PART 1

Understanding Yourself and Your Anxiety

CHAPTER 1

How Anxiety Works

Does any of this sound familiar?

If yes, you’re not alone, and you’re probably suffering from some degree of anxiety. Anxiety is an emotional state characterized by feelings of worry, nervousness, and unease. Anxiety disorders affect 40 million Americans over the age of 18, and “everyday anxiety” affects a far greater number.1

Based on research, we know that similar psychological mechanisms underlie all types and degrees of anxiety, even if forms of anxiety can look very different on the surface. No matter how your anxiety manifests itself, you’ll find the information you’re about to read relevant and useful, whether you have an anxiety disorder or are, like me, just anxiety-prone by nature.

How Anxiety Works

Anxiety shows up as a variety of symptoms, from behavioral and emotional to physical and cognitive (which just means thoughts). No anxious person has the exact same set of symptoms, but everyone has some of each type. See the table on the next page for examples of each component.

Although anxiety can sometimes seem like a flaw, it’s actually an evolutionary advantage, a hypervigilance system that causes us to pause and scan the environment. Feeling anxious triggers us to start looking out for potential threats. If you detect a potential danger, it’s not supposed to be easy for you to stop thinking about that threat. While that’s great when you’re a caveman worried about protecting your family, it’s not as great when you’re an employee convinced you’re getting fired.

For many of us who suffer from anxiety, our anxiety alarms fire too often when there isn’t a good reason to be excessively cautious. Why does this happen? We may have more sensitive anxiety systems. Or we may have been doing things to decrease our anxiety in the short term, such as avoiding things that make us feel anxious, that have actually increased it in the long term.

Having some false anxiety alarms—where you see threats that don’t exist or worry about things that don’t eventuate—isn’t a defect in your system. Think of it in caveman terms: In a life-and-death sense, failing to notice a real threat (termed a false negative) is more of a problem than registering a potential danger that doesn’t happen (termed a false positive). Therefore, having some false anxiety alarms is a built-in part of the system, to err on the side of caution.

People feel anxious when they step outside their comfort zone. Avoiding stepping outside your comfort zone would lead to living life less fully. Since I’m anxiety-prone by nature, almost every major decision I’ve made in my life has involved feeling physically sick with anxiety. If I weren’t willing to make decisions that lead to temporarily feeling more anxious, my life would be much emptier than it is today.

Reducing your anxiety to zero isn’t possible or useful. Anxiety itself isn’t the problem. The problem occurs when anxiety gets to the point that it’s paralyzing, and you become stuck. I think of these bottlenecks as anxiety traps. We’re going to work on managing your responses to five anxiety traps: excessively hesitating before taking action, ruminating and worrying, paralyzing perfectionism, fear of feedback and criticism, and avoidance (including procrastination).

The reason I’ve chosen to focus on these particular five traps is that I’ve found them to be the common threads that affect virtually all of the anxious clients I’ve worked with. The traps are self-perpetuating because they generate additional stress. For example, someone hesitates so much that she misses important opportunities, and this leads to being financially worse off. Or someone avoids feedback and then isn’t alerted to real problems that could have been rectified earlier. When people are caught in any of the five anxiety traps, they often fail to see the big picture and don’t problem-solve in effective ways. Learning how to navigate these bottlenecks will allow you to manage your anxious tendencies so that you can pursue your goals in life, whatever those goals may be.

How will this book help you learn to successfully navigate your anxiety stuck points? The tools presented here are based on the principles of cognitive behavioral therapy (CBT). CBT is widely regarded as the most effective type of treatment for anxiety and has decades of research behind it.2 The term cognitive behavioral just means that the approach focuses on both thoughts and behaviors and emphasizes that this dual focus is the best way to get results. It’s more accurate to say cognitive behavioral therapies, since the term actually refers to a family of therapies that have the same underlying principles. However, most people just say “cognitive behavioral therapy,” and I’ll use the terms interchangeably for convenience.

There are three main things you’ll need to successfully navigate your anxiety bottlenecks. The first is self-knowledge about the thinking and behavioral patterns that have caused your anxiety to develop and persist. We know what these are from research on anxiety, and I will discuss how you can learn to recognize them.

The second essential element is a set of tools for coping when you find yourself caught in the web of anxiety. I’ll share a toolkit of strategies that will help you unblock your anxiety bottlenecks, so you can head toward your goals and feel better.

The third piece of the puzzle is some general confidence in yourself. You’ll need to believe you have the capacity to use the information and tools provided to solve your own problems. If you don’t have this self-belief just yet, we’ll work on it together—particularly in Part 3.

Why This Book Is Different

You may be wondering if this is going to be one of those saccharine, stick-a-smiley-face-on-it, positive-thinking books. Heck no. The traditional “Don’t worry, be happy” message rubs me the wrong way because I like to feel prepared for things that could go wrong. And I know a lot of other anxious-by-nature people who feel the same way. Many anxious people have had a lifetime of people telling them “Don’t worry,” “Don’t stress,” “Don’t overthink it.” As a result of constantly being told to just relax more and chill out, anxious people often end up feeling like there is something fundamentally wrong with their natural self. The “Don’t worry, be happy” message ignores research showing that there are benefits to both optimism and what’s termed defensive pessimism.3

Successfully navigating anxiety involves learning how to accept, like, and work with your nature rather than fighting against it. Personally, I like my nature, even though I’m anxiety-prone. If you don’t already, I hope you’ll come to understand and like your natural self too. Once anxiety isn’t impeding you, this will be easier to accomplish. If you take nothing else away from this book, understand that there’s nothing wrong with having a predisposition to anxiety. It’s fine to be someone who likes to mull things over and consider things that could go wrong. If you’re not spontaneous or happy-go-lucky by nature, there’s absolutely nothing wrong with that either. It’s fine to consider potential negative outcomes . . . as long as you also:

In the coming chapters, you’ll learn some tips and tricks for switching out of anxiety mode when the volume gets turned up too high. You can use these micro-interventions to handle times when you find yourself overchecking, overresearching, overthinking, or being unwilling to try something that’s important to you because of the chance that something might go wrong. You don’t need to fundamentally change your nature; you just need to understand your thinking style and learn tricks so you can shift your thoughts and behavior when it’s advantageous to you to do so.

Another way this book differs? I’ve learned from the adults I’ve worked with that they want to understand the principles behind the advice they’re being sold. They want to adapt specific strategies to suit their personality, their lifestyle, and their goals. This book will give you the tools and encouragement to do that. I’m going to help you navigate, but ultimately you are the driver.

How Did I End Up Writing This Book?

Even though I don’t have an anxiety disorder, I’ve always been anxiety-prone. I was the type of kid who refused to go to camp because I was terrified that the camp leaders would make me eat food I didn’t like or tell me off for something I hadn’t meant to do. In the days leading up to a new school year, I would get so stressed out about having to adjust to a new teacher that I’d feel physically sick.

Before I started graduate school, I had very little understanding of my own anxiety. I then trained in clinical psychology, which is the psychology of treating disorders, like panic disorder, obsessive-compulsive disorder, depression, and eating disorders. During my training in cognitive behavioral therapies, I noticed how much CBT was helping me understand my own thinking and behavioral patterns. I wasn’t using the exact techniques used to treat clients with clinical problems, but I used the principles I was learning to change my thinking patterns and ways of reacting to stress.

When I graduated and started my own practice, I found that the initial problems people came to see me for would often resolve relatively quickly using a CBT approach. For example, when people came for treatment of panic attacks, they would often stop having panic attacks quite quickly. If they came for depression, their mood would frequently lift quickly to the point they wouldn’t be considered clinically depressed anymore. When people came for problems with binge eating, they would often break the cycle of bingeing and dieting after just a few weeks of treatment. These people weren’t problem-free at this point—they just weren’t showing their main symptoms anymore. They still had a lot of questions about how to cope with anxiety and stress and needed additional skills for doing this. The therapies I’d learned didn’t seem as useful for this stage of the treatment process, so I started developing my own materials. I was guided by my clients, by research findings, and by what I know works for me in terms of coping with life and anxiety.

I began sharing the materials I’d developed on a blog, and was soon approached by magazines to give expert tips for their stories. I found there was a lot of interest in learning how to use cognitive behavioral tools to solve everyday problems. This interest often came from people who struggled with a degree of anxiety but didn’t have clinical disorders. I also noticed that people who had anxiety disorders would come to see me for treatment based on information I’d written on my blog or in magazine articles. The information they were finding useful was about general cognitive behavioral principles but wasn’t necessarily specific to their disorder.

As my career progressed, I began to specialize in adapting CBT principles into tools that can be used for dealing with everyday problems, especially anxiety. Because I trained in both clinical and social psychology, I am able to incorporate knowledge from both areas. As a result, my approach is a bit different from other people’s. I’m able to blend information from social psychology research (about how people generally think and behave) with that of clinical psychology.

The tools you’ll learn about have not only worked for me but have also worked for my clients, and I hope they’ll work for you too. I continue to use virtually all of the principles I’m going to share with you. Because it’s been more than 10 years since I started my training in CBT and because I use the principles and tools every day, I now use extreme shortcut versions of the tools themselves. The more you practice, the more you’ll develop your own shortcuts.

What’s Coming Next

This book is divided into three parts. Part 1 lays the groundwork for you to understand how anxiety works and better understand your nature. In Part 2, each chapter deals with a specific anxiety bottleneck. For each bottleneck, I’ll provide you with a toolkit of actionable strategies to unblock it. In Part 3, we’ll cover how to integrate the material into your life going forward and proactively troubleshoot problems that people often encounter. I’ll also offer suggestions for ongoing self-development work that goes beyond the anxiety focus of this book.

From this point onward, each chapter in the book begins with a quiz so that you can gauge how relevant that particular chapter is likely to be for you and get a sense of the learning aims for the chapter. Each quiz question requires you to answer A, B, C, or (sometimes) D. The content of the chapter will help you move toward the A answers.

Within each of the chapters in Part 2, we’ll cover recommended thinking shifts and then behavioral shifts. For each thinking shift, there will be a thought experiment to help you make the change. You’ll probably want to keep a notebook handy while you read for completing these experiments.

Use This Book in the Way That Works Best for You

You can interact with the material I’m sharing however is best for you. Remember: You’re aiming to build your own personalized Anxiety Toolkit by finding strategies you like and adapting them to suit yourself.

Here are a few things to keep in mind:

This book is intended as a reference book. You can dip back into any chapter as required. Come back to the material when you need to get insight into a problem you’re having or when you want to try something new (like when you’re in the mood to try a new recipe). If you start to feel a sense of information overload, stop reading once you’ve gained an insight that you want to implement in your life. You can always come back to the rest of the material whenever you feel like it.

You may notice that thinking and reading about anxiety causes you to feel some of your anxiety symptoms. The times when this happens can be a bit random. If it happens one day, it won’t necessarily happen the next time you pick up the book. To be honest, there are times when writing or talking about anxiety triggers anxious feelings for me. This is all par for the course, a course we’ll be navigating together. If reading about anxiety is making you anxious at any point, you can choose whether to keep reading and see if it naturally subsides or put the book aside for a few days.

You also may find reading to be a more comfortable state than doing. You may find yourself reluctant to try the suggested experiments because you’re not 100% sure if they’ll work for you or if you’ll do them perfectly. The key is to realize that you can’t wait for those feelings and concerns to go away before giving things a go. You’d likely be waiting forever. The good news: Taking any action while feeling a sense of uncertainty will make it easier to take action the next time you’re feeling uncertain. Focus on what feels doable, even if that’s just a few bits and pieces.

Many people with anxiety have problems with more than one type of anxiety—for example, problems with worry and social anxiety. If this is you, then you’re likely to find the transdiagnostic (that is, not disorder-specific) approach this book takes particularly useful. If you think you may have a clinical anxiety problem, like social anxiety disorder or panic disorder, then you’re likely to benefit from, at some stage, working through a treatment package that’s specifically tailored to the problem you have (see TheAnxietyToolkit.com/resources for some suggestions). However, the material in this book will complement that work.

Lastly, sometimes good general advice isn’t good advice for you. Part of learning to like and accept your nature is empowering yourself to ignore advice that doesn’t gel with you. Here’s an example: Long before I considered writing a book of my own, I started going to see authors on their book tours. At virtually all these talks, someone in the audience asks the author about his or her writing process. Most authors say they get up at the crack of dawn because they need uninterrupted writing time before their children get up or before they go to their day job. However, at one recent discussion, an author said he writes in little snatches of time throughout the day, whenever he gets an idea—often while he’s at work. This sent a hush over the room because it didn’t fit the accepted wisdom or the advice the other authors on the panel had given. However, this author had clearly learned to understand his own nature and to ignore advice that didn’t work for him.

If you find yourself feeling unwilling to try something in this book, move on from that section. Find something you feel willing to try and start there. Find what works for you based on your preferences and the stage you’re at. If you try suggestions and they fizzle, or some of the advice doesn’t work for you, feel free to ignore it. That’s simply part of beginning to accept your nature. Let’s continue to work on that now.

CHAPTER 2

Understanding the Multidimensional You

This chapter introduces some core personality and wiring concepts that will help you understand how your mind works. Awareness of these aspects of your nature will help you better understand your anxiety.

Take the following quiz to see how this chapter pertains to you. Choose the answer that best applies. If no answer is the perfect fit, pick whichever is the closest.

1. How well do you understand your fundamental nature?

(A) I have a good understanding of what motivates me and what causes me to feel emotionally balanced or unbalanced.

(B) There are some aspects of myself I don’t understand.

(C) There are many aspects of myself I don’t understand.

2. Do you ever feel like your natural instincts are in conflict? For example, you want to reach for new opportunities, but then your instinct to worry about what might go wrong kicks in and you freeze up.

(A) I can keep a balance between being focused on potential rewards and worrying about things that could go wrong.

(B) Sometimes.

(C) Yes, this gets in my way a great deal.

3. How well do you understand what tends to overstimulate you? For example, too much social contact or abrupt changes of plans.

(A) I understand what leaves me feeling jangled. My life is set up to minimize these occurrences and to allow me to effectively reset when I do get overstimulated.

(B) I’d like to understand this better.

(C) I haven’t thought about this.

4. Are you able to distinguish between conscientiousness and perfectionism?

(A) Yes, I recognize how striving for perfection can sometimes result in being less conscientious overall.

(B) Theoretically yes, but in practice I frequently confuse the two.

(C) They seem like the same thing to me.

5. How easily are you able to recognize useful types of care and caution vs. times when care and caution become paralyzing?

(A) I can see when being careful and cautious is an asset and when it isn’t, and can adjust my behavior accordingly.

(B) Sometimes I realize that I’m being too careful or cautious, but I seem to have no control over it.

(C) If I’m being excessively careful or cautious, I usually don’t notice this until long after the fact, if at all.

6. How easily are you able to moderate aspects of your nature? For example, if you’re very persistent, can you moderate your behavior in instances when taking a break is a better idea than continuing to bang your head against a problem?

(A) Most of the time.

(B) I’m hit or miss at this.

(C) No.

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Here’s how to interpret your scores. If you scored:

Mostly A’s

You understand yourself well and can moderate any strong tendencies you have so that they work to your advantage and don’t cause problems for you. While you may not need all the information in this chapter, there’s likely to be at least one or two nuggets of useful info for you here.

Mostly B’s

You understand yourself to some degree but sometimes have difficulty moderating dominant tendencies that might not be the best match for a particular situation. This chapter offers you the opportunity to develop an even more advanced and nuanced understanding of what makes you tick.

Mostly C’s

You may recognize there are ways you seem different from other people, but you feel either confused or ashamed about these. This chapter will help you better understand your nature and how you can best work with it to minimize excessive anxiety. The chapter will also help you recognize times when you get caught up in counterproductive types of care and caution.

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To better manage your anxiety, you don’t need to understand the average anxious person—you need to understand the multidimensional you. By multidimensional, I mean understanding your nature beyond just your predisposition to anxiety. For example, someone who is anxious and agreeable will be different from someone who is anxious and disagreeable. Very agreeable individuals might react to anxiety by agreeing to things they feel uncomfortable with. Disagreeable people might react to anxiety by nitpicking others’ ideas or seeing only the flaws in plans, leading them to opt out of potentially exciting collaborations.