1. Anxiety: beliefs,
body, behaviors
Luke C Payson LPC, CAADC

2. Anxiety: beliefs,
body, behaviors
LUKE C PAYSON LPC, CAADC

3. Foundational concepts
- External vs internal locus of control
- certain levels of anxiety as healthy
- goal healthy vs goal being normal
- emotional self regulation

4. Visual picture of Emotional Self Regulation

6. Overview of Body, beliefs, behaviors
Body-
what is felt
physically,
Panic
Attacks;
symptoms

7.  Palpitations, pounding heart, or accelerated heart rate
 Sweating
 Trembling or shaking
 Sensations of shortness of breath or smothering
 A feeling of choking
 Chest pain or discomfort
 Nausea or abdominal distress
 Feeling dizzy, unsteady, lightheaded, or faint
 Feelings of unreality (derealization) or being detached from oneself (depersonalization)
 Fear of losing control or going crazy
 Fear of dying
 Numbness or tingling sensations (paresthesias)
 Chills or hot flushes
Panic attack physical symptoms (5 or more)

8. Beliefs,
Beliefs- always, never, failure
Anxious about anxiety or
“worry about worry”

9. Behaviors- When Anxiety is driving the bus
Avoidance behaviors- isolation,
withdrawal
Escape behaviors- chemical use,
compulsive behaviors (OCD)

10. Seeing The Big picture

11. News reporter interview example

12. So how do we “throw the rope” or
“build the ladder”
 Even more importantly how do we climb up
the rope or ladder?
Take aways from Tiger example

13. What we can learn from fun house mirrors..

14. Brains are like fun house mirrors
 The brain’s job is to have thoughts
 Those thoughts are not always healthy and accurate
 Our job as a healthy, emotionally self regulated individual is to
determine is those thoughts are healthy for us and change them if
they are not

15. Cognitive Distortions aka Distorted thinking,
self-defeating thoughts, automatic thinking
patterns
- Thought patterns that make complete sense to self; have
unhealthy emotional and behavioral results
- Thought/ behavioral pattern (expectations) based on
history or experience
- The meaning or sense (of whatever happened) we have
created for ourselves
- Like computer viruses running in the background of our
mind

16. Cognitive distortions
Filtering (either the positive or the negative)
Blocking out the negatives or positives of a situation. For instance, a person may pick out a single,
unpleasant detail and dwell on it exclusively so that their vision of reality becomes darkened or
distorted.
Polarized Thinking (or “all or nothing”)
In polarized thinking, things are either “all or nothing”. We have to be perfect or we’re a failure —
there is no middle ground. You place people or situations in “either/or” categories, with no shades
of gray or allowing for the complexity of most people and situations. If your performance falls short
of perfect, you see yourself as a total failure.
Overgeneralization.
In this cognitive distortion, we come to a general conclusion based on a single incident or a single
piece of evidence. If something bad happens only once, we expect it to happen over and over
again. A person may see a single, unpleasant event as part of a never-ending pattern of defeat.
Jumping to Conclusions.
Without individuals saying so, we know what they are feeling and why they act the way they do.
In particular, we are able to determine how people are feeling toward us.
For example, a person may conclude that someone is reacting negatively toward them but
doesn’t actually bother to find out if they are correct. Another example is a person may
anticipate that things will turn out badly, and will feel convinced that their prediction is already an
established fact.

17. Catastrophizing.
We expect disaster to strike, no matter what. We hear about a problem and use what if questions
(e.g., “What if tragedy strikes?” “What if it happens to me?”).
For example, a person might exaggerate the importance of insignificant events (such as their
mistake, or someone else’s achievement). Or they may inappropriately shrink the magnitude of
significant events until they appear tiny (for example, a person’s own desirable qualities or someone
else’s imperfections).
Personalization.
Personalization is a distortion where a person believes that everything others do or say is some kind
of direct, personal reaction to the person. We also compare ourselves to others trying to determine
who is smarter, better looking, etc. A person engaging in personalization may also see themselves
as the cause of some unhealthy external event for which they are not responsible.
Control Fallacies.
If we feel externally controlled, we see ourselves as helpless victims of fate. For example, “it is a bad
day that is causing this”. The fallacy of internal control has us assuming responsibility for the pain and
happiness of everyone around us. For example, “Why aren’t you happy? Is it because of something
I did?”
Fallacy of Fairness.
We feel resentful because we think we know what is fair, but other people won’t agree with us. As
our parents tell us when we’re growing up and something doesn’t go our way, “Life isn’t always
fair.” People who go through life applying a measuring ruler against every situation judging its
“fairness” will often feel badly and negative because of it. Because life isn’t “fair” — things will not
always work out in your favor, even when you think they should.

18. Blaming.
We hold other people responsible for our pain, or take the other track and blame ourselves for every problem.
For example, “Stop making me feel bad about myself!” Nobody can “make” us feel any particular way — only
we have control over our own emotions and emotional reactions.
Shoulds.
We have a list of ironclad rules about how others and we should behave. People who break the rules make us
angry, and we feel guilty when we violate these rules. A person may often believe they are trying to motivate
themselves with shoulds and shouldn’ts, as if they have to be punished before they can do anything.
For example, “I really should exercise. I shouldn’t be so lazy.” Musts and oughts are also offenders. The
emotional consequence is guilt. When a person directs should statements toward others, they often feel anger,
frustration and resentment. DON’T SHOULD ON YOURSELF
Emotional Reasoning.
We believe that what we feel must be true automatically. If we feel stupid and boring, then we must be stupid
and boring. You assume that your unhealthy emotions reflect he way things really are — “I feel it, therefore it
must be true.” (confusing feelings for facts).
Labeling.
We generalize one or two qualities into a negative global judgment. These are extreme forms of generalizing,
and are also referred to as “labeling” and “mislabeling.” Instead of describing an error in context of a specific
situation, a person will attach an unhealthy label to themselves.
For example, they may say, “I’m a loser” in a situation where they failed at a specific task. When someone
else’s behavior rubs a person the wrong way, they may attach an unhealthy label to him, such as “He’s a real
jerk.”

19. fallacy of
control

20. filtering the
negative

21. Building the tool set
Needing a tool belt?
-feeling overwhelmed, don’t
know where to start
Getting a tool belt- accepting
need for change, increase self
awareness
Filling the tool belt- any and all
coping skills, starts with making a list
of any and all current tools

22. Therapeutic Lifestyle Changes (TLCs)
 Studied in connection to brain chemistry
 “Neurotransmitters, hormones and the brain: How
counselors can use these concepts in daily
practice”.
 Within six weeks significant changes in brain on
chemical level

23. ABCDE method
A- Activating Event
Original-
Current-
B- Belief System (cognitive distortion, meaning)
C- Consequence (emotional result of belief- feelings)
D- Dispute (reframing the distortion)
E- Effective new thinking patterns/ evaluation

24. Biblical look at cognitive distortions
Romans 12:2 “Do not conform to the pattern of this
world, but be transformed by the renewing of your
mind. Then you will be able to test and approve what
God’s will is—his good, pleasing and perfect will.”
Philippians 4:6-7 “Do not be anxious about
anything, but in every situation, by prayer and petition,
with thanksgiving, present your requests to God. 7 And
the peace of God, which transcends all
understanding, will guard your hearts and your minds in
Christ Jesus.

25. Formation and reframing of a few CDs
All or nothing thinking- believing that there is no middle ground- I’m either all
good or all bad, my day is either spectacular or terrible
-often the result of parents who demonstrated this thinking pattern,
coaching that failed to praise progress and only looked for results, feeling like
the only way to get love was to earn it by being perfect etc
Group work- example: saying and feeling that you had a terrible day “that
was not even worth getting out of bed for” because.. A friend no showed for
lunch… you got a test back with a lower score than you wanted… you lost
your patience in the wal-mart shopping line and yelled at the cashier
HOW DO YOU Reframe this?

26. All or nothing thinking reframing..
 Disputing (Creating Healthy Meaning): identify the
progress, effort, aspects that go against the all or
nothing thinking- ie- nothing ever goes right in my
life- to identifying aspects that are good
 Gratitude list daily
 Identifying the gradient of a situation or an
emotion

27. Personalization- believing that everything others do or say is
some kind of direct, personal reaction or attack to you. Can
also be blaming self for some unhealthy external event for
which they are not responsible.
-often develops from emotional abuse in childhood/ toxic
relationships as adult, or from death or divorce at young age-
believed self was at fault
Group Work: Example- feels “attacked by supervisor” when
boss complains that there was no food at the meeting (note:
two people were assigned to do this and did not), walk into
lounge in residential hall and almost immediately three
people leave-talking and laughing with each other as they
do- believe “they hate me and are talking about me and left
because I came into the room”

28. Personalization reframing
 Disputing (Creating Healthy Meaning): consider other
reasons for people’s behaviors, counseling to identify
emotional abuse, consider what would say to a child at
that age of death or divorce

29. Emotional reasoning- what we feel must be true
automatically thinking that “if I feel an emotion it is
the reality of the situation”
-often develops when not encouraged to find
healthy expression of emotions, poor emotional self-
regulation
Disputing (Creating Healthy Meaning): feelings are
the result of my thinking patterns, what am I
thinking to cause me to feel this way

30. Run down of TLCs for Anxiety
Management

31. Acceptance Commitment Therapy
Combines acceptance and mindfulness (what can anxiety teach us?
 Blue Bird of happiness (seeking a vital and meaningful life)
 Beach ball (observing feelings and thoughts)
 Finger trap (struggling against feelings and thoughts trap self)
 Glasses- perspective
 Nike 123 (three most important things in our lives- take action)
ACT: the live better series. Tom Lavin

32. Progressive Muscular Relaxation
 Multiple times daily
 Use to reduce overall feelings of tension in body
 Night for calming body for sleeping
 General principle- create tension in muscle group- relax

33. Grounding techniques (WS handout)
 Great for keeping self in the moment (opposite of dissociation/ PTSD)
 Best for panic attacks, worst of anxiety
 ONLY use if safe around you (plane vs tiger example)
 Great to build into life on a regular basis- mindfulness eating, walking
etc
 USE SIX SENSES for grounding (WS handout)

34. Helping others
 Encourage deep breathing, teach basics of PMR and grounding suggestions
 Focus on thoughts behind the feelings- they will likely have limited insight into
this
 Once identify some of the thoughts (cognitive distortions) make sure to
dispute and reframe the THOUGHTs and NOT the person (ie there may be
another way to see that vs you are crazy! No one thinks like you do)
 Encourage Healthy vs normal
 Encourage concept of emotional self regulation- tool belt with coping skills
(most will assume that they have to survive with whatever skills they currently
have)
 ACT in the image of the beach ball under water
 TLCs- try to identify 3 (ie PMR, grounding-specifics, sleepo, deep breathing)
 Remember- you don’t have to fix the anxiety- be a resource to point to
counseling, TLCs they can do

35. Good references
Medical viewpoint
I want to Change my Life
Stress less
Biblical viewpoint
God will Make a Way
ReNew
PTSD
PTSD sourcebook
Seeking safety