Sarah Edelman - No Worries: A Guide to Releasing Anxiety and Worry Using CBT

Contents

DR SARAH EDELMAN is a clinical psychologist, author and trainer. She previously worked as a researcher and lecturer at the University of Technology Sydney. In addition to her clinical work Sarah conducts training programs for mental health professionals and business organisations, and runs workshops on Changing Your Thinking at Sydney University Centre for Continuing Education. She has published articles in professional and mainstream journals, and is a regular guest on ABC radio. Her book, Change your Thinking, is a best seller in the self-help genre. She is also co-author of Good Thinking: A teenagers guide to managing stress and emotions using CBT.

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First published in Australia in 2019

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Copyright Sarah Edelman 2019

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Contents

No regrets, just lessons.

No worries, just acceptance.

No expectations, just gratitude.

Life is too short.

UNKNOWN SOURCE

Some peoples lives are easy. Not because they are particularly privileged or clever, but because they have been blessed with a calm, easygoing nature. Like everyone, they experience difficulties, demands and pressures in their lives, but they are able to face them without unnecessary anguish. When problems arise they look for solutions, and in circumstances where there is nothing they can do, they adapt. They are able to do this because they have a relaxed disposition and a flexible thinking style that enables them to adjust to stressful situations, without the additional burden of worry, rumination and overthinking. So, they rarely experience the distressing thoughts and intense bodily sensations that accompany high levels of anxiety.

To have such a disposition is a gift. In the card game of life, they have been dealt a good hand.

Many of us are not so fortunate. A combination of nature and nurture have conspired to make us prone to anxiety, making our world feel unsafe. We may be overly focused on a myriad bad things that could happen to us or our loved ones, or we may zero in on specific threats, such as failure, disapproval, humiliation or not fitting in. We may be particularly anxious about unwanted thoughts that pop into our minds, or unwanted body sensations that signal the possibility of panic. We may be excessively apprehensive about potential illness and death, or we may fear being in places from which escape would be difficult, such as tunnels, lifts and freeways.

While the objects of our angst vary, the underlying problem is the same. Our mind keeps directing us to be alert to danger, and our body is prepared for action. Anxiety affects the way we feel and behave, and deprives us of the ability to relax and enjoy life.

Anxiety disorders affect approximately 14 per cent of Australians each year, and over 20 per cent at some stage in their lives. Thats over three million people annually, and over five million people over the course of their lifetime. It is also not uncommon for people to have a combination of anxiety disorders, sometimes with occasional periods of depression. Anxiety disorders are the most common mental-health problem experienced by both males and females, though women are affected more frequently than men (18 per cent versus 11 per cent).

Some people are particularly prone to worry. Although our life circumstances may be quite agreeable, we feel unsafe. So, we might find ourselves planning solutions to non-existent problems, or overthinking situations that dont warrant analysis. At work or at play, with friends or with children, on holidays or at home, worry prevents us from being present. It impairs our ability to engage with what is happening right now. It robs us of joy and occupies too much of our mental space. It wastes energy and distracts us. Yet it can be such a habitual part of our thinking that it feels perfectly normal, and we may even assume that everyone thinks this way.

Anxiety is a big subject, and its various manifestations have been described in detail in many books. In No Worries, we will explore habits of thinking and behaviour that are common to many anxiety disorders. Understanding the way that anxiety operates how it affects our brains, minds, bodies and behaviour provides insight, and a rationale for strategies that can help us to recover. Working through the exercises in this book will increase understanding of your own anxiety, including the things you unwittingly do that perpetuate it.

In addition to exploring anxiety more broadly, we will focus specifically on worry, and the anxiety disorder characterised by excessive worrying: generalised anxiety disorder (GAD). Some researchers have described GAD as the prototype anxiety disorder, as many of its features are observable in all anxiety disorders. These include unrealistic assessment of threat, hypervigilance, physical arousal, muscle tension and other physical symptoms, reasoning errors, use of avoidance and safety behaviours, insomnia, restlessness, concentration difficulties and fatigue. Worry and intolerance of uncertainty are common manifestations of most anxiety disorders. Interestingly, successful therapy for GAD often results in reduced symptoms in coexisting anxiety disorders, including social anxiety, illness anxiety, panic disorder and phobias. So responding to the processes that give rise to and perpetuate anxiety and worry is likely to be helpful not just for resolving GAD, but for managing anxiety more broadly.

Individuals who are prone to anxiety also have greater likelihood of experiencing panic attacks. In some cases, repeated panic attacks can lead to panic disorder, which is characterised and reinforced by fear of further panic attacks. Panic disorder sometimes co-occurs with GAD, as well as with other anxiety disorders, and can be the source of much distress. Fortunately, it is a disorder that lends itself well to psychoeducation and self-help strategies. Understanding the nature of panic, what perpetuates it and how it can be relieved can lead to a significant reduction in symptoms. For this reason, I have included a chapter on this topic towards the end of the book.