Need to give a speech and feeling butterflies in your stomach? That’s normal. But what if the tingly feelings of unease keep reappearing, disrupting your life, discouraging your ambitions, and demoralizing your spirit?

Worry is a small word for an overwhelming feeling. But we can strip it of its fangs. Professionals share ways we can use the brain, that normally plagues us with worries, to achieve a calm state of mind

The Price You Pay

You worry a lot. Big deal! You’ve been doing it for the last 20 years, why not just keep going? Here’s why not…

While anxiety, worry, and stress typically don’t cause medical problems, says Ronald S. Kaiser, PhD, licensed psychologist and director of psychology at the Jefferson Headache Center, they can trigger and intensify a number of medical conditions including migraine and tension-type headaches, COPD, cardiac issues, and gastrointestinal problems. That’s enough of a reason to try to find techniques to combat worry.

What We Worry About

“Social anxiety is one of the most common forms of anxiety I see in my practice,” says Nina Kaweblum, LCSW, DBT-LBC™, MA, MEd, a certified DBT and trauma therapist based in Lakewood, NJ. “I also see fear about the future, fear of being hurt, fear of failure, and fear of feeling too emotional. Three things that exacerbate worry are catastrophizing, excessively reassuring oneself, and interestingly enough, becoming anxious about one’s anxiety. People think that ‘normal’ people don’t worry like this and there must be something awfully wrong with them. This thought causes its own worry cycle.”

According to my informal research (see pie chart), the four biggest worry triggers are finances, wellness of loved ones, children, and health.

The frum world has its own unique set of worries, such as finding a shidduch, doing something that might affect our shidduchim, kids going off the derech — even if the kid shows no signs of being headed in that direction — the fear of not being ‘good’ enough and getting punished for it, and the recent spate of anti-Semitic attacks.

Mrs. Miriam Gewirtzman, LCSW, of MG Counseling in Lakewood, NJ, says, “Worry about our kids’ chinuch makes us constantly afraid of saying the wrong thing. And there can be a fine line between taking our responsibilities as Torah observant Jews seriously and being anxious that we aren’t accomplishing enough. Although these fears are exclusive to our community, the treatment is the same as for any other form of anxiety.”

10 Ways to Combat Worry

Name It to Tame It

“Don’t push away your feelings. It’s important to give yourself permission to acknowledge what you’re feeling,” advises Nina Kaweblum. Crystallize in your mind what you are worried about and give it a name — is it money? Marriage? Health?

Bring in the Positive

Worry carries a sense of foreboding. It predicts failure or tragedy before it happens. “One of the things I encourage my patients to do when they’re feeling nervous,” says Ronald S. Kaiser, PhD, author of Rejuvenaging: The Art and Science of Growing Older with Enthusiasm, “is to ask themselves, ‘What can go right?’ They’re already thinking what can go wrong, and I want them to entertain the possibility that things can go right. I encourage them to think of anxiety and excitement as two sides of the same coin. If they can stop over-focusing on the internal feeling of anxiety but instead think about what will be exciting about successfully managing the thing they’re worrying about (speaking in front of a crowd, having a job interview, etc.), it can go a long way toward overcoming worrying.”

According to Rav Dessler ztz”l, visualization is the only way to influence our feelings, says Chaya Hinda Allen, who teaches Jewish Positive Thinking classes on emunah, bitachon, which provides practical Torah tools for a happier, calmer life. If we want emunah, happiness, and peace of mind, we have to learn the art of training our thoughts to imagine ourselves being enveloped by Hashem’s love.

Since worrying is generated by our imagination, the opposite of worry — that is, trust in Hashem’s protection, in His loving hashgachah and guidance — is also generated by our imagination.

That doesn’t mean our trust in Hashem isn’t real! It’s very real, it’s just that our eyes can’t see it and our ears can’t hear it. Once we’ve mastered the tools to imagine Hashem’s love and protection, we can become worry-free.

Cognitive Behavioral Therapy

CBT is based on the theory that our thoughts affect how we feel and what we do, explains Frani Pollack LSW, PhD, who runs a private practice at Bala Child & Family Associates and trains therapists at the University of Pennsylvania. “If I’m studying for a test and thinking, ‘Yay, I’m preparing, and I’m going to do great!’ I’m going to be calm. But if my thoughts are, ‘Uh oh, I’m going to do terribly,’ the result is apprehensive, tense behavior.”

Negative thoughts are exaggerated at best and sometimes completely untrue. With CBT, you follow a specific thought in your head regarding an event, the feeling it brings, and your reaction to that feeling — your behavior. The next step is to work on replacing your thought pattern with one that serves you better in the long run, granting you a worry-free state of mind.

Affirmations

Mrs. Miriam Gewirtzman uses affirmations to offset worry caused by negative thought patterns. Since thoughts of the unknown or worst-case scenarios cause worry, she says, thoughts of peace, security, and confidence are a counteractive solution. Affirmations should be practiced daily when you’re calm and repeated when anxiety strikes. They can be as simple as, “Breathe in calm, breathe out stress,” to “I choose to fill my mind with positive, nurturing thoughts,” or “I look forward to the future with hope and happiness.”

The Toras Avos of Slonim recommends the best affirmations yet, says Chaya Hinda Allen: positive affirmations of faith and trust. Words of emunah like, “Ein od milvado — There is no one other than Him” (Devarim 4:35) or, “I trust You, Hashem, that whatever happens is for the best,” do more than alleviate worry, for “he’emanti ki adaber — I believe what I speak” (Tehillim 116:10). After we speak words of faith, we think words of faith and become inculcated with emunah — and that can actually change our situation for the better, says the Toras Avos, since Hashem responds with bounty to the positive shift in our emotions.

Observation

Try and step back, suggests Frani Pollack, and say “Those are my worried thoughts.” Notice and watch your thoughts as if from the outside, as a dispassionate observer, rather than being overwhelmed by them.

Mindfulness

One simple mindfulness exercise you can use to deal with stress, says Frani Pollack, is to count to 20 while breathing in and out and then from 20 back to zero. Build your ability to focus so that you can easily call upon this skill during stressful times. Mindfulness gets you to live in the moment, in your breath, in the here and now — as opposed to anxiety, which is all about the future.

Another great mindfulness trick, especially when feeling panicky, is saying random numbers out loud, says Hadassah Levin, LMSW, a social worker in Monsey, NY. “Saying numbers in no particular order requires our mind to concentrate, taking away the ability to ruminate on unhelpful thoughts,” she says.

Mindfulness teacher and author Padraig O’Morain suggests moving our awareness of our worries to what’s going on outside our minds and in our bodies: for instance, our breath, sensations in our feet, or what we’re doing with our hands.

Breathing Exercises

There are many types of breathing exercises we can do to help us relax. “Count to four in your head while inhaling, hold it for two–four seconds and slowly exhale,” recommends Hadassah Levin. “Do this as many times as you need to feel calm.”

Do the Things You Love

Find an activity/hobby that helps you relax, says Hadassah Levin. For some it might be reading, for others it’s getting their nails done, taking a bath, a walk (which releases stress-reducing endorphins). The options are endless. Discover what calms you and do those activities during times of stress and anxiety.

Physical Exercise

Research shows that exercise is very helpful if done four times a week for 30–40 minutes. Aerobics and yoga are both great for reducing worry.

Relaxation Exercises

An easy at-home, anti-stress skill Hadassah Levin suggests is a full mind and body relaxation technique. Lie down, close your eyes, and take a deep breath. Then focus on relaxing each part of your body, one at a time, starting with your toes and slowly moving up your entire body. Feel the stress and pressure being released.

The Right Combo

“Sometimes when stress is quite high,” says Frani Pollack, “a combination of techniques works best. For example, a few days ago, I had a very stressful board meeting which left me feeling stressed the following day. I reached a 9–10 on the scale. Going for a very long swim integrated both exercise and distraction for me, which brought my number down to about a 7. Then I was able to do some CBT and talk to a friend, which further brought my number down to around a 4-5. Yes, I still felt upset about what happened, but doing a combination of stress reducers helped lower my unease.”

A Friendly Poll

I polled friends and strangers for the home tools they use to calm down and relax in times of worry and stress. These are the top ten, in order of popularity.

(Nature) walk/Exercise

Deep breathing

Davening /Saying Tehillim

Listening to music

Confiding in a trusted person

Eating

Taking a shower or hot bath with bath salts

Reading a book or listening to a shiur on emunah

Doing yoga

Drinking herbal tea

(Thank you Bashi Fordonski for your help conducting this survey. Thank you, friends, family, and the Philadelphia community, for your patience with the endless polling.)

Other suggestions included applying essential oils, meditation, reading, journaling, having a good cry, even screaming.

I asked Ronald S. Kaiser for his professional opinion on these suggestions. He responded, “The important thing to remember, is that a person can’t be relaxed and tense at the same time, so anything that increases relaxation is helpful in coping with stress. Included in the poll’s response are positive, relaxing suggestions — nature walks, breathing exercises, relaxing music, yoga, a bath or shower. While exercise can also be relaxing, especially if you’ve been doing it for a while, the key benefit that it provides in dealing with worry is the benefit of distraction.

“Reaching out to a friend can be helpful as long as the friend is supportive but not anxious. The proper reason for eating is because it’s mealtime; it’s not a constructive tool to handle stress... and unless you’re a fan at a sporting event or if you’re being chased by someone, screaming is not particularly helpful; you don’t control anxiety by losing control.”

When to Turn to Treatment

“There are many things a person can do about incessant worry,” says Nina Kaweblum. “People don’t have to suffer; therapy can help. When a person tries to suppress her emotions, they only become more overpowering and the sense of shame — and worry — becomes stronger.”

While self-help can be just the thing for many people, says Hadassah Levin, if worry turns into anxiety that doesn’t go away, therapy and medication can be beneficial for many people.

Frani Pollack sees past trauma as a clear indication for therapy. “An unprocessed childhood trauma that has risen to the surface can be the cause of your overwhelming emotions,” she says. Another sign that therapy is needed, she adds, is a stress-ridden primary relationship, such as with a parent, child, or spouse. Support is of paramount importance, so that you don’t collapse under the burden of a marriage riddled with strife, or a child who is struggling. Be kind to yourself and don’t go at it alone.

Symptoms of anxiety may sometimes be confused with other medical conditions, cautions Miriam Leah Frankel, MSW. “If someone has a sudden onset of anxiety or any mental health issues,” she says, “the first line of defense should be a full medical workup to rule out any underlying issues causing it. Both UTIs and an underactive thyroid can cause mental health symptoms.”

Snoozing with Anxiety

Many people have a hard time falling asleep or going back to sleep after waking in the middle of the night, says Nina Kaweblum. The reason? Anxious, racing thoughts. For some, it’s worrying about everything they need to get done, for others, financial difficulties, and for yet others, something embarrassing they did or something hurtful someone did to them.

Unable to sleep, they worry they’re never going to fall asleep and won’t be able to function the next day. And that keeps them awake, and they enter the sleep-anxiety cycle, looping between worrying about life keeping them awake and that staying awake will disrupt their life.

The solution: A sleep hygiene protocol that includes not doing anything in bed besides sleeping, and keeping a set bedtime. Make a commitment to yourself before you get into bed that if you start thinking worrisome thoughts, you’ll postpone that thought for tomorrow and instead, focus on something not anxiety-provoking.

If you can’t stop thinking stressful thoughts, get out of bed and do a quiet activity (reading, listening to relaxing music, nothing electronic) until you feel sleepy. This may need repeating at the beginning until you sleep train yourself. During the time out of bed, stay mindful — focus on calming activities and keep away from worrying thoughts.

The Wrong Way to Worry

Eating, drinking, shopping, and spending time at the computer are all methods to distract ourselves temporarily from our worries, says Frani Pollack. But at the same time, she cautions us not to abuse our bodies or introduce damaging habits into our lives. Instead, she says, we should aim to go for less potentially destructive distractions, like reading, cooking, talking to a friend, exercising, or playing a game with a child.

The Pros of the Con

Worry can be helpful on occasion, points out Nina Kaweblum. Emotions help us understand what’s happening to us and pick up on things that logic may miss. Anxiety, fear, and worry are warning systems, cautioning that something harmful is about to happen. If someone’s worried about something that’s actually dangerous, that’s helpful. Instead of trying to soothe yourself, you need to problem-solve. The carbon monoxide alarm is going off? Respond, get out! Don’t just calm down! This is also how we pass tests, do well at work, and strengthen our relationships. Stress, at a healthy intensity, can motivate us to take positive action.

(Originally featured in Family First, Issue 643)