Recently, I had the pleasure of interviewing Gary M. Blau, Ph.D., who is involved in wide variety of programs designed to improve the lives of children and families and has been working to raise awareness of Children’s Mental Health.

In my interview with Dr. Blau, I asked about the treatments that are available for children with mental health challenges.

There are numerous evidence based treatments, Dr. Blau said.  There is hope and children do recover.   With grant money through SAMSA and other programs and coordinated networks of care, such as the National Traumatic Stress Network, support services provide children with helpful and necessary services.  Dr. Blau states that varying forms of specific kinds of treatments such as trauma focused cognitive behavior therapy, which is a short term treatment focused on becoming aware of thoughts and traumatic event might effect reactions and behavior are highly effective.  Other promising treatments include SPARCS for teenagers  and ARC.  Dr. Blau emphasized the importance of becoming aware of a child’s mental health challenges, early intervention, addressing problems, finding and effective treatment approach.

What are barriers to receiving services?

People have a hard time thinking of children’s experiences as traumatic, says Dr. Blau, and people often believe children will not remember traumatic events.  But, he goes on, even infants have visceral reactions to violence.  Adding to our difficulties in acknowledging a child’s traumatic experience, is the stigma that is attached to being identified with mental health conditions.  Some have little access to treatment or to qualified treatment providers, while others simply don’t recognize the symptoms of trauma.

Helpful Links

Awareness Day Web page: http://www.samhsa.gov/children/index.asp

List of Awareness Day Collaborating Organizations: http://www.samhsa.gov/children/participants.asp

2011 SAMHSA Short Report: http://www.samhsa.gov/children/SAMHSA_Short_Report_2011.pdf

Community Conversation: http://www.samhsa.gov/children/cc_home.asp

How to be a Hero of Hope: http://www.samhsa.gov/children/cc_howto_hero.asp

Blog post about the Twitter chat with the Surgeon General of the United States that Dr. Blau mentioned with links to the Storify archives of the chat: http://blog.samhsa.gov/2012/05/02/awareness-day-2012-twitter-chat-highlights-cmhchat/

Suicide hotline: 1-800-273-TALK

You can find strategies to cope with the anxiety and pressures that come with parenting a child who has mental health challenges in my new book, The Stress Response and by clicking here to sign up for more of my tips and podcasts using DBT strategies to improve how you feel.

About Gary M. Blau, Ph.D.

Dr. Gary M. Blau is a Clinical Psychologist and is currently the Chief of the Child, Adolescent and Family Branch of the Center for Mental Health Services.  In this role he provides national leadership for children’s mental health and is responsible for implementing the Comprehensive Community Mental Health Program, the Circles of Care Program, the National Children’s Mental Health Social Marketing Campaign, the National Technical Assistance Programs, and a wide variety of other programs designed to improve the lives of children and families.  Through the Director of the Center for Mental Health Services and the SAMHSA Administrator, he is also responsible for translating the President’s New Freedom Commission Report for children and families, and for implementing the children’s portion of the CMHS Action Plan.

Prior to this, Dr. Blau was the Bureau Chief for the Bureau of Quality Management at the Connecticut Department of Children and Families (DCF).  In this capacity Dr. Blau had responsibility for DCF’s oversight of child welfare, juvenile justice, substance abuse and mental health service providers, including outpatient psychiatric clinics for children, extended day treatment programs, emergency shelters, group homes and residential treatment centers.  Dr. Blau was also responsible for DCF’s administrative case reviews, child fatality investigations, program planning and development, policy and regulation and the DCF Training Academy.  Dr. Blau also served as DCF’s Director of Mental Health and provided leadership and oversight to Connecticut’s mental health service delivery system for children and adolescents.

Dr. Blau was formerly a member of the National Association of State Mental Health Program Director’s Division of Children, Youth and Families, and from July 1, 1998 through June 30, 2000 he was the Division’s Chairperson.  Dr. Blau has received several awards including the prestigious Governor’s Service Award, the Phoebe Bennet Award for outstanding contribution to children’s mental health in Connecticut, and the Making a Difference Award presented by Connecticut’s Federation of Families for Children’s Mental Health.  He currently holds a clinical faculty appointment at the Yale Child Study Center.  Since receiving his Ph.D. from Auburn University (Auburn, Alabama) in 1988, Dr. Blau has worked in children’s mental health with a primary emphasis on issues of victimization, child custody, permanency planning and innovative service models. He has held an appointment on the editorial board of the Journal of Primary Prevention, and has numerous publications and presentations in the areas of child custody, primary prevention, managed care and clinical service delivery.

Your body language and style not only affect the outcome, but also the way you feel.  Sometimes we interact in ways that wear at our own self-confidence.

It’s vital to our own sense of self-worth to interact in a way that makes you feel effective, rather than helpless.  Interestingly, you don’t have to be confident to act confident.  In the case of communication, actions often precede feelings.  Act confident and you just might find that you’re feeling better about yourself, as well.

Signs of Confidence:

1. A Stable and clear voice tone. You my need to practice, but speaking in a clear voice without whispers or stammering conveys self-assurance.
2. Making eye contact.  No staring at the floor or looking out the window.  Confident eye contact isn’t a persistent stare, but it is a meeting of the eyes as you speak and make your point.
3. Listening to others. Listening to others is a way of expanding your view of the world, bridging the differences between you and someone else and demonstrating that your belief in yourself is strong enough to take in other points-of-view.
4. Not attacking or threatening. Self-confidence isn’t aggressive.  A self-assured person can hear what someone is saying, respond to them and maintain their own point-of-view or make compromises to solve the real problems that are presented.
5. Speaking from the heart.  Try connecting to your inner sense of well-being and your inner convictions when you talk to others and assert yourself.  You might appear passionate, but passion can exude a sense of sureness.
6. Looking for win-win solutions. When you’re confident, you know that getting your own way doesn’t have to come at someone else’s expense.  Approach a situation with the attitude that it is possible that both perspectives are valid and that two or more people can gain from an interaction.
7. Using humor.  When something is vital to us, it’s sometimes hard to discuss it in a light-hearted way.  But humor can ease tension and shows you’re comfortable with yourself.
8. Expressing Gratitude.  Confidence is very different from arrogance.  Someone who is confident is able to express appreciation and gratitude to someone else.  An added bonus is that expressing gratitude happens to be one of the most effective ways to strengthen relationships.
9. Apologizing when in the wrong, but not for being alive or having legitimate human needs.
10. Acknowledging others, giving and receiving compliments, recognizing other people’s difficulties.

Acting confident doesn’t mean that you’ll always get your way.  Sometimes the world is more powerful than us and we don’t have the ability to change a situation.  However, behaving with poise, refusing to sell out everything to get approval and giving respect have the added benefit of making you feel more respected and more self-confident.

You can find more strategies to improve how you feel in my new book, The Stress Response and by clicking here to sign up for more of my tips and here for podcasts using DBT strategies to improve how you feel.

Many Americans experience stress on a daily basis.  To better understand the stress faced by average people in America, the American Psychological Association (APA) conducts an annual survey to determine where our stress is coming from.

It’s important to understand and address factors that interfere with your ability to cope in positive ways.  In the 2010 APA survey, lack of willpower was the top barrier to changing stress levels.

In this survey, women were more likely than men to view lack of willpower as preventing them from making the lifestyle and behavior changes recommended by a health care provider.

In order to improve their willpower, women said they needed to decrease fatigue, increase energy and improve confidence.

Men were more likely to say they need more money, while women were more likely to say they need more time.  Women identified household chores, in particular, as interfering with their willpower to cope with stress in healthy ways.

Strategies to Decrease Fatigue and Increase Energy:

• Keep regular sleep hours.  Sometimes it’s hard to do, but skipping that late show and getting into bed at the same time each night can make a big difference in how you sleep and your energy the next day.
• Get natural light.  Natural light helps our bodies regulate when to wake up and get energized and when to fall asleep.  Sitting by a window or making a point to get outside several times throughout the day can leave you awake during the day and tired at night.
• Get exercise.  This is a big one and often the hardest to do.  But remember that it doesn’t have to be all or nothing.  If you’re having trouble getting started, try exercising for 3 minutes.  Get up and walk around, do a few lunges or stretch.  You can always increase your time or build more in later.  The important thing is to get started.
• Notice illness or pain.  Often pain, illness and health problems interfere with both energy and your ability to sleep.  When we’re stressed, we often ignore health problems until they become severe.  Take note of how you are doing physically and go to a doctor or treat health problems before they escalate.  Both your energy levels and sleep will likely improve.
• Improve your eating habits.  During times of stress it’s normal to crave salty and fatty foods or extra sweets.  But overindulging can have a significant impact on your energy levels.  Too much sugar can give you a spike in energy and then a sudden crash.  Foods with a lot of simple carbohydrates (a bagel, for example) can have a similar effect.  Swapping out a few problem foods and replacing them with something healthier (say a fruit, wheat toast or popcorn) can have more of an impact on your energy then you might think.

Part II, which will be posted in one week, will include strategies to improve confidence and decrease the pressures that interfere with your willpower.

You can find more strategies to improve how you feel and stick to your goals in my new book, The Stress Response and by clicking here to sign up for more of my tips and podcasts using DBT strategies to improve how you feel.

If you are stuck “doing the right thing” while sacrificing what you want, your beliefs about how you ‘should’ act may be holding you back. Often, we give up on our dreams or find ourselves mired in daily duties, not because others are expecting things from us, but because we expect them from ourselves. These internal rules guide how we spend our money, use our free time and view our careers and relationships. They can originate in external expectations, moral codes or rules that you internalized long ago and now place on yourself.

Do you relate to any of the following beliefs:

1. “I should solve problems on my own (not doing so is weak, needy or means I’m inadequate)”
2. “I shouldn’t make requests from other people (I don’t deserve it or it’s selfish and self-centered)”
3. “I should just deal with it.”
4. “I should sacrifice my needs for others.”
5. “I shouldn’t feel the way I do.”
6. “I should have done better (at work, in a relationship, on a task)”
7. “I can’t fail (failure would be disastrous)”
8. “Other people’s needs and wants are more important than mine.”
9. “I can’t handle criticism.”
10. “I should never need to be criticized (I should behave perfectly so that there is no need for criticism)”

When you carry around a heavy load of internal rules—“shoulds”– you become worn down and burdened by your own expectations.

Try picking one thought that you’re willing to let go.  Look over the list or identify a thought of your own that contributes to your feeling overburdened and overwhelmed.

Try one or all of the following:

• Notice the thought, when you have it, and imagine it drifting in and out of your thoughts, like a cloud drifts across the sky. You might watch the thought “I should sacrifice my needs to others” come into your mind, drift by and float out.  Don’t push the thought away or try to engage with it. Just notice it is there.

• Think the thought, but change the word “should” to “could.”  If it’s a thought with the word “can’t” change it to “I feel sad, disappointed, anxious, when I.”  Notice if the word change has an impact on how you feel. For example, you might change “I should just deal with it” to “I could just deal with it.”  This subtle shift can increase the flexibility of your thoughts and expand your sense of having options.

• Imagine doing the thing you “should not” do and in your image, imagine a positive outcome.  For example, if you tend to think “I should not need help,” you might imagine asking a supervisor for help.  Now imagine that while your supervisor helps, you realize you have commonalities and end up developing a stronger relationship.

Life can be full of uncertainty and pressure.  You might face it when you’re in college and are uncertain about such things as who you are, how you fit in, what is your future and how can you best prepare yourself for it. Or you might suddenly find yourself uncertain and feeling vulnerable and as though you have no purpose while awaiting difficult news about your health or experiencing changes at work.

Stress, anxiety and depression are often consequences of the combination of uncertainty and pressure.

Whether we are encountering health problems, are a college student, or are experiencing some other unexpected uncertainty and stress in your life, we all need strategies to get mental distance from their worries and burdens, so we can work, carry out normal day-to-day functions, and concentrate.  Without these strategies your life can feel like it’s spiraling out of control.

It’s important to have a number of approaches to get through difficult times. This post focuses on two simple options for reducing built up tension in the body.  These strategies won’t solve your problems, but they will improve how your body is responding to the stressors in your life.  In one study focused on reducing anxiety and depression in college students, physical exercise and relaxation techniques were found to be valuable remedies for depression and anxiety (Cai, 2000).

Below are strategies for slowing your body and your  mind by increasing relaxation and incorporating exercise into your life.

Progressive Relaxation

Progressive relaxation involves tensing and then releasing the muscle groups of the body.

Try this:

• Focus on the muscles of your face and neck.  Tense your facial muscles, scrunching your face into a ball and hold for five to ten seconds, then relax.  Allow your muscles to relax for thirty second and then repeat.  Now tense your shoulder and neck muscles. To do this, raise your shoulders to your ears, straining to lift them as high as possible.  Hold this pose for five to ten seconds and then release.  Allow yourself thirty seconds to imagine all the tension draining from your neck and shoulders and then repeat the exercise always ending by allowing tension to drain from your body.
• Try a similar exercise with your hands.  Clench your fists as tight as you can and hold, straining to keep them tightly clenched, for five to ten seconds and then release.  Allow yourself thirty seconds to imagine all the tension draining from your arms, hands and fingers and then repeat one to two more times until the muscles in your arms feel completely relaxed.

Exercise

Every day routines that include exercise can decrease the amount and intensity of stress that you experience.

Your thoughts and your physical response to stress improve with exercise. Exercise is like preventative medicine for stress.  It improves your ability to cope with stress and makes you more resilient to stressors (Salmon, 2001). Exercise can be a distraction from problems, can make you feel competent and can reduce muscle tension.

Try this:

• Choose an easily accessible form of exercise, for example walking, running, exercise videos at home, using your gym membership or any other form that you can get to easily.
• Challenge thoughts that you don’t have time to exercise.  Try telling yourself that exercise will help you cope, will improve your mood, will have a positive impact on your productivity or will make you better able to handle difficult challenges.
• Set a goal (for example twenty minutes, three times a week) and make a commitment to exercise.  Tell people around you.  People who make public commitments are more likely to follow through.
• Make it social.  A partner can hold you accountable and get you going on days you might skip.  Be careful to choose someone who is motivating. If you prefer to exercise alone, consider having making a joint commitment with someone with whom you compare notes and hold each other mutually accountable.
• Add a reward.  Give yourself rewards at the time you exercise or immediately after (say checks in a calendar, self-praise, noticing improved mood, money set aside immediately after exercise that is earmarked for something special, listening to a favorite song or podcast while exercising, walking with a good friend, thinking of it as time to yourself etc.) The physical effects of exercise are typically not immediate.  Pairing exercise with something immediately positive can help keep you motivated.

These strategies are meant to be used in the midst of difficult times.  They won’t change your circumstances, but they can improve how your body is responding to stress and can have a positive impact on your body, your  mood and your ability to cope.

You can find more strategies to improve how you feel in my new book, The Stress Response and by clicking here to sign up for more of my tips and podcasts using DBT strategies to improve how you feel.

You may experience events, such as unexpected circumstances, loss, relationships turning out badly, finding that circumstances are worse than you expected and being separated from loved ones that leave you in emotional turmoil. At times, it can feel like you barely pick yourself up from one emotional crisis when the next hits.

Unfortunately, it’s impossible to fully anticipate, plan for or avoid loss and other circumstances that contribute to emotional pain and misery.  As much as we’d like to avoid these painful situations, they are a part of life.

Even so, even in the midst of emotional pain, it is possible to experience joy.  When you’re in pain, it can feel like happiness is out of our control, but it’s not.  You have the ability to increase your own happiness and to more frequently experience joy.

You can plan for and increase positive experiences in your life. And with these positive experiences, you can increase the joy you feel today.

Feeling better, even briefly, won’t eradicate painful feelings or misery, but it will keep your emotions on a more even keel and help you begin to feel better.

Do three enjoyable things every day. Don’t take lightly the impact a pleasant experience can have on your mood and emotions. Today, schedule at least one thing that makes you feel good in the morning, mid-day and in the evening. It could be anything: an extra few minutes to enjoy a warm shower, a phone call with a friend, gazing at a picture of a loved one, re-reading positive emails, exercising, a special cup of coffee, watching a movie, taking a walk, reading a book or magazine, or being alone.

Search for Positive Circumstances. When you are unhappy or stressed, your focus narrows.  The result is that you keep noticing only those things around you that contribute to your misery.  When you are happy, your focus expands and your thinking becomes more flexible.  To get from a narrow mindset to one that is more open and flexible, set aside a portion of the day to hunt for those moments when someone does something nice for you or you share a special experience with someone.  Notice when you are offered something you want or need or achieve a goal after hard work. Make a list of what your grateful for or remember what happened today or this week that made you smile, laugh or gave you a sense of calm.

When you have good reason to feel bad, it’s hard to make positive changes. However, it’s important to plan positive life experiences into your life.  Joy doesn’t have to be missing, even when you are stressed-out or in emotional pain.

You can find more strategies to improve how you feel in my new book, The Stress Response and by clicking here to sign up for more of my tips and podcasts using DBT strategies to improve how you feel.

Each of us makes sense of the world through our past experiences, internal expectations and beliefs about the world.  We think about the events that occur in our lives and interpret their meaning based on our history, past learning and our own personal tendencies.  Sometimes our thoughts about our lives serve us well.  They help us maintain our moral compass, weather adversity, form strong relationships and find happiness.

When your thinking is making your life worse, rather than better, shifting how you view events in your life can have a big impact on changing how you feel.

Strategies to improve how you feel by changing how you think:

1. Don’t approach interactions with the goal of explaining or convincing someone of your point-of-view.  When you disagree with someone, instead of attempting to prove your viewpoint as “right,” attempt to see how both viewpoints may exist and hold truth.
2. Try to find commonalities in seeming opposites. Although some things may appear to be mutually exclusive, search for how they are in fact a part of a whole.  This might mean that you are both materialistic (interested in having new things) and at the same time concerned for the environment.  It could mean that you are light hearted and serious, forgiving and angry, doing your best and needing to do better.  On the surface these may appear to contradictory, but they are all part of a whole.

Key words:  DBT skills, dialectical behavior therapy, dialectical thinking, absolute truth, negative thoughts, rigid thoughts

1. Give up on a search for one final indisputable truth.  Think of all the times in history when we believed we knew the truth—that the world was flat, that Vikings wore horns on their helmets, that Crisco was a healthy alternative to butter, that women don’t have the intellectual capacity to vote, that the earth was the center of the universe.  Acknowledge that our sense of “truth” evolves over time.  Allow yourself to loosen your hold on any “truths” that may change with time and circumstances.
2. Let go of extreme language.  The words that we use have an impact on how we feel.  Using words such as never, always, must, should, shouldn’t, fair, unfair, ideal –increases the emotional intensity of your thoughts and narrows your attention, making it more likely that you will have faulty or exaggerated views. Think, instead in terms of sometimes, often, helpful, unhelpful, effective, mistake, and interest.  Allow yourself to think about what works, rather than how things “should be.”
3. Remember that all interactions occur in a social world.  We have personal control over what we do, but we are influenced by our past experiences and our current life circumstances.  Someone who grew up in poverty might have very different views of money, for example, than someone who grew up with great wealth.  Each person’s view developed based on these very different experiences are neither right nor wrong.  Rather they are different based on each person’s history.  When you interact with others, don’t assume that their social context and therefore their beliefs developed in the same way that yours did.  Focus on accepting that despite our ability to think and act rationally, we are all influenced by our environments.  When you interpret someone’s behavior remember that it occurs in a context and that you can never fully know that context.  Although it’s different from yours, other viewpoints can hold personal truth.

If you feel stuck in a narrow set of beliefs or expectations, find yourself in repetitive patterns of conflict with others or find that you are stressed, anxious or fearful much of the time, changing your thoughts might have a big impact on changing how you feel.

Children, parents, partners and chores all seem to infringe on what little free time women have today.  Not to say that we don’t love and cherish those important people in our lives, but for our own well-being it’s essential that we have some time to care for ourselves and recharge.

If you feel you are one of those people who have little free time and what little you have is continually interrupted, you may need to get active, in order to carve out a little more time for yourself.

Demands—those things you must do, which can include watching the children, managing household finances, cooking, grocery shopping and going to work–are expectations of those people around you.  They can eat up a lot of our time, leaving little for rest and leisure.  But our own internal shoulds also contribute to our sense of having little time to spare.

Women, in particular, often have a long list of shoulds.  Shoulds are those expectations that we have internalized and continue to place on ourselves.  For example: “I should clean the house myself, even if I work long hours and can afford household help” or “I should not hire extra child care, even if I can afford it”

We often have internal myths that perpetuate our cycle of busyness and time pressure.  Do any of these sound familiar to you?

• “I can’t ask my partner for help with chores because he/she won’t get do it the way I like them.” 
• “If I did less around the house everyone would feel like I wasn’t taking care of it.”  
• “If I don’t clean up messes immediately, I am a bad housekeeper.”
• “I do not deserve time off to take care of myself”  
• “Others (i.e. my partner or children) should notice how much I do and offer to help.”

If you relate to these statements, it may be time for you to re-evaluate all those things you feel you “ought” to do.  A healthy lifestyle requires some level of balance between what you want to do and what you are doing out of a sense of obligation.  Letting go of some of those internal obligations can allow you to care for yourself and in the long-run have more energy as you care for others.

Technology may have improved your life and at the same time, contributed to increased expectations that you be constantly available to work.  Do you answer emails and return phone messages before and after work?

If you’re overwhelmed with work stress, you are not alone.  In a nationwide poll by the American Psychological Association, three-quarters of Americans list work as a significant source of stress.  A down economy has left many people with increased work demands and fewer resources to meet those demands.   Even as the economy improves, the pressures at work don’t necessarily decrease.

Work stress results in both physical and mental symptoms.  Headache, fatigue and upset stomach are common physical symptoms of stress.  Mental symptoms, such as difficulty concentrating, lack of motivation and excessive worry emotional distress, in the form of increased irritability, anger and nervousness can disrupt relationships and impact your job performance.

Stress during any given day can leave you distracted by worry, unable to focus, jumpy and jittery or frozen and unable to perform as well as you might otherwise.

Tips quick tips for handling daily work stress:

1. Know your limits.  Everyone has limits work limits. Reflect on what you are willing and able to do.  Then consider what expectations are tolerable in situations that push your limits.  Articulate and negotiate ahead of time, when you can anticipate expectations that will stretch your limits. Consider enlisting your supervisor or colleagues in helping you find solutions to meet work demands that stretch your limits.
2. Know when your limits are stretched.  Some days are more challenging than others.  Work expectations may increase temporarily or family or social obligations may impact your ability to manage job demands. Being aware of days when you’re temporarily stretched can help you plan how to get through them, whether it’s by communicating your needs or taking better care of yourself.
3. Prioritize self-care.  It is essential to be kind and compassionate toward yourself when you are overloaded with work. You may be so focused on getting the job done that you have put yourself last. When you work long hours or are drained by your job, it’s easy neglect self-care or simply fail to notice that you are missing this essential ingredient to tolerating difficult circumstances.  Simple activities, such as listening to soothing music, eating comfort food, wearing a favorite scent, washing your face with warm water or dressing in soft fabrics can have an impact on your ability to tolerate difficult days. If you noticed you’ve skipped basic activities such as going to the dentist or scheduling an eye appointment it’s a sign to focus on taking care of yourself.
4. Take a vacation. A relaxing week or two off might be ideal, but if that isn’t realistic right now, take small, planned breaks during the day.  You might assign work-free zones in your life. For example, restrict phone and computer use while eating meals, identify 1 hour in the evening that is dedicated to a leisure activity or wait until after breakfast to check your email on your smart phone.  At work, consider taking a 5-minute break every 90 minutes.  Use that 5 minutes to stretch your legs, focus on deep breathing or make a cup of tea or coffee.
5. Get physical. Your physiological stress response originally developed to provide your body extra amounts of energy.  You may be trapped behind a desk or in a meeting when stress hits.  Channel that energy into something positive.  Regular exercise can bring that energy to manageable and productive levels.  During the work day taking a quick jog up the stairs, walking around the building, stretching your arms or delivering documents in person can help modulate nervous energy that comes with stress.

Work demands can be stressful.  The stakes of a meeting may be high, your job may be uncertain, you may have tense interactions with a supervisor or work colleagues or you may work in a less than ideal environment where noise or poor lighting increases stress levels.

There are times when you can improve your work circumstances to lower stress levels, but sometimes you have to find ways to get through difficult days.  Finding healthy ways to manage your work stress each day can keep you going and make it less likely that you’ll develop unhealthy habits, such as overeating or smoking, that may seem like stress relievers in the short-term, but only add to stress in the long-term.

Like anger, which I discussed in a recent post, anxiety, even when painful, can serve an important purpose in our lives. For example, anxiety about your child’s health can cause you to stay up all night to monitor a high fever.

But sometimes we can get stuck.  We become nervous and overlook parts of the situation that are not threatening.  Or we feel doubt and begin a relentless cycle searching for solutions, missed details and anticipating all possible outcomes. When anxious, we’re more likely to attend to any potential threats in our environment and to interpret circumstances as threatening that at other times we would not. Once the cycle begins, anxiety can stick around, damage our relationships and keep us from positive life experiences.

As with anger, sometimes the only way to change painful anxiety is by changing how you act.  The key word here is sometimes.  In the case of anxiety, it’s important to determine whether you have reason to feel anxious.  If your child’s health is at risk from a high fever, then it is important to respond to your anxiety.  But, changing how you act will change your levels of fear and anxiety if you are exaggerating or misinterpreting the danger.  Anxiety about speaking in public, for example, can be greatly reduced by speaking in public.  Usually our fears of criticism are overblown and exaggerated beyond any real disparagement we might encounter.

Changing how you act will only change how you feel if you change both your actions and your thoughts.  Speaking in public, all the while thinking “this is awful” “I can’t stand it” or “this is a catastrophe” will not reduce anxious feelings about public speaking.  You have to change your thinking, as well as your behavior.  This could mean thinking “I’m nervous, but doing okay.”

Steps to Change Anxious Feelings

1. Figure out your emotion. Emotions can be complicated and confusing.  Figuring out what you are feeling, for example nervous, annoyed, fearful or anxious, is an important first step.  Are underlying feelings of guilt or anger influencing your anxiety?
2. Ask yourself what action goes with that emotion. For example, avoidance generally goes with fear.  Anxiety often has an impact on our thoughts.  Anxious thoughts are often repetitive and focused on possible negative outcomes.
3. Ask yourself ‘do I want to reduce my levels of anxiety?’  It only makes sense to try to change those feelings you want to change.
4. Figure out what the oppositeaction is.  The opposite of avoidance is approach.  Remember, in the case of fear and anxiety changing how you act only works if your fear is not justified.  If you are in physical danger or under threat, your anxiety can be serving an important purpose.
5. Do the opposite action all the way.  Throw yourself in to acting differently in both your actions and your thoughts.  Acting differently, without thinking differently won’t work.  You have to do both.

The ability to solve life’s problems and live the life you want to live sometimes means acting in opposition to your feelings.  You may need to approach a feared experience or re-focus on aspects of your life that are non-threatening.  Doing so can reduce anxiety that has become destructive in your life.