Fight or Flight: Ways to Challenge Your Anxiety

As a former member of the Community Outreach Team at The Recovery Village at Cherry Hill Cooper, Jordan Katz is dedicated to helping clients, families, and organizations find quality treatment options. Jordan spent six years in public relations and marketing in New York City and nearly five years in behavioral health specializing in the treatment of OCD, anxiety disorders, and phobias in Houston and Philadelphia prior to her time with Advanced Recovery Systems.

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Welcome to the Community Education Series hosted by The Recovery Village and Advanced Recovery Systems. Jordan is a member of the community outreach team at The Recovery Village Cherry Hill at Cooper. Jordan is dedicated to helping clients, families  and organizations find quality treatment options.

Before joining ARS in 2020, Jordan spent six years in public relations in marketing in New York City and nearly five years in behavioral health specializing in the treatment of OCD, anxiety disorders, and phobias in Houston and Philadelphia. Jordan holds a BA in public relations from Hofstra University and a Master of Social Work from Baylor University, where she graduated with top honors and was named outstanding MSW Student of the Year. She’s a licensed social worker in New Jersey and Pennsylvania.

Jordan is a published researcher and maintains an active role in clinical research related to OCD, mental health, stigma, and access to care. She’s excited about the opportunity to engage with the community to raise awareness, provide education and encourage hope in order to improve the lives of those with substance use disorders and mental health issues. So, I’m going to toss it to Jordan, and then if you have any questions, again, just please leave them in the chat, and we will answer those after Jordan’s presentation.

Alright. Well, thank you, Ashley, and hi everyone. Thanks so much for coming today. Today, I’m going to talk to you about managing anxiety during stressful times, and really this presentation is around tips and coping skills to use in order to manage your anxiety and ultimately lead a healthier lifestyle. Okay. So here’s the agenda for our discussion today. Point one: we’ll discuss knowledge as power. And really the idea here is that when you learn about what’s happening when you learn about what you’re feeling when you learn about the stress that you’re experiencing now, how does it manifest in your body? What are the symptoms once you know that, you will start to feel better? So, really this is one of the most important steps to be aware of.

The second point we’ll discuss is to understand the difference between reacting and responding to the situation. And again, how that will help you to feel better and much more in control. Next, we’ll discuss breathing exercises and techniques to use as another tool to have to help manage your anxiety in your toolbox. And you know, when you feel anxious, you can absolutely use one of these breathing techniques, all of which have been proven effective to use.

The next discussion point is to understand the concept of cognitive-behavioral therapy and how your thoughts affect your feelings, which affect your behaviors, and really how to challenge your automatic negative thoughts and redirect them to help you feel better and to change your behavior. So we’ll talk about that, and then finally, we’ll talk about how, if you accept certain situations and practice mindfulness and make healthy choices, and that could be with food or with exercise or whatever, ultimately, that can help you feel better and help manage your stress and anxiety.

Okay. So, for me, I like to start by asking you to take a few minutes to think about a recent situation or a trigger that may have caused you anxiety or stress. So just think about a situation that was very, very stressful. What happened? How did you respond to the stress? And here I’d even go as far as to suggest that you take a minute to write down the details of the situation that you remember, how did your body respond? You know, what did you do? And again, this exercise helps to give you a good starting point for right now, how you manage your anxiety.

So when we talk about stress and anxiety, the most important thing is to understand what is happening when we are stressed. What are we feeling? You know, I always like to use the cycle of anxiety because what is happening is that we are experiencing stress. So for example, with the pandemic and the coronavirus, everyone is feeling stressed. It’s a very, very stressful anxiety-provoking situation, and then we automatically respond to what’s happening.

So with physical symptoms, our bodies are responding and everything happens very, very fast, and we often don’t take the time to step back and think about what is happening. So it’s important to understand what’s happening and also attempt to identify what you’re thinking about, which when in a very stressful situation, it’s often hard to do because often our first instinct is to react and fight or freeze and almost enter a mode where you’re not able to respond.

So, it’s important to identify your feelings and ask yourself what’s happening. What am I thinking about now? Especially with the pandemic, this feeling of uncertainty has caused excessive worry. I’m stressed, you know, when is this going to end? When will we go back to normal living and then add on top of it financial stress, kids stress, so many stressful situations at once? I think if you start to develop awareness about stress, this can serve you very well. So, the biggest lesson to learn, of course, is that everybody experiences anxiety and everyone experiences stress, and it’s how you handle it that will change your mindset. You know, ultimately anxiety can be a good thing. It can motivate you. It can challenge you and it can keep you safe.

For example, if I was walking down the street and a truck was coming towards me, if I didn’t have anxiety, I wouldn’t jump out of the way. You know, if I was playing a sports game and I didn’t feel anxiety, it might not challenge me too, let’s say, make the goal in the soccer net. So again, anxiety can be a good thing.

Alright. So, I like to put this out there. I don’t know how many of you have heard of the four F’s of stress reaction, but really these four F’s are how most people respond and it’s either fight, flight, freeze, or faint. And I like this picture, of course, because it’s clear that the lion is in fight mode and the zebra is in flight mode. And again, this is usually how we react to stress and stressful situations.

When thinking about stress, we need to first understand, what is stress? So, basically, it’s a lot of demands from the environment or the situation or whatever it is. There’s all the stress. And as human beings, we often don’t have the innate resources to deal with excessive stress and anxiety. So it’s crucial to have a toolbox that includes skills and tips and coping skills to use when placed in these stressful situations. And once you are equipped with the tools, you will feel better and you’ll feel more in control, and then you will have more of a balance between the demand and your resources, and ultimately won’t feel as much stress.

So it’s important to be able to recognize the signs and symptoms of stress. And as I’ve mentioned, there’s the cognitive part of stress where you were thinking, what’s going to happen? How am I going to stay home this whole time? How will my kids be able to keep up with their education from home? Then there’s the physical aspect. There’s an emotional aspect. And then, of course, there’s a behavioral aspect. How do you respond? What is the actual behavior? Are you biting your nails? Are you eating too much? Are you sleeping too much?

You know, we know that substance use is on the rise with the pandemic, so a lot of people are using alcohol or other forms of substances to help them through it. It’s important to really be able to get in touch with what you’re feeling. There are a lot of symptomatic symptoms of stress. People feel many aches and pains, stomach discomfort, muscle tension, or different symptoms that they may not pay attention to and ignore, or it might be the opposite and just really focus on that discomfort, and then they might stay in that loop of anxiety and stress. So again, just being aware of your thoughts and feelings when in a stressful situation will help.

Next, it’s important to understand reacting and responding. If you can respond to a situation rather than react to a situation, you will feel so much better. For example, let’s say you were listening to the news about the pandemic, which in turn causes many people to feel excessively stressed about what’s going to happen. Will we be okay if you can take a step back and say something to yourself, like, “How can I respond to this situation?” When you respond you’re asking questions, you’re considering the consequences. You’re not pushing it away or avoiding what’s happening. You’re stepping back and asking yourself questions. What if I’m not going to be able to go back to work? What if my kids are going to be home for this entire school year?

What if instead of being carried away by the stress and your body is reacting, you would be able to consider the what-ifs and the uncertainty, and then you were able to answer the questions and start making plans? You can come up with different answers to the what-if questions if you were looking at the situation in a different light. You were curious about what’s happening rather than allowing things to happen and lose control. So, this is an important distinction to make that when you are able to do that, you can feel so much better and you are able to manage the situation better. Really for us, we’ll go into more depth in this when we get to thought challenging.

So this slide really discusses the difference between reacting versus responding. We know that when you’re reacting, you are losing control and almost losing yourself in a way. And when you are responding, what you actually do is stop, take a deep breath, and then you really try to assess your reaction that way. You’re not trying to get rid of the stress, but rather respond differently to it because ultimately we want to remember that stress and anxiety or a normal part of life. We just need to learn to manage that, and sometimes we can learn that stress can serve us. And ultimately you’re making changes to your mindset and reaction that will put you in a different, better position instead of shutting the system down, almost like the fight or flight response.

So in this slide, we’ll go over some breathing techniques. So to do that, I’ll ask you to close your eyes for five to ten seconds. And I’m going to ask that you simply observe your breath and your breathing pattern, you know, how does it feel in your body right at this moment? And then you can open your eyes. And the situation here is simply noticing your breath and asking yourself how you’re breathing.

So if you could simply put your left hand on your chest and your right hand on your belly, and I’ll ask that you take a deep breath. Pay attention to what part of your body is being affected right now. So for a lot of people, they raise the upper part of their body. It’s more of a chest breathing, but really the proper way to breathe is from your belly and it’s called diaphragmatic breathing. When you take a deep breath, the goal is to raise your belly and to make sure that the actual part of the body that’s being raised is your belly.

And the best way to do that is to lie down on your bed or on your floor, or when you take your phone or whatever you have and just place it on your belly and then take a deep breath and make sure that that’s part of what’s raised. And so that will give you the foundation to learn to breathe the right way.

So, I have just a little video for that. The first exercise is diaphragmatic breathing. Your diaphragm is a muscle that helps you breathe. You can find your diaphragm by placing the hand on your upper belly and giving a quick cough. This exercise helps to strengthen your diaphragm muscle, decrease your breathing rate and allow you to breathe with less effort.

By getting into a comfortable position, lying down is preferred, although sitting up works as well. Rest one hand on your belly and one hand on your chest, close your eyes and relax your mind and body. Take a few breaths and notice how your hands naturally rise and fall. On your next inhale, breathe in through your nose, trying not to let your chest move. Notice your belly, filling up with air like a balloon. As you exhale, notice your belly lowering. Try not to force this movement. It takes practice. You should try to do this exercise for three to five minutes.

Alright. So the next is four-square breathing or even breathing. So for this, you inhale while counting to four and exhale, you count to four. So inhale one, two, three, four, and exhale, count to four one, two, three, four. And again, the idea is to have more control over your breathing, because that way, when you’re in a situation where you don’t know what to do or how to respond, you can take a step back and think, okay, let me take a deep breath. Let me get myself to breathe the right way with that belly breathing, to be aware of my breathing and then to come up with a way to breathe as functional in the situation. But I have another little clip for four-square breathing.

Four square breathing technique: square breathing is a technique used to reduce your anxiety, thereby enabling you to gain more control over your breathing pattern. It is also meant to balance and cleanse your entire nervous system by inhaling and exhaling in equal proportions. It’s called square breathing because you create a box with your breath in this way. Take a deep breath in for four seconds, suspend or hold your breath for four seconds. Breathe out slowly for four seconds. Suspend or hold your breath for four seconds. Count at a speed that is comfortable to you. When you become more familiar with using the technique, you will naturally find yourself counting at a lower pace as you get better. As your lung capacity expands, you can increase the number of seconds from four to five to six and so forth.

Alright. So the four square breathing is a simple technique and the most important thing here is that we inhale. You think about something positive. So, for example, joy, love, health, anything really that’s positive for you. You think about the word and when you inhale, you say the word, you take a deep breath and say that positive word in your mind. And then when you exhale, you exhale the negativity in your body, the stress, the anxiety, the anger, anything that you can think of, that you’re holding in your body, you breathe out.

So I’m holding onto negative thoughts or ideas. I always remind myself that I don’t want to rent space in my head; anything that is not serving me well, or that’s not productive. You learn to let go of all this negativity, this negativity from your body and leave space for much more positive things that you can bring. And so much of this is awareness and practice and the more you practice, the better you get, you internalize it better, and then ultimately you’re feeling better.

So, this slide is really important to understand. When you are breathing, you’re activating, you’re taking a deep breath and activating the parasympathetic system. So when you think about the nervous system, it’s like 2 sensitive systems, the rest versus digest. And when you breathe properly, you’re activating the parasympathetic system.

And really we’re able to feel so much better aiming at the calm system. It’s time for you to work instead of constantly being in the stress system and feeling out of control.

So, if you feel stressed, if you just take a deep breath, you are actually activating the part that exists down and these two systems can really work together. In the beginning, it might feel challenging, Jane, but the more you do it, the more you feel like you’re in control and you’ll feel more calm. Of course, my suggestion would be to practice and really practice this for not feeling stressed and anxious because as we all know when we do feel that stress and anxiety, it can be difficult. Put those tools to use when we practice it. When we’re not feeling stressed and anxious, then it almost becomes automatic.

So: progressive muscle relaxation. It’s a great technique for stress and anxiety. With practice, you’ll have reduced levels of stress and anxiety that lasts, but ultimately we are purposefully stressing different aspects, different muscles in our body, tensing them, and then releasing them. We start from our head to our toes, and ideally, we’re practicing for ten minutes a day. There are YouTube videos to help. This is one of my favorite YouTube videos to work, to use, and to practice from. I’ll play a tiny little clip. It is a 15-minute long video. I’m not going to play the whole thing, but I just want everyone to get the idea of what progressive muscle relaxation is. And afterward, I’ll put this in the chat for anybody that’s interested and wants to follow through.

Begin by allowing your body to get more comfortable wherever you are. Right now, take some full, slow breaths in through your nose and out through your mouth, allow any distracting thoughts to come and go as if you’re watching them floating down a stream, and guide your attention back to your slow and easy breathing. When you’re ready, breathe in and make a tight fist with your right hand. Hold and focus on what that tension feels like to you. Now breathe out and release all the tension in the chest, your hand.

So I’ll pause there, but again, progressive muscle relaxation is intentionally tensing and releasing different muscle groups in the body. You learn what that feels like to be able to relax them. Yeah. Alright. So now we’ll talk about one of my favorite things to talk about, and that is the CBT model or the cognitive-behavioral model. And as a side note, Ashley talked a little bit about this, but I do have advanced training in CBT therapy and techniques and I love talking about CBT because ultimately I view it as a lifestyle change. Really understanding this model can help change your life.

The basic idea of CBT is that how you think determines how you feel and ultimately how you behave. So, something happens. It could be anything, you know, it is something that is a trigger. And you have thoughts about what just occurred. You experience emotions based on your thoughts, and then you respond to your thoughts and feelings with behaviors.

So, for example, let’s say you’re walking down the street pre-COVID and a stranger scowls at you. Your initial thought might be, “I must’ve done something wrong, I’m so awkward,” which in turn makes you feel embarrassed and upset, which in turn causes you to apologize to the stranger and replay the situation over and overcompensate, trying to understand what you’ve done wrong. Here, we can really see that this isn’t very rational thinking that a stranger could have scowled at me for any number of reasons. Maybe he’s stressed, having a bad day.

Ultimately it’s important to remember that we all have irrational thoughts, and unfortunately, irrational or not, the thoughts will affect how we feel and how we behave. But if we can challenge these thoughts, you can challenge the interpretation and ultimately your behavior. So the CBT model helps to identify patterns of thoughts, emotions, and behaviors. And once you can identify your own irrational thoughts, you can change them.

A good way to identify and challenge your irrational thoughts is by writing them down. You know, we can start to break the automatic negative thoughts cycle, anxiety, and stress sort of thinking by causing us to overestimate the likelihood of something going wrong and imagine the potential consequences as worse than they really are. So, for example, if you’re about to give a speech, a nervous and anxious person might think, “I’m going to forget everything and embarrass myself, I’ll never live it down.” But from an outside perspective, a more rational thought might be my speech might be only okay, but even if I do mess up, everyone will forget about it soon.

Really starting to write them down, being able to challenge them, and coming up with new rational thoughts will help you to be able to practice to ultimately do it on your own. Really important to note here, though, that thought challenging is not thought stopping. We want to allow the thoughts to happen and challenge them as needed. Right? We don’t want to thought stop because if I were to say to you right now, whatever you do, don’t think about a pink squirrel. Don’t think about it, whatever you do, right? What are you doing? All you’re doing is thinking about a pink squirrel. So, ultimately we want the thoughts to come because they will, we can’t control whether they come or not. And we want to be able to challenge them, not stop them.

So, acceptance is part of mindfulness, and accepting that right at this moment, this is a situation with the pandemic, with the stress of coronavirus, this part of mindfulness, right? At this moment, we might not be able to challenge what’s happening, but we are going to accept that it is what it is and not try to change it and accept that right now, we are socially distancing and how can I make the most of it? When you accept something, your baseline is healthier, your headspace is better and it opens your thinking to more positivity.

For me, I always try to accept the situation at hand. Even though all of the flaws, I try to accept what is happening. And if it doesn’t, if I don’t, then I’m able to utilize some of the tools that we talked about, especially anything which ultimately will open your headspace up to mind your thoughts. Then, you might not feel the itch to change what you cannot.

So, that’s it for me, it’s a little quicker than we thought it was. But I’ll open it up to any questions or any thoughts. Thank you for watching this video. We hope you enjoyed the presentation.