Anxiety Treatment in An Anxious Time

Rising COVID rates, the election, wildfires, the economy-- all of them have been causing us stress and anxiety in the last nine months. This is on top of the stress and anxiety of working from home while homeschooling children, being an essential worker who has to go to work in a hospital or grocery store, or being laid off.  If you’re struggling with anxiety during this anxious time, Dr. Jane Rubin has some thoughts about what anxiety treatment might look like.

How Are People with Anxiety Managing During These Days?

The pandemic has definitely made people’s anxiety worse. People with obsessional anxieties feel even less in control of their lives than they did before.  People who engage in catastrophic thinking have more catastrophes to worry about. People’s hypochondriacal worries have been exacerbated. Everyone’s version of anxiety is the same as it was before, but worse.

In What Ways Do You Try to Help Them?

My approach has shifted in a couple of ways during this time. First of all, many of the anxieties people are experiencing-- about COVID, the election, the fires--are anxieties that I share. My patients know that we’re in these situations together. So, I’m much more open about acknowledging my own anxieties than I am when we’re just focusing on a patient’s individual issues. I think it’s important for patients to know that their therapists aren’t immune to the anxieties that affect all of us. It normalizes their anxiety and, I hope, keeps them from thinking that there’s something wrong with them for feeling anxious about all of the dangers that are out of our control. I’ve also shifted my focus a little bit more to what I think of as a “harm reduction” approach to people’s anxiety symptoms. I’ve always taken this approach to some degree, but I’ve also always tried to help people understand the root causes of their anxieties--in early experiences, for example-- in the hopes that they can become progressively freer of the anxieties that cause them suffering. So, for example, I’m working with people to reduce the number of times they need to engage in a ritual like checking the stove before they leave the house and focusing less on helping them not to have to do it at all.

What Else Is Working for Your Patients Receiving Anxiety Treatment?

For some people, having something to focus on for a good part of their day has been helpful in reducing their anxiety. I have a few patients who started school in the fall. Having something time-consuming that fills their days has helped them to feel less anxious. Some people are able to focus on their work, especially if it’s something that really matters to them. And, perhaps most importantly, people who have kept up important relationships with family and friends either online or through socially distanced meet-ups, have done better than people who are more isolated.I’ve also encouraged people to take as much pressure off themselves as they can. Especially for people who are perfectionists, this can be hard. Turning in work that’s not completely up to their standards or feeling like less-than-perfect parents is difficult. But the resulting anxieties that come from holding themselves to impossible standards become unmanageable if they can't relax.

Do You Find That Lowering Expectations is Harder for Them Or A Relief?

It’s a relief. People who work in organizations can see that everyone (on Zoom) is burned out, They’re afraid to admit it. Once people can admit it to themselves and trusted co-workers, they can take some of the pressure off themselves. People I work with have learned to ask for more days off than they would have in the past. They’ve also encouraged their teams to practice better self-care. It doesn’t solve the problem, but it makes work life somewhat less stressful.Similarly, parents feel relieved when they know that, some days, their kids are going to be on screens playing games or watching videos. They may be doing so more time than their parents would ordinarily allow, but parents need a break, too. It’s a tremendous relief to acknowledge that. Making even just a little time for themselves and their partner is key, instead of having none.Click to learn more about anxiety treatment with Dr. Jane Rubin.Jane Rubin, Ph.D., is a clinical psychologist in Berkeley, California. She works with individuals in Berkeley, Oakland, the East Bay, and the greater San Francisco Bay Area who are struggling with depression and anxiety. She also specializes in working with people who are trying to find meaning and direction in their lives.