Hi. This is Dr. John Dacey, with my weekly podcast, New Solutions to the Anxiety Epidemic. If you have started carrying out a plan to reduce your anxiety levels, and I hope you have, it’s time to lay the groundwork for evaluating your progrgess. I’m going to introduce you to the concept of formative evaluation. The good news about formative evaluation, that is, checking while your plan is in effect, is that once we learn to do it, this process alone can help to reduce anxiety. Evaluating progress in your plan as you are carrying it out offers several advantages:

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  It helps you gain perspective on the problem.

  
  
  
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  It takes you away from your worries about future dangers back to a concern with the present (called “centering,” as you may remember). Concentration on checking progress often also disrupts anxious thoughts.

  
  
  
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  Being self-aware tends to breed a sense of self-control.

  
  
  
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  Evaluation causes you to think of yourself as a person who "has anxiety," rather than a person who "is anxious." This allows anxiety to be seen as a part of you rather than the whole, and thus it becomes more manageable.

  
  
  
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  Formative evaluation encourages “how” questions (“How are you feeling right now?”) and “what” questions ("What is the most troubling aspect of your situation?"). These promote the sense of being a "self-observer." "Why" questions, on the other hand, only produce more worrying.

  
  
  
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  At its best, formative evaluation amounts to what has been called "watching myself watch myself." When you master this skill, your anxiety levels are always reduced.

  
  
  

In this section, I present activities that illustrate effective strategies: charting; using drawings; getting help from buddies or from a therapist; check listing; journaling; and photographing. I hope that as you learn the techniques I recommend, the beneficial outcomes of evaluation will become obvious to you. I feel certain that you will experience these benefits.

Checklists and Charting

A major problem with most anxieties is that they tend to build up to a high level of stress without your being aware of it.  Checklists and charts can help you keep track of the symptoms of your anxiety while you carry your out his current plan. They also inform you of the frequency of certain symptoms that may be reoccurring.

There are many ways to use charts to keep track of the effectiveness of your plan. For example:

Design a chart like this, done by José X. He drew one of three faces on the chart three times a day; one at breakfast, one at lunch and one at dinner. If Jose’s anxiety level was low, he drew a happy face, if moderate, a neutral face, and if his anxiety was high, he drew a frowning face. He couldn’t help noticing the differences in the pattern in his chart.

When you fill out the chart three times a day, you may be surprised at the results. For example, most mornings, your anxiety level may be high. You might think you would realize this without the chart, but anxious people are often unaware of their emotional patterns. We tend to repress most information about our problem because we find it too painful to think about.

Variation: Some people do not like to use happy faces for this exercise – they consider this image to be too childish or out-of-date. Any other image will do. Thinking up a good one can be an important part of this activity, one that calls for using some of the creative thinking techniques I discussed earlier in these podcasts. Draw four or five icons that could be used as markers for your chart, and then you can choose the one you like best. If you are a baseball fan, for example, you might use a baseball diamond as your icon. If you rate your anxiety level to be high, you could draw a diamond with no bases crossed out. If you find your anxiety level to be moderate, you could draw a diamond with second base blacked out. If you feel you did a really good job, the diamond you draw would have home plate blacked out. If you favor some other sport, an icon might be shorter or longer passes on a football or soccer field or number of pins knocked down on a bowling alley. A non-sports image might be partially closed doors to wide open doors.

As a result of using the charting activity above, José found that his anxious feelings usually dissipated by noon, and by dinnertime he generally felt much better. This pattern is quite common. I think it results from the production of adrenaline that occurs as we sleep, making the morning time seem more fraught with frightening circumstances. As the day goes on, we burn up some of our supply of adrenaline just by living, so that when we reach the dinner hour, we tend to feel calmer.

Using Drawings

Psychologists have long understood that a person’s drawings can reveal her feelings in ways that words or symbols like numbers cannot. Instruments like the “Draw-A-Person Test” allow a person to express attitudes and evaluations that she might not even be aware of consciously. This technique may be adapted for evaluating anti-anxiety plans by drawing pictures, of two kinds:

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  Realistic pictures that portray what happened while you attempted to carry out your plan.

  
  
  
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  Abstract pictures that portray your feelings about yourself before you started the plan, your feelings during the plan’s operation, and even how you feel about the plan itself.

  
  
  

You will have to exercise good judgment in interpreting these drawings. It is easy to over-analyze them. For example, one parent I know was worried because his child would come out from his room having produced drawings that were always colored in black. This father was concerned because he assumed the color indicated a seriously depressed child. When the child was asked why he only drew in black, he replied, “Because that was the only crayon I could find.” Nevertheless, you don’t normally need a Ph. D. in psychology to get a great deal of relevant and valid data from these drawings. They can provide a most useful evaluative tool.

Working with a Buddy

Anxious people often don't want their circle to know about their problems. Often, though, you can make a lot more progress with your plan if you have the help of one or several of your buddies. When you have come to accept your anxiety problem without a sense of blame and shame, then you will be able to talk to friends about it in a matter-of-fact way. Remember, it’s not your fault!

This allows you to explain your performance to your friends effectively, and also show them that you expect to be treated like a sane person who has a problem rather than someone who is not acceptable. Also, your friends are often in a better position to make judgments about your behavior than you are.

Explain what has been happening with you to a friend whom you see as being completely trustworthy. The buddy need not be the same age as you. The buddy might be another family member or even one of your not-so-close friends. If you make a daily report, you may become aware of many details that have escaped you in the heat of the day's activities. Your report can be made in person or over the phone. If the buddy is farther away, messaging or e-mail may be a quick and easy way to communicate.

Your report should be made in terms of actions taken and how they worked out, of course, but also should include your feelings about those strategies.  Your description of feelings should involve one or both of two dimensions:

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  Qualitative -- a subjective evaluation of your feelings ("I felt scared before I started my plan, and a little sad that I'm the type of person who has to do this sort of thing, but I felt great when things went okay!").

  
  
  
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  Quantitative -- how many times or how well you have performed ("I would rate my anxiety level before beginning the plan at about 8. It dropped to around 6 while I was doing it, and was down to 3 by the time everything was over.")

  
  
  

As you speak to your buddy, you are also hearing yourself review how well you have been

Working with a Therapist to Become More Objective about Your Progress

You may decide that your symptoms are not so severe that you must have professional help, and that you can probably handle the problem effectively with the help of my podcasts. Nevertheless, you may want to engage a psychologist to advise you on the plan you have formulated, to provide encouragement when the going gets rough, and, especially, to offer expert evaluation of your progress.  Creating an imaginative plan is one step, but there are numerous plans and revisions that could help you succeed in reducing your anxiety. No one is as well trained to gauge various aspects of your progress in reducing anxiety as a licensed psychologist or social worker.

Psychologists have learned that once a habit has become embedded in the mind, elements of it will pop up unexpectedly, even after the habit has been broken. This they call “spontaneous recovery.” For example, even when you have overcome acrophobia (fear of heights), later a picture of a view from a high place might set your heart racing. Don’t worry; this too shall pass.

Another good idea is to compile a list of reminders of things you need to do to make your plan work well, such as giving yourself a pep talk before an oral report.  These items should be written on cards, one item per card.  Then tape up the notes in conspicuous places around your personal space – on the door, above the light switch, and in the closet, for example.  As you work on your plan, you can't help being reminded to make spot checks on your progress regularly.

Journaling

There are many ways that you can keep a journal.  you needn't be restricted only to making notes in a notebook. For example, go to your "grokking rock,” the peaceful place somewhere in your house or neighborhood where you can get good ideas for reducing your anxiety level.  This is also a good place for doing formative evaluation of your plan. Once you have established a routine of going to your grokking rock (perhaps on a daily basis), you might bring a journal to write about how well your plan has been working. You should be able to write more freely because you are in a place where you have already been conditioned to be calm.  Leaning against the rock should encourage you to be reflective, and to write more objectively about how you have been doing.

A related strategy is to write yourself a letter describing in detail how well your anti-anxiety plan has been working. You should then mail it to yourself.  When you open it a few days later, you may discover that your evaluations were colored by your emotions at the moment.  With the passage of time, you may view the situation with a less jaundiced eye.  If you get tired of writing letters to yourself, you can always write a poem about your experiences, or draw a picture or cartoon, and mail that.

Candid Camera

Cameras can be useful adjuncts to any formative evaluation approach. There are many uses for snapshots. You can use photography as an especially productive tool when dealing with social phobias.  You may tailor the photography to your interests and aspirations. Let's suppose that you have performance anxiety -- for example, you find it difficult to speak in public.  As surreptitiously as you can, ask a friend to take pictures of you while you are in the midst of combating this phobia.  Ask her if she possibly can to do it so that you are unaware of it.  View the snapshots your friend has taken and ask her to analyze the expressions she has seen and heard, and your body language as well.  These judgments should help you get a more objective conception of your performance. I’ll have more on this topic, next week!