Book Review: The Mindfulness & Acceptance Workbook for Anxiety

When you experience anxiety, worry, or fear, have you ever thought about embracing it rather than running away from it? In The Mindfulness & Acceptance Workbook for Anxiety, John P. Forsyth and Georg H. Eifert present a whole new way of thinking about anxiety that is quite different from traditional treatment methods. What’s interesting is that they do not aim to teach the reader ways to control anxiety. Instead they try to go to the root of the problem and get beyond simply treating the symptoms. They do make a very good point when they say that, ”thinking and feeling well does not automatically translate into living well, nor is it a path to genuine happiness,” and that’s why their approach is more holistic than traditional treatment methods.

Part One of the book invites the reader to consider this new way of thinking about anxiety and using a new treatment approach. Forsyth and Eifert say,“We know that to get a different outcome we need to change what we’re doing now.” It’s such an easy concept, yet it’s one we tend to forget as we fall back into our old habits and routines. This section of the book gives a lot of introductory material that is beneficial to those who are not familiar with the concept of mindfulness. It starts with the practice of helping people learn how to be in the present. From the very start, Forsyth and Eifert teach readers practical exercises that can be done at home. They also provide recommendations at the end of each chapter on how to practice what was learned. A number of quizzes are provided to help readers understand the difference between anxiety and fear, and understanding the difference between the two helps people learn how to respond to those feelings.

Although their intention is not to label, Forsyth and Eifert do distinguish between panic disorders, phobias, social anxiety disorder, OCD, GAD, and PTSD. This is helpful for readers who can sense that something is wrong but do not have the background or education to distinguish between the different types of anxiety disorders. The authors steer away from complicated clinical language and provide easy-to-understand descriptions of a concept. For example, they compare anxiety to poison ivy, saying that when people scratch at poison ivy, it only gets worse. Likewise, if you scratch anxiety by struggling against it, anxiety only gets worse. I also appreciate that they discuss common misconceptions about anxiety and fear, which will give hope to those readers who might not have had good experiences with anxiety treatment in the past.

Part Two provides steps to start this new journey of self-care. The authors help readers determine how invested they are in their own treatment by asking them to examine the current cost of managing their anxiety. Whether this impacts them with career, health, energy, or emotions, there is a cost in trying to continually manage anxiety. Readers are also asked to evaluate what they’ve given up to manage anxiety using only traditional treatment methods. The authors challenge readers to think about how they want to be remembered, what legacy they want to leave behind, and how that is negatively impacted by spending so much time managing anxiety. The solution they propose is to stop struggling with anxiety and surrender to it.

Surrender does not imply that one is surrendering the hope of getting well, but rather accepting that thoughts and feelings will be with the reader wherever they go and that continuing to fight may not the best answer. One thing everyone has control over is his or her own actions. And yes, it can be hard to admit that at times because it is much easier to blame someone else and adopt a victim mentality. On the other hand, it can be reassuring to know that many things people don’t like in their lives are things they do have control over.  Acceptance in this context is about accepting the experience of the anxiety, not liking the experience. But awareness is the first step to help people recognize what might need to change. As Forsyth and Eifert say, “we can only choose what we pay attention to, how we pay attention, and what we do.”

Part Three is very detailed, with suggestions on how people with anxiety can reclaim their lives. This process starts by examining their values, asking, “Am I making choices based on what I deeply value and care about for my life? And am I doing things that really matter to me and make my life worthwhile? Or have my choices and actions been driven more by avoiding or minimizing my pain?” Defining one’s values is a way to get started and to stay focused on healing. It involves stopping to examine the actions one takes and determining if those actions get him or her closer or further away from living the type of life desired. This section is filled with exercises that build on the concepts presented in Parts One and Two. Exercises are both cognitive and behaviorally based, encouraging the reader to take action.

As a therapist, my one caution about The Mindfulness & Acceptance Workbook for Anxiety is that some clients might do best working through this book with a counselor. Although the book was written as a stand-alone workbook, patients with severe anxiety would benefit from the support and guidance of a trained clinician as they get at the root of these concerns. Also, readers have to be very self-motivated to address these concerns on their own. It is a lot of work and can seem overwhelming initially, which is why I would recommend having a guide or even accountability partner to help walk someone through this workbook.

What I appreciate about Forsyth and Eifert’s approach, though, is the focus on quality of life instead of avoiding anxiety. And it makes sense. Do we really want to spend so much of our effort and focus on things we do not want? Instead, shouldn’t we invest our efforts on the things we do want in our lives? And although this is a different approach, it is similar to CBT with the emphasis on how we think and take action through our behaviors. The takeaway from this workbook is that as people begin to examine what they need to live a valuable life, the anxiety, worry, and fear will naturally decline.

The Mindfulness and Acceptance Workbook for Anxiety: A Guide to Breaking Free from Anxiety, Phobias, and Worry Using Acceptance and Commitment Therapy
New Harbinger Publications, April 2016
Paperback, 342 pages
$24.95