Anxiety Attack - And Counterattack

How do you manage your anxiety so that it does not run your life?

I regard anxiety as part of the human condition. We all stress about things over which we have no control, such as illness, losses, accidents, and the prospect of death (our own or that of someone we love). To maintain equilibrium, each of us needs to feel a certain amount of control over our lives. No one has complete control, but we all have enough to move forward with energy and optimism.

When we take charge in any situation, we are trying to impose order on an otherwise chaotic reality. Occupations tell me something about how people manage their anxiety. Doctors do it with diagnoses. Accountants do it with numbers. Writers do it with words. Lawyers do it with laws.

Some people satisfy their need for control by managing people. Examples include teachers, supervisors, military commanders, and the president of the United States. Some people appear to need more control than others!

When I see someone who is very stubborn-child or adult-I assume that this person has a huge amount of anxiety and therefore also a huge need for control. People who find part or all of their lives out of control lose flexibility. The more unmanageable things seem, the more rigid they become.

Anxiety can cause problems either continuously or intermittently. We've all had periods when we can't sleep. Some of us wake up at 3:00 am with dire thoughts. Some people freak out before or during tests. Medical exams or procedures terrify many of us. Serious losses and catastrophic events-fires, auto accidents, major illness, and death in the family-shatter our peace of mind.

Sometimes, too, anxiety tells us that our bodies are going on strike. Panic attacks, for instance, may indicate that our lifestyles are jeopardizing our physiological equilibrium: achtung! If you live in fear of such attacks, you should realize that managing anxiety is a life skill we all must acquire.

To help us maintain ourselves, our brains constantly give feedback to the rest of our bodies and get news bulletins in return. At any given moment, I might notice that my nose itches, that I'm starting to get hungry, or that I feel nagging irritation (anxiety!) from an unpleasant phone call or a big bill that arrived in yesterday's mail.

In each case, I will need to recalibrate myself by taking some form of action. Anxiety is just one of many inner feeling states to which I must respond. I call on a variety of strategies for solving problems and making myself feel better. By fine-tuning myself throughout the day I can keep working and stay true to my values.

If anxiety looms too large in your life, take stock of the problem. When do you feel anxious? Where are you when the anxiety hits? How does it feel in your body? Get yourself a notebook. Jot down a few lines each day. How anxious did you feel, on a scale of 1 to 10? What was happening at the time? How long did it last? What helped reduce it or bring it to an end? How frequently do you feel anxious in the course of a week?

Play scientist. The more you understand about the part anxiety plays in your life, the better able you will be to manage it. In so doing, you will be gaining control.

Strategy 1: Take Control. If certain kinds of activities or events fill you with anticipatory anxiety, plan ahead. What precautions and supports can you put in place to make the ordeal less painful? Imagine the worst case. Then tell yourself that you are prepared for anything.

Some of life's most unpleasant chores are unavoidable. For these, consider putting blinders on: don't think about that mammogram until you reach the doctor's office. If dread creeps up on you in the days before the appointment, treat it as you would a glass that you dropped on the kitchen floor.

If the glass shattered, you would immediately sweep up the shards with a dustpan and brush and dump them in the wastebasket. Afterward, so that no bare foot could step on any slivers you missed, you would probably vacuum the floor. If you had small children around, you'd take the trash out of the house altogether. Do the same thing with unwanted thoughts. Give them the heave-ho, and empty the bin.

Cheer yourself on. Talk to yourself out loud. If this feels weird, try practicing in front of the bathroom mirror: "Piece of cake! I can handle this. No big deal. This won't take long. I've done harder things before. This'll be over soon," and so forth.

Remember that the antidote for anxiety is control. Viktor Frankl, the author of Man's Search for Meaning, described surviving in a concentration camp by detaching mentally from the horrors. In his mind's eye he imagined himself surveying and interpreting the scene around him from a distance. This technique, familiar to novelists, helped him stay sane while many others perished. You can do the same thing by reframing your nemesis to remind yourself of the ways in which you, the choreographer of your life, have control. If your heart pounds loudly when you are stranded on the Claiborne Pell Bridge, remind yourself of how much you wanted to see Newport, Rhode Island, on the other side.

Strategy 2: Avoid Your Anxiety. When dread creeps up on you, distract yourself. Stay busy. Pick a task or activity that will keep your mind occupied and out of trouble.

Schedule worry time. Tell yourself, "I'm going to worry about that between 4:30 and 5:00 tonight, so I can't think about it now." Then hold yourself to the bargain. When 4:30 comes, see how much worrying you can get done.

Wrack your brains for something wonderful from the past, perhaps a day at the beach or time spent with an important family member. Pick a memory with lots of sensory detail-azure blue, wind-swept sky; sparkling summer day; the smell of hot, sweet hay; the lick of cool lake waters; the mellow peal of old church bells; the taste of gooey roasted marshmallows. Then, every time bad thoughts strike, just switch your mind over to the rich, satisfying memory that you have identified.

Strategy 3: Accept Your Anxiety. If your anxiety is a monster that threatens to overwhelm you unpredictably, give it a name. It's not you, after all, but something separate from you.
Embrace your anxiety. Talk to it. "Okay, Angie, I'm ready for you. I'm all yours. Sock it to me. Do your worst and be done with it. You can't get the better of me."

If specific activities make you panic-airplanes, elevators, syringes, crowds, traffic jams-try some exposure therapy. Plan a campaign to desensitize yourself. For example, if you were afraid to go up in an elevator, you might take a friend with you to look at one. On successive return visits, you would bring yourself closer and closer to the elevator. Eventually, you would step on with the doors open. Then you would step on and close the doors.

You get the picture. On each visit, you would push yourself as far as you could before the anxiety became overwhelming. Eventually you would succeed in reprogramming yourself!

Strategy 4: Parent to Yourself Wisely. Take good care of body and soul. Alcohol, caffeine, and cigarettes feed anxiety. Eat sensibly, and get a full night's sleep every night. Exercise daily, and let your workout strip you of stress. As you work up a sweat, think about the things that bug you. In this way you can drive anger and tension out of your body.

Take stock of your progress frequently. Congratulate yourself on your accomplishments. Celebrate yourself.

Recognize that tough jobs merit rewards. Bribe yourself to endure ordeals. Know how to give yourself treats that take a few seconds, a few hours, and a few days. Be as kind to yourself as you would be to a small child.

Don't sweat the small stuff or things that are past or otherwise out of your control. Ask yourself, before you waste a lot of time and energy, "In twenty years, who will know the difference?"

Have faith. Tell yourself daily or more often, "With God's help I can handle anything that this day will bring."

Marcia E. Brubeck is a graduate of the University of Connecticut Schools of Law and Social Work (go Women Huskies!). Before becoming a social worker, I edited scholarly books in the humanities and social sciences, including psychology. In my spare time, I like to identify wildflowers and watch birds with my cat, Charlie W. Brown. I also enjoy taking long walks, learning about antiques, seeing art films, gardening, baking bread, and writing popular fiction and nonfiction