Margaret Wehrenberg – The New Face of Anxiety: Treating Anxiety Disorders in the Age of Texting, Social Media and 24/7 Internet Access

Outline

NeurobiologyNeurobiology: : The Impact of 24/7 Internet and “Information Overload”The Impact of 24/7 Internet and “Information Overload”

• Is it an addiction? The role of dopamineIs it an addiction? The role of dopamine
• Variable interval rewards: The most powerful reinforcementVariable interval rewards: The most powerful reinforcement
• Perpetual state of “fight or flight”Perpetual state of “fight or flight”
• Impact of technology on the prefrontal cortexImpact of technology on the prefrontal cortex
• “Multi-tasking”: Changing the landscape of learning“Multi-tasking”: Changing the landscape of learning
• The impact of screen time on ruminationThe impact of screen time on rumination
• Impulse control at all ages: Instant v. delayed gratificationImpulse control at all ages: Instant v. delayed gratification

Why the Increase in Anxiety? Why the Increase in Anxiety?

Understand the Problem to Help Clients Find SolutionsUnderstand the Problem to Help Clients Find Solutions

• The psychological hook of “checking in”The psychological hook of “checking in”
• Broad skills deficits for coping with normal situationsBroad skills deficits for coping with normal situations
• Collective anxiety due to 24/7 news cyclesCollective anxiety due to 24/7 news cycles
• Generational differencesGenerational differences
• Illusions of perfection onlineIllusions of perfection online
• New fears created/exacerbated by digital media: New fears created/exacerbated by digital media:
  • Negative evaluation/rejectionNegative evaluation/rejection
  • Having behavior recorded or posted publiclyHaving behavior recorded or posted publicly
  • Fear of missing out (FOMO)Fear of missing out (FOMO)
  • ConfrontationConfrontation
  • Taking on responsibilities (“Adulting”)Taking on responsibilities (“Adulting”)
  • NomophobiaNomophobia
• Use of technology to avoid emotional experiencesUse of technology to avoid emotional experiences
• The meaning of “friend” has changedThe meaning of “friend” has changed
• Cyberbullying at all ages: The power of anonymityCyberbullying at all ages: The power of anonymity

Strategies that Promote Healthy Use of TechnologyStrategies that Promote Healthy Use of Technology

• Key questions that uncover anxiety related to digital media useKey questions that uncover anxiety related to digital media use
• Techniques for providing meaningful psychoeducationTechniques for providing meaningful psychoeducation
• Use “demand delays” to diminish impact of rapid screen shiftingUse “demand delays” to diminish impact of rapid screen shifting
• Tools for setting device boundaries to create more balanceTools for setting device boundaries to create more balance
• “Be still” techniques to tolerate time away from devices“Be still” techniques to tolerate time away from devices

Therapy Tools to Improve Emotional Regulation, Reduce Anxiety and Build Self-Worth Therapy Tools to Improve Emotional Regulation, Reduce Anxiety and Build Self-Worth

Exposure Therapy/CoachingExposure Therapy/Coaching

• Avoid avoidance!Avoid avoidance!
• How to provide meaningful psychoeducationHow to provide meaningful psychoeducation
• The 3 C’s: Calm, Competent and ConfidentThe 3 C’s: Calm, Competent and Confident
• Accurate anticipation: The power of imagination exposureAccurate anticipation: The power of imagination exposure
• Techniques for teaching social skillsTechniques for teaching social skills
• 5 ways to overcome fears of social situations5 ways to overcome fears of social situations
• Utilize FOMO (fear of missing out) as a tool for goal developmentUtilize FOMO (fear of missing out) as a tool for goal development
• Address “adulting” fearsAddress “adulting” fears

Cognitive-Behavioral TherapyCognitive-Behavioral Therapy

• Challenge the “comparison fallacy” of online interactions Challenge the “comparison fallacy” of online interactions
  Identify and challenge distorted beliefs about the selfIdentify and challenge distorted beliefs about the self

• Create new self-talk by changing the scriptCreate new self-talk by changing the script
• Combat perfectionism and procrastinationCombat perfectionism and procrastination
• Ellis’ ABCD approach to identify inhibiting beliefsEllis’ ABCD approach to identify inhibiting beliefs

Stress Management Stress Management

• Eliminate the stressor – incorporate media “time outs”Eliminate the stressor – incorporate media “time outs”

• Manage time and environmentManage time and environment
• Shifting attitudesShifting attitudes

Relaxation and MindfulnessRelaxation and Mindfulness

• Skills for calming the persistently vigilant nervous systemSkills for calming the persistently vigilant nervous system

• Interrupt rumination and build resilienceInterrupt rumination and build resilience
• Apps that promote calming breathing techniquesApps that promote calming breathing techniques

Clinical ConsiderationsClinical Considerations

• Identify and address personal bias/countertransference issuesIdentify and address personal bias/countertransference issues
• Between-session recommendations that reinforce skillsBetween-session recommendations that reinforce skills
• Limitations of the research and potential risksLimitations of the research and potential risks