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ОглавлениеChapter Two
The Anxious Brain
Anxiety is sneaky. It wears many masks. The more intensely a person experiences anxiety, the more difficult it can sometimes be for them to tell the difference between anxiety and a host of heightened emotional states such as excitement, anticipation, surprise, stress, nervousness, agitation, anger, frustration, and others. This confusion can be especially strong when a person is struggling with panic attacks. In such cases, something as benign as simply feeling excited about an upcoming birthday celebration can sometimes trigger fear that another panic attack is just around the corner if they allow themselves to get “too overstimulated.” Ironically, obsessively attempting to live a less stressful or stimulating life can become its own stressor, as the person feels both overwhelmed by the impossibility of the task and suffocated by the sense that their life just keeps getting smaller and smaller. Agoraphobia — where a person can become so fearful that they cannot leave their house — is a perfect, albeit extreme, example of this.
Even people who do not experience crippling levels of anxiety can be helped by learning how to distinguish between the various emotional states that are often confused with or can lead to anxiety.
For instance, a prominent public speaker I once worked with perceived an increased heart rate, slight sweatiness, and light-headedness before speaking engagements. These feelings caused her to imagine a cascading series of events that would undoubtedly go wrong and ruin her talk and, ultimately, her career. Over the course of several sessions, I was able to help her reinterpret these sensations and come to see them not as anxiety but rather as a kind of anticipatory excitement — a sign that her body was ramping up to help her put on a dynamic presentation. Reframing her experience as an adaptive response — rather than a threatening one — helped her see that her body was actually trying to help her do a good job. Understanding these sensations in a new light enabled her to more effectively focus her mind on the performance she was about to give. Because excitement (along with most heightened emotional states) triggers increased heart rate and respiration, muscle tension, retinal dilation, and increased body temperature, including perspiration, excitement can easily be interpreted by the body as anxiety. This simple reframing intervention did not completely cure my client — who was struggling with other issues as well — but it did allow her to more effectively reinterpret and manage the physiological symptoms that were threatening her ability to go on stage.
An Ocean of Emotion
We’ll talk more about how the mind creates your feelings (and can learn to change them) in the next chapter. For now, it’s enough to know that every emotion begins with molecular shifts that occur throughout your body as you interact with the outside world. Neuroscientists refer to emotions as molecular action programs. Everything that happens to you, every choice you make, every thought you think, every response you make sends a wash of hormones, neurotransmitters, and other chemicals through your body. An emotion, then, is simply the process of your primitive brain (your limbic system) collecting all this information to allow you to identify the change that has occurred in your physical, psychological, relational, and/or spiritual well-being.
But that’s a lot of information to gather. The primitive part of your brain responsible for collecting information about the molecular shifts in your body is too unsophisticated to say whether a particular change is good or bad, much less what you should do about it. That job belongs to a much more advanced part of your “thinking brain” called the insular cortex (IC). It’s the IC’s job to take all the information from the primitive brain about the various micro-shifts constantly occurring in your body and give that constellation of symptoms (heart rate, body temperature, degree of muscle tension, respiration, chemical shifts, etc.) a label that identifies it as a particular emotion. Having labeled it, the IC then sends messages back down to the primitive brain so it can tell your body how to adjust or what behaviors to enact so that you can function most effectively in any given situation.
I Love Lucy’s Brain
The IC usually does a great job, but when it gets bombarded with too much information too fast, sometimes the process breaks down. There is an old gag that first aired on the classic television program I Love Lucy. Lucy and her friend Ethel are at work in a chocolate factory. Their job is to wrap the chocolates that roll past them on a conveyor belt so that they are ready for packing. The supervisor, fed up with them for having failed at every other job in the plant, tells them that if even one chocolate goes to the packing department unwrapped, Lucy and Ethel will be fired.
It all starts out just fine. The chocolates roll past at a manageable pace, and Lucy and Ethel capably and confidently wrap each piece. Suddenly the conveyor belt starts speeding up. They have to move faster and faster. Pretty soon, they are mortified to discover that they just can’t keep up. In desperation, Lucy and Ethel start shoving chocolates in their mouths, stuffing them down the front of their dresses, hiding them in their chef’s hats, hiding them around the room — anything to prevent the chocolates from getting to the packing department unwrapped and costing them their jobs. The supervisor comes out and, failing to notice that their mouths and uniforms are bursting with candy, sees that the conveyor belt is empty, compliments them on their good work, and yells up the production line, “Speed it up a little!”
Sometimes, especially when people struggle with chronic anxiety, the IC is like Lucy in the chocolate factory. The primitive brain/limbic system is throwing so much information at it so quickly, the IC just can’t wrap each emotion in the correct package. Eventually it gets overwhelmed, labels everything “anxiety” just to get it over with, and goes fishing.
Why does this happen? For some people it’s because they have either lived through prolonged, traumatic events or at least experienced singularly stressful situations that left their nervous systems stressed and overwhelmed. For these folks, their IC gave up a long time ago. As a result, every time they experience almost any heightened emotional state (excitement, stress, anger, anticipation), it feels like anxiety.
Other people may not have experienced particularly traumatic events in life, but they simply have an underdeveloped IC that can’t process information as rapidly as it should. The good news is that, for either of the above groups, brain research shows that the brain is like a muscle. Just like physical exercise builds muscle tissue, creating bigger muscles, different thinking exercises and behaviors create thicker, faster neural connections between different parts of the brain. The process by which we can “beef up” the volume of different structures in the brain is called neuroplasticity. Neuroplasticity allows the brain to constantly rewire itself so that it can retain new information and adapt to new environments.
A Body of Fear
The process of reframing that I described at the beginning of this chapter (in the story of my public speaker client) is one simple exercise that helps the IC learn (or, in some cases, relearn) its job of wrapping and packaging emotions correctly. Consciously renaming a particular experience as something else teaches the IC to stop automatically slapping an “anxiety” wrapper on every heightened state that bubbles up from the primitive brain and, instead, be more and more sophisticated and efficient at detecting subtle differences between different heightened states.
It is beyond the scope of this book to help you identify all the different feelings that can masquerade as anxiety or trigger feelings of anxiety. But the most important distinction to make is the one between anxiety and fear. Although people commonly use these two terms interchangeably, from a psychological perspective they are quite different. Fear is the natural, biological, and appropriate response to an imminent threat. Anxiety is when the brain’s natural fear circuits get hijacked by something that isn’t an immediate danger or could even be good for us (for instance, accepting a great new job or standing up for ourselves). In a sense, anxiety is fear’s evil twin.
We develop the capacity for fear early. By eight months in utero, a baby’s fear and protection circuitry is fully developed and ready for action. Throughout life, in the face of a real threat, this circuitry injects chemicals into our brain and bloodstream to ramp up our senses and speed up our reaction time so that we can see all the ways we could respond and, if necessary, escape. When the fear-systems in our brain work properly, they serve a protective function, warning us away from danger and easing off once the threat has passed.
Anxiety hijacks this God-given fear-threat system and causes us either to fear things that could be good for us (e.g., new opportunities, commitment in a healthy relationship), experience disproportionate responses (either in intensity or duration) to actual threats, or suffer feelings of panic when, in fact, no danger exists (e.g., panic attacks).
In short, fear, as unpleasant as it may be, can be a great gift, a servant of our physical, emotional, and spiritual health and well-being. But anxiety represents a threat to our physical, emotional, and spiritual integrity that, left unchecked, can tear our lives apart.
Feeling Burned Out?
People often say they feel “burned out” by their struggles with anxiety, but most are unaware of the deeper truth behind this metaphor. Imagine soaking your hands in bleach for several hours, even days. You would get a chemical burn that left your skin severely raw and irritated. Even brushing up against something afterward might hurt tremendously. In a similar way, the chemicals (glucocorticoids) produced by the brain’s fear response are caustic. When persistently stressful or traumatic events trigger prolonged or too intense exposure to these chemicals, they create something like a chemical burn on your amygdala, the CEO of the fear/protection system. At the very least, this can cause us to feel every stressor more acutely, making it harder to respond in a calm, rational way. If anxiety persists, the amygdala blasts chemicals at another part of the brain called the hippocampus, which stores emotional memories.
If the amygdala is the CEO of your fear/protection system, the hippocampus is the board secretary. While the amygdala is triggered in the presence of a threat, it’s the hippocampus’ job to “take notes” and remember that a particular event was anxiety-producing in the past. The next time you encounter that same event, or even something remotely similar, the hippocampus triggers the amygdala and reminds you that you “should” feel anxious — even if there is no practical immediate threat present. In the face of long-term stress, or an unusually traumatic stressor, the amygdala can blast so many stress chemicals at the hippocampus that it can cause it to shrink (like you might curl up in a ball if someone was yelling at you for a long time). When this happens, we tend to become less emotionally flexible and more easily stuck in unpleasant emotional states. In a sense, as the hippocampus shrinks, the secretary loses the notebooks filled with our happy memories and resourceful ideas and retains only the notebooks filled with frightening, scary, and traumatic experiences. Although this is not a pleasant experience, our brain responds this way to constant or overwhelming stress so that we can always be ready to respond to whatever new threats come our way.
At its best, this partnership between the amygdala and hippocampus enables us to anticipate and head off potential problems. At worst, it causes us to develop an anxiety disorder in which an undercurrent of constant worry or even bursts of terror intrude upon every aspect of our lives.
The takeaway from all this is that even though fear and anxiety feel very similar to one another — because they both are produced by the same fear-threat system in your brain — they are very different phenomena. The person experiencing fear reacts because they are having a genuinely protective, biologically pre-programmed reaction to an imminent threat to their safety or wellbeing. For instance, if you cross the street and notice a car bearing down on you, fear causes you to run across the street to get out of the car’s way. If someone was chasing you, intending to do you harm, fear would cause you to run faster to try to get away. If you were unable to escape, fear would enable you to fight back and defend yourself against your attacker. In the worst case, if you couldn’t get away, fear would cause you to try to hide and be as still as possible in the hopes of escaping your pursuer. As distressing as all these scenarios might be, they make sense. All these different responses to these various threats are adaptive. They are intended to preserve your life and safety. An immediate threat to your wellbeing provokes an immediate, defensive response.
Anxiety, on the other hand, is akin to suffering a pinched nerve in the brain’s fear-threat system. The pain is real enough, but it’s the result of something happening inside of you, and not a response to an external, physical threat. For instance, if you had a pinched nerve in your leg, you wouldn’t call an ambulance. You would feel pain, and it might hurt terribly, but you would (1) recognize that the pain was coming from the inside of your body, not from an outside assault; (2) focus your attention on trying to breathe through the cramp and relax your leg; and (3) eventually engage in some limited exercise to work through any remaining soreness.
Three Steps to Anxiety First-Aid
One of the simplest ways to help your brain do a better job of dealing with anxiety is similar to that intuitive three-step approach I described that most people use for dealing with any other pinched nerve in their body: Relabel, Reattribute, and Respond. These steps are adapted from psychologist Jeffrey Schwartz’s groundbreaking work treating OCD as described in his book Brain Lock.
Step One: Relabel the Threat
You feel anxious. Don’t act out. Don’t start thinking obsessively about what you can or should do to try to get control of whatever is happening around you. Instead, check the feeling. Ask yourself, “Am I responding to an imminent (not a past or potential future) threat to my life or safety?”
Remember, fear is an appropriate response to an imminent threat. It kicks you into high gear in the moment so that you can escape some clear and present danger — and then it goes away. That’s how fear is supposed to work.
Anxiety, on the other hand, tends to be a fear response triggered by something that has either happened a long time ago, has not yet happened, or may not actually be happening at all. Likewise, instead of kicking you into high gear so you can escape an imminent threat to your life or safety, anxiety tends to hang around and haunt you. For instance, if you are afraid you might have said something embarrassing while out to dinner with your friends last week, you might keep replaying the scene over and over in your head and experience a low-grade sense of dread. Or if you have to give a presentation at work next week, you might imagine all the ways you might make a fool of yourself and struggle with a constant feeling of dread and terror. Or, alternatively, for no reason at all, you might just be suddenly struck with an overwhelming sense of panic that causes you to feel like something terrible is going to happen.
The feelings associated with each of these experiences is not fear, but rather anxiety, because you are not responding to an imminent and obvious threat to your safety or wellbeing. In each of these instances, your fear-threat system — the part of your brain that is supposed to help you respond to imminent threats to your health and safety — is actually being hijacked by something that may be concerning but is certainly not an imminent threat.
What difference does this make? It means that in each of these cases, you are not really experiencing fear. Rather, you feel fearful in these instances because the concerning event caused a misfiring of your fear-threat system. This is a small, but significant difference. It means that the answer to your problem — despite how you might be feeling — is not obsessively thinking about how you could apologize for an offense you’re not even sure you committed, staying up all night trying to figure out how you are going to pay your bills and where you are going to live after your boss fires you for messing up the presentation, or obsessively looking around for something — anything — to blame for your looming sense of panic and dread. Instead, you must step back and help your insular cortex relabel your experience of anxiety, not as a reasonable reaction to an obviously threatening situation, but rather as a sign that your fear circuits in your brain are misfiring. Instead of running around trying to figure out how you can fix something going on around you, you must instead figure out how to control your brain and body. Then, and only then, will you be able to correctly assess what to do about the situation itself.
Step Two: Reattribute (and Relax)
Once you have determined (however tentatively) that the situation triggering your anxiety is not the source of any imminent, immediate danger, the second step is to relax your body. As I indicated above, instead of continuing to tell yourself that “I am anxious because X (non-life-threatening event) happened” you must reattribute the anxiety you feel to a “pinched nerve” in your brain that results in the misfiring of your fear-threat system. You can then intentionally shift your focus away from the concerning event for the time being (we’ll come back to it in a minute) and refocus on relaxing your body and getting your fear-threat system back under control.
I want to be clear. In stating this, I am not saying that your anxiety is not real. It is very real. Because anxiety hijacks the fear-threat system, you are feeling genuine fear, perhaps even a crushing amount. What you are reading here should not be interpreted to suggest that your anxiety isn’t a serious problem. In fact, what I am asserting is that more than some figment of your imagination, problems with anxiety are always serious physiological events. The good news, however, is that rather than being made fearful because of some situation that is largely outside of your control, your anxiety is actually being caused by a process that, with practice, you can learn to control.
Anxiety is controlled by two different systems in the Autonomic Nervous System, the neurological system that is responsible for things like heart rate, respiration, blood vessel constriction, temperature, etc. The sympathetic nervous system (your “speed up” system) acts like a gas pedal. Stimulating it makes your bodily systems race. By contrast, the parasympathetic nervous system (your “slow-down” system) is like a brake pedal. These two systems function in harmony with one another, but they can also function independently — just like the gas and brake pedals on your car can be used separately or simultaneously depending on what the situation calls for.
When you feel anxious, your “speed up” (sympathetic) nervous system is being hyper-activated. In essence, the gas pedal is floored and stuck. The good news is that you can unstick the gas pedal by tapping the brake, i.e., activating the parasympathetic nervous system. At first, your metaphorical engine might continue racing, even after you’ve applied the break. But within about fifteen to twenty minutes, your brain should re-regulate and sync back up again. With practice, it’s possible to learn to get this process to happen within seconds. There are actually a few simple ways to do this.
One of the most effective, yet simplest, techniques involves consciously speaking and acting more slowly than you feel like you want to. Often, when we are anxious, our thoughts and speech automatically race. On top of this, because our brain is preoccupied with being anxious, we stop paying attention to what we are doing. Both of these symptoms are signs that our sympathetic (speed-up) nervous system is over-engaged.
But we can learn to reach down and “unstick” the gas pedal by intentionally activating our parasympathetic nervous system (slow-down system). Intentionally speaking a little slower than we want to, acting a little more slowly and intentionally than we naturally prefer in that moment, and forcing ourselves to pay attention to what we are doing taps the brake pedal. This creates little bit of a jarring sensation as the speed-up and slow-down nervous systems try to sync up with each other. They don’t like to be at odds with each other, so consciously depressing the brake on the slow-down nervous system unsticks the gas pedal and forces the speed-up nervous system to stop racing.
We’ll discuss more sophisticated interventions later in the book, but here are a few other simple techniques that can help you consciously regain control of your runaway speed up nervous system.
Deep breathing exercises can be tremendously helpful for getting your sympathetic nervous system unstuck. Here is a simple one. Place one hand on your stomach and one hand on your chest. Close your eyes. Breathe in through your nose for the count of four, hold your breath for the count of seven, and blow out through your mouth to the count of eight. Repeat for at least five minutes or until the anxiety passes.
To someone struggling with anxiety, suggesting that they should breathe deeply can seem remarkably stupid and banal, but it turns out there is solid science behind it. Recent research by scientists at Stanford University School of Medicine found a small patch of 175 nerves, deep in the brainstem, that act as an emotional pacemaker. These nerves monitor how quickly you are breathing and relay that information to a different part of the brain that monitors your state of mind. It turns out that you can trick these nerves into thinking that you are calmer than you actually feel by intentionally breathing deeply and slowing down your respiration rate. Although you might be tempted to dismiss the power of simple suggestions like “take a deep breath” for relieving anxiety, science shows you may be missing out if you do.
Reflective prayer (as opposed to “Help! God, save me!”) is also very helpful to “tap the brake” and slow down your brain and body. We’ll discuss spiritual interventions for anxiety in more depth later, but a simple way to employ prayer is to close your eyes and intentionally recall the times God has been faithful to you or carried you through a difficult time. Take a moment to praise God for these things. Your heart won’t be in it at first, but that’s okay. It’s what Saint Paul called a “sacrifice of praise” (Heb 13:15), and it helps to remind you of the fact that if God has been present to you so many different times in the past, he isn’t going to fail you now. It also reminds you of all the other times you were sure your life was going to irreparably fall apart, but miraculously it didn’t.
Grounding is another simple way to “tap the break” on your slowdown nervous system. Grounding reconnects you with your body and the present moment instead of letting you fly away with your thoughts. Count five things you see, four things you hear, three sensations you are feeling in your body. Identify two people who care about you, and one simple thing you could do to feel even a tiny bit better right now (for instance: have a hot cup of tea, listen to your favorite music, do something you enjoy for a few moments). This technique works because anxiety wants your thoughts to race ahead to anticipate all possible future problems. Forcing yourself to re-focus on the present moment, especially at this level of detail, activates your para-sympathetic nervous system and slows the anxious brain’s tendency to race ahead.
Finally, reconnecting with others can be tremendously important. Go to your spouse or a good friend and ask them to give you a hug. Don’t be quick about it. Relax into the hug until you feel yourself exhaling the stress. Hugging actually syncs your heart rate to the other person and increases the presence of oxytocin, a powerful “calm down” hormone produced through interpersonal bonding.
Each of these simple exercises, alone or together, have been shown to have a powerful impact on the autonomic nervous system, causing it to let up on the gas and depress the brake and at the same time rapidly decelerate the stress response.
The problem is, most people think doing any of these things is nonsense. “How is breathing and getting a hug going to stop me from losing my job when I screw up my presentation? Don’t be an idiot!”
Remember, unless there is an immediate threat to your life or wellbeing, you should not be experiencing fear. If you are, something in your nervous system is misfiring. The more you ignore this simple biological fact and instead try to control all the outside factors that might be causing the anxiety, the more anxious and out of control you will feel. Because you are ignoring the real cause of your anxiety, the unnecessary or disproportionate triggering of your autonomic fear response, any attempts to “fix” the problem by trying to control your external world will simply backfire. First, remind yourself that having a legitimate concern about X does not mean that X is an imminent threat, and then refocus on getting this fear-threat system back under control. You will be able to consciously and intentionally restore a sense of peace and confidence.
At first, with any of these exercises, depending on the intensity of your experience and how long you have been suffering from anxiety, it might take up to fifteen to twenty minutes of concentrated effort to get yourself back under control. With consistent practice, however, you can reduce this time to mere seconds.
The point is, anxiety — unlike fear — is not a reaction to your environment. Anxiety may be triggered by context, but it is caused by a misfiring of the autonomic nervous system (the combined speed-up/slow-down nervous systems). Because of this, your best hope for reclaiming a sense of peace is to focus primarily on getting control of your body rather than your environment.
Step Three: Respond
The final step in the Relabel-Reattribute-Respond process is addressing the situation that triggered the misfiring of your fear-threat system. Again, just because your anxiety wasn’t strictly caused by something outside of you doesn’t mean there isn’t a real problem to deal with. It’s just to say that the particular stressor shouldn’t be producing the kind of intense, fearful panic usually reserved for an imminent, physical threat.
Now that in step 2 you successfully reattributed your experience of anxiety as a misfiring of your fear-threat system and used several of the suggestions you read above to get your fear-threat system back under control, you’re ready to do something productive about the situation that inadvertently triggered the misfiring of your fear-threat system.
When you are stuck in an anxious response, you can’t effectively problem-solve. You can only react to a problem, which will probably cause you to do something impulsive that can only make things worse. But if you take the time to calm your body down, turn off your fear-based reactive brain, and turn on your thinking brain, you will be in a much better place to respond to the specific event that triggered your anxiety.
The key is “think small.” In fact, the smaller the better. You might not be able to identify the “one big solution” to the problem of your un-supportive marriage, but you can place a call to a marriage therapist right now. You might not be able to figure out how to not prevent your antagonistic boss from firing you, but you can ask yourself how you could do your absolute best on the next step of the project you are working on and write down some ideas, or you could even get your resume together and start looking for a different position. If you can’t think of even the smallest change you could make to affect the problem, then at least ask yourself how you could take a little better care of yourself. Perhaps you could take a walk, call a friend, pray, or do something you enjoy, even for a few minutes.
One of the chief antidotes to anxiety is thoughtful, productive action as opposed to the “chicken-with-your-head-cut-off” reaction that occurs before you have gotten your body under control. If you can convince yourself to make even a small change that helps you respond more effectively to the problem or improves your mood, you will feel more powerful. When you make yourself pursue even a tiny change, you’ll be surprised at how little it actually takes to regain a sense of power in your life, and how much of an impact this sense of personal power has on helping you overcome anxiety.
This three-step process of Relabel-Reattribute-Respond is a simple but powerful way to begin to master those feelings of anxiety that threaten to master you. Begin practicing these tools today. Even if they don’t take away all of the anxiety you feel, they will decrease your overall emotional temperature and help you use the more sophisticated anxiety-busting techniques we will discuss in future chapters. You will be taking some of the first, important steps down the road to a life without anxiety.
Exercise: Relabel, Reattribute, Respond
Directions: Use the following exercise for any situation that causes you anxiety.
1. Relabel.
Identify a situation that causes you anxiety. Write it in your notebook.
Does this situation represent an imminent threat (not a potential, future threat) to your health or safety? Yes or No?
If YES, your fear response is legitimate. Do what you must to escape the situation.
If NO, then you probably need to respond to this situation rather than react to it. Proceed to step 2.
2. Reattribute.
The situation itself may or may not be serious, but your emotional reaction is probably disproportionate. Your emotional reaction is caused not by the situation, but by the fact that the situation has hijacked your fear-threat system. DO NOT respond to the situation at this time. Focus on getting control of your body by doing any/all of the following.
Intentionally slow your rate of speech. Let you mind catch up with your mouth. Slow down until you have eliminated all “um’s” and “ah’s” and can speak what you are thinking calmly, thoughtfully, and without hesitation.
Deliberately slow down your actions. Focus on what you are doing. If your mind is racing ahead to the next activity, bring it back. No matter how mundane the current task is (i.e., reaching for a glass, walking through a room) focus your mind totally on what you are doing in this moment.
Breathe. Use the four-seven-eight breathing technique described in this chapter. Repeat for at least five minutes or until the anxiety decreases or passes.
Pray. Concentrate on specific times you have felt God’s love. Remember times when God delivered you from difficulties. Thank him for these times. Praise him for his constant love and providence. Ask him for the grace to believe that he is right here for you in this moment in the same way, loving you, providing for you, and delivering you just as he always has.
Make connection. Is there someone who could give you a hug? Go to them. Don’t talk about your problem … yet. Just tell them you are feeling out of sorts and need some help pulling yourself together. Relax into the hug. Focus on matching their breathing. Sync your body to theirs. If possible, stay in the hug until you find yourself exhaling spontaneously. That lets you know your “calm down” nervous system is fully engaged.
3. Respond.
Now that you have gotten your body and brain back under control, you are ready to respond (rather than react) to the situation that hijacked your fear system in the first place.
What is one small step you can take to make the situation even a little bit better? Do not look for what you can do to resolve the whole situation once and for all. Just look for one small, even tiny, thing you can do right now to make a small improvement. Do that thing.
Or, if nothing can or should be done at this time, look for one small thing you can do to help you refocus on making the rest of the day as pleasant as possible despite this troubling situation. Do that thing.
The goal of this exercise is to: 1. Help you identify the real source of your anxiety (your body, not your environment); 2. Re-engage your calm-down nervous system so you can respond rather than react to stressors; and 3. Identify one simple step you can take to effectively respond to the problem situation. This process will allow you to, one step at a time, take control of your anxiety and respond more thoughtfully and productively to life’s stressors.
