Anxiety Tracking Form

Are You Anxious? – What event are you reacting to?





Rate how much real danger you are in from 1 – 10? _______

Is your response proportionate to the danger?  yes or no

If exaggerated, use the following procedure:

Repeat the following in a stern inner voice:

            I will not faint.  I will not die.  I will not lose my mind.

            I can cope with these feelings and other symptoms.

            I need to trigger the Calming Response.

The Calming Response:  Gently inhale through your nose and fill your lower lungs. (Push your tummy out.)  As you breathe out calmly say in your mind, “Relax, I can handle this.” Repeat this 10 times until your breathing is under control.  (Feeling a bit faint is not abnormal when you do this.)

The Calming Response may be combined with a statement of truth to reduce negative feelings by common irritants.  For example, if you are often irritated by:

Poor drivers - state the obvious truth e.g. “some people drive poorly,” practice the Calming Response and then focus on YOUR driving.  Signal properly, keep a safe distance, and match the speed limit etc.  

Lazy co-workers – “some people have no pride in their work; too bad they’re missing a perfect source of self-esteem…” 

Poor manners – “some people are neglected by their parents…”

Tardy People – “some people just can’t organize themselves…”

Messy People – “I’m glad I’m more organized…"