Couples & Anxiety

 

Couples

If you are having difficulties in your marriage, assess whether if one of you has anxiety.

Research indicates a link between anxiety and martial distress, with anxious individuals reporting greater martial conflict and lower levels of marital satisfaction (Whisman, 2007; Whisman, Sheldon, & Goering, 2000; McLeod, 1994).

People with generalized anxiety disorder (GAD) are more likely to divorce (Hunt, Issakidis & Andrews, 2002) and report low relationship quality with their partners compared to those with other psychiatric diagnoses (Wittchen, Zhao, Kessler, & Eaton 1994), suggesting that the treatment of anxiety stands as an important topic when approaching successful techniques in couples therapy.

Stay Calm in Love: Dr. Daitch’s Tips for a Happy Valentine’s Day

CupidValentine’s Day is just around the corner. For those couples wishing to enhance their sense of connection,

Dr. Carolyn Daitch, Director of the Center for the Treatment of Anxiety Disorders in Farmington Hills, MI has five easy tips to recommend.

C.U.P.I.D

C: Communication requires de-escalation: successful communication requires deescalating your own heightened emotion before engaging your partner.

U: Understanding is NOT automatic: you and your partner are not always going to share the same perspective—so the assumption that your partner should, by default, understand your perspective can cause frustration and alienation for both of you.

P: Practice makes permanent: repeated practice, not just good intentions or a single instance of success, brings about the change in your relationship that you want to see.

I: Interdependence is the key: a good balance of dependence and independence is the key to healthy relationships.

D: Deescalate whenever needed: when you are in conflict with your partner and emotions start to escalate, take an immediate cease-fire, or “time-out” to calm down before reengaging. Heightened emotion, whether it’s anxiety, fear, anger, or sadness, only heightens disconnect in an interaction. You need to deescalate your own heightened emotion before you’re going to experience connection in any communication.

Embracing and putting these tips into action will help couples feel the warmth of Cupid’s arrow without its sting this Valentine’s Day.

CoreBrain Journal Podcast- Treatment Options for Anxiety

Listen any time to hear from Carolyn Daitch Ph.D. She is the director of the Center for the Treatment of Anxiety Disorders in Farmington Hills, Michigan and is a Fellow with both the American and the Michigan Society of Clinical Hypnosis. She is a routinely invited speaker around the world and frequently presents on ADHD and anxiety. Recognized for her practical, easy-to-implement interventions, Dr. Daitch is the author of four books, including the award-winning Affect Regulation ToolboxAnxiety Disorders: The Go-To Guide, and Anxious in Love. Her newest book is The Road to Calm Workbook. Dr. Daitch is quick, and her experience with insightful solutions for rethinking anxiety takes a different, constructive turn. Let your Road to Calm start here!

When Eye Rolls are Appropriate: Staying Calm in the Midst of Chaos

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The Chinese curse “May you live in interesting times,” seems to be active today. Globally. The news sounds more and more like the most alarming drum roll.

In the past few weeks, the world has been gripped by reports of terrorist plots and attacks in the US, in France, in Bangladesh, in Istanbul, in Baghdad, in Munich. Refugees from Syria are drowning by the hundreds as they desperately seek a safe foothold. Everywhere the number of the dead mounts.

On the heels of the economic earthquake called Brexit, we’ve sustained horrifying videos of two citizens being killed by police; within days, we’ve seen a vigilante execution of five policemen during peaceful protests in Dallas. Only days later, gunshots in a small Michigan town’s courthouse left two bailiffs dead. And now, more atrocities in Munich.

These breath-stopping events have pushed aside reports of brain-eating microbes in White Water playgrounds in North Carolina and of hungry alligators in at Disney World in Florida. Almost as background noise to this fire-engine timbre, we have the off-the-chart weirdness of the 2016 Presidential election. All this in the midst one of the hottest summer on record, with Mother Nature wildly signaling for us to stop destroying our atmospheric buffer.

The near daily announcements of tragedies all over the world are hard on all of us. It’s nearly impossible or even desirable to be immune to human suffering. But for some people, these horrific acts and the uncertainty they cause are just too much to handle. The feeling of vulnerability causes extreme suffering for some.

For more than three decades, I have worked as a psychologist specializing in the treatment of anxiety.  Everyday I help people who suffer anxiety that results in great difficulties keeping worries in check. These clients have a debilitating propensity to overreact to stress. Compounding the problem, they have a hard time accepting the inevitable uncertainty of life.

Even when life is running smoothly, chronic worriers focus on unknown disaster looming around the corner. If you are a worrier, you suffer on three levels: cognitive, emotional and physical. Cognitive anxiety shows up as the worried thoughts you experience—the host of “what ifs” that plague you. On the emotional level, you may feel on edge or irritable most of the time. You feel particularly vulnerable because the world seems uncertain and unsafe. On the physical level, heightened stress hormones often lead to bodily ailments, stomachs, muscle pain, headaches. To make things worse, sometimes the symptoms gang up and act up in mob fashion or in an insidious sequence that creates a biological loop that feeds on itself.

Talk about a vicious circle! Vicious in its propensity to seem to continually tighten its grip on you; even more vicious because once set in motion, the slightest thought, event, or threat adds to its force. A loud noise of an ambulance siren, news of a catastrophe at the other side of the world, a colicky baby, the delay of an appointment, a stuck zipper, a rude clerk — any little thing that is part and parcel of the day-do-day ticking of life–affirms the danger and vulnerability of your existence.

When fear grips you, your muscles tense, your body releases adrenaline and cortisol hormones, and you experience psychological stress. When this state becomes chronic, or even constant, both your body and mind functions at less than optimal levels. Excessive anxiety and reactivity make it difficult to respond effectively to the ups and downs of life. And ineffective responses, obviously, lead to unsatisfactory results, which add to feelings of vulnerability. So, what is a person suffering from persistent anxiety to do?

 The Stop Solution to Anxiety

A growing number of psychologists, myself included, coach their anxious clients in ways they can control the often-unbearable symptoms of anxiety. You can practice the following easy-to-learn techniques that I call “The STOP Solution” whenever and wherever you want to stop runaway anxiety in its tracks. Here’s how it works:

Picture in your mind a huge, red, octagonal sign with the word “STOP” in the middle. Let that simple word serve as an acronym that mobilizes your first-responder defense mechanism against anxiety. STOP stands for:

Scan your thoughts, emotions, behaviors and bodily sensations to notice if anxiety is occurring or is about to occur;

Take a time out;

Overcome initial emotional flooding by using fast-acting techniques to interrupt and stop emotional escalation.

Put the tools in your anxiety “tool box” into use.

STOP should become a strategy and tactical guide in your ongoing fight against anxiety in any of its forms. This is how it works, and it works well.

The moment you sense that anxiety is about to overwhelm you, step out of the situation you are in. Take a Time Out. Time outs are not just for children. You have to take a break, even a short one, to dial down your anxiety. Find a place in your home or office that is peaceful and calming, a place where you can do what works best for you to soothe and calm yourself. And take that time out as often as you need.

When you settle into your time-out place, try doing an Eye Roll. It’s simple: roll your eyes upward as if you are trying to look at the centermost point in the arch of your eyebrows. At the same time, take in a slow, deep breath.   Continue holding your eyes gazing upward while holding the breath and then exhaling slowly, allowing your eyes to drift back to their original position. The Eye Roll is the first, and amazingly quick, step in moving into calm and soothing yourself.

Another simple and easy stress buster you can do either in your time out or on the sly in a meeting or any public place: Tight Fist.

By alternately tightening your fists and relaxing them, you actually trick your body into becoming aware of the means of releasing the tension. The Tight Fist exercise accumulates the tension from the entire body into the fists, and then releases it, eliciting a total-body tension release. Some people find it helpful to simultaneously visualize their tension as being crushed in their fists. The exercise can be repeated as often as necessary.

Then there’s breathing, something we do automatically from the moment we cry out our first breath, to the moment we stop breathing. Focusing narrowly on the breath is a key step to controlling runaway anxiety. When we focus on a function that is normally automatic, we take control and comfort from the purposeful, self-regulating action. Slow, deep, deliberate breathing is self-soothing because the focus of attention is diverted from worry or fright to the rhythmic, life-affirming intake and release of air.

A close focus on breathing is also used in meditation practices. You can focus your attention on your breath in you office chair, in bed, on a park bench, in the line at the grocery, and yes, in the dentist’s chair. Your breath is always available to you. Here is one way to use Breathing to reduce your anxiety:

Once aware that an emotional flood is on its way, or up to your neck, you can to inhale deeply and slowly, concentrating on that intake of air, feeling it filling your lungs. You count, say, to four while breathing in. Hold the breath for a count of four. Then count to eight while you exhale, slowly and deliberately from the diaphragm all the way up to the upper tips of your lungs.. When your lungs are empty, concentrate on that to the count of four. Then, take another, deep, slow, breath and feel the calm.

With focused concentration, observe your own slow, rhythmic breathing. Observe how calming it is and note how each deliberate breath is making your body relax. Note the difference your control of your breathing has made to how you feel physically and emotionally. You took control simply by concentrating on your breathing.

Now that you have moved into calm, you can use the P in the Stop Solution: Putting the tools into practice. I teach a whole toolbox of tools to use to counter worry and anxiety. Three of my favorites are Mindfulness, Wise Self and The Okay Signal.

Mindfulness is the practice of calm, detached observation of your current experience. It’s about focusing on the situation and thoughts and emotions it has caused with objective curiosity, almost as if you were a bystander and not the subject. This non-judgmental, slightly detached vantage point will provide a new perspective of the charged situation and of the range of potential reactions you actually have. In other words, mindfulness offers a view of your choices as well as a reasoned acceptance of what is — an acceptance and openness to reality.

Mindfulness by no means is a negation of what you may be thinking or feeling. To the contrary: have an internal chat with yourself: “I observe how frustrated I am. I feel my jaw clenching. My stomach is in knots.”

Remind yourself that thoughts, feelings and sensations come and go. Like changes in the weather or cars passing on the street.

Another tool in the STOP solution is the Wise Self. We all consist of many parts. Some parts may be anxious and vulnerable and other parts are grounded and wise. When you are calm, you can access a strong and wise self as a resource for the more vulnerable parts of yourself. You can literally use the words coming from the wise part of self to support your worried self. You wise self might say to your anxious self:

  • You can cope with this moment.
  • You may not like uncertainty, but you can tolerate it
  • You are safe.
  • You can choose to stay calm.

Another calming tool is called the okay signal   The okay is an anchor that serves as a cue to re-set the feel of calm and to physically and cognitively remind your self that in this moment, everything is okay. You may fear the future but in the moment you are okay.

To create a cue for that truth, place your thumb and forefinger together and make a circle that signifies an Okay signal. Continue to hold the fingers together, and repeat to yourself three times, . “I am okay in this moment.”

Now a final word about worry: It is important that you acknowledge and respect your worry and your worrying self. Welcome it and let it be. What you cannot allow is for that worrying self to take over. It can learn, with these techniques, that it is a member of a team. Teach it to be a team player by creating a break, or a time out when it is out of control. Use the techniques that dial down stress until the worrying self calms down. Cultivate detached curiosity regarding your anxiety to confront blind fear. Call on your Wise Self to talk to your worried self. With these interventions, you can move out of the anxiety trap and tolerate and accept the uncertainty in your own world and the world at large.

Life is a reality show without a script–we must all go with the flow. Going against it, at best, makes us flail wildly in place. You can stay calm in the midst of chaos. Go ahead, roll your eyes at what’s happening in our world.

Carolyn Daitch is a clinical psychologist who along with Lissah Lorberbaum is the author of The Road to Calm Workbook.

How Not to Sweat the Test

Test angstThis time of year, flyers and posters in every classroom and school hallway remind students of looming test dates and the importance of scoring well on exams. Parents, teachers and counselors as well as college recruiters and counselors admonish about how the test results can impact a student’s entire life. They leave little doubt that the results of SAT, ACT,  H.S. Exit exams are make-it-or-break-it trials.

Sang froid isn’t running in most adolescents’ veins. More to the point, youngsters prone to anxiety understandably begin to experience the emotional and physical symptoms of test anxiety often even before the winter break is over. Overwhelmed by the make-it-or-break-it trials ahead, they begin to struggle with everyday functioning, unable not only to discharge responsibilities but also unable to experience any joy.

As a psychologist focused on helping clients with anxiety disorders, I have seen up-close the extent of the debilitating effects of rampant anxiety. I’m happy to add, quickly, that I have also seen how effectively and relatively simply anxiety can be controlled.

We are all aware that some level of stress is healthy and helps drive students toward excellence and achievement. As parents, teachers and life coaches of all sorts we preach to the young the values of successful study habits, of staying focused, on being resilient and yes, even on the sharp but invaluable lessons of failure.

Experiencing a moderate degree of stress in a testing situations is optimal. A moderate degree of stress ensures alertness and motivation to perform at peak efficiency. Personally, I know I’ve performed best in my life, whether leading workshops, writing, teaching , when I was anxious enough to prepare, and even over-prepare. The just right level of anxiety acts as a driver to excellence.

My work has been focused on helping people who tend to cross over the line of healthy, moderate, constructive anxiety, people whose reaction to stress is excessive, sometimes completely debilitating as it focuses them not on the task but on everything that will go wrong…for sure. Jokingly, I often explain that anxiety is too much of a good thing.

The truth is, anxiety is no joking matter. In young people it is often even more serious because young people have yet to learn about perspective, analysis, self-control and emotional self regulation, briefly, the martial arts of survival. For highly sensitive, highly reactive students, test anxiety is an overwhelming, paralyzing hurdle that can sabotage performance by turning them almost comatose, wiping out their solid preparation, knowledge and actual competence at the very moment they should be demonstrating them.

Like any other type of anxiety, Test Anxiety has physical, mental and emotional manifestations. Common physical symptoms include jitteriness, lightheadedness, nausea and stomach ache. Mental symptoms include scattered attention, a sense of dread and doom and often shame — shame that certain failure will disappoint parents or teachers who, albeit well-intentioned, might have built up pressure to get into the best, most prestigious college.

Unidentified and untreated, test anxiety can have long-term physical, mental and emotional consequences and often, even economic consequences.

Today, test-taking skills are essential for success in academic and professional circles. The ability to perform on a level commensurate with actual knowledge of a given subject in testing situations, can, indeed, be a make-it-or-break-it ability. Yet, research shows that anywhere from 15-20 percent of college students suffer from a significant level of test anxiety, which interferes with their ability to fully demonstrate their knowledge and ability.

My experience with students at any level,  including young adults   facing graduate admissions tests and board exams, , have led me to create a program specifically aimed at helping students who suffer from Test Anxiety. It addresses the short-term necessity to immediately and effectively deal with Test Anxiety but it also addresses the long-view need to develop a different relationship with anxiety — to accept rather than avoid it, to use it constructively rather than fear it.

The program is called Test Anxiety Solutions and consists of a workbook and accompanying audio CDs that provide specific techniques for regaining composure and focus and explains the use of research-based tools for re-establishing optimal states of mind, body and emotion in testing situations.

The program offers numerous techniques and “tools” that are as effective as they are accessible. Here are five simple, easily practiced on-the-spot techniques:

►Visualize success on the test. See yourself confidently answering the questions you immediately know the answers to first. See yourself reading every question carefully and calmly. See your brain as a repository of all the knowledge you stored into it and go to it with confidence.

►Before the test, take 90 seconds to do a set of deep relaxation breathing, inhaling slowly to full lung capacity, then exhaling slowly until your lungs are empty. Focus on the breathing exclusively.

►You can repeat the breathing exercise during the test, as needed.

►Anticipate  speed bumps when you come across a question that seems difficult. Read the question calmly and carefully, then reflect realistically on whether to skip it or continue working on it.

►Reject unrealistic, exaggerated thoughts as if to put them off for later and decide to choose for the moment only thinking that will help you pass the test. Recall the mind-frame that helped you achieve success in the past. Let that mind-frame crop your thoughts during the test.