People who are anxious not only avoid situations, but also often develop habits or “fixes” they rely on to temporarily alleviate their anxiety. In clinical terms, these are called safety behaviours.
- repeatedly texting your partner to make sure he or she hasn’t been in an accident
- asking for the same reassurance from family and maternity care providers, over and over
- spending a lot of time on the Internet looking up symptoms of pregnancy complications or car seat crash test ratings
- choosing a spot at the back of an exercise class, or a seat near the exit, so you can leave a situation easily
- avoiding eye contact and slouching so strangers are less likely to comment on your pregnancy
Quick fixes are often counterproductive
Quick fixes feel good in the short run, because they relieve anxiety temporarily. In the long run, however, they just keep your anxiety going. You act as if what you are afraid of is true, so quick fixes usually serve to confirm rather than disconfirm your fears. In addition, these fixes are often a lot of work, so they leave you tired and irritable.
Anjali worries that the baby isn’t growing enough, and often telephones her doctor whenever her weight doesn’t increase as much as she thinks it should. If she does not feel the baby moving for a few hours she will sit or lie still until she feels movement. She frequently asks her husband and sisters to reassure her that the baby will be okay. She spends hours every day looking up websites on pregnancy after miscarriages, genetic defects, and other issues, to try to relieve her anxiety about this pregnancy, but she just continues to feel anxious.
Anjali’s moment-to-moment anxiety is relieved by her quick fixes. But in the long run, she ends up preoccupied with fears about the pregnancy instead of focusing on other things. She cannot learn to trust her own judgment about the baby’s growth and well-being. Her actions send her the message, “My baby is in danger,” over and over again.
Here is another example:
Susan, who has begun having panic attacks, often takes her pulse to make sure it isn’t “too high.”
In the moment, Susan’s anxiety about her heart rate is relieved by the quick fix of checking her pulse. In the long run, checking her pulse keeps her focused on her heart rate and what might go wrong. It prevents her from being able to trust that she is healthy, and really learn that a faster heart rate because of exercise or anxiety isn’t, in fact, dangerous. Checking her pulse is like sending herself the message, “Danger! Don’t let your pulse get high or something terrible might happen!” over and over again.
Resisting the habit of quick fixes
Quick fixes are tricky because they make you FEEL safer, but don’t actually MAKE you safer. They are a lot of extra effort and usually result in more anxiety over time.
You can break this habit by following a basic rule: when you identify an action as safety-seeking, try doing the opposite. Act as if you don’t believe your anxious thoughts. Instead, act as if you believe you are safe and confident in your own judgment. This way you can prove to yourself that you are safe, without all the extra effort.
You can do things like:
- Delay texting your partner or asking for reassurance. Set a timer for 15 minutes, and see if the urge to do it has reduced. Do something fun or relaxing in the meantime.
- Give yourself the reassurance you are asking from others. You know what they were going to say anyway; they aren’t going to tell you anything new.
- Step away from the Internet. Set some limits on the time you spend investigating potential problems and striving to find perfect solutions. Ensure that the information you are accessing is from reputable, established health organizations, and that you are using unbiased search terms. Keep a list of things you want to figure out and give yourself 15 minutes per day for research. The rest of the time would be better spent going for a walk, or talking to your partner about topics you used to enjoy talking about.
- Travel light. See what it’s like to carry around only what you think you will probably need. If you are heavily pregnant and you realize you cannot carry all your groceries home with you, someone will lend you their cell phone to call someone. Just because you are pregnant, it does not mean you have to go around in a state of perpetual emergency preparedness.
Exposure tools help too
Fear Ladder: Anjali’s quick fixes – asking for reassurance and Internet research
Goal: Act opposite to anxiety. Act AS IF I am confident in my health, my baby’s health, and my own ability to judge.
|Step||Fear Rating (0-10)|
|1. Lie down to check baby’s movement only three times per day, after breakfast, lunch, and dinner.||2|
|2. Lie down to check baby’s movement twice per day, after breakfast and dinner.||3|
|3. Weigh myself every other day (instead of daily).||3|
|4. Keep list of things I want to look up on Internet. Schedule two Internet periods per day, 30 minutes each.||4|
|5. Ask family members to stop giving me reassurance, and provide them a prepared answer to my requests for reassurance (such as, “You can trust your own judgment Anjali, I don’t need to tell you”).||5|
|6. Lie down to check baby’s movement once per day only, after dinner.||6|
|7. Weigh myself twice per week, Monday and Thursday.||6|
|8. Keep list of things I want to look up on the Internet. Schedule one Internet period per day, 30 minutes.||6|
|9. Stop weighing myself at home, rely on doctor’s office weigh-in only. Do not schedule extra prenatal appointments just to get weighed!||7|
|10. Ask my husband to stop giving me reassurance, by asking him to provide a prepared answer to my requests for reassurance (such as, “You can trust your own judgment Anjali, I don’t need to tell you”).||8|
|11. Look at list of things I want to look up and cross out pregnancy complications or abnormalities (Down syndrome, gestational hypertension). My doctor has given me a list of “red flag” symptoms that warrant a call to her office; that’s enough.||9|