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Mary Zaunbrecher, MS, LPC | Clinical & Family Services Therapist

May 1st, 2020

Empowering Strategies for Managing Anxiety

Mary Zaunbrecher, MS, LPC | Clinical & Family Services Therapist

Anxiety is a powerful force, and in this day and age, triggers seem to pop up everywhere. In fact, the National Institute of Mental Health reported that “an estimated 31.1% of U.S. adults experience any anxiety disorder at some time in their lives.” It shows up in many different ways for a variety of people and age groups, from fear of failure at school or work, to fear of forgetting something important on our to-do list, to stress about social interaction with others.

I first teach my students and families that anxiety is normal! Anxiety becomes problematic when it interferes with our ability to move through everyday life. If we can attune to our bodies and attend to our physiological needs as these situations arise, we can navigate events in our lives in a way that is more congruent with who we want to be—from a place of wise mind, informed by both our thoughts and emotions.

Learning about the way anxiety manifests in our bodies can empower us to manage our internal environment. By doing so, we are better equipped to face our external environment with intention and confidence and manage daily stressors so that they do not interfere with our lives.

 

Actual vs. Perceived Threat

Anxiety is the body’s natural response to actual or perceived threats in our environment. As humans, we have evolved to be wired to overinterpret the danger of the stressors we face today. For instance, a “fight or flight” response was necessary for survival thousands and even hundreds of years ago, when humans needed to protect themselves and their families from the threat of wild animals while hunting and gathering. It is also a necessary and useful biological response to actual threats to life or limb that one may face today. However, when struggling with everyday anxiety or anxiety disorders (such as generalized anxiety disorder or social anxiety disorder), these responses can be out of proportion to reality and our needs. In these cases, fight or flight can actually hinder us by sabotaging our ability to act in line with our values from a grounded state.

 

Physiological Response to a Perceived Threat

The fight or flight response is a function of the sympathetic nervous system. It begins with the release of adrenaline in the bloodstream. This causes bodily responses such as muscle tension, increased heart rate, and shortness of breath. Your body is mobilizing oxygen to the muscles, preparing to quite literally fight back or flee from danger.

You can see why this would be necessary for life-threatening situations. However, this response is out of proportion to the causes of general or social anxiety for many people (i.e. an impending test at school, deadlines at work, social interaction with peers). This is why we must take steps to activate the parasympathetic nervous system when feeling anxious. This nervous system is responsible for relaxing the muscles, regulating normal bodily functions, enabling connection with others, and responding appropriately to the cause of the anxiety.

It’s highly important to recognize physiological cues that indicate you are reacting to anxiety from a sympathetic (fight-or-flight) nervous state. Interoception helps with this and is something that students and parents work on at Open Sky. It is a therapeutic and mindfulness approach that increases our awareness of the connection between the mind and body.

 

How You Can “Rest and Digest” More Often

Many people tend to try to think their way out of their anxiety or try to convince themselves that things are okay. While it is important to mentally recognize that your life is not in immediate danger, we have an additional opportunity to biologically communicate, “I am safe, I am not in danger.” Some refer to the parasympathetic nervous system as the “rest and digest” state. It communicates with the liver to absorb the adrenaline coursing through our bloodstream and tells our muscles to relax (rest). It also signals the body to resume normal biological functions (i.e. digest). From this grounded state, one can then choose a response that is values-based and proportionate to the circumstances.

So, how exactly can one activate the parasympathetic nervous system? This direct activation can occur via the vagus nerve, whose name derives from the Latin word for “wandering.” The vagus nerve extends from the brain to the abdomen and contains parasympathetic nerve fibers, which provide almost immediate activation of the parasympathetic nervous system. Here are some tools and strategies to stimulate this nerve and activate the parasympathetic (rest and digest) nervous system. By building a practice around these coping skills, you are training the nervous system to reduce the frequency, intensity, and duration of the anxiety. 

  1. Mindfulness/Relaxation techniques 
    • Breathing techniques – we can use breathing as a way to directly activate the vagus nerve. Here are some examples:
      • Extend your exhale twice as long as your inhale
      • Pursing lips to put pressure on the back of the throat while breathing through the nose (ocean breathing/ujjayi, pranayama)
      • Sing! Singing extends the exhale
      • Abdominal breathing – long, full, deep breaths into the abdomen
    • Muscle relaxation: Tighten a specific muscle group for 10 seconds and then release, starting at the top of your body and moving down to your toes. The key is to bring focused awareness to the release of the muscle tension.
    • Meditation: Meditation brings us back to the present moment, in which we can focus on a calmer breath pattern, lower the heart rate, and send messages to the body that it can relax. Meditation, therefore, increases our objectivity, resiliency, and capacity to choose how we respond.
    • Yoga: Integrates all of the above: muscle movement, breath, and mindfulness. It incorporates focused breath and attention as different muscle groups are activated in a meditative flow.
  1. Identify and Name Emotions: Dan Siegel calls this “Name it to Tame it”. By bringing awareness to emotions and verbally expressing our “inner world,” we are biologically moving into the executive part of the brain, which activates the parasympathetic nervous system.
  2. Diet: Stimulants like caffeine increase the physiological response triggered by anxiety. Reducing these stimulants in our diets sets the stage for our bodies to feel relaxed.
  3. Exercise: By choosing to exercise in moments of anxiety, we are “using up” the adrenaline that was released in the fight-or-flight state and allows our bodies to become balanced and relaxed.
  4. Decrease screen time: Constant screen use may provoke anxiety through stimulating images and headlines.

 

How To “Tend and Befriend”

In a parasympathetic nervous state, our body and mind recognize we are safe enough to step outside of our internal world and engage with our social environment. This is why some refer to the state as “tend and befriend.” It is in this state that we are able to connect with others (befriend). It is also how we are able to offer support or protection (tend).

It’s fascinating how this is playing out right now during the coronavirus outbreak. Some may be experiencing anxiety due to the resulting loss of jobs, concern for their own and each other’s health, and the general inability to predict the timeline or outcomes of the pandemic. Social connectedness is extremely important as we face this anxiety. Patterns of protection and helping others (i.e. sewing masks, checking in with loved ones, offering to get groceries for the more vulnerable) keep us grounded as well.

Here are some “tend and befriend” strategies for getting into and maintaining a parasympathetic nervous state when feeling anxious:

  1. Communication tools: By naming your emotions to someone else (see #2, above), we are also building connection with others, making ourselves open to support, and becoming a source of support. Some assertive communication skills that we teach students and parents at Open Sky are the “I Feel” Statements and the 4-Line Feelings Check (see descriptions here).
  2. Intentional time with others: schedule time with loved ones to nurture connection and relationship.
  3. Helping others: Emotional and behavioral compassion is proven to have positive effects on mental health by reducing depression and anxiety and increasing self-esteem.
  4. Connection to a higher power: Practice prayer, keep a gratitude list, or recite mantras to be in connection with a higher power and foster closeness with others through those practices.

 

Incorporating these Concepts into Wilderness Therapy Treatment

As a Clinical & Family Services Therapist at Open Sky, I have the opportunity to support both students and parents in developing skills to cope with anxiety. I individualize my approach based on the person’s current patterns of coping. I’ll often ask that a student try a certain new behavior every time they feel anxious during the upcoming week, keep a log of their anxiety and new behaviors, and report back during the next session. For instance: talk it out (“name it to tame it”) using “I Feel” statements instead of holding it inside, practice new breathing techniques, or do jumping jacks. The following week, we evaluate what helped and discuss why it worked. Students begin to recognize that with those helpful strategies, they’ll begin to feel safe, in control, connected, and able to focus on higher-level thinking and decision-making rather than the perceived threat.

One effective aspect of life in the field at Open Sky is limiting what we call, “future information”. Students don’t always know exactly what is coming next, whether that be events happening later in the day or later in their stay at Open Sky. There is also the factor that the wilderness itself provides a setting for the unexpected to arise. As an intervention, this steers students away from coping with anxiety by managing the external rather than the internal. Instead, we empower students to focus on the here-and-now, resource from within, experience success in managing the unknown, and develop self-esteem for tackling challenges in the future.

Through Parent Coaching, I often help parents who frequently want to “rescue” their children from the discomfort of the unknown. I will often ask parents to tell me about their desire to “fix things” or remove stressors from their child’s life. This often buds into a rich conversation about resilience, grit, and self-efficacy. They begin to learn that, by constantly coming to the rescue of their child, they may be limiting their child’s opportunities to develop self-esteem and confidence in coping effectively with anxiety.

We also look at generational anxiety and maladaptive coping. By reacting to stimuli from an anxious state, parents are modeling reactivity to family members. I support parents in attending to their internal experience to break this dynamic within the family system. We practice the strategies listed above, such as “name it to tame it,” a breathing technique, or an “I Feel” statement. Parents themselves will also feel empowered through these tools and become more effective in communicating and role modeling for their children.

Mary Zaunbrecher, MS, LPC | Clinical & Family Services Therapist

May 1st, 2020

Mary Zaunbrecher, MS, LPC | Clinical & Family Services Therapist