Tackling Anxiety Series, Part Two

Developing an Action Plan

Diana L. Paulk, PhD

In Part One of our Tackling Anxiety Series, we talked about the importance of getting curious about anxiety instead of avoiding our anxiety and worries, and highlighted two ways to get curious that included IFS therapy and using an FTD Journal. Today, we will talk about the importance of having a plan for how to deal with anxious and worrisome thoughts before we experience them.

I love scales and numbers! Using a scale when thinking about anxiety can help your therapist understand more quickly what you are experiencing. Using a scale can also help you and  your therapist get a clear picture of what is happening so together you can identify what may be related to your unique experience of anxiety. I like for my clients to rate their anxiety on a scale of 0 to 10. (Remember from Part One of our series, Zero means no anxiety and Ten means it’s time to go to the emergency room!) Over a fairly short period of time, clear patterns usually begin to show up.

Having a plan before you experience that uncomfortable sensation of anxiety is super important because when anxiety is creeping up, your thoughts tend to move toward the avoidance instinct we discussed in Part One of our series. When this happens, especially if panic sets in, the brain goes into “fight or flight mode.” When your brain is in “fight or flight mode,” part of your brain goes into action, but another part – the more logical part – cools off. It’s simply very difficult to “think straight” when in this mode, and having a plan before this happens can really help. For more on this topic, see Part Three of our Tackling Anxiety Series in future blog posts.

For your Action Plan to Tackle Anxiety, I recommend deciding what you are going to do at each intensity level of anxiety, from Level One all the way to Level Nine. You would do nothing at Zero because you have no anxiety and at Ten you would go to the emergency room. To be able to use this Action Plan, it means you must be more aware of your feelings of anxiety. I know, I know…that sounds painful and who wants more pain? Think of it like setting an earthquake detector to a more sensitive level so you can prevent more damage. And I promise you: It is way easier to bring a Level One on the scale down to a Level Zero on the scale than it is to bring a Level Nine of anxiety down to Zero on the scale!

Deciding how to respond to each level of anxiety can be challenging. A therapist who specializes in anxiety can help you identify different ways you can be successful with this. All of our therapists at Birmingham Anxiety & Trauma Therapy specialize in working with many types of therapy for anxiety and would love to help you. But today, let me give a couple of examples from my own plan for tackling anxiety:

  • Level One: I notice and acknowledge the anxiety, but remind myself that “this is just something my body does from time to time,” and that the anxiety can go away as quickly as it came. Often, acknowledging the anxiety but turning back to what you were doing before you noticed the anxiety is enough to find some relief.
  • Level Two: I notice the anxiety at Level Two, but also tell it that I really don’t have time to deal with  anxiety today.
  • Level Three: I will do some Box Breathing. Shallow breathing can limit the amount of oxygen going to the lungs and brain. When this happens, it can promote a feeling of  anxiety. Deep breathing promotes energy and resilience. “Box breathing” involves “four counts of four.” Imagine rounding the four corners of a box. At the first corner, inhale slowly and deeply while counting to four. At the second corner, hold the intake of air – don’t inhale or exhale – for four counts. Third, exhale slowly and deeply while counting to four. Fourth, hold that state of exhalation – don’t inhale or exhale – for four counts. You have made it all the way around “the box” – now do it again! In summary, “Inhale for four, hold for four, exhale for four, hold for four, repeat.” This is a very powerful technique to use when you need some therapy for anxiety, but aren’t with your therapist. 
  • Level Four: I begin making an FTD Journal entry. I notice any similar patterns from previous bouts of anxiety and then how that anxiety was resolved. Often, what I worried about or feared never happened. In fact, about 95% of what I worry about never happens! For more on this, check out the following link:,them%20a%20lesson%20worth%20learning.

It is important to note that for some people, having medication available is a helpful part of their personal Anxiety Action Plan. Some medication for anxiety is taken daily and other types of medication are taken at the onset of anxiety. If you believe medication may be right for you, speak with your primary care physician or schedule an appointment with a psychiatrist in your area. 

My goal for my personal Anxiety Action Plan is to never go above a Level Four. Indeed, it’s been years since this has happened. By employing a variety of physical, emotional, cognitive, and spiritual strategies for tackling anxiety, you will get closer to reaching your personal goals as well. Stay tuned for future blog posts in the Tackling Anxiety Series.

Finally, parents sometimes wonder if anxiety therapy for children is a good idea, and the answer is a resounding yes. Children often pick up the skills faster than adults!

If you know someone who is looking for anxiety therapy for children or anxiety therapy for adults, the anxiety therapists at Birmingham Anxiety & Trauma Therapy would love to help, and can be contacted via [email protected] or 205-807-5372.

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