This edition first published in 2015 by Conari Press, an imprint of
Red Wheel/Weiser, LLC
With offices at:
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www.redwheelweiser.com
Copyright © 2015 by Peter Bongiorno
All rights reserved. No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or by any information storage and retrieval system, without permission in writing from Red Wheel/Weiser, LLC. Reviewers may quote brief passages.
ISBN: 978-1-57324-630-9
Library of Congress Cataloging-in-Publication Data available upon request
Cover design by Jim Warner
Cover photograph © Miliga / Shutterstock
Author photograph by Inner Source Health
Interior illustrations © Peter Bongiorno
Interior by Jane Hagaman
Typeset in New Baskerville and Gotham Condensed
Printed in the United States of America
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To my courageous patients, who take the less traveled road of natural healing, and to the researchers and clinicians whose tireless and meticulous research work gave this book substance.
Acknowledgments
Disclaimer
Introduction: You Can Do This
1. What to Do Right Now
2. Your Thoughts
3. Sleep
4. Exercise
5. Guts, Food, and Blood Sugar
6. Mind-Body Therapy
7. Supplements
8. Challenge the Anxiety
Appendix I: Checking Under the Hood: Lab Tests
Appendix II: Great Natural Medicine Resources
Appendix III: Supplement Resources
Appendix IV: Quick Breakfast Ideas
References
Index
In no way would this work have been completed without the vision and gentle pushes from Caroline Pincus at Red Wheel. Much thanks to Rachel Leach for editing my stream of consciousness into something more readable. Profound gratitude to Patricia Karpas, who started me on this writing journey a few books ago. To my parents, Patricia and Peter, who embody unconditional love, and to the Bongiornos, LoGiudices, Coppolas, and Aunt Rose Zaccaria for providing constant support. My never-ending love goes out to my wife and fellow naturopathic doctor, Pina, the fixed foot who makes my circle just. And to my daughter, Sophia—you inspire me to be my best every day.
This book is not intended as a substitute for professional medical advice. If you are experiencing difficult symptoms of anxiety, please contact a healthcare practitioner, bringing this book with you, if you'd like.
We all have a greatest challenge we are working on. This book is special to me, for it allows me to collide, head on, with my strongest challenge and greatest ally—anxiety. And head on is how you and I are going to deal with it for your health, too.
You may be surprised that I called anxiety my greatest ally. Well, it is. Anxiety has helped me make changes that were needed in my life, and I believe anxiety can be your greatest ally and friend, too.
I know you have what it takes.
The very fact that you are reading this book tells me you are ready to face anxiety and move your life forward. Mustering the courage to face this issue squarely is the toughest part and will become its greatest reward. You can do it.
You may have read other books on the subject. You may have seen a psychiatrist or psychologist or two. You may be trying to avoid medications, or you may be on some medications right now. You may think you will never beat this thing. I believed I wouldn't. I can tell you firsthand: you can. You do not have to live the rest of your life in anxiety's grip.
I am a naturopathic physician. Naturopathic physicians are taught to view health problems from all angles, to look for underlying causes, and to create plans that address these. If there were just one factor causing your anxiety, you would have figured it out already. The truth is there are many factors that uniquely affect your brain and body. These factors then interact with your genetics in such a way to create this syndrome we call anxiety. But genetics are only about 30 percent of the controlling share. The rest of it—the majority of the reasons for your anxiety? You have control over these.
This book gathers about twenty years of my research and eleven years of my clinical practice, and looks at all the factors that contribute to anxiety: lifestyle, diet, sleep, brain chemistry, genetics, and much more. In this book, you and I are going to go over all the things you have control over. I'll outline a clear plan, and give you clear steps help you face anxiety from every angle, in synergy, to truly get to the calm and healing you need and deserve. I will share stories from many other people in your situation, patients of mine who have successfully used these approaches. You will see that you are not alone, and you're not saddled with anxiety—or the medications to treat it—forever. These tools work.
Overall, physical health and good mood are not caused or maintained by any one factor. As I explain to my patients at a first visit, achieving good health is like sitting on a stool. The stool has a number of legs and cross supports that keep it upright and keep you from falling on your butt when you sit down. When one of the legs or supports is weak, your health suffers. The legs you need for getting rid of anxiety for good include:
Figure 1.1: The anxiety-free stool
As you can see, the anxiety-free stool has four legs (supplements, foods, exercise, and sleep) and four cross supports (mind-body work, blood sugar balance, healthy digestion, and nutrient and hormone balance)—all supporting a seat of healthy thoughts.
That may sound complicated, but it's really not. It's all about developing awareness of what helps—plus some new habits—and sticking with them. I promise you, if you work on these all together, you will find and maintain your emotional balance.
And by the way, this isn't about being perfect all the time. I do not always eat healthy food. (Trust me, I'm a Sicilian boy at heart who enjoys a good pasta dish or pizza every now and then.) I also occasionally miss days of exercise, and sometimes I miss my supplements. But one thing I have learned is that as long as I keep all of these in mind, and do my best overall, my body and brain reward me. If I go a bit off track with my diet or stay up too late, there is still enough support to keep me up temporarily. And I can get back on track anytime. This process has rewarded me greatly in my journey with anxiety. It will reward you, too.
You can do it! Let's get going . . .
Today is a new day.
—Chicken Little
You're probably not feeling so good right now. You may have been diagnosed with generalized anxiety disorder. You may have depression with anxiety, or you may have panic attacks, like I had. You may or may not be taking medications. You just want to put anxiety behind you—preferably forever. I get it. In this short chapter, I will share with you some quick suggestions to help bring things down a notch right away. The rest of the book will give you a more complete view of the factors that contribute to anxiety and offer a way out—but for starters, let's look at some things that can get you feeling better right now.
Follow these quick steps, and then start moving through the rest of book at whatever pace you need.
For most people, anxiety is “just anxiety.” Nevertheless, it is good to get a general checkup and physical to rule out other health issues that might be contributing to (or even causing) how you feel. Have your doctor check your blood pressure and ensure that your body is handling the anxiety. If you can see a naturopathic doctor, definitely do so. See appendix II to find a creditable naturopathic doctor or other holistic practitioner.
Ask your medical professional to run some blood work on you. There are specific blood tests that look for odd things that can cause anxiety, like tissues that might abnormally secrete stress hormones. We'll discuss this in more detail in appendix I, which includes a list that you can take to your doctor and an explanation of the blood tests that will uncover other factors that are contributing to your stress. First step: make an appointment for a physical exam. I know this visit alone can cause anxiety for some of you. Nevertheless, when you leave your doctor's office, you will be glad you went.
When you go to your doctor and describe how stressed you feel, the subject of antianxiety medications will likely come up. You may already take them.
If you're taking antianxiety medication, even if you don't feel that it is helping, do not abruptly stop taking it. Let your doctor know you'll be trying natural medicines—bring this book along and share it if you like. Remember, it is not safe to discontinue medication without speaking to your doctor first. Even people who have never been anxious who regularly take these medications for a few months will likely have a hard time stopping cold turkey.
If you believe your medication is helping you, then consider it a blessing. You can start adding in some of the other treatments you'll learn about in this book, and eventually you might try weaning off your medication. Under supervision, of course.
If you're having side effects from your medication and you think the medication is making you feel worse, tell your doctor. He or she may want to adjust the dosage or switch the medication you're taking. Typical side effects of antianxiety medication include memory loss, fogginess, and sleepiness. Some patients will even have physical symptoms like stomach upset, nausea, or problems with coordination. If you are experiencing any of these symptoms, talk to your doctor about discontinuing your medication or switching to another.
If you are not on medication, this simple quiz can help you decide if medication is a good idea for you.
If you answered “yes” to any of the above questions, you should talk with a psychiatrist, physician, or naturopath. I am not a fan of medications and only recommend them as a last resort or in the short term in cases of clear safety concerns. My recommendation would be to look for a licensed naturopathic physician or licensed holistic psychiatrist who can provide medication if needed (see appendix II of this book for resources) while also working with the natural solutions in this book.
If you answered “yes” to the last question and are thinking about hurting yourself, please take action right away. There is a wonderful group of caring people at the National Suicide Prevention Center Lifeline at 1-800-273-TALK (8255)—they want to help. Please call them now.
Your thoughts are a driving force of your anxiety, and we explore them at length later in this book. But for now, my recommendation is to find a psychologist or therapist with whom you can talk freely. While there is no one best approach, cognitive behavioral therapy (CBT) is considered one of the most effective methods, and it is a good place to start. Consult the Anxiety and Depression Association of America website for a listing of therapists in your area (see appendix II). Also, some wonderful therapists offer Internet-based visits via videoconferencing services like Skype. While I strongly recommend the warmth of an in-person interaction, if your anxiety makes it difficult for you to leave your home or interact directly, a virtual visit might be the place to start.
When your sleep is not right, your body naturally gets very anxious.
Sleep has a profound impact on mood. Most people need seven to eight hours per night; some need more. No one really functions well on less. If you are not sleeping enough, do your best to get to bed earlier, preferably before midnight. An ideal sleep schedule is going to sleep at 10:00 p.m. and waking at 6:00 a.m.
While I know many of you reading this are saying “well, that's not for me . . . I'm a night owl,” I assure you: you are not an owl. We will work on this in chapter 3. For now, do the best you can to back up your sleep time. If you have a hard time falling asleep, be sure to keep your room as dark as possible at night; avoid the TV, computer, or cell phone for at least a half hour before bed.
Much more about sleep is in chapter 3.
Exercise is nature's way of burning stress hormones. When a dog chases a squirrel, the terrified squirrel's body creates stress hormones and burns them up in the process of running for its life.
Most of us live very inactive lives, yet we are stressed. Our bodies create stress hormones that coarse through us, but we never give ourselves the opportunity to burn them up. It's so important to get up and move:
Often when we are stressed out and don't know why, it's because our blood sugar is bouncing all over the place. Time and time again I have seen amazing results come from balancing blood sugar. The short of it is this: when our blood sugar is unstable, the primitive brain sends out a stress response. There is a quick way to fix this.
When anxiety seems to be controlling you, sometimes you need outside intervention. These are some of my favorite ways to bring the noise down a few decibels:
All of my patients take a triumvirate of supplements that support the body, brain, and digestive tract, while improving production of calming brain neurotransmitters.
In chapter 7, we will talk more about these basic nutrients for your body and mood. The supplements I use in my clinic can be found on the website www.3UNeed.com.
There are many supplements for anxiety out there. In my practice, I have often found the following supplements to be as effective as medications, but with fewer side effects.
In chapter 7, we will take a closer look at the supplements discussed in the last two steps, as well as a number of others.
I hope you have found this brief sketch helpful. If you are struggling to put one foot in front of the other or even to get out of bed, these suggestions can be a real lifeline. Next, we'll loop back to the beginning and explore what anxiety is and how and why it happens.
The cave you fear to enter holds the treasure you seek.
—Joseph Campbell
Linda was a fifty-eight-year-old lawyer who originally came to see me for support during breast cancer treatment. She had already had a lumpectomy and was looking for care to help support her body during chemotherapy and radiation treatments. Together, we outlined a strong diet to help her body stay healthy, discussed strategies for better sleep hygiene, and selected nutrient supplements for overall health. Linda came to visit me for regular acupuncture on a weekly basis to complement her naturopathic care. During her cancer treatments, she did beautifully—and felt she was healthier than others in her treatment group. She stayed energetic, upbeat, and in a way felt better than ever.
But once Linda's chemotherapy treatment was finished, she felt “unprotected.” Life began to feel dark and anxious. This is a common reaction in patients who have just finished cancer treatment. Linda's sleep suffered. She told me about her anxieties regarding her relationship with her husband, which had been strained for many years—he had cheated on her once or twice. Linda forgave her husband because they had three children whose lives she did not want to disrupt. She also did not think she could make it financially on her own. She felt trapped and powerless.
We talked about her self-esteem and how relationship issues can settle, energetically, in breast tissue—the area of nurture. I recommended that Linda read books on self-esteem and start considering what was important about life. While her conventional doctors recommended antianxiety drugs, I recommended that she face her issues head on. We also started some herbal remedies, such as St. John's wort and rhodiola, as well as tryptophan for sleep.
While this was a difficult time for Linda, it also became a time of empowerment. Eventually, she was able to confront her husband, who had his own issues of anxiety. For the first time, she was living her “real life.” Linda realizes that the breast cancer was an unfortunate wake-up call that ended up helping her more than anything had before.
This book is about healing from anxiety and taking back full control of your life. To do this, we need to address the physical part of you—your sleep, your digestion, your foods and nutrients. Most of this book is designed to do that.
While most of this book deals with your physical body to help calm your brain, this chapter looks at the thoughts that drive anxiety and gives you the tools to start working on them. Chapter 8 will help you design a plan to challenge the anxiety when you are ready.
For me, anxiety was the catalyst that led to the lowest points of my life. As you probably know, anxiety and panic attacks are truly frightening. At times, my feelings of dread, nausea, and overall ugliness were more than I could bear. Even more, the toll anxiety took on my life was profound: I was unable to do certain things because of anxiety, and I felt ashamed and embarrassed. It woefully lowered my self-esteem.
Does this all sound familiar to you?
If so, that is good.
Huh? Did I say that was a “good” thing?
Yes, I did. Because if it's in you to feel that scared, that fearful, that embarrassed—then you can feel that great, too. The same mechanisms that cause you to fully feel the anxiety, also allow you to feel happy and excited about life. It is completely in you to feel your best—your body can do it.
Why do I know you can do it? Because your mind is imaginatively creating anxiety. If it can do that, then it can create a life without it, too. One of the best pieces of information I was given when I started my anxiety journey was that I was the creator of my anxiety—and I could uncreate it, too. Up until that point, I thought external factors caused my anxiety or that there was something wrong with my brain. Actually, my brain worked well—a little too well.
You know how some people love riding roller coasters, while others hate them? Why is that? Well, when a roller slowly brings you up to the top of the drop and you expect to plunge down at breakneck speed, what happens in your body?
Before we move any farther, I want to briefly explain the stress system. This way, as you read this and other books, you will have a good framework to make sense of it all.
Any time you are excited or threatened, a part of your brain called the cerebral cortex responds. This is the outside surface of the brain—the part that makes humans different from all the other animals. The cerebral cortex decides right there: “Hey, this is gonna be fun” or “Hey, this is dangerous; I think I might die here.”
Whichever it is, that input gets sent into the middle of the brain—the hypothalamus. This brain center is where your immune system, nervous system, and hormonal system meet up to coordinate responses. From the hypothalamus, the signal goes to the bottom part of the brain, the pituitary, which sends a signal to tiny glands on the top of the kidneys called the adrenal glands. These adrenal glands are responsible for emitting stress hormones like epinephrine and norepinephrine (also known as “adrenaline” in England and other parts of the world). Epinephrine is the hormone that causes you to react and feel afraid (by raising your heartrate and increasing sweating, muscle tightening, tingling, and so on—all the feelings you know so well). Norepinephrine helps you focus on the threat—so you keep feeling anxious. Cortisol is another stress hormone that moves blood sugar and makes you hungry. Cortisol also beats up on your brain tissue, giving you that surreal and floaty feeling medical professionals call “depersonalization.” The hypothalamus may share signals with the amygdala, a fear center in the brain that can help coordinate and enhance the sensation of fear and panic. This system is called the Hypothalamic Pituitary Adrenal response system (HPA). Below is a diagram to help you follow this.
Figure 2.1: The hypothalamic pituitary adrenal response system
In the short term, the release of stress hormones readies your body for action—to fight or to run. This reaction can save your life. In the long term, however, this reaction can cause imbalances in your system. High levels of epinephrine, norepinephrine, and cortisol make it difficult for the body to keep up.
In the 1920s, Hungarian endocrinologist Hans Selye conducted research on a condition he called general adaptation syndrome (GAS). Selye realized that the stress response that can save your life can become a problem if it goes on too long. Let's say a bear is coming at you. At first, you have a stress response called the alarm reaction—your body creates stress hormones, and you run from that bear. But let's say the bear doesn't let up—it chases you for days and days. You start to adapt to it—you get used to that bear chasing you to the point where it feels almost normal. It's sort of like a little Volkswagen that is running RPMs in the red—it may be able to do so in the short term to push past a tractor-trailer on the highway, but you can't run a car like that all the time.
Your body has a similar reaction to stress. Like the little Volkswagen, you end up “running out of gas” and break down, feeling anxious and depleted. In the 1990s, researcher Bruce McEwen teased out this issue further by documenting the unhealthy changes to the body that occur with long-term stress: McEwen noted changes in blood pressure, cholesterol, blood sugar, inflammation, and many other body processes. You get used to running in the red for a while, but over time, the body breaks down. Most of my patients with anxiety have been in the red for a while or are starting to break down. The adrenal saliva test described in appendix I can help your doctor understand where you are on the stress continuum.
Now that we have a little stress physiology under our belts, let's get back to the thoughts that push this physiology with a question: How come some people love wild roller coaster rides, while others are scared of them? It all starts with your thoughts! You have the mechanism to be anxious or to enjoy life—it really is up to you in the end. The key is changing the thought and retaking control of what you're thinking. While the rest of this book will focus on what you can do for your body to reduce anxiety, this chapter focuses directly on changing those thoughts.
While I know it may not sound possible right now, this is something you can do. Remember, if you have the mechanism to be afraid, you also have the mechanism to enjoy life and move through anxiety!
We're in a free-fall into future. We don't know where we're going. Things are changing so fast, and always when you're going through a long tunnel, anxiety comes along. And all you have to do to transform your hell into a paradise is to turn your fall into a voluntary act. It's a very interesting shift of perspective and that's all it is . . . joyful participation in the sorrows and everything changes.
—Joseph Campbell
I have already quoted Joseph Campbell twice in this chapter. I first came across Campbell's work as a high school student in the mid-1980s, when I saw the Power of Myth series on PBS. Filmed over a few days at George Lucas's Skywalker Ranch, the program features Bill Moyers in conversation with Joseph Campbell. In this interview, Campbell discusses a concept called the “hero's journey” and relates it to both ancient civilizations and our modern world.
Like the typical teenager, I was preoccupied with superficial fancies, but Campbell's words mesmerized me. They started me on a path to think more deeply and completely about my life and what made me happy.
In case you don't know who this fellow is, let me fill you in: Joseph Campbell was a mythologist who lived from 1904 to 1987. As a mythologist, he spent time trying to understand the different religions, philosophies, and stories (“myths”) as told in various cultures, art, and literature from around the world.
What Campbell learned from his collected research was that many cultures and civilizations that had no communication with one another (no Internet, no Facebook, no Snapchat or Twitter—maybe carrier pigeons, but that's about it) had many similar ideas about the universe, God, and religion. Campbell found that even though these civilizations did not communicate, many of them independently honored the theme of “the hero.”
The typical hero (or heroine) story was about someone who may have lived a normal life for a time, went through a great challenge, and somehow came out on the other side transformed. Because these heroes are not looking to be heroic and usually feel out of place where they are, they experience anxiety of their own. At the end of the story, the hero always ends up wiser and is restored to an even higher sense of self and purpose in the world.
Famous examples of the hero's journey include major figures from world religions, such as Buddha, Moses, Mohammed, and Jesus. Classic literature also carries the hero theme—there is the character of Odysseus from the Odyssey or Stephen in James Joyce's Portrait of the Artist as a Young Man. Popular culture repeats the same beautiful theme with characters like Dorothy from the Wizard of Oz, Harry Potter, Disney's Mulan, Spiderman, and Luke Skywalker from Star Wars.
What I am trying to get at is that you are the hero or heroine, too! Don't look around the room—I am talking to you . . . yes, you.
Figure 2.2: Breaking up anxiety
We need to talk about the challenges you are facing, how to think about them as a part of the hero's journey, and how to get you to the other side. From now on, you are not a vulnerable person facing insurmountable problems. Rather, you are someone with challenges that can be worked through. As you read through this book, you will work on both your physical body, which can drive anxious thoughts, as well as the thoughts themselves. Working from both sides is the best way to break up and get rid of anxiety for good.
Today, maybe for the first time, you are going to summon the hero you have in you—the hero we have in all of us—and learn to move through the murky darkness into a new light of understanding, a light of calm, love, and greatly reduced anxiety.
To help with this metamorphosis, we will focus on three steps.
There's an old saying someone told me when I started this journey for myself: “Keep doing the same thing to keep getting the same results.” Similarly, if you keep thinking the same thoughts, you will continue to invoke the fear reaction you have been dealing with all this time.
At one point in my life, I thought I couldn't ride on an airplane anymore. In fact, I was sure of it. These feelings were so strong—the panic was too overwhelming. But in the long run, it turns out that the thought was wrong—and I was wrong. These days I fly all the time, giving lectures and traveling for fun. I worked on changing my thoughts about airplane rides, and you can change your thoughts, too.
The first step to changing your anxiety is to start bringing in other ideas. This isn't really any different than working with other disease states. Often, I work with patients who are very sick due to toxic accumulation in their bodies—toxins like pesticides, plastics, unhealthy fats, excess calories, heavy metals, chemicals from the environment, and foods to which they are very sensitive. These toxins can cause many types of sickness: autoimmune diseases, cancers, heart disease, diabetes, and skin problems, to name a few. Essentially, these toxins provide bad information to the body—they tell the cells to stay unhealthy.
The best way to counteract toxic accumulations is to nourish the body with new foods and good information. Foods such as blueberries, mercury-free fish, organic carrots, organic green vegetables, and organic olive oils have the opposite effect—they send positive messages to our cells. Similarly, to change anxiety, you will need to change the messages that go to your brain's prefrontal cortex. The messages we tell ourselves make all the difference.
I had a teenage patient who came to see me with her mom. She was sixteen years old and had suffered from anxiety for the past year. We talked about her diet, sleep, stressors, and the right nutrients for her brain. I explained to my patient that changing the messages in the brain is like “a cassette tape, playing a negative message over and over.” I suggested that she “erase that tape—and record a new one.” She looked perplexed—she did not know what a cassette tape was. So we switched it to an MP3 on her phone, and she understood—whew!
Whether it's on a cassette tape or an MP3, we have to start bringing in new messages—messages that look at the roller coaster and say “hey—that looks fun” versus “I am going to die.” Now, I am not saying that you have to go on a roller coaster. Whatever your personal roller coaster is, you have to “transform that hell into a paradise.” It is within you to do this.
It was helpful for me to read different books that sent me new messages. I learned that no one book is going to do it. This is certainly one of those books, but as you take your hero's or heroine's journey, I want you to look for more. Go to the bookstore (yes . . . I know the bookstore is a vanishing breed, but it is much more charming than Amazon), take a look at some books and videos, see which ones resonate with you, and start with those.
Here are a few of my favorites. Please note some do not necessarily focus on the theme of anxiety, but they bring out themes that are super important.
Taking the Leap. Pema Chödrön was the first Western female to become a Buddhist monk. This book is short, but thick with insight and peaceful beauty. Read this one slowly, chapter by chapter. Read it twice.
How We Choose to Be Happy: The 9 Choices of Extremely Happy People–Their Secrets, Their Stories. Foster and Hicks's book discusses how happy people think and the choices they make.
Accepted (film). This is a favorite movie of mine that uses comedy to reveal the importance of being who you are and realizing that the greatest opportunities will come when you follow your passions.
The Power of Myth (film). These recordings of Bill Moyers's interviews with Joseph Campbell allow you to hear, in Campbell's own words, how to look at literature and art in the context of your own life's journey.
How to Make Yourself Happy and Remarkably Less Disturbable. Albert Ellis's classic book is a favorite among psychologists. It explains how to use your natural ability to think positively.
The Hero with a Thousand Faces. Joseph Campbell's 1949 book describes the hero's journey and gives examples throughout literature and art.
Feel the Fear and Do It Anyway. Susan Jeffers's practical book is about how to think about anxiety and move through it.
Ferris Bueller's Day Off (film). A classic comic movie not just for those who like to ditch school. Ferris Bueller is really about letting go of the mundane in order to appreciate life to its fullest.
From Panic to Power. Lucinda Bassett's book is an excellent guide to accepting anxiety, instead of running from it, as a means to move through it successfully. A wonderful primer on changing thoughts.
Overcome Your Fear of Driving. Rich Presta's self-help program is a valuable resource for anyone with a specific fear of driving. Presta uses a commonsense approach combined with anxiety-busting ideas from many other approaches to create a program that can really help you get back on the road. While focused on driving, it can apply to any anxiety or situational fear.
Rio (film). Animated film about a bird who faces a fear of flying. The main character, Blu, finds something more important in life than his fear.
Talladega Nights: The Ballad of Ricky Bobby (film). Starring Will Ferrell, this offbeat movie explores a racecar driver's work to face his fear of driving after an accident. I can't stop laughing about this one—and it's hard to be anxious when you're laughing that hard.
Why People Don't Heal, and How They Can. Carolyn Myss's book and audiotape from 1998 dives into emotional baggage and how it holds us back. Myss has an excellent four-disc CD set entitled Self Esteem: Your Fundamental Power that gets to the heart of anxiety and lack of self-esteem.
I also have thoroughly enjoyed Oprah Winfrey's “Life Class,” which can be accessed on her website. By the way, Oprah Winfrey is a very successful person who has overcome her own severe anxiety as part of her journey, and now her mission is to support others in their journeys.
The alcoholic's main issue is clear—too much drinking. Do you know the first step the alcoholic takes toward recovery? Recognizing and admitting that he or she is drinking too much. Some alcoholics don't even realize they are going for that drink. The habit has become so ingrained, they aren't even conscious of what they are doing. So the first step is that simple—just notice when you take a drink.
Like alcoholics, those of us who are anxious move to anxious thoughts without even realizing we are doing it! Even though we always have a choice, we default to anxiety. I remember I used to wake up in the morning, and already the negative messages were buzzing:
“This is going to be a bad day.”
“I won't be able to get everything done that I need to.”
“I will probably fail at what I want to do.”
“I am not smart or talented enough to achieve my goals.”
“I am too anxious to succeed.”
There's no way in the world someone can succeed if they are thinking that way. Let me ask you a question. If you were my patient, and every time you came to see me I told you that you were a bad person, or a loser, or a jerk, would you come back to me for help? If I hit you in the head with an emotional baseball bat and beat you up during every visit, would you return for more visits and more abuse?
No, of course not. But when you have anxious thoughts, you are doing that to yourself. You are keeping the anxiety going. When we are angry or scared, we bottle it up inside us until it comes out as anger and negative thinking. This negative thinking has to stop.
How can you stop it? The first step is recognizing it when it happens. Pick up a notebook or find a spot on your cell phone where you can make a note every time you catch yourself having a negative thought. Do it throughout the day for the next two days. When I first did this exercise, my hand hurt because I was writing all day!
I have noticed that when I ask my patients to do this, some people will make a note in their head but not physically write it down. While noting in your head is a first step, it is not enough to accomplish your goals. So don't just think about it—write it down. This is key. Why write it? Many famous writers have weighed in on the power of recording your thoughts. One smart person after another has said the same thing about writing:
How do I know what I think until I see what I say?
—E. M. Forster
Writing has got to be an act of discovery . . .
I write to find out what I'm thinking about.
—Edward Albee
I never know what I think about something until I read what I've written on it.
—William Faulkner
I write entirely to find out what I'm thinking.
—Joan Didion
I write because I don't know what I think until I read what I say.
—Flannery O'Connor
I don't know what I think until I write it down.
—Norman Mailer
I think you get the point—and research backs this up. Basically, if you write down the thoughts and then read them, you will be able to process them through more parts of your brain and create a better perspective. When you have a better perspective, things feel less scary, and you are more amenable to positive change.
Once you have written your thought, I want you to give it a score, from one to ten, of how strong it is for you. A one is a pretty weak thought that doesn't cause much anxiety. A ten is very strong—your anxiety is through the roof.
Once you have rated your anxious or negative message, the next step is to ask yourself whether it is really true. If it is true, you can make a realistic plan to fix the problem. If it is not true (most are not), write down a more positive thought. Here are some examples:
“This is going to be a bad day.” 7/10
Is this true? No.
The new thought: No one has a crystal ball, and I am sure there will be good aspects to this day.
“I won't be able to get everything done that I need to.” 5/10
Is this true? Yes.
The new thought: I might be doing way too many things—more than any one person can do. I will prioritize my tasks and be okay with whatever I can do. The things that don't get done? Well, I will get to them tomorrow.
I will probably fail at what I want to do.” 4/10
Is this true? No.
The new thought: I do many things well. I can only try my best today. Anything that doesn't go well I can learn from and use it to my advantage to do even better tomorrow.
“I am not smart or talented enough to succeed.” 8/10
Is this true? No.
The new thought: Actually, I am a smart person with many strengths.
“I am too anxious to be successful.” 9/10
Is this true? No.
The new thought: Most successful people are actually anxious people. I can control my anxiety and use it to my advantage.
And, by the way—it is completely true that anxious people tend to be successful, smart, and creative. Abraham Lincoln had serious anxiety. The famous singers Adele and Barbra Streisand have terrible stage fright and phobias. The soccer star David Beckham is known to have obsessive-compulsive disorder. Whoopi Goldberg had a tremendous fear of flying. As I mentioned, Oprah Winfrey fashioned her personal anxieties to her advantage and has become one of the most successful business and entertainment personalities of all time.
When anxiety is controlled, it can help you stay alert and interested. We are not going to rid you of 100 percent of your anxiety—for some anxiety is good to keep you sharp and focused. We are just redirecting the anxiety when it becomes debilitating. I have realized that I am an anxious person—and that is okay as long as I have compassion for myself and use the anxiety to better myself rather than stopping myself. When anxiety stops me, I work on changing the thought.
Much of the time, people with anxiety have scary thoughts. They think they are going to lose control or that they will embarrass themselves by not being able to handle a situation. Even more, they may have fleeting thoughts about hurting themselves or others. There may even be a moment when they think it would be easier if they were not around. If you are having scary thoughts like this, it is always good idea to check in with a psychologist or counselor.
Typically, though, my anxious patients who have scary thoughts do not act on them. In fact, they do just the opposite. If you ask an anxious person to stop in the middle in the road and go berserk, he will not do it—he is too embarrassed! This illustrates how your scary thoughts are just manifestations of your creative mind running amok. They are part of the anxiety cascade that is attempting to take over your life. Like spoiled kids, they want your attention—and the more attention you give them, the more they act up. Don't give them too much attention—just check in with someone, then move on to step 3.
First, let me say that I am not suggesting that you have to become a Buddhist.