St. Louis CBT for Anxiety: Thought Spirals
When you’re looking for teen therapy for anxiety, you want to make sure you find a counselor who actually has concrete, useful tools.
It’s very well and good to talk about anxiety, and to talk about your thoughts and your feelings, but don’t we all want to know how to change the patterns that keep getting your way?
This is where the thought spiral comes in, AKA anxiety spirals. One anxious thought leads to another and another and another, and before we know it, a small problem has turned into this life altering catastrophe. At least, that’s what our brain tells us.
We need a way to break this cycle and feel less overwhelmed.
And that’s where the anxiety spirals worksheet comes in!
Anxiety Spiral Video
Access the free training on how to use the anxiety spiral worksheet - just like how I would present it in session!
Transcript:
Hey everyone, I'm Kelsey Torgerson Dunn, the author of When Anxiety Makes You Angry, and today we are going to be learning about anxiety spirals, also known as thought spirals.
Thought spirals is a concept to kind of explain how when we have a lot of anxiety, or anxiety driven anger, our brain usually starts with one small thought, one small thing that doesn't go our way, and then kind of spirals, and spirals, and spirals into this big humongous-like catastrophic thought.
A lot of times for anxious people, we get really focused on our performance, or how we're doing, or how we're being perceived by others, and our anxious mind is very focused on protecting ourselves and helping us do well at all times and all ways.
Small perceived failures often turn into huge catastrophic thoughts because we think about and extrapolate from one small thing to a huge humongous thing.
It's very normal for anxious minds to do this. It's honestly kind of a survival mechanism because if we think through all the worst case scenarios maybe then we'll be prepared for them.
But that's not actually how it works, right? Often we tell ourselves something terrible happened. And it never happens at all.
Thought Spirals Worksheet (access your own copy here!)
We have a worksheet that I created for my book, which is again When Anxiety Makes You Angry. These are a bunch of free resources from my book, like The Parent's Guide for Anxiety Driven Anger; The Body Outline Activity, where we talk about identifying emotions in our body; Emotions Elevators, different levels of emotions; CBT Triangles Worksheet, so our thoughts, feelings, behaviors; The Window of Tolerance; Thought Spirals, which we'll be doing today; The Perfect Day Guided Visualization; and a bunch of relaxation walkthroughs.
All of these, I think, are pretty helpful. But we're going to be working on our thoughts spirals worksheet today. This is the free printable that you can access called the Anxiety Spiral. And the introduction is, when our thoughts are anxious, they tend to spiral. This is very true. One thought leads to another, and another, and another. Our anxious minds just want us to be prepared for the worst case scenario.
When Anxiety Makes You Angry
Anxiety can look like anger, like stress, like perfectionism… and regardless of how it looks, it’s getting in the way of everything else. When Anxiety Makes You Angry is a CBT skills book written for teens, to help them really get underneath the surface of their explosive temper.
But when we get caught up in a spiral, we get focused on that, rather than the actual issue at hand.
So we're going to take a step back and observe how anxiety is spiraling for you. This one just has four little thought bubbles. Oftentimes I find that anxiety spirals kind of, can take up a lot of bubbles. So one option is to print this out and to use little tiny post-its, just a little extra small size. And then you can put the little post-its on here if you need more than just four thoughts, but we'll do this walkthrough with four. And then you can go ahead and apply it to your own situation.
Often what I find is that the the starting thoughts are usually something small.
And then it gets bigger and bigger and bigger. So let's start off with this number one thought bubble. And for anxiety and performance, maybe we'll do something like, “I got a B on this test. This is a very bad grade. All right, I got a B on the test. It's a very bad grade. All right, number two.”
A “bad” grade means I'm a bad student. Maybe you said something like “I'm stupid” or “I'm dumb” or “I'm an idiot.” But a lot of times negative self-talk is like that. When you say this means that I'm bad as a person that is very, very common for anxiety. It's not just like I did poorly. It's like I am bad. I am stupid. Not just this was bad, I am bad. It impacts our view of ourself.
And then maybe a bad grade means “I'm a bad student. I'm stupid. I'm going to fail this class and other classes and I won't get into the College I want.” Okay, wow.
And then here it means “I won't be a doctor and I'll have a terrible unfulfilling life.”
Okay, let me start with I got a B on the test which is a very bad grade. A bad grade means I'm a bad student. I'm stupid. I'm gonna fail this class and other classes and I won't get into the college I want which means I won't be a doctor and I'll have a terrible unfulfilling life.
My life is ruined.
Alright, wow! So all of this from getting a B on this test! This anxious conclusion right here, it's not bad. It's not good. It's pretty common. But it's maybe not so helpful for you.
Let's see with this anxious conclusion: I won't be a doctor. I'll have a terrible and unfulfilling life. Is this thought 100% true? Probably not. Probably not 100% true. Even if it is true, is it a helpful thought to tell yourself, “My B means that I won't be a doctor and I'll have a bad life?” Probably not so helpful. So let's go through and figure out what else could be true. And what else is more helpful?
And we'll actually walk you through each point of this anxiety spiral. I got a B on this test which is a very bad grade. Let's go through a cognitive reframe with this.
When we have unhelpful, anxious, overwhelming thoughts, we always have a choice.
We can work it out. We can reframe it, telling yourself something else would be more helpful. We can use more of an acceptance and commitment therapy approach or ACT approach and just like notice it. It's not bad. It's not good. It just is kind of instead of trying to push it away and ignore the thought which never works.
We can just kind of accept it and let it go or you can kind of take a hybrid approach. You know this thought isn't good or it's not bad. It just is. It's a thought that comes up for me during test time and at the same time I can tell myself something different, something maybe a little more helpful.
I don't ever want to have you shame yourself for your unhelpful thoughts. They're very normal. They're just trying to help but they're not always so helpful.
Let's figure out what else we can say.
Image by Siora Photography on Unsplash
I think a B on this test, is it actually a very bad grade or is it just not the grade that you wanted? Maybe it's more like, “I got a B on this test, which is disappointing, but it's just one test.” Right?
“A bad grade means I'm a bad student. I'm stupid.”
Well, you know that B isn't bad. And mistakes mean that I'm learning. That one really feels a little bit uncomfortable. But mistakes are good. Right? Think about when you first learned how to tie your shoes. That was so hard to do. And the only way you learned how to do it was by making mistakes and figuring out what you needed to do next time.
Those little mistakes, they help you grow as a person.
You learn how to do things, mistakes, and learning are so important. I'm gonna fail this class and other classes, which means I won't get into the college that I want. One grade doesn't mean I'll fail. Even if I do, I can figure out how to go to college, right?
Even if you don't get into the Ivy league just based off of this one grade and this one class, which is pretty unlikely. But even if you didn't, you could go to a state school. You could start at community college. You're probably a pretty successful person who can figure out solutions to other different problems. So one thing is just one small piece of the pie.
And even if the catastrophic thing happens, even if you fail, you can probably figure out your way to move forward even with that failure.
I won't be a doctor and I'll have a terrible and unfulfilling life. Alright, so how many medical schools are out there? How many ways are there to become a doctor? How many students are they looking to bring into the program? And even if you get the worst grade in the med program, you are still a doctor and that's the important thing. So, you’d probably figure out a way to be a doctor.
Second question, do you think that you would, even if you're not a doctor, find a way to have a fulfilling life? Probably. Probably. You could be happy doing a lot of different things, right? If you are so focused on one path forward and then it doesn't work out and you get stuck, you know, you have to have a little bit of flexibility to figure out what else could be more helpful. And like what's another way that I can live my life and still find it to be fulfilling?
We often have ideas about how our life should look.
Image by Luis Villasmil on Unsplash
And even when they don't meet that we still find ways to be happy and fulfilled and have good friendships and eat good food and go on adventures. There are lots of different components of it. So let's figure out what would be a more helpful life than a more helpful thought than “I won't be a doctor. I'll have a terrible and unfulfilling life.” Maybe something like, “Even if I don't become a doctor, I'll find a way to be happy in my life.”
That's probably true, right? Let me find a way to be happy. So, rather than the catastrophic thinking, what if we said, I got a B on this test, which is disappointing. A B isn't bad, I made a mistake and I'm learning. One grade doesn't mean that I fail and even if I fail I can figure out how to go to college. And even if I don't go to med school, even if I don't become a doctor, I can still find a way to be happy.
Often what happens when we get on the anxiety spiral is we spiral so quickly, we don't catch ourselves.
Just kind of start to notice when this is happening for you. That's kind of my first piece of advice. Notice when you're starting to spiral in your thoughts and then use your copy of this anxiety spiral worksheet, document it out and then go through and figure out “what else can I tell myself in this situation?” "What might be a little bit more helpful and applicable is a little less shaming and is a little bit more focused. Or “what is actually true, what is actually helpful and what is a thought that can help me move forward instead of just like leaving me in this wave of anxiety and sadness and depression?”
Again, anxiety spirals are so common.
This is a good tool to figure out what's happening for your brain and what else you can say about it. And I think this can apply to a lot of people and can even be something helpful to take with you to school or to work or into session with your therapist to really kind of break it down and figure out what else could be true and what else could be helpful.
Kelsey Torgerson Dunn is the author of When Anxiety Makes You Angry
She specializes in anxiety therapy for teens and college students, and offers mindset coaching to perfectionist adults.
Compassionate Counseling St. Louis specializes in anxiety therapy for teens, kids, and college students, along with partnering with parents through parent coaching - basically therapy for parents here in St. Louis. We’re located in Clayton and work with clients throughout the St. Louis region. To schedule a free phone consultation, please use our contact page.
