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  • The Reflective Doc

Your Secret Weapon to Defeat Anxiety

If I asked you to determine the exact moment anxious thoughts enter your mind, how successful would you be? At the start of this essay, it may seem impossible, but by the time you finish reading, you will possess a secret weapon to identify your anxious mind.

What if you don’t? What if you read the entire essay and know less than when you started? What if, while reading this essay, you forget to turn off the coffeemaker and it shorts out, starting a catastrophic fire that destroys all of your belongings?

You may have guessed by now that the “secret weapon” to identify anxiety is the phrase “What if?” Try this exercise: create your own “What if” thought from scratch. If you are like me (and pretty much everybody), the words that follow will contain a feared or negative outcome. Rarely do we ask “What if” something positive or desired will occur. “What if I’m so amazing in my meeting today that I win a trip to Paris?” (Ah, remember traveling?) It may be that this happens from time to time, but since the ancient parts of our brain are wired to notice threats far more easily than happy events (hence our survival as a species), these thoughts are readily dismissed.

Next step—look for this phrase throughout the day. It likely pops up repeatedly, especially when you’re already feeling stressed, or preparing for a dreaded event. It may surprise you with its flexibility, arriving at diverse points throughout your day to hijack your attention. But by beginning to notice your anxious thoughts, you can learn to reexamine their usefulness.

Let’s add a quick note about medication here. If you are regularly overwhelmed by fear and dread from the intensity of your anxiety, I may suggest a low dose of an SSRI (selective serotonin reuptake inhibitor) such as Lexapro. The goal of medication here is NOT to flatten out the quirks in your unique personality, but to give you some necessary space from those distressing thoughts. Rather than uncomfortably close to your face like a hungry toddler seeking snacks, they are several steps away, more easily identified and challenged. When working well, this type of medication can help remove the overlay of anxiety, allowing the person underneath to emerge and thrive.

Now back to the thoughts. Part of my job is to remain alert to the ingenious techniques my patients create in the service of lowering their anxiety. Naming their worried mind so they can recognize and talk back to it? Genius. “Jolene, knock it off. I’m trying to actually prepare for this talk.” (How amazing is that song, by the way? Dolly Parton is a national treasure.)

After mastering the recognition of anxious thoughts with your new secret weapon, what’s next? In their terrific book designed for children and adolescents, Super Powered: Transform Anxiety in Courage, Confidence and Resilience, Dr. Shefali Tsabary and Renee Jain write “Sometimes your brain just needs a little help creating the plan. It’s time to kickstart the planning process by writing down your what-if question and following up with if-then plans.”

This book, which I believe should be required reading for all kids ages 7-15 (or any age, really) provides blank lines to practice transforming these “what if” thoughts to “if-then” plans. A simple notebook would also work. You just need to try it out. “What if I’m late for school?” becomes “If I’m late for school, then I will…” You are essentially expressing faith in the ability of your future self to manage the situation.

Key point: Worrying is NOT the same as preparing.

Worrying is energy poured down the drain, but not before it twists your stomach in knots and tightens your shoulders. Preparation, on the other hand, identifies areas in your control and helps you move forward. Worry tricks you into thinking you can have some control. “If I keep thinking about the bad outcome, I won’t be surprised when it happens.” But worrying about bad outcomes doesn’t mean you’ll feel nothing when they occur. You’ll still experience the pain or frustration of that moment. Worrying just costs you time and energy leading up to the event. It’s an expensive brain drain.

Worry is spending three days imagining how your trip to the dentist will end with a sore mouth, a report of several cavities and shame about your flossing history. Preparation is remembering to brush twice daily, floss regularly, and bring a set of headphones so you can listen to a celebrity gossip podcast instead of your hygienist.

Everyone can learn how to adjust these thoughts. Look for the “What if” giveaway, try an “If-then” substitute, and give yourself grace to keep trying, even when it seems impossible. What if anxiety was no longer your daily companion? Think of all the space that would free up in your mind. You would finally have time to write the next great American novel. Prepare to be a smashing success.

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