Dr. Laura's Meaningful Psychological Services
Dr. Laura's Meaningful Psychological Services
Online Cognitive-Behavioral Therapy
Cognitive-Behavior Therapy, Mindfulness, CBIT, ERP, CBT-I, Behavior Consultation, and Treatment for Anxiety and Insomnia
Laura Van Schaick-Harman, Psy.D., BC-TMH
|Posted on March 27, 2019 at 12:00 AM|
Reassurance seeking is a common anxiety symptom that both children and adults exhibit. When we feel anxious, it is a generally uncomfortable feeling, so we will want to try different things to alleviate the discomfort. One very common method is seeking reassurance to help calm the anxiety or worry.
Reassurance seeking can be done verbally or through physical behaviors.
Here are some verbal examples:
“Am I going to be ok?”
“Do you think she heard me?”
"Should I send this e-mail?”
“Do you think I sounded ok?”
“Are you sure you will be there to pick me up?”
Here are some behavioral examples:
Re-reading e-mails after they are sent
Replaying conversations in mind
Looking up health problems online
Checking to see if the door is locked
Seeking reassurance will help us feel better quickly if we receive the answer we want. How can this be a problem? Well, when we engage in seeking reassurance excessively (more than once), we are reinforcing anxiety.
There is a difference between reassurance seeking and information seeking. When we seek information, we are learning about a new topic, illness, schedule, plan, routine within an appropriate boundary.
For example, if your child is asking what time you will be picking them up from the birthday party because they forgot or they haven’t been told yet, this is not considered reassurance seeking. This is information seeking. If, however, your child presents with anxiety (possibly separation or social anxiety) and he/she is asking you what time they will be picked up multiple times and if you will remember to get them, this is reassurance seeking.
What do we do?
We limit seeking to information from approved and appropriate resources (e.g., avoiding misleading websites and forums). We limit re-playing conversations and re-reading messages, to once or not at all once originally checked. We stop asking others to participate in reinforcing our anxiety. For parents, make a plan with your child to discuss how the questions will be answered. We set a goal to answer each question only once so we can teach the child to learn to seek only information, but not extra reassurance.
There is so much to discuss around this topic. Let me know if you have questions or additional thoughts!
Dealing with Test Anxiety
|Posted on April 11, 2016 at 1:35 PM|
It's April, and for many of you college students you are preparing for finals in a few weeks. For those of you not in college, this post still applies for any type of test or work presentation. If you suffer from worry, anxiety, or panic symptoms before, during, or after an evaluation, continue reading for some helpful strategies to get you through.
Five Ways To Cope With Test Anxiety
Deep Abdominal Breathing
When we take deep breaths, it is important to make sure the air is getting deep enough. To know if you are bringing the air to the right spot, place one hand on your belly and one hand on your chest. Both should be rising and falling as you breathe, but your belly should be rising higher. Picture a balloon inside your belly slowly filling with air and then slowly deflating when you breath out. Focus on the way the air feels or how your body feels taking in this nourishment as you inhale and exhale.
This may seem like a no-brainer, but it is still important to cover. Our mind and body give us feedback about our environment. This is necessary for survival and healthy functioning. It is why we become fearful in dangerous situations. If we do not prepare for the test/evaluation, our mind says "uh, wait a minute here. I don't know how to process this situation. Alarm, alarm, alarm!" And our body feels the corresponding anxiety symptoms. While taking a test is not necessarily a dangerous situation, there are negative consequences for not performing well on a test. Hence, our mind will react accordingly. Note that this is unlikely to occur if you do not care about the negative consequences or the outcome of the test.
Healthy, Realistic, and Optimistic Thoughts
The way we think affects the way we feel which in turn impacts our behavior. We can be responsible for the thoughts we have about a test. If we interpret studying for a test as boring and a waste of time, we are less likely to prepare. If we interpret the test as a challenge that provides a stepping stone to our career, we are more likely to prepare. Our thoughts about the test while taking it also matter and can influence our performance. It is important to be realistic. If you haven’t studied at all and really never had a good handle on the material, thinking you are going to ace it is unrealistic. Thinking that you will do your best with what you have is more effective. Thinking that one test will make or break your life is also unhelpful and most likely not true.
Mindfulness-Focus on Here and Now When Taking the Test
Every second you have an opportunity to be mindful- to be fully aware of your experience taking the test. This means getting comfortable with being uncomfortable, focusing on the test itself, and being aware of any distracting thoughts with non-judgment and acceptance. This is a skill that takes practice. It is a good thing that we can practice any time we want because there is always the current moment available to us. Why not live in it?
Awareness of Cycle of Anxiety and Panic
Sometimes we get so anxious preparing or taking a test that we experience feelings of panic or a full-blown panic attack. While incredibly uncomfortable and terrifying, panic attacks on their own are not usually dangerous. It is important to understand the cycle of panic to stop it before it starts. We may feel anxious and start to notice our breathing and heart rate increase. Once we have had panic attacks diagnosed, we can understand that our body is falsely alarming us to a danger that is not real. Using healthy coping skills (some of them are mentioned above) can make a big difference.
I hope you apply these skills and have some great performances on your upcoming tests!
What's Your Movie Theater?
|Posted on July 10, 2015 at 9:00 AM|
Several years ago, I experienced a panic attack (yes, psychologists can get them too). I was sitting in the middle of a packed movie theater with friends when another movie goer had a medical emergency that was very scary and yucky (I'll spare you the details) and involved 911 and several medical professionals. The scene played out in the theater and blocked the only non-emergency exit. Faced with sights and sounds of the other person as well as being in the middle of a row with people on either side of me, I panicked.
Panic attacks occur very suddenly and sometimes can feel as if they come out of nowhere. Other times, we are able to identify an event that sets it into motion. Let's break this down using my panic attack example. The trigger was the medical emergency. The way that I interpreted this event ("I'm trapped," "are they going to be ok?" "why hasn't the theater stopped the movie and gotten us out of here?" "what's wrong with that person?") affected the way that I felt (nervous, sweaty, breathing rate increased, dizzy, tingling). The cycle of panic continued. I then interpreted the feelings as being more severe or dangerous ("I'm going to be sick," "why do I feel like this?") and then the feelings intensified (sense of derealization, heart rate increases, lose feeling in hands, stomach upset). Thankfully, I recognized the symptoms as a panic attack and was able to utilize coping skills to break the cycle and prevent symptoms from getting worse. I was able to stay for the remainder of the movie, rather than leave once the scene was cleared. If I left, I would have reinforced my anxiety by escaping the situation.
For a long time after this experience, I struggled with returning to that theater. This is called avoidance. The problem with avoidance is that you feel better in the short term (e.g., "good thing I didn’t go to that mean and scary movie theater because I feel better now") but the longer we avoid, the harder it is to go back. Family and friends would invite me to go, but I would work hard to get everyone to choose a different theater so I could avoid going back. This was the wrong thing to do!
Once I finally decided that this was ridiculous and unhealthy, I went back. This is called exposure. The first time was pretty uncomfortable. Over time, it became easier and easier to go to this theater. This is because I had to actively work on breaking the connection between the movie theater and having a panic attack and/or witnessing a scary medical emergency. The more I went and nothing scary happened, the easier it was to go. I also paired the exposure with relaxation techniques. This is to help replace the scary environment with a relaxing one.
If you are avoiding a situation that has an uncomfortable memory for you and is a place where you should be otherwise safe in, I invite you to decide to change this. A psychologist can assist you with the necessary tools and skills to regain the courage and the strength to return to your movie theater, wherever that may be for you.
It feels great to be able to see movies in this theater again, and to be able to share this story with you (which is another form of exposure, by the way).
|Posted on April 1, 2015 at 7:55 PM|
"Hakuna Matata- it means no worries" (from The Lion King). This is a phrase I often sing to my baby. We even put a picture of the phrase on his nursery wall. As a Mommy, I never want my son to feel anything but happy and I don't want him to ever feel anxious. As a Psychologist, I actually do want him to experience worry and anxiety at certain points in his life, within reason. Why?
It is unrealistic and unhelpful to be happy and carefree all of the time. Negative emotions such as anxiety, sadness, and anger serve as motivation to make changes in our life. These feelings provide feedback to us that something is not quite right, very wrong, unsafe, dangerous, or not the right fit for us. It can also be an indicator that we need to develop better coping skills or seek professional help.
As parents, we might want to rescue or save our children from worries and anxious feelings. I believe this is a natural parental reaction. But attempts to save your child from anxiety can actually be making anxiety stronger.
Picture this. A child we will call Bobby is looking at a group of peers playing at a birthday party. Mom and Dad know that Bobby has concerns about playing with new people and is nervous to initiate play. Mom and Dad want him to have fun and end his anxiety so they bring him over to the group of peers and the parents initiate the play for him. They might say, "Bobby wants to play with you. Can he join in?" Sounds ok enough, right? Sure, Bobby can now play with his peers. But let's suppose there is a problem during the play such as a peer takes a toy away from him. Bobby becomes nervous and looks for parental support to solve the problem for him. In fact, Bobby learns to wait for his parents to initiate play for him in the future too. Bobby has just given his anxiety and worries a big reward by allowing his parents to speak for him. Bobby learns that he is not strong enough to deal with his worries, so he is likely to avoid situations on his own unless a parent is there to speak and solve problems for him.
This is one example of how anxiety can be reinforced. There are other ways anxiety can be reinforced and other circumstances when it is totally appropriate and helpful for parents to help their children initiate play and solve problems as described above. My goal in this month's post is to challenge parents to take a deeper look into their child's behavior and see if anxiety has been reinforced accidentally. You can discuss your observations and concerns with a mental health professional who can help you with managing your child's behavior.
I hope you and your children do not have too many worries and that you can recognize anxious feelings as providing you with valuable
And maybe sing a song of "Hakuna Matata" to someone today.
Live Meaningfully With Anxiety
|Posted on February 12, 2015 at 7:05 PM|
Living with anxiety can be overwhelming, smothering, and in some cases, debilitating. Living with anxiety can also be meaningful, purposeful, and embraced. Yes, that is what you just read. For those of you reading this post who suffer from anxiety, you may think I am kidding. I'm not.
The truth is that we all experience anxiety in one form or another. There are many purposes for the experience of this uncomfortable, yucky, and scary feeling. Anxiety is necessary for survival. Our bodies and brain provide feedback to us when we are in a potentially dangerous situation. Anxiety can motivate us to change our current situation. Anxiety prepares us for novel experiences and difficult tasks such as a job interview or test.
We know from research that a little bit of anxiety can be helpful, but too much or too little could hurt our performance. This is explained by the Yerkes-Dodson Law. A simple diagram can be found on this website.
Basically, anxiety can be used for helpful and purposeful activities, when in moderation. Too much anxiety is what leads to feelings of being smothered and wanting to avoid the world around us. Many students describe this feeling as their mind "going blank" when taking a test. Too little anxiety can lead to being unprepared for new and difficult tasks.
It is important to remember that anxiety has a purpose. We can check in to our surroundings, environment, habits, activities, and lifestyle. Is there a change that needs to be made?
This information is one of the reasons I created the Live Meaningfully With Anxiety Room. There are several recordings available that explain how to live with anxiety in a healthy way. These resources are completely and totally free. You can access them on my website under Anxiety Resources.
Please seek the support of a mental health professional if you experience increased anxiety.