Mya,
Here's an excerpt from our program. Hope it helps!
Challenging Your Anxious Thoughts
The following ten questions will help you to challenge any anxious thoughts. When you have an anxious thought, answer some of these 10 questions:
1. Is it "true"?
2. How do I know it€™s true?
3. Is it 100% true? (remember something that is 75% or 99% true is not 100% true)
4. What's the evidence for it being true?
5. What's the evidence against it being true?
6. Has it ever happened before?
7. What's different now?
8. If it were true, how bad would it really be?
9. What's the worst thing that could happen?
10. If the worst thing happened, how bad would it really be?
Let's look at an example of how you could use these questions to challenge your anxious thoughts.
We'd like to introduce you to Anne. Anne has panic disorder and agoraphobia. Right now she's sitting in a restaurant waiting for her lunch date (she doesn€™t know him very well). Anne's been working really hard for the past two weeks and she's just closed a deal. She hasn't eaten anything all day and was out a bit late last night celebrating her success. She's drinking a cup of coffee when she notices that her heart is beating faster than normal. She begins to feel dizzy. Anne happens to have an Anxious Thoughts Recording Form with her and she jots down the following thoughts:
* "I'm having a panic attack"
* "I'm going to faint"
* "my date will see me panicking"
* "he'll think I'm crazy"
* "I have to split - he can€™t see me like this - it'll ruin everything!"
Let's try to help Anne challenge each of these anxious thoughts. We'll challenge them one at a time. Anne will ask herself the following questions (in bold), and her answers will appear in regular text:
Anxious Thought 1: "I'm having a panic attack"
1. Is it true? It certainly feels like it. I don€™t know for sure yet.
2. What€™s the evidence for the anxious thought? My heart is beating faster. I€™m starting to feel a bit dizzy. This feels like what happens when I start to panic. It feels like the start of a panic attack so it could be true.
3. What's the evidence against the anxious thought?
# I've been stressed from work
# I was up late
# I haven€™t eaten today
# I'm drinking coffee €“ caffeine makes me jumpy
# My date makes me a bit nervous €“ this could really work out!
In answering these questions, Anne may come up with some alternatives. Such as:
"It feels like I€™m starting to have a panic attack. On the other hand, it seems just as likely that my heart is beating faster because I€™m drinking coffee; I€™m overtired; and I€™m waiting for date that still makes me a bit nervous. I could be having a panic attack but then again...maybe not. I do know that if I keep thinking that I€™m going to have a panic attack, I probably will. Maybe I should just eat something."
What kind of an effect do you think those alternative thoughts might have on Anne€™s anxiety? It seems likely that if Anne could challenge this thought, she might be able to stop her Panic Cycle.
Anxious Thought 2: €œI€™m going to faint€
1. Is it true? No. People don€™t faint during panic attacks.
2. What is the evidence for the anxious thought that I am going to faint? I feel like I€™m going to faint.
3. Do people faint during panic attacks? No. People don€™t faint during panic attacks.
4. Have I ever fainted before? No
5. What€™s different about this time? Nothing
6. So what are the chances that I will faint this time? No chance
In answering these questions, Anne may be able to come up with an alternative to her anxious thought such as:
€œPeople with panic attacks don€™t faint. I€™ve never fainted before, so it is pretty unlikely that I€™ll faint now. I may feel like I am going to faint, but I won€™t.€
Once again, what kind of an effect do you think those alternative thoughts might have on Anne€™s anxiety?
Anxious Thought 3: €œMy date will see me panicking€
1. Has it ever happened before? Has anyone ever noticed me panicking before? Yes, people have noticed me panicking before. Once my friend even asked what was wrong. It was really embarrassing.
2. Is the anxious thought 100% true? No - most of the time I can hide it. I think people only notice about 10% of the time. Even then, they only notice when it€™s really bad. The time my friend noticed was during one of the worst panic attacks I€™ve ever had.
3. What is the worst thing that could happen? He might ask me what€™s wrong.
4. How bad would that really be? I guess it wouldn€™t be all that bad. I could just tell him I was up to late celebrating, or that I haven€™t eaten all day, or that I€™m feeling a little bit out of it.
5. What else really bad could happen? What€™s the worst thing that could happen? He might not believe me. He might think that I€™m crazy.
Notice that challenging anxious thought 3 leads us straight to challenging anxious thought 4: €œhe€™ll think I€™m crazy.€
This is a great example of how often when you start to challenge an anxious thought you end up challenging a number of other ones as well. That€™s okay - as you start challenging your anxious thoughts other anxious thoughts will appear. You should challenge them as well, one thought at a time, until no more appear. When you€™re challenging anxious thoughts €˜follow the fear€™ until you get to the thought that seems most important.
Anxious Thought 4: €œhe€™ll think I€™m crazy€
1. Has this ever happened before? No. The one time when my friend noticed she just asked me what was wrong. I told her I wasn€™t feeling well and she asked me if I was sure I was okay.
2. Is there any evidence that your date thinks you€™re crazy? No. He seems to like me a lot. He€™s not even here yet, so how can he think I€™m crazy?
3. What if the worst were to happen and he thought you were crazy, what would be so bad about that? I guess if he thought really thought I was crazy he might not want to see me anymore.
4. What would be so bad about that? That would be a real drag. I really like him.
5. Would you survive? Yeah. I guess I wouldn€™t like it, but I guess I€™d eventually survive. We really only started dating.
6. Would you really want to date someone who would judge you that harshly? I guess not. Maybe if he thinks I€™m crazy for having a bad day and working hard, I€™d be better off without him.
In answering all of these questions, Anne may be able to come up with some alternatives to Anxious Thoughts 3 and 4, such as:
€œMost of the time people don€™t notice. I can usually hide it pretty well. People will only notice if I have a really bad attack. If he notices, he€™ll probably just ask me what€™s wrong. I€™ll just tell him that I was up late last night, or that I haven€™t eaten today, or that I€™m feeling a bit run down. Maybe I€™ll tell him that before he notices. Then he won€™t be surprised if I seem a bit €˜out of it.€™ If he thinks I€™m crazy for being a bit out of it because I€™ve been working hard, this relationship wasn€™t meant to be.€
What kind of an effect do you think those alternative thoughts might have on Anne€™s anxiety?
Anxious Thought 5: €œI have to split €“ he can€™t see me like this €“ it€™ll ruin everything!€
Notice something interesting here. If Anne has successfully challenged her other anxious thoughts, she won€™t even have to deal with this one. This is a great example of how being good at noticing what you€™re thinking and where The Panic Cycle gets started can help stop the cycle before it gets going.
1. What is the evidence for the thought? Is it 100% true that you €œhave to split€? Do I always have a panic attack when you feel this way? I guess I don€™t always go into a full-blown panic attack when I feel this way. Maybe only 60% of the time. Sometimes it just kind of settles out. I feel crappy but I don€™t panic.
2. What if I don€™t leave? What€™s the worst that can happen? I€™ll have a panic attack. I€™ll be freaking out for the next half an hour. I won€™t be able to take it.
3. What do I mean, by €œI won€™t be able to take it?€ Do I mean I won€™t survive? I feel like I won€™t survive. It€™ll be awful. I€™ll feel terrible.
4. What is the evidence that you won€™t survive? I always survive but I€™ll feel terrible.
5. Have I ever had a panic attack in a public place like this before, been unable to leave, and still survived, even though I felt terrible? Yes
6. Is this panic attack going to be as bad as the worst I€™ve you ever had? Probably not. It€™ll feel terrible, but I€™ll survive.
7. What€™s different now? I know more about panic and what is happening to me. I feel like I have some control so the panic attacks don€™t seem as bad. I know what€™s happening to me. I€™m not going to die or go crazy no matter how bad it feels. It€™s just another bloody panic attack.
In answering all of these questions, Anne may be able to come up with an alternative to Anxious Thought 5 such as:
€œI feel like I have to get out of here right now but I really have other options. If I had a panic attack right now it€™d be pretty bad. But I€™ll survive. I always survive. I don€™t have to get out of here. I know what€™s happening. I€™m not going to die or go crazy no matter how bad it feels. I€™m not going to buy what this panic attack€™s selling.€
Once again, what kind of an effect do you think these alternative thoughts may have on Anne€™s anxiety?
Let€™s put it all of these alternative thoughts together for Anne:
€œNot eating all day makes me feel dizzy and weird and drinking coffee makes my heart beat faster. Maybe I€™m not having a panic attack. Maybe I should just eat something.€
People with panic attacks don€™t faint. I€™ve never fainted before, so it€™s pretty unlikely that I€™ll faint. I may feel like I€™m going to faint but I won€™t.
Most of the time people don€™t notice. I can usually hide it pretty well. People will only notice if I have a really bad attack. If my date notices, he€™ll probably just ask what€™s wrong. I€™ll just tell him that I was up too late, that I haven€™t eaten today, and that I€™m feeling a bit run down. Maybe I€™ll tell him that before he has the chance to notice. Then he won€™t be surprised if Ii seem a bit €˜out of it.€™ If he thinks I€™m crazy for being a bit out of it then maybe this relationship wasn€™t meant to be.
I feel like I€™ve got to get out of here right now. But actually, I don€™t. If I had a panic attack right now it might be bad but I€™d survive. I always survive. I don€™t have to get out of here. I know what€™s happening. I€™m not going to die or go crazy, no matter how bad it feels. It is just another panic attack and I€™m not buying into what it€™s selling.€
Imagine the effect of this kind of thinking on Anne€™s anxiety. Imagine if Anne was able to write down her anxious thoughts and challenge them in all situations like this. Imagine if she practiced challenging her anxious thoughts for several weeks and got so good at it that he could do it all €˜in her head€™.
In the next section, we€™ll talk about how you can challenge your anxious thoughts.
We€™ve just covered a lot of ground, so before you continue, pause for a moment, and remember some of the important parts from this section.
Good luck tonight!
Danielle, Bilingual Health Educator
