Anxiety: A Practical Guide

We are the most advanced creature in this world, but how we work is actually the same as all other animals, even single-cell organisms: we go towards what feels good and avoid what’s not.

For single-cell organisms, this mechanism is driven by physical sensation, like this: Hot → Hurt → Avoid.

For humans, we have this mechanism too. But because of our higher-level brain, we have another mechanism that is driven by emotion. It’s the ETEAR model:

Event → Thought → Emotion → Action → Remodeling

  • Event: Something happens (licked by a dog)
  • Thought: We give it an interpretation (he likes me! / he wants to bite me!)
  • Emotion: This thought generates an emotion (happy / fear)
  • Action: We take action (pet the dog / jump away)
  • Remodeling: The brain remodels its thought model for dogs, so the next time we see a dog, we will be more happy or more fearful.

When we were born, we only have some basic built-in thought models (or thought patterns). As we grow up, for each new daily event that happens to us, we process them with our thought model and go through the ETEAR process. then keep remodeling our thought models or adding new ones, so we can deal with future events better.

This is how we learn, how we live, and how we feel.




OK, what does this have to do with anxiety?

Everything.

To start with, anxiety is a kind of emotion.

Anxiety is the emotion generated when your brain thinks you are in danger (like facing a bear), then it activates this fight or flight mode to get you ready physically and emotionally so you can get out of this danger. It’s totally normal to have this anxious feeling if we are indeed in danger.

The problem is, when we keep telling our brain we are in danger when actually we are not, and this fight or flight mode keeps being activated, that’s when we develop generalized anxiety.

There are 4 things we need to know about emotion (anxiety).

1. The difference between sensation, thought, and emotion.

Suppose we are facing a bear.

Sensation is what we feel physically. Like a pounding heart, tight chest, sweaty palms, and shallow breath.

Thought is what we think logically. Like “Should I run or fight?”

Emotion is actually a mix of how we feel and what we think.

Stress is sensation, worry is thought, anxiety is emotion.

2. Evolution drives our behavior with emotion.

Evolution wants us to reproduce, so it gives us the “horny” emotion as a drive toward sex. Evolution wants us to live, so it gives us the “fear” emotion toward a bear.

3. No emotion is bad or dangerous, they are just messengers.

Just because some emotion makes us feel bad doesn’t mean it’s bad. So does anxiety.

That anxious feeling drives us to run before the bear kicks our ass. If we feel nothing or even feel good in front of the bear, we were already killed.

4. Emotions come and go.

Emotions only last for a short period of time, for example, 20 minutes. They are the effect of some hormones that the brain release into our blood, so when the hormones go away, the emotion stops. So does anxiety. When the bear is gone, you stop being anxious too.

Anxiety became a problem when we constantly tell our brains that we are in danger, so our bodies are constantly alert and in this fight or flight mode, which starts to have bad impacts on our lives. Our health start to decline, we feel like shit, and people who were close to us leave because we are acting like assholes (both to them and to ourselves).

So why this anxious mode is constantly activated?




How did we develop anxiety?

It’s a snowballing process with two stages: The initial stage and the general stage.

Let’s take little Ted as an example.

Little-Ted-Tedwild.com

Initially, some trivial event triggered him to be anxious, which is pretty normal. Say one day he woke up and realized that his parents were not home, he felt fearful and anxious, screaming and crying for them. After a while, he fell back to sleep and forgot about it. That’s it, pretty normal.

Then one day, again, he woke up with his parents not around, but he accidentally tripped and fell, and there was no one to pick him up.

Then one day, a kid bullied him at school, but his dad told him to just let it pass

……

Each time something like this happened, his thought models remodel a little bit, and he learn something specific like “better watch my steps”, and “avoid that kid”. And each time, his fear circle expands a little.

Eventually, at some point, this fear of something specific becomes a kind of general fear. He felt that he was on his own, no one is trustable, and life is full of danger. Nothing bad really happened, but he was constantly worrying, feeling anything could go wrong, and that worry stayed since.

That’s when he got to the general stage of anxiety.


One important point is that the cause of the initial stage and the general stage of anxiety are totally different:

Initial stage: Initial cause → Learn a lesson → Temporary anxiety

General stage: No real cause → Worry → Constant anxiety

The initial cause of anxiety could be any trivial thing, but worry is the only thing that maintains your anxiety (causing your anxiety NOW).

The initial cause of anxiety could be past trauma, bad childhood, stress, relationships, etc. What we need to know about this initial cause is that:

It’s not important. You don’t need to figure out the past and trauma to solve your anxiety problem. The key is not in the past but In the present.




OK now, why is worry the reason?

Worry is trying to solve some future problem that is either not real or not solvable at the moment.

To understand this we need to go back to the ETEAR model:

Event → Thought → Emotion → Action → Remodeling

The critical step is thought. We change our emotions and thought models by changing our thought.

Our brain is just like a computer, thought models are the software running on it. Just like machine learning, you feed in a picture, and by telling the model that this is a cat, not a lion, it modifies the model and recognizes the cat more accurately the next time.

Similarly, by labeling something as good or bad, safe or dangerous, your brain changes its thought pattern, then it produces different emotions the next time you face the same situation.

We are the teacher of our brain, and the tool we use is thought.

(PS: Why just “think” something can cause emotional and physical changes? Because the brain is a magical thing, it is the only organ in our body that connects and regulates all three responses. Thoughts are generated in the frontal lobe, then the amygdala is responsible for emotions, and the hypothalamus could produce hormones that cause all kinds of physical reactions. )


Now back to worry.

When we face a dog and jump away, this is a kind of avoidance. This avoidance teaches our brain that this dog thing is dangerous, so it remodels “dog” as “dangerous”.

Worry is a kind of avoidance.

Worry may look like problem-solving, but it is actually a kind of distraction. By keeping our attention away from the painful emotion of anxiety, it gives us the illusion of control, so we can feel a little bit secure at the moment, but in the long run, this avoidance tells our brain that anxiety is a dangerous thing, so we keep worrying and keep having anxiety.

Each time we worry about something, we teach our brains that this thing is dangerous. As we keep worrying about more things, our brains keep remodeling more things as dangerous, which again feeds back to this snowballing process of anxiety, eventually, some people can’t even step out of the house as everything is now dangerous.




So how to deal with anxiety?

The only component we can control in the ETEAR process is thought.

We can’t control what happens to us.

Emotion is the result of our thought, which is out of our control. You can’t stop your anxiety by just deciding not to be anxious.

Action is also the result of our thought or emotion.

Remodeling is the brain’s automatic process that we don’t even realize happening.

Thought always comes before emotion. It’s just the process is often so fast and subtle that you won’t notice.

Worry Always Comes Before Anxiety.

And that’s how we treat anxiety: We can’t deal with anxiety itself, as it’s an emotion that is out of our control. Instead, we deal with one thing: Worry.

Worry is a kind of thought model.

Thought model is a kind of habit.

This means it is changeable, but also needs some effort.




Practical tools to deal with anxiety

First, no drugs unless it’s serious.

Unless you have intense physical symptoms, medication is not recommended. Anxiety started with your thinking, it should end with it too.

Cognitive and behavioral approaches are generally shown to be more effective than medication for anxiety disorders and also to have fewer side effects and certainly no withdrawal effects. – Nick Wignall




2 Don’ts

Our default responses to anxiety are: 1. Try to analyze anxiety, and 2. Try to run away.

Don’t do either of them.

  • Analyzing anxiety only makes it worse, you will end up worrying more.

Because the human brain can’t distinguish reality from imagination, when we are recalling our memory, or imagine something, the brain will believe it’s reality.

So every time you recall your painful past, even if you are trying to analyze it, your brain thinks you are literally living in that situation again. And the more you reinforce a certain feeling, the more your brain remembers it.

Also, the past is just unsolvable, because it’s gone.

  • Running away from it won’t solve the problem either.

Because you are telling your brain what you are running away is dangerous.

The most common distractions are social media, games, videos, eating, porn, and sex. But the moment you put it down or pull it out, your problem and anxiety flood in, only more intense. And you know it.




Mindsets

1. Accept it.

To get away from anxiety we must have the willingness to have it.

Accept that anxiety is normal.

Accept that having anxiety is OK.

Because this tells your brain that anxiety is not dangerous. When we stop resisting anxiety, it actually becomes less painful.

Once you feel anxious, it will last for a while. The best you can do is not make it worse.


2. Treat anxiety as a guest.

Be kind to your anxiety and your anxious self.

Give your anxiety a name. Your anxiety is not you. By giving it a name, your brain treats anxiety as something objective, so it losses power over you. I am using Tweek, the anxious yellow-haired kid in South Park as the name of my anxiety. You can give it whatever avatar and whatever name you like, could be a cat named Jinxy or a monkey named Dan, and the more specific the figure the better.

Tweek-Anxious-Tedwild.com
Tweek

Treat your anxiety as a guest. He is that annoying kid that comes to your house once in a while. Whenever he comes, just say to him “OK Tweek, you are here again, come on in and have a cup of tea.” He will just be around for a little while and leave.

He often dresses in a King’s costume and tries to rule your life. Don’t let that happen. Remember, he is not a king, just a kid.

3. Anxiety is a habit.

Tell yourself “It’s a habit, I can change it, I am responsible for it.”

4. Don’t feed it.

Whenever anxiety comes, ask yourself “What do I want to teach my brain about this anxiety?” (The ETEAR Model.)

These mindsets are the prerequisite for dealing with anxiety. Next, we’ll walk through all the tools you need to deal with anxiety. Most of the tools are centered around the one thing you have control over: your attention.




When it comes

When you are feeling intense anxiety, do the following in order. These tools are just for temporarily releasing your anxiety.

1. First, say this sentence to your anxiety:

“OK, [Name of your anxiety], come in and sit for a while.”

This is to evoke the mindsets toward anxiety.

2. Remind yourself you are safe.

Quickly look around and remind yourself that you’re physically safe at this moment.

3. Observe it mindfully.

What sensations are you feeling now? Tight chest? Shallow breath? Are you sweating? From head to toe, which part of your body is tight?

What thoughts are you having now? Are you worrying about something? What is it?

4. Write it down.

Don’t worry in your head, write your worry down.

Everything you observed, your feelings, your thoughts, write them down.

This has several benefits:

First, it’s an expression, you will feel better just by putting it out instead of boxing it in your head.

Second, you can’t write as fast as you think, so the written worries will be less catastrophic.

Third, writing it down helps you to see your worries objectively. When you worry in your head, you are dominated by your worries and thoughts and can’t see clearly what’s going on. By putting your worries on paper, you can tell your brain 1) This is just my thoughts, not me, and 2) Now I see it, these thoughts are kinda ridiculous……

The next time you start worrying, worry on paper instead of in your head.

 

5. Relaxation Techniques

If you feel intense physical symptoms, such as a panic attack, then you can do some of these physical relaxation techniques to release the anxiety in your body. By breaking the fight and flight mode physically, you are telling your brain that you are not actually in danger. This is not avoidance.

– Breathing.

There are a lot of breathing techniques that we will cover later. Here just doing one is enough: Oxytocin Breathing. It has three simple steps:

→ Inhale through your nose until your lung is full

→ Then hold your breath for a couple of seconds

→ Then exhale through your mouth until your lung is empty.

– Muscle relaxation.

Again, there are a lot of Muscle relaxation techniques that we will cover later. Here just doing one is enough: Progressive Muscle Relaxation. It has three simple steps:

→ Squeeze every section of your muscle as hard as you can

→ Then release them

→ Notice the muscle tension difference before and after.

6. 3Ms: Move, Meet, Make

About 20 minutes should have passed by the time you have done the above steps. But if you are still feeling intense anxiety, you can try the 3Ms: Move, Meet, Make by Nick Wignall:

  • Move: Physically move your body. Go outside and take a walk. Do several pushups.
  • Meet: Talk to somebody.
  • Make: Make stuff. Draw pictures. Strike the guitar. Cook a meal. Break some shit. Repair some shit.

Normally your anxiety should have decreased significantly halfway into this.




Long-Term Tools.

Following are the “real” tools that we use to deal with anxiety. Use these when you are not feeling intense anxiety.

1. Understanding How Useless Worrying is.

Most of what you worry about will not happen. So 99.99% of all the time you spent worrying is a waste of your life. You just toss a big chunk of your life into the trash can. How much of your past life has been spent on worrying? Months? Years? Decades? Whoosh~ right in the trash.

0.01% of what you worry about will happen, but you can’t prepare for them now. If you can, that’s called “planning”, not “worrying”. Planning is real action with real progress, and you will not feel anxious.

If something you can’t prepare for happened, all you can do and all you need to do is accept. Accept that shit has been done, we just need to start from there and do what we can. Depressing, but also liberating.

The time needed to solve a problem is objective. It’s out of your control, but also liberating. A task could be divided into 5 sections, each section 3 steps, each step 3 minutes. That’s it, worrying and being anxious won’t help you solve the problem faster. Don’t keep kicking yourself in the ass and try to beat gravity.

2. Take care of your basic needs.

This is the foundation.

Eat well, drink water, exercise, sleep well, and play everyday.

I know maybe you are “Duh”ing this. But everyone would be a jumpy and grumpy bitch if they only sleep 4 hours a day and never let themselves play.

Listen to your body, eat when hungry, sleep when sleepy, relax when tired, and play when desired.

Let your body have its healing power.

3. Get away from that toxic environment or people.

This is the hardest among all these techniques, but I am gonna put it right here because it’s so important.

If people at your soul-sucking job that you hate so much keep piling up tasks for you to do, no amount of mindfulness practice will help with your anxiety. So find a way to get from it, you don’t need to quit right away, but start getting prepared, now.

If your dickish boyfriend keeps telling you that you are no good and worthless, no amount of journaling will calm you down.

You can’t heal if you keep walking on knives and adding new cuts to yourself every day.

Pull a paper, write down 5 things or people in your life that are causing you anxiety in a toxic way.

Then start to gid rid of them.

4. Meditation.

If you practice only one thing after reading this post, it should be meditation. You can forget about the rest if you can consistently practice meditation.

Depending on how bad your anxiety is, it might take months or over a year to see significant change. But it’s powerful and it’s totally worth every minute you put in it.

All you need to know about meditation is here.

5. Mindfulness.

Mindfulness is like meditation, but you can do it anywhere at any time throughout your day.

The basic idea is that you just notice and observe your sensations and thoughts without judgment.

More about mindfulness practices here.

6. Cognitive Restructuring.

Cognitive Restructuring is a major tool used in treating depression, anxiety, and other mental issues.

It works by going through all your thoughts that lead to anxiety, then generating alternative thoughts for the unrealistic thoughts you had.

It works in this 5-step process:

Step 1: Situation. Write down what makes you anxious.

Step 2: Feeling. Anxious? Hopeless? Shame? Anger? Write down all the major feelings you have.

Step 3: Thought. What are your thoughts that generated these feelings?

For example, ask yourself, “What bad thing do I expect to happen?” “What
kind of danger am I in?”

Be specific and keep asking yourself “Then what? “

Step 4: Evaluate the thought.

Evaluate the accuracy of your thought objectively. Find any thought that might be inaccurate and not evidence-based.

Then generate alternative thoughts for these inaccurate thoughts.

Step 5: Make a decision.

Remind yourself that your original thoughts are unrealistic and kinda ridiculous, then do what your evaluation tells you, regardless of your feelings.

This is actually the “See Reality” step of the ASASA model.

7. Journaling.

Start a F-ing diary, today.

It’s good for all of your mental issues. It’s my most recommended habit right after mediation.

You can write whatever happened, whatever thoughts and feeling you had for the day, but writing about these 3 things can help you deal with anxiety:

1. Scheduled Worry

Worry the hell out of it in your diary.

Be catastrophic. Think about the worst that could happen. Pour all your thoughts onto the paper.

But only give yourself 10 minutes each day on this scheduled worry. When time is up, just stop.

Why does this help?

It’s writing on paper instead in your mind, as we said earlier.

And it frees up your day since this tells your brain that you have this worrying task covered.

“Don’t worry my dear brain, I promise I’ll worry later.”

2. Self-compassion diary

If your friend screws something up, will you keep beating him up with your mean words like “You are so useless” “How could you be so stupid?” “He will think you are an idiot!”?

Then why do this to yourself?

Are you not more important than your friend?

Be gentle to yourself, and treat yourself like you would treat a good friend, with empathy and understanding.

Here’s how to do self-compassion diary:

  • Write down the things that didn’t go so well in your day.
  • For each thing, imagine it happened to a friend instead of yourself, and he is now telling you that this happened to him today. How you would respond to him? Write it down.
3. Gratitude diary

Worry creates negative feelings. Gratitude creates positive feelings.

Each day, list 5 things that you are grateful for in your diary.

It could be the smallest thing.

It could be you are healthy, you are still young, or the lunch is so good, you have running hot water…… Anything that you can think of.

Gratitude is deliberately forcing you to notice the bright side of your life, since you have spent most of your day worrying about negative stuff, this reminds you that life is not as bad as you think.

8. Exposure Therapy.

One of the most common treatments for anxiety.

Exposure therapy means letting people with anxiety face what they fear, but without causing any real danger, and normally in a systematic manner.

For example, people with social anxiety can start by imagining talking to people, or stepping outside the house, then by buying groceries, etc.

But I think exposure therapy is better suited for treating specific anxiety like phobia, not generalized anxiety. Because in generalized anxiety you don’t really know what you are anxious about, or you are anxious about everything, so it’s hard to face your fear.

9. One thing at a time.

Don’t multitask.

Try doing everything more slowly.

Deliberately eat slower, walk slower, feel it, observe it. Don’t push the close button of the elevator, wait for it to close on itself.

Slow down.




Summary

The ETEAR model that drives our behavior with emotion:

Event → Thought → Emotion → Action → Remodeling

Anxiety is a kind of emotion.

Anxiety is the emotion generated when your brain thinks you are in danger. When we keep telling our brain we are in danger when actually we are not, the fight or flight mode keeps being activated, that’s when we develop generalized anxiety.

Stress is sensation, worry is thought, anxiety is emotion.

No emotion is bad or dangerous, they are just messengers.

Emotions only last for a short period of time

We developed anxiety in a snowballing process with two stages: The initial stage and the general stage.

The initial cause of anxiety could be any trivial thing, but worry is the only thing that maintains your anxiety (causing your anxiety NOW).

You don’t need to figure out the past and trauma to solve your anxiety problem. The key is not in the past but In the present.

The critical step of the ETEAR model is thought. We change our emotions and thought models by changing our thought.

We are the teacher of our brain, and the tool we use is thought.

Worry is a kind of avoidance, and avoidance teaches our brains that anxiety is dangerous.

We can’t deal with anxiety itself, as it’s an emotion that is out of our control. Instead, we deal with one thing: Worry.

Worry is a habit, and just like any other habit, we can change it.

Practical tools to deal with anxiety:

Don’t try to analyze anxiety or try to run away from it.

Mindset:

  1. Accept it.
  2. Treat anxiety as a guest.
  3. Anxiety is a habit.
  4. Don’t feed it.

When it comes:

  • “OK, [Name of your anxiety], come in and sit for a while.”
  • Remind yourself you are safe.
  • Observe it mindfully.
  • Write it down.
  • Relaxation Techniques: Breathing and muscle relaxation.
  • 3Ms: Move, Meet, Make

Long-Term Tools:

  • Understanding How Useless Worrying is.
  • Take care of your basic needs.
  • Get away from that toxic environment or people.
  • Meditation.
  • Mindfulness.
  • Cognitive Restructuring.
  • Journaling: Scheduled Worry, self-compassion, gratitude.
  • Exposure Therapy.
  • One thing at a time.


Notes:

The ETEAR model is a modified version of the Cognitive Behavioral Model.


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