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The ABCs of Anxiety

Anxiety is one of the most commonly diagnosed mental health conditions. It is estimated that more than 40 million Americans struggle with some type of an anxiety disorder (Altman, 2014). Anxiety is a reaction to the experience of stress and is directly impacted by how well stress is managed.

Stress is a normal and healthy part of life. As with many things in life, balance is key. The lack of balance when stress is poorly managed can significantly increase anxiety. When anxiety remains elevated over an extended period of time, it begins to negatively impact physical health and can contribute to the experience of unwanted emotions (Livheim, Bond, Ek, & Hedensjo, 2018). Learning to manage stress and anxiety levels is important for developing a healthy and fulfilling life. The ABC’s of Anxiety can get you started on this journey of taking control of your stress and anxiety.

A – Adjust your Thinking

An important step in overcoming anxiety is to recognize thinking patterns. Our minds are processing thoughts constantly throughout the day, and much of this is automatic thinking that we are not fully aware of.

Words have power, and the words we use, both in thought and speech, have a profound impact on our emotional health. We are often not aware of the unrealistic expectations that our thoughts place upon us. How often do you find yourself thinking in terms of “always” “never” “everyone” “I have to” and “I need to”? These absolute terms create rigid thinking patterns and have great potential to increase anxiety.

The only things we really need to do are eat, sleep, breathe, and have somewhere sheltered to live (Abel, 2018, p. 39).

There is a high potential for increased stress when you rank the importance of making a good impression at your work presentation the same as the importance of food and oxygen. Without food and oxygen, one cannot survive. If your basic needs are threatened, anxiety may actually serve a survival function to produce responses to the situation that keep you alive.  However, in other situations, such as anticipating and reacting to a presentation, as if the outcome of it is an absolute need, high anxiety is more likely to impair your performance.

Once we become aware of the presence and risk of absolute thinking, or other negative thoughts, we have an opportunity to adjust our thinking. When you catch yourself thinking in absolute terms, replace the thought. For instance, you might find yourself thinking “I need to get this presentation perfect.” Instead, try replacing that thought with “I am nervous about my presentation”. By replacing the absolute thought, you are acknowledging your emotion without placing the unrealistic expectations of absolute thinking on yourself.

Becoming more aware of your thinking creates two opportunities to address anxiety. One is to adjust your thinking and re-wire how your brain responds to stress. The other opportunity is to combine your insights into your thoughts with mindfulness techniques.

B – Be Mindful

Often the first step in mindfulness is to acknowledge that we are thinking. You may be surprised by the nature of your thoughts if you stop to notice them. Research studies have been conducted that suggest that the majority of thoughts that people experience are negative ones. (Livheim, Bond, Ek, & Hedensjo, 2018)

The answer, though, to changing these negative thought patterns is not to just repeat positive statements to yourself. While this might feel relieving temporarily, the long-term impact is minimal because the power of positive thinking is limited by your belief in the positive thoughts. Positive thoughts cannot benefit you if you do not believe the positive thought to be true. Trying to force yourself to believe positive thoughts can increase the frustration and negative emotions you are hoping to improve (Abel, 2018). “Emotions have no on/off switch. Emotions happen to us as a consequence of our interactions with the world. They are not something we deliberately do apart from that world” (Eifert & Forsyth, 2005).

Instead of engaging in a power struggle with your emotions, mindfulness techniques can help you develop healthier emotional regulation. It may seem counter-intuitive but often healthy emotional regulation starts with no longer attempting to control unwanted emotions (Eifert & Forsyth, 2005).

Mindfulness is an approach for directly confronting those difficult questions and situations that arrive at our doorstep each day. Instead of shielding us from uncomfortable truths, mindfulness pinches us gently, but firmly—reminding us to awaken to the way things are, which is a stable and valuable vantage point from which to cultivate change (Altman, 2014, p. xv).

Mindfulness changes how we relate to our thoughts and emotions. Instead of working hard to avoid your anxiety, mindfulness can assist you in developing compassion and acceptance of your experience, allowing your mind and body to naturally relax. There are a lot of resources available for mindfulness skills. Some of these techniques are designed to address your thinking directly. Others are designed to manage the physical effects of anxiety. One of the most common forms is breathing techniques which can help slow down your heart and create whole body relaxation. Meditations can also be used to increase your awareness and acceptance of your thinking. If being aware of your body and breath is too difficult, you may benefit more from grounding techniques, such as going through your five senses to notice your surroundings and calm your body. As your body relaxes, this will also relax your mind. Navigating the available options for learning mindfulness may feel overwhelming, but you do not need to do it alone. A skilled therapist can help guide you.

C – Consider Therapy

How can a therapist help?

  • A therapist with specialized training in anxiety will be able to assess the nature of your anxiety and will be knowledgeable about multiple techniques and resources for the treatment of anxiety.
  • Different strategies work for different people. If a therapist has worked with someone whose anxiety looks similar to yours, they may already know specific strategies that may work well for you.
  • A therapist offers a safe judgment free place to openly talk about your anxiety experience.
  • Anxiety can be overwhelming to face alone. A therapist can help support and walk alongside you as you combat your anxiety.

When left unchecked, Anxiety Disorders can have a negative impact on both emotional and physical well-being. The ABCs can play an important role in your efforts to manage your anxiety. Adjust your thinking by becoming aware of your thoughts and then replacing rigid thoughts as needed. Be mindful of how your thinking is impacting you, and use mindfulness techniques to manage the physical aspects of anxiety. Consider working with a therapist who can help you navigate your anxiety. You do not need to face anxiety alone.



Abel, J. L. (2018). The anxiety, worry & depression workbook. Eau Claire, WI: PESI Publishing & Media.

Altman, D. (2014). The mindfulness toolbox: 50 practical mindfulness tips, tools, and handouts for anxiety, depression, stress and pain. Eau Claire, WI: PESI Publishing & Media.

Eifert, G. H., & Forsyth, J. P. (2005). Acceptance & commitment therapy for anxiety disorders. Oakland, CA: New Harbinger Publications.

Livheim, F., Bond, F. W., Ek, D., & Hedensjo, B. S. (2018). The mindfulness & acceptance workbook for stress reduction. Oakland, CA: New Harbinger Publications.


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Jack Gordon, MSW, LCSW, CCATP

Jack is a Licensed Clinical Social Worker and a certified clinical anxiety treatment professional. He works with adults, families, and adolescents ages 12 and up. He specializes in anxiety treatment and has a passion for work with clients with chronic pain/illness. His clinical interests include anxiety, parenting skills, life/career transitions, and family/relationship issues.

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