Mental Health Q&A: Control (and lack of) & its affect on anxiety

Colucci: One key to what can cause anxiety for some people is the factor of control. So especially with what's going on, there's a lot of what's happening that we cannot control at all. We can control staying at home and aspects of that, but we can't control the disease. So how can we deal with the difficulty of control and if it exacerbates our anxiety?

Pere: That's a really important concept. And there's so much that we can't control right now. So you may be familiar with what's called the serenity prayer. And it's actually very long. But the first part of that is what people usually quote and it's typically used in drug and alcohol treatment. But it's applicable - I think it's one of the wisest phrases or mantras or things to live by that there really are and it applies to so many things that certainly applies to what's happening now and this concept that you're asking about of anxiety and control. So, the essence of the serenity prayer is “Give me the serenity to accept the things I can't change; the courage to change the things I can - and the wisdom to know the difference.”

So (it's a) simple concept but It's a hard thing to doBut we often see people in therapy who are struggling with one of those two things. They are trying to accept something that they don't think they have any ability to change. And they actually are empowered. they have agency that they didn't realize they had. And other times they're doing the opposite. They are thinking that they are powerless when they are trying to change something that they can't change. And the situation that we're dealing with right now, there's so much that's out of our control. So it's do what you can within reason to affect the parts that are in your life and accept the rest. It's a hard thing to do. It's a really easy thing to say. It's a really hard thing to do. We're asked to accept a lot of lack of control right now.

But the last part of that, the "Wisdom to know the difference" is really the heart of that - to get better and more skilled and we have to practice it to get more skilled at noticing, is this something for me to change and realize I can actually work on? Or is this something that's out of my control and I need to accept.

In addition to that - returning again to mindfulness to the present moment. Coming back to where you are. Control is typically not about what's happening in the moment. Usually the present moment is controlled. What we're worried about is what we imagined in our minds about the future that would be out of control. So coming back to where we are, which is where we're stuck anyway, again, breathing, realizing that you are in the present moment, that nothing that you've anticipated has happened, right?

You are in this moment, you're okay, you have food. You are not sick, right? Connect to your senses, right? But sometimes it helps to have a motto. We use this in different ways. I do a relationship and sex therapy and often our motto is "Lose your mind and come to your senses." Lose your mind and come to your senses. Come down out of your thinking, worrying brain, which is where all that anxiety and control comes from and come down into your body with breathing and noticing what's happening around you and with you. What do you feel? What do you taste? What do you smell? It's amazing how powerful that can be to get us away from anxiety and this need for control.
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