As you begin your own journey to recovery from workplace anxiety, it is important to know the four essential steps you must take.

Your training—which requires attention, precision, and repetition—will free you to use that flow of adrenaline energy to become active, productive, and expressive at work. Tom is one of thousands who have done so. His transformation led to a dramatic improvement in self-esteem and a healthy, happy, and high performance lifestyle. He was promoted to a senior position and is now among his company's most motivating leaders.

Tom was smart. He recognized his most valuable asset. Do you know what your most valuable asset is? Think for a moment. Seriously, think carefully right now. Do you have the answer? It's not your bank account or 401(k). It's not your car or your home. It's not even your career. Your most valuable asset is time. Time is finite. Time is not elastic. Time does not stretch. You can borrow money; you cannot borrow time. Spending your precious time to complete this self-guided program will be one of the best investments you ever make. Imagine how much extra time you'll gain when you won't have to spend minutes, hours, days, and nights obsessing over your workplace stressors. Your health will improve, and you will be able to make the most of every workday.

Having picked up this book, you have demonstrated your potential as an astute investor in time. Spend time now to gain time later. If you spend—that is, waste—time suffering from anxiety, that negative investment tends to grow, leading to more and more anxiety.

Invest your most valuable asset wisely—and expect great returns!

Before almost every public appearance I've ever made, an amazing phenomenon has occurred. About 10 to 15 minutes before each presentation, my anticipatory energy manifests itself by making my hands cold. This was true when I started seeking publicity for my social anxiety therapy programs back in 1988, and it is true 20 years later. I am a confident, experienced speaker. Yet I still get cold hands!

That may surprise you. But let me explain. Our peripheral blood flow is affected by the body's natural fight-or-flight response: In get-ready-for-action mode, less blood flows to the hands, so they feel either cold, cool, or sweaty. The hands of a relaxed body are dry and warm. These processes are called "vasoconstriction" (cold, cool, or sweaty hands) and "vasodilation" (warm, dry hands). Varying degrees of stress and relaxation occur from person to person and from moment to moment, and the hand's skin temperature varies up to 25 degrees Fahrenheit in any one day, sometimes within minutes. Skin temperature is not the same as body temperature, which is considered normal at 98.6 degrees Fahrenheit. A hand temperature of about 90 degrees or higher represents relaxation. Here is a table showing precise skin temperature measurements and what they indicate.

So what do my cold hands mean? They mean that my adrenaline is flowing. My blood vessels are constricted. I am gearing up to perform. This is good stress for me—a positive example of the fight-or-flight response. Nothing to be scared of. But those same cold hands could represent the beginning of a panic episode to a person who does not understand performance physiology.

Becoming aware of hand temperature lets you gauge your stress level. Your challenge at this point is to begin to differentiate between positive and negative stress and how they relate to your hand temperature. You will learn that "stress" and "anxiety" are not dirty words but important phenomena that require a practical understanding.

Often in my clinical work I integrate biofeedback with therapy. The term has a simple meaning: "bio" refers to body processes and "feedback" refers to the collection of objective information reporting about those processes. As I mentioned, I use high-tech biofeedback machines at my office. But there are other effective ways to receive biofeedback—ways you can employ every day, such as using a cuff to check your blood pressure, getting on a scale to weigh yourself, and even looking in the mirror!

The basic idea is this: Measure where you are, learn to recognize what is happening, and master steps to control it. Taking an objective measurement allows you to condition yourself. First, you observe: "My hands are cold." Then, you ask questions: "What am I thinking? What am I feeling?" The essence of biofeedback is to pair, associate, or connect your internal (proprioceptive) sensations as they relate to objective feedback—the more you are able to do so, the more effective the technique becomes. And the more confident you will be.

Skin temperature measurement is one biofeedback mode. I have used hand-warming training to help people resolve panic and anxiety attacks, migraine headaches, and many other stress-related disorders. I have been a proponent of hand-warming since early in my career, when I witnessed how the technique helped stop hemorrhaging in an adult with diabetic retinopathy. Picture it: This man learned to recognize his body's stress signals—in this case, bleeding from his eyes—and engage in a quick technique that actually stopped his eyes from bleeding! Powerful stuff. And it's yours to learn.

Hand-warming is an internal process, and ambient temperature has only a slight influence. Rubbing your hands together or putting them in warm water is not going to work. As you learn, be aware that sometimes, when a person consciously increases skin temperature, it can cause a tingling sensation as the hands warm. That's a good sign!

Most people's adrenaline flow increases before a performance—which can be anything from a conversation to a full-scale speech in front of an audience of hundreds or thousands. How a person handles that adrenaline is the only difference between feeling anxiety and "going with the flow."

For me, the adrenaline flow means, "Ready! Set! Go!" I don't interpret the feelings as negative—trouble swallowing on a few high-stress occasions, cold hands, and so on. They're not scary, but just a reminder to focus and remember that adrenaline is my friend.

To promote my message that people can live happier, more productive lives by freeing themselves from anxiety, I have appeared on more than 1,500 radio and television shows in the last 20 years or so. I love doing shows that reach a large audience because of what I can teach and the great public relations and marketing opportunities they give me. I still feel stress. The difference is, I have trained my body and mind to kick into control mode using the techniques that I will teach you. It's almost automatic, and it takes only seconds. Once, I was beginning a three-minute live segment on Fox television. The producer was in the process of counting down "5 ... 4 ... 3 ... 2 ... 1 ... and Live!" On the number four I had difficulty swallowing due to stress (not a good thing to have when you are about to speak to an audience). But by the number one and the exciting call of "Live!" I was ready to go, having utilized the same Five-Step Adrenaline Control Technique you will learn.

On another occasion, I was waiting by the phone for famed "shock jock" Howard Stern to call and interview me live for a radio show about "involuntary virginity." (The perfect subject for Howard, don't you think?) This was a big deal for me—and I had told about 1,000 people I would be on. As I waited, I felt a lot of anticipatory energy and the same swallowing challenge I had right before the Fox interview. I used my technique, and used it, and used it ... But alas, Howard blew me off for "the biggest rubber band ball in the world" and a hermaphrodite. My call never came. Such is the nature of show biz!

These two experiences characterize the physiology of performance. When you understand it, and learn to control it, the result will be high performance and more potential for confidence and success. When you do not understand the physiology of performance, there is more of a chance that adrenaline will control you instead of you controlling the adrenaline.

Why discuss public speaking? Because public speaking is most people's number one fear (ahead of even death!). It is also—according to self-made multibillionaire Warren Buffett—"the number one business skill." At its most essential, the definition in my program is that public speaking occurs any time you are the only one talking. In this context, public speaking means speaking in or to a group—and a group is defined as more than one person. Public speaking is therefore not limited to making a speech or presentation. It also means speaking spontaneously around the conference table or in another meeting, participating in a conference call, standing up to ask a question during a presentation, and even informal chatting around the water cooler. Think of it as "speaking up." Public speaking is not the only workplace stressor that makes people nervous, but its broad definition encompasses many of the specific anxiety triggers in the workplace. Addressing nervousness at work is critical because, as one business reporter put it, "In today's workplace, there is no room for the shy."

Nor is there room for nervousness on the job market. If professional, comfortable interaction and a certain level of confidence are absent, job interviews are liable to go poorly. Networking opportunities are left unexplored. Instead, many people who are nervous at work hope in vain that a job search Web site will hand-deliver their resumes to dream employers—or in a lot of cases these days, to any employer at all. But sitting in front of the computer—avoiding true human interaction—will not land you a job. A very small percentage of hiring occurs through advertisements. To excel, you have to sell yourself, make connections, ask for favors, follow up, and keep following up, all of which are almost impossible to do while sitting at home by yourself in front of a computer screen.

Of course, anxiety about speaking up is not the only thing that makes people nervous at work. Ask 50 people (and we did; see the sidebar) and they may well give you 50 different answers for "What makes you nervous at work?"

We began writing this book just before the economy collapsed in 2008. As job losses soared into the hundreds of thousands, I heard from more and more people whose anxiety was through the roof because of a perceived lack of job security. It's a reasonable thing to fear—even people without an anxiety problem feel anxious about the circumstances. But it is reality, and coping with it can mean the difference between keeping your job and being among those who are laid off and not merely reassigned. According to New York Newsday, "Losing your job is painful, but worrying about losing the job you have may be even more harmful to your health. Researchers at the University of Michigan concluded that 'chronically high job insecurity is more strongly linked with health declines than actual job loss or unemployment.' The study also found that job security is more strongly linked with health declines than actual job loss or unemployment."

In 1988, 10 years into my clinical practice, I hired my first public relations firm. I did so out of the desire to provide community education about social anxiety and the related issues with which I was working. The timing obviously was right. Three months into the public relations effort, I was booked on The Oprah Winfrey Show. Oprah was relatively new to the TV airwaves at the time, but it was already a very big deal to appear on her show. From 1988 to now, I have done well over 1,500 television and radio shows and countless newspaper and magazine interviews and given many lectures. I have experienced the good, the bad, and the ugly of working the media. Public speaking has very much been a key to my career success. I have learned to be productive with the art and science of public speaking and high performance at work. As I've described, I use the same adrenaline-channeling techniques as I will teach you. And they work. They work for me, and they work for thousands of other people whose anxiety once crippled them.

It's just about impossible to have a panic attack when hands are dry and warm! And increasing your hand temperature three to four degrees is enough to stop a panic attack in its tracks. Developing awareness of hand temperature is the first step in learning to control it. Your training begins now. Here is what I want you to do:

Here are some typical examples of people who suffered social and performance anxiety in the workplace:

By his mid-40s, Roger held an important position in banking, working with hedge funds. Making a seven-figure salary, Roger was the go-to guy in his department when it came to public speaking. Only his wife and I knew that his obsessive worry regarding public speaking was so debilitating that he was considering changing careers.

Jim, age 25, recently married, was highly intelligent, a good athlete, and a social butterfly. He was preparing to take the reins of his family-owned business. But he dreaded the idea of being in charge and having to appear front and center because he knew he blushed. At one point, Jim considered getting an operation to sever his nerves because of fear of blushing.

Carol, an ovarian cancer survivor who had almost died, once said to me very genuinely, "Jonathan, I'd rather be back in chemotherapy than speak in front of a group."

Lauren graduated from an Ivy League school with a 4.0 average and was holding a $95,000-a-year job by the age of 28. She shocked her family, though, when she quit abruptly because of burnout caused by the anxiety that her excessive perfectionism was causing.

Alice, a 48-year-old human resources associate director earning $55,000, never said a word during weekly staff meetings because she suffered from selective mutism—in other situations, she could quietly hold her own. But in these meetings, she was silent.

Jerry, an accomplished Army flight surgeon, experienced heart palpitations and racing thoughts whenever he had to make "rounds" or give presentations to his peers—he never told anyone about the problem, and instead tried unsuccessfully to treat his problem with prescription medications.

Kevin was a lawyer who had once dreamed of running for public office. He abandoned that dream after he began feeling extremely nervous in court. He even had to leave courtroom proceedings due to his sweating attacks.

Maureen was a psychology intern at a children's hospital. Four months into her internship, she realized that she had never introduced herself to the doctor in the office adjacent to hers. At first she had merely been too busy getting settled into the program, but as the weeks became months, she felt more and more awkward when she walked by his open office or saw him around the hospital. Yet she couldn't work up the courage to remedy the situation before it grew even more uncomfortable for her.

Bill, age 55, a senior vice president in a national advertising firm, traveled nationally on a weekly basis to meet clients and division executives. As top dog in those meetings, it fell to him to lead the meetings. He was fine in discussions, but whenever the spotlight was on him to speak for several minutes while everyone else listened, his anxiety would take over. Bill developed an elaborate technique for avoiding these monologue situations: For example, he would be introducing a new vice president to a regional staff. That introduction should take 10 to 12 minutes to complete. But Bill would manage only 20 seconds before figuring out a way to take the spotlight off himself and turn the monologue into a dialogue. He was very skilled at doing so, and this went on for 30 years—becoming a kind of "tic" that Bill was known for. The toll it took was exhausting: Bill lived on high alert—in a constant state of apprehension that he would be asked to speak. Sadly, he became alcohol-dependent because of this anxiety—he would always have a drink right before one of these meetings no matter what time of day it was.

Sherry, age 20, a hair colorist intern, was stuck in her career due to her panic during consultations. Despite excellent training in a leading cosmetology program, she was terrified of producing a result that her client wouldn't like. Having the client tell her that she could just do whatever she thought would look good only heightened the anxiety.

Corey, age 24, a gifted musician, dropped out of music school because of his performance anxiety. By himself, he played and composed music and astounded his professors. But he simply couldn't replicate those performances onstage because his stage fright shut him down.

Phyllis, a vice president in an accounting firm, was let go after a 20-year career because of the changing culture in her bank and management's perception of her unproductive poor social skills—even though she was an excellent manager. Phyllis, too, was a selective mute, and barely spoke to her colleagues, even informally.

One out of eight individuals suffers from social anxiety, yet the medical and psychotherapy communities have not been productive in their response to this problem. The primary reason for this is that people who experience this problem are so controlled by fear of feeling embarrassed, ashamed, and humiliated that they do not seek help. This is not the type of problem a person shares with a friend over a cup of coffee. Most suffer in silence. In most cases, it's an invisible problem. The last thing that perfectionists are going to do is to let anyone know they aren't perfect!

Sometimes the problem comes out of the closet. Pro football player Ricky Williams, a Heismann Trophy winner, had social anxiety. The press at one time thought it was quite weird when he would not take his helmet off during interviews. This was to protect himself—not physically, but emotionally. Zack Greinke, an all-star pitcher for the Kansas City Royals, lost 17 games in 2005. Greinke's struggles reportedly deepened his depression and bouts of social anxiety, distancing him from his fellow players. Although Greinke does not talk publicly about social anxiety, others have made comments about what he was going through. Dayton Moore, the Kansas City general manager, said, "I can't speak to this because I've never experienced it, but I can only imagine how difficult it must have been to recognize his condition and evaluate it honestly and do something about it. He's been able to take all of those experiences and combine them and that's why he is where he is today."

Numerous performers have identified themselves as having performance anxiety—commonly called stage fright. Superstar Beyoncé describes her last moments backstage as fraught with fear: "I get so terrified before I go onstage. My secret is no eye contact. I find that if I don't look directly at people and just concentrate completely on the singing and dance moves, then I can get through." A star since childhood, Donny Osmond admitted to a serious panic attack onstage in 1994 during which he was unable to sing and feared he would black out; the attacks continued to plague him, and he began to fear going out in public because he thought fans would make fun of him. The legendary Barbra Streisand did not perform for 27 years after an embarrassing concert during which she couldn't remember the lyrics to some of the songs she was singing.

Sir Laurence Olivier, regarded as one of the greatest actors of all time, confided in his memoir that he suffered social phobia for five years after he began to fear he would be too tired to remember his lines on stage. When actress Kim Basinger stood onstage to accept an Academy Award, she was unable to speak—even though she had practiced a speech to give if she won. Basinger apparently suffered anxiety as a child also, becoming mute when she was asked to read in class (a poorly understood disorder called selective mutism).

Highly respected NPR talk show host Diane Rehm's distinctive voice is the result of a neurological disorder called spasmodic dysphonia. According to a Washington Post interview with Rehm, there are surprising psychological side effects—stage fright, shortness of breath, excruciating self-doubt. "It's not the anxiety that originates the problem," she says. "The anxiety follows. But the anxiety feeds the fear and the fear feeds the anxiety, and caught in the cycle is the voice." In her 1999 memoir, Finding My Voice, Rehm discusses her lifetime struggle with self-esteem: "I couldn't overcome the constant self-criticism I heaped on myself. It was as though there was a voice inside telling me that no matter what I did or how others might praise me, there was no truth to what they were saying."

Tony-nominated actress Cherry Jones describes feeling "nearly paralyzed by a profound case of stage fright" because she was following in the footsteps of a play's previous star and feared she couldn't equal her talent. Nicole Kidman says she never feels worthy of the acting roles she is offered: "Every time I star in a film, I think I cannot act. I've tried to pull out of almost every one I've done because of sheer terror."

Many performers, however, learn to ride the wave of adrenaline, using it for energy. Actress Alison Lohman, for example, seems to have borrowed a page from our book—recognizing that the adrenaline some people experience as anxiety can come in handy. "It's those nerves that bring you to a higher level and make you more hyper-aware," she explains. "It makes your performance better."

Prescription drugs and alternative treatments have their place in the treatment of anxiety. I want to make this clear: I am not opposed to using those treatments as part of an overall treatment plan; in fact, I embrace their use because they can be so effective when used the right way. But most of the time, working through my program is enough (we discuss the appropriate use of medications in a later chapter). I do contend that there is a right way and a wrong way to apply them. Aggressive marketing has made it harder for patients and their doctors to determine the best way to integrate prescription drugs into an overall treatment program. Viewers who see advertisements promising a drug will eliminate anxiety believe there's a quick fix—and do not stop to consider whether that fix is short-term or long-term.

During the last decade, pharmaceutical companies have embarked on a mega campaign to sell their goods. This is a multibillion-dollar industry, and much of their campaign has been aimed at social anxiety. The good thing about this media phenomenon has been that for the first time many individuals understand that they are not alone in what they have. But the negative is that many people are left with the belief that they have a "medical disorder"— a physically rooted problem that can be resolved only via medicine. Nothing is further from the truth. I am not opposed to medication, but I am opposed to its misuse. Later in the book, we will discuss this issue in detail.

Heavy advertising of prescription medications for depression, anxiety, and bipolar disorder led first to patients' clamoring for prescriptions. More recently these media campaigns have faced opposition, which has had a negative effect on the serious but treatable problem of anxiety. For example, on one radio show where I was a guest, the well-known host attacked my "cause" from the get-go: "I don't believe there's anything called social anxiety. It's just something that the pharmaceutical companies made up." My response to this was, "I guess there's a chance I've been hallucinating for the last 30 years." I hope the listeners got the point: The host was being provocative, but not productive. Anxiety is real. And it can be treated. The bottom line is that there is a tremendous amount of confusion in our society about social anxiety. This book will help to resolve it.

We all remember that one kid who always sat in the back of the classroom. The teacher never called on him, and he never raised his hand. He talked to no one. You and your classmates got used to him, and the kid became all but invisible.

There is a clinical term for that behavior: "selective mutism." A person—and it is not always a child, though children are most often brought for treatment by their worried parents—simply does not talk (is "mute") in certain situations (hence the term "selective"). Parents occasionally seek treatment for their children's selective mutism. Unfortunately, only a very small percentage of parents decide to take that step. Far too often, the attitude among parents, teachers, and even school counselors is, "He'll grow out of it" or "She's just shy." Selective mutism is so insidious and complex that it can bring schools to their knees. The school psychologists and guidance counselors are not equipped to deal with it in most instances, nor are the teachers. If there is a precursor of social and performance anxiety at risk, this is the earliest indication.

It's not often that I use the term "mind-blowing," but I feel compelled to do it here. Selective mutism is a very specific form of social anxiety, awareness of which is just emerging. Here is what's mind-blowing: Ten in 1,000 children have some form of autism—thank goodness society is now being educated about this disability and the many therapeutic programs that are in place. But get this: Seven out of 1,000 children have selective mutism, and it is extremely difficult to find effective help anywhere in the world. This typifies the state of social anxiety in our society. We may hear the term "selective mutism," but many of the people using it do not know what it really means.

Most of the information available regarding selective mutism is about children, in whom it is often misdiagnosed as a speech disorder or autism. But on the contrary, it is a very specific social and performance anxiety–related self-censorship that affects people of all ages. For example, Alice, the human resources consultant, never said a word at Friday staff meetings. She believed she "had nothing to say of importance" and that what she might say would be "stupid." Choosing silence protected her from feeling the adrenaline that would flow if she took the risk. In essence, she was specifically censoring herself. This is a key component of selective mutism.

Fear of being noticeably nervous is a major concern for workplace anxiety sufferers. Blushing and sweating are major causes of this fear. A medical procedure to treat these symptoms is becoming more and more popular. Called endoscopic thoracic sympathectomy, it severs the nerves that cause facial hyperhidrosis, a condition that includes excessive sweating and blushing. My client Jim sought this surgery but backed out at the last minute, opting for treatment with me instead; his success story is featured in www.socialanxiety.com's free one-hour teleseminar on blushing and performance anxiety. Jim was fully prepared to go through with this risky surgery, but changed his mind in the waiting room and left. He eventually resolved his problem via therapy with me.

I have no doubt that this surgical procedure has helped some people; however, the invasiveness of it shows the desperation and intense degree of embarrassment that many people experience by being noticeably nervous. Another client had this surgery before pursuing treatment with me. "It did resolve 50 percent of my sweating," he says, "but it left me feeling imbalanced internally." Of course it did. Just because no one can see you blushing or sweating does not mean that you are not experiencing that same uncomfortable adrenaline rush. Until you learn to ride that wave—to welcome adrenaline as the energy that will make your performance shine—you are doomed to suffer. Before you choose to go under the knife, I urge you to research your options completely.

How about injecting a little botulism into your body to prevent excessive sweating? That's right—Botox, the same popular injection used to freeze-frame facial wrinkles using botulinum toxin type A—is being used to reduce axillary hyperhidrosis, also known as excessive underarm sweat, a condition that affects up to one million people in the United States. Is it safe? The FDA approved its use for this purpose in 2004. Is it the best solution for someone whose anxiety causes him or her to sweat profusely? In some cases, it can be helpful. But I think the surgery is overused for this purpose and is not always the best option. I feel the same way about facial injections of Botox to prevent people's emotions from appearing on their faces during meetings and other anxiety-causing situations.

Whatever You Think, Think the Opposite. As the title of Paul Arden's book makes clear, sometimes "the opposite" is right. Paradoxical (opposite) thinking and behaviors will be important in your learning to control anxiety and stress and developing a High Performance Mind. It comes down to trust. Imagine that you are in training, and you must open your mind to coaching and do just as the coach says in the order he says to do it. This reminds me of the 1980s classic movie The Karate Kid: A young teen seeks training from an elderly sensai whose coaching begins with several weeks of chores around his property. The boy is about ready to quit when he's asked to wax the sensai's car. "Wax on," the sensai tells the kid, making a clockwise circle with his right hand. "Wax off," he then says, circling counterclockwise with his left. Eventually, the boy recognizes the method in his coach's madness: The gestures he embedded in his muscle memory became highly valuable moves in karate competition.

"Wax on, wax off." I know doing what the coach says can be challenging. I exercise regularly and diligently and am in good shape. I once hired a personal trainer to help me prevent basketball injuries. My trainer took me through a new routine that exercised muscles I usually did not work out. There were times that I dreaded going to a training session because of this challenge. But the payoff was great! I became stronger and more flexible. I gave up dreading and gave in to the coaching, and it worked. Such is the nature of this book. Much of the content may be the opposite of what you know or believe currently. Invest strongly in this cross-training.

I have often been asked, "What kind of therapy do you practice?" My answer often has been "a productive one." The therapy I practice integrates many different modalities, including analysis and deep emotional work, cognition, behavior, family dynamics, and physiology. It brings mind and body together in a way that allows me to teach a systematic self-regulation and relaxation incorporating simple but proven biofeedback methods. It presents biofeedback-based techniques along with diaphragmatic breathing, progressive relaxation, and imagery—which are the cornerstones of stress management and recovery from anxiety.

This program is highly systematic. You owe it to yourself to work it start to finish—ideally within 21 days the first time. You can reread passages as you wish. But proceed in order because the concepts, exercises, and techniques build on what has come before.

We highly recommend using a specific notebook, computer file, or handheld application to complete the exercises and chart your progress. Please make your decision now and plan to use the same place for notes throughout the process. Refer back to your notes as you progress. Here are 10 things to bear in mind as you transform yourself.

Clearly, people today are subject to an increasing barrage of stressors, all of which cause distinct patterns of mental and physical arousal. At work, those stressors include speaking to groups, dealing with authority figures, dealing with conflict, problem solving, facing unexpected challenges, and more. The individual's adaptive reactions have been variously characterized as "emergency," "alarm," or "fight or flight." Whatever the label, the stress responses are virtually automatic. The initial response usually occurs within five or six seconds of the body's perception of a stressor threat. The body's response is characterized by a flow of adrenaline. It is adrenaline that either drives the symptoms of panic and anxiety or becomes a source of power. For example, if you are walking down the street and you see a grizzly bear, you are going to use the power of the adrenaline to either fight or flee. The reality is that everyone is susceptible to the fight-or-flight response. Adrenaline is in all of us.

According to stress-management expert Charles Stroebel, PhD, MD, "Healthy individuals exhibit a capacity to cope effectively with stressors, usually regaining balance from the fight-or-flight response within a relatively short time after the emergency response. This inherent quieting response allows their bodies to restore needed energy reserves, and prepare them for subsequent and inevitable arousal periods." On the other hand, people who are predisposed to, or actually suffering from anxiety, have "autonomic hypersensitivity," meaning their nervous system is overreactive and they recover their balance much more slowly. In his pioneering research in biofeedback-based stress management, Stroebel identified a phenomenon he calls the Quieting Response. Based on that concept, the system of biofeedback-based exercises in this book will help you use the energy of adrenaline productively and help you control what appears to be an automatic response. We begin your training with the Five-Step Adrenaline Control Technique.

Are you ready? The five things that you are about to learn will change your life.

Our breath is the most valuable tool we have to control our nervous system and manage anxiety. How can we make this tool available to us on command? By taking control of our breathing apparatus. Basic breathing is automatic. We seldom pay attention to it, let alone use it as the effective yet instantly acceptable stress management tool it is.

Conscious diaphragmatic breathing not only can help you control anxiety and manage stress but also can facilitate high performance in any situation. For example, all highly trained athletes and stage performers use conscious breathing techniques to enhance their efforts. A friend of mine is a third-degree black belt who has been practicing martial arts for about 30 years. He demonstrated the power of breathing as he was going through certain intricate moves including cracking thick boards with his hands. Very impressive, very powerful! Despite the act's intensity, my friend remained cool and calm. He was extremely focused—obviously channeling his adrenaline into his concentration and physical challenge.

At the 2010 Winter Olympics, legendary American speed skater Apolo Ohno, who has won more winter medals than any other athlete, drew attention to himself by doing the same thing seconds before each race: yawning, taking a deep breath in, then exhaling. "It makes me feel better," he told Yahoo! Sports. "It gets the oxygen in and the nerves out." Are you convinced?

Here are the basics of breathing: First, you intake oxygen through your nose into your lungs. The air then travels through the trachea. Next the lungs expand the ribs, and the pectoralis minor muscles contract. Finally the diaphragm contracts and flattens. This exhaling process involves the diaphragm's relaxing and moving up. Then the lungs contract, and the intercostal and pectoralis minor muscles relax. Carbon dioxide is then forced out of the mouth and nose.

TUNE IN: Now, in a relaxed sitting position, place your hands just above your navel, facing each other, fingertips facing and touching. Underneath your rib cage is a dome-shaped diaphragm muscle. It moves up and down as you breathe in and out. As you breathe, you will feel your fingertips separate upon inhalation and exhalation. Draw the air in through your nose as slowly as possible. As you draw the oxygen into your diaphragm rhythmically and slowly, concentrate on the diaphragm muscle under the ribs and notice your hands; feel them moving back and forth as you inhale and exhale. After you inhale slowly through your nose, pace your exhale to a slow count of 4 ... 3 ... 2 ... 1. This is conscious breathing. Train yourself to pace the inhale–exhale to between 8 and 12 seconds total.

TUNE IN: Slow down for a moment. Calmly put your dominant hand up to your cheek. Keep it there for several seconds. Feel the temperature. Really feel it. Warm, cold, cool, sweaty, dry? In the next chapter, you will complete an important series of exercises that require your focus and your honesty. What are your thoughts and feelings as you get ready?

You will be tuning in throughout the book. Being able to put your feelings into words is critical for attachment—a vital part of your recovery program. Use the following Feelings List as a starting point for identifying where you are emotionally. As you identify other feelings, consider adding them to the list. Refer to this list whenever you need help identifying your feelings or putting them into words.