Jane R. Coyle, LCSW

 

Specializing in the Treatment of Anxiety 

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[Scroll down page for anxiety self-test]

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Anxiety Bytes: What Box?


Does any challenge make you more anxious than, "Think outside the box"? Outside the box lie so many possibilities that considering them is more likely to lead to paralysis, not analysis.

Brainsteering authors Kevin and Shawn Coyne have a better 
idea. Instead of getting lost and frustrated outside the box, start inside the box. For example, an entrepreneur wanting to create a new candy product can start outside the box and spend the rest of his day frustrated. Or he can ask a question like, "What was it about jelly beans that I loved as a kid?" Then he remembers that it had to do with the flavors and colors. So he buys some of those jelly beans to taste. But now, as an adult, the colors seem insipid, the flavors artificial, and the texture sugary. He goes on to ask, "What would make this great kid memory a hit for an adult palate?" He designs a smaller bean, so less sugary; more vibrant colors; and many more flavors, such as root beer, cotton candy, and chocolate. 

And he calls them "Jelly Bellies." They become Ronald Reagan's favorites. 

Avoid the anxiety of thinking outside the box; first think inside the box. 
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Get anyone to like you in two minutes or less. Such. A. Hype.

But this works. Updating the Willy Loman's "shoeshine and a smile" advice, consultant Leil Lowndes reports in Bottom Line Personal that it is still possible to win friends quickly. 

Lowndes' points abridged:

1. Use a slow smile. Instant flash-bulb smiles seem phony. When you meet someone, turn on the teeth slowly. 
2. Have soft and following eyes. Use your eyes to make sincere and constant contact. If you find that makes you anxious, focus on the other's eyebrow instead of the eye itself. And do NOT look over the other's shoulder at other people. 
3. Use your body. No, not seductively. Don't come within two feet of the other's face but do angle yourself toward the other. Don't fold your arms over your chest. Project yourself warmly by cocking your head and shifting slightly over the conversation. 
4. Stand with one foot ahead of the other. Seems dumb, but it works. 
5. Shake hands firmly and give one last touch before separating. This works for both males and females. As you are shaking initially, try to touch the other's wrist with your index finger. That connotes warmth. As the shake is ending, give one last squeeze. Men, do not try to impress the other with a vise grip. It conveys insecurity. 
6. Treat business cards with respect. When you get another's card, treat it like it's the other's credit card. Because it is, in a way. Put it carefully in your breast pocket or your purse.
7. Use your face and head to convey respect when listening. Women tend to nod too much; men tend to keep a poker face. Find the balance between the two. Use your eyebrows to send an approval message. Furrow your brow to convey gravity when appropriate. Avoid seeming either too cool or too eager. 
8. Listen for words that suggest the other's interests. For example, if she talks about her mother's illness, don't tell her about your similar illness. Ask her if she is close to her mother. If she talks about her garden, don't tell her you hate getting dirty. Ask her about her veggies. 


Twitter feeders: Myth #2, "Just Put It Out of Your Mind"

"Just don't think about it" is common advice. Generations of parents have used that phrase to tell their children how to cope with a problem. If you can push it out of your consciousness, it will go away. 

Sort of like the little boy at a recent picnic. He got a song from a movie in his mind and could not get its rhyming nonsense out of his mind. He was annoying his friends. They all told him to think of something else but the more he tried, the worse it got. Likewise, we adults will perseverate on an upsetting thought, maybe a relational hurt or a failed effort at something. The myth says that you just need to push it out of your mind and it's gone forever. 

Back to our little boy at the picnic: A teacher wisely suggested to him that he step away from the group and sing the song as many times in a row as he could. After singing it perhaps ten times in a row, it got boring. And it went away. 

Research (Daniel Wegner et al.) shows that trying to put an upsetting thought out of your mind by pushing it away in fact increases it probability of recurrence. A better way is suggested by the teacher's method with the boy at the picnic: Focus on the problem in a mindful way. Eventually the problem will recede because the mind gets bored of focussing on it. 

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Twitter Feeders Myth #3:  "It's better to vent your anger than to keep it in." This myth has been misused by millions. Popular culture loves characters such as the one in "Office Space" who continues to show up for work despite not receiving a paycheck in years, having his cubicle moved to the basement, and having his favorite stapler confiscated. When pushed too far, he vents -- literally blowing up the office building -- and flees, ending up on a tropical beach. Sadly, he is disrespected there as well, and finds no real peace despite his major venting.  

How many of you know someone who practices venting her anger? Does it make you want to be with her?  Nope. Her whining and complaining just gets boring.

In fact, research (e.g. Bushman, Baumeister, & Stack, 1999) shows that venting actually increases aggression. The venter may experience some temporary relief but the long-term effect is turn her into the "Incredible Hulk," lashing out at whatever comes her way. 

The ancient Greeks had a much better idea. They believed in katharsis, in which the viewing of a tragic drama allows one to release negative feelings and emotions in a cleansing way. I'd recommend that you watch "Love Story" rather than cuss about your boss at a bar. 
Or take Sigmund Freud: his strategy, still valid today, was that talking about negative emotions in a controlled and thoughtful way was the answer. Again, I'd rather you figure what's really bothering you and talk to a shrink than engage in "road rage" next time you drive.
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Twitterers: Myth #4, "Women communicate differently from men."

While it's true that women do communicate in different ways than men do, the similarities are far greater than the differences. Pop psychologist John Gray has sold millions of books exploiting the age-old curiosity 
(q.v. Tiresias
between the sexes. His Mars and Venus series has given a whole new meaning to pseudo-science, since his fascinating observations about men and women are largely without clinical evidence. Louann Brizendine in her opus The Female Brain only added to the confusion. Such claims as "men evolved as typically less communicative because they were the hunters and needed silence to stalk their prey," while women "talked more because they were the gatherers and needed to tell each other where the edible foods were" were the stock in trade of this genre of pop psychology. 

  • In fact, both men and women talked about 16,000 words per day. (Mehl et al. 2007)
  • In fact, women are only slightly more self-disclosing than men. (Hyde, 2005)
  • In fact, men interrupt more often than women only when the situation allows it. For example, when the man's perceived employment or social status is higher than the woman's. When women are in charge, however, they tend to interrupt more than men. (Aries, 1996; Barnett and Rivers, 2004)
  • In fact, finally, there is evidence that women are somewhat more able than men to pick up non-verbal clues. (Hall, 1978, 1984)
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Twitterers: Myth #5, "It's been a year. Get over it."

This is usually said by a well-meaning friend to one who has suffered a loss. The loss may be caused by a divorce, by an impending death, or by the death of a loved one. The concept that one needs to be "over it" comes from the famous Kubler-Ross five stages of grief: denial, anger, bargaining, depression, and acceptance ("DABDA"). Dr. Kubler-Ross' model stipulates that when we become aware of a major loss, whether our own fatal illness, another's dying, or a divorce, we first tell ourselves it's just not so. Next we become angry at the reality that it ishappening, followed by an attempt to stave off the event by bargaining with an unseen power. When the bargaining doesn't work, we move to sadness at the prospect of the inevitable. Over time, we eventually accept the outcome with serenity. 
The problem with the model is that people are not machines. In dying, people will go through all five stages in one day, then back to the anger stage the next day, then toward the depression stage for the next month. In dealing with the death of a loved one, some will move to acceptance on the rational level but live daily with a smoldering anger at the loss. In divorce, a spouse's reaction may be affected by the apparent happiness of the ex-spouse. 

In all cases, people are not machines. Each's reaction will differ.

Most of the time, when a friend says, "Get over it," it's not that it's the invariantly scheduled moment for acceptance. There is no such thing. More often, it is really that the speaker is tired of dealing with the bereaved friend. Moral of the story: Friends, be a friend. Just listen, don't prescribe. Be patient. 

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Female Twitterers: Myth #6 "Play hard to get"
Not sure why this canard continues to circulate. I remember first hearing it in junior high school. At first it seemed to make sense. Then I noticed that the girl who gave me that advice was playing anything but hard to get. And she was swarmed with boys. 

It's a crock, ladies. All the research shows that men are more interested in women who are responsive than those who are standoffish. After all, most men are scared to death to approach us, right? 

Can you imagine a female sales rep playing hard to get? Of course not. She has to be personable, assertive, and willing to make sales calls, some of which will bring business and some of which won't. But she has to be out there. And if she plays hard to get on the dating scene, she will spend a lot of evenings with Netflix...alone. 



If you think you might be suffering from anxiety, take this test from the Anxiety Disorders Association of AmericaThe test  is private, so no one will see the results but you. If you check "yes" to more than five questions, you may need help. And if you need help, call or email me.  

GENERALIZED ANXIETY DISORDER SELF-TEST

How much anxiety is too much? If you suspect that you might suffer from generalized anxiety disorder, complete the following self-test by clicking the "yes" or "no" boxes next to each question.


Yes or No?
 Are you troubled by:

Yes  No  Excessive worry, occurring more days than not, for a least six months?
Yes  No  Unreasonable worry about a number of events or activities, such as work or school and/or health?
Yes  No  The inability to control the worry?

Are you bothered by a least three of the following?

Yes  No  Restlessness, feeling keyed-up or on edge?
Yes  No  Being easily tired?
Yes  No  Problems concentrating?
Yes  No  Irritability?
Yes  No  Muscle tension?
Yes  No  Trouble falling asleep or staying asleep, or restless and unsatisfying sleep?
Yes  No  Does your anxiety interfere with your daily life?

Having more than one illness at the same time can make it difficult to diagnose and treat the different conditions. Illnesses that sometimes complicate anxiety disorders include depression and substance abuse. With this in mind, please take a minute to answer the following questions

Yes  No  Have you experienced changes in sleeping or eating habits?

More days than not, do you feel:

Yes  No  Sad or depressed?
Yes  No  Disinterested in life?
Yes  No  Worthless or guilty?

During the last year, has the use of alcohol or drugs:

Yes  No  Resulted in your failure to fulfill responsibilities with work, school, or family?
Yes  No  Placed you in a dangerous situation, such as driving a car under the influence?
Yes  No  Gotten you arrested?
Yes  No  Continued despite causing problems for you and/or your loved ones

If you checked "yes" to five or more questions, you may need help. Contact me or your health professional.


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 February 25, 2009     Home Page

Sally B., a young married mother of two, was afraid to go out and leave her children at home. Even when her husband was taking care of them, she would panic as soon as she left the driveway. She was sure something bad would happen to her...and she would leave her children without a mother. She was convinced she would get into a fatal accident. Or that she would get mugged. Or...or...or...

The result was that she left her home less and less. Even when the children were in school or at a friend's house, Sally stayed in the house. She would only go grocery shopping with the whole family. She tried to make health appointments so they all could go at once.

As a result, her marriage became strained. The children starting acting out at school. Sally's own quality of life was declining rapidly.

When she entered therapy, we focused first on the fears underlying her behavior. Sally, like many others, was initially embarrassed to discuss her fears. She thought they would seem foolish to someone else. She said she was afraid she was crazy.  But simply naming them began to diminish their power over her.

As she began to be more comfortable with therapy, Sally wanted to tackle her main phobia, that of leaving home. We worked out a plan to desensitize her to the physical act of leaving the house. We began with the simple things, like just going out of the front door and standing on her porch. Then we worked toward going down the driveway to the mailbox.

Sally gradually became confident about going out. Her debilitating phobia is gone. Today she is fully capable of enjoying her life, whether in the home or outside it. Her marriage and family life are much improved. They're not perfect, but everything is better.


 April 2, 2009  Home Page

Being cool, not showing feelings of any sort, is the way of today. That's especially true for men. Think of Curt Schilling pitching for the Red Sox while bleeding through his sock: I've got to play through the pain. So we, men and women alike, hide our feelings. That hiding can make us anxious. Unfortunately, hiding the anxiety just gives it more power.

When a client gets tired of being driven by anxiety, he wants to get rid of it. But even the idea of addressing it often makes him anxious.  Part of my work is to help him overcome the anxiety of disclosure. Seeing the relief on his face as he begins to be free is one of the best parts of my day.



 May 7, 2009  Home Page

E-GAD,who in his right mind isn't worried about the economy. Students have to be concerned about finding jobs. Adults who have jobs worry about losing them. Retirees fret about having enough money to maintain their health and their lifestyle. Being worried is a fact of life for most of us.

But when that worry becomes so persistent and pervasive that it colors every aspect of every day, that's anxiety.  Even when things are going well, the anxiety-ridden person expects the worst, even when there is no apparent reason to do so.

That pervasive and and persistent fear is called generalized anxiety disorder (GAD).  It's a condition that is highly treatable and I love helping people overcome it. 


 June 15, 2009  Home Page

"Saturday Night Live" featured a skit some years ago in which a depressed and highly-anxious couple would encounter various challenges. The couple's names were Doug and Wendy Whiner.  My personal favorite was the time they entered a restaurant, approached the maitre d', and immediately began whining that they had a reservation. After a few seconds it was obvious that the couple's negative approach was not working for them but they persisted in it. Watching the skit was worse for me than fingernails on a blackboard.

Many people allow their anxiety in a given situation to turn them into Whiners.  Those who are uncomfortable in a social situation, such as a restaurant, or those who nervous about being assertive, find themselves whining like Doug and Wendy. 

That's an unfortunate tactic. Unfortunate because it rarely works to get them what they want. The whining behavior elicits two quick responses: one, it confuses the communication about the need at hand, and, two, it makes the respondent defensive. 

Take another restaurant example.  You are seated, you order, and the meal arrives. You then discover you don't have any utensils. The "Doug" in you whines at the server, "I don't have a fork. How am I supposed to eat without a fork?"  To which the server, gritting her teeth, says, "Oh, sorry, I'll be right back with a fork."  But the server is annoyed at the complaint and takes her time bringing back the setup. By now Doug's food is getting cold and he's even more unhappy.

Instead of getting anxious and using the Whiner Way, try using what I call the Wiser Way. In employing the Wiser Way, Doug focuses not on what the problem is but on what the solution is. Sure, he's entitled to a fork, and, sure, the server should've made sure the table was set up properly. But she didn't. And the Wiser Way tactic simply overlooks the mistake and goes right to the need.  So Doug would employ a tactical sequence like this: 

-- [Doug thinks] I don' t have a fork. I should have one, but, heck, everybody makes mistakes. 
I need a fork to eat my food. So I'll just ask the server for one.
-- [Doug says] "Excuse me, would you please get me a fork?'
-- [Server says] "Oh, I'm so sorry, right away."

And the server returns with the desired solution, a fork, faster than Doug can take a sip of water. 

Instead of letting your anxiety turn you into a Doug or Wendy Whiner, think of the Wiser Way next time you are in a situation where you need something. Think not of the problem; think of the solution. 


 July 25, 2009 Home Page

Bad heart?  A good friend of ours suffers from it, although we remind him that he actually has a very good heart, it's just sick. 

In New York not long ago, he found the two-block walk from the theater where we'd seen "Billy Elliott" to the garage where we'd parked the car an excruciating exercise. He felt he needed to stop and catch his breath every few yards. 

Later my husband asked him what was going on, especially since earlier in the day he had managed to walk twenty blocks pretty well. Our friend said, "Well, I just couldn't remember how close the car was to the theater, so I got anxious about making the walk. When I got anxious, my breath got shorter, and when my breath got shorter, I got more anxious." 

Our friend had unconsciously created a negative feedback cycle. The anxiety of not knowing the walking distance made him short of breath and the more short of breath he got, the more anxious he got. And the more anxious he got...well, you see.

My husband was surprised because this friend has gotten good at managing his heart issues so he can lead a full -- indeed, a very full -- life. But in this case the anxiety caught him by surprise and the cycle was off and running before he even took a step. 

What might he have done to prevent the anxiety cycle?  

One, as we were waiting to exit the theater he might've asked us how far a walk was ahead. Our answer of "two blocks" would've probably eased his anxiety.

Two, he might've asked as we were underway about the distance. (In this case the sidewalks were very crowded in the Theater District so stopping for a chat would've been difficult.)

Three, if we had known we would have been happy to circle the block and pick him up. 

The lesson here?  Most anxiety centers on fears of the unknown. Better to admit your concern and ask someone who knows what's ahead than be silent.  Communication almost always lessens fears. 



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  February 25, 2009      Ask Jane


Dear Jane,

I am scared to death of going to the dentist. I've been that way all my life. Once, when I was young, a dental assistant scraped my gum with her scaler and I bit her. My mother was so mad at me!  Now I just don't go at all. In fact, it's been maybe 20 years. My teeth really need attention. What can I do?" 


-- Chattering Teeth, Vero Beach


Dear Chattering,

Discomfort in the dental chair is not uncommon!  In fact, I have treated a number of people with problems similar to yours.   In your situation, we would start by simply talking about your early experiences in the dentist's chair. Then we would discuss your fear: is it being out of control? Is it being afraid of choking? Is the fear of pain?  Next we would find a caring dentist, such as
Dr. Mickey Conway. When I've worked with Dr. Conway before, he was most willing to help my client ease out of her fear. We began with her sitting in his parking lot, and then progressing to sitting in his waiting room.  Next, he met her in the office and just talked. Next visit she only looked at the dental suite. Then, she sat in the chair, no more than that. Gradually, she became accustomed to being in his office and allowed him to work on her teeth. Now she has no fear of going to the dentist and has healthy, beautiful teeth. So can you!

 

  March 15, 2009    Ask Jane


Dear Jane,

Am I the only one who doesn't know exactly what anxiety feels like?  I mean, it seems like everyone else knows exactly what it is, so I am always afraid to ask. I don't want to sound dumb. Can you tell me how to tell if I am anxious?  

-- Dying to Know, Vero Beach

Dear Dying,

You sound anxious to find out what anxiety is. 

Anxiety is not necessarily a condition that is dysfunctional. For example, if you are heading into an interview for a job that you really want, being anxious can help you make sure you dress right, eat right, have your resume and references ready, and are focused on the opportunity to make a good impression. However, if your anxiety climbs to the point that you spend so much time picking out the shoes you are going to wear that you arrive late for the interview, that's a problem. If your anxiety makes you talk aimlessly during the interview and the HR person's eyes glaze over, that's a problem. If your anxiety moves you to have a drink to steady your nerves before the interview, that's a problem.  Get it?

Check out the
Anxiety Disorders Association of America. They say: 

  • Anxiety disorders may develop from a complex set of risk factors, including genetics, brain chemistry,    personality, and life events.
  • An estimated 40 million adult Americans suffer from anxiety disorders.
  • Anxiety disorders are highly treatable, yet only about one-third of those suffering from an anxiety disorder receive treatment.

  • If you are worrying daily about being anxious, you are anxious. But
    email me again or call me and we'll talk it over.  



     
     April 2, 2009  Ask Jane


    Dear Jane,

    I read somewhere that exercise helps reduce anxiety. But I am so busy that trying to fit exercise into my day makes me even more anxious. Another problem is that I am on an antidepressant that has put some weight on me so I am less motivated to move.

    Do you agree with that theory about exercise? And if you do, how much do I need and how often? Please tell me there's an easy way!

    -- Tense and Chubby, Vero Beach


    Dear T&C,

    Sorry, but the research is pretty clear that exercise helps most people relieve anxiety. Since each of us is different, the amount of exercise needed and the results produced both vary.

    The US Dept of Health and Human Services 
    guidelines for adults recommend at least 2½ hours of moderate-intensity physical activity (e.g. brisk walking) each week, 1¼ hours of a vigorous-intensity activity (such as jogging or swimming laps), or a combination of the two. 

    But here's the key:
      start with a program which works for you. If you try to do the entire recommended week's exercise in one day, you'll be sore for sure. Or if you try to do a half-hour every day for five days straight, especially with your busy schedule, you won't get it done. Rather, find a time of day during the week when you can get out and walk, just walk, for ten minutes. Start small. For week one, then, you will have gone from no exercise to 50 minutes total.  That's a big improvement right away. Then in week two, add five minutes. By the end of week two, then, you will have exercised 75 minutes. You are on the way!

    To keep it interesting, try biking or swimming in week three on alternate days. For example, on Monday walk 20 minutes. Tuesday, bike for 20 minutes. Wednesday, walk for 20 minutes. Thursday, swim for 20 minutes. Friday, walk for 20 minutes.

    I think you'll find your anxiety levels going down, you'll sleep better, and your weight will drop. (If your weight is resistant to change, check with your doctor about a new medication. There are some new anti-depressants which are weight-neutral.)


      June 6, 2009   Ask Jane


    Dear Jane,

    My problem is that I am avoiding people. It's not that I don't like people; I do. And I used to love being in social situations. I struggle every day just to go to the office and when I'm there, I keep to myself as much as possible. I'm good at my job, which is research, but even my boss has noted in my annual review that I don't seem to communicate other than by email. 

    My family and friends just think I'm being shy. They think I should just get over it and get out more. 

    I want to get out more. I want to have friends at work and social friends. I want to become active in the synagogue in town. But right now my dog is my best friend. 

    There's even a part of me that hopes you can give me a magic answer or recommend a pill so I don't have to come in and meet a therapist. What can I do?

    -- Hiding in the Dark in Florida


    Dear Hiding,

    You are not alone in your loneliness. Some 15 million Americans suffer from what's called Social Anxiety Disorder (SAD).

    It is not just being shy or introverted.  Those who suffer from it report, as you do, that it negatively affects every aspect of their lives, from work to romance to family. Those with SAD find that they afraid that their peers and family will think they are crazy. Most are emarrassed even to admit their feelings and fears around being with people.

    The good news is that SAD is a treatable condition. About 70% of those diagnosed with SAD are taking a prescription medication, which helps. Of those, about half are also in therapy. One-third report that exercise is a good tonic, while faith and prayer help about a quarter of those with SAD.

    You can change your SAD-ness today. Contact your doctor, a therapist, or me. We're here to help you regain your life.


      September 20, 2009   Ask Jane

    Dear Jane,

    I was watching "Dr. Phil" and he had a segment on phobias. I went to his website to read some more.  I thought his advice was really good, and he refers to the same national organization on anxiety that you do. 

    Here's the problem:  even though I tried following his four-step method for overcoming my phobia, I am still afraid of elevators. Luckily, living in Florida means that I don't have to deal with elevators all the time. But I do occasionally have to use them and I just can't bring myself to go through those doors.

    What do I do?

    -- Grounded in Stuart, Florida 


    Dear Grounded, 

    While I groan at Dr. Phil's sensationalizing of people's problems, I also appreciate the fact that his program reaches millions of viewers. Add to that those who follow up, as you did, by researching his website, and Dr. Phil becomes a serious resource for mental health in America. 

    You may have noticed that, in addition to the steps listed on his website, Dr. Phil also recommends seeking cognitive therapy. That's what I offer people. 

    The reason cognitive therapy works is that an intellectual understanding just isn't enough. You may well grasp the steps required to resolve anxiety and phobias. The problem lies in our mind's ability to undermine itself. So having someone else guide you through the steps is often the link critical to success. If you are interested, call me at 772-569-0716 or email me. 


    P.S. -- my office does have an elevator. But I will gladly meet you on the first floor and walk up to my third floor office with you.  


      November 10, 2009   Ask Jane


    Dear Jane, 

    I am the mother of a 14-year old female, Circe. She's a bright kid and has always done what she's told to do. But lately she's changed. She is refusing to go to school. She says it makes her anxious and her stomach aches all day. 

    On top of that, I was recently diagnosed with rheumatoid arthritis and fibromyalgia. This aggravation with Circe is just making it worse. What do I do? 

    -- RA in FLA, Vero Beach


    Dear RA, 

    First, I'm glad you are seeking help.

    Second, I would guess that there is a connection between the onset of your health problems and Circe's anxiety about school. In fact, it may be that Circe secretly feels responsible to care for you. It may also be a fear that she may come home and find you dead. 

    Finally, I think we can't get Circe back on track until your own health is stabilized. Once you and your doctor get you on a course of treatment, Circe will begin to feel relief, not fear. Meanwhile, talk to her about your commitment to your own health and your commitment to Circe's schooling. Invite her to be frank with you about any fears she may have related to your health or about going to school in general.  Until you get stabilized, Circe will be unstable as well. 


      December 13, 2009 Ask Jane


    Dear Jane, 

    I am an executive who retired five years ago. My career required me to travel often by air. It never bothered me. In fact, I used to fall asleep as soon as we were airborne. What's more, I liked flying enough that I earned my private pilot's license and have over 1000 hours in the air. 

    About two years ago I started getting nervous the day before I had to fly commercially. Oddly enough, I don't get nervous when I am in the cockpit of a plane I'm flying. But my anxiety about flying on a commercial jet reached a peak when six months ago I boarded a plane, buckled in, and panicked even before we had left the jetway. I became so anxious that I asked to leave the plane, which the crew allowed me to do. I was embarrassed beyond belief.

    But it's not just the embarrassment. I have children and grandchildren in California whom I love to visit. If I can't fly, I can't see them. 

    Can you help? 

    -- Grounded on the beach, Vero Beach


    Dear Grounded, 

    While there are many reasons for anxiety about flying, I would start with what I call a "targeted approach." First, I would get your permission to talk with your doctor about prescribing some anti-anxiety medication. Then we would develop a plan which would involve these steps:

    1. an education about the nature of anxiety
    2. an analysis of your "triggers" and a plan to avoid or cope with them
    3. a visualizing of the pre-flight and airborne experiences
    4. a systematic desensitization, including "self talk"
    5. creation of a "flight-care package" which might include snacks, water, an iPod, reading materials, puzzles, and so on to divert you during the wait and the flight.
    This targeted approach will be detailed enough to draw your attention, thereby taking it off your fears. While I can't guarantee you will not feel any fear, I can be sure that if you participate in developing the plan with me, and you in fact follow that plan, you will succeed in flying commercially again. California, here you come!


      January 22, 2010  Ask Jane

    Dear Jane,

    My doctor has prescribed Xanax to relieve my anxiety. It seems to work but my anxiety always comes back after a while. What should I do?  

    -- Al Prazolam, Vero Beach


    Dear Al, 

    Xanax belongs to a class of medications known familiarly as "benzos." They are usually effective in treating the symptoms of anxiety and panic disorder. Their drawback is a) that they treat only the symptoms; and b) that by the time the patient feels the symptoms of anxiety, it may be too late to effectively mitigate them. That is likely why your anxiety returns sooner than you expect. 

    There are two things you can do medically to treat your symptoms.  One is to take the Xanax before the onset of anxiety. If you know you are about to enter a situation which will produce anxiety, take a Xanax before you encounter the situation. The second solution is to seek a medication which treats the root cause of the anxiety rather than, or in conjunction with, your symptoms. For either of these medical solutions you must see your doctor. 

    Benzos can produce addiction, so, again, consult with your doctor for the best use for you. 


      May 10, 2010  Ask Jane



    Dear Jane, 

    I am drowning in stuff. I just can't throw anything away. I mean, what if I were to need it next week?  

    I grew up in a household that was not overly materialistic. But it was a home in which being frugal was valued. My parents were Depression-era kids, so they learned to save everything. My dad kept a huge ball of random string until his dying day. Never know when a piece of string might be needed. 

    But now it's out of hand. My husband and I are getting into fights all the time over my stuff. I feel like some kind of addict, because when I try to throw something out I get all anxious. Every closet and cupboard is full. Can you help me find a balance?

    -- H. O. Arder, Sebastian


    Dear H. O. -- 

    If your house were on fire, what would you take first? (Assuming you and your husband are already safe, of course.)  And if you could only make one trip out of the house afire, what would you carry?

    You can see where I am going. Anything beyond what you carried on that first trip out of the fire is disposable. 

    I understand how hard it is to deal with stuff. "Where do I put it? How do I arrange it?  How can I start to create a process to handle it?"

    Those are all legitimate questions. I have a step by step approach to solving your hoarding issues. Email me and I'll send you the plan, free. 




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