To prepare for the anxious moment, we want to:

● predict distressing thoughts, feelings, sensations and interpretations;

● identify triggers as opportunities to practice;

● use our values to motivate commitment to the present moment;

● use helpful self-talk to strengthen our motivation and commitment to practice before, during, and after the anxious moment.

Triggers can be internal and they can be external. External triggers are the things that show up in your environment that make anxiety more likely. Common triggers include social situations, travel, or any part of your home that reminds you that something could go wrong. There are all kinds of external triggers that are frequent and common for many people. You may also have internal triggers such as an intrusive thought or anxious sensation that doesn’t necessarily have an extra predictable external trigger.

You need to trigger sensations and thoughts on purpose. Any time you have either an internal or an external trigger, it’s a huge opportunity to practice and show yourself that you can relate to it differently rather than bracing. You want to see it as an opportunity where you learn to predict distressing thoughts, feelings, sensations, and interpretations. You don’t have to know exactly what’s happening in an anxious moment. Rather the better that you predict what’s likely to occur, the easier it will be to get distance from it. It’s important to identify anxiety beforehand so that when it shows up, rather than thinking, Oh, no, why am I anxious? What’s happening? you can think, Oh, yeah. I was expecting this! This happens when I go towards my triggers and this is really my opportunity to practice.

You should identify why it is worth it for you to experience your anxiety as soon as possible. Rather than needing to avoid, compulse, get reassurance, or otherwise neutralize your anxious experience, it can be an opportunity for efficacy, to feel strong, and courageous that you can go toward and tolerate it. You can predict what’s going to happen. Going towards it on purpose, handling it, and then getting to the other side is worth it for its own sake.

Finally, let’s talk about some helpful self-talk that could strengthen your motivation and commitment in the anxious moment. Anxious moments have three different parts:

● anticipatory anxiety

● situational anxiety

● post-event processing.

Anticipatory anxiety is an indication of your past rather than a prediction of your future. Anticipatory anxiety is a feeling, not a fact or prediction. If in the past, you braced and avoided, your amygdala will warn you, Hey, watch out here. Here’s that trigger coming again. I’m going to give you some sensations so that you know what to avoid. You should learn to override your amygdala and say, Hey, no, it’s okay. We can hang out with this. This anticipatory anxiety is not predicting that anything is going to go wrong. It’s just indicating that in the past, I’ve avoided. It’s important to have some amount of self-talk around anticipatory anxiety so that you don’t avoid it again.

You reframe the anxious moment as an opportunity to learn something new. Your self-talk may sound like, Great. I was hoping for this. This is my chance. I want to go after my anxiety. I want this to get worse. I want this to make me stronger.

After the experience, you may experience post-event processing. You should expect to be sensitized and expect to have the urge to replay the experience. You might think My mind wants to replay this because I’m doing something I value, rather than getting caught up in all the self-criticism that often comes after an anxious experience. When people replay, they find things that they’ve done wrong and then use it to beat themselves up. An alternative is just to say, Yep. I’m sensitized. I’m proud that I did something that I value and I’m just going to let any interpretation or urge to criticize that my mind has. I’m going to let all of that pass.

Predict distressing thoughts, feelings, sensations, and interpretations.

Your goal is to interpret an anxious experience as an opportunity to predict your distressing thoughts, feelings, sensations, and interpretations. You want to predict them ahead of time. You don’t have to know exactly what’s happening in your anxious moment. But, the better that you predict what’s likely to occur, then the easier it will be to get distance from it.

Predict that you’ll get anxious.

If your trigger often makes your heart rate increase or often makes you sweat, you might frequently have the same types of anxious thoughts based on certain triggers. These are all helpful to identify beforehand.

Predict that you’ll have fear of fear.

Your anxious process probably looks something like this:

First, you experience a trigger, either internally or externally.

Next, your mind says, Oh no, why am I anxious? What’s happening? That’s fear of fear.

Your mind will then answer why is this happening? with a catastrophic response in alignment with your content area.

If you experience health anxiety, your mind will say, It might be a heart attack or a stroke.

If you experience harm intrusions, your mind will say, I probably did something wrong. It will probably harm someone.

If you experience social anxiety, your mind will say, I feel anxious because I showed my incompetence as a coworker, a friend, a person. Everyone will judge me and no one will like me.

It’s important to think about this type of thinking as a catastrophic answer to your mind’s fear of its fearful reaction. When you feel fear, your heart races, you start to sweat, and your mind has catastrophic thoughts. The catastrophic thoughts are not messages, predictions, or threats. They are just thoughts that show up when you feel afraid. They are the same types of thoughts every time because you have a well conditioned response cycle that reinforces the presence of those thoughts. They are not happening again because they are true. They happen again because you are afraid of them.

If you can predict this pattern, you have the chance at relating to it effectively.

You get triggered and your mind says, Oh no, why am I anxious? What’s happening?

You can answer, I know what’s happening. I was expecting this! This anxiety happens when I go towards my triggers and this is really my opportunity to practice. Right now, I need to stay with my sensations. I need to turn courageously towards my sensations and approach them like a crying child — slowly, tenderly, curiously. My catastrophic thoughts are not messages. They are just what my mind does when my heart is racing. I just stay with this experience, without adding secondary fear, until it passes.

Predict that you’ll feel hopeless when you feel fear of fear.

A secondary process that’s very common for those with anxiety, OCD, and depression is that you experience sensations and intrusive thoughts, you feel fear of that fear, and then you feel hopeless, helpless, or worthless because it’s happening again.

Try predicting that too.

You might think to yourself, I have this type of thought and I have this type of sensation and then my mind says, ‘Oh no! it’s happening again. This is going to happen forever. I’m never going to get out of this.’ Then I feel hopeless, helpless, worthless and forget to go towards it and surrender to it.

Your new response is Oh, yeah, that’s what happens when I do this type of activity. If you don’t act as though it’s true, then you can get to the other side of it without it feeling true.

When you try this new approach, it will be uncomfortable at first, but eventually your anxious moment becomes an opportunity for courage, empowerment, and self-trust.

As you learn to disarm anxiety, knowing its patterns is one of your best strategies.

One part of the pattern of suffering that anxious people experience is anticipatory anxiety, which is the feeling of dread about an upcoming thought, feeling, sensation, or situation that might bring about the feared situation.

If you have an anxiety disorder, its typical to have difficulty staying with the feeling of dread long enough to recognize that it’s a feeling, not a fact or prediction. The nature of an anxiety disorder is that your mind is experiencing your thoughts, feelings, memories, or sensations as unwanted and dangerous and is getting away from them as soon as possible.

Identifying and labeling dread when it's happening is a powerful step because it is the opposite of avoidance. Here’s a suggestion of what you can say to yourself:

What I’m experiencing right now is anticipatory anxiety. My dread is a feeling, not a fact or prediction. It’s an indication that I feel uncertain. The feeling of uncertainty does not mean something bad is about to happen. In fact, uncertainty might indicate that something good is about to happen! This is just a feeling. I can allow dread to be present while I do what I want to do right now.

If you’re wondering if some of this self-talk is reassurance, it is true that it might feel reassuring to think like this. Reassurance compulsions, like other neutralizers, are marked by your intent rather than the content of what you’re saying. If you use this type of self-talk repetitively to make your anxiety decrease, you are using a self-assurance compulsion that is going to keep your anxiety going over time. If, on the other hand, you use this type of self-talk to observe the process in your mind, remind yourself of the pattern, and redirect your attention so that you can refocus on what you care about, then you’re on your way to relating to anxiety more effectively. In this case, the incidental experience of dread was an opportunity to catch the pattern in action and show yourself that you don’t have to play by anxiety’s rules.

After I explain what dread is and tell them to identify and label it, many people say, “Okay. And, then what? How do I make it go away?”

My answer is, “Label it and then do nothing. You can’t make it go away.”

Doing nothing to resist it or make it go away is a powerful and intentional stance. Just like other parts of the anxious pattern, every time you label and actively accept what you’re experiencing, your mind is less likely to associate that experience as something to fear. The anticipatory anxiety may not dissipate in this moment, but you’re setting yourself up for success in future moments.

Let’s discuss what people with anxiety disorders often do instead of self-monitoring, identifying, labeling and allowing dread:

Listening to dread by avoiding

Because people with anxiety disorders characteristically avoid what they are thinking and feeling, they don’t recognize their dread as part of the pattern of anxiety. Rather it feels like information, as though whatever it's saying is true.

Feeling dread, you may think, I’m so nervous right now. What if my anxiety just gets worse and worse? What if something bad is going to happen? Maybe I shouldn’t do it. Maybe I should do it some other time when I don’t feel like this. Maybe I don’t actually want to do this because I feel so bad when I think about it.

Dread, when interpreted as information, triggers indecision and doubts; avoiding based on doubting thoughts causes more anxiety and more dread.

Listening to dread and becoming depressed

Dread can feel like depression, and can hit you like a sudden lack of energy and motivation. If there are many thoughts, feelings, sensations, and situations that trigger your anxiety, you may feel a consistent and pervasive sense of dread that doesn’t feel like a passing feeling.

Similarly, if you always listen to what your dread says and avoid activities and people that are important to you, the feeling of dread can influence your mood. Depression is the intrusive, sticky mood state that tells you’re that you’re worthless and that things will not get better.

Whereas anxiety typically speaks in uncertainties like, What if something bad happens? What if I can’t do this?, depression is more certain. Depression says, Something bad will happen. I can’t do this.

As dread becomes more and more associated with avoidance, depression is likely to join in, and make it harder and harder for you to do the things you fear.

Listening to dread and self-criticizing

Dread can also sound like a search for an explanation but actually inspire self-criticism. Feeling dread, you might think, What’s wrong with me? Why do I always feel this way? Other people don’t feel like I do. I’m just a _(fill in the blank with your favorite bad name)__ for being like this.

The cause of suffering here is that you did not recognize that dread is a feeling. The beginning of this self-talk, What’s wrong with me? could potentially be helpful if your underlying attitude is curiosity, openness, and observation. With this stance, you can transition to, Let me observe what’s happening, what I’m thinking and feeling. In that moment, you could identify and label that you’re experiencing dread; remind yourself that it is a feeling, not a fact; and work to redirect your attention to what you wanted to do in that moment while still feeling the uncertainty. The labeling process cues you to turn this experience of anticipatory anxiety into an opportunity to practice relating to your anxiety effectively.

If, on the other hand, you listen to the self-criticism and get fused to the idea that there is something wrong with you and you will never get better, rather than being an opportunity to overcome your suffering, this experience is likely to increase your suffering.

Listening to dread and wavering in your decision making

Dread feeds on ambivalence, which is the experience about wavering back and forth about what action is to be taken.

Some people with anxiety disorders wake up with a sense of dread that is very distressing to them. If the dread was talking, it would probably say, What will I be triggered by today? Will I be able to handle it? Am I going to face my anxiety or avoid again?

The cause of suffering here is the sense of uncertainty you have about how you will behave and the lack of trust you have in your ability to act the way you want to act. Just like relationships with others, the only way to develop trust with yourself is to act in a trustworthy way. You learn to trust yourself by following up on commitments that you make with yourself.

The more triggers you have, the more likely you are to feel dread about how you will respond.

But then again, the more triggers you have, the more opportunities you have to practice.

Most people have unwanted intrusive thoughts at one time or another. They try to avoid the thoughts, suppress the thoughts, do something to make the thoughts go away. Most people notice uncertainty in their life and have anxious sensations. Catastrophic thoughts are common. Muscle tension is common. Difficulty sleeping is common. Moments and experiences when people feel worried, lost, helpless or hopeless are all common human experiences.

Experiences of stress, worry, demoralization, uncertainty, and pain become episodes of suffering when you add a pattern of fear, criticism, resistance, and avoidance that becomes its own problem. The pattern of responding to stress of all kinds with avoidance of all kinds leads to subjective distress or functional impairment. We call that episode an emotional disorder.

It may seem like everyone has an emotional disorder these days. It is, in fact, true that overall people have been under more stress in the last several years. Those that didn’t already have good strategies for coping with stress – including curiosity rather than fear and criticism and compassion rather than resistance and avoidance – are now more likely to fall into patterns that become episodes that we classify as disorders.

The increase in suffering in others doesn’t make yours any less real. If you had a life circumstance where you were chronically hungry, and then suddenly no one else had food, you would still be in need of food. You might be more aware of your hunger and it might seem scarier to you. Or, you might compare it to others and feel ashamed or critical about your experience of hunger. Ultimately, you would still need food.

Everyone has underlying biological processes that make mental illness more or less likely. Lately, environmental stress is making those who aren’t particularly biologically vulnerable more vulnerable. Whether your emotional distress or impairment is primarily biological or environmental or a combination or the two, responding to yourself with courage, curiosity, and compassion is the key to responding well.

You want your experience of distressing emotions to be an experience, and nothing more. When you are relating to it well, it shows up, you experience it, and it passes. It doesn't become an episode. This is recovery.

Experiences, not episodes

Anxiety disorders, OCD, and mood disorders are chronic, intermittent conditions, meaning that those that are biologically vulnerable to them are vulnerable to them throughout their whole lives, although the episodes come and go. I hope you are not discouraged by this. This isn't foreshadowing a lifetime of suffering. It's information about how your body and mind works, much like information about blood glucose or your menstrual cycle.

You can show up to the body you were born with by accepting this reality and making a plan for how you will manage your underlying biological vulnerability. You'll like yourself more when you show up. Let's try it.

Show up to your experience. Some people hear that anxiety and mood disorders are chronic conditions and give up, assuming that they'll suffer no matter what they do. Wrong! You are more sensitive to distressing emotions than those around you, but if you practice the right way to relate to anxiety, the spikes of sensations, feelings, and thoughts become experiences, not episodes.

Giving up through avoidance will make you feel demoralized and make your suffering worse. The most important commitment you can make to yourself is to keep trying. If you've decided that you're always going to keep trying, you'll eventually figure out a way to manage your sensitivity in a way that works for you. If you're looking for the perfect solution in the quickest amount of time without committing to persevering no matter what, you're likely to have trouble maintaining your gains when you hit inevitable challenges. So, you've taken responsibility, now what?

Respond effectively. A panic attack, a thought attack, or a low mood goes from a few moments of uncomfortable sensations and thoughts to several days or weeks of fear, overwhelm, bracing, sleeplessness, general distress and loss of functioning because of how you respond. It's not your fault that you have the sensitivity you have, but whether or not it escalates is within your control. How you respond either deescalates or amplifies the experience. Here are some examples:

Shame and guilt. Did you feel shame and guilt when I said that your suffering is escalating because of how you respond? Notice that. It's okay that it showed up. Here's how to challenge it:

I, like all other humans, am always doing the best I can. Whatever my mind has come up with as my response to myself and my environment is the best it could come with and it's okay to be exactly where I am. If my response is not effective for my values and goals, I can learn new responses. Rather than beating myself up about what I did or do wrong, I'm focusing my attention on learning new skills so that I have new options in similar situations in the future.

Anticipatory anxiety. When you're in it, your mind might go to, How do I know this will work? How long will this last? How do I know I can handle it? What if I can't sleep because of this? This is all in the future. Your anxiety disorder owns your future. You own your present. Challenge these thoughts by labeling them as anticipatory anxiety and coming back into the present, focusing on whatever you are doing right now.

Perfectionism. Your mind says, how do we know that we're doing it right? The answer is we don't! You have to try stuff out, get information about yourself, and then continue or change your strategy based on what you learn. Giving up on perfectionism isn't giving up on excellence. It's about showing up to yourself as you are and giving yourself the chance to learn and grow.

Subtle and not-so-subtle avoidance. Some people immediately understand what they do while anxious that helps in the moment, but makes it worse over time. Many people don't understand how this applies to their thinking or behavior. As you get to know yourself and your emotional disorder, look for where you avoid to led you through your suffering.

Self-compassion for your own process. You're in it for the long-haul with yourself. Giving up is demoralizing and will increase your suffering. Demanding perfection isn't sustainable and will create a secondary self-critical loop that makes recovery harder. Commit to yourself and your own process. Even before you recover, you'll find that you like yourself when you own and appreciate your own journey. You have hope because you have you. (Also, I can help you until you can help you, but I ultimately want you to help you.)

Post-event processing is a term from social anxiety research. It is used to describe the combination of worry, rumination, and self-criticism an individual with social anxiety experiences after a social event. I use it to refer to the after-effects of every anxious situation or after you challenge depression. The way I use the word is to include to the experience you might have after something you worried about doesn’t happen, after behavioral activation, or after you spent a lot of time doing compulsions.

Recovery from anxiety, OCD, and depression starts at the end of the process of challenging it. When you attack yourself during post-event processing, the feelings you experience are aversive. You are teaching your body that anxiety or depression is a threat, because after you experience it, you are going to experience self-criticism and shame. As you learn about the processes that maintains your anxiety, OCD, and depression, pay attention to how you treat yourself after the (mostly) functionally synonymous experiences called exposures, experiments, behavioral activation, and intentional or incidental practice. If you treat yourself with compassion after you challenge your suffering, no matter the outcome, you will reduce your future anticipatory anxiety and it will be easier to see these challenging experiences as an opportunity rather than a threat.

The repetitive negative thinking patterns that occur during post-event processing include concepts including worry, rumination, mental compulsions, and self-criticism. The concept of post-event processing is useful because of its ability to increase your motivation to get distance from unhelpful thoughts and feelings.

The first step to the therapeutic attitude of acceptance is expecting and labeling your moment of suffering as the voice of anxiety, OCD, or depression. In doing so, you’re saying:

• This is a false alarm, not a real problem for me.

• I accept that this is a part of my experience right now. I’m not going to pretend like this doesn’t happen to me.

• I have compassion for myself for having this experience. Given that I have this experience, I should respond to it as effectively as I can.

When you are able to pull up this attitude, you will also be able to head into an anxious episode and predict:

Anticipatory anxiety Doing nothing to resist it or make it go away is powerful and intentional stance. Just like other parts of the anxious pattern, every time you label and actively accept what you’re experiencing, your mind is less likely to associate that experience as something to fear. The anticipatory anxiety may not dissipate at this moment, but you’re setting yourself up for success in future moments.

• Self-talk: Anticipatory anxiety is a feeling, not a fact, threat, message, or prediction. Anticipatory anxiety is an indication of my past, not my future. I beat myself up after situations like this in the past, so now my body is pumping me with adrenaline to try to get me to run away from it this time. It doesn’t predict situational anxiety unless I believe it. Anticipatory anxiety means that I’m doing something important, values-based, challenging, and consistent with who I want to become. I’m practicing staying with my anticipatory anxiety without adding second fear.

Challenge situational anxiety and behavioral activation Attend to the anxiety-provoking situation or the task that you committed to (which may or may not provoke distress at that moment). Focus attention on the situation, rather than whether or not you feel anxious or depressed and what it means or doesn’t mean. Situational anxiety could be either intentional or incidental. Behavioral activation can be a chosen distress tolerance task or an obligation you don’t choose. If you frame it as an opportunity, it can serve as a helpful exposure or experiment.

• Self-talk: Excitement and nervousness feel the same. I feel excited that I’m challenging myself to grow beyond my comfort zone. It’s time to focus on my task, rather than my sensations, feelings, or thoughts. Now is a good time to set a behavioral goal — something I can do with my arms and legs — rather than a goal for what I should think or feel.

Post-event processing Expect post-event processing and reframe it as the consequence of being tired and sensitized after an exposure or experiment rather than a threat. If you said or did something about which you actually feel embarrassed or guilty, assess whether there is any way to problem solve (for instance, by correcting an error or apologizing).

You can’t make mistakes or offend people if you don’t try, but you also can’t grow and change if you don’t try. Putting forth effort towards anything puts you at risk for feeling judged, rejected, embarrassed, guilty, ashamed, and regretful. The most reasonable stance is to surrender to these possibilities in order to move towards a rich, full, and meaningful life.

• Self-talk: My body is sensitized and my mind is sticky because I just did something that is anxiety provoking. I do not need to judge the outcome of what just happened. I am going to bring up the conditions of pride and stay with them, so that I have the opportunity to shift this moment from one that makes me feel stuck, to one that heals me.

Common worries during post-event processing:

What if I said or did something wrong? What if I said something boring, stupid, or offensive? What is that person going to think of me because of what I said or did?

I feel fine now, but what if I start thinking about this again? What if it ruins my night or my weekend? What if I can’t sleep because of it? What if I can’t concentrate because of it? What if I fall into an anxiety or depressive spiral? How do I know that I’m not going to feel bad later and how do I know that I’ll be able to cope at that time?

Here’s some alternative self-talk to try:

• I typically worry after situations like this. What if nothing is wrong and I just have leftover sensitivity? Is it just anxiety and uncertainty that I feel or are there other feelings here? Where are those feelings in my body? What sensations come along with those feelings? If I were going to describe the sensations that make up anxiety as though I am teaching a child, how would I describe what the sensations are? I am human and every human has these sensations. How can I take care of myself right now?

Common rumination during post-event processing:

Why did I say or do what I did? What is wrong with me? Will this ever stop happening to me? Why do I have this feeling? Is this because of that thing that happened in the past to me? What if I’m inherently broken? Does this mean that I’m hopeless, worthless, and unlovable?

Here’s some alternative self-talk to try:

• I typically ruminate after situations like this. What if I didn’t actually make a mistake, but rather my mind is just sticky? I’m noticing thoughts of hopelessness, helplessness, and worthlessness. I wonder what my feeling is under that? Where is that feeling in my body? I am human and every human has this feeling. How can I take care of myself right now?

Common mental compulsions for those with OCD during post-event processing:

I feel really anxious and uncertain. I can feel my mind is scanning everything that just happened to me to make sure one of my feared outcomes hasn’t occurred or will not occur. What if I made a mistake? What if I hurt someone? What if I touched something that will contaminate me or someone else? What if I was thinking something I shouldn’t have been thinking and that means I’m creepy, weird, or a bad person?

I feel fine right now. What does that mean? Does it mean I don’t actually care about the content areas I fear and what would does that mean? What if I feel anxious later and I can’t handle it? Oh no! Now I’m anxious. What does that mean? Did I do something wrong?

Here’s some alternative self-talk to try:

• I typically have compulsive replay after situations like this. What if I didn’t actually make a mistake, but rather my mind is just sticky? It will take some time for my mind to stop buying into this replay as something that is helpful to me. Can I bring the compulsive replay along with during my day without engaging with it? It’s hard to concentrate when I have replay in the background. As I choose to redirect my attention, I’m surrendering to the possibility that these thoughts will intrude and cause me distress. I’m choosing not to respond as though the intrusions require problem-solving or attention. I am human and every human sometimes has intrusions. How can I take care of myself right now?

Common self-criticism during post-event processing:

I can’t believe that made me anxious! I’m better than that! I should have had the skills to not get anxious. I should be able to respond better when I do. Now I’m worried, ruminating, and mental compulsing. I’m never going to get over this and I’m never going to get my life back. This is hopeless.

I can’t believe I actually said or did that! AND I can’t believe I didn’t say or do that! Why am I such an expletive? Why can’t I do anything right? I’m never going to change if I keep this up?

Here’s some alternative self-talk to try:

• I typically have self-criticism after situations like this. Let me orient my thinking toward what I did right. Where do I see growth in myself compared to some point in the past? Where am I continuing to get stuck? What thinking patterns or behavioral patterns are still common for me, such that I’m prone to get stuck? I’m choosing act as though I am proud of what just happened. I tried something and therefore I gave myself the chance to learn and grow.