Part 2: A Practical Exercise for Managing Anxiety, and More Useful Tips

“We don’t need the self-critic, we just need some compassionate authority.”

In the second half of our conversation with Cognitive Behavioural Therapist Tracey Patrick, she gives us a simple breathing exercise to try when anxiety gets on top of us. If you haven’t read part one of our conversation, you can do so here.

So Tracey, what can you do if you are suffering from anxiety? Have you got any practical advice, firstly to recognise it, and then to try to address it?

I’m coming at this very much from a CBT perspective. So, in CBT it’s a case of working with those emotions and the physical sensations. Looking at the thinking and looking at the behaviours. If you can notice that all those physical sensations, all those symptoms of anxiety, one of the absolute best things you can do is slow your breathing down.

But people often say to me, “Well, I’ve done breathing, and slowing it down just doesn’t work”. It isn’t just about slowing your breathing down. It’s about developing a rhythm to your breathing – a nice, soothing rhythm.

And how you approach it is really important. Think about how you’re sitting. It’s no good doing it leaning forward with your head in your hands, breathing in and out through your mouth. That’s what we do when we feel awful. The feedback that posture is giving to our bodies is, I’m in danger, there’s something not right here.

So the things that we can do are – think about your posture. Have your feet flat on the floor. Have your hands in your lap. Roll your shoulders back. Give your big old lungs some space. Create some space between your ears and your shoulders. Keep your head upright. Relax your jaw.

And then, just slow your breathing down. Breathe in and out through your nose. Try to get your breathing down to five or six breaths a minute. Breathe in for 3, pause for 2, breathe out for 3, pause for 2. Keep that rhythm, keep that breathing smooth – especially the outbreath. That will help.

Finding a rhythm that is comfortable and soothing activates our para-sympathetic nervous system which helps change our emotional state when we feel under threat. In short, it helps us feel better.

Whilst you’re breathing, just put a slight smile on your face. It might seem a really odd thing to do, and the thing that you feel least like doing. But when you do that, again you’re letting your body know – it’s ok, there’s no tiger. Before you put the smile on your face, just imagine saying hello to some people that you really like. In doing this we are using imagery to help foster feelings of friendliness and well-being.

Put the smile on your face and just breathe smoothly and rhythmically. This can be really powerful. It gives such different feedback to your body and it can take the edge off the anxiety. It might make it dissipate altogether, but even if it doesn’t, it will definitely reduce it.

Know that your attention will be apt to wander and try to ramp you up again with anxious thoughts. Just practice bringing your attention back to the breath. It’s also a good practice in putting your attention where you want it to be.

And give yourself some time. The more anxious you feel, the more time you will need. Slow everything down. And be aware of your tone of voice. How are you speaking to yourself? Are you speaking to yourself like you would a friend? “It’s ok, take a rest. You’re doing fine. It doesn’t matter”. Or are you saying yourself – “Must do more, must try harder, got to keep up with everybody else”? So watch the tone of your voice. These are things that we can do that are really important.

Considering the tone I talk to myself in is something that really helped me. It’s something I had never noticed before. We can be quite cruel to ourselves.

We can. And often we can say the right words to ourselves but in the wrong tone. So I can say, “I’m doing a good job, I’m doing the best I can.” But if the tone is negative, harsh and angry, I won’t believe it. If I say it in a warm and friendly tone, I’m going to feel more supported and therefore less anxious.

So that’s a useful exercise to deal with anxiety in the short term, right when the feelings come up. Outside of that, think about how you’re spending your day. Are you packing too much in? Are you having to do the old folk, do the young folk, prep for a meeting, eke some time out, cook the tea, etc, etc? Don’t forget to think about yourself, and to consider your needs to be as important as those of the people around you.

And what about sharing how you’re feeling? Talking with other women, talking to family members? Presumably that helps us acknowledge how we’re feeling.

Very much so. Connection with other people is so important. It’s bizarre isn’t it, there’s 7 billion people on the planet, so roughly 3.5 billion women. How many billions of those are going through the menopause? And yet, how many conversations have you ever had with people about it? Not many.

Yet you can spend half of your life being affected by it.

Another thing is that, actually, the conversations about menopause will probably be quite negative – “Oh, it’s awful, it’s rubbish”. Yeah, ok, it has its downsides. But, have I ever missed having a period? Never! No, absolutely not.

You and all the other people who responded said that was the best thing!

I can honestly say, there’s not a day in my life when I’ve woken up and thought, “Oh, I miss having that period.” No! Not at all.

So, there are some advantages of it – that being the main one, I would say. And the chance to learn to be more supportive of yourself. And of other people.

Being your own worst critic, wondering why you are feeling like this, beating yourself up over things – if you can talk to other women about it, you realise you’re not the only one experiencing those things.

It’s ok to be feeling like that. It’s normal.

And presumably, there may come a time, when the next generation is coming through, that they’re going to push back on this and say, actually we need to have more awareness of this, at home and at work.

Everyone knows someone that they are close to who’s going through it, whether it’s through work, parents, family members. It’s something you need to be able to understand and deal with. So I think it’s important for everybody to learn about it.

One of the things I’ve noticed is the number of people that are surprised by how they feel. Because I think there’s probably always that little bit of, “Oh I’m going to be the one that sails through all of this without any problems.” I’ve yet to meet that person. You’re going to have something. But because we set our expectation that we’ll be the one who gets through this without any struggle, when we do struggle, it’s that much harder. So we need to really examine our thinking and what we’re saying to ourselves.

We need to be sensitive to the struggle. We need to have more empathy and sympathy. We need to be able to have much better care for our wellbeing. And we need to be able to do all of that without that judgement. Adopt a non-judgemental approach – I’m not broken, I’m not coming to the end of some kind of useful, productive life.

Actually, I’m having the menopause. These are the problems that I’m having with it. This is how I’m going to work with it. I’m going to lean into it and manage it as best I can. And it’s not my fault. I’ll just make some adaptations that I need for my wellbeing. And that’s ok.

If you’re interested in learning more about cognitive behavioural therapy and the work Tracey does, visit her MoodWise clinic or find her on Twitter @MoodWiseCBT.

Encouraging conversations about menopause is a key focus for us at Emepelle. Our survey Real Woman, Real Feedback has given us insight into the experiences of lots of different women leading up to and post-menopause, and has given us a great steer on the topics that you want to talk about more. That’s why we’ve teamed up with experts like Tracey to bring relevant and interesting content about menopause and everything around it to our fantastic customers and online community.

Emepelle is a revolutionary skincare range designed to treat the root cause of menopausal skin ageing – oestrogen loss – for skin that’s hydrated, brighter and firmer. It features revolutionary MEP Technology, a non-hormonal oestrogen receptor stimulator, as well as numerous anti-ageing ingredients.

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