The No More Worries Book. By Dr. Lewis (the worry coach)

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1 The No More Worries Book By Dr. Lewis (the worry coach)

2 Hi! Do you ever get all stressed out about things? Does this happen a lot to you, or someone you know? Some people have too many worries. This can make them unhappy and stressed out! I work with kids who have worries, and this book is for you to help you figure out what you worry about and how to get rid of those worries!

3 There are lots of kinds of worries that kids have. Some kids worry about things that might happen. They use words in their head like What if this happens and What if that happens. Or they spend too much time thinking about the shoulds!!! These thoughts sound like he should do this, I should do this, I wish she would do this, etc. etc All of these worries are NO FUN!!! They make you feel yucky. We want to think about ways to get rid of these kinds of worries. If you don t have these kinds of thoughts, then GOOD FOR YOU!!! If you do have them, then let s start working to chase those annoying thoughts away! Some kids worry about things that already did happen. They use words in their head like I wish I had, or I wish I had not.. These worries are NO FUN!!! You can t change the past, so why spend time worrying about what did happen, or what could have happened, or should have happened? Move past those thoughts and BE HAPPY!!!

4 Some kids don t worry at all, but their bodies feel yucky all the time because they are NERVOUS! Their brains may seem quiet, but their body tells them that they are STRESSED OUT! These kids might have stomach aches, or headaches, or all kind of body feelings that just don t feel good. Kids who worry a lot also have stressed out bodies, so they can have the same stuff going on! We can learn how to relax our bodies so they don t feel yucky anymore. Some kids have FEARS and PHOBIAS. These are things we are very afraid of, but maybe our parents keep telling us that there is no reason to be afraid. Like, maybe, being afraid of dogs, or bugs, or water, or whatever. Fears and phobias can cause a lot of problems, so we absolutely want to make sure we get rid of these! Sometimes fears and phobias show up in other ways, like maybe being afraid to be away from your parents, or afraid to sleep in your own bed at night, or even being afraid to go to school! Fears are definitely no fun, but we can find lots of way to tame those fears and make them go away!

5 Some kids tell me that their brains just won t ever be quiet. They have busy thoughts all the time and a lot of these thoughts are not very kind or calm or even very nice. They would like to learn to have a quiet brain. We can do that! Some kids tell me that they have obsessive thoughts these are thoughts that just don t really make sense, but the thoughts won t go away it s like a bad record that just repeats over and over and over again!!!! This is very, very annoying! Other kids have behaviors that they do that they can t stop things like pulling their hair out, or washing their hands, or maybe even something like clearing their throat or cracking their knuckles. These are things our body does that we wish we could stop doing, but for some reason we haven t been able to make it stop. This is also very, very annoying! But I know how strong you are, and I know that we can make these annoying obsessive thoughts or behaviors go away for good!

6 All of the above things have official names, but I d like you to write down your own worries on a piece of paper and then lump it all together and give it your very own special name. We can use the proper names like anxiety, and OCD, and Phobias, and all that, but those names are boring. So let s think of a name for your worries maybe the worry monster, or GBG (goofy brain glitch) or Gumba, or whatever! Then draw a picture of what those worries might look like if we gave them a shape or a body. This will help us have a picture of what we are going to fight back against! So, here s the thing it s totally normal to have all of the above worries and symptoms. No big deal. But maybe you have MORE of these things than most people and we want to get things back into balance again! It might be because your body just likes to be stressed out more than most people maybe your body thinks you are in high gear all the time and should be stressed out!!! Or maybe it s because you have a little glitch that makes your brain forget that it s supposed to turn off. Oops, bummer about that. But don t worry about it we can learn to turn that brain glitch off just like when your computer or game system has a problem we can always find a way to fix it! The important thing to know is that it s not your fault you didn t do anything wrong, you just got one of those brains that likes to be stressed out! But we can teach your brain to relax!!!

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8 Good Job, hopefully you are still with me you re doing great! Now, let s write! First let s try writing down ALL the worry thoughts or fears or body feelings or whatever. Make a big long list of all the things that make your brain or your body crazy! Then see if you can write down, with your parents help, the times that those things bug you the most (like, maybe at bedtime?). If you don t know, then try keeping a chart for a week and write down the times that each of these things bug you. This will help us figure out just how much of the time your worries are bugging you and how strong they are!!! There s a chart at the back of this book to help you with this. Now let s write down our goals what do you want to fix here? If we write it down, then we know what we are going to work on! You are the one in charge here I need your help to tell me what we want to work on! Ok now bring all that back to me and we ll work with it a bit next time I see you. Thanks so much for your help!

9 So, now we get to move on to the next thing that s going to help you. We have to make an imaginary TOOLBOX for you. We need to come up with some ideas of what you can do when you are worried or stressed so that you can chase away those worries. These will be your worry tools! Let s start with MY list, and then you can add your own things to it and make your OWN list! When you have a good list, and you practice these things regularly, then you will have a whole set of TOOLS that you can use to help chase your worries away! And you ll keep them all handy in your brain, so you can use them whenever you need to! It may not seem like this will work, but all of these ideas were given to me by kids and it worked for all of them, so I know it will work for you too! On the next page, you will find a stress chart. This is a good way to think of stress we kind of move up and down the stress scale. Sometimes we are at the bottom, sometimes we are at the top! Hopefully you can learn to stay at the bottom of this stress scale all the time! Our Tool Box ideas will help us figure out how to stay at the bottom of the stress scale. Just use your tool box whenever you start to move up the scale!

10 Big Time Stress Getting pretty anxious Calm and relaxed This is a stress scale. How can you stay at the bottom?

11 MY LIST OF WORRY CHASERS: 1. BREATHE. Try taking several slow, deep, belly breaths. Breathe in nice and slow and feel your tummy getting big and round when you breathe (that way you get lots and lots of oxygen) Maybe count to five as you breathe in, and five as you breathe out. Super slow, relaxed breathing helps your body relax! 2. MUSCLE MAN when your body feels all tense and yucky you can use muscle man. First, you take a couple of slow deep breaths. Then, you tighten up all your muscles as tight as you possibly can (but don t hold your breath at the same time you ll get all red and funny looking!). Hold those muscles super tight for ten seconds, and then let them all relax all at once so you feel like a great big rag doll! See how warm and relaxed you feel? That s a good thing. You can also do this one muscle at a time tighten and relax each muscle, one at a time, and go all the way through your whole body. This is a great exercise to do at bedtime to help you relax pair it up with deep breathing and you ll be relaxed and calm in no time! 3. Q.R. The Q.R. is a Quick Relaxation you should practice it a lot! Several times a day stop what you are doing and take a nice, slow breath. Then relax your muscles and think of a happy, confident thought. This only takes a couple of seconds, but if you practice it several times a day, then your body gets really good at relaxing quickly and you can use the Q.R. when you start to get stressed! Remember, though practice makes perfect it won t work unless you practice several times a day when you are NOT stressed out!

12 4. POSITIVE THINKING First you have to CATCH your negative or worry thoughts as they happen. Now, tell your worry thoughts to STOP and go away then quickly replace them with happy, positive thoughts. Tell yourself how calm, relaxed and happy you are, and how strong and awesome you are! Think of you best day ever, or your favorite place in the whole world. Fill your brain up with happy and positive thoughts and the worry thoughts won t have any room to stick around! 5. TALK to someone find a friend or an adult who you like to talk to. You can use this as a way to distract yourself from your worries talk to a friend about anything at all and you won t have time to think of your worry thoughts! Or, you can talk to an adult about your feelings let them help you sort your problems and thoughts out. Together you can think of some solutions to what you re worried about. You can also get a hug from a parent or teacher when you talk to them this helps a lot! 6. DISTRACT yourself find something interesting or fun to do you can go outside and play, listen to music, sing or paint or draw, read a book, hang out with a friend, play a board game, help your mom with chores, play with your toys, watch television or play video games (if you are allowed to) Pretty well anything that is NOT worrying will work the more distracted and busy you are, the less time there is for worry thoughts to get in the way! 7. EXERCISE. Any kind of physical activity helps chase worries and yucky feelings away! Take a walk, shoot some hoops, take your bike out, or ride your skateboard. Any kind of exercise is great! If you are stuck indoors, then you can do some quiet exercise like jumping jacks or push-ups!

13 8. LAUGH!!! do something funny, tell jokes, watch a funny video, or whatever these things help chase anxiety away because you can t be laughing and anxious at the same time! The more you laugh, the less you worry! 9. READ or LISTEN TO MUSIC. This is a great way to relax and chase away worry thoughts especially if you make sure you are reading or listening to something that is interesting and keeps your brain busy and happy! If you play an instrument, then playing your favorite songs can help you a lot. Or just sing! Anything to help your brain calm down! 10. Time for your OWN thoughts - add in what works for you! GREAT JOB!!!!!! I am so proud of you you are doing great!!!!!!!!

14 Now, it s important that you PRACTICE your worry tools a lot, if you don t practice them when you are calm, then they may not work for you when you are really stressed out! It s easier to learn to use these tools when you are in a happy and calm place!!! The more you practice, the stronger you will get!!!! YEAH!!!! So now that you have a tool box, and you ve practiced those tools, and made sure that they work for you now we can use those tools to chase away your worries! Go back to your stress scale and write along the right side of it. Write down the things that make you move up the scale. At the bottom you can write out the things you do to relax. Then in the middle you could write out the annoying things that get your sort of stressed out and worried or afraid. Then, at the top, you could write out the MOST STRESSFUL things that happen to you, or the worst things that your brain thinks about. Next, write the things you will do to calm down as you move up the scale. So, on the left hand side of the scale, write some of your favorite tools that you can use to relax and calm down again. Now, take this stress scale and post it somewhere, so you will remember to use it!

15 PART II Now I m going to talk about each kind of worry specifically. You can just skip to the section that helps you the most. 1. Fears and Phobias 2. Negative Thinking and Busy Brain 3. Panic Attacks 4. Separation Anxiety 5. Obsessive Thoughts and Compulsive Behaviors. There are more types of anxiety, but these are the ones that we ll talk about in this book! Remember, this book is your helper we ll be working on all these things together too. Some of this stuff won t make sense until you talk to me and I can explain it to you, so don t get stressed out wondering why you don t understand it all yet!!!! We ll get through this together!

16 FEARS AND PHOBIAS I m going to start with fears and phobias. If you have fears and phobias, we need to tame those fears and chase them away. Here s a great way to do that. The name of this TOOL is systematic desensitization isn t that a cool word? Anyway here s how to do it: 1. FEAR SCALE: Make a list of the things you are afraid of. I ll help you with this when you see me. Now let s take a few of them the really big ones and let s divide them up into smaller steps. Write out a list of numbers from one to ten. Think about just ONE thing you are really afraid of and think of all the smaller parts to that fear. Write down the part that you are LEAST afraid of on the number 1. Let s say you are afraid of dogs, but you are OK with seeing a dog far away so that might be a number 1 for you it s just a little scary, but not too bad. Now, go up the number ladder and write down more small parts of that same fear. Maybe being in a room with a small dog is only a number 5 on the fear scale for you, but petting a big dog, or feeding a big dog a bone, would be the worst kind of dog fear activity you can even imagine! So that would be a number 10. Once you have a list like this, then we ll move onto the next step.

17 2. Take your list and set it aside for a moment. Now, do something relaxing, so that you feel all calm and relaxed. Now go back to your list and read and think about the number 1 thing how do you feel? Are you anxious at all? If so, then stop and take a few deep breaths and relax again. Keep doing this until you can think about and imagine the number 1 part of your fear without feeling any anxiety at all. This might take several practice sessions (only practice for a few minutes at a time maybe once or twice a day). Once you get good at imagining your lowest fear scale item, then move onto the next item and do the same thing keep imagining it until you can think of that in your head and not feel any anxiety at all. This is training your brain to not feel anxious when you IMAGINE doing those things on your fear scale. After a few weeks, you should be able to imagine doing even the big number 10 thing without any anxiety at all. You ll practice it in your head until you feel relaxed and calm thinking about it! GOOD JOB!!!! I m very proud of you this is a tough thing to do, and you did it! WAY TO GO!!!! 3. Ok, now we get to the part where you take your list and try doing it in reality!!! I know, this sounds scary but it s not. You already PRACTICED all this in your head, so you know exactly what to do and you ve trained your brain not to get anxious! Start with the lowest thing on your list and do it for real (with your parents help, of course)! Practice your relaxation and breathing and don t let yourself get anxious. You might need to try this several times before you are ready to move to number 2 and then number 3 and so on. No worries be patient. It took a long time to learn to be afraid of something, and it can sometimes take a long time to stop being afraid! Give yourself lots of rewards for doing this. Get your parents to find some incentives for you to keep you motivated! 4. Great Job just keep using this tool on all your fears one at a time, until they go away! You are training your brain to stop being afraid you are just incredibly awesome!!!!

18 NEGATIVE THINKING There are lots of types of negative thinking and busy brain problems. Maybe you have lots of worry thoughts, or you don t feel good about yourself sometimes, or you worry about your performance during a sports competition, or you worry that your friends don t like you, or maybe that you won t do well on a test, or whatever. Whatever your negative or busy thoughts are, we can get rid of them! Here s a few tools to use. 1. Keep a list of negative or annoying thoughts these are thoughts that you don t like and that cause you to feel yucky! Write them down. 2. Now, let s write out a BETTER thought for each of those let s say that you normally think to yourself I m going to screw up this volleyball serve I know I m just not good at this game. That s not a very helpful thought! So let s write out a new thought to use instead: I have practiced this serve a lot and I think I m getting really good at it I can t wait to try it out in my game today!. That s a much better thought! 3. Use THOUGHT STOPPING whenever you catch your negative thought intruding into your brain (think of it as a sort of little gremlin!) then CATCH IT! Do a quick relaxation and tell yourself to STOP! Now, quickly substitute in your more positive thought and then get busy doing something so the negative thought does not have time to return! Good job! Keep doing this and eventually those negative thoughts will learn that they are not welcome in YOUR brain!!!!

19 4. If you have worry thoughts or fear thoughts try writing out a list of reasons why the fear or worry DOES NOT MAKE SENSE! For example maybe you think that the kids on the playground don t like you. Let s get rid of that thought and write out a list of all the reasons that thought is NOT TRUE. For example, you could write out things like my friend Johnny asks me to play soccer almost every day, so that means that he likes me. Or you could write I have five friends who invite me over to their houses all the time and they also play with me at recess, so I have a lot of good friends and that means that kids do like me. See how that works? We re talking back to those negative thoughts start bossing them around instead of letting them boss you around!!!! BE THE BOSS OF YOUR THOUGHTS!!!!

20 PANIC ATTACKS Panic attacks are not nice at all. This is when your body all of a sudden just FREAKS OUT! For no reason at all. You might feel short of breath, or you feel sick, or your whole body starts tingling or feeling weird, or something else. The point is that your anxiety all of a sudden gets REALLY BAD, and there is no good reason for it to do this! This is a panic attack. Lots of people have them and they feel really yucky and scary. But a panic attack is just a really bad brain glitch your brain is telling your body to get all stressed out even when it s not the right time for that. We can fix panic attacks we just have to learn that all they are is a brain glitch! 1. The most important thing to do when you start to have a panic attack is to BREATHE!!!!! You have to slow your body down by taking slow, deep breaths. This will help tell your brain that you are NOT STRESSED OUT RIGHT NOW!!! Then your brain will start to relax, and your body will relax, and you will feel better! Lots of deep breaths. Slow. Easy. GOOD JOB!

21 2. The next thing to do is to tell your brain that it is OK. Keep telling yourself that this is just a panic attack and it is NO BIG DEAL. You ll be fine in just a few minutes. Don t let your brain tell you anything different. It s just a brief little glitch and as soon as you can breathe and calm down, it will go away. Keep telling yourself this and it will start to work 3. It s really important that you find something to do to distract yourself. You might need to go talk to someone, go outside and run around, blast your music or pound on your drums, or whatever. But you need to get your brain busy as quickly as possible. If you are at school, then you could maybe let the teacher know in advance about these panic attacks and you could work out a signal so you can tell her that you need to leave for minute. Then you could maybe go to the office for a few minutes to calm down. Get a drink of water, or find something to distract your. Work out a signal with your parents also, so they ll know when they need to step in and help you get your brain thinking about something else. Hugs help a lot! 4. Use all the tools in your toolbox to help your body calm down! Remember, this will go away in a few minutes as long as you keep busy and relax!

22 SEPARATION ANXIETY Separation anxiety means that you feel really anxious when you are away from your parents or when you are alone. Some kids don t even like to go upstairs in their own house alone! Some kids don t like to stay at sports activities without their parents there, or they won t go on sleepovers to friends houses, or maybe they won t even sleep alone in their own room at night. They just don t like to be alone or away from their parents at all! But now that you have a toolbox full of good ideas to use to relax and chase anxiety away, you will have no problem getting your body relaxed and happy again so that you feel confident and STRONG and you can fight this type of fear and chase it away!!!!! CREATE A PLAN AND USE YOUR RELAXATION TOOLS to help learn to be alone or away from your parents, you first need to make a plan and write out some positive thoughts. Write out some situations where you will be alone and then write out all the reasons that it will be OK to be alone and away from your parents. Write sentences that say things like It s OK, because. this helps you tell your brain that you will be fine and that being away from your parents is NOT SCARY! Right now your brain is probably making up all kinds of reasons why it s NOT OK, so we need to chase these negative thoughts away and start over with some new, positive thoughts! Practice these positive and strong thoughts in your head a lot,

23 until they become automatic! Then you can write out a step-by-step plan that will help you get through the time you will be alone or away from your parents. For example, if you are afraid of a sleepover make a plan that involves little steps first, like going to your favorite friend s house a lot of times during the day, then staying later and later into the evening until it feels comfortable to maybe stay overnight. Think about whether you would be more comfortable with LOTS of friends sleeping over, or just you. Think about all the activities you could do with your friend and all the fun and comforting things you could bring over from your house that would make it even better. Practice your plan in your imagination until it feels comfortable, then put it into action in reality! Or, if you are trying to sleep in your own room at your house again, your plan could involve decorating your room just right, leaving a light on, leaving the door open so you could hear people in the house, maybe having your fish tank in your room so you can look at it, listening to music and reading as you fall asleep, etc. Be sure to write these out. Your parents job is to help you follow through with your plan and help you feel relaxed and comfortable enough that you don t cave half-way through! For sure you will need to use your toolkit as part of your plan use your relaxation techniques, your breathing, your favorite distractions, etc. Maybe we can get your parents to come up with some good incentives and rewards for getting better at this!

24 OBSESSIVE THOUGHTS OR COMPULSIVE BEHAVIORS Some kids get thoughts stuck in their head. These are usually scary or weird thoughts and they just don t really make sense. It might be a thought about getting contaminated with germs, or a thought about dying, or a thought about having done something bad (even though you didn t). These thoughts are brain glitches they are not about REAL things, but they are made up worry thoughts that we just need to get rid of! You probably have tried to turn them off, but they won t go away. And you ve probably tried to get your parents to reassure you that everything will be OK, but that doesn t help either. Some kids have things they DO that they do over and over again in an obsessive way, like counting the cracks in the sidewalk or something. These are obsessive behaviors and they are part of a brain glitch also. Sort of like having a computer virus in your head! We need to find a way to get this glitch to turn off and go away! So, let s come up with a plan that WILL work!

25 1. FIRST let s make a list of all your obsessive thoughts or behaviors. You ll know that they are the obsessive ones because they keep coming back over and over and your parents have probably told you that these thoughts or behaviors don t make sense. Common obsessive thoughts and behaviors are: a. Fear of germs or of being contaminated b. Worry that something bad is going to happen c. Worry that you are sick or going to get sick d. Worry that you ve done something bad and don t know it e. Feel the need to keep confessing about things you have done f. Thoughts or worries about hurting someone g. Need to have everything lined up just right h. Need to keep checking whether you locked the door or turned off the lights or zipped your backpack or whatever i. Thinking you didn t do something the right way and you need to do it over j. Counting things over and over and over k. Organizing your stuff over and over and over until you get it just perfect l. There are lots more tell me what yours are. 2. Now that you know what things you are thinking or doing that are obsessive, let s make up a name for your brain glitch that makes you think or do these things. The REAL name is obsessive compulsive disorder, or OCD. But you can make up a better name than that. Try to draw a picture of what your brain glitch might look like. This avatar from the Mario Brother s Video Game that looks a lot like what I think OCD would look like if it had a body!

26 3. Now, we have to make a decision to start chasing OCD away! You have a list of your most common OCD thoughts or behaviors. You and your parents can now identify when OCD is bothering you. When you notice OCD, then get your parents help and start chasing it away. Silently tell OCD to GO AWAY or STOP. Start doing something else right away the busier you are, the less room there is for OCD. Don t talk to OCD don t ask your parents to reassure you that the thing you are afraid of is not going to happen. When we talk to OCD, we just make it bigger. When we let the thoughts or behaviors happen, we just let them get stronger. We re going to be bigger and stronger than OCD and we re just going to CHASE IT AWAY!!! 4. You ll have to use the tools from your tool kit to help out here. Take lots of deep breaths and relax. Try to keep your brain and body busy so there is no room for OCD. Get hugs and help from your parents. Go outside and exercise. Do whatever it takes to keep OCD away. Even if it comes back after a few minutes, you ll know that you were strong enough to fight it off for at least those few minutes!!!! You are so strong!!!! Next time you ll fight it off for even longer, and soon it will go away for good!

27 Anxiety Monitoring Chart use this to help monitor your anxiety Times I felt anxious this week Anxious scale: Not at all anxious a little bit some a lot very, very much When What Happened How did your body react How Anxious? What did you do? Time/Date any triggers and how long did it last and did it change what worked?

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