We covered this topic in an episode of our Podcast, Talk Therapy To Me. If you prefer to listen rather than read, you can do that here:
Shayla loves everything about mental health. She has been with Mindsight for about a year and she says you should have all your therapeutic services done through here.
She also is doing a YouTube channel on Wednesdays. Her videos cover literally everything about mental health. From the how-to, to relationships, to how to identify barriers. That's what it's all about. Go check it out.
To check out her YouTube, you can just type in Mindsite Behavioral Group and get to watching.
From your clinical perspective, what is anxiety?
Common symptoms of anxiety could include feeling nervous, and restlessness. You get a lot of talk about the physical symptoms that go along with it. Like feeling tense and experiencing an increased heart rate. Some people talk about heavy breathing, breathing rapidly, and maybe some sweating. So a lot of physiological symptoms are related when it comes to anxiety.
Something I notice for myself is my ears get red when I'm feeling really anxious. Do you experience anything like that?
I do have a few quirks. I would say a lot of my personal anxiety includes cognitive symptoms. For example, negative self-talk, which can lead to intrusive thoughts, which can lead to rumination.
We address the symptomology of anxiety, how do you know you have it?
Okay, so one thing that I love about diagnosing these symptoms, in general, is that it's going to be very individualized. Just like how we just talked about the way you experience anxiety is completely different than the way that I do.
However, there are some common links. Something that I've noticed from the collective is that there has to be some form of consistent worrying as well as a marked perceived fear. Whether the fear is rational or irrational, it's the fact that your body is reacting to it that matters. It's a fear to you regardless.
That's what helps us keep the treatment truly focused on the individual, their insight, and their worldview. And that constant worry or that marked perceived fear leads to trouble concentrating or thinking about anything and everything other than the present worry. So your mind is kind of really disorganized, and we're struggling with prioritizing.
How do you treat anxiety?
Treatment, treatment, treatment. Again, counseling gets me so hyped because it's like, what are the options that we have to help you have the most optimal life?
And I'm for it.
So when it comes to treatment, I really feel like that approach is legit. Between the clinician (and their expertise) and the client, it should definitely be a collaborative effort based on what the symptoms are. And also based on the most recent and effective evidence-based practices. When we throw that together, we create our own ingredients to come up with this recipe for optimal well-being.
So what kind of approaches come to mind off the top?
One of the most effective treatment approaches is cognitive behavioral therapy. But because we're dealing with anxiety, that crosses over from the cognitive aspect into the bodily aspect as well. Somatic therapy may be beneficial, or even just talk therapy, depending on where you're meeting the client at.
Yeah, and it's funny that you mentioned somatic therapy. I actually had a client who would get more nervous about focusing on her breath, so we had to come up with a different solution.
Oh, that's perfect. That sounds like the ideal therapeutic alliance. Again, you're meeting a client where they are, based off of what you feel might meet their needs. When the client can not only be receptive but also have that confidence within the session to express back, like vibe.
Yes, that client let me know what was in their comfort zone, and what they're already dealing with. And I was like, wow, thank you so much for bringing that up.
Right. And I mean, that's even their insight into their symptoms and how it impacts them, their worldview, and their engagement with people. There are some people that aren't even at that point yet.
You mentioned that self-awareness.
Can you elaborate on that?
Mental health-wise, there's still a lot of stigmas. I mean, think about how many movies or songs kind of blanket what mental health is. I know today, again, we're talking about anxiety specifically, however, I want to put this little reminder out that your mental health is not a cliche. Your mental health is not a song lyric. It is literally something that impacts you and the way that you interpret yourself and your fit in the world.
So sometimes, that insight and that self-awareness aren't there. I have this model that breaks it down.
Well, let's look at it from cinematography. So we're in a hallway, and as soon as something scary or offputting happens, it's almost like a zoom-in. And when you explained how she felt like that wasn't an option for her, that's a huge portion. When it comes to the cognitive piece, we don't feel like we have any options. So when they have that zoom-in, it's almost like their back goes up against the wall. Then, of course, go with the visualization of the body, the tents, the shoulders rise, and the feeling of being trapped.
Now that's actually a really good metaphor for anxiety and feeling a freeze response as well.
And it's just introducing them.And why, again, adding the visual pieces toit is because, again, not a lot ofindividuals or there are some individuals that dostruggle with going from this stigmatized blanketed approachto how is it individualized for me?
Tell me about this self-awareness model.
It is called a total behaviors chart, but I like to call it the car.
Why the car?
Because we're talking about anxiety and even language is important. It really helps us visualize and break it down piece by piece. I don't know about you, but if somebody comes to me with a whole list full of items of things that I need to complete throughout the day, I'm going to respectfully look at that list and hand it right back.
Absolutely, I just want one or two things at a time. So how do you break it down?
So this is how we're going to break it down: You are the car. It's individualized how people talk about their anxiousness or their nervousness and even the schema of their brain. And so when I said, okay, we're going to break it down like it's a car the responses are: Am I the car? Am I in the driver's seat? Am I in an area? What is it? What part of the car am I?
So, I'm going to say let this model turn into you If it's better fitting for you to be in the driver's seat, go ahead and be that bad driver. If it's better for you to physically imagine yourself as that car, that's okay.
So the car is basically a breakdown of your bodily functions?
Yes, that's why it's called the total behaviors chart.
Which two tires leave the car? The front two tires leave the car and then essentially the rear tires follow.
So taking that analogy that the front two tires leave the car and the back two tires follow, we're going to give some names to these tires. The front two, the first driver side tire is thinking what thoughts come to mind? We mentioned earlier how some symptomology that is involved with anxiety and also depression and some other mental health illnesses includes negative self-talk. That involves your inner critic, social structures, and what you grew up on.
So, within that therapeutic alliance, how do you guys decide what the approach is for that particular tire?
That's all up to you. However, that first tire is thinking for this example. I mean, thoughts lead everything, right? We have control of how we behave on those thoughts, but thoughts are going to come.
The other tire is the emotion taking a reality therapy approach. They say that people typically stay in their miserable states because of the association that they have with a particular event. So those front tires, the thought and emotion that you associate with it leads the behavior.
What about the back two tires?
One back tire is the physiological response. That really relates to a lot of the symptoms that we talked about at the very beginning. Rapid heart rate, body tension, muscles soreness, etc. Think about it, we've just talked about two other components that contribute to how our anxiety manifests behaviorally, and that's what that last tire is, the overall behavior.
I just pictured a tire coming off of its track, wheeling out, and then the whole car crashes. Of those pieces are in overdrive, What does that look like if they're all overwhelmed and trying to go in different directions?
Absolutely. I love that because I think that really drives home the point of it all. When we talk about that blanketed aspect of anxiety, it really is all these breakdowns of what it is. And you said what happens when each one of those areas are overwhelmed and is in overdrive home. That's where we get fatigue. Mental exhaustion is where we get comorbid aspects, and where anxiety can lead to depression.
If one of those parts is kind of just like doing a wheelie on its own, then what is everyone else doing to try and make up for that? So that leads into the behaviors you were talking about.
To add on to that, research does say that the quickest way to change behavior or change your outcome is either change what you're thinking or do something. I really want to make that specific because sometimes we juke ourselves and we think of the coping skill or we think of the behavior that would be different. And because it is satisfying, we kind of stop there. So, think of it as a verb: the act of doing that means you have to do it.
I love that because that is actually something I try to address when I talk about certain coping skills. I'll say, try and practice them outside of those anxious moments, outside of those high-energy moments, so they eventually become muscle memory.
That's why this model is so important because it gives you those options. So if we get stuck on the physiological responses again, we're using that. Because we've been talking about anxiety and it's common symptoms, notice the most.
Breakdown of the thinking: Okay, so where do you get the most anxious? Is it in a public setting? Is it at home? What's the dogma? Or what are the thinking patterns that come in when you're in those different settings? You can really break down how anxiety manifests in different social settings as well. It's also how they see themselves in the world, and that's in their community.
So is that kind of the definition of social theory overall?
Absolutely. It not only takes into consideration the individual, but also how the individual views themselves and sees themselves as a fit in the world. So it's almost like a bubble and a bubble in a bubble.
Wrapping up, what do you feel is your personal takeaway about anxiety?
I think my biggest takeaway is to acknowledge that anxiety is normal. It lets us know that we're alive, that we're alert. And honestly, it's a tale as old as time. Think about hunters and gatherers way back in the day. Imagine being a hunter with no adrenaline, no cortisol being released into your body.
You're just, like, chilling in front of whatever lion. You're like, yeah, I don't want to fight you, but I have to hunt and stuff. Yeah, right, it's not a match. It does not make sense. No alert, no danger, no alert again.
So, that adrenaline and cortisol are released because it's there to protect us. It's trying to keep you safe.
Absolutely. I don't know if this might be a little far-fetched, however, I see it as a superpower because when it's released, it helps us run faster. It helps us move swifter, and jump higher.
I remember back in the day, talk show host Donahue maybe. There was this guest of a woman that was in a car accident, and her child was trapped underneath the car. That mother lifted the car. That's due to the chemicals that are associated with anxiety being released into the body.
So, trying to utilize the strength-based approach, how can you make your anxiety work for you?
Let's talk about how we can make it work for us. We've talked a lot about anxiety in general, and what it can look like in different realms. Even using it as a signal that your body is trying to communicate.
It's a huge cognitive piece. Dealing with the blanketed term of anxiety is shifting that perspective of anxiety from being fear-based, so it can be turned into or used as an indicator. And so that could be used as a tool for mood regulation. Yeah.
Just recognizing anxiety and when it hits for you, does it hit in the morning? Does it hit in the evening? In a certain social setting around a group of people?
And making a routine once you know those things could be really helpful.
Yes. Routine, routine, routine. Having a routine can definitely set the emotional tone just for your day. A routine is absolutely a part of those five components. When it comes to just mental health, which everybody has mental health, we cannot dismiss that message.
We've talked about so many good things today, and I feel like we've gotten in-depth with anxiety, and I love that. We'll have Shayla on again soon, so stay tuned for that. Also, to hear more from her, check out our YouTube channel. Just type in Mindset Behavioral Group. You'll see her face and then you can click on all those videos.
Caitlin Bloom, LPCA
Caitlin is a Behavioral Health Clinician who enjoys reading, writing, as well as spending time with her husband and cat, Coffeebean, when she’s not counseling others. Caitlin likes helping clients guide themselves into deeper meaning, purpose, and connection for their lives. She focuses on finding resources, techniques, and coping skills on their journey for further fulfillment.
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