Reference no: EM133717468

Question: Hello Goutam, my name is Rachael and I'm a Psychiatric Mental-Health Nurse Practitioner. I'm hearing that you have been struggling with generalized anxiety and have been for quite some time. I understand that you have been seeing a therapist who practices CBT and that it has not been effective for you for the past six months. However, I would like to explain how you could use a CBT practice, called systemic desensitization to help you cope with your anxiety disorder. I am going to lead you through some relaxation exercises, thought exercises, and future behavioral exercises (Thomas et al., 2017).

You feel anxiety when you perceive a threat; this is why your heart pounds, and your breathing quickens. In your case, you are perceiving non-threatening situations as threatening (Wheeler, 2022). I want you to learn how to take yourself out of fight or flight through simple relaxation. Now, I am going to guide you through a guided meditation.

Find yourself seated in a comfortable place on a chair or floor. You can make any adjustments needed to get comfortable. Feel the support below you as you take a deep breath in...and out...feel your diaphragm lift and lower with each breath. You are exactly where you need to be. Here in this moment. Your body is fully supported, and your muscles are starting to relax. Feel the muscles around the eyes soften, then the muscles around the jaw. The throat and neck relax next, followed by the shoulders. Any tension relaxes more and more, with each breath you breathe in...and out...thoughts might come into your minds, as soon as they come in, let them float away. Your thoughts have no hold on your present state. You are here, now, breathing in this exact moment. Let relaxation roll down towards the hips, allowing you to relax even further. Feel yourself sink deeper into your seat. Finally, feel your feet sink into the floor, imagine your breath is connected to the breath of the earth, rooted to your through your feet. Calm and peace wash over you with every inhale and exhale. Remember this beautiful space that you can create for your body and mind. This place is always here, inside you. You always have access to it, all you have to do to get here is to breathe deeply and focus on relaxation. *Pause. Wiggle your fingers and toes, take a deep breath, and, when you feel ready, open your eyes.

This space of calm can be achieved in a few short minutes at any time that you feel anxious. I understand that it has been difficult to go to class or spend time with friends due to your anxiety. Before the start of class or going out with friends, I want you to listen to my guided meditation. I want you to think about feeling calm and content in class and with your friends. Connection with things that matter to you, like your friends and your classes, will likely decrease your anxiety. It sounds counterintuitive, that the things that give you anxiety are ultimately what will release you from it (Markowitz & Fanselow, 2020). When you are out of the house socializing and you feel anxious, I want you to bring yourself back to the calm during the meditation. You can even go to the bathroom to be alone and listen to the meditation. This practice will train your body over time to be calm while in class and with friends.