Announcing My New Course: Easing Worry & Anxiety with Internal Family Systems

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I am pleased to announce the launch of my second Premium Audio Course for Insight Timer – Easing Worry & Anxiety with Internal Family Systems. If you sign up to this six-day course today you will learn why you feel so anxious, starting with the evolutionary and neurological roots of anxiety, explaining why it’s a crucial emotion for us all to feel, because it alerts us to threats and helps us react to them, quickly if need be.

Understanding why you feel so anxious is a key step in learning to accept it, because anxiety is something we all feel and is an important alarm signal when things need our attention. And then helping you ease it over time – this course will help you start to feel calmer, safer, and more at peace, step by step.

Over the six days you will also learn about internal family systems therapy, which is one of the fastest growing and most popular models of therapy in the world right now. As an Internal Family Systems Therapist, I use this warm, compassionate, and highly effective treatment approach with my clients and in my teaching, because it offers a revolutionary way of understanding problems like chronic anxiety.

Meeting your young, anxious part

You will learn that this anxiety comes from an anxious young part of you, holding painful thoughts, feelings, and memories of difficult experiences in your childhood. To ease your anxiety, you need to learn how to connect with, understand and soothe this anxious little boy or girl inside.

I will also teach you that worry comes from another part of you, called the Worrier. Again, you will learn how to accept and even value this protective part, because it’s just trying to help, even if the way it does so can be stressful and exhausting at times.

I hope you join me on this transformative six-day journey, which includes theories and techniques drawn from my many years of helping clients better manage their anxiety. As well as trauma-informed teaching about the mind-body source of problematic anxiety, I will lead you through powerful calming techniques including breathwork and guided-imagery exercises, drawn from IFS and other trauma-informed therapy models.

The course is free if you become a Member Plus Supporter. This costs just $60 for 12 months of high-quality content like this on the Insight Timer app from me and thousands of other leading teachers. ⁠

Try it now by visiting my Insight Timer collection or clicking on the button below. ⁠

I hope you find it insightful and healing. ⁠

Love ❤️⁠

Dan

Why Do We Worry? And is it Always a Problem?

Would you call yourself a worrier? And if so, what kinds of things do you habitually worry about? Let me take a guess… My hunch is that your worries take the form of ‘what if…’ thoughts, like ‘What if I lost my job? How would I cope? Would we lose our home? Would my wife leave me?’

Or, ‘What if I make a fool of myself giving that speech at my daughter’s wedding? What if my mind just goes blank and I can’t remember what to say? Everyone would think I’m a pathetic loser. That would be horrendous – I would never live it down.’

Our worries commonly show up as these ‘what if…’ thoughts for a few reasons:

1. Worries are always future-focused. We never worry about things that have already happened. And that’s why worry (a cognitive process) is linked with anxiety (a feeling), which is also future/threat-focused. So we worry about bad stuff that could happen, imminently or further down the line.

2. Worries are often catastrophic. Not always, of course – worries range from mild to severe. But they often involve ‘catastrophising’, because that’s what worry is for – imagining worst-case scenarios and how we could cope with them. So in the above example, losing his job led to losing the house and potentially divorce, rather than simply having to downsize or rent for a while.

3. Worry involves ‘bridge-crossing’. This links to the future-focused idea, because when we worry we are crossing every potential bridge on the road ahead, seeing where they all lead and how best to cross them. Some of those bridges we may well have to cross, but probably 99% of them we won’t, which is one reason that worry can be stressful, exhausting and potentially very unhelpful. We live through a vast number of horrible imagined situations, most of which never actually happen.

Worry is not a bad thing, per se

I have had many clients who worry in an obsessional, relentless and exhausting way – so for them, worry is definitely unhelpful. But I tell even these people that worry is not a bad thing, per se – it’s the way we worry that’s tricky.

Let’s do a thought experiment. Imagine that a team of scientists could miraculously stop your brain from worrying, ever again. Pow! No more worry. Would that be helpful? Not so much.

Imagine you now have to plan your daughter’s wedding (and write that damned speech). But you can’t do any future-focused problem solving because you have lost the ability to worry. And remember that this is what worry is for – imagining challenges in your future so your brain can think and think (and think!) about them until it has come up with a solution.

Which part of you does the worrying?

Looking at this through an internal family systems lens, as I increasingly do, it’s helpful to understand that there’s a part of you who feels anxious (a young part, probably) and another, protector part, who starts worrying to try and help the little one feel calmer, safer and less stressed. This is what protectors do, inside your head – try to make sure that hurt parts of you never get hurt again.

We usually call this part, unsurprisingly, the Worrier. And Worrier parts are busy little bees. They are super-hard working, hypervigilant, relentless (when you ask them they will tell you they never switch off, 24/7, every day of your life). They work so hard to protect you – and especially those young, anxious parts of you – from being criticised, attacked, shamed, rejected, or hurt in any other way. They’re kind of heroic, in my opinion.

But of course all this worry is exhausting. It often leads to insomnia, as you lie there at 3am going over and over that tricky morning meeting. Excessive worry can lead to chronic stress, burnout, being constantly on edge and never able to switch off. It’s not much fun.

So if you worry in this unhelpful way, we clearly need to help you worry less, altogether, and worry in a less catastrophic, more helpful/problem-solving way. Luckily, internal family systems gives us a clear, concrete road map of how to make these internal changes – one of the many things I love about this incredibly creative, highly compassionate model.

If you would like to find out more, do come along to my next workshop – Overcoming Anxiety: How to Worry Less, Feel Calmer and More at Peace, on Saturday 10th December 2022. This is an online workshop, so you can join from anywhere in the world. As with all our Heal Your Trauma events, it offers a limited number of free places, as well as a Low-Income Ticket and Supporter Ticket, if you are able to support the project.

So money should be no barrier, if you need help, even if you are struggling financially right now.

I hope to see you there!

Warm wishes,

Dan

Can’t Stop Worrying? If So, This Simple Technique Will Help

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Why do we worry? It’s an important question and – if you struggle with worry and anxiety – one we need to answer before thinking about how to help you. One way to think about worry is anticipating stressful, threatening, upsetting or even dangerous events that might occur in the future. This is known as ‘bridge-crossing’. Your brain knows there is a challenge up ahead, so crosses every possible bridge that might lie in your path, to try and help you manage the challenge as best you can.

You could also say that worry is a wired-in, evolutionary response to threats and dangers. Let’s say you were a hunter-gatherer, walking through long grass on the savannah, 10,000 years ago. The threat system in your brain would have been (rightly) highly sensitive and hypervigilant, using all your senses to scan for predators lurking in the grass. You might even have imagined a lion leaping out and how you would try and fight them off, or make your escape. In doing so, you would have visualised the whole scenario, as if playing a video in your mind’s eye.

That would have required a uniquely human capacity: the ability to use a kind of virtual-reality simulator in your brain to imagine the future – sensing it, visualising it and even living through it – to help protect you from potential threats. When you worry, you are using these high-tech neural capacities to anticipate bad stuff on the horizon and how to protect yourself.

More simply, we can also say that worry is a kind of problem-solving thinking, helping you anticipate upcoming problems and then helping you find solutions by running through a whole host of possible options, until you find one that could work.

How anxiety leads to worry

Another key thing to understand about worry is that it’s the cognitive response to the emotion of anxiety. It’s important to emphasise this, because people often get the two mixed up. They say, ‘I feel worried,’ when what they mean is, ‘I feel anxious and am worrying to try and deal with that.’ (I’m sure my clients get fed up with me reminding them of this, but it’s important, so I brave their eye-rolling and say it anyway.)

If we add to this puzzle the fact that anxiety is a threat-focused emotion, triggered by your brain as an alarm call to let you know a person or situation is threatening and you should do something – right now! – to deal with it, you can see why anxiety is designed to feel so bad; and how it’s intended to provoke some kind of urgent, problem-solving action. And we’re back to worry – the urgent, problem-solving action that your brain takes when you feel uncomfortably anxious.

Getting to know the worrier

Yet another way of thinking about worry (last one, I promise) involves understanding that your personality is made up of a number of different parts. I have written about this extensively in previous posts and pages on my site, so if you need to know more I will just point you to either this page on ‘modes’ in schema therapy or this one on internal family systems.

One of the most effective ways of managing unhelpful worry is to speak to the part of you that does the worrying when you’re feeling anxious (usually named the Worrier, for obvious reasons). Here’s a step-by-step guide to doing just that…

The practice

Having a dialogue with your worrier

1. You can try this in two ways. One way is to use these guidelines just to have an internal dialogue with your Worrier part – this can happen many times throughout the day, whenever you find yourself worrying about something. But if you have time – and especially when you’re starting out with this talking-to-parts approach – I recommend trying this longer method first.

2. Start by switching your phone to silent and carving 10 minutes out of your busy day. If you are plagued by constant worry, which as you know can be very stressful and unpleasant, you should be highly motivated to find the time.

3. Now take two chairs and place them so they are facing each other. One chair is for the Worrier, the other your Healthy Adult. First sit on the Worrier chair and let rip about something you have been worrying about recently. It could be a problem at work, with your partner or kids, losing weight, health issues, or more global stuff like the cost of living crisis or climate change. Any subject will do, as long as it has been bothering you lately.

4. Now be the Worrier. Just act as if you are this part of yourself and (here’s the slightly weird bit) imagine that you are sitting on the other chair. So, if this was me, as the Worrier I would say: ‘Dan, I’m really worried about this post you’re writing. Honestly, it doesn’t seem that great. What if nobody reads it? What if they all think it’s crap and unsubscribe? And what if this whole Heal Your Trauma thing just crashes and burns? You’re not working hard enough on it, this is not your best work, so I think you should just scrap it and start again.’

5. Spend a couple of minutes being the Worrier, telling James or Jenny (you) in the other chair all the things he/she needs to worry about right now.

6. Then switch to the Healthy Adult chair. Plant your feet, roll your shoulders back and lengthen your spine. Close your eyes and breathe deeply, in through your nose and out through your mouth. Let your belly rise and fall with each breath. Keep breathing until you feel a little calmer, then open your eyes and respond to the Worrier from your (calm, strong, wise, compassionate) Healthy Adult.

7. Using myself as an example again, I would say, ‘Worrier, I know you mean well and you’re just freaking out right now. But I am working hard on this post – I always do. My writing is really important to me, so I try to make every post informative and interesting. And even if a couple of people unsubscribe, that’s OK, it’s not the end of the world.

   ‘It’s good to work hard but not helpful to have my whole self-worth riding on one post, that doesn’t make sense. So it’s all good – you can just relax and let me handle it. Thanks again for looking out for me.’

8. Notice that on the Worrier chair I say ‘you’ and on the Healthy Adult chair it’s ‘I’. This is important, because I want you to own what you’re saying on the HA chair more, for obvious reasons.

9. Try this, many times, until you feel the Worrier start to calm down. Make sure the way you speak to this poor, frazzled part of you is friendly and kind. It’s not a bad, or mean part – it is trying to help. But the way it’s helping is not very helpful! So you just need to learn how to empathise with, then reassure the Worrier. As ever, practice makes perfect so repeat, repeat, repeat until this is working for you…

I very much hope that’s useful for you. And if you would like some help with your worry and anxiety, do come along to my new one-day workshop: Coping with Anxiety: How to Worry Less, Feel Calmer and More at Peace. This powerful, highly experiential workshop takes place from 10.30am-4.30pm on Saturday 10th September 2022. It costs just £99 for the full day, including refreshments – there are also a limited number of reduced-fee places available.

Coping with Anxiety: How to Worry Less, Feel Calmer and More at Peace will be held at the Gestalt Centre, a short walk from King’s Cross Station in central London. Don’t miss this chance to learn from and spend a day with me – places are limited, so find out more and book using the button below:

I look forward to seeing you in September or at one of my upcoming workshops.

Warm wishes,

Dan

Would You Like Help With Your Worry and Anxiety?

Due to unforeseen circumstances, this event has been cancelled. If you were interested in attending, do book the online version of this workshop, which will run on 10th December 2022. Bookings for that workshop open in November. We apologise for any inconvenience caused.

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Coping with Anxiety: How to Worry Less, Feel Calmer and More at Peace features teaching, powerful exercises that will help you feel calmer and more relaxed, and the chance to put your questions to Dan Roberts, a leading expert on trauma and mental health.

In this powerful, highly experiential webinar you will learn:

• Why high levels of anxiety are a common problem for people with a trauma history – and how that’s linked to a ‘dysregulated’ nervous system, as well as elevated levels of ‘stress hormones’ like adrenaline and cortisol in your bloodstream

• How anxiety is the brain’s ‘alarm’ emotion, warning you that something bad is about to happen and that you should do something, immediately, to keep yourself safe

• Why anxiety is linked to the fight-flight-freeze self-protection responses – useful for escaping from a hungry lion, but not if you’re sitting at your desk in a quiet, safe office

• Simple, evidence-based strategies to calm your anxious inner child, quickly and effectively

• Why anxiety (an emotion) and worry (a thinking process) are inextricably linked – and how to reduce both overwhelming emotions and unhelpful thinking

• Key experiential exercises – such as Compassionate Breathing and 4-7-8 Breathing, guided meditations and imagery – you will learn to help you cope with your anxiety, reduce unhelpful worry and feel calmer and more in control

• And throughout the day, you will get the chance to put your questions to Dan Roberts, Founder of Heal Your Trauma and an expert on trauma healing and managing anxiety

Don’t miss this chance to learn from a leading trauma therapist and expert on mental health and wellbeing – watch the video for more information and book your place now using the button below.

Warm wishes,

Dan

Is Worry Driving You to Distraction?

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My clients often tell me that they feel worried. And, while I understand what they mean, I always tell them that worry is not a feeling – it’s a thinking process linked to the feeling of anxiety. So, really, what they are telling me is that they feel anxious about something and have gone into worry mode to try and think their way out of the anxiety.

In schema therapy, the part that feels anxious is your Vulnerable Child mode – Little Jane or James. This is the emotional part of you, which gets triggered whenever you feel sad, anxious, stressed, hurt, upset, down… It’s also the part of you that holds all your painful memories from childhood and can get triggered when you feel threatened by something – especially if that reminds you of a stressful event from childhood.

Worry is a symptom

Let me give you an example. *Helen comes to see me because she can’t stop worrying. It’s driving her crazy, because she worries about every little thing. ‘If I have a meeting at work, I worry beforehand, about what I’ll say, whether my boss is annoyed with me, whether my colleagues like me, what I’m wearing, what I say in the meeting… You name it, I’m worrying about it,’ she tells me.

And this worry is exhausting for Helen. It makes her feel stressed before, during and after the meeting. She just can’t stop thinking about these problems. It’s like her mind is a vice – it grips on to the problems and won’t let go. ‘The other problem is that it’s driving my husband crazy,’ she adds. ‘He tries to reassure me but it doesn’t work, so I go on and on about these petty things until we’re both ratty and exhausted.’

Of course I feel for Helen – her worry is causing huge problems in her life. It maintains her low self-esteem, because she doesn’t believe she will ever do anything well enough, and that people think she’s rubbish at her job, even that she will get fired because her boss doesn’t rate her. But in our first session, I tell her something surprising and counterintuitive – even though it’s driving her nuts, worry is not the problem. It’s a symptom. And the root cause of her worry is anxious Little Helen.

Anxiety warns us about threats

I ask her to tell me more about her boss, to see if he reminds her of anyone from her past. She thinks about it, then has one of those lightbulb moments. ‘Ohhh,’ she says, ‘He is just like my dad!’ Helen goes on to tell me that her dad was highly critical when she as a child, telling her that nothing was ever good enough. If she got a B on a test, he would ask impatiently why it wasn’t an A. If she came second in a cross-country race, he would berate her for not being first. And so on.

So when she goes for a meeting with her boss, Little Helen feels highly anxious – just like she did around her dad as a child. And that’s what anxiety is for – it’s an alarm-bell emotion that warns us about potential threats. Her Worrier part then kicks in, with lots of ‘what if…’ thoughts to try and problem-solve the threats. ‘What if you say the wrong thing?’ ‘What if your boss criticises you?’ ‘What if you get fired?’

Trying to help. Trying to protect her from this nit-picking, critical, perfectionistic boss who is just like her dad. Not mean, or horrible, but trying to help Helen deal with the anxiety-provoking situation.

Comforting your little self

In order to help Helen, in schema therapy we do a few things. First, we work with the Worrier, helping Helen see where it came from, what its function is, the pros and cons of worrying, and so on until we can help it calm down a bit. Second, we help Little Helen feel safe, comforted and genuinely, deep-down reassured (not the temporary fix of reassurance that worry provides). There are many ways to do this – plenty of which are provided in this blog – but a simple first step is to use this self-compassion practice to help your little self feel calmer and more at peace.

Third, we build up Helen’s Healthy Adult, so she feels stronger, more rational, having better perspective – seeing the big picture rather than obsessing about the details. If you are a worrier by nature, you need to do all three things, rather than just focusing on the worry. Otherwise, you’re treating the symptom, not the cause, so the worry will just keep coming back.

Warm wishes,

Dan

*All of the case studies on this blog are composites of actual people – I would never reveal any personal or identifying information about my clients.

Try this Mindfulness Technique to Help Quiet Your Mind

Image by Nathan Dumlao

One of the biggest misconceptions about mindfulness meditation is that you should be able to clear your mind of all thoughts – and that, if you can’t do that, you are somehow getting it wrong.

As anyone who has tried meditating knows, not only is it impossible to stop thinking – as if you could turn off some kind of mental tap – but also that the whole point of mindfulness meditation is to become aware of how your mind works.

And a central part of that is to begin noticing the ceaseless whirl of thoughts that accompanies you throughout your every waking moment. When you meditate, perhaps focusing on your breath, thoughts naturally and inevitably arise.

The point of the practice is to notice this, then gently escort your attention back to the breath. That is meditation, not achieving some perfect state of complete mental silence and tranquillity.

That said, there are times when we might want to quiet the mind. With my clients, that might be when their thoughts are racing, making them feel highly stressed, anxious or agitated. Or it could be to help with insomnia – especially those 3am ‘what if…’ worries when everything looks bleak and scary.

I recently tried a superb mindfulness practice designed to quickly and effectively quiet the mind. I loved it, so have tried it with my clients and it really seems to help them too. The practice is offered by meditation teacher Bodhipaksa (you can try it for yourself on Insight Timer – where you can also make a small donation, if you wish, to thank him).

The practice

Here is my version of the practice, for those who like to read and not just listen to instructions:

1. This practice takes around 10 minutes, so find a quiet time in your day when you won’t be disturbed. Switch your phone off, but set a timer for 10 minutes. Sit on a straight-backed chair or cushion, finding a posture that is upright but relaxed.

2. Start by becoming aware of the points of contact between your body and the cushion/chair/floor. Notice the weight of your arms and hands resting in your lap. Then shift your awareness to your breathing. You don’t have to change your breath in any way, just let your body breathe itself.

3. Normally in mindfulness of breathing we focus on one point in the body, like the nostrils, chest or stomach rising and falling. In this practice, we will try something different – start by bringing your attention to your upper back. Notice the muscles expanding on the in-breath and contracting on the out-breath. Keep your focus here for a minute.

4. Now, while still holding the back in your awareness, also focus on your belly rising and falling. Zoom right in to the contact between your skin and clothing. What’s that like? You might notice warmth, coolness, friction, softness, or perhaps nothing much at all, which is perfectly fine.

5. Then add an awareness of the breath entering and leaving your nostrils, flowing down your throat and into the lungs. So you are now holding three distinct parts of the body in your awareness, all at the same time.

6. You might start to notice a sort of dance between these three areas of the body, as the breath flows in and out. Stay with that for a few minutes until your timer goes off. Slowly and gently open your eyes.

When I have tried this practice, holding three separate areas in awareness is effortful. It’s not easy, so it takes up a lot of mental bandwidth. I found there wasn’t much left for thinking, so my mind automatically became quiet and still. I hope you find it helpful too.

Warm wishes,

Dan

Why You Can't Always Think Your Way Out of Trouble

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Humans are thinking creatures. More than any other animal on Earth, we have the ability to think, reason, analyse, remember our past and imagine a future that hasn’t even happened yet. That is because of the cortical layer of our brain, especially the prefrontal cortex – the most evolved part of our brain, which is involved in high-level, executive functions like impulse control, rational thought and predicting the consequences of behaviour.

And this miraculous supercomputer in our skulls is what allowed humans to write symphonies, build the Pyramids and fly to the Moon. That uniquely human brain is also what allows me to practice psychotherapy, or write this post. And it helps you problem-solve your way out of difficult situations – a vital and sometimes lifesaving skill.

When thinking is not your friend

But if you are struggling with your mental health, feeling highly stressed, anxious or depressed, thinking may not be your friend. That’s because the kind of thinking we do when we’re experiencing high levels of painful emotion can be deeply unhelpful. Let me give you an example.

Jane is a highly anxious, frequently worried type of person. And when she hits bumps in her life, she tries to think her way out of them. Jane engages that thinking brain and then worries, obsessively, projecting into the future with hundreds of ‘what if’ thoughts (‘What if my boss doesn’t like my work and I get sacked?’, ‘What if I can’t find another job?’, ‘What if I lose my home and end up on the street?’).

These obsessional, catastrophic thoughts are especially bad at night, when Jane lies there for hours worrying, worrying, worrying. This just makes her more anxious, stressed and, of course, exhausted. So the next day her resources are low and she feels ten times worse.

Keep it simple

In schema therapy language we would say Jane has a Perfectionistic Overcontroller mode, which tries to be in control all the time, hates uncertainty or feeling out of control, and believes that there is always a perfect solution if she just thinks long and hard enough! If I were helping Jane I would work with this mode to help it calm down a bit and give her a break from the relentless worrying.

I would then help Jane to develop a range of activities that did not involve thinking. This would first involve drawing up a list of coping skills. Try this yourself – write ‘coping skills’ on top of a blank sheet of paper. Then come up with 10 skills, with different types of activities you can use at different times. The first four skills I teach clients are always my Posture, Compassionate Breathing, Supportive Touch, Compassionate Self-Talk sequence (read all about those in this post).

Use what works for you

The other six are negotiated with my client, depending on what they find helpful, calming or relaxing. Yoga is fantastic, if it works for you. Mindfulness or other forms of meditation often go on the list. We might also add taking a long, luxurious bath; watching a TV show or movie you find comforting; calling a trusted friend; getting a hug from someone you love; stroking your favourite pet; drinking a warm, milky drink; going for a walk, preferably in some green space; reading a blog like this one, which focuses on improving mental health; listening to a song you find moving or joyful…

The list is endless, really. It’s just about finding ten things that will help you feel (depending on the emotion you are struggling with) calmer, more peaceful, more grounded, happier, more energised, or mindfully in touch with the present moment. Try it now – write up a list and then stick it on the wall next to your computer, on in your bedroom, where you will see it every day.

Then practice those skills, on a daily basis, until they become so familiar it’s like muscle memory. Over time, you will find that you are able to take the edge off whatever painful emotion you are feeling – that also gives you a strong foundation to begin therapy, use self-help books, or whatever way you choose to work on the deeper wounds that cause those painful emotions to bubble up.

I hope that helps. In my experience, it really does, so I hope it benefits you as much as it has hundreds of my clients.

Warm wishes,

Dan

What are Anxiety Disorders?

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In either cognitive or schema therapy we first try to understand exactly what is causing someone’s problems, before going on to help solve them. If someone is struggling with anxiety, part of this understanding is making a diagnosis of exactly which ‘anxiety disorder’ someone is struggling with.

Some people find this idea a little uncomfortable, but it’s just like your GP diagnosing whether you have the common cold or flu, so they can prescribe the right treatment.

There are seven anxiety disorders, which I summarise briefly below – map your symptoms on to the disorder to see whether you might have one. If you are unsure, please get an assessment from a cognitive or schema therapist; and remember that it’s common to suffer from more than one of these disorders at the same time, as well as other problems like depression or low self-esteem.

Panic disorder and agoraphobia

A panic attack involves a sudden increase in anxiety, accompanied by physical symptoms of anxiety, such as a racing heart rate, breathlessness or dizziness. Panic disorder involves recurrent panic attacks and may or may not lead to agoraphobia – anxiety about being in situations in which escape would be embarrassing or help would not be available in the case of a panic attack. People with agoraphobia may struggle to leave the house or be in open or public places, like shopping centres.

Health anxiety

Health anxiety (also called ‘hypochondriasis’) involves a fear of having a serious illness, like cancer or heart disease, and a preoccupation with bodily symptoms. The problem will not go away with medical reassurance and is often extremely distressing – you may be convinced you have a serious health problem but that no-one believes you, which is understandably frustrating and upsetting.

Social phobia

People with social phobia have a fear of social or performance situations, or both; you may feel comfortable with one trusted friend, but become anxious if their friend joins you. You might be fine in small groups, but the bigger the group the more your anxiety grows. And you might struggle in performance situations, like public speaking or university seminars – you may hate being put on the spot or have the feeling that everyone can see how anxious you are and will think badly of you in some way.

Specific phobia

This involves the persistent fear of a particular object of situation – it’s ‘specific’ because you fear that and not a wide range of things. The most common phobias are a fear of heights, public speaking, snakes, spiders, being in enclosed spaces, mice, needles and injections, crowds, clowns, darkness and dogs. Of course, some people struggle with more than one phobia. And it’s worth noting that specific phobias are relatively easy to treat with CBT – in around six sessions or less.

Generalised anxiety disorder (GAD)

GAD is defined as excessive anxiety and worry occurring more days than not for a period of at least six months and about a number of events or activities. The two key features of this disorder are ‘free-floating’ anxiety, which attaches itself to one thing after another; and persistent worry, which is more severe than normal worry, seems hard to control and causes distress and/or makes it difficult to function.

Obsessive-compulsive disorder (OCD)

If you are suffering from OCD, you will experience obsessions (intrusive images, impulses or thoughts) and/or compulsions (repetitive behaviours engaged in to minimise the anxiety or upset caused by the obsessional thought or because of rigid rules). Although the compulsion – which could involve checking, washing, prayers or replacing negative thoughts/images with positive ones – is intended to reduce distress or prevent a feared outcome, like someone you love being harmed. Unfortunately, the compulsion only provides short-term relief and is a key element of what maintains the OCD.

Posttraumatic stress disorder (PTSD)

PTSD occurs as a reaction to a profoundly distressing event that threatened death or serious injury to yourself or other people; a response that involved intense fear, helplessness or horror; and key symptoms of re-experiencing, avoidance and hyperarousal. There is some debate over whether PTSD is an anxiety or stress/trauma disorder, but as it does involve very high levels of anxiety, I have included it here.

Warm wishes,

Dan

Excellent Self-Help Book on Worry

I am always keen to promote the best sources of information to help people gain insight into their problems, because without insight into what is making us unhappy, we cannot hope to overcome it. I'm currently reading Dr Robert L Leahy's The Worry Cure: Stop Worrying and Start Living – one of the best self-help books I have read for a long time.

Dr Leahy is one of the world's pre-eminent cognitive therapists and condenses 25 years of clinical experience into this informative and highly readable book.

As I often tell my clients, there is nothing wrong with worry per se – it is a normal and even helpful cognitive strategy for thinking about and solving problems. But, as Dr Leahy so eloquently explains, for some of us worry can be both excessive and distressing.

Chronic worry is associated with a wide range of psychological problems, from depression to anxiety disorders including OCD, health anxiety, social phobia and especially generalised anxiety disorder (GAD), in which persistent worry is one of the distinctive features.

Your worry profile

The Worry Cure explains why some of us worry more than others; offers a range of questionnaires and other diagnostic tools to help you understand what your 'worry profile' is; and, crucially, provides a wealth of tips and techniques to help you reduce your worry and learn to confront the problems that unhelpful worry actually stops you solving.

One of the paradoxical things about worry is that it can be a way of avoiding actually solving your problems. Although you may spend many hours fretting about them, which gives the illusion of control and makes you think you are tackling them, it can actually get in the way of confronting problems head-on.

This means separating the things you can control from those you cannot; coming up with solutions to those problems and taking action to actually solve them, not just spend fruitless hours worrying about them.

Warm wishes,

Dan