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Book Summary: Coping with Anxiety – Ten Simple Ways to Relieve Anxiety, Fear and Worry by Edmund Bourne and Lorna Garano

In this user-friendly workbook, Edmund Bourne and Lorna Garano take you by the hand to help you understand anxiety and what you can do about it. The authors start by asking why more people are suffering anxiety now than in the past.

About 50 million people in the US suffered from this malady in 2015. Bourne and Garano designed their book to help readers handle anxiety by relaxing their bodies and minds – and by developing the capacity to deal with life realistically. We recommend this manual to anyone who wants a primer on anxiety – whether for yourself or to help a relative, friend, employee or colleague.

Summary of Coping with Anxiety - Ten Simple Ways to Relieve Anxiety, Fear and Worry by Edmund Bourne and Lorna Garano


  • More people suffer from acute anxiety than ever before.
  • You need not understand the causes of an occurrence of anxiety to deal with it.
  • Distinguish between normal anxiety and “anxiety disorders” by the severity of the experience and how much it paralyzes you.
  • What you tell yourself determines how you feel.
  • When you gradually begin to face situations you find unsettling or found unsettling in the past, they lose their ability to control you.
  • Exercise is one of the best ways to combat anxiety.
  • Reduce the amount of caffeine you ingest to reduce its ability to promote anxiety.
  • Establish periods of “downtime” when you give yourself the freedom to relax and recuperate.
  • To live with less anxiety, simplify.
  • Spend more time in conversation. Try to talk about things other than your worries.


“Acute Anxiety”

More people – about 50 million of them in the US in 2015 – suffer from acute anxiety than ever before. Of course, people confronted difficulties in the past, but modern society promotes anxiety.

Three elements generate anxiety:

  • The rapidity of change in modern societies.
  • A lack of agreement on moral and social norms to live by.
  • An increasing disaffection with “postindustrial society’s” functioning.

“By facing the situation fully without resorting to devices such as a support person or medication, you learn you can handle the situation even if you feel some anxiety.”

People feel vulnerable and anxious when they lack attachment to something greater than themselves – perhaps a mission, the good of society or faith in the divine. People can regain a sense of security and comfort by caring about other people or about situations that lie beyond their own concerns.

“Acceptance of anxiety symptoms is the key. By cultivating an attitude of acceptance in the face of anxiety, you allow it to move through and pass.”

To understand anxiety, first distinguish it from other psychological states. When you experience fear, your emotions focus on specific, concrete issues around you. For instance, you could fear losing the approval of someone important to you.

Your sense of anxiety could preoccupy you, especially if you don’t know why you feel anxious. To tackle anxiety, address your body, behavior and thought processes.

“Anxiety Versus Anxiety Disorders”

In order to distinguish between normal anxiety and anxiety disorders, gauge the severity of the experience and how paralyzed you feel. Mental health specialists classify various kinds of anxiety disorders, including panic disorder, agoraphobia, social phobia, specific phobia, generalized anxiety disorder, obsessive-compulsive disorder and post-traumatic stress disorder.

“Workaholism produces an unbalanced way of life which often leads first to chronic stress, then to burnout, and potentially to illness.”

An anxiety disorder’s onslaught may feel so unexpected that you wonder why it’s happening. Keep two things in mind. You don’t need to understand the causes behind anxiety to deal with it. And don’t assume that anxiety has only one cause. People experience anxiety due to a number of factors, including their genetic and biological makeup, how their parents treated them as children, their more recent history and their beliefs.

“Relax Your Body”

People experience anxiety emotionally at first, and then intensely as a physical sensation. Sufferers feel short of breath, their muscles tense and their heart rate spikes. You may think you have no control over these symptoms. But you can learn to control your physical responses to anxiety and curb its paralyzing grip.

“Self-nourishment means maintaining a daily routine of sufficient sleep, recreation and downtime.”

One useful technique is “progressive muscle relaxation,” which Chicago physician Edmund Jacobson devised in 1929. He found that the body tenses its muscles when it confronts anxiety-provoking ideas. If you prevent your body from tightening up, you can prevent or defuse the tension of anxiety.

Progressive muscle relaxation calls for tightening and loosening muscle groups throughout your body – your lower and upper legs, gluteal muscles, shoulders, and so on. Tighten each group for about 10 seconds and then let them go. Take a break for about 20 seconds, and do the next set of muscles. Do this for at least two 20-minute sessions a day. Pick a quiet place and strive to not let anything disturb you. Stick to a consistent schedule.

“Relax Your Mind”

The modern world thrives on hyperactivity. When you feel anxious, your mind zooms into overdrive. Most people in Europe and the US think that taking deliberate action to induce a sense of peace is an odd thing to do, but people in other parts of the world have taken steps to reach a calm state for centuries.

“Fearful thinking takes many forms, but anxiety sufferers are often intimately acquainted with catastrophizing.”

How you envision your life affects how you live it. Images help shape human thought. You could picture your life like a suspense movie, or you could conjure images to calm yourself using the technique of “guided visualization.” Think of going to the beach or being in a forest, to experience the beauty and peace that visiting such places brings.

“The most effective way to overcome a phobia is simply to face it.”

If stilling your mind is difficult, try meditation. It can help you learn to let go of your fears about the past or future and concentrate on the present. To meditate, find a quiet place. Play calming sounds, like a recording of ocean waves. Relax your muscles. Either sit on the floor cross-legged or sit in a comfortable chair. Focus on your breathing or on an image. Stop judging yourself or striving to solve every tiny problem. Practice regularly, even if only for a short time each day.

“Think Realistically”

Consider two people who are stuck in a traffic jam. One gets mad. The other accepts the inevitable and listens to music. What you tell yourself determines how you feel. Knowing that is a great source of strength and a path to a calmer, more peaceful life.

“When blood sugar falls too low, your adrenal glands kick in and release adrenaline and cortisol, which causes you to feel more anxious and aroused.”

People who are prone to anxiety tend to fixate on thoughts about something going wrong. That makes them feel anxious. You may overestimate the possibility that something disastrous can happen as you denigrate your capability to tackle the consequences. Learn to recognize “distorted thoughts.” Ask if they make sense. Replace them with productive thoughts that reflect reality.

“Face Your Fears”

You may suffer anxiety due to a phobia, such as being afraid of public speaking, using an elevator, or going to a doctor or dentist. People develop phobias when they become sensitized to a particular circumstance or situation. To address a phobia, break the link between a situation and your anxiety with “exposure therapy.” This overexposes you to something you fear, in order to blunt its impact.

“The rising intake of sugar began in the 20th century and has reached an unprecedented height in present-day America.”

When you gradually face situations you find unsettling or found unsettling in the past, they lose their ability to control you. The initial stages of exposure therapy can be uncomfortable. You need to commit to facing the immediate pain to enjoy the long-term gain of alleviating the phobia.

Divide the exposure process into two parts. First have some assistance, like the presence of a friend or a professional or even mild medication. Next, for “full exposure,” don’t rely on support. You will learn that you can manage situations you avoided in the past.

“Having a life that is freighted with onerous financial and time commitments, as well as excessive material items, is a modern source of anxiety.”

Remain conscious of what you hope to achieve. For instance, you might want to be able to speak in public. For exposure therapy to work, create a series of measures you intend to use to face your fear. Write down the steps you’re planning to take. At the beginning, list something related that makes you mildly uncomfortable. Don’t confront the most troubling situation until your last step. When you can cope with that situation with minimal discomfort, you’ve completed the process.

“Get Regular Exercise”

Exercise combats anxiety. When you feel anxious, your body reacts as it would to any danger. It releases adrenaline as part of its fight-or-flight response. Your body naturally seeks exercise under that circumstance. Exercising affects several aspects of your physiology that anxiety activates. For instance, exercise helps you minimize muscular tension. It helps your body break down “excess adrenaline and thyroxin” that help keep you tense. Exercise increases oxygen in your bloodstream, and produces endorphins and serotonin that enhance your sense of well-being.

“Stop the muscle tension, stop the cycle. ‘An anxious mind cannot exist in a relaxed body,’ Dr. Jacobson once said.”

Before you start an exercise program, make sure that you don’t have heart disease, high blood pressure or diabetes. Attempt aerobic exercise at least “four to five times a week.” Activities that involve stretching, such as yoga or dancing, work well with aerobic activities. Unfortunately, you can always find many reasons not to work out – lack of time, how tired you feel, how boring you find exercise, or that you tried it in the past and couldn’t stand it. Counter these excuses with positive thoughts of exercise’s benefits.

“Eat Right to Stay Calm”

Most people include coffee as part of their daily routine. Unfortunately, caffeine increases the neurotransmitter norepinephrine in the brain. Norepinephrine keeps you from sleeping. It makes your body feel as if it’s experiencing stress. Caffeine can make you feel constantly stressed. Reduce the amount of caffeine you ingest to fewer than 100 milligrams a day – the equivalent of “one cup of percolated coffee,” or two cola drinks or fewer.

“From the time we awaken until we fall asleep, we are engaged in an almost constant mental bustle.”

In the past, people consumed little sugar unless they possessed great wealth. Today, people cannot adequately process the amount of sugar they consume. They increasingly suffer from diabetes – an excess of sugar in the bloodstream – or hypoglycemia, which is a deficit of sugar.

The symptoms of hypoglycemia resemble those of anxiety; you might feel dizzy, apprehensive and unsteady. To tackle hypoglycemia, eat fewer “simple sugars” and “simple starches” such as white rice and bread. Read labels in the grocery store. Minimize the use of processed food. Change your food habits. Cut down on meat and cheese – they make your body more acidic.

“Rather than trying to stop worry or obsessive thoughts altogether, you may opt to try postponing them for a bit.”

Until recently, conventional wisdom among nutritionists held that you should increase your consumption of complex carbohydrates while cutting fat and protein. Now, nutritionists argue against eating high amounts of carbohydrates because that increases the insulin your body produces. That disturbs the body’s ability to produce hormones that increase peace and serenity.

“Nourish Yourself”

Modern life is fraught with so much activity that people forget they need to rest to gain emotional and physical stability. Take care of yourself. Get enough sleep every night; make space for having fun and “downtime.” Create periods during the day when you give yourself the freedom to relax and recuperate. If you do not take time to relax, you bank the tension you build up while working or handling personal tasks. If you spend most of your time working, you may be ignoring your “physical and emotional” needs. This can increase tension and make you unwell. Decide to do less. Make sure you get some exercise every day. Set up a schedule for going to bed and getting up.


Anxiety springs from having too many possessions and demands on your time. To live a more fulfilling life, simplify. Distinguish between “simplicity” and “austerity.” Austerity implies you are denying yourself and creating deprivation. A simple life means shedding extras that require time and money, but that don’t give you anything in return.

“It’s what we say to ourselves in response to any particular situation that mainly determines our mood and feelings.”

Duane Elgin’s book Voluntary Simplicity proposes that you spend more time with your family and people you like. Use your time working on your “physical,” “emotional” and “spiritual” capacities. Feel care and concern for the poorest people in the world. Minimize what you consume, and buy enduring products that consume the least energy. Get rid of things that you don’t need that other people could use. Build connections with people, society and your spirituality. Your perceptions can make you feel separate from everything around you. But in truth, you connect profoundly to everything in reach. Experiencing that natural connectedness with the universe will begin to cure your anxiety.

Turn Off Worry

Excessive worry creates a list of things to feel concerned about. You could find it hard to stop worrying and to think of other things. Shift your focus from your worries by paying attention to a project you’d like to complete. Do something physical – a sport or something around the house. Speak to someone. One affliction of the modern world is people who do not spend enough time in conversation. Talk about things other than your worries.

About the Authors

Former director of the Anxiety Treatment Centers in California, Edmund Bourne earned his PhD in behavioral sciences. His bestsellers include The Anxiety and Phobia Workbook and Beyond Phobia and Anxiety. Lorna Garano is a freelance writer.

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