Sonya Thomas lcsw

Working with Anxiety – Part 1

One of the hallmarks of treating anxiety is self-monitoring, which is a tool in the Cognitive Behavioral Therapy (CBT) repertoire.  We use self-monitoring to identify negative automatic thoughts (NAT’s), as well as to help us understand the links between our thoughts, emotions, sensations in the body and how we respond. Here you will find a tool called the anxiety self monitoring record to be used to record specific instances in which you felt/are feeling anxious.  There are 4 parts of this tool, separated into columns:

  1. In the first column (Situation) you record what you were doing when you started to notice a significant change in how you were feeling. You want to record specific details (who you were with, where were you, and what had just happened), which can be helpful in understanding the reasons for subsequent thoughts and responses.
  2. In the second column (Emotions and Body Sensations) you will record the emotional reactions that caught your attention in that moment, which can typically be described using single words, e.g. anxious, scared, terrified.  You will also record any associated body sensations (e.g. tightness in my stomach). You will also rate the intensity of these sensations on 0–100% scale.
  3. In the third column (Anxious Thoughts) you will record any automatic cognitions/thoughts. Cognitions can take the form of verbal thoughts, but can also take the form of images, or memories. Anxious thoughts often take the form of (negative) predictions about the future. If a recorded cognition is an image (e.g. “I had a picture in my mind of my daughter falling over the edge”) you should question what that image means  (e.g “It means I’m careless and not capable of looking after her”) and then record that idiosyncratic meaning.
  4. In the fourth column (Coping Responses) you will record what you did in response to the anxious thought and feeling. Did you make efforts to express or suppress it? Did you respond overtly (e.g. safety behaviour) or covertly (e.g. self-reassurance)?

Therapists will often ask clients to use a tool such as this to assist in understanding and coping adaptively with anxiety.  Anxiety is not cured, it is managed.  If anxiety is negatively interfering with your ability to function or enjoy life, please consider seeking treatment.  Despite its ubiquity, anxiety can be a very painful condition to live with.  You don’t have to face it alone.

Until next time, peace.