The Coping With Stress and Anxiety System

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Copyright 2004, Randy A. Gilchrist, Psy.D. All Rights Reserved

Best Used in Conjunction with Managing Stress and Anxiety by THE HYPNOSIS NETWORK

The Coping with Stress and Anxiety System

Welcome to the Coping with Stress and Anxiety System. This system will help you learn to

effectively manage stress and anxiety. In order to get optimum results, it is recommended that you

augment this program with the hypnosis audio CD program Managing Stress and Anxiety.

These techniques are divided into 3 sets of 10 based upon the primary manner each helps relieve stressand anxiety. Accordingly, adaptation interventions help you better adjust or accommodate to stressand anxiety absorbing interventions are preventative efforts to help you delay the onset of

symptoms and reduce symptom intensity and management interventions help you directly remove

or modify the power of the challenge(s) you are currently facing. Choose and rotate these exercisesdepending on your needs and what you find helpful at the time.

Regards,

Randy A. Gilchrist, Psy.D

Adaptation Interventions Page

Abdominal Breathing------------------------------------------------------------- 1

Progressive Muscle Relaxation-------------------------------------------------- 2Biofeedback------------------------------------------------------------------------ 3

Self-Hypnosis---------------------------------------------------------------------- 4

Cognitive Distortions------------------------------------------------------------- 5Balanced Thinking---------------------------------------------------------------- 6

Coping Statements---------------------------------------------------------------- 7Self-Esteem------------------------------------------------------------------------ 8

Support Systems------------------------------------------------------------------- 9

Restful Sleep---------------------------------------------------------------------- 10

Absorbing InterventionsMedical Checkup----------------------------------------------------------------- 11

Nutrition--------------------------------------------------------------------------- 12

Substances to Avoid or Minimize---------------------------------------------- 13Exercise---------------------------------------------------------------------------- 14Relaxing Environment----------------------------------------------------------- 15Meditation------------------------------------------------------------------------- 16

Visualizing a Peaceful Scene--------------------------------------------------- 17Guided Imagery------------------------------------------------------------------ 18Humor----------------------------------------------------------------------------- 19

Stress Education------------------------------------------------------------------ 20

Management Interventions:Coping with Hassles and Life Changes--------------------------------------- 21Problem Solving----------------------------------------------------------------- 22

Time Management--------------------------------------------------------------- 23

Play Time------------------------------------------------------------------------- 24

Taking Time Off----------------------------------------------------------------- 25Assertiveness Training---------------------------------------------------------- 26

Communication Skills----------------------------------------------------------- 27Responding to Criticism-------------------------------------------------------- 28

Negotiation Skills---------------------------------------------------------------- 29

Influencing Skills---------------------------------------------------------------- 30Cited References----------------------------------------------------------------- 31
http://www.hypnosisnetwork.com/hypnosis/stress_anxiety.phphttp://www.hypnosisnetwork.com/hypnosis/stress_anxiety.php


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Abdominal Breathing

Abdominal breathing consists of breathing fully from the bottom of your lungs near your abdomen.

This is exactly the reverse of how you breathe when youre anxious or tense, which is typically

shallow and high in your chest. Relaxing effects of abdominal breathing include drooping eyes andshoulders, lower heart rate, and increased oxygen into your system.

To practice abdominal breathing, observe the following steps:

1) Place one hand on your abdomen right beneath your rib cage.

2) Inhale slowly and deeply through your nose into the bottom of your lungs to the lowest point you

can reach for 4 slow counts. Your chest should move only slightly, while your stomach area risesand pushes your hand upward like an expanding balloon.

3) When youve inhaled fully, pause comfortably (1-3 seconds) and then exhale fully through yourmouth (or nose, if you prefer) for 8 regularcounts. As you exhale, let yourself go and imagine

your entire body going loose and limp. Pause again (1-3 seconds) before continuing.

4) In order to fully relax, take and release ten or so of these breaths. Try to keep your breathingsmooth and regular throughout, without gulping in a big breath or exhaling suddenly. You mightcount each breath as follows:

Slowly inhale for 4 countsPauseExhale for 8 countsPause (count 1)

Slowly inhale for 4 countsPauseExhale for 8 countsPause (count 2)and so on (untilyou reach 10 series of breaths)

*If you start to feel light-headed while practicing abdominal breathing, stop for 30 seconds and then

start again. If you still feel light headed, stop and resume at a later time.

*If the breathing counts or pauses suggested here are uncomfortable, adjust them to your personal

preference. The counts offered here are just suggestions.

Youll find that abdominal breathing will help to slow down or eliminate feelings of anxiety or panic.

In fact, two or more minutes of abdominal breathing can abort a panic attack if you initiate it beforethe panic has gained momentum. Abdominal breathing also counteracts hyperventilation symptoms,

which can be mistaken for symptoms of panic. In general, abdominal breathing exercises will help

change your breathing from a stressful, anxious process into a more relaxed, soothing rhythm. Thiswill help calm your body and provide more oxygen into your system.

(Adapted from Bourne, 1992)
http://www.hypnosisnetwork.com/hypnosis/stress_anxiety.php


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Progressive Muscle Relaxation

Progressive muscle relaxation is a time-honored relaxation technique that effectively reduces skeletal

muscle tension, a principle contributor to anxiety and stress. This exercise tends to work best when it

is done for at least 20 minutes, at a regular time, before or at least 1 hour after a meal, in a quietsetting, and with your head supported. Note: skip tensing any of the muscle groups below that are

excessively sore, painful, or at risk to aggravate a preexisting physical condition.

To engage in progressive muscle relaxation, follow these steps:

1) Clench your fists tightly, holding them 7-10 slowly counted seconds.

2) Feel the buildup of tension in your hands and visualize your muscles tightening.

3) After 7-10 seconds, relax the muscles in your hands abruptly, imagining them going looseand limp. Allow 10-20 seconds to pass before proceeding. Use this same tense, count, and

relax while visualizing process for all of the remaining exercises.

4) Tighten your biceps by drawing your forearms up towards your shoulders and make amuscle with both arms.

5) Tighten your triceps (the muscles opposite the undersides of your biceps). Do this by

extending your arms straight and locking your elbows while tightening your muscles.

6) Tense up the muscles in your forehead by raising your eyebrows up as far as you can.7) Tense up the muscles around your eyes by clenching them tightly shut.8) Tighten your jaw by opening your mouth so wide that you stretch the muscles around the

hinges of your jaw.

9) Tighten the muscles in the back of your neck by pulling your head back as if you were going

to touch your head to your back.10) Tighten your shoulders by raising them up as if you were going to touch your ears.

11) Tighten your muscles by pushing your shoulder blades back as if you were going to touch

them together.

12) Tighten the muscles of your chest by taking in a deep breath and holding.13) Tighten your stomach muscles by sucking your stomach in.

14) Tighten your lower back by arching it up.

15) Tighten your buttocks by pulling them together.16) Squeeze the muscles in your hips and thighs all the way down to your knees.

17) Tighten your calf muscles by pulling your toes towards you.

18) Tighten your feet by curling your toes downward.



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Biofeedback

Biofeedback refers to a method of gaining information about the physiological activity occurring in

your body to gain some control over these responses. To gain a reading of the physical distress or

calm your body is experiencing, a monitoring device is attached to your body to alert you when youare stressed (or relaxed). Then, after paying attention to these alerts, you can lessen times of anxiety

and stress by gaining some control over physical functions previously thought to be beyond yourconscious control, including body temperature, heart rate, muscle tension, and brain waves.

There are three basic forms of biofeedback equipment available for use: muscle tension feedback, skintemperature feedback, and sweat gland activity feedback. Because skin temperature feedback is the

most cost effective and easy to implement, this is the biofeedback format that will be promoted for

this exercise.

There are three affordable, easy to use versions of skin temperature feedback: mood rings, body

temperature cards, and body temperature dots (called biodots). All three make contact with yourskin and give a color reading representing a continuum from anxious/tense to calm/relaxed. A mood

ring is worn on your finger, a body temperature card fits in your wallet and works as you press your

finger on it, and a body temperature dot is a small adhesive dot you place on your skin that continually

changes color like a mood ring. You choose which version you prefer.

After attaining your biofeedback tool, follow these steps to lessen your anxiety.

1) Wear (or press) your biofeedback tool on your skin and check it often to notice when you areanxious or relaxed.

2) Notice the times you are relaxed and what is going on at those times so you can make them occur

more often.

3) Notice the times when you are anxious, tense, and stressed and what is going on at those times soyou can minimize these occurrences. You may even wish to keep a written log to increase your

self-awareness of when you reach high stress levels.

4) When you find yourself anxious or tense, implement one or more of the Coping with StressSystem interventions promoting immediate stress relief: abdominal breathing, progressive

muscle relaxation, visualizing a peaceful scene, self-hypnosis, meditation, rest, etc.

5) As you become more aware of your physical reactions and how to lessen your stress, practiceaddressing your anxiety immediately withoutusing your biofeedback tool so you can lessen your

reliance on outside biofeedback tools. Eventually you can detect and relieve anxiety and stress

through you own efforts alone.

(Adapted from Greenberg, 1990)


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Self-Hypnosis

Self-hypnosis in its basic form is a three-step process: 1) relaxing yourself in a quiet, comfortable

environment, 2) absorbing your conscious thoughts in a very focused way (called a trance), and 3)

unobtrusively giving yourself suggestions for positive change that bypass your conscious resistance.In short, self-hypnosis is telling yourself to be different under a trance state to minimize self-

sabotaging positive change. Follow these steps to engage in self-hypnosis:

1) Over a count of 4 seconds, breathe in deeply through your nose in a comfortable way.

2) Hold comfortably for 1-3 seconds.

3) Slowly exhale through your mouth (or nose, if your prefer) for a count of 8 seconds.

4) Wait 1-3 seconds before breathing again and repeat several times. Keep breathing in this

rhythmic manner until you feel relaxed, comfortable, and ready to concentrate.

5) Gradually eliminate the formal breathing counts and pauses until you breathe in a deep,

comfortable rhythm not requiring extra thought or attention.

6) Slowly allow your eyes to close. Visualize a place that is relaxing to you. Enjoy this experiencewith all of your sensessight, smell, sound, touch, and taste. Examples may include the beach,the mountains, the woods, etc. Stay focused on this experience, thinking only of your experience

there. Redirect yourself gently back if your thoughts wander to other subjects

7) When you are highly absorbed in your experience and your limbs feel heavy, slowly repeat

positive statements to yourself consisting of the changes you want in life through single words or

short phrases, such as relax or more happiness. Note: make sure you state the positivechange you want to occur more, not the negative thing you want less of. For example, more

relaxed is better than not anxious.

8) After continuing in this state for an adequate period (such as 15-20 minutes), reorient yourself toyour environment slowly and comfortably. Allow this whole process to occur naturally and

comfortably. Do not use an alarm clock, a beeping timer, or anything else that may disrupt yourexperience.

9) Remember this relaxing experience throughout the day, such as when stressful events occur orwhen you are bored.

10) Revisit this place for at least 15-20 minutes every morning.


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Cognitive Distortions

Cognitive distortions are extreme, irrational ways of thinking that aggravate stress. Review this list

carefully, checking the distortions you engage in on a regular basis. Then, practice catching and

balancing these distortions through the balanced thinking exercise following this list.

1) All-or-nothing thinking: You look at things as being either black or white, good or bad.If its not perfect, it is a failure. There is no middle ground.

2) Overgeneralization: You view a single negative event or piece of evidence as a never-ending pattern of defeat, or you balloon problems much bigger than they actually are.

3) Negative Filtering: You magnify the negatives and ignore the positives of a situation.

4) Jumping to conclusions: A) mind reading: you assume what people are thinking, and B)

fortune telling: you arbitrarily predict how things will turn out in the future.

5) Magnification or minimization: Two ways of doing this: A) magnificationyou blow

things way out of proportion, and B) minimizationyou shrink their importance.

6) Emotional reasoning: You reason from how you feel (I feel bad, therefore I am bad).

7) Should statements: You have a list of ironclad rules about how you and other people should

or need to act. You feel upset when others (or yourself) break the rules.

8) Labeling: You identify yourself or other people globally according to shortcomings, such as

I am a jerk, she is stupid, or youre a loser.

9) Blaming: You blame yourself or someone else for something you or they were not entirelyresponsible for (if at all).

10) Discounting the positives: You insist that your (or others) accomplishments dont count.

11) Personalization: You think that everything people do or say is some kind of reaction to you.

You also compare yourself to others, trying to determine whos better or worse.

12) Control fallacies: You think that your feelings, thoughts, and behaviors are out of your

control, and that you are the helpless victim of others making you be a certain way.

13) Fallacy of fairness: You feel resentful because you think you know whats fair, but other

people wont agree with you.

14) Fallacy of change: You assume others will genuinely change in the ways you want if you just

pressure them enough. When this doesnt occur, you become upset.

15) Being right: You are continually on trial to prove that your opinions and actions are correct.

Being wrong is seen as a weakness to be avoided at all costs.

(Adapted from Burns, 1990)


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Balanced Thinking

This exercise helps you change your feelings through challenging and changing how you think about

difficult situations. To practice balanced thinking, write out each of the numbered headings below

with a space beneath to write your answers:

1) The Situation: Think of the most recent (or current) situation that has left you feeling stressed orupset. Examples of stressful situations may include getting fired from a job, getting stuck in heavytraffic, learning a family member is sick, thinking of all of the work you have to do, etc.

2) My Automatic Thought: What was your immediate, reactive interpretation of this situation? This

is where most of your stress will be triggered: not by the situation alone, but by yournegative

interpretation of the situation. When you write out your reaction to the situation, be as honest andcomplete as possible. Most automatic thoughts that lead to stress are extreme, generalized reactions to

situations. Examples may include this will never work, Ill never be able to handle this, he hates

me, Im such a loser, shes out to destroy me, etc.

3) Scaling My Feelings: Pick a number between 0 100 to scale how stressful and upsetting your

automatic thought has made you in response to the situation. Think of 0 as representing no stress or

upset at all and 100 representing feeling as stressed and upset as possible. For instance, after youget fired from a job, your automatic thought of Im such a loser upsets you at 90/100.

4) Evidence Against: Your automatic thought fueling your stress will likely be extreme and

unrealistic in some way. To identify what cognitive distortions you may have adopted in your

reaction, review the cognitive distortions list given in the last exercise and note which apply. Then,make a list of as much evidence against your reactive interpretation of the situation as possible . For

example, evidence against you being a loser could include your main accomplishments in life, the

friends and family you are close to, your previous successes at your job, the unfairness of the firing,

etc.

5) Balanced Thought: Taking all of the evidence against your automatic thought into account, create a

more balanced, realistic thought in response to the situation. In the case of losing your job, you couldlook at all of the positive evidence showing your successes and good points and think: I am a good

person with a lot of positive things going for me. Ive handled setbacks before and been OK, and I

will do so again!

6) Scaling My Feelings Again: Now, scale your stress and upset feelings again as in stage 3, but now

do so with yourbalanced thoughtin reaction to the situation. For instance, the balanced thought of Iam a good person may now scale the upset feelings at just a 40a large decrease from the 90 after

the Im such a loser thought.

**Write out as many formal balanced thought exercises as possible. Then, remind yourself of the

evidence against your negative thoughts and focus on your balanced thoughts as much as possible

throughout the day. Eventually with enough practice, your automatic thoughts will become balanced

thoughts and your stress levels will be far easier to maintain.


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Coping Statements

When feeling stressed or anxious, you can cope better by reviewing and repeating some positive,

reassuring, truthful statements to yourself until you calm down and gain control. If one statement

stops working, try another until a better match is found for your particular situation. You can practicethis exercise during deep abdominal breathing if you wish.

You may come up with your own coping statements and/or use these examples:

This feeling isnt comfortable or pleasant, but I can handle it.

I can be stressed (or anxious) and still deal with this situation.

This is not an emergency. Its okay to think slowly about what I need to do.

This is not the worst thing that could happen.

Im going to go with this and wait for my stress (or anxiety) to decrease.

This is an opportunity for me to learn to cope better.

Ill just let my body do its thing. This will pass.

Ill ride this throughI dont need to let this get to me.

I deserve to feel okay right now.

I can take all the time I need to let go and relax.

I can always leave if I need to.

Ive survived this before and Ill survive this time, too.

I can do what I have to do in spite of the stress (or anxiety).

This is just stress (or anxiety)it wont hurt me.

This is just stress (or anxiety)Im not going to let it get to me.

Nothing serious is going to happen to me.

Fighting and resisting isnt going to helpso Ill just let it pass.

These are just thoughtsnot reality.

I dont need these thoughtsI can choose to think differently.

So what?



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Self-Esteem

Your self-esteem can be thought of as the extent to which you value yourself and see yourself as a

good, worthwhile, acceptable person. Low self-esteem occurs when you unfairly criticize yourself,

you push yourself hard with negative, critical pressure, and you believe the negative evaluationsothers give you more than the positive ones. Low self-esteem causes anxiety and stress from two

sources: 1) the negative pressure and criticism you heap on yourself, and 2) worrying too much aboutgaining acceptance and validation from others.

To increase self-esteem (and lower your anxiety), it is important to surround yourself with positive,supportive people. However, your self-esteem will be mostly made or broken by how you treat

yourself. You can measure your self-esteem by asking yourself: would I treat my best friend the way

I treat myself? If not, some self-esteem work is needed. To increase your self-esteem, consistentlyreview and practice the following:

1) Stop Criticizing Yourself: Accept yourself exactly as you are and do not put yourself down.Putting yourself down will tear down your spirit more than motivate you to change. The trade off is

not worth it. To accept yourself does not mean you are not driven to improve, but that you are

acceptable now and will be even better with additional growth and development.

2) Use Positive Motivation: For the improvements you want in your life, practice thinking about andvisualizing what it will be like when you accomplish your goals. Then, add some thoughts andvisualizations consisting of the steps youll need to take to make it happen. This change in focus will

be more motivating and energizing than focusing on either a) the negative thing that will happen if

you dont change, or b) all of the hard work it will take to make it happen.

3) Praise Yourself as Much as Possible: Whenever you succeed at something, privately give yourself

credit for the part you played. Be generous with yourself (but still truthful). Praise yourself for your

accomplishments whenever you can to build confidence and self- worth.

4) Allow Mistakes: When you try and fail, that is a success in and of itself because the effort itself

will act as learning experience to bring you closer to your goals. Be easy on yourself during yoursetbacks and pick yourself up. Life is a continual trial and error process. The only true failure is to

give up, because then you are guaranteed failure. When you fail, give yourself a break, congratulate

yourself on your effort, regroup, and try again.

5) Do Mirror Work: Practice looking at yourself in the mirror often. Look into your eyes and tell

yourself whatever positive true statements you can. Remind yourself about your successes, what youare good at, what you are capable of, what positive things lay ahead for yourself, how you are

improving, etc. Practice forgiving yourself and others in the mirror. Mirror work is a very intimate,

vulnerable, exposing experience. This uncomfortable feeling will let you know the power thisexercise has to help you change.

6) Be Happy and Relaxed NOW: Allow yourself to be happy and relaxed NOWnot after everything

falls into place in your life. As soon as one anxiety or stress is taken away from you, another maysoon follow. Therefore, allow yourself to enjoy life now, rather than waiting for happiness or

relaxation at some mythical point in the future. Your life IS nownot later.


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Support Systems

Anxiety and stress levels can be much easier to cope with when you have others there to listen and

give support, empathy and reassurance. To create a social support system, identify those people

around you that are trustworthy and will support you without judging or criticizing. Typical supportsystems may include: family, friends, psychotherapists, coworkers, group therapy members, online

support group members, religious leaders, fellow church members, sports associates, and/or anyoneelse you know and trust.

Next, ask each support person if you can open up to them about the difficulties you are having with_______ . If you know them well, they will probably say yes and mean it. However, if you ask them

to listen and they say no (or imply they arent interested), kindly refrain from opening up to them and

go to someone else (or ask this person later when they are in the mood to listen). Opening up to aperson who doesnt want to listen will probably make your anxiety worse. Bad listeners tend to act

impatient, give unsolicited advice, say I told you so, blame, criticize, switch the conversation to

make it about them, etc.

Finally, after choosing a good support person, let them know what your anxieties are, why they are

affecting you like they are, what you wish you could do about it, etc. Its usually more helpful to use

I statements and express your feelings rather than just blaming and criticizing others. Thisempowering stance allows you to feel more in control of yourself and your feelings, rather than justfeeling victimized and powerless.

For example, it can be helpful to say I feel anxious when my day starts out badly because Im

worried the rest of the day might go that way. I wish I could take better charge of my life and feelmore confident. This is the I feel ___ when ___ because ___ I wish/I would like ___ format.

Conversely, a less helpful way to vent may sound like that S.O.B. always takes his problems out on

me. Hes a loser. This lose/lose approach will strain the ability of the listener to stay engaged and

make you feel more like a victim.

After opening up and having others listen to you, ask them for their advice, but only if you are open to

it. Then, before going on too long, allow them to talk about theirown issues or just allow the subjectto change completely. At this point, you can just enjoy the rest of your time by listening to them or by

getting involved in a different enjoyable activity. This helps you maintain your support system

without burning them out or draining them.

Everyone has a limit, so as soon as your support person has reached their limit in the discussion, allow

the conversation about your worries and stresses to end, and then simply pick it up with someone elseat a later time. You can expect your anxiety to be relieved with your support system through 3 means:

1) identifying and expressing your feelings in a healthy way to a sensitive listener, 2) hearing their

advice (if you are open to it), and then 3) putting your worries aside and focusing on them for a while.Allow them to support you, but dont make it always about you! Make it a balanced give and take

relationship.


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Restful Sleep

Different people need different amounts of daily sleepsome need 8 hours, whereas others need 6 or

10. Furthermore, some can achieve restful sleep best with a nap during the day, whereas others need

to sleep straight through the night. In any event, your body requires adequate rest to revitalize itselfand cope with anxiety and stress. Busy lifestyles promoting sleep deprivation leave less physical

resources to handle whatever stressors may arise. In short, get the amount of restful sleep you requireevery 24-hour period in the form that works best for you.

To get the restful sleep you need, practice the following:

1) Create a relaxing sleep environment, including a comfortable bed.

2) Remind yourself that skipping sleep will fail to revitalize your mind and body, and that the work

you do under less sleep will probably be less productive anyway.

3) Sleep enough, but only as much as you need to feel refreshed and healthy. Under or oversleeping

leads to fragmented, shallow rest. Sleeping for 7-8 hours a night is usually best.

4) Go to bed and wake up each morning at a regular, consistent timepreferably early.

5) Practice regular physical exercise at the same time of day to prepare you for your sleep.

6) Make your environment as quiet as possibleuse earplugs if necessary.

7) Make sure you keep the room you sleep in at a moderate temperature.

8) Dont go to bed with a full or an empty stomach go to bed with a light snack.

9) Unless prescribed and recommended by a physician, avoid sleep medications, which may lose

their effectiveness over time or even be harmful.

10) Reduce caffeine intake, which tends to disturb rest.

11) Avoid alcohol consumption, which results in fragmented, poor-quality sleep.

12) Only lay on your bed when you are trying to sleep. This will make it easier to fall asleep.

13) When having trouble falling asleep, do something else for a period of time to help you relax, such

as the following relaxing exercises and activities:

--abdominal breathing

--progressive muscle relaxation

--visualizing a peaceful scene

--self-hypnosis--pleasure reading

--listening to soothing music--taking a hot shower or sitting in a hot bubble bath, whirlpool, or spa


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Medical Checkup

Because 75-90% of all office visits to health care professionals are for stress-related symptoms and

disorders, anxiety and stress take an immense physical toll on the body. The body becomes very

strained when confronted with stressful worries, threats, or changes, leading to the fight-or-flightsyndrome and the general adaptation syndrome. Over time, these syndromes exhaust the body and

can create or amplify many physical problems and illnesses.

Physical symptoms from stress may include fatigue, sweating hands, paling or flushing of the face,

sleeping problems, eating problems, skin problems, muscle tension, migraine headaches,cardiovascular diseases, stomach and intestinal problems, rheumatoid arthritis, aches and pains

(especially in the neck and back), a weakened immune system, slowed recuperation from illness, high

blood pressure, heart attacks, diabetes, ulcers, aging, or even death.

Given the physically debilitating nature of anxiety and stress, visiting your medical doctor for a full

medical exam is highly recommended. Your physician will help direct you to change your physicallifestyle habits in essential ways for your unique situation.

Another benefit of visiting your medical doctor is to get a recommendation for what diet and exercise

recommendations from this ebook will be acceptable for your specific situation (and which, if any,may not).

Finally, a visit to your medical doctor can also be an opportunity to get a prescription for anti-anxiety

medication to lessen your worry and stress. Please consult with your physician on all of these matters

for the highest benefit and protection to yourself and your health.

(Sources: Stroebel, 1989 Greenberg, 1990 Manning, Curtis, & McMillen, 1999)


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Nutrition

Particular nutrients, herbs, and foods can help alleviate anxiety and stress in different ways. These

recommendations are based upon a compilation of medical research and should only be used sparingly

and as recommended on the label. Important: Consult a physician before using any supplement,especially if you are using any medications or if you have an allergy, illness, or other physical

condition of concern. Discontinue supplement use immediately if negative symptoms occur.

Nutrients Benefit/Effect

Gamma-Amino-Butyric Acid acts as a tranquilizer helps brain functionGlutathione protects the cells against damage

Nicotinamide Adenine Dinucleotide aids in the creation and transfer of chemical energy

Vitamin B Complex for proper nervous system functioningVitamin C helps produce anti-stress hormones

Calcium & Magnesium reduces anxiety

L-Tyrosine helps reduce stress on the body a sleeping aidMelatonin a natural hormone that promotes sound sleep

Fiber for healthy bowel cleansing and functioning

Free-Form Amino Complex helps supply proteins used rapidly at stressful times

Lecithin for cellular protection and brain functionMultivitamin with Antioxidants replaces nutrients lost during stressVitamin E & Zinc needed for immune system functioning

Herbs Benefit/Effect

Ashwagandha acts as a sedative and nerve tonicBilberry preserves cells throughout the body

Ginkgo Biloba aids in circulation and proper brain function

Milk Thistle cleanses and protects liver acts as an antioxidant

Dong Quai, Rehmannia, Schizandra supports major organs during stressHops eases nervousness, restlessness, and stress

Kava Kava relaxes the mind and body

Passionflower has a calming effectPolygala Root & Sour Jujube Seed Chinese herbs known to soothe and calm the spirit

St. Johns Wort helps with nerve pain

Siberian Ginseng helps the body cope with stressSkullcap good for nervousness and headaches aids sleep

Valerian aids nervous system helps sleep soothes headaches

Wild oat known to restore balance to the nervous system

Foods Benefit/Effect

Raw Fruits and Vegetables supply vitamins, minerals, and flavonoidsPurified Water (32-64 ounces) cleanses liver, kidneys, and colon flushes toxins

(Adapted from Balch and Balch, 2000)


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Substances to Avoid or Minimize

Particular foods and substances can aggravate anxiety and stress in different ways and are therefore

helpful to minimize in your daily life. These recommendations are based upon a compilation of

medical research and should act as a guide with your diet and lifestyle choices. Remember: these aregeneral rule of thumb recommendations for most people. Consult your physician to construct a

complete diet plan for your best individual health and relaxation needs. Furthermore, the assistance ofa substance abuse inpatient or outpatient treatment program is recommended for those who need extraassistance in stopping addictive tendencies with alcohol, nicotine, or the abuse of illicit or prescription

drugsespecially when tolerance, withdrawal symptoms, and/or psychological dependence hasdeveloped.

Foods to minimize

Processed foods and other unhealthy foods that aggravate stress:

artificial sweeteners, carbonated soft drinks, chocolate, eggs, fried foods, junk food, pork, red meat,

sugar, white flour products, foods containing preservatives or heavy spices, chips, and other similar

foods

Dairy products (healthy in moderation, but may promote nervousness when taken in excess):

milk, ice cream, butter, cheese, etc.

Substances to minimize

Caffeine (promotes nervousness, sleeplessness, and the jitters):

cola soda drinks, coffee, iced tea, hot tea, wake-up pills, alert drinks, etc.

Alcohol, tobacco, mood-altering drugs (offer only temporary relief, do nothing to resolve main

stress-promoting problems, hurt health) :

beer, wine, hard liquor, cigarettes, tobacco chew, amphetamines (meth, diet pills), marijuana,

cocaine, hallucinogens (LSD, ecstasy), inhalants (glue, paint), opioids (morphine, heroine),

phencyclidine (PCP), etc.

Helpful links: www.na.org, www.aa.org, www.hypnosisnetwork.com

(Adapted from Balch and Balch, 2000)
http://www.hypnosisnetwork.com/http://www.aa.org/http://www.na.org/http://www.hypnosisnetwork.com/hypnosis/stress_anxiety.php


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Exercise

In general, a program of regular physical exercise will help you to reduce your vulnerability to anxiety

and stress. Exercise provides a natural outlet for the excess adrenaline and physiological arousal that

accompany anxiety and stress states. It also releases muscle tension and stimulates production ofendorphins in the brain, resulting in a state of increased calmness and well-being.

To optimize the tension-reducing effects of exercise, it is best to do an aerobic form of exercise atleast four times per week for at least 20 to 30 minutes. Aerobic exercise includes brisk walking,

jogging, aerobic dancing, bicycling, riding a stationary bike, swimming, jumping rope, running inplace, inline skating, etc. If you do brisk walking, youll want to double the minimum time of

effectiveness from 20 to 40 minutes for the best results.

If you havent been doing cardiovascular exercise recently, it is best to start exercising briskly for

short periods (5 to 10 minutes) and then gradually extend to over 20 minutes. If you have any medical

conditions that might limit exercise, experience symptoms of high blood pressure, diabetes, chestpains, fainting spells, or joint stress, and/or are forty or older, be sure to consult with your medical

doctor before undertaking an exercise program. (Actually, it is best to consult with a medical doctor

before undertaking any new exercise program).

Many people find it helpful to vary the type of exercise they do. This can help reduce boredom andgive you the chance to exercise different body parts. Popular combinations include doing a soloaerobic type of exercise such as jogging or cycling in combination with a social form of exercise such

as tennis, racquetball, volleyball, or body building.

If you are starting an exercise program or are otherwise not used to vigorous exercise, observe the

following guidelines:

1) Approach exercise gradually2) Commit yourself to at least a one-month trial period of your program before giving up (unless

your program is causing problems that logically warrant a change)

3) Expect some discomfort initially4) Find ways to reward yourself for maintaining a commitment to your exercise program

5) Warm up before exercising, and have a cool down period before ending, such as with stretching,

jumping jacks, or walking6) Avoid exercising within 90 minutes of a meal

7) Stop exercising if you experience any sudden unexplainable pains or dizziness

8) If you find yourself getting bored with exercise, find a partner to go with you and/or chooseaerobic activities that require you to have a partner (such as tennis or racquetball)

9) Exercise more than once a week

10) Make your goal of aerobic exercise be at least 4 days a week for 20-30 minutes



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Relaxing Environment

The sights and sounds of the environment can serve to either elevate or decrease your anxiety and

stress levels. It is important to make whatever changes you can to make your home and work

environments as relaxing as possible.

The following are some helpful suggestions to create a relaxing, stress-free environment:

*Keep your noise levels down. Loud noises are upsetting and invoke anxiety. Intermittent and loud

noises tend to cause more upset than soft, constant noise. The more disturbing noises you caneliminate, the better. To minimize noise, consider padding and sound-proofing the rooms you spend a

lot of time in, such as with wall hangings, wall padding, and noise sealers at the bottom of your doors.

Also, consider turning down the ringer of the telephone, turning down the television, stereo, and radio,having professional ear plugs made for you to wear (such as those made for swimmers), and

periodically isolating yourself from others in a quiet place.

*When not seeking after complete silence, play soft, relaxing sounds or music. White noise

machines also can be used to muffle and drown out disturbing noise. Other options include playing

soft classical or instrumental music. Finally, consider playing tapes or CDs of the various soothing

sounds of nature, such as the ocean, a stream, or a babbling brook.

*Have as much natural lighting in your home (or office) as possible. Unnatural fluorescent lightingcan be especially aggravating. Consider opening your window blinds, opening your sky light (if you

have one), or just spending more time outside. When using artificial lighting, consider using soft light

lamps with lower wattage, rather than the brighter ceiling lights with higher watt light bulbs.

*Keep the main rooms you spend your time in uncluttered. Cluttered rooms can be aggravating and

tend to increase anxiety and stress levels.

*How you position your furniture and wall hangings can either increase or decrease your stress levels,

depending upon size, shape, angle, space, walkways, etc. Consider reconfiguring your rooms to a

more practical, user-friendly, relaxing set up. If needed, you may wish to consult a professionalinterior decorator or feng shui expert.

*The color themes that set the tone for your rooms should also be soothing, calming, and relaxing.The following colors tend to promote stress and anxiety, as well as higher blood pressure, heart rate,

and respiration: red, orange, yellow, hot pink, and other striking fluorescent colors. These colors

should be minimized to help promote a more relaxing environment. Conversely, the following colorstend to calm, soothe, and relax, as well as lower your blood pressure, heart rate, and respiration: blue,

green, violet, and soft pink.

*Keep your room temperature at a relaxing, comfortable level. Room temperatures should be no

warmer than 72 degreespreferably lower. Hot, humid room temperatures increase irritability and

drain energy. When air conditioning becomes too expensive to run, consider wearing lighter clothes,

running a fan, and periodically cooling down your skin with a cool bath or shower.


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Meditation

Meditation is a mental exercise that affects body processes. The purpose of meditation is to gain

control over your attention so you can choose what to focus upon, rather than just reacting to whatever

confronts you. The relaxation and control inherent in meditation can serve as an excellent relief toanxiety and stress. Meditation has its tradition grounded in Eastern cultures (such as India and Tibet),

but has become popularized in Western cultures since the Beatles visited India in the 1960s. Topractice a simple form of meditation, follow these directions:

Find a quiet place where you can relax and be alone. Choose a time when you will not be so tired thatyou risk falling asleep. Use a comfortable straight-backed chair that helps you sit up with minimal

effort. A chair that also supports your upper back and head is even better.

Then be seated with your buttocks pushed against the back of the chair. Place your feet slightly

forward of your knees with your hands resting either on the arms of the chair or in your lap. Let your

muscles relax naturally. Dont try to relax. Trying is work, not relaxation. Just assume a passiveattitude in which you focus upon your breathing. Allow whatever happens to happen. If you feel

relaxed, fine if not, accept that too.

Next, close your eyes and repeat in your mind the word more every time you inhale and the wordrelaxed every time you exhale. (If you have a preference, you can substitute any other two relaxingwords, providing the words are short and either positive or neutral). Repeat this process for abouttwenty minutes. During you meditation, do not consciously alter or control your breathing breathe

naturally.

Finally, when you are ready to stop your session, allow your body to become naturally readjusted to

its normal state. Open your eyes gradually, first focusing on one object in the room, and then several.

Take a number of deep breaths. Then, stretch while seated, and when you feel ready, stand and

continue your stretching. Since your blood pressure and heart rate are decreased while meditating,rising from the chair too quickly might cause dizziness and is not recommended. If you rush to leave

the meditation session, you are apt to feel tired or lose the sense of relaxation. In short, end your

session slowly and comfortably for the best results.

Further Recommendations:

1) Have a goal to meditate twice a day for approximately twenty minutes.

2) Cease your meditation if you feel uncomfortable, dizzy, or hallucinate (which is rare).

3) The best two times to meditate tend to be immediately upon rising and just before dinner.4) To assist achieving a relaxed state in your meditation, avoid all stimulants, such as caffeine.

5) Make sure your head is held up with support otherwise, allow your head to droop forward.

6) If you want to know when your time is up, simply peek at a clock or watch. Eventually, youshould acquire a mental alarm clock that will alert you when your time is up.

7) Eliminate any loud sounds that may interrupt your experience: phones, alarms clocks, etc.

8) When you find your thoughts wandering, gently refocus and continue.

9) Slow yourself down as much as possible. Relax and enjoy this process.

(Adapted from Greenberg, 1990)


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Visualizing a Peaceful Scene

By changing your thoughts to something relaxing and peaceful, you can ease your mind and soothe

away psychological tension. To prepare for this exercise, say the words below into a tape recorder in

a soothing, slow-paced tone of voice. Pause long enough at each noted pause to become fullyabsorbed in the experience (perhaps 1-3 minutes each). Then, relax and listen to the directions. Or, if

you prefer, simply read and memorize the following script to rehearse these directives from memory.Choose a time you will not fall asleep, find a quiet place, and lie or sit in a comfortable position.

Now, take several minutes to listen to your tape (or guide yourself from memory). Allow yourself to

become absorbed in the following experience (or a similar one of your own making):

Take a few deep breaths and slowly close your eyes. Imagine youre in a very peaceful, comfortable

setting that has a special meaning to you. It can be outdoors or indoors. It can be a realistic place orimaginary. You find that you feel very safe and supported therethis is a safe place. (Pause) Now

look all about you and notice the colors of everything in this particular scene. (Pause) You might

focus on one color in particularand you find this color to be very relaxing. (Pause) As you feelmore and more relaxed, take notice of any sounds that you can hear in this special place. (Pause)

You might focus in on one sound in particular, and you find this sound to be very relaxing. (Pause)

Now become very aware of anything that you are touching on the ground or elsewhere. How does it

feel? Let these tactile sensations help to relax you still more. (Pause) Just continue allowing yourselfto settle in, feeling relaxed and at peace in this wonderful place. Youre feeling very safe, secure, andat ease. Stay in the wonderful place as long as you wish. Continue experiencing your relaxing placewith all of your senses. (Pause) You have the power and ability to revisit this wonderful, relaxing

place whenever you wish during the day to enjoy these same feelings. At your own pace and as you

are ready, reorient yourself to your surroundings and open your eyes at a comfortable, natural pace.

Any scene that feels very calming to you will do for this exercise. It could be in the outdoors like a

remote beach, a mountain stream, a lake, or a wooded area. Or, your scene may consist of an indoor

scene such as a cozy fireplace or a comfortable bedroom. It is very important in a visualizationexercise to take the appropriate amount time and to experience your scene in as much detail and

through as many senses as possible. Focus on all of the objects you can seetheir colors, shapes, and

sizes. Also be aware of any sounds, smells, or things you can touch. Finally, take all of the time youneed to fully experience the relaxing nature of your scene.

Remember that the more you picture yourself in this peaceful scene, the easier it will be to return therewhenever youd like. You can eventually learn retreat to your own special scenethe safest place in

your mindwhenever youre feeling anxious or tense. This exercise can be as formal or informal as

desired, as long as the effects are achieved.



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Guided Imagery

Guided imagery exercises help minimize the distressing nature of your worries and stresses by

changing the way you see them. To prepare yourself for this exercise, choose one or more stressful

situations that you currently struggle with (such as the things you have to do). Then, loosen yourclothing, go to a quiet room away from others, and sit or lie in a comfortable position. Take a few

slow, deep breaths, close your eyes, and slowly visualize one or more of the following scenes:

1) See yourself and the anxiety-invoking situation. Have yourself remain regular size, but have the

anxiety situation slowly shrink. Have it become smaller and smaller until it eventually disappears. Ifdesired, have yourself also grow in size until you dominate the picture and the anxiety is nowhere in

site. Then, visualize yourself as relaxed and relieved as possible.

2) See yourself, along with the anxious situation. View yourself normally, but visualize the anxious

situation fading to black and white. Then, allow the black and white anxiety scene to fade further

until it becomes foggy, blurry, and then, completely invisible. All the while, see yourself in regular,sharp color, increasingly happy as the stress leaves. Feel free to wave goodbye to the anxiety.

Finally, end the scene by seeing yourself engaging in some of your favorite relaxing activities (like

having a bubble bath or lying in a hammock).

3) See yourself dealing with a anxiety-invoking situation from beginning to end, but have it be in theform of a movie you are watching on a wide screen. Add as many Hollywood features that you can tomanipulate the mood in a humorous, different way that deflates your worries. Give it a funny

dramatic title and name the cast with goofy nick-names (yourself and others involved with the stress).

Then, speed the anxiety scene up (fast forward), change the scene to slow motion, add humorous orcorny, dramatic music, rewind it, add laugh track sounds in the background, and change the scene by

adding anything else that is humorous and different from how you currently experience the event.

End the movie with either a very good, positive ending, or a catastrophic ending farworse than would

occur in real lifeso worse that it is actually humorous when you watch it. Finally, see yourselftaking a final bow as if on a stage and roll the final credits with positive music.

4) Visualize yourself in a very relaxing scene, such as the mountains, the ocean, the woods, etc. Enjoythe scenery with all of your senses. Then, briefly switch to seeing the anxiety situation for 1-2

seconds only. Finally, stop seeing the anxiety situation and go back to your initial relaxing scene very

quickly, where you will stay as long as you wish until you are very relaxed again.

5) Choose an anxiety-invoking situation, and transform it all into a funny little creature of some sort

wearing a t-shirt naming the worry. Notice how small, funny, and unthreatening the creature is.Laugh at it and see it walk away in shame until it is out of site.

6) Choose an anxiety-invoking person or situation, and transform it into a bag (like a suitcase). Seeyourself approaching a one-way bus or train, place the bag on board, and watch it drive away until it

slowly disappears from view. Wave goodbye to the anxiety, and have yourself walk away in the

opposite direction with a large smile on your face.

**After deflating an upsetting image through one of the visualizations above, you may find it helpful

to then switch the image to a positive, enjoyable, relaxing scene of your own choosing.


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Humor

Humor can be defined as the ability to appreciate or express that which is funny. Laughter is a

universal genetic response to socially funny cues in a series of short syllables such as ha-ha, ho-

ho, or hee-hee. The most obvious effect of humor is on our mood, helping us feel joy, surprise,and amusement.

Correlational studies of anxiety and stress have connected humor with many positive outcomes,including: lower feelings of depression, anxiety, and alienation, as well as lower blood pressure, heart

rate, pain, and stress hormones. Humor has also been associated with higher positive moods, astrengthened immune system, and increases in relaxation, endorphins, social cohesion, creative

thinking, and feelings of control. In short, humor tends to lessen the physical and emotional impact of

anxiety and stressespecially with those who have already cultivated a strong sense of humor.

To increase the humor and laughter in your life, do the following:

1) Figure out and define what makes you laugh out loud. List everything that comes to mind that

makes you laugh in this way, including where you are, who you are with, and what you are doing. Be

honest with yourself. If needed, carry around a pad of paper and write out the situations and

circumstances when you catch yourself laughing.

2) Next, use your list to build a humor library of all the artifacts that make you laugh: books,magazines, movies, music, TV shows, etc. Then, go to these resources whenever you need a laugh-

lift.

3) Finally, because humor intensifies when you have someone to share it with, list all of your friends,

family, and associates you feel close enough to that you can laugh with. Then, engage in as many fun

activities with them as possible from step 2, as well as additional fun activities typically enjoyed with

others: going out to funny movies, playing funny get to know you games, going to comedy clubs,etc.

(Adapted from Provine, 2000 and Doskoch, 1996)


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Anxiety and Stress Education

It can be helpful to engage in some additional research and reading about anxiety and stress. The more

you understand the problem, the better you will be able to control it.

Books on Anxiety and Phobia Management

The Shyness and Social Anxiety Workbook(2000). Oakland, CA: New Harbinger Publications.

*offers plenty of simple ways to overcome shyness and social anxiety

Triumph Over Shyness: Conquering Shyness & Social Anxiety (2001). Murray B. Stein and John R.Walker.New York: McGraw-Hill.

*a good book on understanding social anxiety and shyness

The Anxiety & Phobia Workbook(2001) by Edmund J Bourne. Oakland, CA: New HarbingerPublications

*an easy to read workbook version with a variety of anxiety and phobia management techniques*

Books on Stress, Stress Management, and Relaxation

Stress: Living and Working in a Changing World (1999) by George Manning, Kent Curtis, and Steve

McMillen. Duluth, Minnesota: Whole Person Associates, Inc.

*this stress book is comprehensive, easy reading, and highly recommended*

The Relaxation and Stress Reduction Workbook(2000) by Martha Davis, Matthew McKay, and

Elizabeth Robbins Eschelman. Oakland, CA: New Harbinger.

*an easy to read workbook version with a variety of stress management and relaxation techniques*

Wherever You Go, There You Are (1995) by Jon Kabat-Zinn. New York: Hyperion.

*a helpful, in-depth look at what meditation is an how to do it*

Web Sites

www.algy.com/anxiety

*A comprehensive website for understanding anxiety, panic, and all of the forms of anxiety disorder.

www.stress.org

*The official website of The American Institute of Stress offers some good, comprehensive stress

information
http://www.stress.org/http://www.algy.com/anxietyhttp://www.hypnosisnetwork.com/hypnosis/stress_anxiety.php


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Coping with Hassles and Life Changes

Hassles:

The hassles in your life can be thought of as the small and medium-level annoyances that slowly buildanxiety and stress levels in your life. To assess which hassles are currently affecting you in your life,

answer the following questions:

Y (Yes) N (No)1) I am concerned about my weight being too heavy or too light Y N2) The rising cost of living bothers me Y N

3) I have a lot to do to maintain my home Y N

4) Misplacing or losing things is a problem for me Y N5) I have too much to do and too little time to do it Y N

6) I am not satisfied with my physical appearance Y N

7) Managing finances and keeping records take a lot of time Y N8) Someone close to me is in poor health Y N

9) I am concerned about crime and safety Y N

Each of these hassles has the potential to build your stress levels and interfere in your life.

Life Changes:

Whenever major life changes occur in your life, the resultant stress takes a large physical and

emotional toll. When life changes happen together, and/or are of strong enough intensity, the resultcan be illness, hospital visits, and even death. Note which of the following stressors you have

experienced over the last 12 months (listed in order from most stressful life change to least):

*death of spouse/partner, divorce, marital/partner separation, jail term, death of close family member,personal injury or illness, marriage, fired at work, marital/partner reconciliation, retirement, change in

health of family member, pregnancy, sex difficulties, gain of new family member, business

readjustment, change in financial state, death of a close friend, change to different line of work,change in number of arguments with spouse/partner, mortgage or loan for major purchase (home,

etc.), foreclosure of mortgage or loan, change in responsibilities at work, son or daughter leaving

home, trouble with in-laws, outstanding personal achievement, spouse/partner beginning or stoppingwork, change in living conditions, revision of personal habits, trouble with boss, change in work hours

or conditions, change in residence, change in recreation, change in church activities, change in social

activities, mortgage or loan for lesser purchase (car, TV, etc.), change in sleeping habits, change innumber of family get-togethers, change in eating habits, vacation, Christmas, minor violations of the

law*

How you handle stress depends upon the total demands you face (your hassles + life changes) in

combination with the resources you possess for meeting these demands. This system aims to build

your stress absorbing, adapting, and management resources. Practice identifying the current and

recent hassles and life changes you have faced. Then, match up and use appropriate interventions inthis section that address both your specific anxiety and stress relief needs now, as well as the relevant

concerns to address early to prevent future problems.

(Adapted from Manning, Curtis, and McMillen, 1999)


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Problem Solving

How you conceptualize and plan to tackle your problems will greatly determine how well you resolve

them and how much stress and anxiety you experience in the process. Most of these problems come

from worrying or being upset about what we cant controlleaving less time, energy, and focus forefforts that actually will resolve our problems. Write out the following exercise when you are facing a

stressful problem to minimize your stress and better resolve the issue.

Step 1Identify your problem: Write out the specific problem you are facing: what the problem is

andwhy it is a problem for you. (Only write out one problem at a time).

(For example: My parents are visiting and I dont like how they give me critical comments)

Step 2What do you WISH you could do to resolve your problem if you had the power? In other

words, if you had a magic wand and had ultimate power to change this problem, what would you do?

What would you make happen?

(For example: I would make it so they would never give me advice or criticism againunless I ask

them for their opinion).

Step 3What are you NOT able to do to solve the problem? Realistically admit your limits and statewhat you are unable to do to solve the problem.

(For example: I cant change their personalities or make them more sensitive and respectful)

Step 4What ARE you able to do to solve the problem? What can you reasonably do to try to change

the situation? What are all of the ways you could approach this that are within your power to do?

(NOTE: the better you get at this brainstorming, the bigger your list will be. Usually, the bigger your

list the better it will be).

(For example, you could choose to 1) respectfully let them know your feelings and request they only

give critical advice and opinions when asked for, 2) cancel their trip, 3) avoid talking to them aboutsensitive topics during their visit, 4) have a friend be with you during their visit to avoid their giving

opinions on sensitive subjects, 5) pretend you are sick, and/or 6) read a book on responding to

criticism and use the ideas during the visit).

Stage 5Choose your course of action to solve the problem: First, cross off what you wish you

could do and what you cant do. Then examine what you can do. Cross off the ideas you dontprefer and plan for how you will implement whatever ideas are left. Expand on the remaining ideas

until you have a very complete, doable plan. Then, persistently follow through on your chosen

course of action until your problems are solved (or at least moderated).

(For example, from your options of what you can do in step 4, you choose to prepare for their trip

by reading a book on responding to criticism and then plan to use these ideas during the visit. Then

when they arrive, you start off the visit by assertively and respectfully requesting that they only givetheir advice and opinion when asked for. Then you reassure them of your care and concern for the

relationship).


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Time Management

Two common complaints of highly anxious and stressed individuals are that they have too much to

do in too little time and they wish they had more hours in the day. The truth is, the more worried

and stressed you are, the less energy and focus youll have for the tasks at hand because of thedraining nature of stress itself. This often turns into a vicious cycle: the more anxious and stressed

you are, the lower your energy and task performance, leading to more anxiety and stress, and so on.Therefore, the first way to better manage your time is to decrease your stress and increase your energyand task efficiency (such as with the interventions in this section). Rememberspend some daily

time on your relaxation activities. Having 1 less clock hour to work but feeling more invigorated andrelaxed for the tasks at hand will result in more output AND less anxiety and stress at the same time.

Think about it. If you do not believe in this idea, then time management will not work for you.

Second, in addition to doing relaxation-promoting activities, here are some simple, strategic activities

you can do to better manage the time you have for what you need to do:

*Every morning, list every major task you need to do that day, prioritizing your tasks numerically

from highest to lowest in order of importance. Then, cross off your tasks during the day as you

complete them (or delegate them). If you do not complete or delegate all of the lower priority tasks by

the end of the day, it shouldnt matter. By definition, these tasks are lower priority and dontnecessarily have to be done by the end of the day. Your anxiety and stress will lessen as you strike offthe most critical tasks and go lower on the list.

*List all of the current tasks you need to do during the next day, week, month, and year. Rank these

tasks either 3 (critical), 2 (important), or 1 (optional). Cross off the 1s (the optional tasks)from your list completely. Then, write out a plan for how and when you will accomplish the 3s

(critical tasks) and the 2s (important tasks). Post your revised list and chart your progress for

accomplishing them as you only focus on your essential tasks. Delegate whatever tasks you can and

systematically work to accomplish the rest. Remember, you cant do everything, so just do the bestyou can with the time and energy available.

*Regularly clean up and organize your main work and living space. Dont worry about cleaning andorganizing the areas of your home or office you use least. Organize your work materials so you know

what is where in a logical, user-friendly system that works best for you.

*Use a planner every morning, night, and throughout the day. Plan, check off, and re-plan again

and again. Make sure your planner is portable, user-friendly, and attractive (no one will use an ugly

planner!). Your planner can either be of the old-fashioned paper-and-pen variety or a sleek, electronicpalm-pilot. Be selective and only choose a planner you like and will use.

*Remember, the small work youll invest in all of these activities should be more than worth theinvigorating, time-reducing results. The above time management strategies are an investment in

yourself. This is an excellent avenue to make your life easier. See yourself as a worthwhile person

deserving of the help and assistance you will be giving yourself.


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Play Time

Spending your time engaged in some playful activities everyday can be an effective anxiety and stress

relievereven if for a short period of time. Play time helps to relax you by 1) diverting your

attention away from your worries and stress, 2) giving you something else in your life to enjoy andfeel productive with, and 3) giving you an outlet to enjoy, relax, and blow off steam. Play can be

defined as any voluntary activity you choose to participate in whose only purpose is to provideenjoyment, fulfillment, satisfaction, and relief from the challenges and obligations in your life. Inshort, engaging in play is productive by providing times of enjoyment will help to calm you down and

take the edge off.

When considering which play time activities or hobbies to engage in, review the following

complimentary exercises of this section: taking time off and time management. These activitieswill help you figure out how, when, and where you can plan to engage in your favorite anxiety/stress

relieving play activity. Next, brainstorm which forms of play you can practice that will primarily

promote either physical or emotional fulfillment. Finally, implement a consistent, daily, weekly, andmonthly regiment of your activities in whatever practical, consistent way possible.

A good activity or hobby will not only help you take your mind off of your worries, but it will also be

productive in some way. A list of invigorating playtime activities or hobbies you may want to engagein include the following:

Sports

Exercise

Arts/CraftsShopping (actual or just window shopping)

Spa/Massage

Hiking/Camping/Outdoors

Education/Classes/Groups/TherapySpending Quality Time Connecting with Others (without mentioning your stress)

Decorating/Designing

Cleaning, Organizing, and UnclutteringReading/Writing

Games (board games, video games)

TV/MoviesMusic

Cooking/Nutrition

Volunteer Work/ServicePets/Animals

Photography

ReligionSelf-Help


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Taking Time Off

Taking time off from your usual duties can be an effective way to regain energy, motivation, and

composure for all that you have to do. Sometimes it is important to simply avoid the worries and

stresses of life by engaging in reinvigorating activities. Because anxiety and stress causes bothpsychological and physiological strain, it is important to periodically do nothing but recuperate and

recharge your emotional and physical batteries.

It is important to note that this intervention alone will not resolve your worries, because the same

issues that you temporarily gain relief from will still be waiting for you when you return. Therefore,combining this exercise with others in this section will produce the best short and long-term stress

relief results.

Here are some suggestions and considerations for taking time off and avoiding your worries and

stress:

*When you arrange to take time off, fully commit to taking a period of time completely away to allow

for the maximum recuperation. Therefore, plan to leave your cell phone and pager at home (or off) if

its safe to do so.

*Arrange to take as much time off as you can reasonably afford to take without allowing yourproblems to multiply too greatly. Your considerations may include money, job security, family duties,and time-pressure tasks that will multiply if left unattended for too long. A few hours away from your

worries and stresses can be helpful, a day or a weekend even better, and a week or two away being the

best. Vacations longer than two weeks are rare and usually impractical, but can be highly beneficial ifyou can manage it.

*Choose activities to engage in that will reinvigorate you physically and emotionally. If the worry or

stress you want to recover from is primarily emotional, you may want to spend your time in aphysically invigorating activity to change the focus and allow for recuperation. Conversely, if you

want to recover from a primarily physical stress, you may want to spend your time engaged in an

emotionally invigorating (but physically relaxing) activity.

*Brainstorm and plan an appropriate activity that offers relief from the specific type of anxiety or

stress you are struggling with. Examples ofphysically invigorating activities may include skiing,swimming, rafting, rock climbing, hiking, scuba diving, kayaking, dancing, etc. (Note: only plan to

engage in physically invigorating activities that are safe, so consult your physician). Conversely,

examples ofemotionally invigorating (yet physically relaxing) activities may include visiting a dayspa, getting a massage, sunbathing, hot-tubbing, going on a cruise/sailing, site-seeing, taking a tour,

seeing a play or musical, etc.


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Assertiveness Training

Assertive communication is a key to lessening your anxiety and stress levels when facing a problem

or concern involving others. This exercise represents the underlying philosophy behind the

communication skills, negotiating skills, and responding to criticism exercises of this systemand is meant to be used in combination with them.

Assertive communication involves clearly stating your opinions, how you feel, and what you want,without violating the rights or feelings of others. Assertive communicators are open, honest, and

direct with their wants and needs, while at the same time being polite, respectful, and sensitive to thefeelings of others as much as possible. The main advantages of assertive communication include

active participation in decision making and getting what you want without alienating others.

Assertiveness works because your openness allows you to clearly and completely express your wantsand needs, while your sensitivity minimizes the other feeling attacked or threatened, which leads to

defensiveness.

Non-assertive communication increases worry and stress by decreasing cooperation and collaboration

with others. On one extreme is aggressive communication: being open, honest, and direct, yet

forceful and offensive. Examples of aggressive communication include arguing, yelling, calling

names, not listening, making real or implied threats, etc. On the other extreme is passivecommunication: being polite, respectful, and sensitive to the feelings of others, but only expressingfeelings partly (if at all). Examples of passive communication include talking softly, giving the silenttreatment, avoiding eye contact, passive aggression, expecting mind reading, and having slouched, yet

tense posture conveying a message of submission. Poor communication often switches between

aggressive and passive, leading to negative outcomes with others.

To develop your skills of assertive communication, practice the following:

*Speak in a calm, clear, confident tone of voicepractice in the mirror and then with others*Make good eye contact

*Have an upright, yet relaxed posture

*Keep a focus on expressing your feelings, rather than attacking and blaming*Make requests and suggestions, rather than demands and orders

*Take personal responsibility for your feelings

*Focus more on facts and principles than personal differences*Focus on solutions, collaboration, agreement, and compromise

*Consider taking martial arts or self-defense classes

*Express your feelings respectfully, but without apology when none is warranted*Remind yourself that your feelings, wants, and need are important and valid

*Accept that to be heard, validated, and respected can be more valuable than having approval

*Ask yourself before speaking: how can I say this in an open, honest, forthright way?*Also ask yourself: how can I say this in a way that minimizes the other person feeling defensive,

attacked, or threatened?

*Be OK with saying no

*Pick your battles, but disagree and stand your ground when necessary*Stick to one sensitive topic at a time unless both are ready to move to another subject

*When at odds, politely repeat your main argument and agree to disagree



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Communication Skills

The anxiety and stress we experience in life are highly connected to how difficult our interactions are

with the significant others in our life: family, friends, coworkers, etc. How you communicate with

others tends to be more important than whatyou may be discussing. Communicating in any way theotherperceives as threatening or offensive generally results in others getting defensive and either

arguing back or shutting down. Constructive communication at this point is usually futile, resultingfurther contention. Rememberwhether you meant to be offensive or not, an offended person stillwill feel and react in the same way. Their perception is their reality.

Therefore, in order to keep peace and minimize worry and stress levels, it is important to

communicate to others about sensitive matters in ways that open and honest, but also polite, sensitive,

and respectful. The following communication skills can help you achieve this balance:

1) Use I statements (instead of You )

I feel_________when_________because________

I would like it if / I wish that__________________

Otherwise I________________________________(optionalbe careful with this)

(Avoids blaming and shows you take responsibility for yourself and your feelings)

2) Bring up the past as little as necessary to make your point

(This sensitive subject makes people defensive, so use minimally with great discretion)

3) Be specific and dont generalize (avoid always, never, names, and labels)

(dont make a problem bigger than it actually is)

4) Stick to the subject (until you are both ready to move on)

(its hard enough to talk about one sensitive subject bringing up more is overwhelming)

5) Be aware of your body language (keep it open, non-threatening, and attentive)(keep your arms and legs uncrossed and unfolded, keep good eye contact)

6) Keep a soft, respectful tone of voice (avoid yelling, sarcasm, patronizing, or sharpness)(the words you use wont matter if you sound attacking, blaming, or defensive)

7) Admit immediately where you are wrong / agree immediately where they are right(whenever you can honestly do so this puts you both on the same side)

8) Be brief in your argument (avoid lecturing allow for back and forth discussion)(if you ramble too long, you will lose the other person and they will tune out)

9) Listen reflectively without interrupting (listen first, respond second)

(respond only after the other feels heard, understood, and validated)

10) Offer solutions and support the other person trying to (or wanting to) change(be a part of the solutionnot the problem dont be negative)


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Responding to Criticism

A main cause of anxiety and stress comes from dealing with other peoples criticisms and put-downs.

When critical people are open minded and willing to listen, refer to the communication skills and

negotiation skills exercises to talk things out and come to a compromise.

Conversely, rational, logical conversations with closed-minded troublemakers are counterproductivebecause such people are only looking to manipulate you and give you a hard time. The key is this:how you choose to respond to their criticism will largely determine how much contention will follow.

Therefore, you are never a helpless victim to critical peopleeven if they hold some sort of a powerposition over you.

There are three ways of responding to closed-minded critics that are usually not helpful. In fact, theseresponses usually just make things worse:

1) Trying to explain yourself and your position (which they will discredit)2) Firing back a criticism towards them (leading to a back-and-forth argument)

3) Sitting there quietly and taking it (leading to further criticism and less respect)

Responding in any of these three ways will just give ammunition for the other person to use againstyou. A rule of thumb is that when others are contentious and looking for a fight, they are not in themood for reason. Just focus on deflating their argument and escaping damage until a later time whentheyre ready to talk civilly and respectfully (although some troublemakers may never be open to civil

discussionsad, but true). The following four techniques serve to deflate closed-minded criticism

when executed politely, respectfully, and under control:

1) Summarize (or paraphrase) back to them what theyve said to allow them to restate themselves

more specifically and respectfully.

2) Ask for specifics to counteract and minimize the generalized, overblown criticism they have just

delivered against you.

3) Agree in part with whatever portion of their statement you honestly can (without discounting it

with but, although, or howeverusing and will be far more constructive).

4) Use a broken record technique: repeatedly agree with whatever part

The Coping With Stress and Anxiety System

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