Group Support Session 5 - Managing Anxiety

This week was my last support session which brings this mini-series of blog posts to a close, so normal service will resume next week with a post that I'm planning on alexithymia. This week's session was about Managing Anxiety, which is something that I'm sure is a useful subject to cover for the majority of autistics.

We started with a warm-up exercise which is designed to show us a distraction technique for when we need to distance ourselves from the world around us and re-focus. It's a very simple exercise that's in the same vein as the classic "Take deep breaths and count to 10" that I'm sure we've all heard a million times, but this one is to stop and take note of 3 things you can smell, 3 things you can see and 3 things you can hear. It's just something to help you take a moment when you need it to escape the cause of anxiety.

After the warm-up exercise we thought about what causes anxiety for us individually. This session was a difficult one for me to really get into because alexithymia means that I often don't recognise how I'm feeling or why, so it can be difficult for me to identify what actually causes me anxiety, although I suspect that deep down I'm more affected by anxiety than I realise. The main causes of anxiety that we came up with as a group were other people (either other people in general, or large crowds of people) and sensory stimulants such as overly strong or artificial smells for example. Then we all put together a diagram to show what physical symptoms anxiety can give you. Mine were feeling sick, sweaty palms and feeling clammy. Other suggestions were things like headaches, tensing up and shortness of breath. Interestingly, when I feel sick from anxiety I feel it in my stomach whereas others apparently feel it further up in their neck/throat area.

We were shown a model of anxiety in the form of a diagram, which just shows that there are 4 factors in anxiety that are all linked to each other. There are Thoughts, Behaviours, Emotions and Bodily Sensations. So if you change one it can affect all of the others and can be used to reduce and relieve anxiety. For example, in terms of thoughts you can change them by trying to be aware of them, choose to let them go if you can, and ask yourself if your thoughts are the only truth. So by changing your thoughts to something else you can then start to feel better in yourself emotionally, reduce any physical symptoms you might be having and also react in a different way to deal with it better. Similarly, you can change any of the other 3 factors to affect the rest of them and cope better. This is the model that Cognitive Behavioural Therapy (CBT) is based on, and I was interested to find out that the success rate of CBT is more hit and miss than I realised. According to the occupational therapist in our session, CBT is something that really works for some people, but really doesn't work for others. And for those like me who struggle with alexithymia or other conditions, a different approach is needed. I was glad to hear that because that would explain why CBT didn't do anything for me a couple of years ago.

One of the last things we covered was a list of daily interventions - small things that you can do each day (or whenever you're able to) to help reduce anxiety:
- Keeping a diary can help you to notice your thoughts and to change how you think and feel about a situation through your increased awareness. Changing your thoughts can then lead onto the next intervention...
- Challenge your beliefs. Beliefs in this sense doesn't mean your religious beliefs or anything like that. It just means your beliefs about your life. For example whether you believe you're liked or disliked by other people, or what kind of job you believe you should be doing. If you change your thoughts it can eventually change your beliefs so that they match and therefore reduce anxiety as you'll be meeting your own expectations.
-Catch assumptions and chase logical conclusions. This one was a bit long-winded in the session, but basically it means think about the event that's causing you anxiety (the example we were given was going to a party) and think about what the consequences and logical outcome are of the specific reasons for your anxiety. So what are the consequences of meeting new people? You might assume they don't like you? Chances are you've been wrong about lots of similar assumptions in the past so you could be wrong about this one and they quite possibly will like you. And even if they don't, chances are you'll never see those people again so in the long-term it won't really matter. The point being you'll be fine after a while, so being aware of this can help reduce your anxiety.
-Chew it over and act normal. This one caused a bit of a discussion in the group because of the wording of it, but by "normal" it means what's normal for you. The point of this one is to train your anxiety by breaking the feedback loop. All that means is that by letting your anxiety influence your behaviours and your decisions you're then re-enforcing it rather than reducing it. So if you've been anxious about going out to a certain place/event that you want to go to, by going and enjoying yourself you're feeding back to your brain that it's ok to go and that you don't need to be anxious so that you find it easier to go next time.

The final thing we did was go over some examples of relaxation techniques with a particular focus on mindfulness. This is the practice of being present in the moment to help you acknowledge what's around you and respond to it accordingly. There are a few different ways and resources to practice mindfulness such as meditation, apps books on the subject etc. Some of the apps they told us about were ones that you pay for, but one that I think they said was free (although don't quote me on that) is called Brain In Hand. There's a few different apps for it available on the app store/Google Play anyway. Other tips for relaxation are things like listening to music, taking a break, and exercising your body and mind, although how you relax is down to your own personal preferences.

At the end of the session we all took a minute to add each other on Facebook, although I don't really use Facebook these days - I deleted everyone off it when I got fed up of it ages ago. So what I'm thinking of doing is starting a Messenger group with the 4 of us and keeping in touch that way.