CHAPTER 7: From Avoidance to Approach

Life can only be understood backwards; but it must be lived forwards.” — Søren Kierkegaard

Avoidance

A big component of anxiety is avoidance. It makes sense that you would want to avoid something that feels terrible, like anxiety does. Avoiding situations where you tend to be highly anxious leaves you feeling like your world is getting smaller, but it does lead to a short-term relief. The big challenge with avoidance over time though is that you end up making the anxiety stronger. In a way, it is like you confirmed the theory the anxiety had about something being dangerous by avoiding it. For example, imagine that you are anxious about public speaking so you avoid all public speaking. You feel better in the short term as you don’t have to face an uncomfortable and challenging situation, but you strengthen your anxiety over time. It is almost as if your anxiety had a theory that public speaking is scary and dangerous and you will be unsafe if you do it. By avoiding public speaking, you told your anxiety, “see, it was really scary and I am only safe if I avoid this”. This in turn makes your anxiety stronger for next time.

Approach

The antidote is to approach the situations that tend to elicit an anxious response. So, continuing with the public speaking example, you will need to practice public speaking. The key to being able to do this is to start with a situation that is only mildly uncomfortable and work your way up to bigger challenges. You can only do this if you have strategies to manage and shrink your anxious response. This is why we are only talking about avoidance, approach, and challenges at the end of the workbook. A couple of things will really help you be able to engage in approach behaviour. You will need to be able to build a challenge ladder and you will need to be able to imagine future success.

Challenge Ladders

Building a challenge ladder is a kind of exposure to challenging situations. Essentially, you choose a situation that is only mildly anxiety inducing to start with and build up to a challenge that is more difficult over time. The main point here is to move from avoidance of all situations that tend to fuel your anxiety to being able to approach them, as this is an essential part of being able to manage your anxiety.

On the next page, I will show you an example of what a completed challenge ladder might look like for the person who struggles with public speaking. I will also include a blank ladder so you can fill in your own. You won’t necessarily climb up the ladder in a linear manner, there will likely be some up and down. That is normal, just keep considering what your next challenge is that will keep you moving up the ladder. Also remember that your 3A Toolkit will help you manage your anxious response so you can keep moving up the ladder.

Example of a Challenge Ladder:

Present in front of a large audience

Present in front of a small audience

Present to your boss at work

Present to one or two people at work

Present to one or two people you know that are friends or family

Ask a question in a meeting

Blank Challenge Ladder for You to Complete: Really challenging

Somewhat challenging

A bit challenging

Really challenging

Somewhat challenging

A bit challenging

Imagining Future Success

After you have filled in your challenge ladder and before you start to complete the challenges, an important practice is to imagine future success. This is basically the opposite of the debrief. Instead of rewinding and reflecting on an experience of anxiety that has already happened, this time you will fast forward and imagine a situation that has not yet happened and anticipate how your anxiety might show up. Using the 3A Toolkit, you will then reflect on what you will notice (Awareness), what label captures the experience (Assign a Label), and what you will do to manage the worry (Action). You will then rewind this scenario and replay it until you feel like you will be able to manage the worry. This kind of If….Then practice helps prime and prepare yourself to use the strategies you have been practicing and boost your confidence about being able to manage your anxiety. For example, you might think to yourself “If I feel short of breath, then I will use figure 8 breathing to regulate by breathing”. I suggest using this process for each of the challenges on your challenge ladder. Here is a summary of what this process entails:

Future Success: Fast Forward, Reflect, Write a story of success, Replay

To practice this, let’s work through an example.

Fast Forward

• When you are calm, fast forward to a situation that you expect will induce anxiety. • Approach with curiousity, like a scientist or a detective looking for clues. • Mindful and non-judgmental awareness

REFLECT (using the 3A Toolkit) Awareness

Awareness Category

Thinking

Body Activation

Important Reflective Questions

Is this thought helpful? Consider if the thought was helpful at the time and if you think it is helpful now.

What do I remember about my body’s response at the time? What do I notice about my body now? What was my level of activation then? What is my level of activation now?

Assign a Label

What feeling label will you use to capture your anticipated experience?

Action

Using your 3A Toolkit, decide what strategies will work to shrink your worry.

AWARENESS

Thinking

• “This is going to be a disaster” • Your thoughts are jumbled and not helpful • Notice these thoughts are not helpful

Body Activation

• Heart is racing, trouble catching your breath

ASSIGN A LABEL

Label It

“That’s just my anxiety”

ACTION

Helpful Thinking

• Messages of safety e.g. “This feeling will pass”, “I am safe”, “I can do this” • Helpful thinking with a focus on: Present moment Capability • Assess level of activation

What you can influence e.g. “I prepared well for the presentation and will do the best I can”

Body Calming

For low to medium level of activation try using your breath to lengthen your exhale and slow your breathing down. For higher levels of activation, use slow movement such as walking

Write a Story of Success (Using the 3A Toolkit)

Now put all the pieces together and write a version of the anticipated experience or event but this time with you putting the 3A Toolkit into practice and imagining you are able to manage your anxiety. The story of success focuses on shrinking the anxiety, not on trying to control circumstances outside of your influence. For example, if you are imaging managing your anxiety about public speaking, you focus on calming your body and helpful thinking and not on everyone in the audience clapping for you or even not making any mistakes (you are obviously hoping this will happen but cannot not completely control this).

REPLAY

Rewind the scenario to the beginning, but this time replay it and imagine or visualize the successful ending with you managing the worry. This way, you are not only wishing and hoping that you won’t be anxious (this does not usually work), you are expecting some anxiety and you are ready for it!

Using your 3A Toolkit, continue to set challenges using your ladder, use the future success visualization to prepare for the challenge, and use your debrief to consider that you can do differently for next time. This is a recursive process of reflecting on what happened, providing yourself with feedback about what you can change for next time (with respect to thinking in a more helpful way and calming your body), and visualizing enacting that change. Over time, this process will really support improvements in your ability to manage your stress and anxiety.

You now have your own 3A Toolkit that you have filled in with the strategies that work best for you. Instead of a list that will only work once, you now have a complete 3A Toolkit that has equipped you to understand what is happening in your brain and your body when dealing with stress, worry, and anxiety. You also know what to do when you were not able to manage your response in the moment – you can always do a debrief after the fact. And you are equipped to counter an instinct to avoid situations that cause anxiety with your challenge ladder and ability to systematically visualize future success.

You have made amazing progress so far. Let’s proceed to Part Two of this workbook. Part Two will provide some additional knowledge and strategies for those of you who are looking for additional tools and understanding regarding managing your anxiety.