Finding a Therapist
To find a therapist who specializes in anxiety, see this directory of the Anxiety & Depression Association of America:
Anxiety and Depression Association of America
Dr. Roger Tilton
International OCD Foundation
National Social Anxiety Center
The Rule of Opposites, by Dr. David Carbonell
Excerpted from Outsmart Your Anxious Brain
There’s a powerful and surprising rule of thumb that pertains to all of our instinctive responses to anxiety, panic, and worry.
It’s this: your (and my) initial gut instinct of how to respond to a strong anxiety episode is almost always wrong. Not just wrong, but precisely and completely wrong, 180 degrees wrong, like a compass that points north but labels it south.
If you have a compass like that, that’s a problem, but there’s an easy workaround. As long as you know that what the compass calls south is actually north, you can still find your way home. And so it is with the signs and symptoms of chronic anxiety disorders. If you can see that your gut instinct of how to respond to panic, worry, and anxiety is usually dead wrong, then that sets the stage for you to do the opposite next time that anxiety comes into play.
How Anxiety Tricks Your Brain
Why are our instinctive responses to worry and anxiety so reliably unhelpful? It goes to the heart of the worry trick: people experience discomfort and treat it like danger. The responses that are useful for danger—fight, flight, and freeze—are pretty much the opposite of what’s useful for discomfort, essentially, to chill out, float, and give it time to pass.
So when you get tricked into treating the discomfort of anxiety and worry as if it were danger, you get tricked into acting in ways that make your long-term situation worse rather than better. You get a few moments of temporary relief as you retreat from or resist the anxiety. But you end up feeling more afraid and vulnerable in the long term. You’re giving up your long-term freedom for a few moments of very temporary relief and comfort. It’s a terribly bad trade. Making those trades is exactly what keeps people stuck in anxiety disorders.
When people experience a moment of high anxiety, they tend to either try to fend off a “danger” that probably doesn’t exist at that time and place, or try to oppose and silence their fear. Neither helps them calm down. Instead, they become more afraid and also upset with themselves for once again feeling overcome by fear.
People often worry that this means there’s something wrong with them or with their brain. But this is actually evidence of your brain trying to carry out its job—keeping you safe—rather than any sign of malfunction. Our brains are much more willing to make the error of seeing a lion where there isn’t one than of not seeing a lion where there is one. The first mistake just brings on some discomfort; the second one might lead to danger and death. So our brains will naturally choose to err on the side of seeing dangers that aren’t there. The principal task of your brain is to protect you, not to keep you comfortable.
So don’t be too concerned about why your brain so often predicts dangers that aren’t there. It’s just taking a very conservative approach to the task of keeping you alive, and it errs on the side of caution. This means it may frequently spur you to automatically react in ways that are unnecessary and that make you feel uncomfortable and anxious. That’s just the way we’re built, and some people have a little more of this tendency than others, just like some people are more sensitive to light, sound, and all other kinds of stimuli.
Using the Rule of Opposites to Defuse the Worry Trick
The Rule of Opposites says this: My gut instinct of how to respond to panic and high anxiety is typically dead wrong and following that instinct makes my troubles worse rather than better. So I will respond with the opposite of my gut instinct.
An example from my own life: I’ve never been comfortable with heights. It’s much better today than it used to be, mostly because I worked at exposure when I was younger, but I still feel anxious even now when I find myself in high, open situations. My principal exposure practice was walking across large bridges when I had the opportunity, and the first time I did this was on the Golden Gate Bridge.
It’s a bridge for both vehicles and pedestrians. It has sidewalks on both sides and a ten-foot fence for the first quarter of the bridge. I saw kids on bicycles there and was horrified to see that some of them were actually riding their bikes, not cautiously walking them across! I saw people walking dogs, and some of the dogs weren’t even on a leash! There were joggers running across the bridge! And there were also a few older folks, using canes and walkers to take a stroll! They were all out there, walking, running, and riding across the bridge as if it were nothing!
And then there was me—going far slower than all of them. At first, I felt so terrified, so filled with physical fear, that I didn’t believe I could continue. I was moving so slowly. I wanted to turn around but had some weird thoughts (I had a lot of weird thoughts on that first walk) that I might slip and lose control if I did so, as if the surface of the bridge were too slick to maneuver safely! Then I realized that I was moving so slowly because I was trying to keep my feet in contact with the surface of the bridge at all times. I wanted to feel grounded so badly that I was literally dragging my heels in order to feel connected to what passed for the ground up there!
No sooner did I notice this than I remembered the Rule of Opposites. And I was sorry I remembered the Rule of Opposites because the idea was scary. But this was the kind of thing I had often encouraged my clients to do, so I did what the Rule of Opposites suggested to me.
I hopped. It was pretty small as hops go. It probably deserved a mention in the Guinness World Records for world’s shortest hop. And I did it while backed up by a ten-foot fence, so my chances of falling off the bridge were pretty poor! But it’s hard to overstate what a sense of relief I got from this hop. You can’t hop while holding your muscles tightly, and so I relaxed a lot of muscles that I’d been holding tight as a drum. That felt good. It was a silly thing to do and made me laugh. That felt good too. Nobody came running over, the way I thought they would, to stare at the crazy man hopping.
And I was still there, with the ten-foot fence, and life went on just like before, after my little hop. I still had lots of fear to work through, but this made a big difference in enabling me to keep going.
That’s how the Rule of Opposites can help you identify and use a helpful response when you’re caught up in the worry trick.
Does this seem too radical or risky to you? It’s not as radical as it might seem because the Rule of Opposites is meant to be used in response to very small, automatic responses that you can catch yourself using when caught up in a moment of high anxiety. It’s not intended for major life decisions—whether or not to go to college, to get married, or to have a baby. It’s something you apply to micro-behaviors that you can catch yourself in the act of doing during a moment of intense fear.
Examples of How to Use the Rule of Opposites
Driving fears. If you’re afraid of driving, or fear having a panic attack while you drive, you’ll probably find lots of ways the Rule of Opposites can be helpful. Many fearful drivers keep their fingers locked in a death grip around the steering wheel. Maybe they have the idea that this is necessary to maintain control of the car. Maybe having sweaty palms, another common anxiety symptom, leads them to fear their hands slipping off the wheel.
Whatever the case, any driving instructor will tell you that keeping a relaxed, light grip on the wheel is the best, and the Rule of Opposites will take you in the same direction here.
So a fearful driver who notices this particular symptom of gripping the wheel so tightly can use the Rule of Opposites to identify a useful response to this death grip.
The beauty of this is that you can take it one small step at a time. You can initially relax the pinky of your weak hand, if you want to take the smallest step possible, while allowing all the other fingers to maintain their death grip, and see how that small step affects your situation. Once you’re satisfied that this doesn’t disrupt your control of the car, and probably feels slightly better, you can relax some other fingers, going as gradually as you wish. (I’ve worked with several clients who enjoyed “giving fear the finger” as they came to their middle finger!)
Flying fears. In a similar manner, a fearful flyer can probably detect getting tricked into responding in a variety of unhelpful ways—gripping the armrest, keeping their eyes closed, or maybe covering their face with a towel in an effort to avoid noticing that they’re on a plane, maintaining a crash position, and so on.
Gripping the armrest might be helpful if you’re actually being thrown around by turbulence but will simply make you feel more tense and nervous when you’re not. You don’t need to hold yourself in; that’s what the seat-belt is for!
Closing or covering your eyes will deprive you of information about what’s actually occurring around you and leave you at the mercy of your worst imagined fears. Maintaining a crash position for an hour or more is going to leave you feeling cramped, tense, and vulnerable.
What would be the opposite of these responses? Relaxing your hands and letting them rest at your sides or in your lap will let you gradually relax a bit in ways that gripping the armrest never will.
Allowing yourself to look around and notice the interior of the airplane, with passengers and crew, would be the opposite of covering your eyes, and you’ll probably feel better as you view the actual situation around you, rather than the one you imagine with your eyes closed. Sitting back and letting the seat support your body will feel more calming than maintaining a crash position.
It’s the same with thinking that it’s so shameful to feel afraid of flying that you need to hide it. It’s certainly uncomfortable to feel afraid, but it’s perfectly okay to fly on a commercial airline while feeling afraid, just as it’s okay to fly while feeling sad, happy, angry, jealous, tired, or whatever. We don’t want the pilot to feel afraid, but it’s okay to have passengers who are afraid. What’s the opposite of trying to hide it? Telling someone! When we take a flight with my fearful flyers workshop, we always tell the crew we’re a group of fearful flyers.
Public speaking fears. Fearful speakers can similarly catch themselves in the act of getting tricked into certain unhelpful responses—standing rigidly behind a podium and gripping the edges tightly, staring at their notes and avoiding eye contact with the audience, rushing in an effort to keep talking every moment and avoiding any pauses.
The speaker would be well served to notice each of these micro-behaviors of anxiety and do the opposite—standing in a relaxed posture at the podium with hands at their sides or gently resting on the podium, looking out at the audience and making occasional eye contact with various individuals while referring to his notes without reading them or staring at them, and periodically pausing for a breath while giving the audience time to digest what they said. All of these are good counters to the worry trick.
The Rule of Opposites in the Moment
When you’re caught up in a moment of high anxiety, you’re likely to be excessively focused on your symptoms and lots of worrying about what to do and what the future holds. Your attention gets diverted from the immediate circumstances to lots of hypothetical problems that could happen in the future. The anxiety disrupts your ability to be an observer of your present experience and reality. You’ll be better able to use the Rule of Opposites by turning your powers of observation back to your immediate circumstances. Use the following questions for a start.
What are you doing with:
• your hands?
• your shoulders?
• the muscles of your chest?
• your breathing?
• your posture?
Are you tensing and clenching parts of your body? Do you feel tension in your chest and shoulders? Is your breathing short and shallow? Notice the places where you’re perhaps adding tension to your physical sensations. Consider what the Rule of Opposites has to offer about that. Gently do the opposites that occur to you, and then move on.
What are you:
• looking at?
• listening to?
• focused on?
• thinking about?
Where is your attention and energy?
• Is it focused inside your head, with all its what-if thoughts?
• Is it focused on your body, hypervigilant to every physical sensation?
What is there to observe around you? Take a few moments to turn your attention to the objects, sounds, colors, temperatures, and other details of your immediate environment.
Thinking It Over
The Rule of Opposites can be your most useful guide as you seek to reclaim your freedom from a chronic anxiety disorder. My clients find, again and again, that it’s those moments when they catch themselves in the act of some small, intuitive response to anxiety—like tensing their shoulders or gripping the steering wheel—and do the opposite that are the turning points in their recovery.
The idea of the opposites will turn up again and again in the rest of this book, and it underlies all the useful replies you can use when you’re being tricked by worry and anxiety.
Put worry in it’s place — anytime, anywhere…
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