如何克服和焦虑有关的焦虑
By MARGARITA TARTAKOVSKY, M.S.
Associate Editor
焦虑带来的身体刺痛是否使你更加焦虑？例如，对于有些人来说，即使手心出汗,心跳加快、四肢战斗是运动的结果,而不是即将恐慌来袭，他们仍然对他们的焦虑有强烈的焦虑反应。
这就是所谓的焦虑敏感。根据作者和临床心理学家Margo C. Watt博士和Sherry H. Stewart博士在他们的优秀书籍《克服恐惧的恐惧：如何减少焦虑敏感》一书中的看法，焦虑敏感是对“伴随着恐惧和焦虑的肢体感觉恐惧性反应的一种倾向。”简单地说,就是“恐惧的恐惧。”
那些容易焦虑敏感的人倾向于小题大做，或者会自然而然地认为最坏的事会发生。例如,你可能会担心你的颤抖会引起别人注意或心跳加快也许意味着心脏病发作。
Watt和Stewart在他们的书中勾画出一种低焦虑敏感的认知-行为方法框架。你会发现这里的一些建议对你很有帮助。
改变你的思想
我们告诉自己的故事可以加重我们的焦虑。但好消息是我们的故事也会减少我们的焦虑。据作者的看法，我们可以根据身体感觉调大或调小，这取决于当我们体验这些感觉时我们对自己说什么。下面是如何精确地找出消极的想法并调整它们。
识别不正常的思想。知道告诉自己的故事将有助于找出你的思想是如何让你永久焦虑的。要了解这些思想，想想最近的体验，让你的思想恢复到零。“焦虑或恐慌发作之前、之中、之后你的意识里经历的主要思想类型是什么?这是一个灾难性想法的例子：“如果别人注意到我的焦虑、恐慌感，那会很可怕，我无法再面对他们了。”
挑战你的思维。Watt和Stewart引用心理学家William James的话：“对付压力的最强武器是我们能够去选择一种思想压过另一种。”他们认为读者把他们的思想看成猜测，不是事实。找出你的思想的证据，并问自己这样的问题：“发生的真实概率有多大?这以前曾经发生过吗?不会发生的证据又是什么?”他们也建议不要小题大做。换句话说，他们说，“那又怎么样?”他们写道：“如果最坏的情形发生了又会怎么样?你会怎么做?你能生存下去吗?如果你看见别人晕倒你会怎么做，发抖还是脸色变红?如果别人表达了相似的恐惧你对他们怎么说?”
代以健全的思想。目标就是用现实的、理性的、乐于助人的思想取代消极的想法。举例来说，如果你的心跳开始加速一开始你觉得自己可能是得了心脏病，你可能会说：“我不可能得了心脏病。这可能是焦虑，我现在能为自己做的最好的事情是呼吸、尽量放松。我不该和我的身体作对，而应该和其一起工作。我能够驾驭它。”
改变你的行为
减少焦虑敏感的另一种方法是让自己置身于身体知觉中——一个称为体内暴露的过程。据作者的看法，目的是习惯化，即“在重复性出现后降低对刺激的反应。”换句话说,你越把自己暴露于身体知觉，你越习惯他们。随着时间的推移,他们失去了力量。
有许多体内暴漏的技巧，如歇斯底里， 通过狭窄的麦秆呼吸或站着旋转。“做暴露练习的最主要目标是学习新的方式去应对自己的生理感觉。”那就是为什么当你在做这些练习时不能避免或者逃避感觉很重要的原因。
改变你的生活方式
健康的生活习惯对降低焦虑敏感也很重要。Watt和Stewart把我们的身体比作车辆。车辆需要定期维护，因此我们的身体也是如此。
但正如作者所指出的，“有趣的是，相比我们的身体这种24/7原则的车辆，我们更倾向于去维护我们的汽车和卡车，尽管忽略我们的身的适当维修会造成更高的成本。”
据作者的看法，如果我们的身体有一个用户手册，那应当如下：
一辆汽车有的适宜能量，这好比营养，其工作状态最好。
一辆汽车具有干净空气和冷却效果的良好通风设备，这好比呼吸，如腹隔膜式呼吸，其工作状态最好。
一辆汽车有规律运作，好比定期身体活动，其工作状态最好。
一辆汽车能够运作后刹车，好比休息和睡眠，其工作状态最好。
你在和焦虑敏感抗争吗？
什么能够帮助你减少焦虑敏感？
How to Overcome Being Anxious About Being Anxious
By MARGARITA TARTAKOVSKY, M.S.
Associate Editor
Do the physical twinges of anxiety make you even more anxious? For instance, for some people, even though the sweaty palms, racing heartbeat and shaky limbs are a result of exercise — and not an impending panic attack — they still experience intense anxiety about their anxiety.
This is called anxiety sensitivity. According to authors and clinical psychologists Margo C. Watt, Ph.D, and Sherry H. Stewart, Ph.D, in their excellent book Overcoming the Fear of Fear: How to Reduce Anxiety Sensitivity, anxiety sensitivity is “the tendency to respond fearfully to bodily sensations associated with fear and anxiety.” Put simply, it’s “the fear of fear.”
People who are prone to anxiety sensitivity tend to catastrophize, or automatically assume that the worst will happen. For instance, you might fear that your trembling might catch the attention of others or a racing heart might mean a heart attack.
In their book, Watt and Stewart outline a cognitive-behavioral approach to reducing anxiety sensitivity. Here are a few tips you might find helpful.
Changing your Thoughts
The stories we tell ourselves can heighten our anxiety. But the good news is that our stories also can diminish our anxiety. According to the authors, we either turn up or turn down the volume on our physical sensations depending on what we say to ourselves when we’re experiencing these sensations. Here’s how to pinpoint negative thoughts and adjust them.
Identify dysfunctional thoughts. Knowing the stories you tell yourself will help you figure out how your thoughts are perpetuating your anxiety. To get at these thoughts, think of a recent experience, and zero in on your thoughts. “What were the major kinds of thoughts going through your mind just before, during, and after the episodes of anxiety or panic? This is an example of a catastrophic thought: “If other people noticed my anxiety and panicky feelings, it would be terrible and I could never face them again.”
Challenge your thinking. Watt and Stewart cite psychologist William James: “The greatest weapon against stress is our ability to choose one thought over another.” They suggest readers treat their thoughts as guesses, not facts. Examine the evidence for your thoughts, and ask yourself these questions: “What are the true odds of this happening? Has this ever happened before? What’s the evidence it won’t happen?” They also recommend de-catastrophizing. In other words, they say “So what?” They write: “What if the worst-case scenario did happen? What would you do? Could you survive? What would you do if you saw others faint, shake or turn red? What would you say to others if they expressed similar fears?”
Substitute healthy thoughts. The goal is to replace negative thoughts with realistic, reasonable and helpful thoughts. For instance, if your heart starts to race, and you initially think that you might be having a heart attack, you might say: “It’s unlikely that I’m having a heart attack. This is probably anxiety, and the best thing I can do for myself right now is to breathe and try to relax. I shouldn’t fight my body but should work with it. I can just ride it through.”
Changing Your Behaviors
Another way to reduce anxiety sensitivity is to expose yourself to the physical sensations — a process called interoceptive exposure. According to the authors, the aim is habituation, which “refers to decreased response to a stimulus after repeated presentations.” In other words, the more you expose yourself to these physical sensations, the more accustomed you become to them. Over time, they lose their power.
There are many interoceptive exposure techniques, such as hyperventilating, breathing through a narrow straw or spinning around while standing. “The main goal in doing exposure exercises is to learn new ways to respond to your own physiological sensations.” That’s why it’s important not to avoid or escape the sensations when you’re doing these exercises.
Changing Your Lifestyle
Healthy habits also are important for shrinking anxiety sensitivity. Watt and Stewart use the metaphor of our bodies as vehicles. Vehicles require regular maintenance, and so do our bodies.
But as the authors point out, “Interestingly, we’re more apt to attend to maintaining our cars and trucks than our own bodies, the vehicles we live in 24/7, even though neglecting proper maintenance of our bodies comes at a much higher cost.”
According to the authors, if our bodies had a user’s manual, it would say the following:
A vehicle works best when it has proper fuel, which translates into nutrition.
A vehicle works best when it has good ventilation for clean air and cooling effects, which translates into breathing, such as diaphragmatic breathing.
A vehicle works best when it is operated regularly, which translates into regular physical activity.
A vehicle works best when it has a break from operation, which translates into rest and sleep.
