Alternatively, you may want to coach your loved one through the problem. That strategy actually works sometimes, but it’s very tricky and we recommend professional guidance for both yourself and your loved ones if you want to become their coach.

Coaching, like reassurance, can easily backfire, cause arguments, or be perceived as criticism by people you’re trying to help.

Perhaps you’re tempted to try a confrontation or so-called “intervention” in which you and other family members tell the person how badly she needs help. That too is at least as likely to backfire as it is to help. Confrontations usually cause defensiveness and often, anger.

Instead, consider fully and unconditionally accepting your loved one and all of his problems with anxiety. After all, you likely fell in love with this person as a whole package that included issues with anxiety. And you probably have a few flaws and struggles yourself. Who doesn’t? So instead of forcing the issue to a head, consider embracing and loving the one you care about “as is.”

Acceptance delivers a positive message that may allow you and your loved one to actually become closer. When you drop pressuring people to change, it sometimes actually frees them up to make changes. When you convey the message that you’ll care about someone no matter what, it can actually enable them to start taking risks which is one of the things they’ll have to do if they want to overcome their anxiety.

In fact, change always requires being able to take risks, be vulnerable, and make mistakes. When people feel safe, they can do these things more easily. So, try letting go of your need to see your loved one make changes. Realize that whether the one you care about changes isn’t really about you anyway. Acceptance just may take you further than you think, but changing your loved one shouldn’t be your goal. Let go of that need and it just “may” happen a little more easily.

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Well, yes and no. Of course most therapists would love for you to be able to feel calm, relaxed, and peaceful all of the time. However, that goal isn’t possible for anybody. Life is full of unpredictable, often random, dangers, hassles, and perils. Therefore, if you have the goal of eliminating these things, you will almost certainly fail.

So, I first recommend that you give up on the unrealistic goal of purging distress from your life. But then, I have something far more radical to suggest: Welcome anxiety, uncertainty, doubts, and distress into your life! Walk right up to anxiety and let it know that you’re ready to take it on. Seek every single opportunity you can to actually feel and experience anxiety!

What, you say? Have I lost my mind? Am I failing to understand how horrible anxiety is for you?

Actually, I think I do understand how uncomfortable anxiety can be. And I know how much those with anxiety wish to be rid of it. But the only sure fire way to master anxiety is through a process known as habituation. Habituation occurs whenever you encounter a feared situation, event, or object over and over and over again. Ever so slowly, but just as surely, your distress decreases as you go through this process. And it does so by gradually increasing your exposure to your fears.

The key term here is “gradually.” Take a simple case of someone who gravely fears spiders to the extent that she avoids going outside, has her apartment sprayed with toxic chemicals every week, and sprays insecticide around her desk every day. Clearly, her spider phobia is costing her dearly—her health may suffer; she likely annoys her coworkers, and she suffers miserably from worries and anxiety about spiders.

The treatment for spider phobics is much the same as it is for other anxiety problems. I would have this patient ever so gradually expose herself to small spiders (at first encased in a cage) and then move on to looking at pictures of fearsome spiders, then deal with small spiders at a short distance, and so on. Eventually, most people who go through graduated exposure find themselves no longer controlled and dominated by their anxiety. But this improvement comes from their willingness to actively confront their fears one step at a time.

If you have mild problems with anxiety, you may wish to try this approach on your own. Break your fears into a series of gradual steps and then start confronting them one at a time. Remain in contact with each step until your anxiety drops some. We discuss this process in Overcoming Anxiety For Dummies (2^nd Edition) in great detail, but you can also find a lot of information about the approach by Googling.

Make a game out of confronting your anxieties. Rate every fear and anxiety on a scale of 1 to 100 and then go out and rack up as many points as you can. Welcome anxiety! Embrace it. Tell it to give you its best shot. Go into the ring and confront your anxiety. You can’t win by running away—that just makes things worse.

Finally, If your anxiety problems are serious, seek a professional for help and guidance with this approach.

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I think it’s also wise to take one more important step. Specifically, I’d like you first to consider accepting where you’re at, problems and all. That’s right; evaluate yourself as acceptable and OK as you are.

Realize that you didn’t ask to have problems with anxiety and OCD. Rather, you have these problems for lots of good reasons. You may have had genes that tilted you in this direction. Or perhaps you experienced one or more traumas. Maybe your parents were overly critical and overbearing. On the other hand, maybe they couldn’t provide the structure you needed as a child. Perhaps you grew up in an unsafe neighborhood. People acquire anxiety and OCD for these reasons and many more. They pretty much never become anxious because they “wanted” to have these problems.

Yet, many clients judge and evaluate themselves very harshly just because they have some problems that they didn’t ask for in the first place. They see themselves as weak, incompetent, and horribly flawed. Thus, they tell themselves that they absolutely MUST overcome their problems. In addition, they should do so quickly and completely.

Can you see a problem in that line of thinking? I hope so. If your thoughts go in that twisted direction, you’ll merely compound your problems by adding huge amounts of stress and pressure to your treatment efforts. That pressure is likely to cause you to stall out before you get very far.

I frequently tell my patients to think of treatment as an endurance race. When you realize you’re not yet near the finish line, it’s important to merely keep putting one foot in front of the other. But if you judge that your progress is unacceptable and that you haven’t gotten as far as you think you should, you might as well take out a hammer and start beating yourself over the head! That’s not exactly going to get you there faster. Rather, you’re likely to collapse in an exhausted heap.

Therefore, I recommend that you stop judging yourself. Accept that you have anxiety or OCD. You may not “like it,” but try to accept yourself and your problems. You don’t even “have” to change them. Yes, you’ll probably feel better if you do engage in treatment, but don’t make it into an absolute “must.”

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You might wonder why that would be the case. After all, if you have a problem, you should venture out and do something about it, right?

I’d like to suggest that if you’ve had significant problems with anxiety or OCD, yet avoided getting treatment for years, you’ve probably done so for some pretty good reasons. And it makes more sense to take a look at your reasons for not seeking treatment than to beat yourself up for not having done something about your problem. There are six major reasons or beliefs we’ve heard people give for avoiding treatment. See if any of these apply to you:

1. I fear trying to tackle my problems and not making progress. If that happened I’d feel worse than if I’d done nothing at all—in fact, I’d feel like a complete failure.
2. I know that you can’t really change feelings. They are what they are. You’re just fooling yourself if you think you can actually do something about them.
3. I wouldn’t know who I was if it weren’t for my OCD or my anxiety. They define who I am.
4. People never really change. I’ve been this way my whole life; if I haven’t changed by now, I probably never will.
5. My anxiety feels too overwhelming to do anything about it. I’ve heard that treatment make you feel anxious. It’s safer to just let things stay as they are.
6. I’m too busy to go to treatment. Therapy takes time and that’s something I simply don’t have.

So does one or more of these beliefs explain why you’ve avoided treatment? Perhaps you can come up with other reasons—expense, hassle, whatever. I recommend that you write all of the reasons you have for avoiding treatment down.  Take a good hard look at them. You likely haven’t been staying away from treatment just out of laziness. Rather, you’ve had some pretty powerful reasons for staying stuck.

What you ask? Am I actually going to tell you to just live with your problems and not do anything about them? Au contraire. Treatment is usually a very good idea if anxiety or OCD are significantly interfering with your life. But you’re not likely to do anything about your problems until you’ve taken a close look at the reasons you’ve been delaying taking action.

Once you know what those reasons are, you can do something about them. Stay tuned. Our next blog gives you advice on that topic.

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If you’re a parent or someone who cares about kids, you just might want to know what type of messages instill insecurity. I’ll start by laying out three common mistakes that parents make; in other words, the kinds of messages you “don’t” want to give them:

1. Invalidating or Denying Your Children’s Feelings. If your kids seem worried, fearful, upset, or distraught, sometimes it’s tempting to tell them “there’s no reason that they should feel that way” or even that they “shouldn’t” be feeling what they are obviously feeling. Parents give these messages because they don’t want their kids to feel distress. So, they reason that their kids will understand, if their bad feelings have no real basis, they won’t feel the way they do. Big mistake. Children need to hear that it’s normal and OK to have a little fear or distress sometimes.
2. Providing Incessant Reassurance. Messages that “everything will turn out OK” sound so very much like what you should tell kids, and if you don’t say them too often, there’ll probably be no problem. However, when you frequently reassure your kids, you end up giving them the message that they need to turn to you (as an adult or parent) to help them see that things will turn out alright. They fail to learn that they can get through fear on their own. We wrote about this issue in detail in our earlier book, Obsessive Compulsive Disorder For Dummies and if you find yourself reassuring your kids a lot, we urge you to read it.
3. Protecting Your Kids from All Harm. No one ever wants to see a child come into harm’s way. However, growing, developing and learning require kids to face challenges and even take a few small risks along the way. Parents that try to constantly clear all dangers and risks that their kids confront teach them that the world is a scary place and that they need their parents to guide them through it. That message hardly fosters the independence and maturity they’ll need as adolescents and young adults.

So what’s a parent to do instead? One of the best ways to help prevent kids from developing anxiety disorders is to model how to cope.

I recommend that parents express when they’re feeling anxious and tell their kids how they plan to cope with it. For example, you might say, “Sometimes I feel nervous when I have to climb a ladder, but I just need to take a deep breath, be careful, and do it. If I get too nervous, I can always climb back down, but it feels good to get through difficult tasks.” Another good strategy is for parents to praise their kids when they make efforts to do things that are a little anxiety arousing for them.

The bottom line: Gently encourage your kids to confront their fears, let them know that a little anxiety is normal, and don’t try to keep them away from all challenges and risks.

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We saw a report a few years ago that detailed the dangers of buying used, refurbished mattresses due to bed bugs, fecal matter, and various body fluids that still inhabited such mattresses even after the refurbishing process.

Perhaps it’s not surprising that sales of hand sanitizers have soared over the past decade. You can find antibacterial ingredients in products for your refrigerator, floors, body, toilets, and anything else you can think of. We’ve even seen a UV light wand that can destroy bacteria that you could encounter almost anywhere: airline passenger trays, airline headrests, automobile steering wheels; you name it. Just think; you could use that wand to sanitize every doorknob, each pen or pencil you pick up, and every bathroom water fixture (assuming you happen to encounter any that don’t have auto-sensors to save you from inevitable harm).

But wait a minute. If you look for evidence that significant numbers of humans are dying from refurbished mattresses, dirty public toilets, hotel rooms that haven’t been steam cleaned, and homes that haven’t been sprayed thoroughly with antibacterial products, you won’t find much at all. In fact, one study at Columbia University in Manhattan demonstrated no difference in infectious diseases in homes given an array of antibacterial cleaning products versus those in homes that were given products without the antibacterial agents in them.

In fact, if you consistently spend many hours cleaning your home and disinfecting it with every possible cleaning agent, you may actually cause more harm than good. Scientists now generally believe that excessively clean environments may actually result in increased cases of asthma and allergies. A little exposure to dirt and animals seems to confer a protective effect from these ailments.

So why does the media have such a penchant for stories about germs, bacteria, viruses and such? It’s probably because most people worry at least a little bit about the same things that those who have obsessive compulsive disorder do. Everyone is a little grossed out by the idea that you can encounter fecal matter and bacteria almost anywhere—ice machines, handrails, and so on. Therefore, stories about these topics grab people’s attention. And they sell.

But you could do yourself a favor by not attaching too much meaning to headlines that scream about dirt and disease. No, you shouldn’t quit washing your hands and you certainly should try to avoid too much exposure to insecticides, toxic chemicals, and pollution. And especially wash your hands and use sanitizer if you’re in a hospital environment.

Like just about everything else in life, the tricky answer lies in finding a reasonable balance.

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Children and people with mild autism sometimes appear to others as self-contained and aloof. Others may assume that those with autism are pretty calm, cool, and collected. However, they are likely very wrong.

Those with autism may suffer increased levels of anxiety and stress because of interpersonal isolation. They feel different from other people and worry that they may be disliked or misunderstood. This may lead the child or adult with autism to withdraw or avoid. This lack of contact with others can lead to more awkwardness and lack of opportunities to practice social interactions.

Those with autism frequently report hypersensitivity to loud noises, touch, lights or other forms of sensation. When in situations that involve these areas of oversensitivity, they may also experience periods of stress and discomfort. Stress may again result in avoidance of places in which over-stimulation may occur.

Furthermore, people with autism may have trouble understanding the perspective of others. They may misinterpret communications and subtle interpersonal cues. These misunderstanding can lead to anxiety, worry, and difficulties in relationships. Withdrawal, rejection, or avoidance are natural reactions.

In previous blogs, we have described the way that fear and worry can become worse. First there is something feared which results in distress. Avoidance temporarily brings down the feelings of distress and thus feels good. This good feeling is rewarding and results in more avoidance. The next time fear is experienced, there is a strong desire for avoidance. Thus fear grows and avoidance is the natural pathway.

People with anxiety and autism can learn to slowly become exposed to what they fear, just like those with generalized anxiety disorder, panic disorder, or obsessive compulsive disorder. They need a large dose of cognitive behavior therapy given by a patient, understanding therapist.

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The art and practice of psychological assessment and diagnosis can be fascinating. I get a great deal of satisfaction out of accumulating information, administering tests, delving through records, getting to know someone and putting it all together into a description and usually a diagnosis. It’s the sort of work that a good detective does; gathering facts, considering theories, and solving a mystery.

People come to me, sometimes with their children, wanting to know what’s wrong. Why are they having trouble in school, at home, at work, or with their relationships? When I can give them a name, in effect a reason, for their troubles– you have major depression—or obsessive compulsive disorder—or social phobia–your child has attention deficit hyperactivity disorder—or autism then they are satisfied. When I provide them with a diagnosis for their struggles they may mourn, but relief usually follows. Most people cope better when they know what they are dealing with.

Here comes the dilemma. I have some serious issues with diagnosing. Too many people look at a diagnosis of depression, anxiety, or learning disability as something similar to a diagnosis of the measles or the flu. You catch something then simply get treatment and get better. Well, it’s not as simple as that!

For one, giving a diagnosis, whether it should or not, tilts everyone in the direction of looking for biological explanations and therapies. The rise in psychotropic drug use over the past few decades has been astounding, especially since precious little data indicates that medications beat out psychotherapy for most so-called disorders. And psychotherapy has a superior track record in preventing recurrences of the problems. Not only that, the evidence for increased efficacy from combining drugs and psychotherapy is limited as well.

But giving someone a diagnosis lets everyone off the hook—parents don’t have to feel responsible for their kids’ anxiety, and adults with depression don’t need to take a serious, sometimes painful look, at what’s going on in their worlds that might be leading them into depression.

Leaving the issue of medications vs. therapy aside, diagnoses are also highly problematic in that they imply you either “have” something or you don’t. Yet levels of severity differ profoundly from one person to the next (this part of the problem may be partially addressed in the upcoming DSM V for interested readers). And the actual symptoms experienced may depart significantly from one person to another with the very same diagnosis.

I’m not suggesting that we abandon the diagnostic enterprise. However, I believe that everyone needs to keep the issue in perspective. A diagnosis, while valuable, is only one piece of the puzzle and a first step in getting the best treatment.

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Obsessions: Intense worries, thoughts, and images that pop into the mind and create a great deal of distress. Worries about becoming contaminated with germs are an example of a particularly common obsession.

Compulsions: Various behaviors or actions that temporarily reduce the distress obsessions cause. For example, people with contamination obsessions would be likely to wash their hands excessively to deal with their worries about becoming contaminated.

OCD can be fairly mild, but it’s quite common for it to be severe and substantially reduce the quality of life for those who have it. Sufferers often spend many hours a day carrying out their compulsions and feel helpless to do anything about their OCD. The good news is that OCD is highly treatable. The bad news is that a diagnosis of OCD often raises the risk of other emotional problems such as the ones that follow.

• Mood Disorders: Some studies have found that more than twenty-five percent of people who have OCD also have a disturbance in their moods. Left untreated, mood disorders can lead to serious problems. If you have intense feelings of sadness, low moods, fatigue, and/or feelings of worthlessness, it’s important to have it checked out. Conversely, if your moods become extremely high and are accompanied by things such as inflated self-esteem, rapid speech, excessive energy, decreased need for sleep, and/or excessive indulgences, that needs to be looked into as well.

• Anxiety Disorders: OCD has generally been thought to be a type of anxiety disorder although some professionals feel otherwise. In either event, problems with anxiety often go along with OCD. Signs of anxiety include avoidance of people, fears of losing control, intense fears, panic attacks, and tension.

• Attention Deficit Disorders (ADD): The various types of ADD often involve problems with attention, hyperactivity, and impulsivity. Additional problems include troubles staying focused, losing various items, forgetfulness, trouble remaining still, and talking without thinking. Those who have OCD are at increased risk of having ADD, but they also may merely “look” like they have ADD because their OCD requires much of their attentional resources. The good news here is that successful treatment of OCD sometimes results in an abatement of their ADD like symptoms.

• Substance Abuse: Given that OCD causes huge distress for many of its sufferers, it’s not surprising that some of them try abusing substances (alcohol, prescription drugs, and illegal drugs) to quell their anxiety and upset. Unfortunately, the relief provided by substances is fleeting. Treatment should be sought for both problems when they co-occur.

The bottom line is that if you have OCD, you probably feel great distress. That distress can escalate if you also have one or more additional emotional problems such as the ones discussed above. However, OCD as well as these accompanying problems can be alleviated by treatment that’s been designed and empirically validated for these issues.

Just a reminder—when you seek treatment for any of these problems, be sure to ask the mental health professional if he or she has experience and training in treating these disorders.

Since the signs differ a little for kids versus adults, here’s a list of seven signs that tell you if your child needs further assessment:

1. Delayed development: Lists of what to expect in terms of behavior, emotions, and learning at various ages abound on the Internet. We even include a checklist in our recent book Child Psychology and Development For Dummies. Consult a few of these lists. If you see that your child seems to be falling significantly behind (not just a few weeks or one or two months), a screening evaluation is worth getting. Early intervention for kids’ problems has been found to work far more effectively than professionals used to believe for many delays in childhood development. Ignoring delays can cost your child a great deal in potential gains.

2. Feeling fatigued or lacking interest: Parents, teachers, and caregivers should not ignore signs that a child appears to lack interest and engagement with the world or others. Kids who are oblivious to parents or peers, or who look fatigued or lethargic for more than a few weeks should be looked at. Kids who are doing OK are naturally enthusiastic and engaged.

On the other hand, a little lack of interest and withdrawal from families and parents during brief phases in adolescence is fairly common. However, if that withdrawal is pronounced or prolonged, it should be checked since it could indicate a problem with substance abuse, gangs, bullying (either as victim or perpetrator), or depression.

3. Poor Grades: Kids drag home poor report cards for lots of reasons. Sometimes poor performance in school indicates a specific type of learning problem. Other times, it could suggest an emotional disorder is getting in the way of achievement. Occasionally, poor grades could be caused by an intellectual disability; when that’s the case, it’s usually apparent fairly early on. Whether poor school performance starts early or comes later, it’s always worth finding out what’s going on. Grades have a lot of predictive power in terms of later life success so they should never be ignored.

4. Falling back: When children appear to master a particular skill like riding a bike, reading, language, or simply stacking blocks, they really shouldn’t start sliding downhill significantly (at least for very long). If you see a kid regress or backslide from skills learned earlier, consider have the problem checked out. Perhaps it’s a temporary glitch, but we believe it’s better to be safe than sorry.

5. Excessive complaints about aches and pains: Every kid on the planet complains about aches and pains here and there—stomachaches, earaches, leg pains, and more are as common as kids leaving their toys in the living room. However, when these complaints become repeated, intense, or frequently involve vague pains like “not feeling well,” it’s time to consult your medical doctor. Sometimes the physician is going to suggest the problem may relate to anxiety at school or trouble getting along with other kids. In those instances, it’s time to seek a mental health consultation.

6. Feeling over the top anger: OK, it’s true that all kids get angry. Toddlers especially have temper tantrums from time to time. However, when these tantrums start occurring every day or continue much past toddlerhood, or if your child starts hurting others, you need to have things checked out by a mental health professional. This is one problem that can usually be resolved fairly quickly if you don’t wait too long.

7. Feeling excessive fear: Again, fear is a totally normal part of childhood, especially from the ages of six months to 6 years when kids often exhibit fears of strangers, upset when separated from their parents, fears of strange kids, fears of the dark and monsters, and fears of school. However, if such fears continue much beyond the age of 6 or if they seem excessive compared to other kids, consider seeking an evaluation.

The bottom line is that kids’ emotional problems frequently respond to early intervention surprisingly well and quickly. Some problems require more intense interventions than others, but early help is always better than delayed.

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