{"id":152219,"date":"2024-03-03T14:56:58","date_gmt":"2024-03-03T19:56:58","guid":{"rendered":"https:\/\/effectsofanxiety.net\/archives\/152219"},"modified":"2024-03-03T14:56:58","modified_gmt":"2024-03-03T19:56:58","slug":"anxiety-relief-a-sample-15-week-masterclass-with-20-cognitive-behavioral-therapy-strategies","status":"publish","type":"post","link":"https:\/\/effectsofanxiety.net\/archives\/152219","title":{"rendered":"Anxiety Relief: A Sample 15 Week Masterclass with 20 Cognitive Behavioral Therapy Strategies"},"content":{"rendered":"
https:\/\/www.youtube.com\/watch?v=AEBJsS7OhZQ<\/div>CEUs are available at AllCEUs.com\/Anxiety-Master hey there everybody and welcome to this video\u00a0 on 20 anxiety relief strategies i’m your host\u00a0\u00a0 dr donnelly snipes in this video i’m going to\u00a0 walk you through the basic strategies that i\u00a0\u00a000:00:16<\/a>use to address generalized anxiety in someone\u00a0 who comes into my office now it’s important\u00a0\u00a0 to remember that every person is different and\u00a0 every person may display their anxiety slightly\u00a0\u00a0 differently so this just gives you a general\u00a0 idea of tools and techniques that i might use\u00a0\u00a000:00:35<\/a>we’re going to start out by looking at what i go\u00a0 over in the assessment or intake interview and\u00a0\u00a0 how that relates to the symptoms of\u00a0 anxiety then we’ll explore other things\u00a0\u00a0 that i rule out or rule in that might\u00a0 be contributing to the person’s symptoms\u00a0\u00a000:00:52<\/a>then we summarize the typical interventions that\u00a0 i use when treating generalized anxiety disorder\u00a0\u00a0 and i finish up by listing 15 psycho-educational\u00a0 topics that i think are important\u00a0\u00a0 for everybody to have in a foundation treatment\u00a0 program if you’re not familiar with some of these\u00a0\u00a000:01:11<\/a>tools or techniques that i’m using that’s okay\u00a0 i’ve linked to longer videos that i’ve done on\u00a0\u00a0 each one of them in the notes to this video so\u00a0 just scroll down look at some of those videos\u00a0\u00a0 and you’ll be up to speed so let’s start out with\u00a0 the intake assessment or the diagnostic criteria\u00a0\u00a000:01:31<\/a>remember anxiety is a feeling it’s an emotion\u00a0 so the first criteria for diagnosing generalized\u00a0\u00a0 anxiety is excessive anxiety that’s difficult\u00a0 to control on most days for at least six months\u00a0\u00a0 about a variety of things it’s not about one\u00a0 specific thing it’s about a variety of things\u00a0\u00a000:01:53<\/a>it’s also important to recognize that just\u00a0 like you wouldn’t wait to go to the doctor\u00a0\u00a0 until you had a pneumonia you also are likely\u00a0 going to do better if you start addressing anxiety\u00a0\u00a0 when you notice it instead of waiting until\u00a0 you’re at a crisis point or until you accurately\u00a0\u00a000:02:11<\/a>and completely fulfill diagnostic criteria just\u00a0 because you haven’t had it for six months or more\u00a0\u00a0 doesn’t mean it doesn’t need to be addressed so we\u00a0 start out with this first symptom and i ask people\u00a0\u00a0 about what triggers their anxiety what causes\u00a0 them to feel anxious what things do they think\u00a0\u00a000:02:31<\/a>about when they’re feeling anxious and\u00a0 i make a list of these things as we talk\u00a0\u00a0 and then we examine those triggers for themes are\u00a0 they related to things like loss or abandonment\u00a0\u00a0 or rejection or failure or loss of control and we\u00a0 start trying to group them together a little bit\u00a0\u00a000:02:50<\/a>to help the person get a better understanding\u00a0 maybe of where their anxiety might be coming from\u00a0\u00a0 then i asked them about their\u00a0 anxiety vulnerabilities now\u00a0\u00a0 remember vulnerabilities are different\u00a0 than triggers triggers are things that\u00a0\u00a000:03:06<\/a>kick off the anxiety response vulnerabilities\u00a0 are things that make people more likely\u00a0\u00a0 to be triggered when they encounter certain\u00a0 stimuli so being over caffeinated being unrested\u00a0\u00a0 being sick being in a strange environment all of\u00a0 those may be vulnerabilities for people’s anxiety\u00a0\u00a000:03:30<\/a>and i go through each one very systematically\u00a0 we look at physical vulnerabilities\u00a0\u00a0 such as being over caffeinated or having low\u00a0 blood sugar having poor sleep being in pain\u00a0\u00a0 then we move on to affective vulnerabilities\u00a0 if the person’s already feeling stressed out\u00a0\u00a000:03:50<\/a>or overwhelmed about things maybe they’re just\u00a0 starting to feel burned out then that may make\u00a0\u00a0 them more vulnerable to react to things with with\u00a0 anxiety then we look at cognitive vulnerabilities\u00a0\u00a0 when they are in a particular mood perceiving\u00a0 the world as either optimistic or pessimistic\u00a0\u00a000:04:12<\/a>does that make them more likely to feel anxiety\u00a0 and then we’ll look at environment are there\u00a0\u00a0 particular environments that contribute to their\u00a0 anxiety like i mentioned earlier being in a\u00a0\u00a0 strange place or maybe being in an environment\u00a0 where there’s lots of activity like your kid’s\u00a0\u00a000:04:29<\/a>preschool classroom or a very busy restaurant as\u00a0 opposed to your home or the library and finally\u00a0\u00a0 we’ll look at relationship vulnerabilities if\u00a0 you will and that is people in the person’s life\u00a0\u00a0 that may make them more vulnerable to\u00a0 react with anxiety are there people that00:04:54<\/a>make the person feel on edge that may contribute\u00a0 to them being a little bit more hyper vigilant so\u00a0\u00a0 they’re more likely to become anxious and notice\u00a0 for example micro expressions after we go through\u00a0\u00a0 the themes the triggers and the vulnerabilities\u00a0 then we go to effective coping strategies what\u00a0\u00a000:05:16<\/a>is the person doing right now that helps them\u00a0 either a little bit kind of take the edge off\u00a0\u00a0 their anxiety or maybe it helps them relieve their\u00a0 anxiety even if just for 5 10 minutes 30 minutes\u00a0\u00a0 those are things that we can build\u00a0 on and that helps me understand\u00a0\u00a000:05:36<\/a>the types of tools that might\u00a0 be effective for that person\u00a0\u00a0 the next characteristic or criteria for diagnosis\u00a0 of anxiety disorder is feeling restless keyed up\u00a0\u00a0 or on edge now this is different than anxiety this\u00a0 is having difficulty sitting still and this is a\u00a0\u00a000:05:55<\/a>common symptom of adhd so the person may have\u00a0 anxiety but they also may have concurrent adhd\u00a0\u00a0 or concurrent ptsd that is contributing to their\u00a0 sense of restlessness so no matter how much of the\u00a0\u00a0 anxiety that we treat this particular symptom may\u00a0 continue to be present unless we also address it\u00a0\u00a000:06:21<\/a>so again i asked them about what triggers your\u00a0 restlessness what triggers your inability or\u00a0\u00a0 difficulty sitting still and are there any\u00a0 vulnerabilities that make it more likely that\u00a0\u00a0 you will have difficulty sitting still or that\u00a0 you you will feel more keyed up a lot of these\u00a0\u00a000:06:40<\/a>often overlap with the anxiety triggers but\u00a0 it’s still helpful to take a look at them\u00a0\u00a0 then i asked them about their strengths and\u00a0 coping strategies for dealing with feeling\u00a0\u00a0 restless or keyed up what do you do when you have\u00a0 to sit still and you feel restless maybe it’s in\u00a0\u00a000:07:00<\/a>a staff meeting or on an airplane or something\u00a0 else what strategies can you use that help you\u00a0\u00a0 cope with that sense of restlessness and edginess muscle tensions sleep disturbances and being\u00a0 easily fatigued are all additional symptoms\u00a0\u00a000:07:21<\/a>and they can all be caused by a variety of things\u00a0 muscle tension can be caused by poor ergonomics\u00a0\u00a0 and pain for example that is completely unrelated\u00a0 to anxiety so again we can treat the anxiety\u00a0\u00a0 and we can address the stress related muscle\u00a0 tension but if there’s also muscle tension for\u00a0\u00a000:07:42<\/a>other reasons we need to pay attention\u00a0 to that too because muscle tension is\u00a0\u00a0 perceived by the body as a stressor and\u00a0 that is going to trigger the stress response\u00a0\u00a0 which is going to make the person more\u00a0 vulnerable to anxiety so i ask about\u00a0\u00a000:07:59<\/a>different triggers for their muscle tension and\u00a0 what’s an effective coping strategy whether it’s\u00a0\u00a0 progressive muscular relaxation or massage or\u00a0 heat or stretching what is it that helps them\u00a0\u00a0 reduce their muscle tension in terms of sleep\u00a0 disturbances sleep can be disturbed for a lot of\u00a0\u00a000:08:20<\/a>reasons your circadian rhythms can be out of whack\u00a0 your hormones can be out of whack you’re you could\u00a0\u00a0 be experiencing pain that is impacting your sleep\u00a0 none of those are necessarily directly related to\u00a0\u00a0 the anxiety but they could be contributing\u00a0 to maintaining the symptoms so i asked about\u00a0\u00a000:08:41<\/a>what are triggers for sleep disturbances for\u00a0 example watching particular movies before going\u00a0\u00a0 to sleep or checking their email before going\u00a0 to sleep and what vulnera vulnerabilities exist\u00a0\u00a0 for sleep disturbance what things make you\u00a0 more likely to have difficulty going to sleep\u00a0\u00a000:09:03<\/a>and what are some effective street sleep\u00a0 strategies that the person currently uses\u00a0\u00a0 sleep hygiene is a big focus of early treatment\u00a0 for dare i say just about every disorder that i\u00a0\u00a0 treat because when a person is sleep deprived\u00a0 when they’re not getting good quality sleep\u00a0\u00a000:09:23<\/a>it contributes to a whole bunch of symptoms\u00a0 physical symptoms cognitive thinking symptoms\u00a0\u00a0 emotional symptoms as well as emotional ability\u00a0 and difficulty regulating their emotions\u00a0\u00a0 so sleep strategies are important and i generally\u00a0 provide people in the initial intake a link to a\u00a0\u00a000:09:46<\/a>video on sleep hygiene and a handout on sleep\u00a0 hygiene so they can evaluate their own sleep\u00a0\u00a0 and then if they’re easily fatigued why is this\u00a0 is it because they’re not getting good sleep okay\u00a0\u00a0 that could be it is it because their nutrition\u00a0 is poor if you’re not getting good b vitamins\u00a0\u00a000:10:08<\/a>or if you’re stressed all the time so your body\u00a0 can’t use the food that you are eating nearly\u00a0\u00a0 as effectively or if you’re eating foods that\u00a0 don’t provide all the nutrients for your body to make energy available then nutrition may be a\u00a0 cause of fatigue or a contributor to your fatigue\u00a0\u00a000:10:31<\/a>over and above fatigue caused by poor sleep\u00a0 and being anxious or stressed out all the time\u00a0\u00a0 tension can contribute to fatigue even\u00a0 though you may not notice that you’re\u00a0\u00a0 holding a lot of muscle tension holding that\u00a0 tension keeping those muscles clenched takes\u00a0\u00a000:10:49<\/a>energy and that contributes to fatigue and finally\u00a0 deconditioning people who are anxious and people\u00a0\u00a0 who are depressed often feel overwhelmed and\u00a0 exhausted because of life so going to the gym\u00a0\u00a0 that’s a pie in the sky thought they feel like\u00a0 they barely have the energy to get through the day\u00a0\u00a000:11:12<\/a>they can’t imagine mustering the energy to work\u00a0 out but even deconditioning in terms of not being\u00a0\u00a0 able to spend as much time cleaning the house or\u00a0 working on the yard just doing regular activities\u00a0\u00a0 of daily living may seem completely overwhelming\u00a0 so they’re not doing them and after a period of\u00a0\u00a000:11:34<\/a>time the body loses its conditioning it loses its\u00a0 stamina the good thing is stamina can be rebuilt\u00a0\u00a0 but it’s not something that comes back overnight\u00a0 it’s something that has to be gradually rebuilt\u00a0\u00a0 and what helps the person improve their\u00a0 energy when they’re feeling fatigued\u00a0\u00a000:11:51<\/a>you may not be able to go from feeling completely\u00a0 exhausted to ready to go to the gym but if you’re\u00a0\u00a0 feeling fatigued is there something that can put\u00a0 a little pep in your step besides caffeine and i\u00a0\u00a0 ask people about music are there particular songs\u00a0 or playlists they listen to that can give them a\u00a0\u00a000:12:12<\/a>little boost music can actually help increase\u00a0 dopamine and norepinephrine which make energy\u00a0\u00a0 more available to us so music’s one maybe deep\u00a0 breathing or just getting up and moving around\u00a0\u00a0 or going outside into bright light those are\u00a0 all tools or techniques that help some people\u00a0\u00a000:12:33<\/a>get a little bit of energy like i said it’s not\u00a0 going to be a panacea but we want to look at\u00a0\u00a0 any strategies that work for the person at least\u00a0 a little bit and then we can build on those two more criteria for anxiety disorder include\u00a0 difficulty concentrating or your mind going blank\u00a0\u00a000:12:55<\/a>and irritability when you’re stressed when you\u00a0 feel anxious you’ve got that fight-or-flight\u00a0\u00a0 system going on you’ve got your brain in rescue\u00a0 mode if you will so your brain is paying more\u00a0\u00a0 attention to all the threats because it doesn’t\u00a0 feel safe it’s paying attention to more things\u00a0\u00a000:13:15<\/a>that are going on around you because it doesn’t\u00a0 feel safe which means if you’re in an environment\u00a0\u00a0 where there’s a lot of distractions maybe in a\u00a0 busy restaurant or even at work if you work in a\u00a0\u00a0 open area with lots of other people moving around\u00a0 it may be more difficult to maintain your train of\u00a0\u00a000:13:36<\/a>thought because you’re thinking and then all of\u00a0 a sudden your hyper vigilance makes you go over\u00a0\u00a0 here to pay attention to that person that just\u00a0 walked in or over there to pay attention to sally\u00a0\u00a0 who just dropped something on the floor and\u00a0 then you completely lose your train of thought\u00a0\u00a000:13:55<\/a>so it’s important for people to\u00a0 recognize when they’re feeling\u00a0\u00a0 anxious what environments what situations\u00a0 what conditions make them more vulnerable\u00a0\u00a0 to having episodes where they can’t concentrate\u00a0 or their mind goes blank and what can help them\u00a0\u00a000:14:13<\/a>a lot of people find that in this particular\u00a0 situation having noise cancelling headphones on\u00a0\u00a0 sitting in a quiet environment at work\u00a0 maybe in a carol or in a private office\u00a0\u00a0 can help them focus more effectively and\u00a0 what effective coping strategies do they have\u00a0\u00a000:14:33<\/a>to help them deal with this difficulty\u00a0 concentrating in their mind going blank\u00a0\u00a0 making lists is a big one if they have a bunch\u00a0 of stuff to do at work but they’ve got a lot\u00a0\u00a0 of anxiety it may be hard to remember okay what is\u00a0 it that i’ve got to do next but if they make lists\u00a0\u00a000:14:50<\/a>that can help them keep track and\u00a0 follow along with what they need to do\u00a0\u00a0 and irritability is that sense of being\u00a0 short-tempered if you will and it’s important\u00a0\u00a0 for people to recognize what makes them irritable\u00a0 irritability is sort of you can think of it as a\u00a0\u00a000:15:11<\/a>mild form of anger and anger just like anxiety\u00a0 is a response to a threat when a person feels\u00a0\u00a0 anxious when a person feels exhausted when\u00a0 a person feels vulnerable for some reason\u00a0\u00a0 then they’re more likely to respond to\u00a0 any sort of outside input especially\u00a0\u00a000:15:31<\/a>stressful outside input with irritability it’s\u00a0 like i just can’t take one more thing go away\u00a0\u00a0 it’s important for people to\u00a0 recognize that and recognize\u00a0\u00a0 what their triggers are for irritability when\u00a0 they’re angry i’m sorry when they’re anxious\u00a0\u00a000:15:49<\/a>what things tend to trigger their short fuse\u00a0 if you will and what makes them more likely\u00a0\u00a0 to be triggered for example being too hyped up\u00a0 on caffeine or being exhausted or being in pain then i move on to ruling out no matter how much\u00a0 work a person does on their anxiety and their\u00a0\u00a000:16:14<\/a>thoughts and cognitions about their anxiety\u00a0\u00a0 if there are underlying physical issues or other\u00a0 mental health issues that aren’t being addressed\u00a0\u00a0 there’s only so much progress the person can\u00a0 make it’s important to recognize that people are00:16:33<\/a>not just a bunch of independent parts everything\u00a0 interacts so if somebody’s in pain physical pain\u00a0\u00a0 that’s going to trigger their stress response\u00a0 which is going to make them more vulnerable to\u00a0\u00a0 anxiety in order to make them less vulnerable to\u00a0 anxiety helping them address anxiety is great but\u00a0\u00a000:16:52<\/a>we also have to address that pain so the stress\u00a0 response system the hpa axis isn’t always turned\u00a0\u00a0 on we want to rule out thyroid imbalance hyper\u00a0 or hypothyroid estrogen fluctuations lyme disease\u00a0\u00a0 nutritional deficiencies food sensitivities excess\u00a0 caffeine or stimulants and that can come from the\u00a0\u00a000:17:20<\/a>form of energy drinks or diet pills or other\u00a0 herbs that somebody may be taking that have\u00a0\u00a0 stimulatory effects medication side effects some\u00a0 medications have in their list of side effects can\u00a0\u00a0 contribute to anxiety it’s important to recognize\u00a0 that when serotonin gets too high for example\u00a0\u00a000:17:43<\/a>it can contribute to anxiety some people\u00a0 when they start taking antidepressants\u00a0\u00a0 feel anxiety for the first couple of days\u00a0 because all of a sudden their body’s being\u00a0\u00a0 exposed to more serotonin than it was prior\u00a0 to taking the medication now eventually\u00a0\u00a000:18:00<\/a>it all balances out but it’s important to\u00a0 recognize that that is a potential side effect\u00a0\u00a0 alcohol and benzodiazepine withdrawal also\u00a0 contribute to feelings of anxiety now alcohol\u00a0\u00a0 related anxiety tends to be much shorter than\u00a0 benzodiazepine withdrawal when you withdraw from\u00a0\u00a000:18:22<\/a>alcohol usually it’s two or three days that the\u00a0 person experiences high blood pressure increased\u00a0\u00a0 anxiety etc and then things start to level out\u00a0 i’m not going to say their anxiety goes away\u00a0\u00a0 but it levels out quite a bit with benzodiazepines\u00a0 or anti-anxiety medications it can take a lot\u00a0\u00a000:18:43<\/a>longer for the anxiety to go away a lot\u00a0 of people also experience rebound anxiety\u00a0\u00a0 when their anti-anxiety medication starts to leave\u00a0 their system so if they’re taking a short acting\u00a0\u00a0 anti-anxiety medication it may start helping them\u00a0 feel better real quick but then as it starts to\u00a0\u00a000:19:06<\/a>leave their system their anxiety rebounds and it\u00a0 feels like it’s even stronger than it was before\u00a0\u00a0 they took the pill in the first place and it’s\u00a0 important if that’s occurring to talk with your\u00a0\u00a0 doctor about whether there are more longer\u00a0 acting options that would reduce the rebound\u00a0\u00a000:19:26<\/a>anxiety or if there are other treatment options\u00a0 which there are in in lieu of benzodiazepines\u00a0\u00a0 pain as i mentioned can also contribute to\u00a0 keeping that stress response that hpa axis\u00a0\u00a0 turned on keeping the person hyper\u00a0 vigilant when you’re in pain you tend to be\u00a0\u00a000:19:47<\/a>kind of guarding because you don’t want to hurt\u00a0 anymore you don’t want to get injured anymore\u00a0\u00a0 and it can make people more likely to respond with\u00a0 anger or anxiety so we do need to address pain\u00a0\u00a0 whether it’s chronic pain like from fibromyalgia\u00a0 or intermittent pain like from frequent migraines\u00a0\u00a000:20:08<\/a>we still need to address what’s going on for\u00a0 people who have intermittent pain they can also\u00a0\u00a0 experience anxiety because they dread having\u00a0 another episode for people with chronic pain\u00a0\u00a0 they can have anxiety related to the chronic pain\u00a0 worrying that it’s going to get worse and worrying\u00a0\u00a000:20:29<\/a>that it’s going to keep them from having the life\u00a0 they want ptsd post traumatic stress disorder has\u00a0\u00a0 a lot of anxiety related symptoms however people\u00a0 can have both generalized anxiety as well as ptsd\u00a0\u00a0 ptsd symptoms are focused mainly around triggers\u00a0 reminders of the trauma whereas generalized\u00a0\u00a000:20:55<\/a>anxiety the anxiety is about more things but if\u00a0 a person has ptsd they are going to likely be\u00a0\u00a0 hyper vigilant which is going to make them more\u00a0 vulnerable to anxiety about a variety of things\u00a0\u00a0 obsessive-compulsive disorder has an anxiety\u00a0 component people have these obsessions\u00a0\u00a000:21:17<\/a>that they are they can’t get out of their head\u00a0 and they’re worried that if they don’t do if they\u00a0\u00a0 don’t do x if they don’t engage in a compulsion\u00a0 then it is going to end up causing bad things\u00a0\u00a0 or they may just have this repetitive intrusive\u00a0 thought that they ruminate on that contributes to\u00a0\u00a000:21:37<\/a>their anxiety and social anxiety remember i said\u00a0 generalized anxiety the person is anxious about a\u00a0\u00a0 multitude of things in social anxiety the anxiety\u00a0 is specifically about being negatively evaluated\u00a0\u00a0 by people can you have both yes potentially but we\u00a0 do need if somebody has a social anxiety component\u00a0\u00a000:22:00<\/a>we need to make sure that we’re addressing\u00a0 that in addition to the generalized anxiety the general treatment flow that i go through\u00a0 with general with generalized anxiety\u00a0\u00a0 in this initial meeting we have talked about\u00a0 triggers vulnerabilities and current effective\u00a0\u00a000:22:23<\/a>strategies that the person uses so i take all\u00a0 of those and i put them into a spreadsheet\u00a0\u00a0 and we look for themes and i give them to the\u00a0 per give the spreadsheet to the person so they\u00a0\u00a0 are more aware they can start identifying\u00a0 vulnerabilities and triggers that they\u00a0\u00a000:22:40<\/a>want to address i also refer people to their\u00a0 primary care to rule out physical causes and\u00a0\u00a0 contributors like hormone imbalances nutritional\u00a0 deficiencies chronic pain if they need to be\u00a0\u00a0 or they want to be referred to a nutritionist\u00a0 or a sleep specialist i also make a referral\u00a0\u00a000:23:00<\/a>to those particular people at that point in time i\u00a0 also have people start keeping a daily anxiety log\u00a0\u00a0 in which they note the date the time the trigger\u00a0 or triggers for their anxiety the intensity\u00a0\u00a0 of their anxiety on a scale of one to four one\u00a0 being yeah i noticed it but it wasn’t a big deal\u00a0\u00a000:23:24<\/a>two is i felt anxious but i was able to get\u00a0 through just fine three is i felt really anxious\u00a0\u00a0 but i managed somehow to get through it and\u00a0 pushed through but it was really really hard\u00a0\u00a0 and four the anxiety was overwhelming i just i\u00a0 couldn’t i was paralyzed so date time triggers\u00a0\u00a000:23:49<\/a>intensity duration did it last five minutes or\u00a0 five hours and what interventions what things did\u00a0\u00a0 they do that helped to either reduce their anxiety\u00a0 or help them recover after the anxiety episode and then henceforth each week we review their\u00a0 anxiety logs that’s like the first thing that\u00a0\u00a000:24:12<\/a>i do with people after i ask them you know\u00a0 how’s your week been we look at the anxiety\u00a0\u00a0 logs and i evaluate it for repeating triggers and\u00a0 repeating themes for their anxiety then we process\u00a0\u00a0 at least three of their triggers for their anxiety\u00a0 and i use the fcp method what are the facts for\u00a0\u00a000:24:34<\/a>and against your belief about this situation what\u00a0 aspects did you have control of in this situation\u00a0\u00a0 and based on the facts and your ability\u00a0 to control the factors you had control of\u00a0\u00a0 what’s the probability that this\u00a0 actually would have ended up being\u00a0\u00a000:24:55<\/a>a catastrophe would have actually ended up\u00a0 being a notable threat that’s where we start\u00a0\u00a0 a lot of times helping people move away from\u00a0 emotional reasoning into factual reasoning gives\u00a0\u00a0 them a sense of new perspective and a greater\u00a0 sense of mastery over the situation they may not\u00a0\u00a000:25:21<\/a>feel like they can control it yet but they’re\u00a0 feeling like they have a better understanding\u00a0\u00a0 eventually as we go through the treatment process\u00a0 people will learn about cognitive restructuring\u00a0\u00a0 dialectics living in the and purposeful action and\u00a0 hardiness and we’ll apply each one of those tools\u00a0\u00a000:25:40<\/a>as they learn them when we process their\u00a0 triggers i also look at their anxiety\u00a0\u00a0 logs for potential vulnerabilities and i and i\u00a0 identify mitigation strategies include setting\u00a0\u00a0 and maintaining boundaries assertiveness\u00a0 and trigger management so for example\u00a0\u00a000:25:59<\/a>if one of their common triggers was interacting\u00a0 with their boss or interacting with their\u00a0\u00a0 sister-in-law then i would say okay what\u00a0 mitigation strategies could we use how can\u00a0\u00a0 you effectively set and maintain healthy\u00a0 boundaries and manage this trigger in a meaningful\u00a0\u00a000:26:23<\/a>way may not be able to completely prevent the\u00a0 anxiety but how can we help you move from a four\u00a0\u00a0 where you’re completely paralyzed by your anxiety\u00a0 to a three where you can start you can get through\u00a0\u00a0 it it sucks but you can get through it and\u00a0 then eventually we’ll get down to a one\u00a0\u00a000:26:43<\/a>we discuss what tools have been effective\u00a0 in the past week it’s really important in\u00a0\u00a0 my mind to help people identify and build on\u00a0 their strengths and realize the power that\u00a0\u00a0 they already have realize the resources that they\u00a0 already have that they may be taking for granted\u00a0\u00a000:27:04<\/a>and then i provide a video handout and worksheet\u00a0 on a particular psycho-education topic and it’s\u00a0\u00a0 important for a lot of people to have a video\u00a0 that kind of explains it and walks them through it\u00a0\u00a0 and then a handout or worksheet to apply\u00a0 it why do i do this for in between sessions\u00a0\u00a000:27:23<\/a>because i feel that people’s money is best\u00a0 spent when they’re in session with me actually\u00a0\u00a0 processing stuff the psychoeducation component i\u00a0 think is something in most cases is something that\u00a0\u00a0 people can spend their time learning between\u00a0 sessions i don’t want to waste their money00:27:46<\/a>lecturing them when they could watch a video on\u00a0 it i want to spend their time in session actually\u00a0\u00a0 using what they’ve learned\u00a0 and applying the information so the psycho-education topics that i\u00a0 think are important for everybody to\u00a0\u00a000:28:04<\/a>learn about the function of anxiety its connection\u00a0 to the stress response and the impact of fight or\u00a0\u00a0 flight on perception and problem solving and i\u00a0 mentioned that several times in this video that\u00a0\u00a0 when we’re in fight-or-flight mode we don’t pay\u00a0 attention to the good stuff we are actually more\u00a0\u00a000:28:21<\/a>aware of more of the threats in the environment\u00a0 because we are on high alert so to speak\u00a0\u00a0 which means we tend to perceive the world as\u00a0 more dangerous and because of all that because\u00a0\u00a0 of the glutamate and the norepinephrine and\u00a0 everything else in our brain it makes it harder\u00a0\u00a000:28:39<\/a>to think clearly our brain is has tunnel vision\u00a0 adrenaline haze whatever you want to call it that\u00a0\u00a0 is geared towards helping us fight or flee\u00a0 not think about all the possible options\u00a0\u00a0 and problem solving so until people can get\u00a0 into what linehan called the wise mind until\u00a0\u00a000:28:58<\/a>people can get out of that high anxiety state\u00a0 it’s going to be difficult to problem solve\u00a0\u00a0 then we talk about distress tolerance\u00a0 skills which are the skills that people\u00a0\u00a0 need when they feel anxious to help them\u00a0 remember that they can tolerate the distress\u00a0\u00a000:29:17<\/a>so they don’t feed into it by saying oh my\u00a0 gosh this is going to overwhelm me i’m not\u00a0\u00a0 going to be able to handle it these distress\u00a0 tolerance skills help people feel more empowered\u00a0\u00a0 even in the face of anxiety and can\u00a0 help them get into their wise mind\u00a0\u00a000:29:34<\/a>we talk about circadian rhythms and sleep\u00a0 hygiene because it’s so important for developing new skills for learning new things\u00a0 as well as for helping the hpa access the threat\u00a0\u00a0 response system recover that people are getting\u00a0 good quality sleep then i talk about nutrition\u00a0\u00a000:29:55<\/a>and neurotransmitter support what we eat is\u00a0 broken down to make neurotransmitters to make\u00a0\u00a0 hormones to repair the body so if we’re eating\u00a0 like crap we’re probably going to feel like crap\u00a0\u00a0 a lot of people want to get straight down to the\u00a0 nitty-gritty of how can i improve my serotonin\u00a0\u00a000:30:15<\/a>my dopamine my norepinephrine and ultimately\u00a0 everything is in a fine balance so if one goes up\u00a0\u00a0 one happy chemical goes up the other ones are\u00a0 likely going to go up too but that requires\u00a0\u00a0 a healthy diet for example making serotonin to\u00a0 break down tryptophan we need to have vitamin\u00a0\u00a000:30:37<\/a>b we need to have calcium we need to have\u00a0 zinc we need to have iron we need to have\u00a0\u00a0 tryptophan itself and then to break down it goes\u00a0 from tryptophan to 5 ht then to break that down\u00a0\u00a0 even more we need even more vitamins and\u00a0 minerals so it’s important that people\u00a0\u00a000:30:56<\/a>understand the importance of a healthy diet but\u00a0 also understand the regular foods that they can\u00a0\u00a0 eat to support their body’s ability to make those\u00a0 neurotransmitters like spinach and bananas and\u00a0\u00a0 cocoa and tea and colorful vegetables it’s not\u00a0 anything that’s really weird wild and radical00:31:22<\/a>next we talk about mindfulness the difference\u00a0 between focused mindfulness so you’re focusing\u00a0\u00a0 on something like a candle flame or open\u00a0 awareness mindfulness where you’re walking through\u00a0\u00a0 a park for example and you’re not focusing on\u00a0 any one thing in particular you’re just noticing\u00a0\u00a000:31:41<\/a>quote everything as you walk down the\u00a0 path that open awareness encourages you to be mindful be in the moment instead of\u00a0 thinking instead of being in your own head\u00a0\u00a0 and then mindfulness in terms of the self scan\u00a0 mindfully scanning your your head heart and gut\u00a0\u00a000:32:01<\/a>so to speak how am i feeling emotionally how am i\u00a0 feeling physically what am i needing emotionally\u00a0\u00a0 what am i needing physically right now the next\u00a0 lesson is on compassion and loving-kindness\u00a0\u00a0 developing compassion for yourself as well\u00a0 as other people a lot of times anxiety\u00a0\u00a000:32:24<\/a>comes from fears of being rejected\u00a0 fears of being criticized fears of\u00a0\u00a0 not being good enough and sometimes that comes\u00a0 because your own inner critic is just harsh\u00a0\u00a0 and hateful so developing self-compassion\u00a0 recognizing that it’s okay to be imperfect\u00a0\u00a000:32:46<\/a>can be helpful to encourage people to move towards\u00a0 self-acceptance as opposed to self-abandonment\u00a0\u00a0 and loving-kindness meditation is helpful to\u00a0\u00a0 inspire compassion for others even\u00a0 others that are being kind of difficult00:33:06<\/a>the next unit or topic is cognitive distortions\u00a0 what they are their function and restructuring\u00a0\u00a0 them cognitive distortions include think\u00a0 things like all or none thinking mind reading\u00a0\u00a0 and catastrophizing and over personalization so\u00a0 we talk about how those thinking errors are likely\u00a0\u00a000:33:28<\/a>thinking strategies that formed in childhood\u00a0 before you could think more critically so to speak\u00a0\u00a0 and often remained unchecked then we talk\u00a0 about alternatives such as looking for\u00a0\u00a0 alternatives instead of thinking it always\u00a0 happens or it never happens looking for exceptions\u00a0\u00a000:33:49<\/a>you know when has this happened if i if i say it\u00a0 never happens is that true or are there exceptions\u00a0\u00a0 if i’m taking things too personally instead of\u00a0 saying it’s all about me or the person’s mad at me\u00a0\u00a0 or hates me what are three other explanations\u00a0 for why they may have given you a dirty look\u00a0\u00a000:34:08<\/a>besides you you were they even did they even see\u00a0 you or were they caught in their own thoughts\u00a0\u00a0 then we move on to optimism and i\u00a0 have in here tragic optimism because\u00a0\u00a0 unbridled optimism can be just as unhealthy as\u00a0 unbridled pessimism tragic optimism includes\u00a0\u00a000:34:29<\/a>an element of dialectics and living in the\u00a0 and in tragic optimism we recognize what is\u00a0\u00a0 but we have hope that it can get better we\u00a0 recognize the good and the bad and the present\u00a0\u00a0 and we have hope that we can make a difference\u00a0 to move towards a more rich and meaningful life00:34:51<\/a>unit 9 looks at schema schema\u00a0 are our brains cliff notes\u00a0\u00a0 our brain shortcut to help us interpret what\u00a0 to happen you have schema about everything\u00a0\u00a0 stop lights i’m assuming everybody who’s\u00a0 watching drives and so you have a schema\u00a0\u00a000:35:08<\/a>when you see a stop light that’s on yellow\u00a0 you have a schema that tells you how to react\u00a0\u00a0 if you think that yellow lights are really long\u00a0 and you’ve got plenty of time to get through\u00a0\u00a0 then you’re going to keep on going or maybe even\u00a0 floor it if you think that yellow lights tend to\u00a0\u00a000:35:27<\/a>change really quickly and you don’t want to run\u00a0 the red light then you’re probably going to stop\u00a0\u00a0 so based on your past experiences with yellow\u00a0 lights you’re going to react in the current moment\u00a0\u00a0 probably without thinking about it you’re\u00a0 not going to sit there and go okay well the\u00a0\u00a000:35:43<\/a>last three times i came to this light it changed\u00a0 really fast it’s just sort of an automatic process\u00a0\u00a0 that’s the beauty of schema it helps us do some\u00a0 of our things in default mode or on autopilot\u00a0\u00a0 unfortunately if somebody’s been exposed to trauma\u00a0 or has been anxious for a long time then their\u00a0\u00a000:36:06<\/a>schema may have been altered to expect that\u00a0 the world is going to always be a dangerous\u00a0\u00a0 disempowering un unpleasant place so it’s going\u00a0 to be important to evaluate their schema back then\u00a0\u00a0 that may have been true in the current context\u00a0 at the current time is this schema still accurate\u00a0\u00a000:36:32<\/a>if so okay how do we deal with it if not how can\u00a0 you adjust your schema relationships are the same\u00a0\u00a0 way if you’ve been in multiple bad relationships\u00a0 you may expect that people aren’t trustworthy\u00a0\u00a0 but that really sets everybody else up to be\u00a0 at a loss because you’re just expecting they’re\u00a0\u00a000:36:53<\/a>going to behave badly if you adjust your schema\u00a0 and you say okay in this context at this time\u00a0\u00a0 with this person are my beliefs about\u00a0 what’s going on are my expectations true\u00a0\u00a0 or am i just assuming based on other\u00a0 people’s behaviors and past experiences00:37:16<\/a>number 10 is creating a rich and meaningful\u00a0 life vision board helping people visualize what\u00a0\u00a0 things are important in their rich and meaningful\u00a0 life what things do they currently have that are\u00a0\u00a0 important in their rich and meaningful life and\u00a0 instead of using their energy just holding on to\u00a0\u00a000:37:35<\/a>anxiety and tossing it around in their hands like\u00a0 a hot potato how can they instead use that energy\u00a0\u00a0 to nurture the things that are important in their\u00a0 life and what kind of a difference would that make\u00a0\u00a0 number 11 is acceptance purposeful action\u00a0 and heartiness helping people recognize\u00a0\u00a000:37:56<\/a>that sometimes life just sucks it is what\u00a0 it is so to speak but using their energy\u00a0\u00a0 purposefully instead of using their energy\u00a0 to be angry about it and stew on it and pout\u00a0\u00a0 using their energy and saying okay can’t change\u00a0 this situation but what can i change what can\u00a0\u00a000:38:17<\/a>i use this energy for that would help me\u00a0 move closer to a rich and meaningful life number 12 moves into relationships and\u00a0 interpersonal behaviors and i start out\u00a0\u00a0 with setting and maintaining boundaries a\u00a0 lot of times people feel anxious because\u00a0\u00a000:38:38<\/a>they have never been taught how to set boundaries\u00a0 and maintain them they have other people have\u00a0\u00a0 encroached on their boundaries and told them\u00a0 what to think or what to feel or criticized them\u00a0\u00a0 for how they think or how they feel and so\u00a0 learning how to set and maintain boundaries is\u00a0\u00a000:38:56<\/a>really important to helping people feel empowered\u00a0 and safe in any relationship in section 13 we talk\u00a0\u00a0 about secure attachment positive self-talk and\u00a0 the inner child so there’s a lot there hopefully\u00a0\u00a0 by this point in treatment people’s triggers\u00a0 and anxiety experiences are a lot less intense\u00a0\u00a000:39:19<\/a>and a lot less frequent so they have more time\u00a0 to spend on developing additional skills but in\u00a0\u00a0 order to feel safe in order to feel loved people\u00a0 typically need to have some secure attachments\u00a0\u00a0 including a secure attachment with self feeling\u00a0 like you can be there to respond to your own needs\u00a0\u00a000:39:43<\/a>so we talk about what secure attachment\u00a0 looks like how secure attachment is developed\u00a0\u00a0 how to use positive self-talk to enhance\u00a0 your secure attachment with yourself\u00a0\u00a0 and to help heal your inner child that may\u00a0 have been wounded because of past things\u00a0\u00a000:40:04<\/a>in unit 14 we talk talk more about the inner\u00a0 critic because the inner critic is huge and\u00a0\u00a0 contributes to a lot of people’s anxiety the\u00a0 inner critic may bring up past stuff remember\u00a0\u00a0 back then you failed you’re going to fail again\u00a0 which can trigger anxiety or the inner critic can00:40:26<\/a>bring up anticipatory things you\u00a0 think you’re going to be able to\u00a0\u00a0 do this you’re going to fail and\u00a0 then this is what’s going to happen\u00a0\u00a0 and the sky is going to fall so getting that\u00a0 inner critic under control is really important\u00a0\u00a000:40:41<\/a>in 15 we talk about listening without\u00a0 defensiveness because defensiveness is a\u00a0\u00a0 anxiety anger threat reaction when people feel\u00a0 like they’re being criticized or when people\u00a0\u00a0 feel like others don’t necessarily agree with\u00a0 them the automatic reaction for a lot of people\u00a0\u00a000:41:05<\/a>is to feel threatened and to get defensive\u00a0 so we talk about how to hear other people’s\u00a0\u00a0 opinions maintain your own boundaries and not\u00a0 get defensive you don’t have to agree with them\u00a0\u00a0 but it’s important to be able to listen and then\u00a0 finally in unit 16 we talk about assertiveness\u00a0\u00a000:41:26<\/a>in order to feel safe and empowered which is what\u00a0 you need to do to feel not threatened to feel less\u00a0\u00a0 anxious it’s important to be able to assertively\u00a0 communicate your thoughts wants and needs\u00a0\u00a0 so we talk about any barriers to assertiveness\u00a0 and how to assertively communicate what you\u00a0\u00a000:41:48<\/a>need to others while still respecting\u00a0 their boundaries and maintaining yours that gives you a general overview of the types\u00a0 of things that i go through in a 12 to 16 week\u00a0\u00a0 treatment program with somebody who presents with\u00a0 generalized anxiety now remember every individual\u00a0\u00a000:42:13<\/a>is different so i may add things like a unit on\u00a0 abandonment anxiety or a unit on grief and loss\u00a0\u00a0 for people based on what their the themes of their\u00a0 anxiety triggers are but the skills that i have\u00a0\u00a0 already gone over the skills that i’ve highlighted\u00a0 in this presentation i think are essential\u00a0\u00a0
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https:\/\/www.youtube.com\/watch?v=AEBJsS7OhZQCEUs are available at AllCEUs.com\/Anxiety-Master hey there everybody and welcome to this video\u00a0 on 20 anxiety relief strategies i’m your host\u00a0\u00a0 dr donnelly snipes in this video i’m going to\u00a0 walk you through the basic strategies that i\u00a0\u00a000:00:16use to address generalized anxiety in someone\u00a0 who comes into my office now it’s important\u00a0\u00a0 to remember that … Continue reading Anxiety Relief: A Sample 15 Week Masterclass with 20 Cognitive Behavioral Therapy Strategies<\/span><\/a><\/p>\n","protected":false},"author":3,"featured_media":152220,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":true,"jetpack_social_options":{"image_generator_settings":{"template":"highway","enabled":false},"version":2}},"categories":[192],"tags":[],"class_list":["post-152219","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-transportation"],"jetpack_publicize_connections":[],"jetpack_sharing_enabled":true,"jetpack_featured_media_url":"https:\/\/effectsofanxiety.net\/wp-content\/uploads\/2024\/03\/1709495818-maxresdefault.jpg","_links":{"self":[{"href":"https:\/\/effectsofanxiety.net\/wp-json\/wp\/v2\/posts\/152219","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/effectsofanxiety.net\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/effectsofanxiety.net\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/effectsofanxiety.net\/wp-json\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/effectsofanxiety.net\/wp-json\/wp\/v2\/comments?post=152219"}],"version-history":[{"count":0,"href":"https:\/\/effectsofanxiety.net\/wp-json\/wp\/v2\/posts\/152219\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/effectsofanxiety.net\/wp-json\/wp\/v2\/media\/152220"}],"wp:attachment":[{"href":"https:\/\/effectsofanxiety.net\/wp-json\/wp\/v2\/media?parent=152219"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/effectsofanxiety.net\/wp-json\/wp\/v2\/categories?post=152219"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/effectsofanxiety.net\/wp-json\/wp\/v2\/tags?post=152219"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}