Self-monitor in the right way
In order to practice self-monitoring, you’ll benefit from seeking out triggering situations and watching your experience. You want to observe the following aspects of your experience:
1. What was my trigger? Was it internal or external?
2. What sensations did I feel?
3. What thoughts am I having?
4. What is my reaction to my thoughts and sensations?
5. What types of avoidance do I want to engage in?
6. Did I engage in any avoidance/neutralization/compulsions?
7. If yes, what did I do? If no, why didn’t I?
Try to answer these questions as soon after (or during!) the experience as possible. Try to answer in as few words as possible, as if you are a scientist taking notes in a lab.
As you start to self-monitor, you’ll notice that triggers can be internal and they can be external. External triggers are the things that show up in your environment that make anxiety more likely. Common triggers include the kitchen, the door, or any part of your home that reminds you that something could go wrong. It could be your car. It could be showing up to work, being in a meeting, getting an email, or giving a presentation. There are all kinds of external triggers that are frequent and common for many people.
You could also have an internal trigger, such as an intrusive thought or anxious sensation, that doesn’t necessarily have an additional predictable external trigger. The internal sensation or thought could show up at any time.
We want to shift our way of thinking about those triggers away from bracing and avoiding and over into opportunity.
In order to teach yourself that you can handle the anxious moment, you need to go towards your triggers. Trigger those sensations and those thoughts on purpose. Any time you have either an internal or an external trigger, it’s a huge opportunity to practice and to show yourself that you can relate to it effectively, rather than avoiding.
Here are some examples of self-monitoring for different disorders.
Example of self-monitoring for Panic Disorder
1) What was the trigger? Was it internal or external or both? Driving on the highway
2) What sensations do you feel? I’m having the sensations of heart racing, sweating, stomach in a knot, shoulders tight, arms and legs tingling, head hurts a little, dry mouth
3) What thoughts are you having? I’m having the thought, what if I panic while driving?
4) What is your reaction to the sensations and the thoughts? Initially I didn’t like that I was having these sensations and thoughts, but then I remembered that I should practice wanting them, and I told myself, ‘Good job!’ for triggering them.
5) What types of avoidance do you want to engage in? I wanted to avoid driving.
6) Did you engage in avoidance/neutralization/compulsions? No
7) If yes, what did you do? If no, why didn’t you? I didn’t avoid driving because I remembered that I was uncomfortable, but not in danger, and that if I keep driving when I have these sensations and thoughts, they will eventually go away. Once I was a few blocks away, my sensations did in fact subside.
Example of self-monitoring for Social Anxiety Disorder
1) What was the trigger? Was it internal or external? Being at a social event, having critical thoughts about my competence.
2) What sensations do you feel? Stomach in a knot, muscle tension, light-headed, pain in chest
3) What thoughts are you having? What if other people notice how anxious I am and judge me? What if my mind goes blank when I’m trying to talk to someone? What if I don’t know what to say?
4) What is your reaction to the sensations and the thoughts? I remembered that I talked about this happening in therapy, but in the moment I just felt so embarrassed that I couldn’t bear it. The sensations felt out of control and I believed my thoughts.
5) What types of avoidance do you want to engage in? Reassuring myself, getting reassurance from my friend who was there, comparing myself to other people there, leaving the party
6) Did you engage in avoidance/neutralization/compulsions? Yes
7) If yes, what did you do? If no, why didn’t you? I did all of them and it just kept getting worse. The more reassurance I tried to get from myself and my friend, the more anxious I felt. Comparing myself to others made me feel awful too.
Example of self-monitoring for Obsessive Compulsive Disorder
1) What was the trigger? Was it internal or external? My mom told me about her friend that was diagnosed with cancer.
2) What sensations do you feel? heart beating faster, tightness in chest, short of breath, light-headedness.
3) What thoughts are you having? what if I have cancer?
4) What is your reaction to the sensations and the thoughts? what if I can’t stop thinking about this? what if my anxiety doesn’t go away?
5) What types of avoidance do you want to engage in? I knew it was OCD, but I wanted to check my symptoms on WebMD. I wanted to ask my mom about it. Then I wanted to distract myself.
6) Did you engage in avoidance/neutralization/compulsions? Yes
7) If yes, what did you do? If no, why didn’t you? Immediately after my mom told me about her friend, I told my mom I was anxious and asked her if I could possibly have cancer. She said no, but then I felt a weird sensation in my arm and looked it up online. Later in the night, I kept thinking about it and watched some movies to distract myself.