• We need distress tolerance skills to help us cope with extremely trying or painful moments, or emergency situations. When we’re distressed, it’s easy to default to clumsy, destructive, or unconscious ways of coping—these are false coping mechanisms.

• Self-soothing is a way to acknowledge and accept pain that is inevitable—without making it any bigger than it should be. It is not distraction or avoidance, but about anchoring in the present using your five senses—a technique called grounding.

• TIPP stands for temperature, intense exercise, paced breathing, and paired muscle relaxation, all of which can help lower physiological arousal. Try cold water, vigorous movement, or breathing exercises to calm the limbic system.

• Practice radical acceptance, which doesn’t mean we like what is happening, only that we have agreed to not fight with reality. Acknowledge how you feel and the reality of the situation and remind yourself of what matters.

• The ACCEPTS acronym (Activities, Contribute, Comparisons, Emotions, Push away, Thoughts, and Sensations) can help you better tolerate momentary distress—although not for the longer term.

• With anxiety, our goal is not to force ourselves not to worry, but to worry more efficiently. Scheduling worry time puts you in proactive control and helps you gain distance.

• Notice the anxiety, write down the time you’ll postpone to—with the duration and content—then follow through as agreed.

• Mental noting and focused mundane tasks can help you turn anxious moments into opportunities for mindfulness.

#ACCEPTS #Selfsoothing #StopNegativeThinking #TIPP #MasterTheArtOfDistressToleranceAndSelf-Soothing #RussellNewton #NewtonMG #StopNegativeThinking

Few of us will get through life without experiencing an emotional crisis, a big loss, an upheaval, or an accident at some point or another. It’s one thing to learn to master your thought processes so that you’re not creating unnecessary suffering for yourself—but it’s another when you’re faced with a legitimately negative circumstance that cannot be avoided. What then?

In this chapter, we’ll talk about distress tolerance and how to cultivate it. This is a set of skills that most people don’t really think about until they’re in a crisis situation and need them urgently. But many of the same principles of defusing, perspective-switching, reframing, and challenging your cognitive distortions can be used when we’re facing a situation that makes us feel out of control. Call it a toolkit of crisis survival skills!

The tools we’ll describe below can be used when

• you’re in extreme pain—emotionally or physically,

• there’s a formidable temptation that you have to resist,

• you’re dealing with a temporary but very challenging situation that can’t be avoided,

• it’s an emergency and you have to be productive and focused . . . even though you’re completely overwhelmed,

• there’s a conflict and you need to put aside raw emotions to communicate effectively,

• you’re absolutely terrified but need to act wisely anyway.

A crisis can put a major dent in anyone’s sense of emotional mastery and control. When the chips are down, it’s easy to slip back into old patterns of behavior or default to clumsy, destructive, or unconscious ways of coping. Trouble is, though these habits may feel momentarily soothing, they ultimately create more problems and set up negative feedback loops that keep amplifying themselves.

Alex has hurt his back at his job. He’s received some worker’s comp, but he’s basically off duty until he gets better. He’s at home alone (his partner works all day), the doctors and physiotherapists don’t feel like they’re helping, and there’s no end in sight. His boss has been kind enough, but Alex knows it’s only a matter of time before they need to let him go. His back is getting worse, not better, and Alex is unsure how they’ll fund the enormously expensive surgery if he needs it, or what they’ll do for money once his savings and insurance money are gone.

In other words, Alex is in a crisis. He’s in pain and can’t be prescribed any more painkillers since they’re addictive. But on some days, the pain is so intense, Alex doesn’t know what to do with himself. He can’t move. He’s depressed, anxious, bored, lonely, scared, and exhausted. And every day, he faces excruciating pain that doesn’t let up. What can he do?

Alex’s “solution” is threefold: He soothes himself with comfort eating and junk food, he sits immobile on the sofa for hours-long marathon gaming sessions, and he starts abusing alcohol. These things don’t help exactly, but they make everything a little more bearable. They also make everything worse. Within a few months, Alex is not only depressed, anxious, bored, lonely, scared, and exhausted, he’s also gaining weight, usually drunk or hungover, and staying up until 3 a.m. every night and sleeping past noon the next day.

Nobody would say that Alex doesn’t have a legitimate “reason” to feel negative. Nobody could say that he is to blame, and most would agree that the way he is dealing with the crisis is understandable, even if not ideal. However, the irony is that Alex’s methods for dealing with distress have become their own form of distress. Alex cannot help that he injured his back; however, he doesn’t have the skills needed to survive the crisis, and in a way, this is a bigger problem.

The coping mechanisms he’s chosen are false coping mechanisms because, ultimately, they create more of the problem, exacerbate suffering, and keep him trapped where he is. The more he drinks, the less emotionally available he is for his partner, and the worse they communicate. This means that the coping mechanism of drinking robs him of an important source of potential support: a loving relationship.

The more junk food he eats, the worse his overall health. This means that “comfort” eating is actually impeding his body’s ability to heal quickly. The extra pounds that make it even more difficult to complete the exercises the physiotherapist prescribed make him feel anything but “comfort”! The late-night gaming is just as addictive. It’s a welcome distraction, but it also makes him angry and combative, and since he’s ruined his natural sleep cycles, his anxiety and depression get worse, not better.

In a crisis, the challenge of staying calm, positive, rational, and accepting may seem like a Herculean task. It may seem almost impossible. Let’s be honest, it’s not something you want to do. But the point of Alex’s story is to show that living the life that false coping mechanisms create is actually much, much harder! We don’t tolerate distress because we enjoy it and have to learn to grin and bear it. We tolerate distress because it is less hard work and less suffering than allowing ourselves to be swallowed by it.

How to Self-Soothe

In life, pain is inevitable. But we have a choice in how we respond to it.

Self-soothing is a way to acknowledge and accept pain that is inevitable—without making it any bigger than it should be.

When you rail against pain and loss and injustice, you are actually prolonging and expanding that negativity. You are placing all of your focused attention on that pain and amplifying it. There’s nothing wrong with this response—in fact, your ancient ancestors evolved this hyper-focus on pain because it forced them to go into problem-solving mode and quickly remove or escape from the threat in order to survive.

But there are some types of pain that cannot be escaped. For these types of pain, struggling and resisting can only add to the portion of pain you have to suffer through. The person who complains that it is raining has one additional problem compared to the person who knows it is but chooses to just carry on with life instead of focusing on the fact.

Self-soothing is not the same as distraction or avoidance or having a little rant about how unfair life is. Rather, it’s about being kind enough to yourself that you refuse to add any more to the suffering you’re experiencing, whether it’s a suffering on the scale Alex is experiencing or something more trivial like a rainy day. If you genuinely cannot do anything to remove a pain (and we will look in a later chapter at an excellent way to figure this out for yourself), then the only rational next step is to do what you can to bear it.

Grounding is a great way to self-soothe. When you anchor into your senses, you are pulling your conscious mind away from anxieties, ruminations, regrets, and fears that are based in the past and present, and asking it to rest gently in the present instead. The irony is that we create a lot of drama for ourselves trying to run away from a painful moment in the present we think is too much to handle. But if we did stay with it for a while, we’d see that it wasn’t as bad as we thought it was.

Your five senses are your gateway to the present. Pause, breathe, and become aware. Take five minutes to find something to dwell on for each sense—without judgment or any agenda at all. For Alex, when his back pain reaches distracting levels, instead of defaulting to addictive behaviors, he pauses, takes a deep breath, and makes a conscious choice not to run away.

He looks closely at the texture of the sofa cushion and the almost infinite shades of blue he can discern in the weave of the fabric. He listens to the faint buzz of the refrigerator in the next room that he hadn’t noticed before. He smells the reassuring and faint aroma of laundry softener in the blanket on his lap. He touches the blanket; there are places where his own rough skin catches against it. He can sense the lingering taste of coffee still on his tongue from his morning cup . . .

After a few minutes, Alex isn’t magically not in pain anymore. But, what seemed completely overwhelming and engulfing a moment before doesn’t seem so big anymore. He has done something different—instead of fleeing pain, he has anchored into the present and ridden it out.

TIPP Skills

Anyone can see that Alex isn’t helping himself by eating garbage, being sedentary, and wasting hours staring at screens. It’s obvious that maltreating the physical body this way can only cause psychological, social, cognitive, emotional, and even spiritual damage. But we seldom appreciate the fact that this relationship goes the other way, too: If we soothe and regulate the physical body first, we can calm down the central nervous system and improve our psychological state.

TIPP stands for

Temperature

Intense Exercise

Paced Breathing

Paired Muscle Relaxation

These four things can calm down an aggravated limbic system and lower your overall arousal. Physical arousal influences and informs psychological arousal.

Try cold water. Splashing the face with cool water actually activates what is called the “mammalian dive response,” which is an ancient adaptation that results in slower heart rate, slower breath rate, and an overall calmed nervous system. Have a quick, cold shower, rub an ice cube on your neck or wrists, or dip your feet in cool lake or seawater, if you can. Cold temperatures affect your body’s metabolism, limbic system, and homeostatic balance, with the overall effect of making you feel calmer.

Get moving. Intense exercise likewise has a balancing and regulating effect on the body. A burst of intense physical activity releases adrenaline and creates momentary euphoria. Hard exercise is a healthy distraction that floods your body with oxygenated blood, and the increased heart rate reinvigorates every tissue and organ of the body. Do anything that gets you panting for air, makes you sweat, or brings some color to your cheeks!

Pace your breathing. Your breathing and your emotional state are closely connected. If you are breathing slowly, deeply, and rhythmically, you simply cannot be in a panicked or overwhelmed state. Just try it! Inhale slowly for a count of two or three, pause, then exhale with control for a count of two or three. As you do so, imagine your blood pressure and heart rate dropping.

Use PMR—paired muscle relaxation. Choose a pair of muscles (for example, the tops of both thighs or the muscles in each big toe) and tighten them as hard as you can as you inhale. Hold it, then very slowly and with control release the tension as you exhale. It is difficult to be emotionally tense and agitated if your muscles are relaxed. Tensing muscles before relaxing leads to a deeper calm. Repeat a few times and then move on to another paired muscle till you have worked through your entire body. This is an excellent mind-body connector that allows you to slow down, go quiet, and release. It can be paired with paced breathing and is especially useful in bed at night to help you get to sleep.

There is one huge advantage to using TIPP: your mind is not required! You can notice negative thoughts, temptations, upset emotions, and anxious loops. Yet you don’t have to deal with them at all, but engage on the level of your body alone. So many of the more psychological self-soothing techniques don’t work because they’re attempted with a body that is aroused. If you try to have a rational argument with yourself about why you shouldn’t panic, for example, it won’t really sink in if your heart is racing, your muscles are tense, and your blood pressure is through the roof. You need to relax first and then engage at the level of thoughts, feelings, and rational arguments.

For Alex, his situation improves when he starts incorporating a specific habit into his routine. Though he can’t stand for long periods, he does a morning workout where he uses his arms and adapts exercises so he can do them lying down. Once he is hot and sweaty, he cools off in a cold shower and finishes off with a brisk rub with a towel. He finds that no matter how much of a bad mood he started with, he always feels a little more alive and in control when he starts mornings this way.

He is also learning that when the physical pain gets too intense, he can distract himself by grounding and using breathing exercises. He is also finding that paired muscle relaxation at night before bed helps stop a racing mind and lets him get better quality sleep. These things are not miraculous, but they allow Alex to lower his arousal levels so that he is more receptive to other strategies like the above—thought restructuring, reframing, and so on. The pain is still there, and the problem is still a problem, but his response to it is now adaptive and masterful.

What Radical Acceptance Really Means

Most of us have an incorrect understanding of what the word “acceptance” means. We resist accepting things that feel bad because we think that it means we agree with them, that we want them to continue, or that we are passively condoning what we know is wrong. If somebody walks up to us in the street and tries to hand us their bag of trash, then of course we don’t have to “accept” it.

But radical acceptance is not about accepting in the ordinary sense of the word. For some more fundamental aspects of reality, we are not being offered the choice or asked, “Do you want this?” We are not asked if we like it or agree with it. In fact, our agreement seems utterly irrelevant to whether we get it or not! Some parts of reality are up for debate, and others aren’t. We can choose to live a healthy life and to be safe and avoid catching germs. But we cannot choose whether or not we die. We can choose how we respond to crises and emergencies, but not whether those events happen in the first place. For the parts of reality that are not up for debate, we need radical acceptance, which is basically the decision to stop fighting reality.

When we take action against something we don’t like but can change, then we have a chance of changing it.

When we take action against something we don’t like but cannot change, it stays exactly as it is, and we only become bitter, resentful, or exhausted.

You can accept reality without liking it. You can accept reality without liking it and still live a meaningful life. You can make choices and take action on some things even if you don’t get to decide on others. Life can be hard but manageable.

Easier said than done, of course! Let’s imagine that Alex is making strides, but after a few months, the doctors tell him they will need to operate. They also tell him that the procedure carries a roughly fifteen percent chance of resulting in total paralysis from the waist down. Ouch. This fact is like a brick wall he smashes into. Alex researches, gets second opinions, and gathers what data he can, but in the end, he still faces an immovable fact: He needs an operation that has a moderate risk of permanently paralyzing him. If he doesn’t operate, his life will become unbearable and he may damage his spinal column even further. Alex thinks, “This shouldn’t be happening. I can’t deal with this. This is not fair. I can’t face it.”

How can Alex accept this horrible “choice” he has? How could he, heaven forbid, possibly accept being paralyzed, should that be the outcome? You may not be facing a reality quite so stark as Alex’s, but the process he uses to find acceptance is exactly the same one you can use when you find yourself “arguing with reality”:

Step 1: Acknowledge that you are in fact fighting against reality. Really take a moment to let it sink in that you are pushing against an object that cannot move. Did you notice the word “should” in Alex’s thought? Notice your struggle. Notice what it feels like in your body—tension, queasiness, etc.

Step 2: Tell yourself that it cannot be changed. This is harder than it seems. Just like complaining is focusing on a problem without the active effort to change it, wrestling with reality is a negative reaction that does precisely zero to change the facts.

Step 3: Be honest about the reality you face. If you must accept it, know what you’re accepting. The truth is always easier to bear when you can see all sides of it! Look at cause and effect. Become curious about the details.

Step 4: Imagine how you would behave if you did accept these facts. What steps would you take (or not take)? How would you cope? What would you choose?

Step 5: Embrace and honor how you feel. Just because you are accepting your reality, it doesn’t mean that you suddenly don’t feel how you feel. Completely acknowledge any feelings of anger, regret, sadness, or disappointment.

Step 6: Remind yourself of what matters. Life is still worth living even though you are in pain at this moment. Remember the things you value, the principles that guide you, and the dreams you’re hoping to achieve. It may be that you have to postpone or re-size these dreams. That’s okay. Re-negotiate your future and start to be curious about the meaning you can make from your experience.

The ACCEPTS Skill

This acronym stands for:

A – Activities

C – Contribute

C – Comparisons

E – Emotions, i.e., trying on emotions the opposite to the ones you have

P – Push away or shelve the problem

T – Thoughts, i.e., keeping your mind busy on other tasks and not on crisis-related thoughts and feelings

S – Sensations, i.e., grounding in the five senses as described above

For Alex, this might look like:

A – Stays busy with exercises, hobbies, DIY at home, cooking, and pushing himself to do walks when he can

C – Volunteering with a mental health crisis helpline, which he can do from home and which brings him some satisfaction that he can help others

C – Helpful comparisons—he realizes that as bad as his injury is, it could have been worse, and that he was in many ways lucky to have received the support he did

E – When he feels absolute despair, he tries to laugh at himself and have a sense of humor about the situation

P – Overwhelmed at the decision he has to make (operate or don’t operate?), he chooses to just rest and process for a while, shelving the decision until he’s calmer

T – Keeps his mind busy writing shopping lists, making detailed budgets, solving riddles, or planning for a DIY project in detail

S – Does a grounding exercise every time he can feel his thoughts spiraling into negativity again

As you can see, even in a situation that feels totally hopeless, you always have a choice, and there is a lot you can do even when it feels like there isn’t! At the same time, distress tolerance is a set of skills to help you survive and cope—it is not a long-term strategy for living your best life. It’s there as a crutch to help you deal with distress without making things worse. But it’s not enough on its own. Sooner or later, Alex has to decide whether to get the operation or not.

If you’re ever overcome with negative feelings, know that you always have the tools to calm yourself down physically, self-soothe, accept what is happening, and find ways to cope with the most intense emotions as you ride them out. These tools won’t solve the problem—but they will help you make it through the worst of it in one piece until you’re ready to look at solutions when you’re feeling stronger and clearer.

Brain Dumping, Mental Noting, and Scheduled Worry Time

Chris had trouble navigating annoying and irritating life obstacles.

Carrie had to challenge the distorted mental filters she was using to look at herself.

Dan battled to reframe the story of guilt and shame he was living inside.

Ellen struggled to step outside of her depression and low mood.

And Alex had to learn to cope with the very real limitations of physical pain.

Each of these people had to deal with very different problems, but ultimately, each of them worked through their own version of negative thinking and how to find a way out of it. There is one manifestation of negativity that we haven’t yet considered, though, and that’s anxiety. This chapter is for you if you find your negativity taking the shape of worry, rumination, overthinking, and stress.

In the spirit of radical acceptance and not fighting against our mind or against reality, we’ll begin with a basic CBT principle when dealing with anxiety: We are not attempting to force ourselves not to worry. It’s just like being told “don’t think of a pink elephant.” Merely saying it makes you think of a pink elephant! So, first things first: getting anxious about your anxiety and worrying about your worry is not going to get you anywhere.

Instead, tap into the capital letter You and remind yourself that you have a choice. In the technique of “worry postponement,” we essentially tell ourselves, “Okay, Mind, you have full permission to worry. I’m not stopping you. All I’m going to do is decide when you get to do it and for how long.” In fact, tell yourself that your intention is to worry more efficiently. So, for example, you decide that instead of worrying right this instant, you’re going to deliberately worry later tonight at 6 p.m. for twenty minutes.

Scheduling your negativity and worry may seem like an odd thing to do, but it works. This is because

1. You’re learning to be aware that you are in fact worrying. (Again, it’s about gaining distance—it’s not, “Money’s tight!” but, “I’m having a stressful thought about money right now.”)

2. You avoid getting tangled up in that worry but also avoid going to war with it, resisting it, or denying it.

3. You take control. Just because a thought pops up and says, “Look at me!” it doesn’t mean you have to obey.

4. You gain a deeper sense of how worry actually plays out in your life—how it comes and goes, rises and falls, and in time, how utterly useless it usually is . . .

5. You put yourself in a proactive state of mind where you stop worrying and start strategizing.

Anxiety is exactly the kind of mental activity that, if not engaged with, will eventually dissipate. You can probably think of a few things you were really worried about a day or a week or ten years ago, and which barely even register with you now. Why? Simply because some time has passed.

When you schedule your worry to take place some other time, you may notice how often you actually forget about it when the allotted worry time rolls around. Or, when the time comes and you have free rein to worry to your heart’s content, you realize that the issue just doesn’t seem that important anymore. Sometimes, when you arrive at your future worry appointment, you discover that you don’t even want to worry anymore, that you are feeling way more calm and able to deal with any negativity that remains, or that the negativity has already resolved by itself.

Here’s how worry postponement might look In practice.

Be Mindful

You’re noticing a recurrent them here, right? It all starts with simply being aware that you are having anxious thoughts and worries in the first place. Just perceive and observe; don’t judge. Try not to be too hard on yourself if you notice a worry spiral that seems to be getting out of hand. Try to practice a little radical acceptance.

“I’m feeling extremely worried and anxious at the moment.”

“I am feeling so on edge. My stomach’s in knots.”

“I keep having the thought what if and am having trouble stopping it.”

Postpone

Even if you have to do it out loud, give yourself permission to worry; only, the worry has to be deferred to a time of your choosing. Make sure that the time you choose is at least a couple hours away (to give your mental state time to change) but not so far off that you unconsciously feel like it won’t really happen. Write down

• the day, date, and time,

• the duration for the worry,

• what you will worry about.

For example, let’s say you’re worrying about an upcoming performance review at work. You notice your anxious overthinking: “Maybe it’ll be really embarrassing. What am I going to do if they keep talking about the incident in March? It may be that they’ve already discussed it amongst themselves already. Maybe everyone has discussed it, and they’re getting ready to fire me at this very moment. What if I cry or get angry during the meeting? What if I say something I regret . . .?”

You stop and become mindful and realize that your anxious thoughts are getting carried away. You say out loud, “That’s okay, but we’re not worrying right now.” In a notebook, you scribble down “11 a.m. Tuesday, ten minutes worry time, concerns about upcoming performance review.” Then you close the notebook. You’ve made an agreement with yourself, and so you don’t have to keep worrying.

Follow Through

Naturally, your mind will soon start up again with worries. “Do you think you should maybe prepare a few clever rebuttals for if they want to talk about what happened in March? Just in case?” You notice this, and you don’t argue with it. You also don’t act or respond in any way. “No, Mind, we aren’t doing this now—we’re worrying tomorrow at 11 a.m., remember?”

Actively remind yourself that the big important issue your brain is trying to draw your attention to will certainly get the attention it deserves . . . in due course. Tell yourself that you’re allowed to focus on the present moment’s tasks because the worry is actually taken care of for now. All the time from now until 11 a.m. tomorrow is now “free.” When the thought pops up, confidently tell it, “Oh, don’t worry, I’ve already dealt with you!”

What about when 11 a.m. comes around? Well, do as you said you would and sit down and worry for ten minutes. But really worry! Don’t let your mind wander to other worries—just the one you said you’d tackle. You may as well really go for it because once the ten minutes are up, you’re not going to think about it anymore. Notice what happens when you do this. You might

1. no longer care about this problem,

2. feel better able to cope with it or manage it,

3. realize an action you can take to fix it,

4. still be at square one with no solution in sight.

Almost always, the outcome will be 1, 2, or 3. Occasionally, though, you will chew over something, and it will still be bothering you. Try your best to ask if there is one small thing you can do, there and then, to improve the situation. Then schedule that in, and promptly forget about it. If you catch yourself worrying further—then repeat the process. Postpone that worry till another time. At the very least, you are limiting your exposure to a difficult situation that you cannot do anything about.

You might start to notice that you keep worrying about something that either a) never comes, or b) does come and isn’t as bad as you thought it would be, or even c) it does come, it is that bad, and it doesn’t matter because you were able to cope with it.

One variation of this practice is to externalize worries while you’re postponing them. So whatever pops into your mind, imagine that you’re redirecting it to the page and writing it down there. The rule is, once it’s written down in the worry book, it does not need to be in your head anymore. The worry book is like a repository. All through the day, collect little nagging fears and concerns as they crop up and put them aside to mull over later, on your own terms.

After a while of doing this, ask yourself a few questions:

Are there any recurrent themes?

How often does the thing you fear actually come to pass?

Is there any difference in outcome when you do worry versus when you don’t?

A final variation is called “brain dumping,” and it’s exactly what it sounds like. When it’s your scheduled time to worry, go all out and put EVERYTHING down on the page. You can rant, you can rave, you can say what you like and let it all out. For five whole minutes (try not to go too much longer than this!), you have no limits and can experience the full cathartic power of worrying as hard as you can worry.

Imagine that your brain is like a room in a house that has just become too cluttered with junk. When you do a brain dump, you’re basically throwing all this clutter out. The power lies in acknowledging the thoughts and putting them outside of yourself. A big reason we worry is because our brain thinks it’s being useful. It wants to keep drawing our attention to something that may be threatening or a problem in the future, but if you put it down on paper, this sends a strong message to your unconscious mind: “I’ve noted this. It’s being dealt with. I won’t forget. You can stop reminding me now!”

What should you include in your brain dump? Whatever you need to. Scribble down stream-of-consciousness ideas, thoughts, feelings, and fears. Put down things you’re worried about forgetting on your to-do list. Regrets, concerns, complaints—anything you like.

What you do with your brain dump from there is up to you—the wonderful thing is that once it’s out on paper, you can do something about it. Here are a few options:

• Burn, crumple, or throw away the paper if what you’ve expressed is just useless or destructive material. Breathe a sigh of relief.

• Process what you’ve written. Pick one thing that’s bugging you and consciously decide to take a step to address it. Just one thing, though—you can’t tackle it all!

• Go through the material, identify negative and self-defeating beliefs, and gently rewrite them. Turn them into affirmations that you begin the following day with. The ABC method described above can be a great technique to incorporate here.

• If it makes sense to you, pray about or meditate on some of the things that are weighing on your heart but you’re stuck with. Ask a higher power to help you carry the burden, or do a visualization exercise where you release yourself from having to worry about it anymore.

Turning Anxiety into Mindfulness

People who struggle with anxiety are actually blessed with a secret superpower. If they harness it, they are able to tap into an enormous potential for heightened conscious awareness. Every intrusive and anxious thought can be like a “meditation bell” calling you to awareness and bringing you back into the moment. How?

Try “mental noting.” It’s easy.

1. Become aware and observe yourself having thoughts. No judgment.

2. Note the experience and label it. “I’m thinking.”

3. Keep going. Repeat until the thought dissipates or you move on.

Every time you have a thought, any thought at all, you can stop and remember to become aware of yourself. In some Buddhist temples and monasteries, a mediation bell rings periodically so that wherever people are and whatever they are doing at that moment, they can stop and reconnect to the present again. You can do the same with your own thoughts and self-talk. Every time you hear an anxious thought, treat it as a bell that has rung to remind you to come back to the present.

Of course, you won’t be able to maintain awareness one hundred percent of the time, but if you can grab hold of an anxious thought and note it for what it is, then you can transform any thought into an opportunity to be mindful.

This technique is inspired by many different mediation techniques and is designed to quell distractions and calm down what the Buddhists call “monkey mind”—that inner chat that thoughtlessly leaps from one thing to another. Mental noting might not seem like much, but if you pepper your day with little moments of metacognition in this way, be prepared for big, big changes in the long run. Practice this often enough and you will find it much more difficult to become “fused” with negative thoughts. You simply maintain too much distance to ever get too tangled up.

Just remember three key elements when you practice mental noting:

Your intention should be to maintain awareness of the present moment.

Your attention should be on everything that is happening in the present only.

Your attitude should be non-directional, non-judgmental, and kind.

The classical approach during mediation is to say, for example, “There is hearing,” or, “Hearing has happened,” when you notice a dog barking outside. You might be really Zen and simply note, “Hearing.” You don’t allow yourself to run off and follow the hearing so that you are soon thinking, “That’s the neighbor’s dog,” or, “I wish it would shut up.” You simply note and label what your brain is doing, then move on.

In the case of anxiety, you do something similar to stop yourself from getting “distracted” by thoughts that seem urgent and important but really aren’t. So if you’re sitting at your desk, trying to work, and you notice a thought pop into your mind (“The performance review is going to be so awkward!”), you stop in your tracks, note the thought, label it, and move on without engaging. “Ruminating,” you say, and pass it by.

Another way to bring in the principles of mindfulness to a brain that’s hooked on anxiety is called “mundane task focusing.” If you’re one of the many people who dislike meditation or simply don’t find room in their lives to practice it, don’t worry—the Buddhists and meditators do not have the monopoly on mindfulness!

All that’s required to calm an anxious mind is to remain in the moment. Anxieties and worries live elsewhere—they’re in the past or the future. If you anchor right here and right now, though, your world slows down and becomes calmer and way more manageable.

1. Pick a mundane and everyday task that doesn’t require too much brainpower—for example, washing dishes.

2. Do the task but do it very intentionally. Pay ultra-close attention to what you are doing. Focus on the bubbles of the soap. The temperature of the water. The rhythmic movement of your hands, and the weight of each dish as you hold it (as you can see, this is a form of grounding).

3. When your mind wanders, pull it back to the task at hand. Commit every last ounce of your attention to the task unfolding before you, nothing more.

You can find immense relief from overthinking and worry by doing completely ordinary everyday tasks, like walking to the post office or filling the car with fuel.

Summary

• We need distress tolerance skills to help us cope with extremely trying or painful moments, or emergency situations. When we’re distressed, it’s easy to slip back into old patterns of behavior or default to clumsy, destructive, or unconscious ways of coping—these are false coping mechanisms.

• Self-soothing is a way to acknowledge and accept pain that is inevitable—without making it any bigger than it should be. It is not distraction or avoidance, but about anchoring in the present using your five senses—a technique called grounding.

• TIPP stands for temperature, intense exercise, paced breathing, and paired muscle relaxation, all of which can help lower physiological arousal. Try cold water, vigorous movement, or breathing exercises to calm the limbic system.

• Practice radical acceptance, which doesn’t mean we like what is happening, only that we have agreed to not fight with reality. Acknowledge how you feel and the reality of the situation and remind yourself of what matters.

• The ACCEPTS acronym (Activities, Contribute, Comparisons, Emotions, Push away, Thoughts, and Sensations) can help you better tolerate momentary distress—although not for the longer term.

• With anxiety, our goal is not to force ourselves not to worry, but to worry more efficiently. Scheduling worry time puts you in proactive control and helps you gain distance.

• Notice the anxiety, write down the time you’ll postpone to—with the duration and content—then follow through as agreed.

• Mental noting and focused mundane tasks can help you turn anxious moments into opportunities for mindfulness.