Combating stress and worry with CBT

Unsplash / @jeremy_thomas

As it’s geek mental health week, I thought I’d share some of my recent experiences with anxiety and the help I’ve sought to combat it.

Over the last 6 months, I have experienced periods of anxiety and worry and had also noticed an increase in OCD tendencies. Small things like misplacing something or not being able to remember something would niggle at me for longer than was healthy.

Looking back, I think I was seeking control over the small things because some big things in my life were in a state of flux.

I spoke to my doctor about how I was feeling and she suggested I attended a short course on ‘Managing your anxiety’ run by Talking space plus.

It was a free 4-week evening course, focusing on how to combat stress and worry using cognitive behaviour therapy.

The sessions were ‘seminar’ style and focused on learning CBT strategies rather than receiving therapy and therefore no personal situations were discussed during the sessions.

The four sessions covered

  • techniques to manage worry
  • techniques to manage panic
  • changing our habitual styles of thinking
  • techniques for relaxation

In between sessions we were given homework, which admittedly I wasn’t very disciplined at doing but have referred to since the course finished.

Here are some of the techniques & strategies I found most helpful

Worry time

We were taught to keep a ‘worry diary’, noting worries on our phone or on a notepad as they came into our heads during the day but practicing the discipline of not thinking about them or trying to solve them at that moment in time.

At the end of the day, we were recommended to allocate a 20-minute slot to ‘sit with our worry’ — using, this time, to think about why you’re worried about x, is there a trigger, are you still worried about this now?

When you’re feeling anxious, this technique at first might feel counter-intuitive, the first couple of times I practised it I felt emotional having to stare my worries in the face and overwhelmed some days by the sheer amount of them.

Ironically, I even started to worry about ‘worry time’. However, over the course of the weeks my list got shorter and shorter, some days I got to the end of the day and hadn’t written anything down. I also regularly reviewed the list at the end of the day surprised by how many worries were no longer a concern and had been resolved throughout the day without me even doing anything.

Once you’ve finished your ‘worry time’, you are encouraged to do something to divert your attention — cook dinner, read a book or ring a friend. Anything to break that time so you don’t continue to worry.

Classify your worries

Although you’re not supposed to use the ‘worry time’ for coming up with solutions. We were encouraged at the end of this time to think about each worry and ask ‘Can I resolve this in the next 48 hours?’

If you can answer ‘Yes’, then this is a practical worry which you can follow the steps below to solve

  1. Identify the problem
  2. Generate all possible solutions
  3. Write down advantages and disadvantages of each
  4. Choose one solution
  5. Create a plan
  6. Implement
  7. Review

Keep a thought diary

We were also recommended to keep a ‘Thought diary’ to note down unhelpful thinking styles.

It turns out, there are a lot of unhelpful thinking styles. Here are some:

  • catastrophizing i.e. assuming the worst case scenario
  • predicting the future i.e. assuming we know how something is going to play out
  • overgeneralising i.e. assuming that because something happened once, it’ll happen again
  • mind reading i.e. assuming we know what someone else is thinking
  • emotional reasoning — assuming something is true because we feel it
  • disqualifying the positive i.e. focusing in on the negatives
  • all or nothing thinking otherwise known as ‘black and white’ thinking
  • should or ‘must’ statements i.e. assuming we must act in a specific way otherwise it is ‘wrong’
  • labelling i.e. applying labels to ourselves “I’m crap at x”
  • personalising i.e. we claim responsibility for things we don’t need to

When we become more aware of these unhelpful thinking styles we can watch out for them in our day to day lives. You can use a thought record to record these

A thought record should consist of the following information

  • the situation i.e. where you were, what you were doing
  • what went through your mind i.e. what thoughts were you having
  • how were you feeling emotionally
  • can you identify any unhelpful thinking styles?
  • can you think of an alternative thought

Our thinking styles are usually inaccurate and we tend to make assumptions not based on facts. We are therefore encourage to take our thoughts to court.

Challenge your thoughts

We must only consider the factual evidence of the thought, the evidence that supports it and the evidence against it.

Record your evidence for and evidence against your thought.

Most of the time your negative thoughts are likely to be untrue. It is then where we can create a realistic alternative.

Reframe negative thoughts

Use words such as AND, BUT or OR to link comments in both columns i.e. both evidence for and evidence against together to create an alternative thought. The alternative thought should be neutral and realistic but not ‘positive’.

You might, for example, say ‘I might not have run last month’s board meeting perfectly but I have prepared well and in the past, no one has criticised my meeting facilitation technique’

At first you’ll have to rely on a pen on paper to record these thoughts but eventually, you’ll be able to do this in your head and challenge your thinking there and then.

These practical techniques have helped me deal with my anxiety and worry in a very logical, systematic way. Although I’m still prone to worry, I can catch unhelpful or negative thoughts and reframe them. My mind is healthier because of it.

I’d encourage anyone who deals with general anxiety or worry to attend a course like this one or to try some of these strategies at home. I was amazed when I opened up about doing it to friends and family how many replied “Oh, I’ve done that, it was really beneficial”.