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Week 6: Behavior tools to control unhealthy emotions (feeling anxious)

Dear Reader,


It's good to see you in Week 6 of your journey of positive change!

This week is specifically important because it marks a new step for you.


Through weeks 1 to 5 (step 1), you have, hopefully, managed to get to know more about your unhealthy negative emotion.

If you need more assistance, in addition to the published posts you can get some useful tips and some more guiding worksheet materials within the BrainPerpetuum Homework Workbooks.


And now, you can proceed to learn HOW to change your problematic emotion. Congratulations on getting here, and welcome to the step called - the Toolbox!



Find some powerful tools to control unhealthy emotions (anxiety, depression, anger) at the BrainPerpetuum Zone www.bainperpetuum.com


 

The Toolbox


Cognitive-behavioral therapy (CBT) principles tell us that emotions are produced as a chain reaction where events trigger thoughts, thoughts trigger the experience of body sensations, which then trigger certain actions. These elements create vicious loops among themselves, finally forming a perpetuum mobile that keeps the unhealthy emotion alive and growing.


So, how do we break this perpetuum mobile?

We do that by targeting EACH of the elements (event - thought - body sensations - actions) by a set of TOOLS specific to the element (see below).





Let's go backward. Our actions are changed with the Behavior Tools, body sensations with the Body Tools, thoughts with the Mind Tools. When it comes to events, some of them can't be changed so what we should change is our thoughts about them, not the events themselves. However, there will be times where our emotions are triggered by real-life problems (for example failing an exam), which actually can and should be changed, in order for one to lead a functional life. These events are then dealt with by Problem-Solving Tools (for example - making a more efficient study plan).


Now, you may wonder why did we start backward, from actions to events?

The reason is simple - because actions are the easiest to change. Much easier than, for example, thoughts.

Why is that so?

Because unlike our body sensations and our immediate automatic thoughts, our actions are under the direct control of our WILL.

That's right, your arm and leg muscles are receiving the signals directly from your rational brain, and their action depends on your DECISION. To avoid or confront. To be passive or invest effort. To act aggressively and impulsively, or to control your actions.


Do you remember how your rational brain double-checks the "first impression" of your emotional brain when confronting a stimulus? Go back to Week 1 video to get reminded.


We can actually decide what to do, and just - do it!

Sometimes you may feel that your behavior is stronger than you and that you can't resist it. For example, a woman who is afraid to faint on the bus feels she NEEDS to avoid the bus and that this need is stronger than her decision to get on the bus.

However, this is not quite true. It is true that the need to avoid the bus is strong, but it is definitely NOT stronger than the biological power of her rational brain to send signals to her legs. Resisting her need is very unpleasant, but still POSSIBLE, in spite of the discomfort she may feel.


So, the first thing to learn, before starting to use the Behavior Tools to control your unhealthy emotions, is that doing something or not - is up to your decision. And not up to how unpleasant your choice may be.





The Behavior Tools


Now when you know that you are the one in the power of your behavior, please watch the video below to understand why and how you can use behavior to control your unhealthy emotions.


For more videos, subscribe to our youtube channel.



It's now time to list the Behavior Tools by emotion.

Today we will start with the tools for anxiety, and next week we will proceed towards tools for depression and anger.


The Behavior Tools against feeling anxious


In the video above, you saw that the key principle, when it comes to targeting behavior in unhealthy fear and anxiety, is to expose to the feared stimuli and eliminate all avoidance behaviors.


Take a look at your homework from Week 2 (Emotion Profile Record) or Week 5 (Anxiety History Map). What's the stimulus that triggers your fear/anxiety? What are your avoidance behaviors? What are these behaviors keeping you from in your life? How much easier would life be without them? Define the main goal you would like to achieve in fighting it.


For example, the woman in the earlier example fears fainting inside the bus, which is why she actually fears riding on a bus. Therefore, she doesn't use the bus, except for very short one-stop rides but only with the "help" of a bunch of avoidance behaviors (takes her partner with her, sitting right next to the door, having some sweets and water in her purse, checking her pulse, wearing the lucky charms, and ultimately, leaving the bus whenever she feels uncomfortable, before reaching her destination).

Her main goal is to be able to go to her work by bus (an 8-stops ride), by herself.


Thinking about it, she believes that doing that would make her extremely anxious, almost 100%. This is why she needs to define smaller steps to getting there and make an exposure pyramid out of those steps. At the base of the pyramid, there's a situation eliciting low anxiety that she could handle jumping into right away. At the top of the pyramid, there's the most feared situation representing the main goal. See the example below.






How are the exposure steps exercised?


As you saw in the video above, the typical habituation to anxiety takes about 45 minutes or less, meaning that the anxiety naturally increases, peaks, and decreases during that period. If you expose yourself to the feared stimulus that long, your brain gets an opportunity to actually detach the fear from the feared stimulus (this is actually a reverse process of classical conditioning that you learned about in Week 3).


In the example above, the woman's brain needs to detach the fear from the bus (she used to not be afraid of going by bus until she almost fainted while on the bus, and then the bus started to make her afraid, as well).


This is done for each step of the pyramid, by exercising that step until the fear decreases below 20%. This should typically take 45 minutes or less. However, doing this once is not enough. The next time you try to enter the situation of the same step, you may feel anxious again. But - probably to a slightly lesser extent. Each time you repeat the exercise - you will experience more habituation, and your baseline fear will get weaker and weaker. Until this step elicits almost NO MORE FEAR. And then you go practicing the next step of the pyramid and repeat the same procedure until you reach the top - your goal.


There's one catch though. No avoidance behaviors during the exercise - no escaping the situation before the goal of the step is reached, no avoiding of the exercise, no safety behaviors, no seeking reassurance.


The first step exposure for the woman in the example (eliciting 30% anxiety) is consisted of riding on the bus until the next stop. Then getting out, and catching the next bus and riding for one more stop, and repeating all this for 45 minutes, or until the anxiety decreases significantly. No escape, no avoidance, no husband's company, no sweets and water in the purse, no sitting next to the doors, no lucky charms, no checking her pulse.


She does this for 7 days, and then she notices that the one-stop ride on the bus does not elicit 30% anxiety anymore, but maybe only 5%, an amount of anxiety she can handle really well. This is the time she goes up, to step 2 exposure. She repeats the procedure for each step until she is once able to enter the bus towards her final goal destination (8 stops) with anxiety that's 20% or lower.


Ready to make your own pyramid and start your own exposure task?

Use the Exposure Pyramid Task chart below.




You probably think that exercising exposure will be very challenging and overwhelming. Be sure to define as many steps as needed to make it easier for yourself.

Here's some "first aid" you can apply to help yourself cope and complete the tasks.

See the Exposure Coping Card below. Take it with you during an exposure task, and read it when needed.




If your type of task is difficult to be organized as live exposure, you can do it in imagination, using the same principles. When imagining, do it with as many details as possible, by closing your eyes, describing a situation precisely, and "being there".


However, it may be difficult to imagine your feared situations for 45 minutes.

There is another way to "turn off" the fear while exposing yourself in imagination. Instead of exposing yourself for 45 minutes, you can expose yourself while doing an activity that deactivates the fear, such as relaxation techniques. For this you would need to learn the relaxation techniques well first, so we will get back to it when we talk about the Body Tools, and specific anxiety disorders.

 

To summarize…

  • Unhealthy negative emotions are expressed in triggering situations, through thoughts, body sensations, and certain behaviors. Each of these features can be targetted by a specific set of tools - Problem-Solving Tools, Mind Tools, Body Tools, and Behavior tools.

  • Certain behaviors during unhealthy emotions produce instant relief, but do not provide the core solution to the problem; rather they serve as a reinforcer and make these emotions live and grow through time. They need to be removed for the emotion to be controlled. You can use the Behavior Tools to do that.

  • For anxiety, the problem behaviors are avoidance behaviors: escaping the stimulus when facing it, avoiding the stimulus before facing it, or safety and reassurance-seeking behaviors when facing the stimulus.

  • The Behavior Tools for anxiety refers to exposure to the feared stimuli in a gradual way, without any avoidance behaviors, using the Exposure Pyramid Task.

  • You will learn about the Behavior Tools for depression and anger in the incoming weeks.


For your homework …

In the following week:

  • if you have a problem with anxiety, you can try the Exposure Pyramid Task - define the steps of the pyramid with the corresponding anxiety level (%), and start with the first step. Follow the instructions in the chart. Use the Exposure Coping Card to help you endure. Do this task only if your anxiety is irrational, i.e. the danger is not real. But do not do the exposure task if you have a medical condition (such as a cardiological, neurological, or another medical issue) - in that case, please consult with your physician and seek treatment for your anxiety from a mental health professional.

  • if you have a problem with depression, you can prepare for the following week by making a list of all the activities (with people, work, sports, hobbies, etc.) that you have been avoiding due to feeling depressed. Also make a list of 5 activities (List A) that used to give you a sense of functionality (necessary and routine activities of everyday life) and a list of 5 activities (List B) that used to give you pleasure (such as hobbies, social activities..), before you started feeling depressed. You may start doing the easiest activity from Lists A and B, twice a week, and measure the level of pleasure (0-5) and how successful you have done the activity (0-5) after it's completed.

  • if you have a problem with anger, for now, you can make a list of the aggressive behaviors you have done in the episodes of anger (emotional/physical, active/passive aggression, towards others or yourself). If you have a tendency to self-harm, or to physically, emotionally, or in any other way hurt other persons in anger, you should STOP this behavior before it happens (by counting to 10 or more, removing yourself from the triggering situation, trying to calm yourself by the breathing exercise, keeping in mind the negative consequences aggressive behavior would have), and IMMEDIATELY SEEK ONE-ON-ONE PROFESSIONAL HELP from your mental health service provider. These kinds of problems require clinical assessment and treatment by a licensed mental health professional. Self-help programs cannot replace mental health diagnosis and treatment.

  • If you have a mild problem with verbally aggressive or passive-aggressive communication, try recognizing your anger before you act, and prevent the aggressive response (delaying - count to 10, removing yourself from the situation, trying to calm yourself with a breathing exercise, exploring your thoughts and cognitive distortions, imagining the negative consequences such communication would have, even trying to think if there are more constructive ways of reacting, respecting the rights of both you and the other person). Measure your anger before and after that (%).

  • continue usual homework: keep filling in the Emotion Monitor from Week 4, and practice the breathing exercise for 5 minutes, 3 times per day, or whenever you feel stressed.

  • do not forget the 9 rules to follow this blog in the most useful way.

Get more detailed tips, printable worksheets, and additional materials, to help you with your homework tasks.


BrainPerpetuum Homework Workbook Week 6

Good luck with the first week of using your Emotion Control Toolbox!


Yours sincerely,


BrainPerpetuum



 

NOTICE: Please note that this self-help blog program is for informational purposes, and cannot replace mental health treatment. Research has shown more potential in CBT self-help if using such a program is guided by a mental health professional throughout the process.

If you have been experiencing significant distress, mood challenges, behavioral dyscontrol, or similar mental health dysfunction, please contact your mental health service provider without delay. Mental health diagnosis and treatment can only be done after conducting a one-on-one clinical examination of the client by a mental health professional. The owners of this website and the writers of the content provided do not take any responsibility for the mental health outcomes of readers.



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