Imagine, you just got into an argument with your partner over whose turn it is to do the dishes. Your partner decided to leave the house and take a walk to cool off, and you are left inside, ruminating over what just transpired. Your thoughts are racing. You think to yourself, "Was I too harsh? I am just feeling a bit overwhelmed with housework. I'm sure we can talk it out when they're back from their walk." You sit calmly in your favorite chair, maybe feel frustrated for a moment, but decide to listen to some music to cool off and are feeling more calm about the argument only a couple minutes later.
Now, imagine that you had a completely different string of thoughts after that argument instead. Your partner is on their walk and you think to yourself, "They hate me. Why else would they leave me? I shouldn't have even started the argument. I'm such a burden to them. I'm such a burden to everyone." Now, you're feeling sad, hopeless, panicked, and guilty. You feel trapped in your state of anxiety and sadness, unable to do anything to feel better. You sink to the floor and cry.
Why did I just walk you through these two scenarios? I wanted to point out the power that our thoughts have over our emotions and actions. In the first scenario, we thought about the argument that just happened in a more balanced and accurate way. We checked in with ourselves, validated ourselves, and were able to calm ourselves down by listening to music. Our thoughts directly influenced our feelings and our behaviors. This is in stark contrast to the second scenario where we immediately started thinking the worst, otherwise known as catastrophizing. When we catastrophize, we jump to the worst possible outcome, which then makes us feel anxious and hopeless and impacts our behaviors.
Now, let's use a different scenario that is more relevant to food allergy. Imagine that you are at a friend's house for a birthday party. You told her about your severe food allergies ahead of time but when you walk in, you see that someone has brought a dish filled with your allergen. You freeze in the doorway, unsure of what to do. Let's look at two options for how we might perceive this situation.
Option 1: You think to yourself, "Oh no. I'm deathly allergic to that food. My friend probably didn't tell the other guests about my food. Maybe she doesn't care about my allergies that much. Why did I even come? I'm such a burden to everybody. I hate having allergies. I should probably just make up an excuse for why I can't stay long."
Option 2: You think to yourself, "Oh, it looks like I'm allergic to what that guest just brought. I wonder if my friend realizes. I should go let her know because I know she wants to keep me safe and would want me to feel comfortable."
If our thoughts go down a negative spiral like they did in Option 1, we are likely to feel badly about ourselves and engage in behaviors that probably won't help us in the long run. Removing ourselves from the social situation without communicating the issue to our friend will not solve the issue or prevent it from happening again. However, in Option 2, our thoughts are much more accurate and balanced. We noticed that we are allergic to what the guest brought in but we didn't assume that our friend bad intentions and we chose to communicate with our friend instead of lying and leaving.
The idea that our thoughts, feelings, and behaviors are inextricably linked is one of the core tenets of cognitive behavioral therapy (CBT). CBT is a therapeutic modality that has high effectiveness for treating anxiety and depression among other disorders. Although I'm not attempting to delve into CBT or by any means provide it with this blog post, I am sharing a tiny snippet that may be helpful to anyone who struggles with anxious thoughts related to food allergies. I always recommend seeking help from a mental health professional before practicing these tips on your own. If you are interested in learning more about CBT or think you may benefit from it, I highly recommend finding a licensed therapist who is trained in CBT (this food allergy counselor directory is a great place to start!). This blog post is not meant to be a replacement for therapy.
With that being said, people with food allergies and parents of children with food allergies are at risk for having higher levels of hypervigilance and anxiety. The nature of living with a life-threatening food allergy is anxiety-inducing in itself. We have to be on constant alert for our allergen to keep ourselves safe. While that anxiety is completely founded and even helpful, if we have thoughts that are unbalanced or not totally accurate, as we saw in the above scenarios, our anxiety can be exacerbated to the point that it interferes with our life and becomes unhelpful. Below, I outline some simple steps on how you can begin to reframe thoughts that may be exacerbating feelings of anxiety for you related to you or your child's food allergies.
1. Understand the Thoughts-Feelings-Behavior Link
It takes time to grasp the whole connection between your thoughts, feelings, and actions, especially if you are new to the world of CBT. I highly recommend checking out this page that has more examples of how our thoughts directly impact and are influenced by our feelings and behaviors. Additionally, it is useful to look over the list of skewed thought patterns, or what's called cognitive distortions, at the bottom and see if you identify with any of those. I already mentioned one earlier (catastrophizing), but I encourage you to ask yourself if you've ever utilized any of the listed cognitive distortions. The chances are, most of us have used all of them at some point in our lives!
2. Notice Your Thoughts
This one is tricky because most of the time, our thoughts happen so quickly that they are basically automatic. We are used to going about our day just thinking without really being aware of the thoughts we have, so it takes some practice to notice our thoughts! A starting point for some people might be asking yourself when the last time you felt a strong negative emotion like sadness, fear, or anger was, and asking yourself what led up to it? What were you thinking before you felt that emotion? If that's too tricky, another helpful option is creating a thought journal or record. Think about a difficult situation that provoked some emotion for you, briefly jot down what the situation was (only focusing on the facts), identify which emotions you felt in the situation and rate their intensity (0-100), and then put your detective cap on. Ask yourself what thoughts were running through your head at the time and how strongly you currently believe each thought (0-100). Here is a sample of a thought record to further illustrate how to utilize this. Start by doing one of these each day and after the first week, you might find that you have an easier time simply noticing your thoughts without feeling as stressed out by them.
3. Challenge Your Thoughts
Once you have identified some unhelpful thoughts that are causing distress, put them on trial. Imagine that you are a lawyer, interrogating your thought in front of a court, to determine whether it is accurate or not. Some questions that you may want to ask yourself include:
What is the thought I want to challenge?
What is the evidence for this thought? What is the evidence against this thought?
Am I basing this thought on facts or feelings?
Am I looking at this situation without all of the evidence?
What would a friend say about this situation?
Is my thought a likely scenario or a worst case scenario?
Let's imagine another food allergy scenario. Imagine that you are a parent of a child with an anaphylactic milk allergy. Your son has been invited to a classmate's birthday party and immediately, you are flooded with anxiety. You think to yourself, "Oh no, my kid won't be able to go. There will definitely be dairy there. No one will accommodate us and I don't want to ask people to not bring dairy. I feel terrible, he's going to be so disappointed."
Now, let's challenge these thoughts. The thought, "No one will accommodate us and I don't want to ask people to not bring dairy," will be the focus. Ask yourself, what is the evidence for this thought? It's possible that you've had past experiences with people not accommodating your child's allergy. Or maybe, you can recall instances when people made you feel like a burden, or like you were "too much" just for trying to keep your child safe. If so, it is understandable why you fear now that no one will be able to accommodate you.
Now, ask yourself, what's the evidence against this thought? First, we do not know whether anyone will accommodate you. Those past negative experiences do not mean that people will automatically be unaccommodating or open to avoiding dairy for the party. It is just as possible that people will respond positively and be able to accommodate your needs to make you and your child feel safer.
Now, ask yourself, am I basing this thought on facts or feelings? The facts of the situation are that your son was invited to a classmate's birthday party. We do not know anything else. This tells us that we are basing this thought on feelings. We immediately jumped from perceiving the invitation to the birthday party to the worst possible scenario without any facts to back up that that scenario would take place.
You can see that as we continue to go down the list of questions and challenge our thoughts, the emotional intensity behind the thought lessens. After seeing that our initial thought was rooted in feelings like fear rather than facts, we are able to reduce the negative emotion associated with it.
4. Reframe Your Thoughts
Now that we have understood the link between our thoughts, feelings, and behaviors, noticed our thoughts, and challenged them, it's time to reframe them. Reframing thoughts involves shifting your mindset to look at a situation from a different perspective. When this technique is done with the assistance of a therapist, it's known as cognitive restructuring. When we reframe our thoughts, we are shifting our lens to view a situation differently so that our thoughts can be more accurate, balanced, and helpful. Some steps to reframe your thoughts are:
Identify the emotion you were feeling when you had your initial thought and validate it. Validate the feeling, the thought. In the scenario above, we were feeling scared, sad, and hopeless after reading the invitation and immediately thinking of the worst case scenario. You might say to yourself, "I know you were feeling scared and hopeless when you first read the invitation."
Identify why the initial thought was either inaccurate, unbalanced, or harmful. If you're having a hard time identifying this, it is helpful to imagine that a friend is in this exact scenario and had the same initial thought and response that you did when you read the invitation. You might ask yourself what you would say to them to feel better? In this scenario, we might say, "I do not know all the facts. I do not know whether there will be dairy at the birthday party or whether the host is able to accommodate us because I have not spoken to them yet. I was assuming the facts, acting on feelings, and catastrophizing."
Frame the thought in a more accurate, balanced, and helpful way by focusing on the facts while still validating your feelings. In this scenario, one reframe might be something like, "I was feeling scared and hopeless when I first read the invitation due to past negative experiences. I'm not sure if my child will be able to attend the party because I don't have all of the information yet, but there is a chance that he will be able to. I am going to talk to the parents who are hosting the party about my son's allergy and see if there is a way to include us while remaining safe."
My main takeaway from this blog post is that food allergy anxiety is real. Dealing with some level of anxiety and hypervigilance to keep ourselves or our children safe is normal and needed, but when our anxious thoughts are spiraling out of control, it may be time to reframe them. I hope that these tips are useful in giving you some tangible steps to take to reduce the intensity of these thoughts, and as always, I highly recommend speaking to a mental health professional, especially if you are having trouble controlling your worrying.
Please let me know your thoughts on this in the comments or if you have tried reframing your thoughts and what your experience was like!