InInshirahislamically integrated self-help
Approachcbt
TimeAny
MomentComing & going
1The first day back is worse than the weeks before it, not better. Plan for that spike rather than letting it take you by surprise.
cbtThe cost of avoiding20 minutesQur'an 2:155

Anxiety climbs as the return gets close and peaks somewhere near the doorway, then it comes down, but only for someone who stays long enough to find that out. Put the supports in place before the date arrives: who meets them, where they can go if it gets too much, what the first hour actually asks. Deciding all of that on the morning, in tears, rarely goes well.

Islamic evidence

We shall certainly test you with fear and hunger, and loss of property, lives, and crops. But give good news to those who are steadfast (Quran 2:155). The fear is named in advance here, which is a kind of preparation in itself.

We shall certainly test you with fear and hunger, and loss of property, lives, and crops. But [Prophet], give good news to those who are steadfast

Qur'an 2:155

Psychological evidence

Reviews of exposure therapy written from an inhibitory learning view argue that what makes approaching a feared thing work is the gap between what you expected and what happened, and that quiet forms of avoidance blunt exactly that gap. These are theoretical reviews drawing laboratory and clinical findings together rather than a trial of going back to school. Read at that level, they explain why a long absence leaves the frightening prediction untouched and loud.

Craske MG, Treanor M, Conway CC, Zbozinek T, Vervliet B. (2014). Behaviour research and therapy · doi

Review detail

Why it works. A fear that has gone months without being tested has had nothing to shrink it, so it turns up at full size.

anxietyComing & goingscholar review pendingadhd-2778-expect-the-return-spike

Feedback

none yet
On:
2Before you go towards the thing you are afraid of, it helps to have two things to hand: a way to settle your body, and a fairer account of what is likely to happen.
cbtBreaking the worry loop5 minutesQur'an 2:153

Neither of them is meant to take the fear away. They are there so you can stay in the situation long enough for it to teach you something, and that staying is the part that shifts what you expect. If you catch yourself using the slow breathing to get out of the moment rather than to remain in it, that is worth noticing early.

Islamic evidence

seek help through steadfastness and prayer, for God is with the steadfast (Quran 2:153). Two supports are named side by side, one about holding on and one about turning to God, and neither is offered as a way round the hard thing itself.

You who believe, seek help through steadfastness and prayer, for God is with the steadfast

Qur'an 2:153

Psychological evidence

Across two treatments for generalised anxiety disorder, people who improved also became better at standing back from their own thoughts, which points to that skill being part of what helps. The calming side has a more mixed record: in a laboratory study, relaxation itself provoked anxiety in some people with generalised anxiety disorder, in keeping with worry being used to avoid the drop from calm into sudden distress. So there is something behind each of these, and neither is guaranteed to feel pleasant at first.

Sarah A. Hayes‐Skelton; Amber Calloway; Lizabeth Roemer; Susan M. Orsillo (2014). Journal of Consulting and Clinical Psychology · doi

Kim H, Newman MG. (2019). Journal of affective disorders · doi

Review detail

Why it works. A calmer body and a clearer read of the situation make it possible to stay put, and staying put is what changes what you expect next time.

When not to. Deliberately facing a serious fear is best planned with someone trained in it rather than pushed through alone.

anxietyComing & goingscholar review pendingadhd-2809-two-tools-before-facing-it

Feedback

none yet
On:
3Let the person facing it choose the first step, and let them choose an easy one. A rung somebody picked gets climbed. A rung assigned to them gets argued about.
cbtFacing it a step at a time5 minutesQur'an 29:69

Ask which one they would be willing to have a go at this week, not which one they ought to be able to manage. The answer usually sits somewhere in the low to middle part of the ladder, and that is fine. The first step is not there to be impressive. It is there so the week ends with them having done something they were not sure they could do.

Islamic evidence

We shall be sure to guide to Our ways those who strive hard for Our cause (Quran 29:69). The striving comes first and is met, however modest the step being taken.

But We shall be sure to guide to Our ways those who strive hard for Our cause: God is with those who do good

Qur'an 29:69

Psychological evidence

Across seventy five studies of childhood anxiety treatment, the amount of exposure a programme contained was more strongly tied to improvement than the anxiety management components were. What matters most is that steps keep happening, which argues for choosing rungs that will actually get climbed over the most impressive one available. Those studies measured how much exposure was delivered, not who chose it.

Whiteside SPH, Sim LA, Morrow AS, Farah WH, Hilliker DR, Murad MH, Wang Z. (2020). Clinical child and family psychology review · doi

Review detail

Why it works. Doing it because you chose to leaves you with the memory of having done it rather than of having been made to.

anxietyComing & goingscholar review pendingadhd-2812-choose-your-own-first-step

Feedback

none yet
On:
4No step happens without the person agreeing to it. Not ordered, not dragged, not talked round in a bright voice. Agreement is a condition of the thing working, not a courtesy.
cbtFacing it a step at a time5 minutesQur'an 20:46

Coerced exposure teaches two lessons at once: that the situation is dangerous, and that you are not safe with the people who arranged it. After that you have the original fear plus an adult who has to be managed. Ask, wait, accept a no, and offer something smaller instead. The slower route is the only one that ends with someone saying they did it themselves.

Islamic evidence

Do not be afraid, I am with you both (Quran 20:46). What Moses and Aaron were given before walking into what they dreaded was company, not a command.

He said, ‘Do not be afraid, I am with you both, hearing and seeing everything

Qur'an 20:46

Psychological evidence

A meta-analysis of dropout from virtual reality exposure found it was about the same as dropout from real world exposure, so making the format feel gentler does not by itself keep people in treatment. Whatever holds people in is something other than how easy the situation looks from outside, and willing agreement is the obvious candidate. That candidate is not what the meta-analysis tested.

Benbow AA, Anderson PL. (2019). Journal of anxiety disorders · doi

Review detail

Why it works. Going towards something because you chose to is what leaves you with proof about yourself.

anxietyComing & goingscholar review pendingadhd-2816-nobody-gets-dragged

Feedback

none yet
On:
5Offer school again at ten, and at eleven, and after lunch. One refusal at half past seven should not be allowed to decide the whole day.
cbtThe cost of avoiding60 secondsQur'an 12:87

Morning dread usually peaks around the time they would be leaving and then drains away over a couple of hours. A child who could not face it at half past seven can often manage third period, and will almost never suggest that themselves. Keep the offer open, ask lightly, take no for an answer each time without a row, and mean it when you ask again.

Islamic evidence

My sons, go and seek news of Joseph and his brother and do not despair of God's mercy (Quran 12:87). Jacob sends them out again after years of nothing, which is roughly the patience this asks for.

My sons, go and seek news of Joseph and his brother and do not despair of God’s mercy- only disbelievers despair of God’s mercy.’

Qur'an 12:87

Psychological evidence

Reviews of exposure written from an inhibitory learning view argue that the work is done by finding out the expected disaster did not happen, and that this is only learned by going towards the thing. These are theoretical reviews assembling laboratory and clinical evidence, not trials of hourly offers. Read at that level, each fresh offer is another chance for the prediction to be tested rather than confirmed.

Craske MG, Treanor M, Conway CC, Zbozinek T, Vervliet B. (2014). Behaviour research and therapy · doi

Review detail

Why it works. The fear comes down as the morning goes on, so leaving the door open catches the hour when going in becomes possible.

anxietyComing & goingscholar review pendingadhd-2823-ask-again-every-hour

Feedback

none yet
On:
6Find one adult in the building the child already trusts, and have them meet the child at the entrance. The doorway is the hardest minute of the day.
cbtThe cost of avoiding5 minutesQur'an 13:11

The job is small and specific: be there at the door, walk with them to their locker, get them started, be findable later on. It turns the worst moment from something faced alone into something faced with someone. Agree at the start how this will wind down, so that in six weeks nobody discovers the child can only come in when one particular person is at work.

Islamic evidence

each person has guardian angels before him and behind, watching over him by God's command (Quran 13:11). Being accompanied through the frightening part is written into how we are made.

each person has guardian angels before him and behind, watching over him by God’s command. God does not change the condition of a people [for the worse] unless they change what is in themselves, but if He wills harm on a people, no one can ward it off–– apart…

Qur'an 13:11

Psychological evidence

A critical review of safety behaviours during exposure found the evidence genuinely mixed, with some studies suggesting early support does no harm, and argued from inhibitory learning theory that these supports usually have to come off for change to last. Neither the enthusiastic reading nor the strict one is quite right. The practical answer is to plan the help and plan its removal at the same time.

Blakey SM, Abramowitz JS. (2016). Clinical psychology review · doi

Review detail

Why it works. A familiar face makes the hardest minute possible, and stepping that help back later is what makes the rest of the building possible.

anxietyComing & goingscholar review pendingadhd-2826-known-face-at-the-door

Feedback

none yet
On:
7Almost everyone says the same thing afterwards, that the waiting was worse than the thing itself. Say it out loud in your own words, because your own words land differently from anyone else's reassurance.
cbtPractising under provocation5 minutesQur'an 29:69

Before a difficult conversation, write one line about how bad you expect it to be. Afterwards, write one line about how it actually went. Over a few rounds you build a small record of your own predictions running too dark, and that record persuades you far better than being told not to worry.

Islamic evidence

We shall be sure to guide to Our ways those who strive hard for Our cause (Quran 29:69). The striving is met, which is a reason to go in rather than to keep circling the door.

But We shall be sure to guide to Our ways those who strive hard for Our cause: God is with those who do good

Qur'an 29:69

Psychological evidence

Work on how exposure practice helps found that neither the drop in fear within a session nor how calm someone felt at the end predicted how well they did later. What mattered was what got learned. So do not judge a hard conversation by how comfortable you felt during it. This comes from anxiety research and is a theoretical review rather than a single trial.

Craske MG, Kircanski K, Zelikowsky M, Mystkowski J, Chowdhury N, Baker A. (2008). Behaviour research and therapy · doi

Review detail

Why it works. Your expectation only updates when you catch it being wrong in your own words.

angerComing & goingscholar review pendinganger-0546-the-dread-was-the-worst-part

Feedback

none yet
On:
8Before anyone does something exposing, let them check their own conditions and give them a clean way to say no. A public yes given under pressure is not really a yes.
cbtPractising under provocation60 secondsQur'an 2:45

It can be as ordinary as asking someone to consider whether they have the privacy, the time and the state of mind for this today. Ask it first and whoever declines has not failed in front of anybody. It costs a minute, and it is the difference between practice a person chose and something that happened to them.

Islamic evidence

Seek help with steadfastness and prayer, though this is hard indeed for anyone but the humble (Quran 2:45). The difficulty is stated openly, which is a good model for how to ask someone whether they are ready.

Seek help with steadfastness and prayer- though this is hard indeed for anyone but the humble

Qur'an 2:45

Psychological evidence

In 125 male veterans with post traumatic stress and anger difficulties, group anger management delivered by videoconference did as well as the same therapy given in person. The conditions of delivery clearly matter enough to be studied, and they can be got right. That trial compared formats rather than testing how people were prepared beforehand.

Leslie A. Morland; Carolyn J. Greene; Craig S. Rosen; David W. Foy; Patrick M. Reilly; Jay H. Shore (2010). The Journal of Clinical Psychiatry · doi

Review detail

Why it works. People can stay with something difficult when they know they are free to stop.

angerComing & goingscholar review pendinganger-0559-check-before-you-volunteer

Feedback

none yet
On: