Monthly Archives: April 2014

Fundamentally Challenging Your Fears

Helping people deal with situations that provoke in them extreme anxiety isn’t easy, but it is relatively straightforward. The affected individual has to learn to deal with the phobic situations and also how to deal with the panic attack itself. One way to treat this type of situation is through ‘exposure therapy’ or ‘cognitive-behavioral treatment’. Once the person has learned, by experience, that the panic attack, like all feelings, is not in itself destructive, the condition begins to become controlable.

Arguably there is something more important that underlies extreme anxiety; an attitude to life itself that needs to shift or change. Such an alteration needs more than a limited exposure therapy or any other brief method of treatment. It requires a change of perspective on the way life can be lived. The tendency to worry unnecessarily can make everything in life – work, marriage and especially bringing up children – a struggle. This outlook on life can be summarised thus:

Since the world is treacherous, I must always be alert to the possibility of injury or illness. I must forsee disaster everywhere: new business ventures are likely to fail; new relationships likely to founder; new places threaten vague and shadowy dangers rather than promising excitement and the chance to learn something new. Children must be guarded against all the physical and emotional dangers that loom in imagination. Hidden not very far below the surface of these ever-present fears are more profound fears of helplessness and loneliness.

The sort of life brought on by these attitudes is a narrow, constrained existence in which the individual strives primarily to feel secure. Everything else is subordinated to the wish for safety. Relationships with parents, often ambivalent, are maintained very closely into the years of adulthood, although sometimes marked on both sides by guilt and resentment. A spouse is chosen sometimes solely because he or she seems ‘stable’. Employment is chosen because it is safely within the individual’s capacity and therefore does not threaten failure, or simply because it is nearby. Often such a job is kept long after it has proven to be unsatisfactory, unchallenging or uninteresting. In all matters, the familiar is chosen over the unknown.

This is by no means necessarily a miserable life. There is room for satisfaction, achievement and pleasure. But it is not everything life can be. It is not an adventure.

No one is entirely free of self-doubts or anxiety. To that extent it is natural to want to seek out safety. But the struggle to be safe and secure, to be free of anxiety, is not enough to justify living.

This is an argument, then, for continuing therapy past the point of recovery from a phobia. The practice of challenging one’s fears that is the basis of exposure therapy is a reasonable strategy for coping with other more realistic threats. The danger of getting fired from a job, for instance, is managed best by confronting it directly, by talking to the employer and, perhaps, by looking for other work. Whether it is learning how to swim or learning how to address a group, both scary in their own way, a determined step-by-step effort usually brings success – as it does in overcoming a phobia. Being open with others, crucial to the success of exposure therapy, is important also for everyone in developing close relationships and in being able to see oneself accurately through the eyes of others.

Anxiety

Lots of people suffer a great deal from feeling anxious. Of course, nearly everyone will have experiences in their life that they worry about; this is normal. How we then deal with these feelings can be really important in whether or not they are something which we experience in passing or become a pattern of thinking and feeling that stops us from enjoying our lives.

Physical Symptoms of Anxiety

The physical symptoms of anxiety are pretty common: dry mouth, elevated breathing and heart rate, butterflies in the stomach, upset stomach, sweating, trembling, inability to concentrate, sleep disturbances are the most common. This reaction is what is known as the ‘flight or fight mechanism’. It is an instinctive physical response to danger that is designed to help us get away from a threat. What is happening in the body is that chemicals are being released to enable us to literally take flight: to run away or to fight, to protect ourselves physically. Now, as a response to a genuine danger (for example, enabling us to leap out of the way of a car as we are about to cross a busy road) it is appropriate and helpful. If it is in response to an upcoming social situation or a presentation at work it may not be helpful at all and may, in fact, get in our way and stop us from enjoying the experience.

Significant Factors

There are a number of significant factors that I think play a large part in why some people experience high levels of anxiety on a regular basis. Here are two of them.

1) They have great difficulty in soothing themselves when they do feel nervous, anxious or stressed and, therefore, don’t easily return to a state of calmness.

2) They often have experienced one or more of the following: a recent event that may have triggered feelings of stress and anxiety; a traumatic, frightening or distressing event when they were a child that they have been unable to come to terms with; one or more of their parents or caregivers often used to worry about them or were themselves someone who often got anxious.
Self-Help Strategies for Anxiety

So, what can anyone who gets anxious do to help themselves? Here are five suggestions that you may find helpful:

1) Put in place a regime to improve your general health and well-being. For example, cut down on stimulants: reduce how much tea and coffee you drink, particularly in the evenings. Take regular exercise. Eat healthily.

2) Learn how to relax. Make time at least once a day to undertake a relaxation exercise or activity.

3) Develop a series of activities that occupy your mind and provide an interesting distraction for times when you are stressed.

4) Talk about what is worrying you to someone you trust.

5) Challenge your thinking and your worries by reality testing your fears.

Enduring Heartbreak

Sometimes it can feel as if being the one who is left at the end of a relationship is worse than being bereaved. This is not to say that bereavement is easier than being left, far from it, but it certainly evokes less shame. The words we use to describe the two events are very revealing: bereaved has a dignity compared with abandoned, dumped, dropped or left.  These words express and also reinforce how damaged we can feel when a partner leaves. You don’t dump something valuable and the experience can leave a huge sense of shame and failure. Yet most of us have been in a doomed relationship at some point in our lives. Clients who have been left by their partners frequently report that friends are initially hugely sympathetic but then get fed up. It is a truism that only people who have gone through the experience can truly understand the pain and madness that can be evoked in a breakup.  I have often wondered why there are not more face-to-face support groups to help people through their misery. We have bereavement groups, cancer groups, groups for depression but relatively little for the broken-hearted.

The Internet can be a mixed blessing when a relationship ends. There are chat rooms that can be accessed in the small hours of the night but equally in the small hours of the night one can lethally follow an ex-partner on a variety of social networks. At times like this, Facebook for example, can feel like a form of torture. New posts and pictures seem to say, ‘look, I am getting on with my life without you.’ If someone else is involved in the breakup it can be even more excruciating. Jealousy and unhappiness are an agonising mix.

Experts and friends will tell you that once a relationship is over you should cut contact both on the Internet and in the flesh. It makes sense because the temptation is to seek comfort and reassurance from the person who has hurt you and it can keep hope alive when there is none. But making those final moves to really end contact can be very difficult.

How can counselling help in this situation? It can offer an understanding of the enormous pain that can be felt by someone whose relationship has ended. When couples break up it might look like one person’s unilateral decision but it might well not be and understanding the dynamics of an ending is helpful. Perhaps most importantly, counselling will help in understanding why the person involved feels so damaged, so valueless. Very often feelings of worthlessness have deep roots that pre-date the relationship. When adversity hits, these feelings can be activated in a powerful way. It can be very helpful to understand and challenge these early feelings of worthlessness. It is also important to understand that feeling something does not make it reality. Just because we might feel that life is over, doesn’t make it true. Despite the agony, most people do recover from break-ups. Hopefully, they will have learned something from their experiences and will have a deeper understanding of themselves when they next fall in love.