First steps with anxiety
First Steps with Anxiety 

I have had a lot of conversations recently with people who want to know what to do when anxiety starts coming up; maybe before getting a doctor’s appointment or before medication has started to work or therapy begins. 

I thought it may be helpful to outline 3 simple early steps that can change the direction of anxiety in this kind of moment. 


The anxiety we feel in our bodies is part of a network of responses that form part of our ‘Fight or Flight’ response. Unfortunately, in the absence of any distinct danger our bodies can still prepare to run away or exercise superhuman strength. A big part of this process is oxygenating our major muscle groups.

Imagine you are about to swim the length of a pool underwater. Typically you try to take onboard extra oxygen by over breathing, which you will then use during the exercise. Anxiety can make us do something very similar, although we are rarely aware of it. Sometimes breathing can look like yawning, panting or gulping so look out for those. 

The trouble with over-breathing is that it makes your head feel ‘swimmy’. You may feel nauseous, dizzy, depersonalised or light-headed. To counteract these feelings I use 2 breathing techniques that restore my balance between oxygen and carbon dioxide. 

The first is the staple 7:11 technique. 

Breathe in through your nose for 7 beats slowly. Then breathe out through your mouth for 11 beats. Try to focus on your tummy (diaphragmatic breathing) making it rise and fall as you breathe in and out. Continue for 5 cycles.

The second is a little more involved and is called Box Breathing.

Breathe in through your nose for 4 beats. Hold the full breath for 4 beats. Release the breath through your mouth for 4 beats and then hold your empty breath for 4 beats before breathing in again. 

In this model you are only breathing in for 25% of the breathing cycle and it tends to restore your sense of calm and ‘groundedness’ within just 3 cycles. A good general rule when you are anxious is to use your nose to breathe in so as to limit the amount of oxygen you can take in.

Aggressive Relaxation

This sounds like a paradox, but it is a key recovery tool for early anxiety. We tend to have a very pragmatic approach to relaxation and assume it just ‘happens to us’ when we do certain activities. 

The trouble is that when you are filled with adrenaline, your body and mind don’t respond in the ways that they usually do. You can feel on edge and uncomfortable in previously relaxing environments. Rather than being unstructured and pragmatic I take a very direct approach to relaxation which has three steps:

  1. Body scan – observe your body for obvious tension points. These might look like a clenched jaw, holding your body, sitting on your hands, crossing your legs or tensing any number of specific muscles. 
  2. Re-posture – In a sitting position, uncross your body and place your feet evenly on the floor. Place your hands palm side up on your thighs. Drop your shoulders and relax your jaw. (Gripping, tensing or pressing your body sends threat signals back to your brain which further stimulate your fight or flight response.)
  3. Tense and Relax – When you are in a good position begin a progressive relaxation process: Staring at your toes, tense (or flex) and then relax each muscle right up to your forehead. This reminds your body exactly what relaxed versus tense, feels like. You will be amazed at the muscles they you find have been held in tension for hours.

Relaxation Script

One of the most hidden but painful aspects of anxiety are the frightening, often fast-cycling intrusive thoughts that come with the physical sensations. These thoughts pour petrol on the already smouldering anxiety fire and very much keep the whole cycle alive. 

One of the most common responses is to try and ‘make the thoughts go away’. Whilst this is totally natural it is also completely impossible. Even if you weren’t struggling with anxiety you can’t just switch off your thought stream.

Anxiety propagates endless ‘what if’ thoughts, as well as hypervigilant alertness to these threats. So it basically bakes and then eats its own cake. You have to muscle into this process if you are going to get your anxiety down. 

I have learnt that the worst thing I can do is to try not to think about something. However, I can push my relaxation script into this barrage of frightening ideas. Imagine that it’s a bit like the front row of a rock concert; you cannot pull other people off the barrier, but you could squeeze yourself into the line. 

A relaxation script is a visual and auditory diversion that you squeeze into the line of terrifying thoughts in your mind. Mine is an image of simply casting my fishing line out into a gently flowing river over and over again. At the same time, I imagine the sound of the water and the words, ‘And relax. God is with you.’

Relaxation scripts need to be simple and work best when you keep using them over and over again, as your brain locks into their familiarity and takes the prompt to begin shutting the fight or flight system down. But remember, you have to be aggressive and persistent with your script because you are biologically designed to give more attention to threat thoughts. It takes time to gain the confidence to prefer your relaxation script.

Three things to try together: Breathing, Aggressive Relaxation and a Relaxation Script. 

Give them a go and let us know how you get on. Don’t forget that God is present with you in this battle.

Be Blessed, Will. 

Will Van Der Hart, 25/11/2022
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