Skip to content

Health anxiety therapy in a nutshell

“I would just like to thank you for your amazing content and online courses. Thanks to your help I am no longer homebound by crippling panic and anxiety. I went out today into a busy town and was happy, I feel safe and liberated. I have shared all my progress with my doctor and she is ecstatic about my progress and will be recommending your courses to other patients struggling with mental health. I am medication free and happy for the first time in my life. The changes are long lasting and I now can get myself out of a low without going further down the rabbit hole.”

Learn more about grief in this mini-course:
“Grief is unpredictable, and it will go wherever it finds an outlet. If it can’t be expressed emotionally, it may find expression in the body.” (136)
Grief, like all emotions, isn’t just in your head; it shows up in your body in remarkable ways. But most people have never been taught what is common in the grieving process and how grief does show up in your body, and this can leave some people feeling stuck, spiraling through endless grief and pain. Grief has many physical symptoms. When you learn the physical symptoms of grief, you can be more equipped to address it and work through the process of grief and loss. In this video we’ll learn from grief expert Dr. Dorothy Holinger the author of The Anatomy of Grief, how grief shows up in the body and what we can do to work through it. Grief does not have a concrete number of stages of grief. But, when you learn about the physical symptoms you can gain more awareness of your body and be more accepting of those symptoms of grief and loss. I recently recorded an interview with Dorothy about how grief impacts the body, but unfortunately some of the video files got corrupted, so I’m summarizing our conversation here. The full length interview is on my podcast. I’m not going to pretend that grief is some easy thing that can or should be fixed, but there are some things you can do that can help your heart and body work through the suffering.
00:00 Introduction 01:03 All Courses 40% off 02:02 How grief impacts the brain 02:46 How grief affects the heart 03:56 Grief tears 04:48 decreased pleasure after a loss 05:01 Loss of appetite after a loss and difficulty sleepin 05:25 weakened immune system while grieving 05:40 headaches and body aches during grieving 05:56 other somatic changes with grief 07:05 When you’re not allowed to mourn 07:44 How to deal with grief
Looking for affordable online counseling? My sponsor, BetterHelp, connects you to a licensed professional from the comfort of your own home. Try it now for 10% off your first month: Learn more in one of my in-depth mental health courses:
Support my mission on Patreon:
Sign up for my newsletter:
Check out my favorite self-help books:
Therapy in a Nutshell and the information provided by Emma McAdam are solely intended for informational and entertainment purposes and are not a substitute for advice, diagnosis, or treatment regarding medical or mental health conditions. Although Emma McAdam is a licensed marriage and family therapist, the views expressed on this site or any related content should not be taken for medical or psychiatric advice. Always consult your physician before making any decisions related to your physical or mental health. In therapy I use a combination of Acceptance and Commitment Therapy, Systems Theory, positive psychology, and a bio-psycho-social approach to treating mental illness and other challenges we all face in life. The ideas from my videos are frequently adapted from multiple sources. Many of them come from Acceptance and Commitment Therapy, especially the work of Steven Hayes, Jason Luoma, and Russ Harris. The sections on stress and the mind-body connection derive from the work of Stephen Porges (the Polyvagal theory), Peter Levine (Somatic Experiencing) Francine Shapiro (EMDR), and Bessel Van Der Kolk. I also rely heavily on the work of the Arbinger institute for my overall understanding of our ability to choose our life’s direction.
And deeper than all of that, the Gospel of Jesus Christ ori

BACA JUGA:   Most effective stress management techniques

Hi there, I’m Emma McAdam!


I’m a licensed Marriage and Family Therapist. And I have walked with thousands of people as they go through the process of changing their lives. Because I’ve seen so many people do it, I am absolutely confident that your brain is wired to change and deep healing is possible for you. 

I know that understanding mental health can be confusing and stressful. Most people have never been taught the essential skills to work through emotions and all the resources that you can access to start healing. 

My mission is to make mental health skills more accessible through YouTube videos and online courses. Therapy in a Nutshell is built around the idea that small and simple steps can turn into massive change and growth. I don’t just help people get feeling better, I help people get better at feeling. 

I’ve been working in the field of change and growth since 2004. I received my Master’s degree in Marriage and Family Therapy from Utah State University, and I’m currently licensed in the state of Utah.

Sign up for my Free Anxiety Course

We include products we think are useful for our readers. If you buy through links on this page, we may earn a small commission. Here’s our process.

Healthline only shows you brands and products that we stand behind.

Our team thoroughly researches and evaluates the recommendations we make on our site. To establish that the product manufacturers addressed safety and efficacy standards, we:

  • Evaluate ingredients and composition: Do they have the potential to cause harm?
  • Fact-check all health claims: Do they align with the current body of scientific evidence?
  • Assess the brand: Does it operate with integrity and adhere to industry best practices?

We do the research so you can find trusted products for your health and wellness.

Read more about our vetting process.

First, you have to understand what type of cognitive distortion is occurring.

Share on Pinterest

I’ve lived with general anxiety for as far back as my memory goes. As a writer and stand-up comedian, I have the most trouble fighting against social and performance anxiety on a day-to-day basis, as I conduct interviews and interact with editors during the day and then take the stage at night.

My anxiety most often shows itself in what I call “anxiety hangovers,” when I wake up on the day following a social event or meeting or comedy show feeling horrible about everything I did or said — no matter how fun or successful the event felt the night before.

BACA JUGA:   Does better health accept insurance

Everyone thinks you’re egotistical and obnoxious, my inner voice spits at me when I wake up.

You said the exact wrong thing to your friend when she asked for your opinion, because you never think before you open your mouth.

You dominated the dinner conversation. No wonder no one likes you.

You were so embarrassing on stage, of course you aren’t a success.

The mean little voice goes on and on and on.

After big events, like a friend’s wedding or important comedy show, I’ve had panic attacks the following morning: a racing heart, trembling hands, and trouble breathing. On other days, I just can’t concentrate because of the worry and feel mentally paralyzed, and the confidence I need to do my work is sunk.

Where cognitive behavioral therapy comes in

The central idea behind cognitive behavioral therapy (CBT) is extremely simple: If you change the way you think, you can change the way you feel.

But if feeling better and escaping depression and anxiety were that easy, we wouldn’t live in a country where psychological distress is increasing.

While I’ve found that I can’t fully eliminate or “cure” my anxiety (and probably never will), I’ve found a simple five-minute CBT exercise that quiets it down each day. My racing thoughts stop, my foggy brain begins to clear, and my fatigue lifts.

Suddenly, I feel like I can start my day.

Called the triple column technique, which was developed and named by clinical psychiatrist Dr. David D. Burns, all it does is change my mindset. But sometimes, this shift is enough to completely shut my anxiety up for the day. A change in how we think about ourselves is all we really need to find a calmer, happier place.

Recognizing cognitive distortions

In 2014, a friend recommended Burns’ “Feeling Good,” a CBT classic that takes readers step-by-step through recognizing negative self-talk, analyzing it rationally, and replacing it with healthier and more accurate thinking.

(Burns also suggests, for many people living with anxiety and depression, to see their doctor and pair therapy and the appropriate medication if deemed necessary.)

The book made it crystal clear that I wasn’t a secretly bad person and incredible failure who can’t do anything right. I’m just a pretty regular person who has a brain that can distort reality and cause way too much anxiety, stress, and depression.

The first big lesson was to learn the specifics of cognitive distortions — those statements that the little voice makes about who I am and what’s going on in my life.

There are 10 big distortions that can occur:

  1. All or nothing
    When you see things in black and white instead of in shades of
    gray. Example: I’m a bad person.
  2. Overgeneralization.
    When you extend a negative thought so it reaches even further. Example: I never do anything right.
  3. Mental filter. When
    you filter out all the good stuff to focus on the bad. Example: I didn’t accomplish anything today.
  4. Disqualifying
    the positive.
    When you believe a good or positive thing “doesn’t count”
    toward your larger pattern of failure and negativity. Example: I guess I survived the talk — even broken clocks
    are right twice a day.
  5. Jumping to
    When you extrapolate an even bigger and broader negative
    thought from a small negative experience. Example: He said he didn’t want to go out with me. I must be an unlovable
  6. Magnification or
    When you exaggerate your own mistakes (or other people’s
    accomplishments or happiness) while minimizing your own accomplishments and
    others’ flaws. Example: Everyone saw me
    mess up at the game, while Susan had a perfect night on the field.
  7. Emotional
    When you assume your negative feelings reflect the truth.
    Example: I felt embarrassed, therefore I
    must have been acting in an embarrassing manner.
  8. Should
    When you beat yourself up for not doing things differently.
    Example: I should’ve kept my mouth shut.
  9. Labeling and
    When you use a small negative event or feeling to give
    yourself a huge, general label. Example: I
    forgot to do the report. I’m a total idiot.
  10. Personalization. When you make things
    personal that aren’t. Example: The dinner
    party was bad because I was there.
BACA JUGA:   How long does psychoanalysis therapy take

How to use the 5-minute triple column technique

Once you understand the 10 most common cognitive distortions, you can start taking a few minutes a day to complete the triple column exercise.

While you can do it in your head, it works amazingly better if you write it down and get that negative voice out of your head — believe me.

Here’s how you do it:

  1. Make three
    columns on a sheet of paper, or open an Excel document or Google
    Spreadsheet. You can do it anytime you’d like, or just when you’re noticing
    you’re beating yourself up. I like to write mine in the morning when I’m
    feeling most anxious, but many people I know write theirs before bed to clear
    their minds.
  2. In the first column, write what Burns calls your
    “automatic thought.” That’s your negative self-talk, that crappy, mean little
    voice in your head. You can be as brief or detailed as you’d like. Yours might
    read, My workday was the worst. My
    presentation bombed, my boss hates me, and I’ll probably get fired.
  3. Now read your statement (it always looks kind of
    shocking to see it in print) and look for the cognitive distortions to write in
    the second column. There may be just one or more than one. In the example we’re
    using, there are at least four: overgeneralization, all or nothing thinking,
    mental filter, and jumping to conclusions.
  4. Finally, in the third column, write your “rational
    response.” This is when you think logically about what you’re feeling and rewrite
    your automatic thought. Using our example, you might write, My presentation could’ve gone better, but
    I’ve had lots of successful presentations in the past and I can learn from this
    one. My boss was confident enough to have me lead the presentation, and I can
    talk to her tomorrow about how it could’ve gone better. There’s no evidence at
    all that this one subpar day at work would get me fired.

You can write as many or as few automatic thoughts as you want. After a good day, you might not have any, and after a big event or conflict, you might have to work through a lot.

I’ve found that after years of doing this, I’m much better at catching my brain in the middle of a distortion and much more comfortable in recognizing that, at best, my negative talk isn’t rational at all. At worst, it’s exaggerated or overdramatic.

And is it proven to work?

A 2012 meta-analysis of 269 studies about CBT found that while this simple talk therapy is most helpful in combination with other treatments, it’s very successful when specifically treating anxiety, anger management, and stress management. Go forth and fill out your triple columns!

Share on Pinterest

Sarah Aswell is a freelance writer who lives in Missoula, Montana, with her husband and two daughters. Her writing has appeared in publications that include The New Yorker, McSweeney’s, National Lampoon, and Reductress. You can reach out to her on Twitter.