Cognitive Coping Cards

An important tool in your M.A.P. is the ability to change anxious, “tumble dryer” thoughts into helpful, balanced thinking. However, when anxiety strikes, it can be difficult to remember to challenge your fear thoughts, or your anxiety may get the better of you and worm its way in. Fortunately, cognitive coping cards can remind you to use helpful thinking to reduce unwanted anxiety. With practice, you can use cognitive coping cards as soon as anxiety strikes

Cognitive coping cards can include small index cards, handwritten notes, Apps on a mobile device, and even key chain or bracelet messages that contain phrases or short sentences for use when experiencing anxiety. The cards, notes and related items are portable reminders to boss back anxiety. Creating cognitive coping cards will make the most sense if done after you have learned about Challenging Negative Thinking

What sorts of things are helpful to put onto a coping card?

  • A reminder that physical symptoms (e.g. sweaty palms, stomach-aches) are just anxiety and not a sign of something worse
  • A nickname given to your anxiety (e.g. “Mr. Worry”, “the pest”, “Meanie”) combined with a command. For example, Beat it Mr. Bossy Pants! Or, You’re not invited to the party anxiety.
  • A reminder that panic attacks, while unpleasant, aren’t dangerous and only last for a few minutes
  • Positive coaching statements (e.g. “I can get through this!” “I’ve done harder things than this.”)
  • Inspirational statements (e.g. “Courage is resistance to fear…” “If you change nothing, nothing will change.” “Do one thing every day that scares you.”)
  • A reminder to use some coping skills (e.g. I can do relaxed breathing; I’ll go for a walk after doing my exposure exercise.)
  • Useful facts (e.g. Flying is safer than driving! The driver takes this route hundreds of times each week.)

Coping Card Examples in Action

Panic Disorder: Andrea has panic attacks and is afraid she is going to have a heart attack. She has started to boss back her panic by doing muscle relaxation and facing her fears about her panic attack symptoms. 

“Anxiety can’t hurt me! It’s just a bully! If my heart is racing, I get sweaty, and my stomach hurts it just means my anxiety is acting up. I’m not in danger.”

Remember: I do better when I float with the panic and try to stay calm. When I fight against the panic, it makes my sensations worse. Coping cards can calm the storm.

Social Anxiety Disorder: Tony gets very anxious when he is at work. He is worried that his coworkers don’t like him, and that if they knew he had anxiety, that they would laugh and make fun of him. He has been learning to capture, challenge and re-script his anxious thoughts.

I can ask myself these helpful questions:

1. Has this ever happened before? If so, what happened and how did I cope?

2. What would I say to Max if he was worrying about something at work?

3. What would my wife tell me? She always knows what to say.

Remember: Most things that upset and worry me NOW will not bother me LATER!


Health Anxiety: Ms. Sangara has asthma and is extremely anxious about having future attacks and being unable to cope. Until recently she would engage in complex safety measures to be “for sure certain,” that she had everything she needed in the event of an attack. But she is starting to see that this isn’t helpful and is using detective work to help assess her fear thoughts and look for the facts.

Fear: I’ll have an attack and won’t have an inhaler

Evidence for / Evidence against

1. I’ve had attacks / I’ve never forgotten an inhaler
2. Inhalers can seize up / But mine never have and I have an extra in my car
3. My attacks are mild
4. I don’t always need an inhaler

Balanced Thought: Although I might have an attack I can use an inhaler or breathe my way through it.

Remember: Most of my past asthma incidents have been hassles not horrors!

Obsessive Compulsive Disorder: Chris is recently diagnosed with OCD and is terrified of germs. He has started tracking his fear using the Horror or Hassle tool to keep his fears from taking over. It seems to help at work and in the community.


I must wash my hands after lunch or else X
Holding my girlfriend’s hand after she uses the bathroom is so hard but I’ll do it X
No time to change after going to the gym- stayed in sweaty clothes X X

Separation Anxiety Disorder: James is 17 and hates to be apart from his family. However, he’s starting to realize that with some courage and his coping cards, he can handle more than his anxiety makes him believe. 

Situation: Mum went out to the store. I’m freakin out…

Questions to ask:

What is the worst thing that would happen? How would I handle it? Car breaking down. I’ll be home alone for over an hour, but at least I can watch all the TV I want.

What is the best thing that can happen? She bought stuff for ice-cream sundaes!

Think of 5 possibilities. Which is most probable (likely)?

  1. She’s being held at gunpoint
  2. Car broke down
  3. She’s been mugged
  4. She decide to get more stuff than she thought
  5. ****She stopped to talk to a friend**** most likely

Specific Phobia: Jacob is terrified of needles. He needs some dental work and will have to get 10 injections next week. He’s using some of the questions on the Challenge Negative Thinking sheet to help him prepare for this challenge.

  • Fear: I cannot handle these injections

Evidence for ------------- Evidence against

I’ve never had 10 in a row --------------- 1. I’ve coped with past ones

The mouth is sensitive ------------------ 2. I handled a broken arm

I kinda freak out under stress ------------------ 3. I’ll have a sedative

  • Am I 100% sure that I will not be able to handle it?- “No. There is no evidence.”
  • How many times have injections gone badly? “Never. Its always been fine. I just don’t like it.”

Final conclusion: “Although I can be sensitive to needles and no one likes getting shots, I’ll have a sedative to help. Plus, it’ll be over in an hour! I can handle an hour!