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Kill the mental chatter the second it starts. Stop the self-pity and self-doubt conversations. Stop the inner-negativity. It's a bad habit. Tell the mental chatter, as Jocko Willink puts it, "I'm busy. Come back later when I'm not!" Stop worrying about what the voices are saying. Stop listening to them. When it needs to happen, silence your mind and just get it done. Tame your mind. The scared, doubtful, insecure, and disbelieving voices don't get a vote. They have no business in what you do and how you do it. Consciously practice silencing the voices when they're starting to talk too much and create doubt. The more you do it, the easier it becomes until, eventually, it's automatic and your mind is always silent. Kill the thoughts and voices. Kick them out. They're not welcome. Look for EVIDENCE to challenge your thinking. If you believe you always get things wrong', think about occasions when yougot things right'. Check out your thinking by asking people what they really think rather than simply acting on what you believe - your beliefs are only assumptions. Learn to be your own best friend.

Ask yourself what you would say to a friend in the same position. Don't you think it is strange that we are often kinder to others than we are to ourselves? Use the idea of preference' versusabsolutist' statements like should'. <a href=''>When</a> you useshould' you are really saying that the world and the people in it (including yourself) absolutely must behave a certain way. For example, I really would prefer to get things right all the time' instead ofI must not get things wrong'. There is nothing wrong with wanting to do well or wanting others to do the things we would want them to do. However, there is no rule that other people should do what we want, or that just because we want something we should have it! When you find yourself thinking in an extreme way, look for the middle route. For example, could you break the task down into stages? Did you manage to do some of what you set out to do? If so, give yourself credit for what you have done. Challenge your filter by writing down three good things that have happened each day. Watch out and listen for positive comments and when you find yourself worrying about something someone has said, ask yourself if you are ignoring the positive comments. When you tell yourself that what you have done doesn't count, stop and give yourself a pat on the back. Make a point of finding someone to speak to out loud about what you have done. For example, I am really pleased with the way I spoke up'. <a href=''>When</a> you call yourself a negative name like stupid, a failure, or no-good, ask yourself what you really mean. <a href=''>After</a> all, what makes someone a failure? <a href=''>You</a> can fail at something like an exam but failing at something is not a failure. <a href=''>It</a> does not discount the positive. <br /><br /><a href=''>When</a> you find yourself blaming yourself (or other people) because you believe it is your entire fault, draw aresponsibility pie'. Think about all the factors of the situation and how many people or circumstances have contributed to the outcome. As you carve up the pie you will see that you are only one part of a much bigger system. Only take responsibility for what is yours, learn from the situation for next time, and speak to others about their part. Anticipating future threats is the essence of anxiety. As most of us know from our personal experience in other contexts, however, we are very often more afraid of something before it comes than we are when we are actually facing it. Think of going on a roller coaster. When do you experience the most fear and trepidation? During the ride itself? Or during the long wait, when you are staring up at the towering contraption and its huge falls? Chances are, it's the latter. Three researchers who have done much in the field of happiness research--Shigehiro Oishi, Ed Diener, and Richard E. Lucas--tackled the question of whether people can be too happy. They drew on vast amounts of data pulled from four large longitudinal surveys, a huge cross-sectional survey, and more, which added up to more than 100,000 respondents. They found that those who experience moderate levels of happiness (rather than the highest) are the top performers when it comes to income, education, and other areas. Some of the reasons the researchers suggested: If you're completely happy with the current condition of things, you are unlikely to push yourself toward greater achievements in career and education. On a national or global level, individuals who are satisfied with the current state of the world are less likely to attempt to enact change or get involved in politics or activism. But in the same study, when looking at relationships and volunteer work, the researchers found that the ultrahappy performed the best. It seems when it comes to making friends, there is no such thing as being too happy. They concluded that "the optimal mindset for an intimate relationship might be to see mostly the positive aspects of the partner and relationship, whereas the optimal mindset for income, education, and political participation might be to simultaneously consider the empty part of the glass as well as the fullness of it." The same is true with a panic attack: its bark is worse than its bite.

Contrary to some long-held cultural beliefs, addiction is a disease--not a character weakness or a failure of will. The persistence of these prejudices may make it risky for me to discuss the dimensions of character in addiction, but as a psychiatrist I have learned that understanding people's character is a useful way of appreciating how they see the world, how they are apt to engage in relationships, how they respond when stressed, and what psychological capabilities they can bring into the work of overcoming an addiction and remaking a life of dignity and contribution. This exploration of character is another way of considering the factors that matter in addiction, here in the context of real people's psyches and lived experiences. I recall being on call as a resident when a twenty-four-year-old man, Antonio DeLuca, was brought by ambulance to a local emergency room in the middle of the night after impulsively taking a "handful" of acetaminophen (Tylenol, which most people do not know can cause severe liver damage, even death, when consumed in excess). His sister, who had called an emergency line, said that he was famous for brief, intense attachments followed by angry disappointments with vindictive and self-destructive behaviors. His job history too was spotty and tumultuous, with a trail of angry former employers. Antonio's parents no longer welcomed him at home because he typically blamed them and was prone to steal if not watched. He episodically drank heavily and used cocaine when he could afford it. Once medically stable, his stomach pumped and IV fluids given, he complained that his girlfriend was not taking good care of him, expected too much of him, and had ended the relationship, such as it was. He had recently, as well, lost a job as a construction worker for picking a fight with a coworker. When emergency-room professionals tried to get him to think about his next steps, he was sullen and evasive. He remarked, "If you trust anyone, they will suck you dry." While I did not see him again after that troubling encounter, I have seen many other men and women with the same constellation of addictive and impulsive behaviors, contentious relationships with family and others, inability to sustain employment, and an externalizing view of the world, where others are always perceived to be the problem and are always responsible for any difficulties rather than the person himself. That profile does not augur well for gaining control of an addiction and making a better life, though at times I have been pleasantly surprised to see someone gain mastery, over time, and regain a proper place in the world. Four years after the incident in that concert hall, I now live my life largely without anxiety, and without limits, it once imposed on my range of life options. I travel routinely for work on planes and the subway, I ride elevators, I go to concerts, and a whole range of other activities that once felt as if they were next to "impossible" for me. Moreover, I reached this point without the use of medication. In Chapter 6 of this book, we will discuss some of the simple methods I used to begin to regulate my panic responses and to reach this result. If you are struggling with anxiety, the chances are that this is a thought that has occurred to you in the past. Anxiety can strike people at many different stages of their lives, and some reach their early adulthood, or even later, without noticing any symptoms of anxiety. When people do first start to experience anxiety, it can feel as if it "came out of the blue." Things that used to be extremely easy for them to become difficult - or even come to seem "impossible." People who were immensely sociable in the past, for instance, and had no trouble going to parties and meeting new people, may suddenly start to experience forms of social anxiety or phobia that keep them at home.

(See Chapter 3 for a further discussion of social anxiety.) So too, people who have flown around the world or across the country without any concern throughout their lives may develop a terror of flying that prevents them from setting foot on an airplane. We might call this important insight the "Samuel Butler principle," after the famous British author because he once summarized it in a, particularly pithy way. To paraphrase slightly, he wrote: "Life is so much more often an affair of being frightened, that it is of being hurt." So it is with panic attacks. They are very often frightening. But they do not have the power to harm. This can lead to a frightening sense that one's horizons are shrinking, or that one is losing abilities that one used to have in the past. In the classic novel by Nobel Prize-winning author V.S. Naipaul, A House for Mr. Biswas, he describes this feeling in the context of his protagonist's struggle with symptoms that we would now recognize as an anxiety disorder. He notes that his protagonist is unable to imagine how he could have interacted socially with other people in the past when he now finds it so terrifying. "His whole past became a miracle of calm and courage," writes Naipaul. Naipaul knew whereof he spoke. A House for Mr. Biswas - considered by many to be his masterpiece - is based on his father's life story. Toward the end of the novel, Mr. Biswas - the stand-in for Naipaul's father - realizes that his son is experiencing the same symptoms of anxiety and depression he once went through and sends him a book in the mail (perhaps a book much like the one you now hold in your hands) that will help him manage the symptoms. All of these events correspond to things that actually happened in Naipaul's life. Sometimes, to win an argument, it can help to get a bit angry. And sometimes getting angry can be healthy for you. That was among the findings of a study of 175 people in which the participants role-played exercises.