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

Outline

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

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

Why the Increase in Anxiety?

Understand the Problem to Help Clients Find Solutions

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

Strategies that Promote Healthy Use of Technology

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

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

Exposure Therapy/Coaching

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

Cognitive-Behavioral Therapy

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

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

Stress Management

• Eliminate the stressor – incorporate media “time outs”

• Manage time and environment
• Shifting attitudes

Relaxation and Mindfulness

• Skills for calming the persistently vigilant nervous system

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

Clinical Considerations

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