overcoming anxiety - cppe · ten ways to calm down . tips for beating different kinds of anxiety...

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Overcoming anxiety

Published by Pansophix Online 22 Torquay Road, Chelmsford,

Essex, CM1 6NF, England

Written by Chris Carling

This edition published February 2011

Copyright © Pansophix Ltd. All rights reserved.

ISBN 978-1-906460-59-4



Welcome to this useful guide on Overcoming anxiety This guide has been developed by Pansophix Ltd and forms part of a series of guides and learning resources on communication and soft skills available from the Centre for Pharmacy Postgraduate Education (CPPE). As a pharmacist or member of the pharmacy team you will come across different situations in the workplace where effective communication and soft skills can support you in the development of your role, skills such as time management and customer service. In addition to this, the proposed changes to the commissioning process mean you will require the necessary skills to proactively engage with GPs and other commissioners to promote the public health and NHS services you deliver. Effective communication, negotiation and influencing skills will be vital in developing and strengthening new relationships in this arena. Here at CPPE we recognise the importance of developing these skills and have included three themes within our portfolio to support you: • Personal development • Management and leadership • Communication and consultation skills If you are interested in developing your soft skills further then visit the CPPE website at www.cppe.ac.uk to access the three themes in the learning portfolio for guides.

Learning with CPPE CPPE is funded by the Department of Health and offers continuing professional development (CPD) opportunities to all pharmacists and pharmacy technicians providing NHS services in England. We are committed to providing high quality and professional learning programmes. CPPE recognise that people have different learning needs and so we have created three categories of learning - The learning resources within the communication and soft skills themes are category - Core learning (limited expectation of prior knowledge). There are no assessments linked to these guides, however some of them do include activities and toolkit exercises to help you achieve your objectives. You can use your learning to support your continuing professional development (CPD). Use your CPD record sheets or go to: www.uptodate.org.uk to plan and record the actions you have taken.

http://www.cppe.ac.uk/�

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Contents Introduction: what this Useful Guide is about Anxiety and worry: what’s the difference? Three things to know about anxiety What’s there to worry about? A fable Ten ways to calm down Tips for beating different kinds of anxiety …

• anxiety about people we care for • anxiety about security and warding off disaster • anxiety leading to overworking • anxiety due to fear of overwhelm • anxiety due to fear of failure • anxiety due to weak boundaries and fear of others’ demands

Resources Acknowledgements Important note: this Useful Guide deals with ordinary, day-to-day worry and anxiety, not serious mental health problems.



What this Useful Guide is about ‘It is said that our anxiety does not empty tomorrow of its sorrows, but only empties today of its strength.’ Charles Spurgeon The aim of this Useful Guide is to help you recognise the role that anxiety plays in your life, and to take practical steps to reduce its impact. You’ll find 30 tips you can put into practice in your bid to become a more relaxed and calmer version of yourself, at work, at home, or both.

Sounds simple, doesn’t it?

Yet as anyone who has ever experienced anxiety knows (and that means a lot of us at one time or another), anxiety is not a simple state. On the contrary, anxiety can show up in many different guises, and can be a response to a whole range of perceived threats or fears. Some of us sit precariously balanced on a bubbling vat of anxiety yet are only dimly aware of it.

We can be anxious without fully realising it

This was true of me for many years. Though anxiety has played a big role in my life, a lot of the time I didn’t really recognise it. Yes, I worried about people I cared for, but doesn’t everyone? Yes, I tended to come up with ‘worst case scenarios’: ‘what if x happened, or y, or z’. But, hey, that was just sensibly looking ahead and predicting possible problems, wasn’t it? Yes, I could be a workaholic, partly because I took a lot on, but partly too because I did everything very, very thoroughly, checked and double-checked just in case something might be wrong. I didn’t delegate much either: how could I be sure anyone would do the job, whatever it was, as thoroughly as me? But that was just being super efficient and reliable, wasn’t it? And aren’t efficiency and reliability great virtues? It wasn’t until I became a coach, and began to take a closer look at my own behaviour, that I came to question some of my deepest-seated assumptions. My image of myself was as someone who generally had things under control, and this was true. What I came to recognise, however, was that the driver to have things under control all the time was often an unacknowledged anxiety.



Anxiety can be very cunning

I came to see that anxiety can be very cunning. It fools us by showing up in much more respectable and acceptable guises. Anxiety can show up as caring, for example. Almost as a badge of honour. Worrying about someone shows you care. Anxiety can show up as foresight. Anticipating possible problems (my worst case scenarios) can seem like a sensible strategy – until you take it to extremes, seeing disaster round every corner. Anxiety can show up as being very conscientious, working very hard because only that way can you be confident you will succeed.

Does any of this sound familiar?

If it does, you’ll be able to add to the list of guises that anxiety can show up as. In this e-Book we’ll be taking three of the most common guises for starters. You’ll find tips for reducing anxiety that shows up disguised as …

• Caring about other people • foresight or protecting against disaster • conscientiousness, working very hard, putting work before everything else

But there’s more to anxiety than this

Of course there is. What I also came to see more clearly is that anxiety is a response often to different kinds of fears. Sometimes a healthy response, but more often unhealthy. These fears include …

• Fear of overwhelm - A big source of anxiety for those of us who try to keep life very much under control is fear of being overwhelmed. As tasks, responsibilities and demands pile up, we feel more and more uneasy. Fuelling our uneasiness is a feeling of being threatened. It’s as though we are on a knife edge, just about coping but dreading that one more demand that may push us over. A Friday deadline is changed to Thursday and suddenly all our plans for coping are upset. Sometimes our anxiety seeps through. Maybe we flare up, over-react. Or we may keep our feelings hidden and suffer the discomforts of anxiety alone.



• Fear of failure - Another big one is around fear of failure which can result from a loss of confidence in your own abilities. We worriers have vivid imaginations – we can be doing just fine, working on part of a task, when our worry antennae suddenly tune in to the whole task. And it looks enormous. So we start worrying about whether we’ll get it done – which makes it feel even more enormous. If we’re not careful we can generate a mini-panic where we completely lose touch with our abilities and competence (which, in reality, we have in spades: anxious people are usually very competent and very reliable). It can feel as if we’ve never achieved anything before and here is this enormous task bearing down on us. That’s how vivid our imaginations can be. We don’t so much fear failing in a task. It’s more that anxiety can cause us to go blank, blot out our abilities and experience so that we can feel a stranger in our own skin.

• Fear over others’ demands - This fear is around other people and what they may demand of us. Many anxious people find saying no difficult, partly because they are not in close touch with their own needs, and therefore don’t always know what to say yes to, and what they might reasonably refuse. One way of talking about this is to say they have weak boundaries and are therefore easily invaded by others, which in turn can add to their fear of overwhelm. Others can be unpredictable in their demands and can come along at any time and upset your well-laid plans.

Do any of these fears strike a chord?

If so, then like the disguises in which anxiety may appear, you can probably add some of your own fears. The second set of tips in this book will show you ways to reduce anxiety arising from three different sources of fear …

• fear of overwhelm • fear of failure • fear of others’ demands or weak boundaries



Anxiety and Worry – What’s the difference? So far I’ve talked about both anxiety and worry, and both are equally relevant to our subject. The distinction I make between them is this: Anxiety is a state which can show up in both the body and the mind. In the body it may cause, for instance, a quickened heartbeat, sweating, muscle tension, heavier breathing, dizziness or faintness, butterflies in the stomach, indigestion. In the mind it may show up as sleeping badly, irritability, feeling tired, inability to concentrate. Or in many other small ways. You may want to list here how anxiety shows up in you: Anxiety shows up in me as: Worry is an activity which, if prolonged, can lead to a state of anxiety. You are normally anxious about something, even if you don’t know what it is. When you know what it is then you will worry about it. Worrying normally takes place in the mind and often consists of going over and over problems: these problems may relate to the past (‘did I do the right thing?’), the present (‘is disaster about to strike?’) or the future (‘x,y or z may happen’).



Three things to know about anxiety

• Anxiety is a normal human feeling. It can alert us when something is wrong, or we are under threat, or give us the incentive we need to solve problems. It is when anxiety becomes a habit that we need to be concerned, when it is a frequent or permanent state so we are on a constant alert.

• Anxiety is often an attempt at asserting control. This book contains practical tips and strategies for reducing the hold that anxiety and worry have on many of our lives. Much as I would like to claim I have the secret and can make this into an easy task for you, it is simply not true. A key reason is that much anxiety is a reflection of our attempt to assert control in an uncertain and unpredictable world. People who are anxious are putting up a brave resistance to reality. We spend energy in keeping control as far as we can, but it’s never enough. Reducing anxiety comes, not from asserting stronger and stronger control, but, on the contrary, I have come to realise, it comes from letting go of the effort to keep control. And that can feel very threatening.

• Reducing anxiety is a personal development issue. It’s not just

about learning techniques. It’s about relinquishing a way of coping; it’s about accepting uncertainty and living with it rather than working hard to resist. This, it turns out, is the way to make living more comfortable. This is the kind of awareness you need to develop. This is the personal development path ahead.



What’s there to worry about? A fable This letting go can be all the more difficult in that anxiety can play an important role for those who suffer from it. Consider this story: A woman asks her husband why he looks so worried. He tells her he’s worried about the house. There’s been a lot of rain and he noticed some water up in the loft. Maybe there are problems with the roof. Next day the woman contacts a roofing company and they come round and replace some loose tiles. She’s pleased to get the problem sorted out, and her husband seems relieved. Next day though he still looks worried. She asks him why and he tells her he’s worried about their son who spends all his time playing computer games instead of doing his homework. He must be falling behind at school. He’ll never get through his exams, and then where would he be. The woman talks to her son and talks to his teachers, and finds the problem is not as bad as her husband fears. Her son agrees to get his homework finished before playing on his computer. She’s pleased to get the problem sorted out and her husband seems relieved. Next day he still looks worried. She asks him why and he says he’s worried about the car – the engine sounds very loud. She suggests he take it to their local garage who discover a hole in the exhaust which they replace. He seems relieved. And yet his wife can see he still looks worried. ‘What is it?’ she says. ‘What are you worried about now?’ ‘Nothing’, he says, ‘that’s the problem. I’m worried that I haven’t got anything to worry about’. Moral of the story: for anxious people, worrying plays a role. If you’re one of them you will know that you can be uneasy without any worries. Your mind is skilled at casting about looking for a new worry to latch on to. It’s often a way of trying to exert control in an uncertain world: worrying as a way of warding off disaster.



Ten ways to calm down Ten strategies for regaining your calm when worry and anxiety rise to uncomfortable levels.

1. STOP. Wherever you are in whatever you’re doing. Break off. You need to get yourself into a different emotional and mental state.

2. MOVE. Change your seat. Leave the room. Walk around. Shake up your

molecules so they settle down in a somewhat different place. When your mind gets stuck in a negative spiral, you can unstick it by moving the body.

3. BREATHE. When we tense we often hold our breath. Focus on your breathing. Count your breaths quietly till your breathing feels regular and comfortable. Try some abdominal breathing. Stick your stomach out as you breathe in. Breathe from the stomach up into the chest. Breathe out from the upper chest down into the abdomen pulling your navel in as you breathe out.

4. CROSS SEVERAL ITEMS OFF YOUR ACTUAL OR MENTAL ‘TO DO’

LIST. A big cause of anxiety is being unrealistic about what you’ll get done in any given period of time. For each item, ask: ‘What would happen if I didn’t do it today?’

5. LAUGH. Even if you don’t feel anything is funny. Your brain will be fooled into thinking you are enjoying yourself.

6. ACCEPT CHAOS, if that’s how things feel. Chaos is the raw material from

which order is made. Don’t try and fight it.

7. FEED YOUR SPIRIT. Do something that nourishes you as a person. Not that you think should be good for you, but something you love and can disappear into.

8. SEEK OUT SOMEONE WHO HAS A CALMING INFLUENCE. Take in

their aura of calm.



9. GET OUT OF YOUR HEAD. Share. Talk to other people. Let it out rather than bottling it up.

10. STRETCH. Stand on your tip toes, stretch your arms above your head

towards the ceiling. Roll your shoulders. Stretch then relax each part of your body.



Tips for reducing anxiety

Anxiety about people we care for (often disguised as caring) This kind of anxiety is mainly about people in our lives, people we love and/or feel responsible for. Feeling in an anxious state when a loved one is out in the world far from our control can easily seem like a mark of caring. Worrying about our staff and how they are doing can appear as evidence we are a caring manager. And sometimes, of course, such anxiety and worry are natural and justified. That’s what can make it so difficult to spot when we cross the line into excessive worry and anxiety.

The big test

The big test as to whether we are likely to cross the line into over-anxiety and worry lies in unearthing an assumption. This is the assumption:

Anxiety and worry are inseparable from caring People who are prey to the kind of anxiety that disguises itself as caring frequently make this assumption without realising it. They take for granted that to care means to worry. It simply does not occur to them that they can let loved ones out into the world (we’re talking about responsible, mature loved ones, here, not young children) and trust them to look after themselves. And still care. That they can let staff get on with the job by themselves without constantly wanting to check they are doing OK. And still care. It hardly ever occurs to them that shadowing in your mind those you love and/or feel responsible for, which is essentially what you are doing when you worry about others, does nothing to protect them and puts you under pressure and stress.



Do you suffer from this type of anxiety?

Test yourself. Answer the following questions with ‘Occasionally’, ‘Often’ or ‘Never’. Do you …

1. Shadow other people’s activities and progress in your mind when they are out of your orbit?

2. Hover around loved ones or staff ready to step in and help out? 3. Panic when you can’t reach a loved one by phone even if you have no

reason to believe they are not OK? 4. Foresee problems that others may come up against before they do

themselves? 5. Live others’ lives with them such that you feel their emotions?

The more ‘Oftens’ you score, the greater the likelihood that you experience this kind of anxiety.

Possible underlying beliefs

One way to reduce this type of anxiety is to identify some of the underlying beliefs that may be sustaining it. Here are some possible beliefs. Use the space below them to add any of your own: Belief 1: ‘If I didn’t worry it would mean I didn’t care’ or, in another version: ‘People who don’t worry about others don’t really care about them’. Belief 2: ‘I am responsible for the well-being of [fill in the name of anyone you love and/or feel responsible for]’ Belief 3: ‘If I don’t keep watch something terrible may happen’.

My beliefs:



Changing our beliefs

Often we perceive our beliefs as truths forgetting that they are simply what we happen to believe. Other people will have at least some quite different beliefs. In the caring arena, a different belief might be, for instance: ‘People are responsible for their own well-being’, or ‘Worrying about others doesn’t help them.’ And, of course, we can change our beliefs. In the course of our lives, we have taken on and later discarded many beliefs. To illustrate this for yourself, list here: A belief you once held but no longer do: A belief you are just beginning to doubt: A belief you haven’t held so far but are open to taking on:



Go back to the beliefs about worrying and caring you listed above. Are any of them open to change? What might be a new belief that could replace them? What role is this anxiety playing for you? The husband in the fable was uneasy when he didn’t have anything to worry about. His anxiety played a role for him perhaps helping him feel he had all the bases covered and had everything under control. What do you think you may gain from this type of anxiety? What do you risk losing if you lessen it?



Tips for reduced ‘caring’ anxiety

1. This is the big one – it’s a change of mindset. Start by just playing

with the idea that you could allow those you love or feel responsible for to exist independently of you watching over them (remember that worrying about someone is effectively watching over them in your mind). What would it take for you to be able to make this shift?

2. Practise letting go of the need to keep those you love/feel

responsible for in your orbit so you can make sure they are OK. Look for small ways to start trusting them to go it alone.

3. Invent some mantras for yourself when you catch yourself worrying

fruitlessly. ‘They can manage without me’, for instance, or ‘Worrying harms me and doesn’t help them.’

4. Voice your fears out loud – not necessarily to another person, but out

loud so you can hear them. Be explicit: ‘I am afraid that…’, ‘How realistic are your fears?’ Don’t be too hard on yourself - recognise that giving up this kind of anxiety is hard. It’s part of your personal development and growing maturity.

5. Learn to separate genuine concerns from fruitless fretting. Genuine

concerns can usually be articulated and, where possible, acted upon. When talking about them to others, you don’t have that feeling they may think you’re fussing unnecessarily. Fretting is often more generalised with nothing to be done except for the problem to go round and round in your head.



Anxiety about security and warding off disaster (often disguised as foresight) This area of anxiety is generally concerned with security and protection, and shows up in anticipating possible problems. At a moderate level this kind of foresight can be useful, causing us to make sure our computers are backed up, for example, or to be confident parcels or emails have arrived because we ask for acknowledgement (because we have gone through the worst case scenario in our minds that they have gone astray). People with this kind of anxiety often get to appointments ahead of time because they took an earlier train just in case there might be a delay. Again it’s not always easy to see where we cross the line into excessive anxiety and worry. Yes, it’s good to be organised, to check you have everything with you but how many times do you really need to check?

The big test

As with anxiety disguised as caring, the big test as to whether we cross the line into over-anxiety and excessive worry lies in unearthing an assumption. In this case the assumption many worriers hold without realising it is: I can ward off any possible disaster Lurking somewhere inside is the view that if I can scan through all the possible scenarios, foresee all possible problems that just could arise, take steps to avert these possibilities, then everything will be OK. People with this view have a running commentary in their heads along the lines: ‘If we take that route there may be traffic; if there is we can always turn off; of course the others might also be held up; I’ve the feeling there are road works on the M1; I’ll check on the Internet see if they give any details. If there are diversions, I’ll need to let them know…’ It’s a constant buzz that gets very tiring and, almost by definition, can never end. The seasoned worrier can always come up with one more scenario, one more possibility that just might lead to disaster.




Test yourself. Answer these questions with ‘Occasionally’, ‘Often’ or ‘Never’. Do you …

1. Imagine what might go wrong whenever you have to do anything or go anywhere even a little out of the ordinary?

2. Use the expression ‘what if’ (‘what if x or y were to happen’) to others or in your mind?

3. Check more than once that you have everything you need when you go to a meeting or on a trip?

4. Double check things (such as whether doors are locked) you know you have checked already?

5. Scan your environment for risks and things that might be going wrong? The more ‘Oftens’ you score, the greater the likelihood that you experience this kind of anxiety.


One way to reduce this type of anxiety too is to identify some of the underlying beliefs that may be sustaining it. Here are some possible beliefs. Use the space below them to add any of your own: Belief 1: ‘It is possible to foresee all eventualities’ Belief 2: ‘I am responsible for averting possible disasters’ Belief 3: ‘Thinking ahead keeps me secure’ My beliefs:



Review the section on ‘Changing your beliefs’ (above), then consider: Are any of the beliefs you have listed here open to change? What might be a new belief that could replace them? What role does this type of anxiety play for you? We’ve noted that worry and anxiety can play a role, often providing a sense that we are in control. What do you gain from this type of ‘foresight’ anxiety? What do you risk losing if you lessen it?



Tips for reducing ‘foresight’ anxiety

1. Again the big one – the change of mindset. The shift that’s needed is

towards acceptance that you can’t cover all the bases. All you can do is take reasonable precautions, and that’s it. The anxiety you feel comes from hanging on to control that you don’t really have. Relief comes from relinquishing your attempts at control and letting go.

2. Be explicit – what disaster are you trying to avert? You can ease a state

of generalised anxiety about whether things are going to be alright by spelling out what precisely it is you are worried about. The answer is often: ‘Well, nothing really.’ Or if there is a specific worry, you can take steps to deal with it. ‘Foresight’ worriers are usually great in a real emergency, very cool and not at all anxious – it’s uncertainty and what could happen that makes them nervous.

3. Catch yourself imagining worst case scenarios: ‘foresight’ worriers

often have vivid imaginations (I know I do), and can imagine very obscure and unlikely ‘worst case scenarios’. The trick is to become an observer of yourself imagining the worst, so that imagining worst case scenarios just becomes something you do – these awful possibilities just pop into your mind. You just observe them then let them float away.

4. Turn your ‘what ifs’ from negative to positive: make yourself imagine

all the good things that just might happen instead of the bad.

5. Learn to laugh at yourself: ‘Foresight’ anxiety has a funny side – all that checking and double checking, all those elaborate possible worst case scenarios. Start to see the funny side and it can help you let go.



Anxiety leading to overworking (often disguised as conscientiousness) This kind of anxiety is about getting things done and getting them done right. People who experience it often have a strong work ethic and are very conscientious. At a moderate level conscientiousness, like foresight, can be useful. It’s good to get things done, have high standards, pay attention to detail. Anxiety about getting things done right can, however, lead to less healthy consequences. Anxiously conscientious people are often slow to get started on tasks as they spend a lot of time preparing; they sometimes spend longer than they need to as they check and recheck; they’re often reluctant to delegate or if they do then they thoroughly check the other person’s work, and often find it wanting. As a result they are likely to work long hours as work piles up. They can even get almost obsessional, their anxiety causing them to feel, for example, that if a single detail in a piece of work is wrong, then somehow catastrophe will ensue.

The big test

Once again the big test as to whether our conscientiousness crosses the line into over-anxiety and excessive worry lies in bringing to light an assumption. In this case the assumption may be something like this:

I can get everything right Like the ‘foresight’ anxiety assumption, this one too is essentially a belief about control. It runs something like this: if I give the tasks I have to do all my energy and attention, if I work hard, do it all, take responsibility for getting everything right, check all the details, correct all the errors, I can get everything done, and done right. The problem is that this kind of belief soon leads to overworking, constant anxiety about work so that it is hard to switch off and a way of living where work is so central there is little space for the rest of life.





1. Mentally go over work you are doing or have just done when you are supposed to be relaxing?

2. Imagine there may still be errors in work you have already checked? 3. Feel you never have quite enough time to do things as you would ideally

like? 4. Find delegation time-consuming: you end up practically re-doing the

whole thing? 5. Work late, or bring work home to do at evenings or weekends?



As we saw earlier, it can help to reduce the different types of anxiety if we can identify some of the underlying beliefs that may be sustaining them. Here are some possible beliefs underlying ‘conscientiousness’ anxiety. Use the space below them to add any of your own: Belief 1: ‘Work is the most important thing in life’ Belief 2: ‘If I don’t get things right, disaster will ensue.’ Belief 3: ‘Only if I check everything can it be right’ My beliefs:



Review the section on ‘Changing your beliefs’ (above), then consider: Are any of the beliefs you have listed here open to change? What might be a new belief that could replace them? What role does this type of anxiety play for you? We’ve noted earlier that worry and anxiety can play a role, often providing a sense that we are in control. What do you gain from this type of ‘conscientiousness’ anxiety? What do you risk losing if you lessen it?



Tips for reducing ‘conscientiousness’ anxiety

1. A change of mindset: the shift here is towards accepting that you have

choices. You can choose to spend more time on this task and less time on that, depending on priorities and resources. You can choose to give a lot of attention to detail here, and not much there, depending on demands and deadlines. You can choose to accept that certain desirable but not essential things simply will not get done – and that this is OK.

2. Do one thing at a time – and be completely present as you do it.

Anxiety increases if we worry about the next task while doing the current one. Try as far as possible to finish tasks rather than have several open at the same time. Completing something, however small, is a great antidote to anxiety.

3. Stay in touch with your abilities: ‘conscientiousness’ anxiety can

sometimes lead to a kind of panic as we suddenly lose our confidence and feel overwhelmed by the task in hand. The trick to getting back in touch with your own competence and capability is to remind yourself of similar tasks you have successfully completed in the past.

4. Check only once: restrain yourself from checking more than once. Get

used to a more spontaneous style of working where you fly by the seat of your pants.

5. Change the balance between work and relaxation: get help from a

coach if necessary. The more you relax, the more you feed your spirit and soul, the more you carve out space to renew yourself, the better you will work. And the better you work, the less you’ll experience ‘conscientiousness’ anxiety. This kind of anxiety arises often because we daren’t let go of control and simply trust our abilities. Yet the more we trust our abilities, the better we’ll use them to get things done right with less pressure and stress.



Anxiety as a response to fear For many of us fear plays a greater role than we realise in our reactions to the world and its demands. We’re not talking about the kind of gut-wrenching fear that triggers a fight or flight response but rather those fears that live in the emotional brain damped down much of the time by our more analytical and rational selves. Fear of failure, for example, or fear of not pleasing our boss, or fear of rejection. The existence of these kinds of ongoing fears can show up in the form of anxiety and worry. Our anxiety can be a response to fears of many kinds. Here are just a few of the fears that can feed our anxiety …

• Fear of not being good enough • Fear of failing • Fear of not meeting others’ (or our own) expectations • Fear of others’ demands that we can’t meet • Fear of saying no • Fear of being overwhelmed • Fear that others won’t like or accept us • Fear of looking a fool or having one’s ignorance exposed

List here any fears you recognise in yourself that can result in anxiety:



Anxiety due to fear of overwhelm This section looks at three examples of fears that often underlie anxiety. The first we’ve called ‘fear of overwhelm’ and it is linked to the efforts we’ve seen that anxious people often make to stay in control. This kind of overwhelm is linked to tasks and responsibilities and getting things done; it is similar but not identical to our third example: ‘fear of others’ demands’. We saw earlier that anxiety is often disguised as conscientiousness. People who are conscientious (or rather over-anxious about doing it all and doing it all right) often take on a lot, then worry about getting weighed down by all the demands and responsibilities. All the things they have to take care of can start to loom as one large, impenetrable cloud. They can experience a dread of things spiralling out of control: what we’re calling fear of overwhelm. As this fear comes nearer the surface, they may, for example, over react if anyone comes up with a new idea that could mean extra work (the anxious person is trying to protect themselves from being overwhelmed and this new idea, however good it is, can seem like a threat). The fear is often fed by imagining worst case scenarios (a characteristic, as we saw earlier, of ‘foresight’ anxiety), worrying about ‘might happens’, new demands they fear may push them from a state of just coping to being out of control.



Is your anxiety sometimes due to fear of overwhelm?


1. When you’re very busy, imagine things that just might happen, things that, if they did happen, would put extra pressure on you?

2. React emotionally, whether you show it or not, when someone wants to talk about a new project (in person or by email) when you feel up to your eyes in the ones you’ve got?

3. Lose sleep over whether you’ll get everything done? Lie awake at 4 am with things that ‘might happen’ going round your head?

4. Become inflexible, feel very protective of the schedule you’ve worked out to get things done such that you react very negatively when anyone asks you to consider a change?

5. Feel busy but unfocused, moving from one project to another and back, an uneasy feeling in the pit of your stomach that you’re not really getting anything done?




Tips to beat anxiety due to fear of overwhelm

1. Stop and acknowledge what you are feeling: if you’re teetering on

the edge of losing control, make reducing the pressure on you your first priority. Take a break. Review your tasks and make a more realistic estimate of what you can get done by when. Delegate. Accept that certain things will not get done. Do what it takes NOW to regain a feeling of calm and control.

2. Identify any specific fears: a ‘might happen’ that looks as though it will

happen, for instance. Be explicit about what you are worried about. Accept changes to deadlines and schedules if they are inevitable. Don’t waste energy fighting against what you can’t change. Review your tasks again and integrate any new factors, then again make a realistic estimate of what you can get done by when. Keep your boss in the loop but don’t be apologetic. State assertively what you can do and what you can’t.

3. Prune your tasks down to their essentials: accept that you can do

what you can and no more. This way, you’re in control not the task: you do the task in a way that’s possible, and comfortable for you. Delete all emails that are not absolutely crucial and don’t feel you have to break off and reply immediately when new ones come in. You are in control, not your Inbox.

4. Give your attention to one task/domain at a time: get into it and

rediscover your confidence by producing results.

5. Recognise your own inflexibility: as a protective measure you can be inflexible as you try and protect your schedule from additions that could increase your feelings of overwhelm. Be aware that this is what you do – don’t blame others for making suggestions or demands. They don’t know that they feel like the last straw!



Anxiety due to fear of failure Fear of failing is widespread in our success-oriented culture. If you look around at those people you feel are the most confident and successful, in a significant proportion, fear of failure will be lurking somewhere inside. In some cases it’s what drives them on to constantly achieve. It’s as if they are saying to themselves: ‘if I stop, I’ll fall, and fail. If I can just keep going, keep achieving, I’ll be OK.’ These are often the people who keep their fears well hidden, even from themselves. In other people, fear of failing is not so far below the surface. These are often people who are hard on themselves, people who make big demands on themselves but worry that they will not meet their own high standards. They sometimes do not achieve their potential due to anxiety about putting their heads above the parapet in case they are knocked down. What can happen to people who experience anxiety relating to fear of failing is that they can lose touch with their inner strengths and abilities. Tasks they have the ability to do can sometimes feel impossible; it’s as though there is a physical barrier between where they are stuck in their fear, and their actual talents and abilities. What they have to do is break through that barrier and rediscover their own skills.



Is your anxiety sometimes due to fear of failure?


1. Experience stabs of self-doubt – even in areas where you know you are perfectly capable?

2. Notice it when others don’t express appreciation, satisfaction or praise of what you’ve done? Wonder: Did they hate my work? Am I doing well enough?

3. Decide not to go for opportunities that will take you too far out of your comfort zone? Justify your decision with all kinds of rationalisations?

4. Forget/ignore your past achievements? You have this feeling you’ve never really done anything and have to be reminded of what you’ve done before?

5. Find it hard to accept compliments – you don’t really believe you’re that good? If people think too well of you, you might have to use all your talents, and you could fail.




Tips for dealing with anxiety due to fear of failure

1. Think less, do more: don’t give yourself the chance to wonder if things

will be OK. Just do it!

2. Stay in touch with your abilities: if you ever get that feeling of not knowing, of never having done anything before, stop, acknowledge that you have slipped into this state of losing touch with your abilities. Focus on the task in hand and spell out what is required. Doing this will force you to tap into what you know and will start to bring you back into your abilities.

3. Lay out past achievements: write them down somewhere and have

them to hand. They are very valuable as a resource to remind yourself of past successes and counter that feeling that you don’t know anything.

4. Inhabit your whole body, not just your head: learn to use all your

resources: head, heart, gut, spirit. Being too much in your head can mean you don’t know what you’re feeling so you experience anxiety as a kind of uneasiness you don’t know what to make of.

5. Make a start: do something rather than nothing. Shake yourself out of

your fear.



Anxiety due to weak boundaries and fear of others’ demands

People who experience this kind of anxiety can find themselves being too easily invaded by others. They fear the consequences of others’ demands on them (doing things they don’t want to do, overwhelm) without really knowing how to avoid them. These are people, crucially, who find saying no hard, who feel if they say no to someone they are letting them down, or perhaps displeasing them. So they often go along with things that don’t suit them, or take things on they haven’t time for such that they can feel overstretched. The way to combat this kind of anxiety is to strengthen your boundaries, develop a clearer sense of what you will and won’t allow others to demand of you. Strong boundaries come with a strong sense of self such that you are able to assert your own needs in a calm and healthy way.



Is your anxiety sometimes due to weak boundaries and fear of others’ demands? Test yourself. Answer these questions with ‘Occasionally’, ‘Often’ or ‘Never’. Do you …

1. Say yes to things you either don’t want to do, or have not the time to do? 2. Beat yourself up for saying yes when you should have said no? 3. Assume when someone asks you to do something, or go somewhere that

you have to say yes? 4. Think about saying no, but realise you have no idea how? 5. Worry, if you do say no, how the other person will cope, or if they are

offended? The more ‘Oftens’ you score, the greater the likelihood that you experience this kind of anxiety.



Tips for reducing anxiety by strengthening boundaries

The change of mindset: here the shift that needs to happen is from ‘if others need me I must say yes’ to ‘it is OK to say no if I don’t want to or haven’t time to do what others want from me.’ For many people this is a big shift: one from putting themselves last to putting themselves first – not in a selfish but rather in a self preserving way. If you drain your energy by constantly going the way others want you to, you will have little left to develop your unique skills and talents and make a real contribution to the world. Learn ways of saying no: get help from a coach, if necessary. One way is to say what you can do first then what you can’t: ‘What I can do is give you my notes from last time. What I can’t do is the actual presentation.’ Other useful forms of words include: ‘I’m sorry but that doesn’t work for me.’ ‘That’s not something I want to get involved in at present’. Get clear about what you want and don’t want: it’s easier to say yes or no to a request if you have a clear idea of what does and doesn’t suit you. It’s important, if you are saying no, not to give very specific excuses. If you say, for instance, ‘I’m sorry I can’t make Wednesday’ it leaves them free to suggest another day. If you don’t want to do it at all, then you need to use one of the more general ‘it’s not something I want to do’ forms of words. Sympathise with others’ problems but don’t take them into yourself: by all means help others but always remember their problems are their own, not yours. People with weak boundaries often take others’ ‘emotional stuff’ into their own bodies in a way that can sometimes cause them eventually to burn out. Be clear and explicit with yourself about your boundaries: clarify what you will and won’t accept in terms of demands from others.



RESOURCES Some extra resources to reinforce what you’ve learnt here:

Coaching

Working with a personal coach can help you put into practice some of the suggestions made in this Useful Guide, especially in areas such as recognising overwork and overwhelm, and learning ways to say no. I offer a free self assessment with email feedback and an invitation to a taster phone coaching session. Go to: http://www.chriscoach.com. To find an accredited coach in the UK, go to http://www.coachfederation.org.uk (ICF accreditations are ACC, PCC, MCC; I am a PCC: Professional Certified Coach).

The Enneagram

A great personality tool that helps you gain insight into your own behaviour and attitudes. You type yourself rather than having your type imposed upon you. The nine types are arranged in triads – one triad (types 5,6,7) has the underlying emotion of fear/anxiety, though not everyone in these types is aware of their anxiety. The model also helps you see how you react under stress. To learn more, go to http://www.enneagraminstitute.com, or try ‘The Enneagram Made Easy’ by Baron and Wagele.

Yoga

Anxiety can make your head buzz in uncomfortable ways. An excellent way to get out of your head and into your body is to join a yoga class. Try to find one that combines the ‘asanas’ (postures) with deep breathing and relaxation. A particularly useful side effect of doing yoga is often that your breathing slows and you are calmer inside.

Other Suggestions

• Hypnotherapy: some people find working with a hypnotherapist can help

with certain types of anxiety. • Neuro Linguistic Programming (NLP) offers way of changing beliefs and

mindsets that can help clear out old ways of looking at the world that are no longer useful.

http://www.chriscoach.com/�

http://www.coachfederation.org.uk/�

http://www.enneagraminstitute.com/�



Acknowledgements

Big thanks for help and support to the Monday Coaching Co-op (especially Amechi Udo and Martin Howarth), the Cambridge Enneagram Group led by Thomas Hillas, my website designer, Melanie Saunders, and most of all, my partner Terry Moore for reading all the drafts and giving me such wonderful encouragement.

About Chris Carling

Chris Carling is a communication expert, mediator and ICF Professional Certified Coach, with over 2,500 hours coaching experience. A former Director of Communications of the International Coach Federation (UK), Chris has worked as a coach and/or facilitator with a wide range of individuals and organisations in sectors including finance, theatre, pharmaceuticals, local government, education, construction and architecture. Before becoming a coach she ran her own consultancy as a management training specialist and writer/developer of training materials. She is a script-writer of award winning videos, co-author of two books on communication and developer of a pack for trainers aimed at nurturing creativity in the commercial world (Creativity for Competitive Advantage, Fenman). She has an MA and PhD from the Exeter University and an MPhil in Linguistics from Cambridge University.

Contact Chris Carling

By phone: 01223 367271 By email: mailto:[email protected]

mailto:[email protected]�



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