of your expectations for yourself.  People who feel guilty have a constant inner monologue telling them what they “should” be doing.  I tell people to listen to this inner monologue.  Really listen and maybe even write some of it down.  Then you can go back as a rational calm person later and realize the undue pressure to which you subject yourself.  Life is hard enough at times without you beating yourself up.  So as soon as you hear the word “should” enter your inner dialogue it is time to put on the brakes.  Who determined you “should” be doing something?  Challenge these thoughts internally.  You are likely to find that there are a lot of things that you have been telling yourself to do that really aren’t necessary.  Start replacing that internal monologue with the words “nobody is perfect and I will do my best”.  That is all that is fair to expect from yourself. 

Taking care of yourself and recharging allows you to be a better worker, a better friend, a better parent, a better lover, frankly a better all-around person.  It makes you happier and more productive.  It makes your thoughts clearer and makes you more efficient.  So do the work to re-prioritize and change your inner dialogue.  Life is way too short to keep being your own worst enemy.

Simple Meditations for Erasing Worry

It seems now that meditation has become a commonplace skill.  Many patients express familiarity with some form of meditation.  When I was first starting out, this was not the case.  I will never forget being introduced to Dr. Brian Weiss’s guided imagery meditations.  I was planning my wedding at the time and my stress level was particularly high.  I listened to his guided imagery right before bed and was astounded by how much it helped!  I slept better and was calmer all day long.  As I continued my practice, I was introduced to Dr. John Kabat-Zinn and became a huge fan of his guided meditations as well.  Now there are even applications for your smart phone, such as Headspace, that help you work your way through meditation.  I often recommend all of this resources to patients in my practice.

The biggest dilemma that is posed by meditation as a treatment is time.  In our fast paced lives time is a commodity that people do not take lightly and meditation works best when performed regularly.  While a lot of these meditation prompts offer shorter meditations, they also require people to have the time to complete them when they are near the source of the guided imagery.  So I spend time teaching my patients small meditations that they can do in a few minutes at any time during their day.  This practice call allow them to function more efficiently in a current task by temporarily freeing them from the weight of a particular anxiety until a later time when that anxiety can be appropriately addressed. 

One of my favorites for worry and anxiety I call “Wiping the Slate Clean”.  I ask patients to spend time visualizing a dry erase board (or a chalk board depending on their age).  Then I ask them to imagine their concerns written or drawn on the board.  I ask them to fill their board with the dilemmas that are stuck in their heads.  By this point they are feeling the stress of ruminating on their worries.  Then I ask them to erase them one by one.  The act of erasing those problems causes a wonderful reduction in anxiety so once we have gone through it together in session they are highly motivated to practice on their own.

While this works extremely well for individuals prone to anxiety, we all have worries that can use a little erasing.  I encourage everyone to use this meditation regularly.  If you have read any of my discussions in the past you know that I think this would be great at bed time to help improve sleep quality, but I also like the idea of people using it with their morning coffee to start their day off right.  Really, there isn’t a bad time of the day to reduce your stress level a little bit and now you can do it in a matter of minutes.