This past few weeks I have felt like I have been on a crash course on anxiety. Not personally but through my work I have facilitated a group on Anxiety, and was handed clients with an array of anxiety disorders including Generalized Anxiety Disorder, Panic attacks, Obsessive compulsive disorder, and post-traumatic stress disorder.
We all can relate to experiencing anxiety in our lives. I only recently wrote about feeling anxiety in regard to interviews I had gone through. In this regard, experiencing a feeling of anxiety is a normal part of our stress response that enables us to respond to life’s challenging situations. For example, a woman that is assaulted by a particular man may wisely flee the scene when he comes toward her again.
Increased heart rate, sweating, and other symptoms of anxiety prepare us for these flight or fight responses that have helped us through the ages in survival. Now we get these same responses in our everyday technologically oriented lives in response to anticipated event, but also in response to thoughts and feelings about these events.
Those with anxiety disorders are characterized by avoidance anticipatory fear- or more simply fear of experiencing an event or a feeling that has not happened (yet).
Instead of accepting or experiencing fears or unpleasant emotions with an anticipatory event will use methods to avoid these events and control their emotions or thoughts, but unfortunately these only exacerbate anxiety symptoms.
A funny example told in the book I am currently reading on Acceptance and Commitment therapy for anxiety disorders tells the story of how one woman after an accident would try to avoid to take left turns due to having been in an accident where she was taking a left turn. You can imagine how much time and inconvenience it would add to her life and how this increasingly complicated route could cause even more stress in her life as she increasingly revisits her fear of left turns in avoiding them in turn also strengthening her anxiety.
There is a strong physiological component in anxiety, in addition to the usual mix of thoughts, feelings and behaviors that contribute to the cycle of anxiety. Anxiety can result in panic attacks which can be mistaken as a heart attack, headaches, and other bodily symptoms. As a result anxiety sufferers may spend a lot of time trying to figure out what is going wrong with them before they consider anxiety as a possible culprit.
One unanswered question about anxiety is why some people go on to develop anxiety disorders and others do not. For example, the majority of people who experience traumatic events do not develop long term PTSD. We know what makes someone’s anxiety response disordered or problematic but that does not help us with what is behind an anxiety disorder.
In this book Acceptance and Commitment Therapy for Anxiety disorders (Eisert and Forsyth, 2005) they believe that what makes anxiety disordered is a rigid control and non-acceptance. This is most obvious is obsessive-compulsive disorder where a person usually realizes that their actions are irrational and can easily identify alternative action or thoughts but is unable to accept a lack of certainty (“I may have not checked the lock, I better go back, even thought I likely did”). They propose that simply helping someone be better at controlling their emotional regulation and thoughts will not be adequate to help those with anxiety disorders as anxiety sufferers already interpret these negative emotional states as “bad” and needing to be managed and controlled at all costs. They acknowledge that it is important to confront fears by not avoiding, but also recognize that it is important to learn to live with anxiety, rather than flee the actual emotional state.
So that’s my crash course on understanding anxiety in a nutshell! Now how to deal with it in therapy- another post altogether!