How I Treat Anxiety
IFS (Internal Family Systems) and Treating Anxiety
I should start by being totally honest that there are tons of different theories and treatment techniques and modalities for treating anxiety, and tons of ways of making sense of what anxiety is and how it works that counselors learn in school. It’s really tempting for me to tell you that I have found THE BEST way to treat anxiety out there, and that all other ways are inferior and that you’re getting ripped off if you give any other counselor your money…but I know that’s not quite true…
There are lots of methods that work well for some people and can yield really positive results. I’ve even looked at the data and research that shows that these other methods really can lower anxiety rates. I believe that data and the research and I know they can work.
But, I can also tell you that there was a time in my life where a lot of those other methods did not work for me, personally.
I spent years in therapy where my therapist basically tried to convince me using rational arguments about why my anxiety did not make sense and should go away. That definitely didn’t work for me…the more the therapist and I tried to argue about how irrational and illogical and ridiculous I was for having anxiety and for believing the anxious thoughts I was having…my anxiety actually got worse!
And then…I stumbled something that actually DID work…it’s called IFS (Internal Family Systems), and by combining IFS with somatic principles and mindfulness, my relationship with my anxiety, my understanding of anxiety, and how I treat clients with anxiety has never been the same.
But - before we get to how I treat anxiety - let's get on the same page real quick about what some signs are that you may have anxiety:
Signs of Anxiety
I ask all of my clients in the first session (click here to read about what my first sessions are like with clients) if they think that they have anxiety.
A lot of clients say yes right away. And, a lot of clients also say no, they don’t think they have anxiety at all. No matter how they answer the question, I always ask them some variation of these basic questions from the GAD-7, a popular anxiety assessment counselors use. I can’t tell you how many times someone will tell me they don’t think they have any anxiety at all, and then when I ask these questions, it turns out, according to this assessment, anxiety really is playing a dominant role in their life.
Ask yourself these questions, thinking about how often they apply to you in the last couple of weeks:
How often have I felt anxious, nervous, or on edge?
How often have I not been able to stop or control worrying?
How often have you worried too much about different things?
How often do you have trouble relaxing?
How often have you been so restless that you have trouble sitting still?
How often have you become easily annoyed or irritable?
How often do you have the feeling as if something awful might happen to you?
If you’re noticing that you have some of these things frequently…then you should probably consider reaching out to a professional. This blog post definitely isn’t meant to be an official assessment, and I am not giving you any professional medical advice…but…trust your intuition, and if as you read through these experiences and you noticed little light bulbs going off inside you that were saying ‘oh yeah, that’s me!’...then notice those light bulbs going off, and act accordingly.
Those questions all ask the question of FREQUENCY, or HOW OFTEN, do you have any of the above symptoms.
But, another thing you can think about is the INTENSITY of the symptoms when you have them. Or, to put it another way, how much are these symptoms affecting your ability to thrive in life? The way that the GAD-7 put it is like this:
How difficult have these problems made it to do work, take care of things at home, or get along with other people?
Again, trust your own gut and intuition, but - if you feel that the previous bulleted questions are affecting your ability to thrive in your work setting, home setting, or social settings…then that’s something to pay attention to.
Make it stand out
IFS (Internal Family Systems) and Anxiety
Part 1: Anxiety is a PART.
You may have noticed my short little personal mission statement at the homepage of the website, or, if you are visiting this article directly and haven’t first visited from another page, here it is:
I help people who secretly hate themselves, fall in love with who they really are.
When people come to therapy, they arrive because something is happening within them that they do not like - in this case, we’re talking about anxiety.
When I first started therapy, I came because I HATED being anxious.
But the IFS model has a slightly different way of understanding our anxiety than a lot of what I’d experienced previously.
For starters, the IFS model believes that we are not just one person with one way of thinking, but, we’re actually made up of different parts. It sounds a little weird at first, but, it’s also something that a lot of people have intuitively understood…if you’ve ever said something like ‘that’s my angry part’...then, you got it!…we are made up of different parts within us.
That’s the first key difference - rather than understanding yourself as being anxious like other theories do, this theory understands that you have an anxious part.
Maybe you’re reading that and thinking that being anxious vs. having an anxious part doesn't make a lot of difference…but…hear me out:
When I believe I am anxious then I feel the anxiety right up on top of me. I feel it up close and personal because the anxiety is me and I am the anxiety. There’s no difference and no space to breathe at all. But, when we start to come to an understanding that I have an anxious part, it begins to create distance between you and that anxious part that you can work with.
It’s not just an anxious part either, we all have all kinds of other parts…we just don’t talk about or think about ourselves that way: an angry part, a sad part, a critical part, a lazy part, a hard-working part, a part that wants us to get better and quit being so anxious and tells us to just go see a counselor already, etc.
Again, just by understanding that my anxiety is a part, and not all of me, it creates space we can work with and right away gives you a little breathing room.
Part 2: Our anxious part is trying to help us, or, trying to get our attention.
If you’re still reading - I’m going to assume you’re either on board with the idea that we have parts, or, maybe you’re a bit skeptical but you’re going to keep reading just to see where I’m going (and that’s okay too, I was skeptical when I first read about having parts).
A core belief of IFS is that there are No Bad Parts.
That means that the anxious part that you secretly or openly hate so much, is actually trying to help the best way it knows how.
This belief is so different from the kind of counseling I had previously received that I talked about earlier in the post, where the therapist and I tried to basically convince my anxious part that it was being illogical and irrational. Instead, what ended up happening is that my anxiety got worse because the anxious part in me felt like the therapist and I didn’t understand what it was trying to communicate so it felt it had to get even louder to get our attention!
Part of therapy is discovering how your anxious part is trying to help.
That may sound totally crazy to you. I get it.
How could your anxiety possibly be trying to help you when it brings you so much pain and seems to wreck your life?
Here’s an example of how this might work in a counseling relationship. You’ll read about how a client, Sarah, came to better understand how her anxious part was trying to help her. You’ll also read about what healing and transformation looks like using IFS:
Sarah’s Anxiety: A Fictional Case Study
Sarah is in her late 20’s and has just entered a doctoral program at Wake Forest. She loves school work, academia, research, and writing papers. But, part of her doctoral work requires her to teach an undergraduate class in her department each semester. While she knows she’s “smart enough” to teach the class, she experiences significant anxiety each time she teaches. She spends hours more time preparing the class than she realistically has to spend, and still finds herself feeling extremely anxious before, during, and after. She’s just a couple months or so into her program, but she’s already questioning whether she wants to finish her Ph.D. Maybe academia and teaching just are not for her.
Through counseling, Sarah is able to learn to recognize her different parts, including her anxious part. While at first she admits to feeling angry and hating her anxious part and all that it is doing to her, she has been able recently to access a sense of curiosity toward her anxious part. She wants to know what really is going on inside of it.
Working with her anxious part with a sense of curiosity helps the anxious part to relax. Eventually this leads Sarah to a memory she had not remembered in probably 15 years of when she was in middle school and reading aloud in English class. The whole class was taking turns to read, and when it was Sarah’s turn, Sarah had read too quietly for the whole class to hear. A boy in the class had yelled out rudely, “louder Sarah, no one can hear you.” Sarah had reacted at first in anger and tried to speak up saying “is this loud enough for you?!?” in what she thought was a loud voice. However, at this point, several members (and what felt like the entire class) all responded loudly, “No! We still can’t hear you!” Sarah became flustered and started crying in class, and the teacher simply moved to the next student who was supposed to read.
First Sarah realized that this wasn’t just a memory, it was also a part that she had locked away for years. As she accessed this previously hidden part from a place of compassion, she realized that the anxious part inside of her was trying to keep this younger version of her in middle school safe. Every time she got anxious teaching, it was the anxious part trying to tell her - “Hey! make sure this does not happen to you again! It was too painful to do that all over again!”
Sarah understood her anxiety was trying to help her after all!
Through therapy, Sarah was able to access a sense of compassion for her anxious part, and even thank her anxious part for trying so hard to protect her from reliving that painful memory in a new way in the present. Sarah was also able to go back to that painful memory and heal that painful part of her from middle school that was trapped in that classroom reliving that memory.
Eventually Sarah’s anxious part learned to trust that Sarah didn’t need the anxious part in order to be safe, and would no longer try to take over during Sarah’s classes to protect her. Occasionally Sarah’s anxious part would start to get her attention, and Sarah could feel the anxious part coming on, but, she learned to calmly take a deep breathe and communicate with the anxious part, letting it know that everything was okay. She would ask the anxious part politely if it was okay to take a step back, and she would check back in with her after class. The anxious part would disappear, thankful that Sarah could handle it herself, and also thankful to hear that Sarah wasn’t trying to ignore her or get rid of her altogether. After class, Sarah would make it a point to check in with the anxious part after class, ask why it had gotten nervous, and remind the anxious part that everything was okay. Sarah could handle it.
Conclusion
I said it at the very beginning, but I’ll say it again at the end here too…there are lots of theories and models for how to treat anxiety, and there’s research backed evidence to support many of them. But, this is the way that I personally have experienced transformation, and that I wholeheartedly believe in. This story is not some incredible miraculous thing that happens once in a career for counselors…these are the kinds of stories that happen all the time.
If you’ve read this far, I’m guessing a part of you is wondering whether this way of treating anxiety could work for you too. You may have thoughts like…
Could this work for me?
Could this actually help me with my anxiety?
How would this even work?
I’m happy to answer any questions you have as honestly as I can.
If it feels right, feel free to click the link below and book a free 20 minute video consultation where I can answer any questions you might have about the possibility of working together.