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Anxiety Worksheets for Therapists: The Loaded Die ACT Metaphor

Acceptance and commitment therapy (ACT) recognizes that the source of the problem when struggling with emotional issues is the idea of controlling the symptoms. 

So, it sheds light on a common paradox: the more we try to control our internal experiences, the more we struggle. 

This concise approach reveals why efforts to control thoughts and emotions often lead to increased distress, highlighting the need for different strategies.

Understanding Anxiety: More Than Just Worry

Anxiety isn’t just about feeling worried or nervous. It’s a complex response involving thoughts, emotions, and physical sensations.

  • Physical Responses: Rapid heartbeat, sweating, and trembling are common physical manifestations of anxiety.
  • Emotional Impact: Anxiety can lead to feelings of dread, panic, or impending doom.
  • Cognitive Aspect: Worrisome thoughts, often about future events or the fear of losing control, dominate the mind.

Recognizing these aspects is vital for understanding and effectively addressing anxiety.

The Irony of Control in Anxiety

When anxiety strikes, the natural tendency is to desperately try to eliminate or suppress the unpleasant thoughts, emotions, and bodily sensations. Yet ironically, this attempted control often exacerbates the very experiences one is trying to get rid of:

  • Thought suppression amplifies worries
  • Avoidance of anxiety-provoking situations limits life experiences
  • Resisting physical symptoms like rapid heartbeat increase bodily tension

This struggle creates a vicious, self-perpetuating cycle – the more one tries to control anxiety, the more overpowered by it they feel.

Practical Tool: The Loaded Die — Anxiety and Control

This worksheet is a valuable resource for therapists using ACT metaphors to explain the control paradox in anxiety.

This metaphor equates the struggle with anxiety to playing a rigged game, where attempts at control are as futile as trying to win with a loaded die.

The loaded die metaphor aims to:

  • Help clients see the ineffectiveness of trying to control anxiety and encourage exploration of alternative responses.
  • Encourage clients to observe their thoughts and feelings without judgment, reducing the struggle with anxiety.
  • Assist clients in understanding that their reactions to anxiety are normal, alleviating self-blame.

How to Use This Tool?

  1. Normalize struggles with anxiety control using the metaphor
  2. Explore unhelpful coping strategies rooted in the control agenda
  3. Highlight the paradox – how efforts to suppress amplify anxiety
  4. Introduce mindfulness to observe anxiety without battling it
  5. Practice cognitive defusion techniques to unhook from anxious thoughts
  6. Cultivate self-compassion for previous futile control attempts
  7. Commit to alternative values-guided actions despite anxiety’s presence

Loaded Die Metaphor ACT anxiety

With therapist guidance, clients gain new perspectives and skills to approach anxiety with openness rather than combat, restoring agency.

Experiential Learning in ACT

An essential skill for therapists using ACT is facilitating metaphors and exercises experientially rather than just lecturing about the concepts.

It’s easy for beginners to fall into the trap of becoming too didactic – trying to explain the meanings like a teacher instead of guiding clients through exploratory processes as a therapist.

In this video, you can watch a professional going through the metaphors and showing you how to apply them in session.


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Related Articles

If you want to learn more about anxiety management, you can continue your learning here: 

Explore mindfulness and cognitive defusion techniques for anxiety management with our worksheet. Transform client therapy sessions effectively.

Help your clients manage overwhelming emotions and stay present during challenging moments with this grounding skills worksheet.

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Anxiety Worksheets for Therapists: The Loaded Die ACT Metaphor