Managing Uncertainty and Doing the Next “Right” Thing

By Annabelle Parr, MA, AMFT

There are many different reasons why you might decide to seek therapy. Maybe you are struggling with the stress of the pandemic, including but not limited to stressors like working from home and trying to be a full-time parent, teacher, and employee all at the same time; maybe you are struggling with the emotional repercussions of racism; maybe you’ve started experiencing panic attacks; maybe you have developed a phobia of driving, or needles, or spiders; maybe you are constantly consumed with worried thoughts; maybe it feels like fear is making all your decisions for you. What therapists refer to as the “presenting problem” that brings an individual in to therapy may sound, on the surface, very different from client to client. 

But one common thread that underlies almost all of our suffering (and applies especially to anxiety and related disorders, like PTSD and OCD) is a difficulty with uncertainty.

When the outcome of a situation is uncertain or ambiguous, our minds make themselves busy worrying, as if ruminating on every possible outcome (with heavy emphasis on the worst case scenarios) might prepare us. They grasp for certainty, and sometimes they will even convince us that catastrophe is inevitable because even that feels less uncomfortable than the truth: we don’t know. Usually though, this strategy makes our lives smaller. Our decisions become governed by a desire to avoid either the feared outcome itself or the anxiety that comes with taking the risk.

Here is the thing: rarely, if ever, does life truly give us certainty. 

We control what we do and don’t do, but we don’t get to control the outcome. That’s uncomfortable, I know. But what if that actually frees us up? If we can’t control the outcome, maybe we can stop trying. Maybe, instead, we can give ourselves a little grace and make choices with something else in mind.

Earlier this year, when the pandemic had just started and I felt overwhelmed with anxiety about all the uncertainty about what was going to happen and what to do, my friend reminded me of a quote from Glennon Doyle to “just do the next right thing.”

If you’re like me, and you have a tendency to get stuck on what the “right” thing means, this quote as a standalone mantra could be tricky.

But from an Acceptance and Commitment Therapy standpoint, the “right” thing would be defined as the workable thing. That is, the thing that moves you towards your values, towards who and how you want to be in the world, in service of those relationships and parts of your life that matter most to you. The “right” thing is the thing that, though maybe not the easy or comfortable thing, does not come with the cost of making your life smaller and of moving you away from what CSAM director and author of Be Mighty, Dr. Jill Stoddard refers to as “the me you want to be.”

In her book, Untamed, Glennon talks about this as your “knowing.” The core of you that knows who you are, what you want or need, and what matters most to you. Sometimes that knowing is buried under layers of learning and socialization, stories in your mind about what you “should” do or what others want from you, or strategies designed to shield you from pain, anxiety, and discomfort. But if we get curious about what is underneath all of that, if we start to get curious about our pain and what it has to say, we can find that knowing. In fact, when we get curious about our pain, we get valuable information about what’s most important to us. Because it wouldn’t hurt if we didn’t care. Our values lay on the flip side of our pain; they are two sides of the same coin.

Just do the next right thing means that even in the face of enormous uncertainty, what matters is that we tune in to those values — our knowing — and figure out what it is we can do in this one moment that is in line with what matters most to us. Because this one moment is all we are promised. Nothing else is ever a certainty, even when it feels like it might be. And actually, that may just free us up to live each moment more fully, because really, the only certainty is that we are here now…so what are we going to do about it?

CSAM IS HERE TO HELP

If you or someone you love needs support and might benefit from cognitive behavioral therapy (CBT) or acceptance and commitment therapy (ACT) for anxiety, panic, phobias, stress, PTSD, OCD, uncertainty or stress related to COVID-19, or if you would like more information about our telehealth services, please contact us at (858) 354-4077 or at info@csamsandiego.com

Mental Wellness Month: How Do We Define Wellness?

By Annabelle Parr

According to the internet, January is Mental Wellness Month. Sounds like a good cause, right? Absolutely! But pausing to consider our definition of mental wellness is important. Because if you spend much time on the internet, it might have you believing that wellness and self-care are defined by bubble baths, weighted blankets, and being perpetually Zenned out. And bubble baths, weighted blankets, and being in touch with your inner Zen are great! But mental wellness and caring for ourselves are not quite that simple.

So from a therapeutic perspective, what exactly is mental wellness? If we define illness based on a list of symptoms, do we define wellness simply as a lack of said symptomology? Or does wellness have its own particular set of characteristics equally worth defining?

If illness is a sense of dis-ease, is wellness a perpetual state of ease?

Psychiatry and psychotherapy developed based on a model which was focused primarily on pathology and illness or “dis-ease.” Beginning with Sigmund Freud’s exploration of the unconscious mind and evolving toward a medical model of treatment centered around the Diagnostic and Statistical Manual of Mental Disorders (DSM), psychotherapy has historically been centered around identifying and diagnosing a problem and working to treat it. And of course, this is a worthy mission, but it is an incomplete picture of the larger whole of life. Life is not simply about absence of illness, dis-ease, or discomfort. It is about engaging in life in a way that brings us meaning, purpose, and hopefully some joy as well.

Wellness is not about the absence of discomfort, but rather the presence of meaning.

From an Acceptance and Commitment Therapy (ACT) perspective, mental wellness is defined by our ability to engage in life in ways that bring us a sense of meaning, purpose, and vitality. Mental wellness is characterized by our ability to, moment by moment, make choices and take action in the service of our personally chosen values. And this might be surprising, but it is actually deliberately NOT defined by a lack of painful emotions, such as anxiety, fear, worry, and stress. Not only are these feelings and experiences an unavoidable part of being human, but they are directly and inextricably linked to our values.

“We hurt where we care.”

Steven Hayes, one of the ACT co-founders, noted that we hurt where we care. As Dr. Jill Stoddard pointed out in her book, Be Mighty: A Woman’s Guide to Liberation from Anxiety, Worry & Stress Using Mindfulness & Acceptance, when we look at the things that keep us up at night, the ones that weigh heavy on our minds and hearts, they probably do not include the fate of Netflix. We might enjoy a good Netflix binge, but whether Netflix will continue to thrive is probably not on our list of worries. Instead, the things that we worry about tend to be the things that matter to us on a deep level, such as our family, friends, work, home, etc.

Pain and values are two sides of the same coin.

In other words, when we look closely, the emotional pain we experience tends to point directly to what’s important to us. If we want a life that is full of wellness – full of those things that truly matter to us, that bring us joy, connection, passion, and purpose – we have to be willing to risk having difficult and painful feelings. We cannot have one without the other because it wouldn’t hurt if we didn’t care and vice versa. When we try to rid ourselves of all painful feelings, we also restrict our ability to engage with the things that we really care about. As much as we might wish otherwise, we cannot have joy without also risking pain. As Brené Brown said so well, we cannot selectively numb emotion. When we are unwilling to have pain, we will also be less able to experience joy.

Our emotions are not problems to be solved; the problem is when our behavior prevents us from engaging in life in functional and fulfilling ways.

From a diagnostic perspective, it is not simply the presence of anxiety that warrants a diagnosis; rather it is the functional impairment that the anxiety creates that helps determine whether someone meets criteria for diagnosis. Said otherwise, a diagnosis includes consideration of whether your experience of your emotions, thoughts, and sensations causes you to limit your behavior such that your life is restricted in significant areas, like work, school, and relationships.

Wellness is about how we respond to pain when it shows up.

Therefore, wellness is not defined by the absence of stress, anxiety, grief, worry, anger, or frankly any other emotion. Instead it is all about how you are able to manage difficult thoughts, feelings, and experiences and still continue to engage in life in a way that is fulfilling, meaningful, and guided by what is important to you. And ACT, beyond emphasizing the importance of values-based actions, has plenty of wisdom regarding how to increase psychological flexibility such that you are able to respond more effectively when discomfort arises.

If you find that your thoughts and feelings are holding you back from living your life in the way that you might want, ACT can help. For some excellent resources, check out our suggested reading and our suggested podcasts. For professional support, an ACT therapist can help guide you on your journey.

CSAM IS HERE TO HELP

If you or someone you love needs support and might benefit from cognitive behavioral therapy (CBT) or acceptance and commitment therapy (ACT) for anxiety, panic, phobias, stress, PTSD, OCD, or insomnia, or if you would like more information about our therapy services, please contact us at (858) 354-4077 or at info@csamsandiego.com

Empowering Women with Acceptance and Commitment Therapy

by Annabelle Parr

According to the World Health Organization (WHO), women are twice as likely to be diagnosed with anxiety and depression as men. Women are also the largest group diagnosed with post-traumatic stress disorder (PTSD). Some argue that rather than some innate, biological predisposition to these disorders, the context in which women exist may be the cause of the gender disparity (see Dr. Robyn Walser’s article and Dr. Jill Stoddard’s upcoming book Be Mighty). The WHO states, “gender specific risk factors for common mental disorders that disproportionately affect women include gender based violence, socioeconomic disadvantage, low income and income inequality, low or subordinate social status and rank and unremitting responsibility for the care of others.” When gender intersects with other facets of identity, such as race, sexual orientation, and socioeconomic status, risk factors and inequities are further compounded. 

As Dr. Stoddard discusses in Be Mighty, women are paid less for equal work (Bishu & Alkandry, 2017), are largely responsible for household and caretaking tasks even when working outside the home (Pew Research Center, 2015), are less likely than men to be introduced by our professional title (Files et al., 2017), are evaluated as either likeable or competent as if the two were mutually exclusive (Heilman et al., 2004; Rudman & Glick, 1999), and are seen as less desirable when we outperform men (Park, Young, & Eastwick, 2015). Women are also taught that there is a narrow and rigid standard of beauty to which we must conform. Not only is our inherent worth devalued in all the ways above, but 1 in 3 women experience sexual violence in their lifetime (and little girls are twice as likely as little boys to be sexually abused). And 1 in 3 women have experienced some form of intimate partner violence (domestic violence). On top of the violence women are subjected to, we watch as victims are blamed when they come forward. They are asked to provide extensive hard evidence for the injuries perpetrated against them, questioned on their authority to be the expert on their own experience. Meanwhile, the perpetrator’s word that he didn’t do it is sufficient evidence for so-called justice to take his side, and the victim is demonized for having the audacity to speak up.

Things are changing. In the past few years we have seen a dramatic shift with women everywhere speaking up and sharing their stories, both leading up to and following the #MeToo and #TimesUp movements. But there is still a long way to go. When we really let in awareness of the injustice present in our culture, it can trigger enormous anger – an emotion women are taught we are not allowed to have. Though anger can drive productive action against injustice, it can also become overwhelming and a barrier to movement. And particularly when we are not allowed to have it, it can easily turn to depression.

Some argue that in boiling the problem down to individual mental health problems, we do women a disservice and we miss the bigger problem. What if we had an alternative? What if instead of suggesting she is the one with a problem, we saw her pain as a result of a system that tells her she is worth less?

Yeah, what if? But what now? What do we do with all of this information? Acceptance and Commitment Therapy (ACT) has some suggestions to help empower women in a context of inequality.

First, we get present. We attune to our experience in the here and now. We do our best to cultivate a willingness to feel it, to not turn away from it, despite the larger messages designed to silence us, our experiences, and our pain. This allows us to turn toward doing what matters, rather than focusing all of our energy on turning away from our pain.

Next, we cultivate an observer self. We begin to hold ourselves with compassion, like we might hold our 5-year-old selves. No matter how many negative messages we have absorbed about who we are, what we deserve, and how we have to be, there is a self underneath all of that. We are much more complex and greater than those stories we have been taught to believe. When we are able to take a new perspective on how we see ourselves and our pain –holding ourselves with the compassion we would have for a child or a friend – we become our own ally rather than our own worst enemy. In connecting to a sense of ourselves that is more nuanced and complex than any one story, we are no longer defined as unidimensional. We are free to do what matters, to live life according to our values rather than confined by messages designed to keep us boxed in.

With this observer self awareness, we can learn to examine our thoughts, such as those that tell us we have nothing of value to say, that we can’t make a difference, that we are alone, or that we are to blame. And we can learn to see those thoughts for what they are: words. When we can stop taking our thoughts as literal truths, we can choose to take action that deliberately defies them when they do not serve us. We can think “my voice and my actions don’t matter” and still choose to stand up for what we believe in. 

We show up to our pain because it deserves to be acknowledged and seen. And because within pain is valuable information. Behind our pain lies our values – they are two sides of the same coin. We wouldn’t hurt if it didn’t matter. Pain and values are inseparable and both are vital; we can’t have one without the other. Pain can feel overwhelming, but when we listen to the message it is communicating, we can identify those things that are important to us. And when we connect to our personally chosen, deeply held values, we have a compass pointing toward the direction we want to move. When we know what is important to us, we are also afforded the opportunity to connect with others who share our values. The connection to what is important to us and to others who share our values are the fuel that keeps us going when it gets hard. When our minds tell us we can’t keep going, our values remind us why we will try anyway.

Once we know our values and we are able to show up willingly to our experience in the present, we are able to commit to specific actions that are connected to what matters to us. All those thoughts that we can’t make a difference or that our voice is not loud enough are suddenly not quite so significant, because now what matters in this moment is that we act in service of what is important to us. We don’t get to control the outcome, but we do get to know that we are engaging in life in a way that is empowered by our values rather than dictated by systems determined to keep us silent and small.

Just as research shows us the ways that women are treated as “less than,” it also shows us what happens when women are empowered and are present in spaces that were traditionally not open to us. In Be Mighty, Dr. Stoddard notes that patients show health benefits when they are treated by female physicians – including lower mortality rates and fewer hospital readmissions (Tsugawa et al., 2017); corporate finances improve when women are present in leadership (Hunt, Layton, & Prince, 2015) and boards become more effective when women bring our skills to the table (Daehyun & Starks, 2016). Women’s presence in decision making improves the environment (Cook, Grillos, & Anderson, 2019) and helps facilitate more effective and enduring peace agreements (Paffenholz, Kew, & Wanis-St. John, 2006; O’Reilly, Súilleabháin, & Paffenholz, 2015). And when women are involved in politics, the lives of all women and mothers improve as their interests are represented and advocated for (Swers, 2005; Anzia & Berry, 2011).  

The world is a better place when women are represented in positions of power and leadership. And just as it is important to acknowledge that things improve for everyone when women are empowered, it is also important to acknowledge that women deserve equality and empowerment as individuals whose worth is not gauged based on the collective value we offer, but is based on our individual humanity and inherent worth. Our worth is not defined by what we can give to others, but is instead based on the fact that our existence alone is enough to mean we matter. 

So how do we move toward empowerment? We start by holding our pain the way we might hold something precious. It deserves our attention and our care. Once you know your pain, you can begin to consider what it says about what is important to you. And then you can start to take actions, large or small, toward what matters.

For more information on using ACT to empower women, check out Praxis trainings, particularly the upcoming Fierce, Fabulous, and Female online training. Also, check out Dr. Jill Stoddard’s book, to be released January 2020: Be Mighty: A Woman's Guide to Liberation from Anxiety, Worry, and Stress Using Mindfulness and Acceptance and Dr. Janina Scarlet’s upcoming book, release date TBD: Super-Women: Superhero Therapy for Women Battling Anxiety, Depression, and Trauma.

CSAM IS HERE TO HELP

If you or someone you love might benefit from cognitive behavioral therapy (CBT) or acceptance and commitment therapy (ACT) for anxiety, panic, phobias, stress, PTSD, OCD, or insomnia, or if you would like more information about our therapy services, please contact us at (858) 354-4077 or at info@csamsandiego.com

References

Anzia, S. F., and C. R. Berry. 2011. “The Jackie (and Jill) Robinson Effect: Why Do Congresswomen Outperform Congressmen?” American Journal of Political Science 55: 478–493.

Bishu, S. G., and M. G. Alkadry. 2017. “A Systematic Review of the Gender Pay Gap and Factors That Predict It.” Administration & Society, 49: 65-104.

Cook, N. J., T. Grillos, and K. P. Anderson. 2019. “Gender quotas increase the Equality and Effectiveness of Climate Policy Interventions.” Nature Climate Change 9: 330–334.

Daehyun, K., and L. T. Starks. 2016. “Gender Diversity on Corporate Boards: Do Women Contribute Unique Skills?” American Economic Review 106: 267–71.

Files, J. A., A. P. Mayer, M. G. Ko, P. Friedrich, M. Jenkins, M. J. Bryan, S. Vegunta, C. M. Wittich, M. A. Lyle, R. Melikian, T. Duston, Y. H. Chang, and S. N. Hayes. 2017. “Speaker Introductions at Internal Medicine Grand Rounds: Forms of Address Reveal Gender Bias.” Journal of Women’s Health 26: 413–419.

Heilman, M. E., A. S. Wallen, D. Fuchs, and M. M. Tamkins. 2004. “Penalties for Success: Reactions to Women Who Succeed at Male Gender-Typed Tasks.” Journal of Applied Psychology 89: 416–427.

Hunt, V., D. Layton, and S. Prince. 2015. “Why Diversity Matters.” McKinsey and Company Annual Report. https://www.mckinsey. com/business-functions/organization/our-insights/why-diversity- matters. Accessed March 24, 2019.

O’Reilly, M., A. S illeabh in, and T. Paffenholz. 2015. “Reimagining Peacemaking: Women’s Roles in Peace Processes,” New York: International Peace Institute.

Paffenholz, T., D. Kew, and A. Wanis-St. John. 2006. Civil Society and Peace Negotiations: Why, Whether and How They Could be Involved. Paper presented at the International Studies Association Conference, March, San Diego, CA.

Park, L. E., A. F. Young, and P. W. Eastwick. 2015. “Psychological Distance Makes the Heart Grow Fonder: Effects of Psychological Distance and Relative Intelligence on Men’s Attraction to Women.” Personality and Social Psychology Bulletin 4: 1,459–1,473.

Pew Research Center. 2015. “Raising Kids and Running a Household: How Working Parents Share the Load.” Accessed November 10, 2018. http://www.pewsocialtrends.org/2015/11/04/ raising-kids-and-running-a-household-how-working-parents- share-the-load/.

Rudman, L. A., and P. Glick. 1999. “Feminized Management and Backlash Toward Agentic Women: The Hidden Costs to Women of a Kinder, Gentler Image of Middle Managers.” Journal of Personality and Social Psychology 77: 1,004–1,010.

Stoddard, J. A. (2020). Be mighty: A woman’s guide to liberation from anxiety, worry, & stress using mindfulness and acceptance. Oakland, CA: New Harbinger.

Swers, M. L. 2005. “Connecting Descriptive and Substantive Representation: An Analysis of Sex Differences in Cosponsorship Activity.” Legislative Studies Quarterly 30 (3): 407–433.

Tsugawa Y., A. B. Jena, J. F. Figueroa, E. J. Orav, D. M. Blumenthal, and A. K. Jha. 2017. “Comparison of Hospital Mortality and Readmission Rates for Medicare Patients Treated by Male vs Female Physicians.” JAMA Internal Medicine 177: 206–213.

When You Stress About Stress You’re Stressed

By: Jill A. Stoddard, PhD

Image source: https://www.amazon.com/Stressed-Desserts-Spelled-Backwards-Poster/dp/B017C9AZUQ

What is your go-to when you feel stressed out?  Do you like a few glasses of wine, an hours long vent session, or a creative excuse to get out of a social engagement?  These are all examples of experiential avoidance—an unwillingness to experience uncomfortable internal emotions or sensations and active efforts to change, reduce, or eliminate them (Forsyth and Eifert 1996).  Does experiential avoidance work to alleviate feelings of stress?  Yep.  It works or we wouldn’t do it.  But how long does that last?  Look at your personal experience and take inventory:

1.     what do you do or not do when you feel stressed?

2.     what does it get you (i.e., what discomfort does it relieve)?

3.     what is its cost?    

When our reactions to stress result in only temporary relief but come at a cost to our health, our relationships, or other areas of importance, it’s time to reevaluate our relationship to stress. 

Think of it this way (Stoddard, 2019):  Imagine I have you in a little booth suspended above a barracuda tank.  I tell you, “Whatever you do, don’t get stressed and you will be fine.  Unfortunately, if you do feel stressed, the floor of the booth will open, dropping you into the barracuda tank.  But just don’t get stressed and you will be totally fine!” 

What do you think is going to happen?  Right—you’re stressed…and fish food.  Is it because you just didn’t try hard enough to control your stress?  Was the incentive not quite high enough?  Of course not—our most primitive instinct is to survive.  So why did you get stressed and end up swimming with the fishes?  Because when you are unwilling to experience stress, you are stressed about stress so you are stressed (Hayes, Strosahl, and Wilson 1999).  See the trap?  Your relationship to stress becomes one in which you evaluate it as bad, dangerous, and deadly. 

So, of course, you are stressed about having stress. 

So what should you do the next time you hear on Good Morning America or in the Huffington Post “Stress is bad for you!  Stress will kill you!  You shouldn’t get stressed!”  It turns out, stress has been wrongfully getting a bad rap (McGonigal 2013).  While stress does release adrenaline (the hormone thought to be harmful to the body), it also releases oxytocin, the bonding hormone that enhances empathy and motivates us to seek and give care.  Oxytocin is a natural anti-inflammatory—it’s good for our bodies and actually strengthens our hearts.  And, fascinatingly, all we have to do to mitigate the negative effects of adrenaline is simply appraise stress as helpful.

Come again?  Stress, helpful?  YES--stress can motivating!  Stress is what prompts you to prepare for the important job interview, watch over your small children in a crowded place, and get ready for the big game.  If you were totally chill, you’d likely bomb the interview, lose your kid at the mall, and blow the game.  As it turns out, there is an optimal arousal zone when it comes to doing well (Yerkes and Dodson 1908):  when stress is very high or very low, it has the potential to negatively impact performance.  But a moderate level of arousal is helpful. 

The best way to manage stress is simply to change your relationship to it.  So stop struggling to avoid and reduce your stress (how’s that working for you, anyway?), and instead work on accepting that to be human is to know stress, and stress need not be our enemy.  You can do that by remembering:

1.     stress is motivating and can improve performance at moderate levels

2.     stress prompts us to seek connection with others and this is good for our health

3.     stress is only damaging when we evaluate it as damaging

4.     when we are stressed about stress we are stressed

Now, don’t get me wrong—I’m not suggesting you give up your meditation practice because it makes you feel less stressed.  There is nothing wrong with getting your bliss on—as long as your strategies don’t come at the cost of other meaningful and important pursuits.  So go ahead and yoga-it-up—just don’t neglect your friends and family while you’re at it.

CSAM IS HERE TO HELP

If you or someone you love might benefit from cognitive behavioral therapy (CBT) or acceptance and commitment therapy (ACT) for anxiety, depression, stress, PTSD, insomnia, or chronic illness, or if you would like more information about our therapy services, please contact us at (858) 354-4077 or at info@csamsandiego.com

References

Forsyth, J. P., and G. H. Eifert. 1996. “The Language of Feeling and the Feeling of Anxiety: Contributions of the Behaviorisms Toward Understanding the Function-Altering Effects of Language.” The Psychological Record 46: 607–649.

Hayes, S., K. Strosahl, and K. Wilson. 1999. Acceptance and Commitment Therapy: An Experiential Approach to Behavior Change. New York: The Guilford Press.

McGonigal, K. 2013. “How to Make Stress Your Friend.” Filmed June 2013 in Edinburgh, Scotland, video, 13:21, https://www.ted.com/talks/kelly_mcgonigal_how_to_make_stress_your_friend/transcript

Stoddard, J. 2019. Be Mighty: A Woman’s Guide to Liberation from Anxiety, Worry, and Stress Using Mindfulness and Acceptance. Oakland: New Harbinger Publications.

Yerkes, R. M., and J. D. Dodson. 1908. “The Relation of Strength of Stimulus to Rapidity of Habit-Formation.” Journal of Comparative Neurology and Psychology 18: 459­–482.

Anxiety Tools: An Expert's Advice

reposted from Healthline.com

originally written by Healthline Editorial Team featuring an interview with CSAM Director Dr. Jill Stoddard

Anxiety disorders affect over 18 percent of U.S. adults each year, according to the National Institute of Mental Health. This includes generalized anxiety disorder, obsessive compulsive disorder, post-traumatic stress disorder, and more.

Anxiety can work its way into many aspects of a person’s life, which is why it’s so important to find the resources, support, and advice you need — whether it comes from people’s stories, helpful phone apps, or expert advice.

Dr. Jill Stoddard is the founding director of The Center for Stress & Anxiety Management, an outpatient clinic in San Diego specializing in cognitive behavioral therapy (CBT) and acceptance and commitment therapy (ACT) for anxiety and related issues. She’s also an associate professor of psychology at Alliant International University, and the co-author of “The Big Book of ACT Metaphors.”

We caught up with her to learn about some of the ways she recommends for managing anxiety disorders.

Dr. Jill Stoddard’s advice for anxiety

1. Use your senses

Anxiety narrows your focus onto perceived threats (i.e., whatever you’re feeling afraid of or worried about in the moment) which can impact your focus and memory. Practice mindfully broadening your view by using your senses — what do you see, hear, smell, etc. — to improve attention and experience.

2. Have gratitude

Practice gratitude as another way to broaden your focus. There are the things that you worry about, and there are also the things you’re grateful for.

3. Be accepting

Difficulty with uncertainty and a lack of perceived control amplify anxiety. To “fix” this, we often attempt to get more certainty and more control — for example, by doing internet searches about health symptoms. This actually increases anxiety in the long run.

The antidote is acceptance of uncertainty and control. You can read a book or watch a sporting event without knowing the ending. In fact, it’s the anticipation that makes it exciting! So try bringing this attitude of openness to not knowing, and letting go of control. See what happens.

4. Face your fears

Avoidance is anything you do, or don’t do, to feel less anxious and prevent a feared outcome from occurring. For example, avoiding a social situation, using drugs or alcohol, or procrastination are all examples of avoidance.

When you avoid what you’re afraid of, you get short-term relief. However, this relief never lasts, and before you know it, that anxiety has returned, often with feelings of sadness or shame for having avoided it. And often, the exact avoidance strategies you’re using to feel better and prevent a feared outcome (e.g. reading off your notes during a speech or avoiding eye contact) actually create the outcome you’re trying to avoid (namely, appearing anxious or incompetent).

Consider taking small steps to start facing your fears. What’s one thing you might do that takes you out of your comfort zone? You will build mastery and confidence, and your anxiety might even diminish in the process.

5. Define your values

Do some soul searching about what really matters to you. Who do you want to be? What do you want to stand for? What qualities do you wish to embody as you engage in work or school, or interact with people you care about? If friendship matters, how can you create space in your life for that? When you do so, what qualities do you wish to embody as you spend time with friends? Do you wish to be authentic? Compassionate? Assertive?

These are all values, and making choices in line with values — rather than in the service of avoidance — may or may not impact your anxiety, but will definitely add richness, vitality, and meaning to your life.

Healthline’s tips

To help you keep your anxiety in check, Healthline also recommends trying out the following products in your day to day:

• Add some lavender essential oil to your lotions and soaps, use as an air freshener, or rub small diluted amounts onto your neck or feet.
• Take Kavinace supplements, which can help with anxiety-related sleep issues.
• Try practicing self-guided meditations that emphasize self-compassion.
• Get some relaxing sounds from the Stress Relief Collection.
• Check out biofeedback therapy. Some people find it to be an effective tool in managing anxiety. Use the BCIA directory to find a certified practitioner.