Anxiety

Anxiety is the most common and treatable of all mental health conditions, despite the fact that it is one of the most uncomfortable and distressing. It is perhaps the most common reason why people attend my Downtown Vancouver therapy office.

One of the things that excites me most about helping with anxiety is that there are many possible solutions, depending on your symptoms, condition and situation. Options are a good thing.  And the ultimate solution, however, is to face whatever is making you anxious. While this knowledge can be liberating, it is often terrifying for people. It is normal to need support.

If your anxiety is longstanding and entrenched take heart: Some of the best gains I have seen in counselling are among people who have “hit bottom” with regard to their anxiety and are willing and motivated to undertake therapy. With anxiety treatment, the more you put into your homework outside of sessions, the more you can expect to get out of it.

I generally utilize Cognitive Behavioural Therapy (CBT),a research-based method for treating specific anxiety symptoms, unless my clients are seeking a different therapeutic approach. Depending on the symptoms you are experiencing, we may choose from several or most of the following CBT techniques:

  • Cognitive Restructuring – Challenging thinking patterns which feed anxiety and replacing them with realistic thoughts about your situation.
  • Alternative Perspectives –Learning new ways of thinking about and conceptualizing your difficulties.
  • Self-Refection – Increasing your awareness with regard to your own thoughts, feelings and behaviours about your situation: In order to change, we first need to identify the targets for change.
  • Behavioural Techniques – Learning specific actions you can take to manage your anxiety.  A common scenario would be learning techniques that you can apply in the moment to help reduce or eliminate panic attacks.  Therapy also includes follow through with regard to your progress, and making adjustments to the therapeutic plan as needed.
  • Graduated Exposure – rating the situations that make you anxious, from lowest to highest and then starting by facing the ones that make you least anxious while at the same time learning relaxation strategies (see below). We never progress to the next challenge until you feel completely comfortable with the current one you are working on.
  • Relaxation Strategies to regulate your anxiety, particularly when you start to face situations that make you anxious.
  • Lifestyle Considerations – regulating your general stress level: choosing healthy outlets which relieve anxiety, such as exercise, sleep, emotional support, prioritizing decisions and commitments.  For those that want to minimize the effects of alcohol, caffeine, smoking and other drug use, we look at these factors too.
  • Homework – testing the situations that make you anxious “in the field” outside of the office; taking notes, measuring results, etc.  I often approach homework as an “experiment” to help you to determine whether the interventions are working for you.

An important aspect of the therapy is continuing with it between sessions.  Not only do you get more value for your “therapeutic dollar,” you test what strategies are working and which ones are less successful, allowing us to streamline the therapeutic approach to meet your needs.

I also use mindfulness therapy and meditation practice as a complement to CBT.  In particular, I parter with you to learn to cope with distressing and acutely uncomfortable anxiety (and related emotions and thoughts) as they arise.  This is done by learning to radically accept whatever is arising in the mind or body—neither holding on to thoughts or feelings, nor pushing them away.  This may be a simple concept, but it can be difficult to implement!  Practice, practice, and more practice is needed on an ongoing basis. For those who want to establish a regular meditation practice, we can look at how to implement this too.  I feel so strongly about mindfulness and meditation that I employ it on a daily basis in my own life.

I look forward to meeting you and partnering with you on your journey of recovery. Call or email me if you have questions or would like to set up an appointment.  I look forward to hearing from you!

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Recommended Books

The Anxiety and Phobia Workbook by Edmund Bourne

A best-selling self-help workbook using the principles of cognitive behavioural therapy to help with generalized anxiety, panic attacks, phobias, social anxiety and other anxiety-related conditions.

Scaredy Squirrel by Melanie Watt (2006)

Children’s book with excellent adult appeal. The story about how a squirrel inadvertently faces his fears, with positive results.

Resources

Bounce Back Program

Telephone coaching for people with mild-moderate depression with or without accompanying anxiety. Coaching available in English, Cantonese, French and Punjabi. Family doctor’s referral required to access this program. Free.

Mind Shift

App developed by the folks at Anxiety BC to help youth and young adults manage anxiety symptoms.

Reduced-Cost Counselling [PDF]

A resource list of lower-cost professional counselling options in Vancouver. Corrections and suggestions welcome.

College of Physicians and Surgeons of BC

For help in locating a family doctor in BC.

Alcohol Reality Check

Concerned about your drinking? Confidential and anonymous online assessment tool developed at the University of Victoria.

Mood Gym

Online self-help program for depression and anxiety, using cognitive behavioural principles (CBT).

Relaxation Audio Download

From the people at Simon Fraser University’s Centre for Applied Research in Mental Health and Addiction (CARMHA).

Canadian Mental Health Association

604-872-4902
National organization promoting mental health for all.

Vancouver Access and Assessment Centre (AAC)

604-675-3700 – Joseph and Rosalie Segal Centre, Vancouver Hospital, Level 1, East Entrance

24/7 phone, walk-in and outreach support for urgent, non life-threatening mental health and addictions issues.

Anxiety BC

604-681-3400
Information and extensive online resources for managing anxiety.

Here to Help

BC-based website offering comprehensive information on a wealth of mental health conditions and addictions concerns.

1-800-SUICIDE

24-7 crisis service for anyone that is suicidal, thinking about suicide or for concerned friends/family. BC-wide service.

SAFER, Vancouver Coastal Health

604-875-4794
Works to reduce suicide risk among those in crisis, to assist family & friends who care about them and promote healing for those bereaved by suicide.

Coping With Suicidal Thoughts

Self-help guide (pdf). Not intended to replace professional help.