[60] Teen anxiety: tips for parents and students, with Alex Carling

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Teen anxiety: tips for parents and students

Today we’re talking all about anxiety. I hear of a distressing number of students who experience anxiety and I wanted to get a guest in to help.

About Alex Carling

Alex Carling is a qualified and practising psychotherapist who specialises in working with people with anxiety. She has a special interest in working with children and young people, as she has seen that the problems of most of the adults that she works with, started in their younger years and have become very entrenched by the time they have grown up. She works in private practice with children, teenagers and adults in various different settings and contexts. Alex offers local school and colleges free mental health talks which recently, a local college requested for her to speak about stress and anxiety during their students' exam period.

What we explore on the show

What anxiety is and what’s happening inside the body when someone is feeling anxious
What causes someone to feel or be anxious
How some anxiety is necessary
Advice to parents about how to help their children manage and overcome anxiety
Some quick tips for dealing with anxiety when you’re in a situation where you need to perform, like an exam or job interview.

Websites and resources mentioned in the show

Anxiety Awareness Document

Where to find out more about Alex

Alex’s website
On Facebook
Alex’s Facebook Group for Parents & Carers
Alex’s Facebook Group for Teachers
Twitter @AlexCarlingTTS
Linkedin Alex Carling Therapy

And, if you’re looking for more help with exam stress, anxiety or mental health problems, try these things out:

Episode 31 of the podcast with Daniel Licence, Teen Mental Health Today

Episode 49 with Clare Josa, How to beat exam stress with Clare Josa

And, my blog post, How to deal with exam anxiety with positive self-talk

Podcast Transcript

Lucy: Welcome to the School Success Formula Alex Carling.

Alex: Thank you, Lucy, good to be here.

Lucy: it's fantastic to have you here. So first Alex, can you tell us about how you came to be an expert on anxiety?

Alex: Yes, of course. Well I was um, clinically endorsed in psychotherapy in 2012 and whilst I was doing my training I was actually, erm, a children's worker for a local Women's Aid refuge as well. So through that period, which was 12 years and since I've been clinically endorsed to be a psychotherapist, anxiety is a big, it's almost like a really big buzzword that is around trauma, which is around attachment. So, so it's really through the process of the work that I've done on my training that I have developed all my knowledge increased my training and my supervisionary support all around anxiety. So it's an area that I work a lot in.

Lucy: Okay. And is it something you said it's a buzzword now, is it something that is happening more in society or is it something that we are just more aware of?

Alex: I think it's both, Lucy, I think we, we're more aware of it. I think we're more aware of mental health and I think the, as the, as times are changing, you know, we have access to the social media and the Internet and I think that our capacity to cope with all the additional things in life, you know, the extra hours that we work for example, and the pressures like what we're talking about today with exam pressure and things that we need, we need to develop our ability to manage that. And I think whilst we were in the process of developing the anxiety is around quite a lot. So I think it is a bit of both.

Lucy: Okay. So let's start with the basics. Can you tell us what's happening? What's actually happening to someone when they feel anxious?

Alex: Yes. Okay. So I think it's really important to say that when we're talking about anxiety, that we are never going to be without it – that actually anxiety is, um, has been fundamental to our survival as a species. And whilst we are talking about managing heightened anxiety, I think it's important to say that anxiety is really normal and we need it in order to be able to listen to it, and attend to it and keep ourselves safe, um, but with regards to, to the actual anxiety on its own is a physiological reaction to both internal and external triggers. And what happens is that perhaps it may start with a thought process or it may start with an awareness of something in our body or it could be something that we witnessed and are part of. And so that would be the external situation and our body prepares us for survival.

Alex: So that's why I say that what we need it. So when the heart rate will increase, the adrenaline and cortisol will increase and our body will totally out of awareness establish which is the best course of action. Do we need to run for the hills or are we going to fight? So that's the ‘fight or flight' which, which most people are quite familiar with, but there are also some additional things so that we can freeze. We can, we can even flop. So if our body in, you know, out of awareness process assesses the situation and say, okay, there's no point in running and there's no point fighting. Then it's about how can we preserve ourselves best. So in very extreme cases of anxiety, people may freeze and may actually flop as well and if you think about animals in the wild, the, you know, the deer, for example, they will freeze if there's a car and it's in the headlights and that's about trying to kind of reduce the impact, the damage to the physical self. And so anxiety and what happens is really, really powerful process.

Lucy: Okay. So it's basically a form of kind of self preservation isn't in its most basic form, but in society now it seems with the prevalence of anxiety is kind of gone out of control, hasn't it? So, so what's going on there? Why are we seeing more and more people finding that anxiety is a problem to them.

Alex: Yeah, you are right. Lucy is a way of preserving ourselves and you know, kind of like I said, back to survival, but there are a number of reasons why we, we experience heightened anxiety; so there's personality. There is trauma, there is um, the environment. And then our body, you know, the, it becomes if somebody experiences. Let's, let's try and create a scenario that is helpful to be able to talk about it a little bit more. So let's say that somebody grows up with quite a lot of chaos or there's a trauma. Perhaps there's a loss of a significant attachment. Then what, what can happen is that in in the process of these experiences, the person will have a heightened base level of adrenaline and cortisol so that they're used to functioning with these heightened levels. And what happens is the body and the brain can adjust to that and go, okay, so this is the environment that I live in, so I need to be on high alert.

Alex: And so what happens is then the brain and the body starts to anticipate anxiety or the need to survive. And I think that when we talk about life changing and social media and you know, the exam pressures and things, unless we're able to process it, so to acknowledge it, to allow it to inform what we do and how we take care of ourselves and to express it. So when, when I said I, I, I liken it to an energy and if we don't express and therefore release the energy it's contained within the body and that's how it manifests itself and that's how the body, then will start to anticipate and become used to it and function as a way of being. Does that make sense?

Lucy: Yeah, so it's this pent-up, kind of, um, you used the word ‘energy' didn't you? But those hormones, you're talking about the cortisol and things being heightened state all the time. So you never kind of release it and go into a more relaxed state, is that what you're saying?

Alex: That's right, yeah. And then the body becomes used to that and then that becomes the new baseline if you like. A lot of the clients that I work with can actually articulate more often than not that there has been a lot of trauma or there has been a lot of chaos and so they've not had the, the empathetic or kind of containing support of another, be it a parent or a family member to help them process and be with it and get used to it and bring it back down to, you know, that that kind of ‘normal' level that allows us to function with it at times instead of all the time.

Lucy: So, if we're not thinking about families where there's major trauma, you know, you've got kids, you know, the family is stable and it, you know, they've got other siblings who are happy and stuff and you know, people talk about social media all the time. It is something like social media and having that always in the background, always feeling like you need to be checking, always feeling like you need to be on top of it and your snap chat streaks or whatever it is. Is that generating this kind of stressed state as well as more fundamental forms of trauma?

Alex: Yeah, I think it definitely contributes to it, Lucy, and I think also I think until we have this new recent understanding of mental health and I'll need to attend to it and that we all have it and like our physical health we need to, you know, nurture it really, I think that we sometimes presume that we all have a very linear relationship with emotional awareness and our emotional development so that we just learn how to be and how to feel and how to express and we don't always. And it isn't always about trauma. It isn't always about chaos, but sometimes we just need a little bit of help to navigate it. So, so that we can, we can develop our toolkit if you like, and the strategies that we're going to use throughout the rest of our lives.

Lucy: So is it about having, you know, getting rid of the British ‘stiff upper lip' really and having permission to express what you're feeling, what you're thinking,

Alex: Hit the nail on the head. That's exactly what I talk about all the time. Even to family and friends, you know when this “never used to have it in our day”, you know you did, but you just suppressed it and you think about suicide rates and everything else that if you don't take care of yourself, it, it spills out in other ways and anxiety is a big part of that. So it is important that we get rid of that stiff upper lip and we start to listen to our bodies and give ourselves permission to be and do what we need to in order to feel grounded again.

Lucy: So with the kind of letting it out, when somebody has a panic attack, is that kind of your body releasing what you haven't given it permission to release in a different way?

Alex: Yes. Yeah, absolutely. So I often use the analogy of a bucket and erm that we need to continuously start spilling a little bit our creating some time accessing our support network, erm doing exercise because if we don't then our body will, will take over and it will do what it needs to do in order to try and reset.

Lucy: Okay. So if there are parents listening, who um think that children may be showing signs of anxiety, what would be the best approach to take? So firstly maybe if you could suggest some of the signs of anxiety and then you know, what they should maybe do to kind of start taking preventative action before it gets too bad.

Alex: Yeah. So, so some of the symptoms of anxiety would be that you'd see your, your child experiencing panic, fear, irritability and uneasiness. Now I think that when I say I wrote those down before we spoke today and I'm thinking, well they were all around for me when I was doing exams and I think that's also really important as well to put it into context.

Lucy: Yeah. Because they're pretty normal teenage, you know, it's not an easy time with the friendships and you know, changing bodies and all that kind of stuff. You're uneasy and all that kind of thing most of the time when you're a teenager, aren't you?

Alex: Yeah, absolutely. And so I think that, you know, because we are talking about anxiety, a lot more more recently, the, that that's the word that we often go to, it's like, oh, my child is anxious when actually they may have heightened experiences, but sometimes the labelling of anxiety is quite unhelpful sometimes it's sometimes adults as well as, as teenagers see it then as something happening to them instead of something that they are existing within the actually they're owning and that they can, that they can change. Does that make sense?

Lucy: Yeah, it does make total sense. And it's. So it's really about somehow being able to separate out normal teenage anxiety from something that is quite worrying.

Alex: Yes, absolutely. And while I'd like to give everyone permission to attend to it the same, I think the way that we talk about the subtle differences in the way that we talk about it and the way that we, you know, we explain things to our children is really helpful if I say, you know what kind of this is, this is what you might encounter throughout life. When you go for your first job interview or when your first, you know, relationship breaks down. And so let's talk about, you know, what are you feeling and, and what, what can we do to alleviate that? How can you help, how can you help yourself manage it? Um, so, but yeah, so, so to go, continue with the symptoms. Um, sleep is massively affected when, when there's anxiety and that can be because sometimes people get stuck in their own heads so there's lots of rumination or obsessive thinking and the one train of thought can easily trigger off another and it can spiral out of control.

Alex: And that in itself is really tiring as well. So with the lack of sleep that can cause problems, um, not being able to be calm and still; physical symptoms such as being, feeling cold, sweaty, numb and tingling in the hands and feet; short of breath. So either because we, when our bodies start to prepare and in context of anxiety that our heart beats faster and what happens then is that we're not, we might breathe quicker and our body isn't getting the oxygen that it needs. So it's about, you know, kind of being short of breath and then encouraging our teens and our children to take like belly breathing if you like, and our heart as well our heart we can often experience that we have flutters or palpitations and that that actually is a symptom that, a lot of my clients say is really worrying, you know, the, if, if they're starting to feel symptoms in their heart than they, it almost perpetuates the anxiety. Dry mouth feeling sick, nausea. um tense, dizziness, intrusive thoughts and critical thinking. They're really important ones. So, and that is one of the reasons why creating a dialogue with our children. So getting them out of their heads, getting them to draw, to write. If that, if they're creative in that way but also so that we start to develop an understanding about what their experiences are in their own heads.

Lucy: That self talk isn't it?

Alex: It is. Yeah. So it's like, so we refer to it as like the internal voice, the inner critic. But yeah, and self talk and it's sometimes in very stressful situations that can become really, really negative and can be quite scary. And so if we don't, if we don't intercept that and we don't have an awareness about or, we don't encourage our children to appreciate that that happens because I think sometimes when I speak to teens and I say, you know, “the voice inside your head”, they look at me a little bit strange. I'm like “the one that sounds just like you, but then says things that you would never dream of saying to anybody else.” But yet, you say them to yourself and it's like, ah, yes, actually I do. And so we can help them kind of start moving from that.

Lucy: Yeah, definitely. Okay. So if those are the signs, what can parents do if they start to see their children exhibit some of those signs?

Alex: I think the biggest word that I often use when I'm working with parents and carers is ‘permission'. Sometimes it's a thing that they really struggle with because in their mind they should be fighting against the anxiety – we should be trying to make them not anxious. Actually, it's about stepping into the anxiety and validating it because the more that we try and get them to stop, our children become aware that or kind of hear a message in there somewhere that this isn't okay, it's not okay to feel like this and actually we need them to feel like that, you know, what we're saying is that anxiety is normal, especially in stressful situations such as school, teenage years and exams. So it's about stepping into it and giving them permission to explore it. And, so that we are there, and that we are their sensitive other… A big, in therapy and in our parenting as well, developmentally what we need to do for emotion is help them contain it. And so that's not suppressing, or pushing away, but it's, you know, kind of being a strong person to say, I can hold this with you. This doesn't need to spill all over the place. We don't need to lose control. Let's hold it together, let's figure out what it is that we need to do.

Lucy: Yeah, I think that's quite confusing the difference between containing and suppressing it. Do you mean contain that within that intimate relationship between the parent and a child and rather than telling the whole world about it on Snapchat or something? Just go into that a little bit more so that it's clear.

Alex: Yeah, I do mean that Lucy, so it's about, you know, kind of know when, if you envisage a young child that is having a tantrum, let's say then quite often what we do is we hug them and we rock them, and that helps them, you know, kind of, where the other person and I kind of, as I'm speaking to you now, my arms are going out there like I'm holding and I'm saying we have this, we are ok, so instead of, you know, kind of holding it in, suppressing and hiding it, it's bringing it into our space. Let's hold it together, and let's, let's work through it so that they're not having then to, to find outlets in negative strategies like using alcohol and cigarettes for example, you know, to, to unwind or to feel to de-stress. Does that makes.. Does that make sense.?

Lucy: Yeah, it makes perfect sense. So really in order to process anxiety, you need to share it with someone who you deeply trust and preferably have this strong attachment to like a parent or your grandparents or something like that. Um, and not be talking about it with all your school friends and all your teachers and all that kind of thing. Is that what you're saying?

Alex: Yeah. And I think, you know, talking about it is good, but it's, it. Is it a proactive, is it, is it, is it talking about it which is doing something, but at that can also be passive because if you're not getting anything from it, if it's not serving you well then then that's where the change needs to happen. So yes, somebody that you trust, somebody that's, you know, like a strong enough other person to, to, to ride this out with you, really, this is able to give you that p word, the permission to…

Lucy: just to separate this out because there's talking about it, and then you also mentioned creating plan to deal with it and they're two very different things. And I think, you know, I've often found with negative thoughts and feelings in my life actually augments them if I talk about them or write about and dwell on them in some ways. So when I was a teenager I wrote a diary every single day and I stopped that in my early twenties because I realised all it was doing was making me focus on the negative. And so I haven't done that ever since. And um, is that, so just to unpick that a bit for us because I think there's a really clear distinction there between it and maybe wallowing in it and actually making a plan to get out of it, isn't there?

Alex: Yeah. So maybe maybe the idea of your diary was triggered when I, when I say that sometimes when we do something we think that that's a good thing, but actually it can be quite passive because it just sustains the stuck place, which is what I'm hearing you said that the writing about it was potentially, you know, it's a way to express and release it, but actually you find yourself staying within the negative points of your diary. So I think the, you know, if you were to stop doing that, then what can we, what can we replace it with? What is it that if you find yourself stuck with the negativity, what is it that you can then do to help you let go of the negativity? So is it that you might speak to somebody about those negative things and help you rationalise them or to see them differently or to get a different point of view? Um, but if you are on Snapchat for example, and there's nothing happening on the back of that, that you just posting it out there and lots of having lots of witnesses but nothing's actually benefiting you, that you're still kind of the, you, you keep posting stories and pictures and nothing is actually changing and you're still feeling as negative as you did when you first started.

Lucy: So can you think of an example that we could talk through, like of something that might have happened to a typical teenager that, you know, that kind of model way to work through it? Can you think of anything?

Alex: Um….

Lucy: Maybe like they've fallen out with their friends. That's something that I find a lot with girls in particular that they're always falling out with their friends.

Alex: Yeah.

Lucy: So would the right be.. The way, the way to deal with that to be to talk to your mum and then rather than just talking about, well, nobody likes me. Why, what are they picking on me? And all that kind of stuff, you know, like what can we do to, can we, can you join a club and make different friends there? Can you… Just forming a plan like that.

Alex: So as you said that something came into my head, there was a few years ago, there was um, an instance of a photo getting into the wrong hands so that the young person was under 16 and there was a photo and she confided within the therapy space, um, and what, what she was doing was, was, accessing support from the people that she found to be close friends. But that support was very much about not, not tackling it head on and being able to put safe boundaries in place for herself and learning you know, kind of what happened. How did that happen in the first place and what could you do in the future to to avoid it? So because she was working with me, that's something that we were doing. The talking was still the common thread if you like, but it's who she was talking to you that was different. So I was acting as her significant other her attachment figure in that moment and about saying, you know, kind of about her self worth and boundaries and about what's okay and what's not okay and about separating responsibility out, but she wasn't able to get that from her friends. Her friends were just kind of like a, you know, it's funny, or…

Lucy: They didn't have the maturity or the kind of objectivity to help her unpick the problem and move forward.

Alex: Yeah. And then to add to that then, that I wasn't going to be constant attachment person, so it was about encouraging her then to access her parents for that and to be open and to confront her fantasy. Thinking about what might happen when her parents found out that this had happened, for example. So, you know, it's a very much a, it's, it's a I guess… Um, the words to be able to describe it. It's about being proactive and about creating a shift and feeling as the problem is moving and being alleviated that that is a positive strategy as opposed to a strategy that… When nothing changes.

Lucy: Yeah. And just thinking about the parents, you know, if we're saying that parents need to be this kind of go-to person that helps, so listens so their child can let out this negative feeling but also helps them to form a plan. And I can think of a couple of things that might get in the way of that as far as parents are concerned. But from your experience, what, what are the barriers to parents actually acting in that role?

Alex: Not knowing how to. I think that we can only parent with the capacity that we have and that we parent with the experience of our parents' parenting; the permissions that we get from our own support network, you know, the way they parent and the advice that they give. So sometimes we have really limited resources like, you know, like, well I kind of get that. That's what she needs, but how do I give her it?

Lucy: Things that, you know, I've, I've witnessed things like, you know, you were talking about like that girl, with that photo that got into the wrong hands, like some parents' initial reaction might be anger to that and you know, the anger would put up this barrier where the child wouldn't be able to communicate and it's so hard for parents, there are always, particularly teenagers they're always trying to kind of censor what they're trying to say to make sure they're saying the right thing and all that kind of thing. But it's just having that awareness, you know, what is the right reaction in this situation? What is actually going to be the most productive way to react to move forward through this?

Alex: Yeah. And I think, you know, as parents we, we always try and protect our children from things,don't we, and in, in doing that to a degree we do them an injustice. So when I, when I speak to parents in a, in a coaching capacity or therapeutic parenting capacity, it is very much about, you know, like we're saying, if your child is anxious, step into the anxiety and help them explore it also, whatever it is that you want to protect your children from model to them, how you do it, how you would want them to deal with stress and anxiety and to show them that flexibility. This is my thinking when I'm stressed and this and I'm really aware that my heart flickers sometimes when I'm, when I'm trying to get to sleep and how concerning that is. Um, but what I did was I went to speak to Auntie Julie and you know, we kind of, we did this and we did that. And it's about, that's where children get permission from as well. That when we, and it's really important that whatever permission we give our children, that we put it into practice ourselves. Because if we don't, then we are showing them an incongruency. Says, I want you to do this, but I don't give myself permission to do it. So on some level I'm telling you that it's okay, but don't fundamentally believe it.

Lucy: So we need to role model, but also maybe talk about our own experiences about facing difficulties and hard times and all that kind of thing.

Alex: Yeah. And the compassion as well, Lucy, you know? I think that especially with social media that we can be very critical when we see somebody struggling or when we see them make a mistake, like post a picture an inappropriate picture and you're like, wow, can't believe she did that. And it's like where is the compassion? Because when we see when, when children see their parents and adults show compassion, they pick up on the compassion and when we're able to give compassionate with people it will increase the likelihood of being able to give it to ourselves as well. So when we're in times of stress like exams or just adolescence in general, we're able to have a more nurturing self-talk as opposed to that critical one.

Lucy: Yeah. Sorry, that was just one other thing I was going to say is that with parents I think often as well if you've got a very anxious child, it becomes very… It drags you down as well and you know if they're always feeling anxious, they're always feeling negative things and you've always like every day you're having to listen to this and that's really tough to be coping with and I know you do it professionally but you know how, how as a parent can we sustain that and be dealing with that all the time?

Alex: Yeah. I mean, you know, you said that I do it professionally, but then you know, I have to make sure that I have access to therapy should I need it if I'm feeling overwhelmed or the I have regular supervision and I'm able to…or somebody like when we're saying for our young person we help them re-frame it, we help them start to move and change. Either it's the thinking or the behaviours and likewise I have that with supervision so it's always a way to continuously empty that bucket. And so we've just said about modelling, modelling anxiety and stress and the ways the world can play with us at times and it's exactly the same. So if you have a child that has an anxiety that you need to look after yourself as much as you want to look after your child that you will model it, you'll model really healthy strategies by doing that, you will be, you'll, you'll develop your resilience and you will be more resilient each day as your, as your child needs to kind of take that little bit more from you because you know we all have a limited capacity don't we, and if we are overworking or we're not getting enough sleep and we're not accessing support, then we're going to snap and we are only human and that does happens. But when you're, when we're talking about preventative strategies, that parents then, if there's pervasive anxiety around in the home that looking after yourself and being able to nurture yourself like you want to nurture your child is really important.

Lucy: Yeah. So you've got to have that outlet, that person that you trusted person that you can go to and express your own frustrations and fears and worries and all that kind of stuff as well. The other thing that I was just going to say before we moved on is that I'm very aware that I have a tendency now – I don't think I had it when I was a teenager, but to always jump to the solutions first. So how important and and you know, not want to dwell on the negative. You know I want to hear the problem and propose a solution and move on. How important is it to have that space in the middle there to just hear and empathise with someone before you move onto the solution?

Alex: It's really important because that's the…That's the expression part, that's the release of the emotion and if we, if we don't do that, then what can happen is that we can start to override it and then we are in our physiology, our physiology, our emotion, and our emotional experience with each challenge I guess almost gets censored and then it's no longer informing the decisions that we make on help shaping our thinking process so it's really important, but like you say, it's also really important not to get stuck with it. I don't know about you, but you know, the, the clients that I work with, I, I work on a very, very visual basis so it helps me to see more clearly if I'm writing things down. So I've got a whiteboard in my office and I'm always using that to help clients to kind of unpick and see, see their internal space, in the external space. Um, and I think I have a plan. Actually I could, I could send you it, which is, you know, when it comes to exams being having boxes for my head, my body and my emotions, my behaviour, you know, what is it that I'm aware of, am I, am I attending to it or am I ignoring it? And as you are able to kind of create an external process. It just helps you factor in the middle bits, but also come to that, that fundamental conclusion about how are you going to solve the problem.

Lucy: Okay. So I think that that leads nicely onto my next question, which is about teens and rather than parents how can teens themselves manage their own anxiety, and maybe linking that into exams and you've just talked there, it's like, it's almost like a mental checklist or a visual checklist, you know, check this part of me, this part of me to see how I'm doing. Is that what you're talking about?

Alex: Yeah, absolutely. And I think that because exams and adolescence that go hand in hand, it can, it can be quite blurred, the boundaries and what's, what works and what doesn't. And I think I often, it's almost like a mantra. “What serves you well, what is it that serves you well?” So if you think about the, the, the, the categories that I just listed that there was emotions and there was cognitive. So like your thought process and things, but particularly behaviours. I think they're the thing, that is a place where a lot of teens invest a lot of energy is in the behaviour because our behaviour suggests then that we're growing up that we're separating from our parents that we're getting independence. So I think that the behavior for me is quite significant. If we think about some of the negative strategies that people or children and teens may use, so it's about ignoring the symptoms, you know, like suppressing it and just keeping it to yourself, avoiding the problem. So you know, I have a deadline and I'm going to go out anyway and the body will take the hit for that This can minimise the importance of what's going on, you know, like I really, really want to do well in my exams, but it doesn't matter if I don't. There's a real incongruence there which is about avoiding and us trying to escape the problem.

Lucy: So those are all really part of the fight, flight, freeze, flop things that you talked about earlier – they're different ways of dealing with that stress, but actually not dealing with it. Like, you know, putting it off for another day.

Alex: Yeah. Really passive. There's, you know, there's the proactive types and then there's the passive types which are all doing, but some of the things just let the problem manifest and perpetuate, um, you know, leaving until the last minute, being stuck in your own head, you know, just kind of going round and round, like you said, like focusing on the negatives, using alcohol and cigarettes to unwind, um, and using excessive caffeine to stay aware and being sucked into other people's negativity. That's a really big one, you know, almost to justify your. own?

Lucy: Yeah, yeah, definitely. Yeah, I see that quite a lot.

Alex: So I was going to say that the positive then would be is to exercise so that when we talk about the hormones, the adrenaline and the cortisol, that the endorphins help balance that out. So when you're exercising, you're shifting the energy, you're oxygenating your body and you're releasing the endorphins. So you're giving. Because this isn't just about managing the external, we really need to attend to and be accountable to the internal experiences. We are working against hormones. So hormones matches hormones, but you kind of bring the positive, the endorphins ones in. Getting some fresh air, so I'm sure that you speak a lot about, you know, kind of taking revision breaks and things like that, but it's about, you know, kind of not staying in the same space, the same area that you're revising the same thing that's maybe creating part of the overwhelm so to go out and get some fresh air and see somebody, kind of call somebody up. So getting out of your head so we speak about that a lot. So to use your body then, so that might be to stretch, um, to, to create sensations when we create a sensation with our body, it gives our brain something new to process and that can be really helpful.

Lucy: These are all just basic things that every body needs, aren't they, ways to keep yourself healthy and balanced and well, aren't they? I think it, you know, the society we're in has kind of taken us away from a lot of that a lot of the time.

Alex: Yeah. It's almost like we don't have the time for it or we're not, we're not validating how important it is.

Lucy: Yeah. The other thing you mentioned right at the beginning as a symptom of anxiety, was poor sleep. How important is good sleep in, um, in combating and preventing anxiety?

Alex: Sleep is when we, when we sleep, when we have good quality sleep, so it's not when we're kind of, you know, smoking cannabis or you know, lots of caffeine or alcohol in our body, that really impairs our sleep. So we need really good healthy sleep. So it's about having an environment that is, that promotes sleep, so something that smells nice, something that's visually nice, something that helps us feel relaxed, that then in turn that helps our body repair, but also if we are well rested, we are more resilient, we are more able to, to manage the overwhelm and the intensity of emotion, especially through something like an exam period.

Lucy: Yeah. So basically the big tips for preventing and managing anxiety over the longer term to do basic healthy things like sleep well, eat well, exercise, get fresh air, socialise with your friends and family, like face to face, not on the phone and all these kinds of things that just make up a healthy human being aren't they?

Alex: Yeah. And to start early, to start that all those things early, Lucy. So instead of, you know, kind of waiting until the exams are on top of you to try and engage in some of these. It's not one size fits all. Sometimes you need to find your own groove. Find out what works for you, what really serves you well, what energises you and what depletes you, what takes away energy, even the people, what people energise you and what people you know, kind of make you feel exhausted.

Lucy: Yeah, and I've got a module inside The Extraordinaries Club which helps guide people through some of those questions as well about what builds you up and what knocks you down and all that kind of thing so that you can identify the more positive things that you're able to do to kind of sustain that energy and health through, you know, through your life really as well as exams. So just as a last question, Alex, I'd love to ask, if somebody does go into a stressful situation like an exam or an interview and they find themselves heading into an anxiety and a panic attack, is there anything they can do in the moment to pull themselves back and rescue that situation?

Alex: Okay. So again, this is very much a case of finding what works for you and it's about acknowledging that you're in quite a confined space and there's very limited things that you can do, but you can do a lot of things from your seat. So quite often having, having a visualisation, so a place where you feel would normally feel calm, held, secure, safe, and at peace whenever you're not normally stressed. So either that's like a holiday location or it's a place in your house or it's being in the arms of somebody that kind of makes you feel all those things, you know, kind of like a mum or a dad and being able to to use your headspace. Nobody can take that away from you. Nobody can ever know what's going in there and being able to visualise, so visualise something that helps you feel calm and also deep breathe, so we need to get oxygen around the body. Our body cannot feel anxious and relaxed at the same time. So with practice you need to work on retraining and being in control of and relaxing your body. So the deep breathing, the kind of circulating your wrists, having a little bit of movement; moving your ankles, rolling the neck, things that kind of just allow your brain to process something different as a new sensation. There's new things going on and your body will start to react to this. Kind of like, okay, so this isn't what happens in stress. This is what happens when we're relaxed and you can start to gain control again. Something that often helps is a physical sensation, Lucy. So I know that when I first started my training and I was, I was thinking like you have people have elastic bands on the wrist and kind of snap them as a physical sensation. I think that's quite um, quite intense, but I think also, you know, in exams we have pens and we might have a key ring or we might have a brooch and I think that having that in your hand and again having a physical, a physical, something to touch helps the brain process it, but also helps you focus on the sensations so that you can, you can leave the inside space of your head and the panic and you know, along with the deep breathing and kind of focus on what something feels like. Using our senses when we are in heightened arousal. So what we could focus on what we can see, but not just the vase in front of us but the water stains on it. They, the engraving on it, the colours of it, the part of it where the colour started to wear off, really narrowing your focus with all our senses, what we can smell, what we can taste, allows us to disengage from the thoughts and the feelings that are causing us panic.

Lucy: Yeah, and what you're talking about mindfulness isn't it? So if you practice mindfulness in the run up to an exam, even if it's just like five minutes a day with a mindfulness meditation or something that, that, that will give you the tools that you need if you do have a panic attack, but I think it also makes you less likely to have the panic attack in the first place, doesn't it?

Alex: Yeah, and I think you know, these things that it's hard work, especially if you've got… If you're in a place where it's already escalated and now your body's just kind of responding to nonthreatening situations like they are a threat is really hard work. I think that's the importance of us knowing that this is… It's within us. Anxiety is within us. It's not something that happens to us. It's not something that is caused by anything external. It is our body and we need to invest the time, the patience and the love in order to be able to get back on track. So the earlier that you start the better and you know it's consistent the same way as you know, training to do a long run that you need to allow your body time to adjust and develop the muscle and develop the strategy so that it becomes normal way of being and you're easily then in times of stress, able to pick it up.

Lucy: Fantastic. Well I think that's a great place to end, Alex. So is there anything else you'd like to share with us today or do you just want to tell us where we can find you and how we can find out about working with you?

Alex: I think we've covered, covered the anxiety and the exams for teens and stuff quite extensively. There are things on my blog which is www.counsellinginhull.co.uk and I also have. I'm on Facebook, I'm AlexCarling.therapy and I have a group, a closed group for parents and carers, which is all around self esteem, confidence and mental health, lots of anxiety and I have units within that that help people, um, so kind of like process through all the blogs and the video content and I do live videos as well. Um, so, and you can find that through my page. If you're a twitter user is AlexCarlingTTS and Instagram is AlexCarling.Therapy too, but I really do… It's a huge passion of mine to, to support parents and carers. Predominantly, I work with adult clients in private practice, a few teens and I've had a few six year olds recently come through – little teeny tinies, where parents are really starting to value, you know, the, the, a little bit of help just helps people kind of think outside the box and get themselves grounded again. And I really welcome all questions. Um, I create all my content around anything that the people on social media particularly ask. So yeah, feel, feel free to come and join us.

Lucy: Well, it's been absolutely fantastic and really insightful today. Alex, thank you so much for sharing your time and expertise with us.

Alex: You are very welcome. Thanks for having me, Lucy.