How to let go of demands in relaxation when you are born a perfectionist?

Summary Relaxation methods are more difficult to practice for perfectionistic or competitive people because they are usually trying too hard to relax. Because of these perfectionistic traits, these people may suffer from a phenomenon called: relaxation­induced anxiety (RIA), which means their frustration and anxiety levels paradoxically increase during relaxation. Continuing putting perfectionistic demands on relaxation for a long time can lead to an increase of mood problems. Since more and more people are engaging in relaxation or meditation to increase their stress tolerance in a society that promotes perfectionism, there is a need for more awareness about the potential threatening consequences of relaxation­induced anxiety. Especially, people with an anxiety disorder or an anxiety­related personality disorder are prone to experiencing RIA. This is a problem that needs to be addressed because relaxation is an essential element to help manage anxiety. I can say ­ based on my own experience ­ that failing to cope with relaxation demands in an adjusted manner can lead to an increase of anxiety and depression in the long run. Initially, relaxation worked well for me to deal with a generalized anxiety disorder and personality disorder. But then I started to gradually put demands on achieving a relaxed state, leading to frustration. In the end, I became so obsessed with relaxation during the day that it led to an increase of my anxious moods. I trained my brain in demand thinking to such extent that these thoughts grew automatically during relaxation. Addressing this problem, without giving up the practice of relaxation, felt as an overwhelming challenge. Luckily I found a way to resolve this problem. In this article, I will provide my personal experience to provide hope and insights to relaxation practitioners with rigid perfectionistic or competitive patterns. First I will define relaxation­induced anxiety based on existing psychological literature. Then, I will sketch my own personality into more detail; the presented insights do not necessarily apply to all perfectionistic or competitive people, therefore I would like to give some additional context about me. Then I will offer practical insights on how

to prevent RIA by presenting the lessons I learned from my own mistakes, to determine whether you suffer from RIA, by representing a list of symptoms and

associated maladjusted coping behavior, to resolve RIA without completely giving up the practice of relaxation by quoting a

number of strategies that worked for me.

For me, a key lesson is that relaxation is not about achieving a pleasant state or for getting rid of anxiety. Instead, it is about allowing my body to bring itself in a state of rest in order to revitalize my energetic resources. The second lesson I have learned is that always using the same relaxation technique is counter­productive in the long run, because in doing so I unconsciously trigger perfectionistic demands on relaxation. Thirdly, the first key step to resolving RIA is understanding and accepting that my perfectionistic personality is the main cause. Finally, the best antidote for perfectionism is growing self­confidence, or better said, growing trust on your inner self. Perfectionistic demands in relaxation can be addressed by means of cognitive behavioral therapy (CBT) and mindfulness. In my case, these two therapies helped me to learn how to tolerate the symptoms of anxiety again and to increase my confidence in my ability to relax. I also followed a course on acceptance and commitment therapy (ACT) to deal with the automatic demand thinking which has ensued from obsessively controlling my relaxed state. I learned that I could better take some distance from relaxation by focusing on achieving life goals. I also engaged in other ways for relaxing such as distractive leisure or daily exercise Finally, to prevent triggering automatic demand thinking during relaxation, I used a variation of different relaxation techniques for which relaxation demands are less likely to be triggered.

Relaxation-induced anxiety defined Relaxation­induced anxiety (RIA) is defined in the psychological literature as the inability to effectively use relaxation without experiencing anxiety (Borkovec, 1988). There are a number of different causes with the most common being the fear of losing control, perfectionistic demands or expectations leading to frustration, or intolerance of boredom (Monica Frank, personal communication). For people with an anxiety disorder, RIA is definitively a problem that needs to be addressed: if relaxation is the central element of effective treatment of anxiety disorders, then the inability to relax without experiencing anxiety and thus the inability to effectively use relaxation as a coping skill compromise the degree of learning to manage the anxiety disorder (Borkovec, 1988). In therapy relaxation­induced anxiety is managed by determining what is causing the increased anxiety and addressing it. If it is the fear of losing control a systematic desensitization method to the relaxation is used. If it is the demands these can be addressed cognitively. Usually, the intolerance of boredom is more difficult to address, which is one reason to listen to different relaxation audios (Monica Frank, personal communication).

About me During my childhood and adolescence I gradually developed into a perfectionistic and competitive person due to low self­esteem and fear of failure and disapproval. At primary school I did my very best because I was afraid of being punished by severe teachers or being bullied at school. When I thought someone was better than me at doing something or when someone was boasting about his or her performance, I felt inferior or jealous. The only way I knew how to deal with these emotions was by trying to be my best in everything I did. At high school I physically did not develop into puberty. At university I had an extreme acne rash in my face. I did not have real friends or a girlfriend. As a result I threw myself upon my studies. My parents were proud of my school and university performance and people respected me for it. Consequently, I thought that as long as I lived up to everybody’s expectations, things would work out fine. However, later in life, this fear­driven competitive behavior due to low self­esteem was an attack on my health, leading to a generalized anxiety disorder, depression and a personality disorder. I had to combine a career as an academic researcher with the management of a family of a wife with two young children. Whenever I felt I did not have my life fully under control, I started to work harder during the day and worry more during the night. It was of no help that I worked for 15 years for a very demanding and competitive professor who had issues with rude verbal and nonverbal communication and lack of empathy due to the Asperger syndrome. He never told me about his condition until I became sick in my middle thirties. I did not function anymore and I had to quit working. I got depressed because of my fear for my family’s financial future. Initially relaxation was very useful as an essential element of therapy to manage the anxiety. The most effective relaxation method was a combination of multiple relaxation techniques, involving mindful breathing, a body scan, a short visualization and then letting go and indulging myself in whatever happened. This method allowed me to experience a very peaceful state with pleasant visualizations, emotions and sensations. Sometimes I even experienced a so­called mindful state in which thoughts and emotions are observed without judgment. At a certain moment my perfectionistic and competitive personality slipped gradually into my relaxation experience by putting demands on relaxation. First I tried to improve the peaceful state I experienced and I started to try out different relaxation and meditation techniques. After reading a book on spiritual psychology I was convinced that I was on the verge of a personal spiritual transformation and could become a ‘spiritual leader’. Unfortunately this belief led me into putting more demands on relaxation and after a while it created a lot of harm in my ability to relax, leading to frustration and anxiety. Clearly I failed to cope with relaxation demands in an adjusted manner, in the long term leading to stress intolerance and anxious moods again. At that given moment I tried to stop using the relaxation methods. Initially it felt as a relief, but after some time I started building up emotional distress and muscle tension again. I can

conclude by pointing out that I clearly took benefit from using relaxation to manage the stress in my daily life.

How to prevent RIA? An article by Lazarus, an expert in cognitive behavioral therapy, states that some people with perfectionistic or competitive tendencies inherently regard relaxation as an overwhelming challenge (Lazarus, 1990). The article further advises that it is better for these people to relax by just doing nothing for 20 minutes, or by taking a warm bath while leafing through magazines. Using relaxation methods initially worked out very well for me, however. In my primary being I am thus not such a perfectionist. I have learned that my perfectionistic and competitive personality is a so­called schema or life trap (Young, 1994) that can be triggered by simple stimuli such as seeing an image of performance on TV or being confronted with a word of offense by a superior or a friend. The main reason I eventually got into RIA is that my perfectionistic schema has been triggered by various stimuli. These stimuli were both external and internal to me:

The external stimuli are usually easy to prevent. In my case, the external stimuli were statements from a spiritual psychology book saying that it is possible to achieve a unique peaceful state of deep conscience and creativity. Therefore my basic advice is: if relaxation works well for you, keep up the same practice. Just keep on doing it. Don’t read about how to relax. Stop reading this article.

The internal stimuli are more difficult to address. In my case the main internal stimulus was that I started a relaxation session with an expectation that I would experience a pleasant state. Somewhat paradoxically the most effective relaxation technique led my mind to have the highest expectations about achieving a pleasant state. Actually, I was afraid to lose the ability to achieve that pleasant state. This observation is confirmed by Anderson who has pointed out that most negative emotions and sensations are experienced with the “most effective” relaxation strategy (Anderson, 2001).

The best way to prevent a lot of internal stimuli to occur is by means of gaining some cognitive insights and adapting behavior in accordance with these insights. The key cognitive insights are the following:

1) Don’t read about how to relax. If relaxation works well for you, cool! Keep up the same practice. Just continue doing it. Don’t read all those spiritual psychology books that promise that you can completely free yourself from your ego. If relaxation works fine for you, stop reading this article after this section!

2) Relaxation is not about achieving a pleasant state. Instead, it is about allowing your body to bring itself in a state of rest, in order to revitalize your energetic resources. By relaxing

the body’s natural healing capabilities are given a chance to do their work. Don’t try to force the relaxation, just allow yourself to relax. 3) Letting go of perfectionistic demands on relaxation does not mean that you should try to avoid these demands. After all, you are putting again a demand on relaxation. When you continuously control that you are not relaxing too hard, you are actually fighting against yourself. In general, there is nothing wrong with working hard as long as the underlying emotion is the desire to learn and grow, and not the fear for failure or disapproval. 4) Repeatedly using the same relaxation technique can trigger perfectionistic demands. It is important to resist the temptation to always practice the same relaxation technique that once was “most­effective”. After all, if you keep exercising the same method, eventually your competitive mind will unconsciously try to improve the wonderful state that you once experienced. “What if I lose the ability to achieve that pleasant state?” is the underlying silent thought which drives my competitive mind? It is therefore better to engage in a healthy practice of using different relaxation techniques in combination with exercise and distractive leisure and just to allow your body to relax by itself. If boredom is the single cause of RIA, it is okay to repeatedly use the same relaxation technique, but then you can listen to different audios that offer different experiences. 5) Increasing the number of relaxation sessions to more than 2 per day can trigger perfectionistic demands. If you try to do more sessions, you start to put your mind on it. In this way, your perfectionistic demands can also be triggered. This does not mean that you should not take rest regularly. I grew the habit of dividing my day in tasks and take a short rest between tasks just by doing nothing or by doing some light stretching. 6) For each person one technique may trigger more demands than other techniques. It is therefore recommended to try out different relaxation techniques to learn which technique triggers the least demands. Thus, if you experience demands to the method of tensing and releasing various muscle groups, an immediate switch to visualization or relaxing cognitive self­talk may solve the problem (Lazarus, 1990). Several authors propose to decrease the focus on somatic sensations when adverse effects of relaxation are experienced. 7) Relaxation is not meant to reduce acute anxiety attacks. My experience is that regularly using relaxation for getting rid of anxiety may decrease the anxiety in the short­term, but definitely increases the anxiety in the long­term. In fact, when you are anxious, learning a new relaxation technique is less effective. Repeatedly training relaxation does increase your ability to tolerate anxiety attacks however. One of my physical symptoms of an anxiety attack is feeling extremely tensed and weak (Burns, 1999). It is therefore tempting to practice relaxation to deal with the weakness and tensed muscles. However, don’t fall in this trap because this behavior is in fact avoidance of anxiety. Anybody who knows anything about anxiety management can tell you that avoidance of anxiety leads to more anxiety.

The preferred method to manage an anxiety attack is to listen to a cognitive self­talk audio, (such as the Panic Assistance audio at the Excel at Life website), or a 20 minute intense exercise such as cycling or running.

How to determine if you have RIA? A trivial answer to this question is that you experience distress during relaxation. However, when the distress is caused by perfectionistic demands, you may actually not be aware of this distress in the beginning of training relaxation. You might also experience the stress symptoms as pleasant sensations that you think occur because of the relaxation. RIA can thus slip into your relaxation experience without getting noticed. As a result, RIA can grow into a serious condition when you unconsciously keep exercising perfectionistic demands for a long time. Looking back, I can say that I went through three stages of non­adjusted coping behavior, each stage leading to longer and more intense mood problems. Failing to address the non­adjusted behavior caused me to jump to the next stage. Stage 1: Positive stress. I interpreted the stress as a pleasant state because of the relaxation, so I did not change my behavior.

Physical symptoms: after a relaxation session I felt a little bit of muscle tension in my shoulders and a bit of physical exhaustion. Stage 2: Frustrated mood. I was not able anymore to achieve a pleasant state and after relaxation I started to feel frustrated and tensed. I increased the rate of relaxation sessions and tried to achieve a pleasant state with more vigilance and perseverance, leading to more frustration and muscle tension.

Physical symptoms: after a relaxation session my blood pressure was higher than before the session. Stage 3: Obsessive control. I became more and more tensed during the entire day. My main behavioral symptom, as an extreme RIA sufferer, was that of irrational obsessive control and automatic demand thinking (also known as rumination):

Controlling my relaxed state. I could not let go of muscle tension and I was constantly applying short relaxation measures to keep the tension under control during the day. By doing this, I was creating more tension and anxiety.

Automatic demand thinking during relaxation: I trained my brain to exercise demands on relaxation to such extent that this demand thinking became an automatic reaction. I lost control over this demand thinking during relaxation itself, leading to more anxiety A fancy word for training automatic demand thinking is operant conditioning. It means that a negative mood drives negative behavior such as worrying, and the worrying intensifies the negative mood by reinforcing the emotion.

In the long term, this control behavior and automatic demand thinking caused stress intolerance and increased my anxious moods.

Physical symptoms: I had continuous problems with tension headaches, muscle tension, increased heart rate, heart palpitations and increased blood pressure.

Defining control To better understand the vicious cycle of control, I define control as being in a perfectionistic mood where I worry about how to improve my mood. Control entails worrying about something abstract such as “getting rid of a negative mood”, or “improving a positive mood”. Of course it is the worrying itself that causes the negative mood to last longer. The good news is that an anxious mood will pass. It is just a temporary unpleasant state that will pass if you are conscious of the underlying emotions at play. In her article “Understanding mindfulness Step 3: mindfulness and pleasant emotions”, Monica A. Frank clarifies the difference between a mood and an emotion (http://www.excelatlife.com/downloads/mindfulness/understanding3.htm). An emotion is a brief reaction while a mood is longer­term emotional state that is fueled by thinking about it. For me personally, the worrying involves actively thinking about both positive or negative moods:

Positive mood: inventing strategies how to improve a pleasant relaxation experience, and then demanding that the strategies effectively do what I expect them to do.

Negative mood: being alert for some unexpected internal states within my mind or body and inventing worst case scenarios what these internal states may imply, and then trying to apply different strategies to prevent these scenarios from happening.

Both the strategies and the internal states are illusions of the mind. They don’t exist in reality, but in my mind they seem very real. The only way to break through these illusions is becoming conscious of the underlying emotion by feeling the emotion: feel the anxiety.

How to resolve RIA? Resolving RIA, or preventing to jump onto a next stage, involves learning to tolerate the symptoms of anxiety and increasing self­confidence in the ability to relax. The way I gained these two skills was by means of (i) cognitive behavioral therapy (CBT) and (ii) mindfulness. Cognitive behavioral therapy (CBT) helped me to develop realistic expectations of myself. CBT motivated me to look at my thinking and to write out the thoughts that made me anxious. CBT also learned me to truly belief that anxiety goes away by tolerating its associated thoughts and physical sensations. Finally, CBT also helped me to increase my self­esteem by developing positive or realistic self­talk.

The following positive self­talk helped me to challenge my perfectionistic demands on relaxation were:

The need to succeed at everything, that destroys me. I can stand anxiety, it is just an unpleasant feeling I like to be relaxed, but I don’t need it now I have confidence in the universe I believe in God I trust my body as I trust my best friend I don’t have to do anything now I accept everything from myself because I love myself I don’t need to achieve anything now I don’t need to avoid anything now I don’t need anything now

I truly belief that the insights above are true. Believing for 100 percent that you can stand anxiety is important to resolve RIA. The best way to develop your own realistic beliefs, in which you believe for 100 percent, is talking to a relaxation therapist or CBT therapist with experience in relaxation. Mindfulness allowed me to experience that my body is able to relax by itself, and therefore it increased my confidence to relax. Mindfulness also increased my self­esteem in general because it positively changed how I think about myself. Mindfulness is also a great way for feeling the anxiety and letting it go. It is a good method to learn to accept the automatic demand thinking during relaxation, and eventually decreasing its power over you. The following process usually takes place. During a relaxation session, when I notice demands, I stop the relaxation. But I don’t stand up or leave my place. I just do nothing and refuse to give in to the automatic demand thinking to continue the relaxation. Then I notice an increase of anxiety and muscle tension and an increase of thoughts that push me to restart the relaxation. I just observe these thoughts and feel the anxiety without judgment and after some time the anxiety usually flats out. I just let myself enjoy that I’ve conquered my anxiety and indulge in what happens then. Of course, sometimes my perfectionistic personality triggers demands on mindfulness. When that happens, my experience is that it is better to take some distance from mindfulness and just focus on something else, preferably something positive. During the next relaxation session, just try out another relaxation technique that does not trigger these demands anymore. If you have an anxiety disorder due to perfectionism, I advise you to employ the cognitive behavioral therapy self­help methods of Excel at Life first, before learning mindfulness. I did it the other way around, with serious mood problems as a result: I first followed the popular 8­week course on mindfulness­based cognitive therapy (MBCT) before knowing about Excel

at Life. I was trying too hard to become mindful, and I couldn’t accept the anxiety in my body. Nobody explained me why accepting the anxiety is the only healthy way to learn to manage it. Although some CBT principles were integrated in the MBCT course I would have preferred to use the Excel at Life Apps and audios before starting to learn about mindfulness.

Self-help methods If you like to use self­help methods, the resources on the Excel at Life website are very useful, including the audios and articles on improving self­esteem, managing anxiety and mindfulness. For me personally, repeatedly listening to the Rational Thinking Audio was extremely helpful because this audio helps to let go of anxiety and of the perfectionistic and competitive demands that cause the anxiety. Furthermore, the self­esteem blackboard App can be used to record your positive beliefs so you can regularly repeat them. Thanks to the CBT Diary App I discovered I had a lot of irrational thinking styles including shoulds, mind­reading, mind­reading expectations, negative evaluation of myself, internal control, personalization, generalization, all­or­nothing thinking and catastrophic thinking. Mistakes and lessons learned There are a number of common errors made in cognitive behavioral therapy that perfectionistic people should be aware of when using self­help CBT methods. I therefore certainly recommend to read the Excel at Life article “10 common errors made in Cognitive­Behavioral Therapy”. In addition, specifically related to using CBT methods for managing relaxation demands, I made some other mistakes. Below I present the major lessons learned from these mistakes: 1) Be aware of irrational assumptions about your disability to relax. Once I discovered that I was trying too hard to relax, I developed a lot of false all­or­nothing assumptions about my problems with relaxation. I silently assumed for example that I always was trying too hard to relax, while actually I only was sometimes doing that. Or, once I discovered I was obsessively controlling my relaxed state during the day, I assumed that I was always controlling my relaxed state. These false assumption are irrational thoughts at the meta­level, called meta­level thoughts. They are thoughts about my relaxation experience. These thoughts involved a lot of “should nots”: I shouldn’t control my relaxed state, I shouldn’t try too hard to relax. Of course these thoughts were just another layer of obsessive control and demand thinking. 2) Don’t challenge meta­level thoughts at the meta­level. I can confirm the difficulty of challenging the above meta­level thoughts with using self­help CBT methods, such as the Cognitive Diary App. In the beginning I used the diary App in a wrong way to work through these meta­level thoughts. One of my mistakes was that I challenged these meta­level thoughts at the meta­level again such as “I cannot observe my anxiety anymore without judgment, there are so many thoughts in my head when trying to observe anxiety”. In response to these thoughts, I typically wrote another challenge at the meta­level again such

as “My anxiety causes automatic thoughts that check for my anxiety, I need to be aware of these thoughts without judgment in order to get out of this vicious circle". Clearly, this challenge itself was irrational because it is just another demand. In hindsight, a better thing I could have donewas refraining from writing challenges at the meta­level. Instead it was better to use challenges at the “base­level” such as “It is better to let relaxation rest for a while”. 3) Let the meta­level thoughts just be. I was afraid of having these meta­level thoughts in my head because of some irrational assumption that whenever I had these meta­level thoughts I was obsessively controlling my relaxed state. Unfortunately, as a result, I built a lot of fear for these thoughts and I tried to fight against these thoughts. Fighting against your thoughts is a very energy consuming activity, and gets you quickly in an anxious mood however. Instead I learned it is good to try to listen for these thoughts for a day or so, so you get used to them. 4) Less is more. Another mistake was that I was trying to understand how relaxation and mindfulness work. What I have learned is that it is sometimes better not trying to understand what you cannot fully understand, nor trying to control things over which you don’t have control. A mindful or relaxed state is a state that our mind cannot fully comprehend. It transcends our logic­oriented reasoning intellect. Thus, the more I think about trying to be relaxed, the less I become relaxed.

Dealing with Stage 3 obsessive control and automatic demand thinking When you are a Stage 3 RIA sufferer, with automatic demand thinking and obsessive control, resolving RIA using CBT and mindfulness takes time and regular practice. During this period I used a number of additional strategies that helped me to manage RIA, without giving up relaxation completely. These strategies made it easier for me to break out from the obsessive need to control my relaxed state and to reduce the automatic demand thinking during relaxation. These strategies were inspired by a course on Acceptance and Commitment Therapy (ACT) (Hayes, 2012) and a website on managing anxiety (Calmclinic.com). The key strategies were the following: 1) Focus on what you want (instead of what you don’t want): I took some distance from relaxation by focusing on positive values or goals in my life (Riviera, Focus­Meaning­Action). It is important that the activities I engaged in had a positive meaning for me (and others), so I knew the end result was always something usable for me or others. Also once I chose to do an activity with positive meaning, it became important to persevere with consistent action, even when I was anxious or it did not feel good.

When you are a Stage 3 RIA sufferer, focusing on life goals will help you to break out of the obsessive need for controlling a relaxed state. The following scenario usually needs to occur in order to break through this irrational need for control. First there is a rise of anxiety. It is important to tolerate this discomfort (it is just an unpleasant feeling) and to ignore racing thoughts that try to convince you to relax. Instead, I just continued doing whatever I was doing as long as I was sure that it would bring something good for me or others. Usually, after some time, the anxiety flatted out and the need for control disappeared like fresh snow! Congratulate yourself and take a rest by just doing nothing but enjoying yourself. To make it easier to keep my focus away from the need to control my relaxed state, I also developed a list of behavioral tips. These tips included among others ‘how­to questions” and simple tricks to stay in the so­called ‘here and now’ (See Table 1). The basic idea of these tricks is that you cannot control anxiety, but you can control your focus and to some extent your behavior. Therefore, you can focus your attention away from the anxiety symptoms. Table 1. Behavioral techniques to help shift your focus away from relaxation demands

How­to questions Focus on process­oriented goals instead of result­oriented goals Focusing on here and now Problem solving behavior instead of problem avoidance Distraction by following curiosity Respecting priorities amongst values in life Singing Feeling positive emotions (e.g. feeling confident) Believing in myself Taking a confident body posture (straight position, chin up, shoulders relaxed) Slowing down Chewing gum Focus on one of the five senses Focusing on the children

Using these tricks in the morning can make a big difference because depression and anxiety are typically worse in the morning. For example I often used the technique “Focus on process­oriented goals” in the morning to ignore physical tension and anxiety in my body. This technique involves focusing my mind on the steps that I aim to do. I just start the morning with a clear decision to focus my attention on what I am doing to get my breakfast and care for the children on track, and just let the tensions and anxiety of the moment be there. 2) Acceptance: I accepted that demand thinking during relaxation has become automatic, i.e. that I have lost control over these irrational thoughts to some extent. I accepted with serenity that I cannot control all of my thoughts nor the emotions and body sensations caused

by these thoughts. However, thanks to the ACT and CBT therapies, I know that I can control my focus, my self­talk and my intent to achieve things that I value in life. I was thus willing to live my life whilst sometimes having these automatic thoughts. However, the more I am able to tolerate anxiety, the more the anxiety will vanish. And the more the anxiety vanishes, the less the automatic demand thinking will be triggered. 3) Exercise refocusing: I have learned how to more quickly become aware when I was in a perfectionistic mood to control my mood. Whenever I was ruminating about tension in my body, I learned how to quicker become aware of these thoughts and how to redirect my focus to my current activity. Regularly exercising a mindfulness sitting meditation helped me gain this skill. A technique called mindful grounding helped me to redirect focus from my internal world to the real world. Sometimes I am not conscious of my own anxiety. In that case, the anxiety may unconsciously drive me, for instance, to keep repeating the “once­most­effective” relaxation technique several times during the day. Or Inside my head I am so completely mixed up into my thoughts to tolerate the anxiety that I don’t see any more that I am demanding that the anxiety goes away. Or I am so mixed up in trying to avoid getting stuck in a perfectionistic mood to control my mood, that I don’t see that I am bringing myself into that mood. If you focus on what you don’t want, eventually you will get that. Acceptance and Commitment Therapy refers to this unconscious melting between ourselves and our thoughts as “fusion” and proposes “defusion” as the process of becoming aware of the demand thinking and separating ourselves from the thoughts (Hayes, 2011). But becoming aware of the thoughts is not enough in my experience. You also need to allow yourself to feel the anxiety and accept it as it is. You can only accept the anxiety if you have really felt it in your body and can accept it without judgment in your mind. Sometimes it is very difficult to tolerate the anxiety without judgment in your head. In my experience, a key step that helps you to better tolerate the anxiety, is … to regularly employ meditation or relaxation techniques once or twice a day. 4) Meditation: Meditation helps me to increase my stress tolerance. Therefore it helps to achieve or retain a more calm state, from which relaxation can ensue quicker. I meditate by focusing my attention on my breath, a sound, or by repeating a mantra. As stated above, learning mindfulness can also help you feel how your body is able to relax by itself, but this requires some practice during a relatively long time. 5) Resist the temptation to continue to use the same relaxation technique: To prevent to get tied into obsessive relaxation demands, I learned that as soon as I noticed any demands during a relaxation session, it was better to stop the relaxation session. Moreover, during the next relaxation session I had to use another relaxation technique that did not trigger these demands.

For example, suppose I notice demands to keep muscle tension under control during a so­called body scan relaxation. In that case it is better to stop the body scan and to refocus on achieving life goals or distractive leisure. Afterwards I understand I was putting demands on getting rid of some unpleasant body sensations. Then, during the next relaxation session, I select another technique that takes my focus away from these sensations. For example, I could choose stretching or yoga that mainly releases tension by means of gestures. I found it also very helpful to write down on a sheet of paper or mobile device a list of the relaxation techniques that I knew I mastered. Keeping this list of relaxation techniques close to me helped me to resist the temptation to continue to use the same relaxation technique that was once the most effective. In times of anxiety, I may experience a tunnel vision so that I see the “most effective” relaxation as single possibility. By reviewing the list, you are snapped out of this tunnel and you can see the bigger picture again. You can also use the list of relaxation audios of Excel At Life at http://www.excelatlife.com/downloads.htm for this purpose. Since I preferred practicing one relaxation technique at a time (instead of listening to relaxation audios that combine multiple techniques), I developed my own list of relaxation techniques: Distraction

Sport Cycling, Walking

Hobby Painting, Shopping, Cooking

Interpersonal activity Talking to a good friend, Playing with children

Music Listening to or making music

Relaxation Clear your mind

Journaling, Self­talk, Affirmation, CBT Diary, Relaxing self­talk Release Tension

Stretching, Yoga, Progressive Muscle Relaxation, Mindful Breathing Be aware of Tension

Body scan Visualise

Listen to visualisation audio Autogenic training

Meditation Basic

Focus on breath Focussed

Transcendental meditation Spiritual

NLP anchoring Doing nothing, just trusting your own body

Activity­oriented Qi Gong Standing meditation Walking meditation

Mindfulness Sitting meditation: Focusing on breathing, observing thoughts Lake meditation

Self meditation Who am I meditation Neti­Neti meditation

6) Doing the opposite: Another strategy is to chose upfront a relaxation technique where demand thinking is likely not to occur. “Doing the opposite” means that I make a conscious choice not to select the relaxation technique that my mind asks me to do. Instead, I select a relaxation technique that is the opposite of what my mind asks. For example, when I have thoughts that push me to clear my mind by means of engaging cognitive self­talk approach, I select a relaxation technique to release tension in my body or be aware of the tension. On the other hand; when I am overwhelmed by tension in my body and my minds pushes me to release the tension, I try to focus on cognitive self­talk, or visualization. 7) Scheduling relaxation techniques: Another strategy to dodge automatic demand thinking during relaxation is the use of a schedule that allowed me to select a relaxation technique that I didn’t use for a long time. In this way, an anxious mood, due to demand thinking about that particular relaxation technique in the past, is not active anymore in my mind and body. Instead, I have a more open mind with curiosity and confidence that the relaxation technique will now work out fine for me. If I once had a negative mood related to a certain relaxation technique this mood is likely to occur again, after some time, due to reactivation of the demand thinking in my mind. As such it is important to keep rotating the relaxation techniques in a round­robin way over time. My list of relaxation techniques is long, and making a schedule may unfortunately also lead to perfectionistic demands on scheduling in the right way. In this way, you start every relaxation session with anxiety again, which makes the relaxation less effective. Being inspired by the Apps of the Excel At Life website, a possible improvement is to let an App do the scheduling for you. 8) Customizing and varying relaxation techniques according to modality

To implement customizing relaxation to the needs of a specific person, Lazarus distinguishes between several modalities including Behavior, Affect (emotions), Sensory, Imaginary, Cognitive, Interpersonal, and Biomedical. Relaxation techniques can be classified according to the primary modality addressed during the relaxation (Lazarus,1990). The table below represents an adjusted list of modalities and which relaxation technique addresses this modality primarily in my opinion. Lazarus also devised a 35­item test, called structural profile inventory, to determine which modalities someone is most reactive to (Vivian, C. Structural Profile Inventory). The hypothesis is that the according relaxation techniques in these modality classes are the best match for that person. A study by Herman indicated that it is possible to predict which forms of relaxation are likely to be most effective and preferred, on the basis of clients' scores on the SPI test.(Steven M. Herman, 2004). Some relaxation techniques address multiple modalities. For example, the ‘visualization of healing energy’ technique operates primarily in the imaginary modality, but usually leads to relaxing responses at the Somatic and Emotional modalities. Usually, addressing multiple modalities makes the relaxation more effective. This is also the reason why a relaxation audio combines multiple relaxation techniques in a certain order. On the other hand, when multiple modalities are addressed, relaxation demands are more likely to be triggered in my experience. Modality Order

Modality Relaxation Technique

(G) Cognitive 1. Listening to self­talk audio (e.g. Rational Thinking audio)

2. Reading or Writing Cognitive Diary 3. Reading or Writing positive affirmations 4. Talking to yourself in the mirror, cognitively 5. Reading article of Excel at Life website

(H) Emotional or spiritual

1. Feeling connected with nature (e.g. watching the sunset at the seaside)

2. Believing in yourself 3. Praying 4. Feeling confident or happy 5. Doing nothing, just trusting your body 6. Neuro­Linguistic Programming anchoring

technique 7. Listening to Zen music 8. Qi Gong 9. Feeling Chi streaming (resolution of pain body)

(A) Sensory 1. Aromatherapy (e.g. smelling lavender) 2. Listen to sounds in the environment

3. Staring at the clouds 4. Watching leaves rustle 5. Listening to music 6. Making music

(B) Behavioral or gestures

1. Yoga 2. Stretching 3. Tense and release 4. Progressive muscle relaxation 5. Walking meditation 6. Standing meditation

(C) Imaginary or visualisation

1. Mountain meditation 2. Lake meditation 3. Listening to a visualization audio (e.g. Lotus

Flower visualization) 4. Imagining a pleasant scene 5. Visualization of healing energy around your body

(D) Inter­Personal 1. Blowing balloons with children and let them plop. 2. Talking to family or a good friend 3. Hugging family and children

(E) Exercise 1. Cycling 2. Walking

An effective and easy way to dodge automatic demand thinking is to schedule relaxation technique by modality, and within each modality by relaxation technique. So I select upfront the order of modalities (A, B, C, ...J). Secondly, within a modality I also order the relaxation techniques (1,2,3, ….). Each relaxation technique is thus identified by a letter and a number. For example F2 identifies the Mindfulness sitting meditation. The actual schedule is then A1, B1, …, J1, A2, B2, …J1, A3, B3, etc. 9) Focus on something which bears no judgment to the confident observer. In general, relaxation works best if you feel confident and you focus your mind on something which bears no judgment to the observer. For example, during certain relaxation sessions I just engaged in “doing nothing” (Lazarus, 1990) by gazing at an undefined point in space and taking a passive attitude. Sometimes I whispered the positive affirmations mentioned above such as: “I believe in myself”, or “I trust my body as I trust my best friend”. Typically, for me these passive yet open attitudes were a great way to feel that the body knows how to relax itself; I just need to give it a chance. I also said to myself: “I trained very hard on relaxation. My body can thus achieve a relaxed state based on this training. I just need to believe in myself and give my body a chance to

relax”. You can compare this to driving a car or playing the piano. After some learning period, driving a car or playing the piano becomes an easy automatic thing to do, you just need to let it happen.

Conclusion None of the advice of this article will work if you do not allow yourself to feel the underlying anxiety in your body. Feel the sensations and learn to accept it. But also listen to your thoughts and learn to observe them without judgment. Foremost do not feel the anxiety or observe thoughts in a pro­active, continuous manner. Just focus on your life goals and whenever you notice tension or upsetting thoughts, it’s time to give yourself some discrete space for listening to your thoughts and feeling your body sensations. Anxiety is a normal emotion that everybody sometimes experiences. We can decide when it makes sense to listen to the message that anxiety brings us because it is a rational message. Continuing relaxation when we are trying too hard to relax in the end creates anxiety. The anxiety is trying to say to us “hey pal, this type of relaxation is not working, you are exhausting yourself”. The anxiety brings us a rational message. Continuing exercising such a worse relaxation for a long time is not good for your health because it leads to increase of depression, high blood pressure, and heart palpitations. Conversely, we can also decide to ignore the message that anxiety brings us because it is an irrational one. Obsessively controlling your mood during the day because the anxiety says to you “you have to control your mood otherwise you are going to get depressed again” is an irrational message. It is then time to have confidence in yourself, God or the Universe and ask yourself: “What am I actually afraid of now?” and “What do I really like to do now?” And then do it. God grant me the serenity to accept the things I cannot change; courage to change the things I can; and wisdom to know the difference.

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Borkovec, T. D., Mathews, Andrew M., (1988). Treatment of nonphobic anxiety disorders: A comparison of nondirective, cognitive, and coping desensitization therapy. Journal of Consulting and Clinical Psychology, Vol 56(6), 877­884 Burns, D. David, (1999), The Burns Anxiety Inventory, in Ten days to self­esteem, HarperCollins Publishers, 23­24 Hayes, Steven C. (2011), Acceptance and Commitment Therapy, Second Edition: The Process and Practice of Mindful Change. Guilford Press.

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