Anxiety interventions
Changing perspectives and strategies

By Macaile Hutt

Since becoming a Certified Clinical Anxiety Treatment Professional for Children and Adolescents (CCATP-CA), my entire view on anxiety interventions has changed. I used to focus so much on the content of the worry when working with my clients and even when managing anxiety I was experiencing myself.
What are you worried about? What’s the worst that could happen? When does the worry show up? Why does the worry show up?
Without even realizing it, I was “doing the disorder,” as anxiety guru Lynn Lyons often says. When we focus on the content of our worry, our worry grows. When we focus on the process anxiety takes within ourselves, we can learn to overcome it no matter what type of content the anxiety is stemming from.
When I first entered the realm of anxiety in children and adolescents, I had a go-to strategy I used with a lot of my clients. We would create a special “worry box” where the children could write down all their worries and store them in the box so they didn’t have to live within their minds anymore. This seemed to have intermittent success; but throughout my certification process, I learned that we are actually growing our worries any time we focus on what it is we are worried about without stepping into the process of the worry, what it asks of us, and how we can overcome those requests regardless of the challenges we face.
Anxiety demands certainty. And no amount of certainty will ever satisfy the demands anxiety creates. So often we give our children as much structure as we possibly can and wonder why we see major increases in negative behaviors anytime we stray from the precise schedule they are used to following. But what if there was a better way? What if we could give structure when available, and also learn to adjust our sails and go with the flow when unexpected changes happened within our lives or our day? This is Lynn Lyon’s lifework and it has made such a massive difference in the way I treat the ever-growing anxiety epidemic our country is facing.
Without having the ability to download everything I’ve learned from Lynn throughout my practice into your mind, I wanted to share at least a few takeaways I use frequently when treating anxiety in children and adolescents:

1. Learn to expect worry. Once we accept the fact that worry is going to show up, we don’t have to waste so much time being scared of its arrival. Worry is always going to show up, for some more than others, but worry is also extremely predictable and rarely original. Worry feels like a pounding heart, increased sweating, and racing thoughts. It feels like a bully that shows up in our mind trying to boss us around. But we don’t have to listen to worry. In fact, we can talk back to worry and tell it we aren’t going to obey it today. We can tell worry that we are going to do the hard thing anyway.
2. Separate from our worry. I have my clients name their worry, draw their worry, and learn how to talk back to it with a vengeance when it shows up. Separating from our worry makes it feel so much less personal when it shows up, and allows us to tell it to exit stage left without feeling like we are losing a part of ourselves in the process. When we separate from our worry, it makes it a lot easier to identify within ourselves and within those around us. One of my clients named her worry “Frank” and it has become a funny household topic “when Frank shows up.” It feels much less confronting to imagine Frank, a little hairy red troll, showing up in my client’s mind and gives everyone permission to work together to defeat this worry when he shows up unannounced.
   Naming our worry also helps us recognize we aren’t alone in these feelings and don’t have to feel isolated when dealing with them. If mom’s worry shows up the night before a big meeting at work, or dad’s worry shows up sitting in traffic on the way to an important event, we learn to talk about it as a family and lessen the feelings of isolation that often come with such big feelings. When we create a sense of community around these feelings, we can all work on identifying and defeating them together.
3. Celebrate little victories. Rather than focusing on the things we are worried about, let’s focus on the times worry showed up and we chose not to listen. I often suggest families get a stack of Post-it Notes and leave them somewhere accessible to the whole family, near a wall that everyone sees often. Encourage everyone in the family to make note on the Post-its anytime they “do the hard thing” even when worry shows up, or witness a friend or family member defeat worry in their day. Where attention goes, energy flows, and when we focus on these positive times worry showed up and we did the hard thing anyway, our energy goes toward those positive thoughts and creates stronger pathways for positivity in our brain.
4. Get uncomfortable on purpose. Once we learn where our triggers to worry lie, and we become familiar with the process of worry (how it shows up in our body, what it feels like, and how predictable it actually is), we can put ourselves in positions where we know worry might show up, and practice defeating that worry confidently. The saying goes “you can’t teach old dogs new tricks” but that simply isn’t the truth. Our neural pathways are incredibly alterable, and strengthen immensely the more we fire certain pathways. The more we focus on our ability to defeat our worries and the more confident we become in facing worry any time it shows up, the stronger those pathways become and the more readily and habitually they learn to fire.
5. Lighten up! Worry, anxiety, fear, and uncertainty are all really big feelings, especially for a tiny body to harbor day in and day out. When we lighten our approach to worry, and intentionally release the white-knuckled grasp we have on the world around us, we make so much room for joy, innocence, and confidence to grow. If we can learn to become curious about our worries, we can completely shift the lens in which we view them. Once we strip it down to a biological process that is happening within our body and our mind, we reclaim our power to defeat it.
   And any time you can add silliness and playfulness into the approach, it’s a win in my book.

For more information on Lynn Lyons’ approach to anxiety, I recommend watching her video, “Can Mr. Rogers Save Us All?” and exploring her podcast, books, and other resources on her website at www.lynnlyons.com.

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