InInshirahislamically integrated self-help
ThemeFacing it a step at a time
TimeAny
MomentEveryday
1It helps to have one small set of moves you use whatever the worry is wearing today. Not a fresh technique for each fear, just the same few steps, learned well enough to reach for without thinking.
cbtFacing it a step at a time60 secondsQur'an 2:45

Anxiety changes costume. This month it is contamination, next month it is being late, next year it is your health. If every version needs its own method you are permanently starting again, and remembering which method applies becomes another job. A short portable routine you can run in a queue, in a corridor, in bed at two in the morning, is worth more than a clever technique you only half recall.

Islamic evidence

Seek help with steadfastness and prayer (Quran 2:45). What is named is two things a person can return to, whatever the particular trouble turns out to be.

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

Qur'an 2:45

Psychological evidence

A systematic review and meta-analysis comparing exposure with cognitive therapy across the anxiety disorders found that exposure based procedures carry much of the therapeutic weight, whichever diagnosis is in front of you, which supports having one approach that travels. It also sets a limit on what a calming routine can claim. A meta-analysis of attention bias modification, a trainable technique for social anxiety, found the benefits inconsistent, so a portable skill is a way to stay in the situation rather than a treatment in its own right.

Ougrin D. (2011). BMC psychiatry · doi

Heeren A, Mogoașe C, Philippot P, McNally RJ. (2015). Clinical psychology review · doi

Review detail

Why it works. Something you can reach for without thinking is the only thing available to you when you are frightened.

anxietyEverydayscholar review pendingadhd-1722-one-set-of-moves

Feedback

none yet
On:
2A ladder worth climbing has six things: real steps, built with you rather than for you, in your own words, a first rung that is genuinely easy, your hand on the pace throughout, and practice often enough to add up.
cbtFacing it a step at a time20 minutesQur'an 84:19

Most ladders come apart for dull reasons. The bottom rung was somebody else's idea of easy. The wording came out of a manual. Nobody said you were allowed to stop. Or the practice was so spread out that every attempt started from cold. If you are drawing one up, check it against those six before you climb anything.

Islamic evidence

you will progress from stage to stage (Quran 84:19). Growth is described as staged, which is the shape a ladder is trying to copy.

you will progress from stage to stage

Qur'an 84:19

Psychological evidence

Across seventy five studies of treatment for childhood anxiety, how much exposure a programme contained was more strongly related to symptom improvement than the anxiety management components were. Amount and frequency matter, which is the argument for practice that is regular rather than occasional. These were treatment studies in children, so what the pooled figures cannot tell you is how much any one person's ladder needs.

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. Each of those six takes away one of the usual reasons people stop partway up.

anxietyEverydayscholar review pendingadhd-1723-what-a-workable-ladder-needs

Feedback

none yet
On:
3The early rungs do not have to be the real thing. A photograph, a video, or picturing it carefully with your eyes shut is a proper step and not a cheat.
cbtFacing it a step at a time5 minutesQur'an 87:8

This matters most when the real version is out of reach: the dog you cannot summon, the flight you cannot afford, the classroom that is thirty miles away. Start with whatever version you can arrange this week. Having one step behind you early is a large part of what makes the next one thinkable.

Islamic evidence

We shall show you the easy way (Quran 87:8). The path is described as being made passable rather than taken away, which is what a gentler first rung is.

We shall show you the easy way

Qur'an 87:8

Psychological evidence

In a randomised non-inferiority trial, one hundred people with spider phobia were assigned either automated virtual reality exposure or the gold standard single session of real exposure, and the virtual version was not inferior. A separate meta-analysis found that the link between how present people felt in the virtual environment and how anxious they became was real but modest, which suggests the stand in does not have to be perfectly convincing to do something. Both concern virtual reality rather than imagining, so the parallel is suggestive rather than settled.

Miloff A, Lindner P, Dafgård P, Deak S, Garke M, Hamilton W, Heinsoo J, Kristoffersson G, Rafi J, Sindemark K, Sjölund J, Zenger M, Reuterskiöld L, Andersson G, Carlbring P. (2019). Behaviour research and therapy · doi

Ling Y, Nefs HT, Morina N, Heynderickx I, Brinkman WP. (2014). PloS one · doi

Review detail

Why it works. A pictured version stirs up enough of the same fear to be worth practising against.

anxietyEverydayscholar review pendingadhd-1724-imagined-rungs-count

Feedback

none yet
On:
4Panic rarely comes out of nowhere. It usually lands on a body already short of sleep, running on coffee and eating at odd hours, so whatever tipped it over did not have far to push.
cbtFacing it a step at a timeQur'an 4:28

This is not a telling off about your habits. It is that the same argument or deadline arrives very differently at a rested body than at a wrecked one. If panic is a regular visitor, look at the week around it as well as the moment itself: what time you got to sleep, what you drank, whether you ate anything before the middle of the afternoon.

Islamic evidence

God wishes to lighten your burden; man was created weak (Quran 4:28). Bodily limits are stated as part of the design, not as a fault to be pushed through.

God wishes to lighten your burden; man was created weak

Qur'an 4:28

Psychological evidence

There is a laboratory finding that fits here. Acute stress impaired people's retrieval of extinction memory, meaning the learning that exposure practice builds is harder to get at when someone is already under pressure. That was deliberate stress in an experiment rather than sleep debt or caffeine, so the link to your particular week is reasoning rather than something the study measured.

Raio CM, Brignoni-Perez E, Goldman R, Phelps EA. (2014). Neurobiology of learning and memory · doi

Review detail

Why it works. Everything you have learned about handling fear is harder to reach when your body is already running hot.

anxietyEverydayscholar review pendingadhd-1725-mind-the-baseline

Feedback

none yet
On:
5If you are helping someone with their sleep and eating, ask rather than instruct. The moment you sound like their mother you have lost the part of you that was useful.
cbtFacing it a step at a time5 minutesQur'an 13:11

Young adults are busy becoming separate people, and any adult who picks up the parental voice gets folded into that argument whatever they were actually saying. Questions keep you out of it. What do meals look like on a bad week. What time did you get to sleep. Then leave the noticing to them, since the noticing is the part that changes anything.

Islamic evidence

God does not change the condition of a people unless they change what is in themselves (Quran 13:11). The initiative sits with the person, which is worth remembering before you take it off them.

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

An updated systematic review and meta-analysis found internet-delivered treatments for generalised anxiety disorder to be effective, a reminder that people carry out graded practice perfectly well without anyone standing over them issuing instructions. Those programmes are structured and often supported, so this is not an argument for leaving someone entirely alone. It does suggest authority is not the active ingredient.

Eilert N, Enrique A, Wogan R, Mooney O, Timulak L, Richards D. (2021). Depression and anxiety · doi

Review detail

Why it works. People will look honestly at a habit they were asked about and defend one they were told about.

anxietyEverydayscholar review pendingadhd-1726-not-another-parent

Feedback

none yet
On:
6Rather than taking on someone else's routine, ask what actually makes you feel ready for a day, or better looked after. The answers tend to be specific and slightly odd, and they hold up better than anything prescribed.
cbtFacing it a step at a time5 minutesQur'an 18:69

For one person it is a shower before anything else. For another it is having the bag packed the night before, or eating something warm, or ten minutes with nobody talking at them. Write yours down while things are calm, because you will not think of them on a hard morning. Then treat the list as preparation for the step rather than as a replacement for it.

Islamic evidence

God willing, you will find me patient (Quran 18:69). Moses states his own commitment before a hard undertaking, in his words rather than anyone else's.

Moses said, ‘God willing, you will find me patient. I will not disobey you in any way.’

Qur'an 18:69

Psychological evidence

A component network meta-analysis of treatment for panic disorder compared what relaxation, breathing retraining, cognitive restructuring, interoceptive exposure and real world exposure each contribute. The components are not equal, and the soothing ones are not where most of the work happens. So your own preparation is worth having and is scaffolding rather than the thing that shifts the fear.

Pompoli A, Furukawa TA, Efthimiou O, Imai H, Tajika A, Salanti G. (2018). Psychological medicine · doi

Review detail

Why it works. A routine you named yourself is the one you will still be doing in three weeks.

anxietyEverydayscholar review pendingadhd-1727-ask-what-makes-you-ready

Feedback

none yet
On:
7Say out loud, before you start, that there will be bad weeks. Then when one turns up it is a thing you expected rather than proof the whole plan was nonsense.
cbtFacing it a step at a time5 minutesQur'an 65:7

Setbacks get read catastrophically when nobody warned you: back to the beginning, all that for nothing. Agree in advance what happens instead. You look at what changed, you drop back a rung or two, you carry on. Tell everyone else involved, parents included, so that a hard fortnight does not become a household emergency.

Islamic evidence

after hardship, God will bring ease (Quran 65:7). The sequence is given in the order people actually live it, hardship first and ease following.

and let the wealthy man spend according to his wealth. But let him whose provision is restricted spend according to what God has given him: God does not burden any soul with more than He has given it- after hardship, God will bring ease

Qur'an 65:7

Psychological evidence

Extinction research shows the original fear association is not wiped out but competed with by new learning, which is why fear can return when the context changes and why practice has to happen in several settings before it holds. Return of fear is built into how the learning works rather than being a sign of failure. This comes largely from laboratory and animal work, so treat it as an explanation and not as a forecast of your particular bad week.

Craske MG, Hermans D, Vervliet B. (2018). Philosophical transactions of the Royal Society of London. Series B, Biological sciences · doi

Review detail

Why it works. A setback you were told to expect costs you a few weeks, and one you were not can cost you the whole attempt.

anxietyEverydayscholar review pendingadhd-1728-plan-for-the-slide-back

Feedback

none yet
On:
8Coming back after a bad patch is quicker than getting there was the first time. Most people expect the opposite, which is why a setback feels so final.
cbtFacing it a step at a time60 secondsQur'an 3:139

What you learned did not vanish. It went out of reach for a while, usually because something else was going on in your life. Pick up a rung or two below where you stopped and you will generally find yourself back at your old level in a fraction of the original time. Knowing that beforehand is what stops a rough fortnight turning into a decision to give up.

Islamic evidence

Do not lose heart or despair (Quran 3:139). The address is to people whose attempt has just gone badly, not to people who are doing well.

Do not lose heart or despair- if you are true believers you have the upper hand

Qur'an 3:139

Psychological evidence

A meta-analysis found that a drug promoting fear extinction enhanced the effects of exposure therapy, which is evidence that exposure works through new learning rather than by wearing fear away, and learning is the kind of thing that can be held and recovered. Worth adding that when all the trials of that drug were pooled at the level of individual patients, its advantage turned out smaller and more conditional than the early results suggested. Neither piece of work set out to measure how quickly people recover from a setback.

Norberg MM, Krystal JH, Tolin DF. (2008). Biological psychiatry · doi

Mataix-Cols D, Fernández de la Cruz L, Monzani B, Rosenfield D, Andersson E, Pérez-Vigil A, Frumento P, de Kleine RA, Difede J, Dunlop BW, Farrell LJ, Geller D, Gerardi M, Guastella AJ, Hofmann SG, Hendriks GJ, Kushner MG, Lee FS, Lenze EJ, Levinson CA, McConnell H, Otto MW, Plag J, Pollack MH, Ressler KJ, Rodebaugh TL, Rothbaum BO, Scheeringa MS, Siewert-Siegmund A, Smits JAJ, Storch EA, Ströhle A, Tart CD, Tolin DF, van Minnen A, Waters AM, Weems CF, Wilhelm S, Wyka K, Davis M, Rück C, the DCS Anxiety Consortium, Altemus M, Anderson P, Cukor J, Finck C, Geffken GR, Golfels F, Goodman WK, Gutner C, Heyman I, Jovanovic T, Lewin AB, McNamara JP, Murphy TK, Norrholm S, Thuras P. (2017). JAMA psychiatry · doi

Review detail

Why it works. The learning is still there even when your performance drops, so you are starting from a foundation and not from nothing.

anxietyEverydayscholar review pendingadhd-1729-the-climb-back-is-shorter

Feedback

none yet
On:
9Nobody puts a child who cannot swim into the shallow end and calls it teaching. Before anyone goes near the thing they dread, they need something to do with their body and their head when the fear arrives.
cbtFacing it a step at a timeQur'an 2:286

It takes only one overwhelming attempt to teach the opposite of what was intended: that it really was too much, and that the adults will push anyway. Get a few usable skills in place first, practise them somewhere calm, and only then pick the first step. The wait looks slow to everyone watching and it is the reason the rest of it works.

Islamic evidence

God does not burden any soul with more than it can bear (Quran 2:286). A step should sit inside what a person can carry, which is a stated principle rather than a guess.

God does not burden any soul with more than it can bear: each gains whatever good it has done, and suffers its bad- ‘ Lord, do not take us to task if we forget or make mistakes. Lord, do not burden us as You burdened those before us. Lord, do not burden us…

Qur'an 2:286

Psychological evidence

A meta-analysis of sixty five comparisons in panic disorder examined what exposure, cognitive therapy, relaxation and breathing retraining each separately contribute. The calming components are real and they are not the engine. Read that as a caution in both directions: skills alone will not treat the fear, and sending someone in without them is not made harmless by the fact that exposure does the heavy lifting.

Sánchez-Meca J, Rosa-Alcázar AI, Marín-Martínez F, Gómez-Conesa A. (2010). Clinical psychology review · doi

Review detail

Why it works. A step someone can only escape from teaches escape.

anxietyEverydayscholar review pendingadhd-2798-skills-before-the-water

Feedback

none yet
On:
10Being shown a breathing technique is not the same as being able to use one. Practise it while nothing is wrong, often enough that it runs without you having to remember the order.
cbtFacing it a step at a time5 minutesQur'an 73:20

At the height of fear the only skills within reach are the overlearned ones. Something demonstrated once in a quiet room will not turn up in a school corridor with your heart going. Run it in the calm, run it with someone watching, run it when you are slightly bored by it, and then it will be there when it is actually needed.

Islamic evidence

recite as much as is easy for you (Quran 73:20). What is asked for is a practice kept at a size a person can actually sustain and repeat.

[Prophet], your Lord is well aware that you sometimes spend nearly two-thirds of the night at prayer––sometimes half, sometimes a third––as do some of your followers. God determines the division of night and day. He knows that you will not be able to keep a…

Qur'an 73:20

Psychological evidence

In a randomised trial for panic disorder with agoraphobia, exposure that the therapist guided on the spot produced more pervasive and lasting effects than exposure simply prescribed as homework. Guided practice beat handing someone the instructions, which is the same point at the level of a whole treatment. It was one trial in one condition, so it argues for practising together rather than telling you how many repetitions a given skill needs.

Gloster AT, Wittchen HU, Einsle F, Lang T, Helbig-Lang S, Fydrich T, Fehm L, Hamm AO, Richter J, Alpers GW, Gerlach AL, Ströhle A, Kircher T, Deckert J, Zwanzger P, Höfler M, Arolt V. (2011). Journal of consulting and clinical psychology · doi

Review detail

Why it works. Under high arousal you can only use what has already become automatic.

anxietyEverydayscholar review pendingadhd-2801-practise-it-while-calm

Feedback

none yet
On:
11Years of avoiding people leave real gaps, not only fear. How to start small talk, how to join a group already talking, how to get out of a conversation. Those can be taught, and being taught them is not an insult.
cbtFacing it a step at a time20 minutesQur'an 20:28

Sending someone into a peer group without the ordinary moves risks a genuinely bad afternoon, which then teaches exactly the wrong lesson. Practise the mechanics first. An opening line, something to do with your hands, a way out. Then the exposure is testing a fear rather than testing a skill nobody ever gave them.

Islamic evidence

so that they may understand my words (Quran 20:28). What Moses asks for is to be understood, which is a practical aim and a good deal kinder than being impressive.

so that they may understand my words

Qur'an 20:28

Psychological evidence

A meta-analysis of twenty nine randomised studies found that psychological treatments for social anxiety disorder produce moderate to large effects. Social skills work sits inside some of those packages alongside exposure and cognitive work, so the pooled figure is evidence for the combination rather than for skills training taken on its own.

Acarturk C, Cuijpers P, van Straten A, de Graaf R. (2009). Psychological medicine · doi

Review detail

Why it works. A step goes wrong for real reasons when the skills it needs were never learned.

anxietyEverydayscholar review pendingadhd-2804-teach-the-missing-skills

Feedback

none yet
On:
12Put a number on each step, nought to ten, and let it be your number. Two people facing the same school will not agree about which part is worst, and the ladder has to belong to the person climbing it.
cbtFacing it a step at a time20 minutesQur'an 23:62

One child dreads the bus and is fine once inside the building. Another would happily ride the bus all morning and cannot get through the front door. A borrowed hierarchy gets this backwards. Rating each step yourself also leaves you something to compare against later, which is how you notice that the thing that was an eight has quietly become a four.

Islamic evidence

We do not burden any soul with more than it can bear (Quran 23:62). The verse adds that people will not be wronged, so a step sized honestly to you is not a trick being played on you.

We do not burden any soul with more than it can bear- We have a Record that tells the truth- they will not be wronged

Qur'an 23:62

Psychological evidence

Across one hundred and twenty four studies of panic disorder, cognitive and behavioural treatment outperformed no treatment and placebo, and the cognitive elements added little beyond the behavioural ones for anxiety outcomes. The doing is where the weight sits, which is a reason to spend your effort building a ladder you will actually climb. What the numbers you write beside each step measure is your expectation, and nothing more than that.

Mitte K. (2005). Journal of affective disorders · doi

Review detail

Why it works. Only your own ratings put the steps in the order you will be able to climb them.

anxietyEverydayscholar review pendingadhd-2810-rate-your-own-steps

Feedback

none yet
On:
13Pick one picture and keep it. Shallow end, middle, deep end. Then the child, the parents and the school are all talking about the same thing without anybody needing the clinical words.
cbtFacing it a step at a time5 minutesQur'an 2:185

It makes the next step obvious instead of arbitrary. You are not being sent to the deep end, you are moving a bit further along the shallow end. It also survives being passed around. A teacher who has never met the therapist can be told where in the pool this child currently is and will know what that means.

Islamic evidence

God wants ease for you, not hardship (Quran 2:185). It is said about a demanding obligation, so plain language about what is being asked is in keeping rather than a softening of it.

It was in the month of Ramadan that the Quran was revealed as guidance for mankind, clear messages giving guidance and distinguishing between right and wrong. So any one of you who is present that month should fast, and anyone who is ill or on a journey…

Qur'an 2:185

Psychological evidence

At long term follow up of an internet delivered graded exposure treatment, seventy five of the original eighty five participants had held onto their gains. Graded practice that people can describe and run themselves does seem to travel beyond the room where it was taught. That study was in adults with irritable bowel symptoms and says nothing about metaphors, so take it as a note on durability rather than proof about the pool.

Ljótsson B, Hedman E, Lindfors P, Hursti T, Lindefors N, Andersson G, Rück C. (2011). Behaviour research and therapy · doi

Review detail

Why it works. A shared picture lets everyone involved agree on the next step without needing it translated.

anxietyEverydayscholar review pendingadhd-2811-one-picture-everybody-uses

Feedback

none yet
On:
14Before a step, write down what you will do when the fear arrives. Which breathing, what you will say to yourself, who you will speak to. Nobody invents a plan in the moment, they only follow one.
cbtFacing it a step at a time5 minutesQur'an 20:26

Keep it short and specific enough to be followed while frightened. It also gives you something to go over afterwards: what you used, what you forgot, what you did instead. That review is usually where you catch the safety behaviour that crept in, the phone in the hand, the friend who did all the talking for you.

Islamic evidence

and ease my task for me (Quran 20:26). What is asked for is that the task becomes manageable, and a plan made beforehand is one ordinary way that happens.

and ease my task for me

Qur'an 20:26

Psychological evidence

A review of how to get the most from exposure argues for varying the setting, dropping safety props, and choosing steps that deliberately violate what you expect rather than aiming for comfort. A written plan is how those decisions get made in advance rather than in the middle of it. This is a theoretical account of the mechanism, so it shapes how you plan rather than showing that written plans beat unwritten ones.

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

Review detail

Why it works. Deciding beforehand is what stops you defaulting to escape when the fear peaks.

anxietyEverydayscholar review pendingadhd-2813-write-the-plan-down

Feedback

none yet
On:
15Run it in your head first, then act it out with someone safe, then do it for real. It is a preseason, and nobody thinks the preseason is cheating.
cbtFacing it a step at a time20 minutesQur'an 92:7

Each round adds a little pressure while help is still to hand. Imagining it stirs the fear enough to show whether your plan holds up. Acting it out puts the words in your mouth, so your body has been through it once already. Both of them turn up the flaws cheaply, which is a great deal better than finding them in the corridor.

Islamic evidence

We shall smooth his way towards ease (Quran 92:7). The smoothing is tied to what a person actually does, and a rehearsal is one of the things you can do.

We shall smooth his way towards ease

Qur'an 92:7

Psychological evidence

Pooling twenty three studies with six hundred and eight participants, exposure carried out in virtual environments performed comparably to established treatments for anxiety disorders. Another meta-analysis of twenty one studies with three hundred participants found large reductions in anxiety from virtual exposure, with the authors cautioning about how much the outcome measures varied between studies. Practice in a stand in version of a situation does real work, though virtual reality is a more convincing stand in than a role play in a room.

David Opriş; Sebastian Pintea; Azucena García‐Palacios; Cristina Botella; Ştefan Szamosközi; Daniel David (2011). Depression and Anxiety · doi

Parsons TD, Rizzo AA. (2008). Journal of behavior therapy and experimental psychiatry · doi

Review detail

Why it works. Rehearsal gets the response into your body while the cost of getting it wrong is still low.

anxietyEverydayscholar review pendingadhd-2814-rehearse-before-the-real-thing

Feedback

none yet
On:
16Stay with a step until it stops being interesting. Not until you have survived it once, but until it is ordinary, and then move up.
cbtFacing it a step at a timeQur'an 94:7

Moving on too early turns the ladder into a run of narrow escapes, and each escape teaches that you got out just in time. The marker worth waiting for is the shift from getting through it to barely thinking about it. That usually takes several goes at the same rung, which is dull, and the dullness is the actual work.

Islamic evidence

The moment you are freed (Quran 94:7), the instruction is to work on, so the next step follows one that was finished rather than one that was abandoned.

The moment you are freed [of one task] work on

Qur'an 94:7

Psychological evidence

Animal work on fear extinction mapped roles for the infralimbic prefrontal cortex, the hippocampus and the amygdala, establishing extinction as the preclinical model sitting behind exposure therapy. Recordings in animals also showed coordinated theta activity between prefrontal cortex and the amygdala and hippocampal pathways during successful extinction. That is where the confidence in repetition comes from, and being animal evidence it explains the principle rather than telling you how many times to walk back down the same corridor.

Barad M. (2005). Current opinion in neurobiology · doi

Lesting J, Daldrup T, Narayanan V, Himpe C, Seidenbecher T, Pape HC. (2013). PloS one · doi

Review detail

Why it works. Repeating a step until it is unremarkable is what tells your body the thing you feared is not coming.

anxietyEverydayscholar review pendingadhd-2815-stay-until-it-gets-dull

Feedback

none yet
On: