anxious? Switch Questions

​     With a national population of around 330 million people, roughly one-third are anxious in some kind of way. Anxiety can be situational. Why can’t I find a parking space near my store? Anxiety can me chronic. What if nobody likes me? What if this job is wrong for me? Mentalligent psychotherapy (MPT) is a means of treating both types of anxiety.
          After giving your patient an ample opportunity to explore his anxiety and share with you how it affects him, using empathy and affective listening, I start my intervention sequence.
          “Okay, Kyle,” I began prepping him for changing his thinking. “Let me give you some tidbits to chew on that will help rid you of your debilitating anxiety.”
          “Sure, Doc,” he replied eagerly. “Go for it.”
          “First, close your eyes, breathe deeply and rhythmically, and focus on my directions.” Kyle took a deep breath as he nodded to me.
          “Take your left hand from your side and extend it out shoulder height.” He did so.
          “Take your right hand from your side and extend it out shoulder height.” He did so.
          “Now, with your arms extended, lower them slowly to rest together down in front of you.” Kyle lowered both arms, and then took another deep, slow breath. He then opened his eyes and smiled.
          “What you’ve just done, Kyle, is limit your experience of both your anxiety and your depression.”
          He looked at his hands clasped together in front of him. “Really, how so?”
          “Our experience of depression typically comes from past events we have internalized. Our experience of anxiety typically comes from the negative anticipation we have for our yet unknown future.”
          “Okay…” Kyle tentatively understood.
          “By physically moving the position of your arms from by your side to in front of you, you symbolically chose to live in the now or the moment. In essence, you said to yourself, ‘I will not let my negative history hold me back, nor do my unforeseen future keep me from moving forward.’ Staying in the now can be very freeing. Your feelings have nowhere to root and nowhere to grow.
          We talked more about how living mindfully can help him overcome his anxiety, until I felt he was beginning to embrace the concept.
          “Now, Kyle, let’s tackle your anxious feelings. What are you telling yourself when you get anxious?”
          “Well, let’s see,” he pondered my challenge. “Uh, what if I’m late for work again? What if I don’t get along with Mandy’s, that’s my girlfriend, parents? What if I can’t pay my bills? How’s that for a start?
          “That’s great,” I reassured. Now, stay with me here, I’m going to turn each of your ‘what if’ questions into ‘I wonder’ curiosities. Ready? Follow me here.”
          Kyle nodded in agreement.
          “I wonder how I will plan to be on time for work tomorrow. I wonder how I will win Mandy’s parents over. I wonder how I can budget my money better. Do you see what I did there?
          “I think so,” Kyle thought it through. “You turned my questions into statements. You changed my ‘what if’s’ into ‘I wonder’s.’ Is that right?”
          “Yep. Curiosity beats anxiety every time. But also, notice I included something else. The curiosity statement generates action to cure the anxiety.”
          “I don’t follow.”
          “Let’s take the first ‘what if.’ What if I’m late for work tomorrow? It becomes, I wonder how I will plan to be on time tomorrow. There’s a positive subliminal message to yourself embedded in there, that is, ‘I will be on time for work tomorrow.’ I then directed Kyle to unpack the subliminal messages in his next to “I wonder” statements.
          “Great! I think you are getting it, Kyle. You see, as you well know, the feeling of anxiety is constricting, limiting, and binding. The feeling of curiosity, however, is expanding, freeing, and generates boundless possibilities.”
          As a behavioral prescription, I asked Kyle to write down at least 5 “what if” questions that he encountered between his sessions with me. Then pair each with an “I wonder” statement with a positive presuppositional phrase embedded in it.
          When treating anxiety with MPT, you can set the stage with mindfulness, channel positive energy into the healing process, and use cognitive behavioral strategies to challenge your patient’s thinking and change his behaviors. When your patient confronts his anxiety, coach him into switching questions from “what if?” to “I wonder.”
Blessings,
Jon

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