Tag: Stress

What are Dialectics and Dialectical Behavior Therapy Skills? 

What is dialectics? 

Dialectics is based on the idea that two opposing concepts can both be equally true. One truth does not trump or rule out another, which undercuts the dichotomy of a “I am right you are wrong” type of relationship. A common dialectic is that you are perfect as you are (acceptance), and that in order for things to turn out differently in your life, you need to do things differently (change). One is not more true than the other, and one truth does not rule out the other truth. Sometimes people need acceptance, and sometimes people need to be challenged. Both belonging and growth are an inherent part of being in relationship. 

Dialectics challenges the idea that one person is always “right”, because when you take into account diversity of perspective, other truths often arise. Being “right” often fails to take into account effective communication and the value of the relationship. Experience and emotions get ignored. A set agenda of being “right” often gets people stuck in a very rigid, dichotomous, black and white, non-dialectical stance. Dialectics are important in that sometimes you can find the one thing you have in common with your enemy instead of focusing in ways you are different. Relationships exist in context of conflicting truths, yet relationships are the glue that carries us through life. 

What are the four Dialectical Behavior Therapy Skills? 

DBT is a complex treatment that has confusing origins in terms of how it was developed and who it was for, and has been tailored to a wide range of populations and settings. The DBT skills are universally applicable materials that help people with extreme and painful emotions, intolerable life situations, and relationships. The four skills sets are as follows:

Core Mindfulness: Mindfulness is a skill that helps people focus attention, regulate arousal, calm the brain, quiet the mind, and settle in. Being mindful is a way to steady and anchor oneself in order to observe quietly and not “react” to what is going on. It is inherent in all of the other skills in that it requires a steady, quiet, secure stance in the face of demanding life situations.  It takes spaciousness to know what is going in with your body, your self-experience, your wants and desires, and your life. If you don’t pause the moment and check in with yourself, it is easier to get “caught up” in the banging and thrashing of what life throws in your direction. Mindfulness can be a spiritual practice of quiet contemplation, a way to press the pause button, and way to regroup. Core mindfulness skills taught from the DBT material include skills of observing and describing without judgement. Other traditions, spiritual practices, health care services, and therapies teach mindfulness, so it is not “new” nor is it confined to just DBT skills; its roots are actually in Zen Buddhism. There are multiple ways of accessing mindfulness including mindfulness based programs, meditation groups, trainings, and apps. DBT groups are known for implementing a mindful practice or exercise in every group, and like many spiritual traditions are simply considered part of a daily practice. 

Emotion Regulation: This is a set of skills that helps people to observe and describe what they feel (you can see the overlap with mindfulness) in order to help regulate arousal, understand what they feel, and know the reasons why they feel the way they feel. Skills cover ways to reduce emotional suffering through mindfulness and opposite action, and ways to reduce vulnerability to emotional suffering. Skills are quite complex and take practice, feedback, and validation. Since emotions can be tricky, elusive, (and just plain unbearable at times) the emotion regulation content is not something you could “quick learn” and be done with it. Sometimes people are not always aware of how or what they feel in general, and there is nothing pathological about this.  It is a process! Knowing oneself and knowing one’s emotions is a lifelong task not subjected to any particular type of disorder, and does not end just because you have had a first exposure to all of the skill content. That is why working together on ways to regulate arousal given varying life circumstances can best be done over time in small group settings that promote cohesion and intimacy. 

Distress Tolerance: In order to regulate emotional arousal, finding ways to endure the “I-can’t-stand-it-itis” of painful and extreme emotions is critical. Surviving painful life circumstances well means doing so in a way where people do not lose self-respect, forget their values, give up what is important to them, or react in such a way that makes things worse. Sitting in the fire and not reacting is often harder than picking a fight, poking the fire, making others suffer in order to prove a point, exacerbating pain to let others know how bad things are, undermining a person where it hurts, forcing the university to prove its point, perseverating on being “right”, asking “why me”, or engaging in self-defeating or relationship destroying behaviors. Being willing to tolerate the unknown, be zen with the universe, stop fighting reality, and do what works is skillful practice. We all want things to do our way or to turn out for the best. In reality, a lot of people are suffering a great deal and need everything they can to survive well. Distress tolerance skills encompass not only change strategies (if you can do one thing make it better, why wouldn’t you?), but acceptance and willingness skills.  Anyone who has successfully undergone any type of exposure treatment for anxiety knows that the benefit to tolerating anxiety is a decrease in overall anxiety. There is an inherent truth that reality is easier to face once you stop fighting it, thus freeing you up to do what is needed to effectively solve problems. 

Interpersonal effectiveness: True to the concept of the dialectical philosophy of DBT, it is better to be effective than it is to be right. The interpersonal skill content encourages readers to identify objectives in situations (what exactly it is you want or don’t want), how the relationship may be impacted, and if self-respect is at stake. Balancing the three helps people to look at natural barriers and consequences of interacting, and enables readers to problem solve the cost/ benefit of ignoring each. For instance, you can ask for what you want at the expense of the relationship, or you can give into a relationship but sacrifice self-respect. The balancing act of relationships is an ongoing challenge for everyone, and some give and take is part of how people stick together, find intimacy, and keep people close. Interpersonal skills also include ways to get out of or decrease contact with toxic or unwanted relationships, set limits, say no, and to identify barriers to doing so. Direct rehearsal in terms of “what to say and how to say it” benefits group members in that they can try out and receive feedback in both verbal and non-verbal forms. 

Make sure you sign up for my mailing list if you are interested in learning DBT skills, or contact me directly.

How Do You Know That Psychotherapy Is Working For You?

Almost any good psychotherapy service incorporates some sense of increased awareness that has been known to be labeled as “mindfulness.”

What many people want from therapy is a sense of inner peace, the ability to not fall apart when stressful life events happen, and some sense to stability, predictability, and control. Most people in general want to feel a sense of hopefulness, influence, and autonomy. Some need to feel validated, heard, understood, or not invisible. For some it is getting organized, having emotional clarity, gaining skills to address conflict effectively, or being clearer about a life direction.

Mindfulness, from my teaching perspective, involves things that seem simple and basic but in general can be difficult. Being present, sitting with discomfort, or not reacting when there is is urge to control the outcome are challenges for lots of people. Let’s be honest: Life involves painful things. How can it best be survived?

Recently I came up with a brief definition of what exactly it means to be mindful. In some ways it is the nutshell version of the secret to mindfulness. It’s also an overview of some of the best teaching points, and influences my adaptive “mindful minutes” that I invite people to do at the beginning of all the groups I facilitate.

The steps I’ve outlined are ways to open up space inside you. What I wish for the people that work with me is to have a flexible momentum for waves of change, loss, uncertainty, or distress. When people are flexible and adaptive, they are better equipped to solve problems, act with confidence, think more clearly, and move forward with effective actions.

Click here to find out what it means to be mindful and join my mailing list.

Quick Tips For Figuring Out What You Feel

  • Use a list of emotion words to help you identify emotion words. A lot of people have a limited range of description words. Use the internet or google Marsha Linehan’s Observing and Describing Emotions handouts to help you.
  • What does your experience tell you? In your history of having certain experiences with certain situations, is your gut trying to get you to pay attention to something that is hard to pay attention to?
  • What actions do you tend to take or do when you have feelings? Sometimes identifying the behavior of an emotion (withdrawing, avoiding) can help you identify feelings (sad, anxious).
  • If you have a feeling ask yourself where you feel it. Some have a “gut feeling” or “gut instinct.” For myself, when I am ruminating or angry, I feel my head spinning or grinding. Some people feel a constriction in their chest or a change in how they are breathing. Some feel a deep pit or heaviness in the bottom of their stomach.
  • Is there a metaphor, animal, or weather that matches how you feel? Sometimes feelings are best described in the visual arts. If you could draw or paint how you feel, what image might show up?
  • When did you first start having the feeling? Does the intensity go down or up, and if so, what changes its intensity? How long does it last?
  • Is it hard for you to have mixed feelings, or feel opposite things? For instance, being both sad and glad about changes, or angry and in love with the same person?
  • What do you want your feelings to communicate? If someone else were to take action because of how you are expressing or communicating your feelings, what action would that be?
  • Make a list of all the things that are stressing you out right now. Think of as many as you can, and identify how stressed you are about each one on a scale of 1-10. Sometimes we don’t connect the feeling experience with the life stressors, and this can be both validating as well as help you move towards problem solving.
  • Are you avoiding any feelings that are difficult or painful? Consider what distractions are no longer working for you and what it might mean to hold space for yourself with tenderness and compassion.

Stressed Out? Tolerating Uncertainty in Uncertain Times

Anxiety gets the best of us when times are uncertain and outcomes are unknown. Waiting for a change in leadership, a medical diagnosis, a child to return home at night, people getting back to us in a timely manner, a decision about employment, funding or housing, finding out what’s happening are among the many things that people are worried about in general. Some people have significant anxiety in new, novel, or unfamiliar situations; around doctors offices, crowds, or people they don’t know. Some people worry about their health, longevity, future, livelihood, losses in functioning or capabilities, or the security, protection, and well being of family members.

People usually cope better when they have a clear answer as to when the stress and restrictions will end; as they can predict and control how long they will have to tolerate what may not feel tolerable. The not knowing is the challenge.

Sitting with uncertainty is often a major part of adaptive coping. Often when people feel out of control they behave in ways that produce an illusion of having more control, including trying to be more controlling themselves. Anxiety behavior tends to be restricting, rigid, and inflexible. Some pick fights with people they love. Some try to micro-manage the people around them. Some yell, lash out, or escalate. Some people withdraw, sleep, or restrict their interactions with others. Some stop reaching out to friends or people they love. Some avoid getting things done or move forward. Some drink alcohol or use marijuana in excess. Others cope by antagonism or rebellion, externalizing blame to authority figures who others who don’t have control either. After all, who gets to decide who gets cancer and who does not?

Sometimes with anxiety, there is no immediate solution or quick fix. No one knows what will happen. And no one can cheat death. But how, if there was an ideal way to survive or cope, do we get through this? Aren’t there people who do better with uncertainty, have successful relationships, are well loved and cared for, and who have a better chance at surviving painful life situations than others?

Here are some things to keep in mind in the era of uncertainty:

Anxiety behaviors are not a way to obtain certainty. People often have their own “personal fix” of what they do when they are stressed. Some of this has some sense of normalcy and is not harmful, such as sleeping a bit more or eating more chocolate. However, some anxiety behaviors have hurtful outcomes. What is your anxiety behavior when stressed, and does it actually control the outcome of when things will “end”?

Be willing to accept the discomfort of uncertainty. Find the ways in which people are coping well and see what you can do to manage stress and anxiety without making it worse. Reach out and ask what other people are doing with stress, medical conditions, losses or changes, work-life transitions, and other related stressors. Find the news, heroes, and people who have survived great life challenges well. Once you accept what you can not control, your anxiety may not disappear but it will go down. Trying to control what you can not control makes it worse.

Keep in mind your values. What is important to and who is important to you and why? What does this tell you about your spiritual values, who/ what to trust, and who you rely on when you are having a hard time? A willingness to yield control often means finding more trust in community. People are rediscovering lost values as limits are being placed on them, and finding new ways and means of connecting to family and loved ones. Keep asking and looking people for the silver lining, the unseen benefit, or the ways that people are enhancing their sense of connection.

Do your part. If you have something to offer at this time, consider the benefit or value of what you can do for others. Often contributing is a way to distract from our own anxiety and involves universal benefit. Donate to a food drive, reach out to neighbors, do errands for someone who is house bound, pick up trash in a nearby park or bike path, give blood, cook or bake for family members, repair something that is broken, join a neighborhood volunteer task force, or start a social community of your own. What if everyone who was suffering was focused on making the world a better place for others?

Your Emotions Aren’t Causing You To Behave That Way

What causes your emotions?

Most people have stories about why they did what they did, and they often sound like this:

  • My anger caused me to (hit, yell, escalate)
  • My anxiety caused me to (leave the grocery store, avoid a person or situation, or have a panic attack, not go to class)
  • The reason I could not (do anything, come to my appointment) is because of my mental health issues
  • Because I have PTSD, I am not able to (fill in the blank)
  • My mental health problems caused me to (fill in the blank)

The odd thing about these explanations is that no one seems to be very invested in what exactly causes emotions. If we could explain why people behave the way they do because of emotions, it seems the obvious solution would be to make emotions go away, not have emotions, or refuse to tolerate the discomfort that emotions create when situations or events evoke our emotions. If we can’t identify what causes, predicts, or controls emotions; we would have a lot of difficulty managing or controlling our own behavior. Most people want to feel in control of themselves, especially when their emotions seem to control their lives.

Although many mental health professionals believe that emotions are the cause of problems, I do not share this point of view. If we all believed that the reason you can’t get out of bed in the morning is because you are depressed, and the reason you are depressed is because you can’t get out of bed in the morning, we would have a massive problem of rhetorical reasoning.

Also, we don’t have a solution. Or a treatment plan.

The behavioral perspective (hence, my perspective) is as simple as this:

  • Antecedent (what comes before behavior, such as someone doing something mean or hurtful)
  • Behavior (ie, attacking, arguing, badgering)
  • Consequence (what happens as a consequence of yelling)

Anger, as it stands, is an emotion that naturally makes sense under the conditions of someone doing something hurtful or mean. Yelling is an action that a person does when experiencing anger.

If anger functions to prevent further hurt or harm or not be a doormat, effective and skillful solutions could be employed, such as:

  • Skillful advocacy
  • Holding someone accountable
  • Giving someone feedback about what they are doing so they can make changes
  • Acting confident
  • Making changes to reduce future problems
  • Alerting community members to the issue

Consequences generally come to the forefront when problematic behavior creates more problems than solutions (ie, vindictive blaming, domestic assault, relationship destroying behavior).

Here is the question for you: Do you need to change your behavior (ie, become more skillful, manage emotions differently), or do you need to change your emotion? Sometimes, you can manage your emotion by changing your behavior.

How To Survive Painful Life Situations

  • Accept that pain will come your way. The more you pretend that pain is not there, the worse it will get.
  • Write down a scenario in which you imagine coping well.
  • Let go of what you can not control. Stop doing what you can not do. 
  • Rehearse acting according to your values and believing you did the best you could despite the circumstances. 
  • Don’t avoid doing things that are a little bit hard just because you are suffering; approach tasks that give you a sense of accomplishment. 
  • Increase your connections with other people. Pain allows us to be vulnerable, soften our stance, and let others in. Bearing pain is easier when we are not alone. 
  • Find people in your life and express appreciation to them openly. 
  • Are your actions effective? Do what is needed to get through the situation. Don’t do something that will make it worse. 
  • Assume that you are not the only one who is suffering. 
  • Contribute, help out, help others solve their problems; find ways to make other people’s lives easier. 
  • Do one thing to nourish your body and your soul.
  • Write yourself a compassionate letter in which you acknowledge the pain and difficulties you are facing. 
  • Find one thing someone else can do to lighten your load and see if they would be willing to do it. 
  • Find three things a day that you are grateful for and share them with someone else. 
  • Stop comparing, judging, or evaluating your emotions. 

 

Are You Right? Should We Get Divorced? Should We Break Up? Whose Fault Is It Anyway?

We live in a society in which persons tend to dichotomize responsibility, resulting in blaming, scapegoating, and finding fault. When and if persons are at fault, there needs to be a process in place to make changes, resurrect one’s place in society, do repair work, and find a way to prevent further harm from happening in the future. 

Figuring out whose fault it is often results in a person feeling guilty or bad. The value of having a sense of shame or guilt about what a person has done is that the person has the opportunity for corrective action. But blaming or shaming a person without opportunity for corrective action doesn’t help people know what to do that can prevent, fix, or change things in the future. In my experience helping people with anger problems, there is a false sense of having fixed a problem by figuring out who is at fault. Figuring out whose fault it is (“not me”) creates a sense of separateness, polarity, relationship rupture, and inattentiveness to what needs to happen next. Shame can create further problems when people actively avoid being blamed or don’t have clear direction for what to do next. 

A less dichotomous (and dialectical) approach involves one in which people are impacted by each other; people all have roles in how conflicts happen in relationships. While it is possible that one person did something hurtful to cause a problem in a relationship, it does not necessarily negate roles in identifying how people influence each other, what can be done to fix or solve it, or what could be done to ameliorate the situation.  

The next time you figure out that it wasn’t “your fault” consider the following: 

What was your role in the series of events that led the other person to behave they way they did?

How is the other person impacted by your behavior?

What impact do you intend or want to have on the other person? 

What is at stake in terms of your self respect, your ability to keep the relationship, and your ability to be effective in addressing the problem? 

Even if you did not cause the issue, relationship rupture, or problem; what can you do to fix or change it? 

Are you doing anything to make the situation worse (or making the other person feel worse about the situation than they already do)?

What solutions or proposals do you bring to the table to work on preventing the problem from happening in the future? 

What impact does blaming or shaming another person have on your short and long term relationship with them? 

What difficulty emotions are you being asked to tolerate or bear given the complexity of the situation? Is an unwillingness to tolerate discomfort making the situation worse? 

What specific nonjudgmental feedback can you take give the person “at fault”? (In other words, how can you be part of the solution?) 

If it was “your fault”, and you are not sure that shaming and blaming yourself does any good, consider the following suggestions for repair work: 

Start with a succinct, matter-of-fact nonjudgmental description of what happened that includes  a very brief summary and an acknowledgement of the situation. Use the following prompts to fill in the details of your own situation: 

The consequences for my actions are (or may have been)… 

My intention was… 

My intention was not… 

When I behave this way people sometimes react by…or think that… 

I regret that… 

I am sad that… 

I would like for… 

In order to prevent this from occurring again, I am going to commit to the following… 

In order to make up for what I did, I will… 

What I appreciate about you is… 

What I value about this relationship is… 

I hope that in the future…

Even if you are overwhelmed by overwhelming problems such as homelessness, drug use, or abortion rights, remember that people have more influence and power when they work hard to maintain relationships, help people in society do better, or provide solutions. Pointing fingers is never helpful unless you are prepared to give clear and specific feedback and are willing to be proactive in working towards solutions. 

What are Dialectics and Dialectical Behavioral Therapy Skills?

What is Dialectics?

Dialectics is based on the idea that two opposing concepts can both be equally true. One truth does not trump or rule out another, which undercuts the dichotomy of a “I am right you are wrong” type of relationship. A common dialectic is that you are perfect as you are (acceptance), and that in order for things to turn out differently in your life, you need to do things differently (change). One is not more true than the other, and one truth does not rule out the other truth. Sometimes people need acceptance, and sometimes people need to be challenged. Both belonging and growth are an inherent part of being in relationship.

Dialectics challenges the idea that one person is always “right”, because when you take into account diversity of perspective, other truths often arise. Being “right” often fails to take into account effective communication and the value of the relationship. Experience and emotions get ignored. A set agenda of being “right” often gets people stuck in a very rigid, dichotomous, black and white, non-dialectical stance. Dialectics are important in that sometimes you can find the one thing you have in common with your enemy instead of focusing in ways you are different. Relationships exist in context of conflicting truths, yet relationships are the glue that carries us through life.

What are the four Dialectical Behavior Therapy Skills?

DBT is a complex treatment that has confusing origins in terms of how it was developed and who it was for, and has been tailored to a wide range of populations and settings. The DBT skills are universally applicable materials that help people with extreme and painful emotions, intolerable life situations, and relationships. The four skills sets are as follows:

Core Mindfulness: Mindfulness is a skill that helps people focus attention, regulate arousal, calm the brain, quiet the mind, and settle in. Being mindful is a way to steady and anchor oneself in order to observe quietly and not “react” to what is going on. It is inherent in all of the other skills in that it requires a steady, quiet, secure stance in the face of demanding life situations. It takes spaciousness to know what is going in with your body, your self-experience, your wants and desires, and your life. If you don’t pause the moment and check in with yourself, it is easier to get “caught up” in the banging and thrashing of what life throws in your direction. Mindfulness can be a spiritual practice of quiet contemplation, a way to press the pause button, and way to regroup. Core mindfulness skills taught from the DBT material include skills of observing and describing without judgement. Other traditions, spiritual practices, health care services, and therapies teach mindfulness, so it is not “new” nor is it confined to just DBT skills; its roots are actually in Zen Buddhism. There are multiple ways of accessing mindfulness including mindfulness based programs, meditation groups, trainings, and apps. DBT groups are known for implementing a mindful practice or exercise in every group, and like many spiritual traditions are simply considered part of a daily practice.

Emotion Regulation: This is a set of skills that helps people to observe and describe what they feel (you can see the overlap with mindfulness) in order to help regulate arousal, understand what they feel, and know the reasons why they feel the way they feel. Skills cover ways to reduce emotional suffering through mindfulness and opposite action, and ways to reduce vulnerability to emotional suffering. Skills are quite complex and take practice, feedback, and validation. Since emotions can be tricky, elusive, (and just plain unbearable at times) the emotion regulation content is not something you could “quick learn” and be done with it. Sometimes people are not always aware of how or what they feel in general, and there is nothing pathological about this. It is a process! Knowing oneself and knowing one’s emotions is a lifelong task not subjected to any particular type of disorder, and does not end just because you have had a first exposure to all of the skill content. That is why working together on ways to regulate arousal given varying life circumstances can best be done over time in small group settings that promote cohesion and intimacy.

Distress Tolerance: In order to regulate emotional arousal, finding ways to endure the “I-can’t-stand-it-itis” of painful and extreme emotions is critical. Surviving painful life circumstances well means doing so in a way where people do not lose self-respect, forget their values, give up what is important to them, or react in such a way that makes things worse. Sitting in the fire and not reacting is often harder than picking a fight, poking the fire, making others suffer in order to prove a point, exacerbating pain to let others know how bad things are, undermining a person where it hurts, forcing the university to prove its point, perseverating on being “right”, asking “why me”, or engaging in self-defeating or relationship destroying behaviors. Being willing to tolerate the unknown, be zen with the universe, stop fighting reality, and do what works is skillful practice. We all want things to do our way or to turn out for the best. In reality, a lot of people are suffering a great deal and need everything they can to survive well. Distress tolerance skills encompass not only change strategies (if you can do one thing make it better, why wouldn’t you?), but acceptance and willingness skills. Anyone who has successfully undergone any type of exposure treatment for anxiety knows that the benefit to tolerating anxiety is a decrease in overall anxiety. There is an inherent truth that reality is easier to face once you stop fighting it, thus freeing you up to do what is needed to effectively solve problems.

Interpersonal effectiveness: True to the concept of the dialectical philosophy of DBT, it is better to be effective than it is to be right. The interpersonal skill content encourages readers to identify objectives in situations (what exactly it is you want or don’t want), how the relationship may be impacted, and if self-respect is at stake. Balancing the three helps people to look at natural barriers and consequences of interacting, and enables readers to problem solve the cost/ benefit of ignoring each. For instance, you can ask for what you want at the expense of the relationship, or you can give into a relationship but sacrifice self-respect. The balancing act of relationships is an ongoing challenge for everyone, and some give and take is part of how people stick together, find intimacy, and keep people close. Interpersonal skills also include ways to get out of or decrease contact with toxic or unwanted relationships, set limits, say no, and to identify barriers to doing so. Direct rehearsal in terms of “what to say and how to say it” benefits group members in that they can try out and receive feedback in both verbal and non-verbal forms.

A book of all the DBT skills is available for purchase via this link: https://tinyurl.com/y2qad6sk

Here is a short video of me on YouTube with an overview of the skills: What Are the DBT Skills? DBT Skills with DrReneeHoekstra

Is Your Anxiety The problem? Why Getting Rid Of Your Anxiety Isn’t The Answer:

When people start to have anxiety problems they usually believe that anxiety itself is a problem. When anxiety becomes the focus of attention people overlook the actual fear or fears that create anxiety in the first place. The problem with this is that it often fails to activate problem solving, because the anxiety creates distractions from addressing the actual situation that is being avoided. People can successfully avoid treatment for panic by focusing on being anxious about being anxious, which ironically tends to generate more panic and amplify the belief that anxiety is indeed the problem. In some circumstances, because people have tried to get rid of their anxiety unsuccessfully, they believe that nothing can be done for their anxiety. Sometimes people get angry when anxiety treatments are presented as options, because they don’t want to be invalidated for their efforts to get rid of anxiety.

People have anxiety about all sorts of things: Losing people they love, sickness or illness, death; threats of losing power, status, money; being in situations that threaten physical integrity or safety, being humiliated or shamed in public, being verbally attacked, being fired, or loss. In a given situation coping well with these situations means incorporating some degree of acceptance, acknowledgement, and sadness. It also might activate problem solving, fixing, or making changes to prevent these things from happening in the future. This is what normal people do in normal situations, and creates understandable, realistic, and adaptive ways of coping. Community supports, problem solving, religious institutions, family, and other means of coming together helps people to naturally solve painful life circumstances and problems.

People that have a lot of problems with anxiety generally tend to have problems identifying and responding to the actual thing that makes them anxious. If you are afraid of having conflict, and then you tend to avoid people when conflict is present, and then you have anxiety because you have conflict, and then you blame your anxiety, and then you try to get treatment for your anxiety, you can create ways to avoid addressing the actual problem. For example, treating anxiety with relaxation techniques without actually looking at what it is about the conflict, exactly, that is making you so anxious evades problem solving. When “the problem” becomes “the anxiety” most people’s solutions are to get rid of how they feel, not to figure out how to deal with conflict. If you could figure out how to respond to conflict adaptively, chances are your anxiety will naturally go down.

You can’t address emotional problems by failing to identify the thing that evokes the emotion in the first place. Here are some brief questions to help you figure out your anxiety:

What is it about this situation that you are actually afraid of? What is the actual threat?

What is the realistic likelihood of this actually happening?

If you had to approach what you are afraid of, what uncomfortable sensations, emotions, or experiences would you have to be willing to tolerate?

If what you are afraid of is actually happening, how would you approach this situation effectively?

What is one adaptive, problem solving step that you could take?

What can you do to validate the pain or difficulty of this situation to yourself?