Extinguish Your Anxiety

Anxiety attacks occur when your body becomes alarmed by a physical or mental threat. Repeated anxiety attacks result from vividly recalling that feared event. Your body doesn't know the difference between a real or imagined threat. Your thoughts and images can trigger a false alarm that make you panicky. During an anxiety attack, you're mind automatically scans the environment to look for the culprit as a way of protecting you from future threats. Often times, your mind pairs the anxiety attack with things or events that are completely unrelated to the onset of your anxiety. External cues get paired with the initial anxiety attack, and can provoke subsequent attacks. For example, if you had an anxiety attack on a train, just thinking about the train can make you extremely panicky. This eventually leads to avoidance of places, things, and even people that trigger your fear. Pretty soon, you'll find your comfort zone crowding in around you. This is why it's important to extinguish your anxiety as soon it happens!

There are two components of anxiety that you want to focus on: the physical sensations of arousal, and the thoughts/images that fuel your anxiety. You can unlearn your anxiety response by gradually immersing yourself in fearful sensations and imagery until it no longer has an affect on you.

There are two techniques you can practice to desensitize your anxiety: exteroceptive and interoceptive desensitization drills. What's that, you ask?

Exteroceptive Desensitization:
This technique works on changing your external perceptions of fear. Events that cause your anxiety are recalled in your mind, while a relaxation technique, such as deep breathing, is used to dissipate the anxiety. With sufficient repetition through practice, the imagined event loses its anxiety-provoking power. Eventually, when you face the real event, you will find that it too has lost its power to make you anxious.

You would typically create a hierarchy of ten anxiety producing situations, and list them from least to worst. You will then systematically reduce your sensitivity to a given anxiety-producing situation in very small, controlled steps. Start with the least fearful situation, and mentally expose yourself to the situation a little bit at a time, and never let yourself get beyond a level of #3 on an anxiety scale from 1-10. By doing this, your mind can never remember having a "bad" experience in any given place, and therefore you're more likely to return.

Interoceptive Desensitization:
This technique works on changing your internal perceptions (thoughts) of fear. Often times, you become hypersensitive to your bodily sensations. For example, running up a flight of the stairs will cause your heart to race. A racing heart may seem familiar to what you experience during a panic attack. You may become fearful of having a panic attack, and this fear will cause your heart to beat faster, which may actually trigger an anxiety attack. Interoceptive exposure simply means exposing yourself to similar physiological sensations in a controlled amount, so that you can desensitize yourself to these physical sensations of arousal. The drills you choose depend on the physical sensations you fear the most. Here is a list of fears and related exercises that you can try to help desensitize your fear of your physical sensations. It is preferable to do these exercises with your therapist or a trusted friend/relative.

Fear	Exercise	Time	Instructions
Dizziness	Shake your head from side to side	30 sec	Lower your head a bit and shake it loosely from side to side with your eyes open. When the timer goes off, lift your head and stare straight ahead
Dizziness	Head between legs	1 ½ min	Sit in a chair. Bend your head down between your legs, trying to keep it lower than your heart. When the time goes off lift your head and stare straight ahead
Heart Rate	Run in place	1 min	Jog in place or run up stairs
Body tension	Tense your body	1min	While sitting, make fists with your hands, tense your feet,your chest and entire body.
Suffocation	Hold breath	30 sec	Take a deep breath, and try to hold it for 30 sec.
Suffocation	Straw breathing	2 min	Place a thin straw in your mouth and breathe while holding your nose.
Dizziness, heart rate	Hyperventilation	1 ½ min	While standing, breathe deeply in and out through your mouth like panting
Choking	External pressure on your throat	1 min	Use your thumb or 2 fingers to apply pressure to your throat
Vertigo/Dizziness	Stare at spot	2 min	Pick a spot on your empty wall and stare at it with a focused gaze
Thoughts	Focus on your worst sensation	2 min	Remember your worst panic sensation. Close your eyes, imagine a very bad panic & focus on that feared symptom. Or think of a feared thought.
Heart rate	Drink caffeine		Drink a cup of coffee to work on sensations brought on with caffeine. The max effect of caffeine isn't immediate, so it allows you to practice with greater unpredictability.
Warmth/Heat	Create heat	15 min	Turn up heat in the house or car and sit with hot clothing

The ultimate goal of desensitization exercises is to create a personal experience that will change your core belief, which will reduce or eliminate your fear of anxiety.