Rose Medical Center
4500 E. 9th Ave. #660
Denver, CO 80220




Based on the Audio CD Anxiety: Friend or Foe? by Susan Heitler, Ph.D.

available at or

This guide is for therapists.  At the same time, individuals are welcome to use it on their own, or with the help of a friend.

Step I. Identify the conflicts

  1. Ask client to close his/her eyes, and to focus on where in his body he feels the anxiety.
  2. Ask what thought would make this anxiety feel even more intense.  What additional thoughts would also make the anxious feeling more intense?
  3. The therapist explains, “I’m going to be your secretary” and writes down these thoughts word for word, numbering the thoughts sequentially as they come up, until the client has no more anxiety-producing thoughts to add.

Step II.  Guide conflict resolution

  1. Ask the client then to open his/her eyes, and explain that you will proceed together to circle back on the list, taking his/her anxiety-producing thoughts one by one as genuine dilemmas (conflicts) that need a plan of action in response.
  2. Discuss each item on the list, clarifying the underlying concerns, and finding a possible plan of action.  Sometimes deciding on a way to gather more information regarding that concern is a sufficient plan of action, as information is often the best antidote to anxiety.
  3. Have the client close his/her eyes again after creation of each plan of action.  Visualize that action plan, checking to see that it looks like it will be helpful, and how others will respond.  If problems are foreseen with the plan of action, the client opens his/her eyes, and alters the solution plan.  Check again with the new action plan, until when the client visualizes the plan it looks like it will work.
  4. When all the issues appear to have been brought to a positive plan for resolution, the anxious feelings should be lifted.

Step III. Summarize

  1. Circle once more through the list to be certain that each concern and each anxiety-producing dilemma has been responded to.
  2. Ask, “Are there any little pieces of this that still feel unfinished?”

For further guidance on the conflict resolution process, check out

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