Photo Credit: Jewish Press

Dear Dr. Yael,

I have always suffered from anxiety and the current situation we find ourselves in is exacerbating my condition. I know that we have no control over what is happening, but the unknown is scary and it is getting more and more difficult for me to be able to handle my day-to-day responsibilities. Please help me.

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An anxious wreck

Dear Anxious,

Anxiety is a terrible thing and can definitely disrupt your day-to-day life. I am so sorry to hear how much you are suffering and do sympathize. You are correct that there is much we don’t know about the virus and what will be in the coming days.

Using Cognitive Behavioral Therapy (CBT) techniques can be very helpful in treating anxiety. CBT is based on the theory that cognitions, or what we think, affects how we act and feel; behaviors, or what we do, affects how we think and feel, and emotions affects how we think and act. Since all of these (thoughts, behaviors, and emotions) interact, we have to change how we think in order to change how we feel and how we act.

For example, a technique called “cognitive restructuring” can be very helpful in reducing anxiety. It helps us understand unhappy or anxious moods and feelings and allows us to challenge the automatic beliefs that can lie behind them. It is, in essence, reframing negative or anxious thinking into positive or calmer thinking. You can use these 7 steps below that were adapted from the book “Mind Over Mood” by Christine A. Padesky:

Use a calming technique if you are feeling stressed or upset. They include deep breathing and visualization (visualizing a calming or happy scene in your mind).

Identify the situation that is upsetting/stressing you, so you know what it is that you need to target to calm down.

Analyze your mood and put in one word what you are feeling. For example, humiliation, insecure, angry, anxious, frustrated, etc.

Pinpoint your automatic thoughts. These are usually the natural reactions you have when you feel the way you described above. For example, “I will fail.” “No one will like me.” “This is going to get worse.”

Find objective evidence to validate your automatic thought. Your goal is to look at what happened, and then to write down specific events or comments that led to your automatic thoughts.

Find objective evidence to refute your automatic thought. For example, I made a mistake, but I was able to fix it and move on. I was embarrassed, but everyone else seemed to move on and no one appeared to change their opinion of me. It was a stressful moment, but things improved afterward. These statements are more accurate, fairer, and more rational than your automatic thoughts.

Identify fair and balanced thoughts and use these to replace your automatic thoughts. You must come up with some positive affirmations that you can use to replace automatic thoughts in the future. For example, if making a mistake automatically makes you a failure, you replace it with, “I am human and humans make mistakes. I can and will do better next time. There are many times that I am successful.” If the unknown makes you anxious and automatically makes everything in your life begin to unravel, you have to begin to notice this stressful automatic thought and replace it with, “Worrying will not help me have a better outcome, whatever will be, will be, whether I worry or not, so it is best for me to try to remain calm or calm myself so I can be ready to deal with whatever will come.”

Practicing calming techniques when you are not stressed will give you the armor you need when you are worried. Practice doing these techniques several times a day, so they will be easy to do when you get anxious.

That being said, none of these ideas can replace a competent therapist who can help you become more aware of your automatic thoughts and help you learn other CBT techniques that can reduce your anxiety. Please seek help if you are not able to use these ideas on your own. Hatzlocha.

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Dr. Yael Respler is a psychotherapist in private practice who provides marital, dating and family counseling. Dr. Respler also deals with problems relating to marital intimacy. Letters may be emailed to deardryael@aol.com. To schedule an appointment, please call 917-751-4887. Dr. Orit Respler-Herman, a child psychologist, co-authors this column and is now in private practice providing complete pychological evaluations as well as child and adolescent therapy. She can be reached at 917-679-1612. Previous columns can be viewed at www.jewishpress.com and archives of Dr. Respler’s radio shows can be found at www.dryaelrespler.com.