Anxiety Treatment
CREATIVE PSYCHOLOGY WITH DR. DUG
People with anxiety love talk therapy. Why? It allows them to do something they are very good at - think and talk about problems! However, over all these many years of treating people who suffer from anxiety, I've realized that talking and building insight only goes so far and that the real challenge is for folks to take action.
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Therefore, anxiety treatment with me consists of exposure therapy (often using virtual reality), mindfulness, hypnosis, and lots of homework. Let's get started!
Avoiding Fear is Avoiding Life
Avoidance strategies are very good at...​
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Providing short-term relief because they momentarily allow you to not feel discomfort
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Not leading to any long-term improvement - if anything, they perpetuate the problem
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Blocking you from the path of a meaningful life
Fear delivers convincing messages about how to avoid, control, or get rid of discomfort. These coping tools, though, just serve to continue the cycle of fear and distraction from what really matters. The alternative is to get on with life, even when you are feeling uncomfortable.
Exposure Therapy works by helping you move toward your fears, in a graduated and manageable way, until you develop a new relationship with fear.
Avoiding parties even though you miss out on spending time with friends and family
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Avoiding flying even though this means you miss out on seeing people and places you want to see
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Avoiding your partner's stress by not sharing concerns even though this makes you feel less close
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Avoiding speaking up in meetings even though this hurts your chances of a promotion
Hypnosis is used in order to support exposure therapy. Contrary to what you see in movies, during hypnosis you are in total control of yourself and very much aware of what is happening. Hypnosis is merely when one is in a state of deep focus (similar to when you "daze out" when watching a bonfire) during which time your typical defenses (e.g., yes, but...!) don't get in the way and you are more open to new ways of thinking.
The ultimate goal of exposure therapy is to improve your quality of life and help you regain a sense of meaning, connection, and hope. To that end, it is vital to build your mindfulness skills so that you are aware of how you feel and think and can identify what is really important to you (versus what others tell you should be important to you).
Mindfulness should not be confused with "mind-iness." This is a form of avoidance that takes the form of rationalizing, judging, and evaluating. Yes, going down the rabbit hole is often an avoidance strategy!
People who struggle with anxiety often say they have difficulty with mindfulness and focus. This is another area where VR is a game-changer. For some, being in an immersive environment facilitates improved focus and self-awareness.
Treatment Plan
Treatment typically lasts anywhere from 4-12 sessions and is greatly dependent on clients doing their assigned experiential exercises at home.
Session #1
In this first session, we will review expectations of treatment, for both of us, to ensure we are on the same page. Prior to this session, you will have already filled out several questionnaires and provided a detailed narrative so that we do not have to use our time going back over those details. I will provide my understanding of what you have provided and get any necessary bits of clarification. The rest of this session is dedicated to discussing anxiety and the details of your exposure treatment. We will also do our first mindfulness exercise and talk about your at-home experiential exercises.
Session #2
In the second session, we will open with a mindfulness exercise to help you increase awareness of your internal state, go over the at-home exercises, do exposure with virtual reality, and talk about your at-home experiential exercises.
The remaining sessions will repeat the structure of Session #2, with the likely occasional addition of hypnosis.
Living a Valued Life
A vital piece of treatment is for us to identify your values - what are you working toward that gives meaning to your life. Oftentimes, people with longstanding anxiety have difficulty identifying what goes into a valued life because they have lived for so long with the primary focus of controlling, changing, or getting rid of anxiety. That single point of focus then almost acts as blinders to what is really important.
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Those coping strategies may help us to function today, but keep us stagnant and unable to move forward.
The Distress and Disruption Worksheet helps you identify the impact of the problems and coping strategies.
What would it be like to reframe your fears and worries as distractors, rather than guideposts?
Imagine that you are facilitating a meeting at work. You had developed a novel solution to a long-standing problem and had been wanting to launch the solution for the last year. Today, once you walk everyone through the solution, you will be able to make it live and everyone will be using the solution by the end of the day.
Being the organized person you are, you had created a detailed agenda and sent that all to all participants weeks in advance. You arrive 30 minutes early to the meeting have everything prepared. You feel calm and confident.
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You start the meeting on time and review the agenda. Someone says they have something urgent to discuss and that it will only take a few minutes. You feel your anxiety climb, but tell yourself that you don't want to prevent an important piece of communication from being shared. You hand the floor over to your coworker. That topic then leads into other "urgent" matters brought up by other people.
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Here is a situation in which you had a plan and wanted to pursue something that was really valuable to you, and even though you were in charge, you repeatedly let these interruptions take you off track because they seemed important and legitimate. The agenda should have been what dictated how to move forward, but instead, these seemingly urgent matters took priority, preventing you from realizing something meaningful.
One Last Note About Fear
Fear is the unavoidable partner of love. When we care about something, it makes sense that we want to keep it safe. When you bring home a really cool piece of art that you are excited about, you position it somewhere it won't get damaged or fall. If you don't care if it gets damaged, it is probably something you don't care about.
So, when people don't want to feel fear, they choose avoidance, or in other words, they choose to care less. If care goes down, so does fear. But when care goes down, what else goes down? Passion, joy, meaning, purpose, and whatever else makes you a unique being.
Instead of caring less and living a fraction of your desired life, it is possible to develop a new relationship with fear and discomfort so that you can live and love... even when you are feeling discomfort.
