Nothing to fear but fear itself?
We have all suffered from anxiety at some point. Anxiety is that feeling of fear, dread, worry and apprehension, when we perceive that something bad might happen or something that we value is threatened. Anxiety can dramatically limit our lives and restrict our world. If we do not confront our fears we may never overcome them or learn to accept a world that contains uncertainties.
Common causes of anxiety include:
Threats to our material safety: For example, having money worries, being in debt and fears of redundancy or unemployment.
Threats to our physical safety: For example, being alone in an unfamiliar neighbourhood at night or our car breaking down on the motorway.
Threats to our social safety: For example, confronting someone about a faulty product, or being disapproved of by others for speaking our minds.
Threats to our self-confidence: Including failing at a task or doubting our abilities and competence. For example completing a project at work or taking an exam.
Threats to our self-esteem: For example, giving a presentation, making a speech or attending a performance appraisal at work.
Threats to our self-image: Including how others perceive our physical and personal traits, such as whether we are attractive or intelligent. For example, when we meet people for the first time or enter a crowded room.
State Anxiety
The above examples are temporary threats and are referred to as "state anxiety", as after the threat has gone, the anxiety disappears. State anxiety may last a few minutes, for days, weeks and sometimes months. If we know that we are to give a speech, take an exam or attend an interview within a few months, we may feel anxious until that time. If we suddenly get an invite to see the boss about a late report, our heart and stomach may sink; if we get an acceptable extension to the deadline our anxiety will pass. If we have unfinished business such as needing to confront a colleague about their work or lack of personal hygiene then our avoidance will extend our anxiety. What causes us to feel anxious will vary from one person to another, some people may feel anxious about their finances but are fine giving presentations, whereas some people worry about what others think of them but have less fear of dangerous sports and physical danger.
Trait Anxiety
Some people are more predisposed to being anxious and perceive a wide range of situations as threatening; anxiety is part of their inherent character and personality. This predisposition to anxiety is termed "trait anxiety". If we have trait anxiety we tend to view the world as generally unsafe, believe that bad things are likely to happen and assume the worst in every day situations. For example, we may constantly ask ourselves "what if?" questions and focus on possible dangers such as "What if nobody talks to me?", " What if my partner gets sick?" We may have learned trait anxiety from our early experiences if our carers where overprotective, perfectionist or overly critical. A traumatic experience such as being humiliated, a physical attack, burglary or accident, may make us feel that our world is less safe and cause us to be more anxious. Our genes may also predispose us to anxiety. However, having trait anxiety doesn't mean that we cannot change.
Phobias
Phobias are a more specific form of anxiety such as a fear of spiders, dogs or heights. Many people have social anxieties such as a fear of public speaking (one of the most common) and a fear of personal interactions with others or shyness. Phobias can be extremely disruptive and cause difficulties and restrictions to our careers and personal lives. There is more on phobias here.
Stress Responses
Anxiety is often the cause of physical, psychological and behavioural stress responses such as panic attacks, nausea, increased heart rate, sweating, irritability, frustration, avoidance, increased smoking and drinking. There is more on "fight or flight" stress responses here.
Escape Responses
Anxiety causes us to avoid or escape situations that we feel are unpleasant. We may seek escapism through alcohol, smoking or recreational drugs and although these may bring short-term relief, in the long-term they may add to our problems. In order to avoid anxiety we may avoid situations in our work or personal lives, thereby creating limits on what we can achieve. For example we may avoid work that involves public speaking or being away from home. In our personal lives we may avoid social gatherings or unfamiliar environments.
Methods
The methods I employ to treat anxiety are listed below. Of course, the methods used will depend on your individual needs and be agreed by you.
Hypnotherapy
Even though we may know consciously and rationally that our fears are unfounded and that we are in no real danger, our unconscious minds are over-protecting us. Our unconscious minds contain our protective and survival instincts. Using hypnotherapy we can update the unconscious mind so that we can make a rational decision between what is safe or not. We can use self-hypnosis techniques to rehearse situations we feel are threatening, such as giving a presentation or using public transport.
What we fear is stored in our minds as mental images; we can use mental rehearsal techniques as "mental exposure" to our fears, this reduces anxiety and helps us to prepare adaptive responses. For example, rather than picturing an unfriendly and critical audience for our presentation, we can rehearse being confident, speaking clearly and performing competently.
Physical and Mental Relaxation
Anxiety switches on our "fight or flight" stress response; those feelings of nausea accompanied by increased heart rate, muscle tension, sweating, short breathing and confusion. By learning and practising relaxation techniques we can switch on our relaxation response, which is the exact opposite; we can slow down our heart rate to normal, breathe easily, reduce muscle tension and think clearly.
Rational Thinking
Anxiety can interfere with our thinking and limit our concentration and attention. Conversely our thinking can also cause us to become anxious. For example, we may overestimate or exaggerate the chances that something awful will happen and predict the worst. Further, if we have perfectionist beliefs and are over critical of ourselves this will also increase our anxiety. Using rational thinking we can dispute thinking that is causing, or adding to our anxiety and keep negatives in perspective. Rational thinking enables us to be more accepting of ourselves and to live with acceptable levels of uncertainty and unpredictability in our world.
Behavioural Disputing
Behavioural disputing is a means of testing whether our thinking is accurate or exaggerated and whether our predictions and assumptions are correct. For example, in situations where we fear disapproval by confronting someone, we can check whether complaining and standing up for our rights is that awful.
Graded Exposure
If we do not confront our fears, then we will never learn to overcome them; our avoidance reinforces our fears. However, this does not mean that we have to go for an "all or nothing" or extreme approach. Using graded exposure, we can build up our levels of confidence, gradually. For example, by travelling a few stops on the tube with a friend and then alone or attending social events for a short time and then longer. We can also prepare mentally using exposure imagery to increase our success. The more experience we have, the more confident we become. Graded exposure also means that our work together is evidence based and we will know if we are making progress or need to change our approach.
Traumatic Incident Reduction (TIR)
TIR is a non-hypnotic method. It is effective in processing past events that have left negative emotional charges that affect us in the present. For example, if we have suffered a traumatic event such as a physical attack or an accident, these events may cause us to feel the world is less safe than before and cause us to avoid certain situations or activities.
TIR can also be used when we are making negative predictions about the future. For example, if we are imagining the worst-case scenario for a future event (whether probable or not) such as changing careers, becoming ill or being made redundant. TIR removes our resistance and increases our resilience to future events both good and bad. Once we can face the future without excessive anxiety, we have a much greater chance of dealing positively with events both good and bad.
Eye Movement Technique (EMT)
EMT is a non-hypnotic method. EMT is effective at desensitising feelings of anxiety and stress; this can be really useful if you have an exam to take or a presentation to give. Further the technique can be used to visualise and mentally rehearse positive states and outcomes, replacing any mental images of failure or catastrophe with success. Variations of EMT can be used with breathing techniques for relaxation; these techniques are easy to learn and you can use them anywhere and at anytime you feel anxious or stressed. They are so discrete that you can even do them on a train, whilst sitting at your desk or standing up.