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Anxiety: Taming the Butterflies Now is the age of anxiety.
You enter a large room crowded with strangers. Everyone seems to know somebody except you. You wonder if others can see how anxious you are, how out of place you feel. As you entertain such thoughts, your heart begins to race, and your palms begin to sweat. Your head feels encased in shrink-wrap. You feel an urge to bolt from the room. Anxiety is part of our natural defensive system – a close cousin to fear. With fear, however, the threat is more readily identifiable. For instance, someone is waving a gun. A dog is barking, crashing against the cyclone fence. Like fear, anxiety is the body’s red warning light that something is amiss. The brain releases adrenaline. The pupils dilate. The heart pumps out blood like an engine on steroids, gearing the body to stand up and fight. Or perhaps to run faster than we ever imagined. A manageable amount of anxiety can actually enhance our performance — by motivating us to prepare for a test, to drive with care, or to gird ourselves for a difficult confrontation. Anxiety also might carry important information. For instance, if I’m anxious at home, it might be helpful to reflect on what’s wrong in order to figure out ways to change it. Perhaps my roommate makes me uncomfortable or maybe I need to have a conversation I’ve been avoiding. The problem, however, is when our anxiety becomes disproportionate to the situation or is so paralyzing that we are unable to perform. Another related problem is when anxiety becomes pervasive and free floating, no longer linked in any recognizable way to specific demands, challenges or threats. At this point, it might be helpful to distinguish between two kinds of stress. Type I Stress involves a specific stressor, e.g., a cockroach in the bedroom, a car alarm shooting off, a midterm exam. Type I stressors are definable and time limited. Typically, once time passes or we take appropriate action, the stress dissipates. Type II stress, on the other hand, tends to be chronic and vaguely defined. Examples include living in a dangerous neighborhood, persistent financial worries, growing up in a dysfunctional family, anxiety about one’s future or the future of the planet. With Type II stress, we often have a difficult time naming the stress, let alone feel empowered to resolve it. Type II stressors often involve a strong subjective component. For instance, people who are prone to worry will find a host of Type II events on which to focus their anxiety. We all know someone who thinks, What if . . . (name the bad thing that can happen). Other people will feel little or no anxiety about the same possibilities or events. It’s worth taking a moment to focus on social anxiety. Social anxiety may take the form of fearing large groups, unstructured social situations, or going out on a date. Some anxiety when interacting with strangers is quite normal. There may be something biological here since, after all, human beings are the most dangerous animals prowling the Earth. Social anxiety becomes problem when it keeps us from interacting with or getting close to others. The person who is socially anxious may doubt whether he or she is smart enough, attractive enough, likeable enough, _____________ enough (fill in the blank). In sum, this individual may feel socially undesirable and inadequate, uncertain how to connect with others in a meaningful way. Nonetheless, even a socially anxious person may feel comfortable within a narrow circle that includes close friends, roommates, and/or family members. This illustrates that the experience of anxiety is not black or white but rather straddles a continuum. What about Panic Attacks? Panic Attacks are episodes of extreme anxiety often accompanied by such physical symptoms as shortness of breath, racing heart, sweaty palms, dizziness, tingling. Sometimes a person experiencing a panic attack will think that he or she is having a heart attack or is dying. Physiologically, panic attacks involve an activation of the sympathetic nervous system or fight-flight response. When we are faced with an extreme danger, this innate response mobilizes us to confront or escape the danger, sometimes performing what seem like “super-human” feats. This fight-flight response is designed to protect us, not to harm us. Panic attacks occur when this hard-wired, physiological response occurs in the absence of a real threat. Instead of mobilizing us for action, the activation of our nervous system is channeled into anxiety. One problematic complication of panic attacks is that the individual may learn to avoid situations in which the attack occurred. In more extreme cases, a person might develop a fear of leaving the house. This avoidance pattern can cause a person’s world to shrink. Indeed, the fear of having a panic attack can actually precipitate an attack. Franklin Roosevelt might have been counseling a person with panic attacks when he said, The only thing to fear is fear itself. The good news is that panic attacks readily can be addressed by many of the techniques described below. In addition, there are some strategies that pertain specifically to panic attacks. How can I Reduce & Overcome Anxiety? Since some anxiety is natural and normal, the goal of any treatment is not to eliminate anxiety but to lessen it. Some strategies are very simple and easily learned. Other avenues are traversed gradually and entail a process of self discovery, with or without a professional guide. For those who have difficulty with anxiety, stress often has a cumulative affect. Therefore, if you’re anticipating a source of stress rising, say as you head into exam week, it’s advisable to try to lower other sources of stress whenever possible. For example . . . • Postpone a difficult conversation Perhaps the first step in addressing your anxiety
is to ask: where is my anxiety coming from? By engaging in a process
of reflection, sometimes we can figure out what the problem is
and then strategize ways to resolve it. Since anxiety rises with stress, ways that you can develop to lower and better manage your stress will also have a beneficial affect on your anxiety. Some well established stress-reducing activities include physical exercise, going on a walk, talking to a friend, listening to or playing music, yoga, and other forms of creative expression. It’s very helpful to end the day with at least 30 minutes of relaxing activity, which allows us to unwind and more easily fall asleep. If the world situation is getting you down, you might consider going on a “media fast.” The world will stumble along just fine without you reading or watching the news for awhile. Like any skill, Mind-Body techniques for lowering stress and anxiety are more powerful the more often you practice them. This is especially true when you are first learning the technique. If you only make use of a strategy when you are feeling extremely distressed, its effectiveness may be reduced. Deep Breathing: When we are anxious, our breathing tends to be shallow and fast. In contrast, deep and slow breathing tends to relax us at a physiological level. Begin this practice by lying down or sitting in a comfortable chair. Place your hand on your stomach area. Now, as you slowly breath in, draw the air all the way down into your diaphragm. Feel your hand rise as the breath comes in. You can gently count 1,2,3, 4 as you breathe in. Breathe out to a count of 1,2,3, 4 and hold on the out breath for another 4 seconds. Repeat this practice for 3 – 5 minutes. Breath Meditation: One simple and effective meditation is to choose a word or two that evoke qualities of experience that you would like to cultivate. For instance, words like courage, trust, peace, well-being, love, equanimity. Choose whatever words seem most appropriate at this time. Let’s say the words you select happen to be openness and trust, now as you slowly breathe in, imagine breathing in openness, opening up your mind and heart, opening to your feelings, opening to goodness, opening to love, etc. Then, as you breathe out, imagine yourself deeply trusting, letting the sense of trust wash through you, bathing your muscles and tendons, your bones and internal organs all the way down to the cellular level. Body Scanning: Find a quiet room and lie down on a sofa or bed. Take a few deep breaths, letting your attention withdraw from the outer world and to focus in on your body. Now bring your full attention down to your feet. First, allow your toes to relax, then the ball of your feet, then the soul and heel. Very gradually move your mind’s eye up through your body, allowing each part to relax completely, until you reach the top of your head. You can cultivate feelings of relaxation by gently saying to yourself, My feet are relaxing . . . my knees are relaxing, and so on. It’s very important to bring and keep as much of your attention as you can on what your body is actually experiencing. For instance, you may notice sensations of tingling, heaviness or warmth. Whatever sensations arise, just allow them to be as you continue to move up through your body. To the extent that you can relax your body in this way, then your mind also will become relaxed. Cognitive Strategies A woman we know has a cat who runs and hides every time the veterinarian drives up. Once a year the vet will come out to the ranch to give the cat Whiskers her shots and clean her teeth. If we could only sit down with Whiskers and tell her that the veterinarian means her no harm, perhaps she would calm down and stop acting like a “scaredy cat.” But for Whiskers even the sight of the vet’s Dodge Ram portends an hour of pain and unspeakable terror. If cats are anything like human beings, we might surmise that what’s most frightening for Whiskers is that she has little control or understanding of what the vet is doing to her. She can’t say to herself, now she’s cleaning my teeth, now she’s getting ready to give me my distemper shot, which will hurt just a few seconds and then the pain will subside. Human beings — and perhaps even cats — have inner monologues that shape and color our experience. These monologues have been likened to tapes (perhaps we should say, digital streams) that play automatically, often without our awareness. The case of Whiskers suggests that some running monologues engender anxiety, while others prevent or allay it. The eminent Roman philosopher Epictetus observed that while we can’t always change external events, we can change how we perceive them. This is the basis of cognitive psychology. The first step toward changing our inner “digital
streams” is to become aware of them. Affirmations sometimes can be another effective cognitive strategy. The idea here is to re-record our negative tapes with more affirming monologues. Affirmations can help immunize us against anxiety by building up our confidence and self-esteem. While the best affirmations are those you devise yourself, examples might be: I am a worthwhile, compassionate person. I radiate love and draw love toward me. I am a student of life, leaning as much from my mistakes as from my successes. While these may sound corny or artificial, are they any less grounded in reality than such statements, I am stupid . . . Everyone thinks I’m worthless . . . ? If we have a choice about our inner monologue, then why not construct a monologue that builds up our sense of self rather than tears it down? Another cognitive strategy consists of giving ourselves simple reminders when our anxiety begins to build, such as: • I can trust that things will turn work
out. Many factors enter into a intelligent decision about whether to take medication for anxiety. Some psychotherapists believe that mainstream society has been moving too far in the direction of viewing psychological problems as primarily biological, prescribing medication as a rote response to any psychological complaint. This problem has mushroomed in recent years as medications have been allowed to be advertised in the media. If you’re thinking about medication, it’s important to consider both the risks and rewards. One potential benefit includes immediate symptom relief, which may be especially helpful when anxiety becomes crippling. Medication might also be useful when ones anxiety reaches a level where it is difficult to perform in school or in everyday life. Another benefit is that some people prefer medication to psychotherapy or mind-body practices. Some of the risks include drug side effects, treating the symptom rather than getting at the cause, addiction to tranquilizing drugs, and missing out on an opportunity to grow personally by relying on an external substance to change how you feel. Medication and psychotherapy need not be mutually exclusive, Many UO students make use of both. If you have questions about anxiety medication, you might raise them with your therapist and your physician.
It’s quite common for people to seek unhealthy
ways to cope with anxiety. Needing to get to “get a buzz”
in order function at a party is only one example. Substance, shopping,
eating, sexual and other addictions often mask deeper discomforts
and distress. Activities that in moderation can be quite pleasurable
become problematic when they are compulsive and preclude other
ways of finding release and comfort. If you think that you may
be “self-medicating” in this way, it would be important
to raise this with your counselor. Anxiety can originate from a variety of emotional sources. Sometimes we experience anxiety or even panic attacks when we are on the verge of a major life change. Changes and transformations often trigger feelings of loss and related fears, including the loss of identity, loss of support and comfort, and loss of meaning. By talking through such feelings with a supportive listener, they often diminish in intensity. A related source of anxiety arises when we are warding off painful experiences or feelings. Often we are unconscious that we are doing this. By becoming aware of and working through the painful events and feelings that we carry, they tend to lose their energy and capacity to fuel anxiety and other problems. Much anxiety arises from our relationship with ourselves.
If we like ourselves and feel effective in the world and with
other people, this helps to “immunize” us against
problematic anxiety. If you are someone who struggles with self-esteem,
you shouldn’t despair. The path to self-acceptance and self-love
is a journey that has been taken by many before you – a
path walked by many of the most admirable men and women in history.
But this journey does involve time and effort. Sometimes life
itself provides the tools we need to traverse this path. Often,
a healing relationship with a therapist or another caring individual
can help us unlearn and repair the harm that came to us and then
became a part of us. I don’t have big anxieties. I wish I did.
Written by Mark Bradford Evans, Ph.D.
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