In counselling there usually comes a point when the going gets tough. You’ve come to deal with painful and difficult emotions and behaviour and you may well have been avoiding confronting these for a long time. And now you are facing them, and yourself, in the company of someone else. It’s only natural to feel dread; that ‘Oh no, here we go again’ sensation. There will be times when you may well feel pleased with yourself for being brave enough to face your demons and there will be times when you want to run as far away from them as you can. What will help you through is talking to your therapist or counsellor about it, and working on accepting that it is part of the process. If you choose instead to flee in the face of your fear, you run the risk of confirming to yourself at a deep level that your fear is too huge and powerful to ever be understood or conquered. Sticking with it, trusting in yourself and your counsellor, is tough but it allows for the possibility of reperation, of change.
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.
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.
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.
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.
When someone starts thinking about seeing a counsellor or therapist, they become aware of some of their fears about embarking on this unique relationship. Opening up to another person, a stranger, about your intimate, painful feelings is certainly a daunting prospect. There are some common fears and misconceptions about counselling and what you can expect from working with a therapist. Here are the main ones I’ve come across:
Will you think I’m crazy?
I think you are a unique human being, doing your best to find your way in the world. None of us is perfect and there are times we all need help and support. Effective change usually requires trial and lots of errors. Also, if I think you’re being irrational, I’ll tell you.
Will I be able to trust you?
Your ability to connect with me will be the number one factor determining how well we work together. If you don’t feel like you click with me after a few sessions, it’s OK to let me know and seek out a different therapist/counsellor. We all need different things and my main priority is for you to achieve your goals.
Will you psychoanalyse me?
My job is to be curious and to help you gain more understanding. A good counsellor doesn’t claim to have all the answers for why you are the way you are although we may have some ideas that we will willingly share with you. When it comes to getting answers and more understanding, we will form hypotheses together and you will come to your own conclusions. A counsellor facilitates that process. They don’t tell you how to think/believe/act.
Will you tell me what to do?
I’m here to share my knowledge with you and help you make your own decisions that are balanced, rational and well-explored. Strengthening your own reasoning and decision-making skills will increase your independence and self-esteem.
How am I going to feel? Will I be able to bear it?
Therapy is the perfect place to learn how to express your feelings. That’s what I’m here for, to give you a space to try out new ways of being, thinking and feeling. Take advantage of this. When we learn how to work through our negative emotions with others, it increases our relationship skills and makes us more comfortable with voicing our hurts. This is a necessary component to maintaining relationships and managing emotions in a healthy way.
If I slide backward into old behavior patterns, will you judge me?
Most people judge themselves enough for at least two people. I encourage my clients to come clean. It’s only through acknowledging our steps backward that we can figure out what’s standing in the way to moving forward. Relapse is very common and it’s nothing to be ashamed of.
Will I ever be happy?
Happiness is not reserved for special people. Everyone has regrets, things we wish we hadn’t done, people we’ve hurt along the way, people who have hurt us either intentionally or unintentionally. I believe that we can heal our wounds and you deserve happiness just as much as the next person.
Will you fix my life/problems?
I can help you gain more clarity, more understanding and form a plan of action, but therapy is not a magic pill that erases all issues. It takes work, and only you can make the changes/choices necessary for you. But if you’re willing to work with me – and to be as open and honest as you possibly can – we can find the right way for you.
People come to therapy for all kinds of reasons. Beginning therapy can be scary for some as they are showing a willingness to face tough topics. For others, it’s a huge relief to finally be taking action to move in a different direction. Therapy isn’t always easy, but I think it’s the most worthwhile gift you can give yourself. Find someone you trust and who puts you at ease. The relationship you build with your therapist is the most important aspect of all.
I believe we all struggle at times with issues of power, particularly in relationships. Can we really say how we feel? How will the other person react? Will we get what we need? Many of our difficulties are connected to the issue of personal power: Can I do it? Can I express myself? Can I decide?
People often feel stuck and powerless. The position of ‘not enough power’ cannot be understood and overcome if we don’t connect it to its counterpart, ‘too much power’: they go together.
When people have too much power, they have the tendency to abuse others both directly, in a dictatorial way, and indirectly, in a manipulative way. When people feel powerless or without the right to express their power, they are actually repressing themselves to keep everything under control; letting others abuse or manipulate them because of their fear of what might happen if they make themselves more powerful.
Too much or too little power are two dangerous extremes. In both cases, there is no contact with real inner power, and external power is used to compensate this lack.
What is external power? It is a feeling of security, satisfaction and recognition that comes from an external source. We are part of a society, and society is made of social roles that identify our function and contribution: job, relationships, economic and social conditions. If we don’t feel good within ourselves we can start looking for compensation in the outside world in order to bypass this pain. While forgetting about our inner world, we subconsciously try to make others feel as bad as we feel. We can exercise power in a direct way, abusing others, or in an indirect way, manipulating them.
This is the case, for example, if we invest all of our life in order to hold on to prestige and important social status. It happens when we crave for a career and ‘powerful’ positions, like those of politicians, policemen, army officers, managers etc. We can also become bossy in social groups or in our relationships: family, work, friends, children etc.
Someone that exercises external power needs someone to suffer it, and vice versa. The latter is the case if we look for social roles that make us feel a victim or dependent on others. In order to compensate for a lack of self-esteem, we can have external power in an active way but also in a passive way. We absorb external power from ‘powerful’ people who show a strong attitude and personality; at the same time we exercise our own external power by keeping them hooked through a manipulative attitude. We need each other to exist.
There is nothing bad in performing social roles. What is important is not to let them define us completely, narrowing our life down to the dynamics of external power. In this case, we completely move away from our inner self and unconsciously become prisoners of our behavior.
What is inner power? It is a feeling of security, satisfaction and recognition that comes from within. It is a force that has no need to find external confirmations, it simply is. Inner power does not need to prove itself, either by oppressing others or by being oppressed by others.
If we feel trapped in external roles or behaviour, we can start experiencing psychological suffering. This is an expression of our inner power. Suffering takes on the form of physical symptoms or emotional problems. Inner power wakes up our mind to put something in action for a positive change.
Let’s say that you are in a relationship with someone who, even if he/she is manipulative, abusive or controlling, gives you a sense of security and being loved. In this case you are in the role of the victim. You beg for love and accept whatever is coming, even if it is mixed with negative feelings.
If you start suffering because of this situation and feel the urge for a change, it means you are hearing the wake-up call of your consciousness. Here are some tips if you feel the urge to move from a position of being overpowering or powerless to a position of inner power:
Your suffering is the door towards a healthy change, let it manifest itself and have the courage to face your fears and your pain.
There is nothing bad about having a social role and external power. What is important is to balance them with a good connection with your inner power. The more we are in touch with our inner world, the less we feel the necessity to use external power.
If you usually behave in a way that ends up making you suffer, do a reality check: ‘Why do I do that?’, ‘Why do I invest so much in this way of being?’, ‘What can I do to change what makes me suffer?’
Being conscious about ourselves is something we must give priority to and the rest will follow.
Recently several people have asked me about the practice of mindfulness: what does it mean? How can it help me? It’s basically an amalgam of ancient Buddhist teachings about how to live in a more tranquil, accepting and attuned way. I think it resonates with us at this particular moment in time because it is the antithesis of our often frantic, over-achieving lifestyles with their reliance on electronic stimulation and ever-present anxiety. Here is a very simple guide to the main principles of living in a mindful way.
Focus on the Present Moment. When you find yourself getting lost in thinking about the past or worrying about the future, bring your thoughts back to what you are experiencing right now. Try to remain open to how things unfold in the present, rather than having preconceived ideas about how things will or should turn out.
Being Fully Present.. Practice being spaciously aware of whatever you are experiencing in the present moment as you go through your daily life. What do you feel in your body? What are you seeing, hearing, doing, right now?
Openness to Experience. Rather than dreading and shutting out your own feelings and experiences because you think you can’t handle them, endeavour to welcome with curiosity any thoughts and feelings that naturally arise, knowing they are merely sensations in the moment and the next moment can be different. Become aware of your experience as a flow of sensations, thoughts and feelings and watch how these change and transform naturally over time.
Non-Judgment. Don’t categorize your thoughts and feelings as good or bad, try to change them or feel compelled to act on them. All feelings have a purpose, whether to protect you from danger or open you to love. Watch and accept whatever arises in consciousness with an open mind. Extend this non-judging attitude to other people and things.
Acceptance of Things as They Are. Don’t try to force or change reality to fit your vision of what it should be, feel like a victim or bemoan the unfairness of life. Instead, try to see reality clearly and let it be as it is, knowing that you can tolerate whatever it is that comes up. Extend this acceptance to others, knowing they are the best judges of what is right for them.
Connection. Feel connected to all living things and nature in being part of a larger whole. Reflect on and feel grateful for the cycle of life and the food, beauty and protection that nature gives us.
Non-Attachment. Do not try to hold onto things, people or experiences but instead become aware than life is in constant flow. Learn to surf the wave of life, going with the flow and being confident in your own ability to adapt. When one door closes, another opens.
Peace and Equanimity. Know that life is a cycle and you can’t see the whole picture at any one moment. When things don’t go your way, stay firmly rooted in your own clear vision and values. Walk with a peaceful heart and adopt a non-harming, non-violent attitude.
Compassion. Deal gently, kindly and patiently with yourself and others. Rather than judging, or condemning, open your heart to really listen and try to understand your own and other people’s experiences. Allow yourself to feel other people’s suffering. Love people not for what they can give you or because you need something from them, but because you connect and empathise with their experiences.
Developing an observing mind that watches your own daily experience, notices your automatic patterns and gently redirects attention to the present moment is the beginning of growing mindfulness to help you navigate the winds of change and stresses in your life.
Slow your mind – follow your breathing – be gentle with yourself – enjoy the stillness – smile.
When we find ourselves feeling overwhelmed by our emotions, – perhaps triggered by something someone says to us, by memories or thoughts – it can be really hard to understand what is happening. And we need help right then, so we don’t make choices that end up hurting us even more. This is when it can be good to try the simple stuff. What could be more simple than breathing?
So… Breathe. Normally we aren’t aware of our breathing, it just happens. But if we pause for a moment and follow our breath…
The average adult breathes 21,600 times a day and yet is unaware of it 99.9% of the time, even though breathing is incredibly helpful in relaxation and well-being.
Here’s a way to get started: put one hand on your chest and the other on your stomach; close your eyes and do nothing but follow your breath and the movements of your hands. Try doing this for 20 seconds. And then take a moment to notice how does that feel?
At times it can feel impossible to deal with anger without ranting and raving. If we use our anger to frighten and intimidate others, we are in danger of both pushing them away and potentially damaging those relationships. If we want to change our behaviour, we need to understand what lies behind it. Here are some ways that can help you manage your anger:
Becoming Aware of Anger. The first thing to do is to learn to identify where and when you feel angry. Write it down. Is there a pattern? Are there consistent triggers? Can you begin to identify why you are so angry? Is anger masking other feelings such as embarrassment, hurt or shame? If you don’t know why you are getting angry, it’s very hard to learn to control your anger.
Learning to Relax. Notice what anger feels like: do you get a knot in your stomach, a headache or tense shoulders? Relaxation techniques such as deep breathing and relaxing imagery can help with the physical symptoms of anger. Practicing these techniques when you are not feeling upset will help you to be able to use them in the heat of the moment.
Become Aware of your Thinking. When you start to feel yourself getting upset about something, take a moment to ask yourself, ‘Is getting angry or upset going to help?’ Or ‘Is this worth ruining my day over?’ If you can recognize when you’re not thinking logically about a situation, you can replace these thoughts with more rational ones.
Problem Solve. Sometimes our anger and frustration are caused by very real and inescapable problems in our lives. In these cases, use anger to find out ‘What is so wrong in my life that I feel furious, and what do I need to do to change the situation?’ By focusing on problem-solving during frustrating situations you can use anger constructively as motivation for positive change. However, it is important to recognize situations you can’t control or change. In those situations you may need to work on changing your perspective on the situation.
Communicate Effectively. The key to effective communication is good listening. Try listening to what is behind the anger or source of frustration. For example, if your partner is criticizing you for coming home late from a stressful day at work, instead of responding defensively try to understand the underlying message or hurt. Perhaps your partner is feeling neglected or unloved. If you can keep cool you can prevent the situation from escalating. When we are angry we tend to jump to conclusions, often the wrong ones. Slow down and think through your response.
Take a Break. If your anger seems to be building, remove yourself from the situation for a few minutes and do something else – take a brisk walk, listen to some music or try your relaxation techniques. Your chances of resolving the situation in a productive manner greatly increase when you can approach it without feeling full of rage.
When we begin to explore the thoughts that accompany feelings of anxiety we find the prevalence of the dreaded ‘What if…?’ If a thought begins with ‘What if’ then it can usually be identified as a purely anxious thought. Dwelling on such thoughts gives us the illusion of being practical by preparing for all possible outcomes, but none of us know what will happen in the future and ‘What if’ thoughts never seem to involve a good outcome! The reality of ‘What if’ thoughts is that they are rarely productive and often mentally draining. If you think about it, the phrase ‘What if’ implies a problem that doesn’t yet exist: how can we solve a problem that doesn’t even exist?
So, why do we automatically (or what feels like automatically) focus on these ‘What if’ thoughts? Because it is part of our human nature to gravitate toward the negative: it’s a survival mechanism. When our brains find a threat, we focus our energy on getting rid of that threat, and if we are feeling anxious, this tendency to focus on ‘What if’ increase. Our brains misinterpret ‘threats’ or exaggerates the magnitude of actual threats. This exaggeration of stress behavior increases the body’s anxiety levels.
Becoming aware of ‘What if’ thoughts allows us to begin to reduce their impact on anxiety levels. A good way to do this is to set aside a number of 10-minute worry sessions throughout the day where you can write down all your ‘What if’ thoughts. Writing can be a good release and it helps to see the ‘What if’ thoughts on paper; illuminating their irrational and disorganized nature. This helps us identify these thoughts for what they are, fears, not reality.