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Anxiety, Practically Speaking |
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| [ slightly revised 01/26/08 ] | |
Wishing you could
avoid anxiety all together? Keep this little fact of life in mind: Too much anxiety and you might need medications and you might even find yourself now and then in crisis units or hospitals. But, on the other hand, too little anxiety and you don't learn from mistakes, you take foolish risks and you find yourself spending much of your time in jails and prisons. (Be careful what you wish for.)
Understanding Anxiety
Anxiety is a naturally occurring experience, pretty much impossible to avoid completely. As with anything else in life, some get more and some get less. Unfortunately one cannot simply abstain -- or fortunately. This is fortunate because we would probably all choose to go without. But those actually born without the machinery of anxiousness end up in prisons or nursing homes or dead. Functioning is difficult without benefit of the mechanisms that we usually call "anxiousness."
Anxiety is part of an important alarm system. Anxiety is our distant-dangers alarm (distant in time, space or thought). It is the consequence of some part of our mind pressing the alarm button in response to realizing that a possible danger is upcoming -- either that soon the danger will come, the danger is close and/or closing in, or thinking is on its way to dangerous thinking. This is a basic alarm system that is seen throughout the animal kingdom.
A deer will feel anxiety as it wanders down a path similar to one where years ago it was attacked by a cougar. It's vision and hearing becomes more acute and its muscles go on standby alert. The deer is much more ready to watch for and react to attack. This is "adaptive." On the other hand, one of my dogs, on seeing linoleum, becomes anxious because in the past he has found linoleum floors very slippery to walk on. My dog's vision and hearing becomes more acute and his muscles go on standby alert. He is much more ready to watch for and react to attack. But the linoleum is not likely to attack. And because his claws come out for extra traction -- and because claws actually achieve less traction on the smooth floor than foot pads -- his anxiety results in a likelihood he will fall.
Anxiety is an activation of our senses and our physical readiness so we can assess our surroundings or look for dangers -- and so we can be more ready to run or fight. Like the flashing red lights and crossing guards that come down over a railroad track when the train -- still miles away -- goes over a switch. Or like at a military base when someone raises an alarm about an incoming enemy.
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"A crust eaten in peace is better than a banquet eaten in anxiety." -- Aesop |
Anxiety is a very primitive mechanism. Its purpose is to bring our bodies to instant readiness for one of two primitive responses -- running or fighting. Anxiety is not a mechanism intended to help our thinking. In fact, anxiety virturally shuts down a lot of our finest thought processes.
The Problem of Anxiety
Anxiety can be a false alarm. Though the mechanisms of anxiety are intended to protect us, they are automatic and only indirectly accessible to conscious control. Anxiety is not related to thoughtful considerations of situations but rather to mental mechanisms that are not consciously thought about or controllable at all. Like the alarm switches in railroad tracks that switch the alarms on down line when weight is applied to the track -- and thus causing warning lights to flash and barricades to come down over intersections ahead of the train -- anxiety is triggered when thoughts go down certain pathways and trigger danger switches in our minds. The railway alarm system doesn't discriminate between real trains barreling down the tracks versus other weights that do not represent dangers down line. Crossing lights, etc., come into play whether it is a train moving along the tracks or a train crew simply stopped on the tracks.
In the same way that a railway crossing can be triggered by other things besides trains, anxiety does not come only when actual danger is perceived but rather any time the possibility of a possible danger is perceived. The anxiety system in most people has a "warning first and check it out later" attitude about possible dangers. Unfortunately, this can cause problems -- as in the example above of my dog whose claws come out on linoleum because he is anxious about falling -- anxiety can cause us to act illogically and even counter-productively. In the case of my dog, anxiety actually increases the actual danger of slipping and falling that it's trying to warn him about.
Anxiety's "helpfulness" can backfire. Though of great benefit in the days when mankind lived more closely intertwined with environmental dangers like lions and bears, anxiety is not as helpful in modern-day living. Though there are environments where modern man must worry about lurking muggers or car-jackers, most modern danger situations are more subtle, complicated and are best dealt with by cool-headed thinking -- not running or hitting. In most modern danger situations (e.g., taking an important test, being required to account for actions by an angry boss, needing to figure out our taxes, handling an abusive spouse), shutting down complex thinking in favor of increased vigilence and increased readiness for running or fighting is usually an inadequate (if not a down right terrible) strategy. In modern life, we more often need to put our thinking caps on, not our running shoes or boxing gloves. We need increased readiness for complex thought. Anxiety can actually cause an increase in danger.
Understanding Anxiety:
Biology and Unconscious Processes
It is important to understand anxiety -- especially that it turns down brain power in support of readiness for running and fighting -- and it is important to understand that anxiety does not mean that there is imminent danger but rather that there might be. It's not a good idea to ignore anxiety. But it's also not good to let anxiety cause you to ignore logic or other more complex thought processes.
It is also important to understand that anxiety is a basic, primitive response that is automatic and unconscious. It is a biological event within the body, triggered and maintained by mental processes that are not consciously controlled. When the "alarm" is triggered, adrenaline and other chemicals instantly flow into the blood stream and arousal is more or less instantly experienced. These chemicals can trigger the alarm system themselves, so calming down is not simple. Calming down involves either 1) depleting the physical body of its energy -- by either running like heck or physically fighting a hard fight, or 2) the body must clean the alarm chemistry out of its own blood stream. Though raising the alarm is instantaneous, when the alarm is over it can take quite a while -- sometimes several hours -- for the body to clean out the alarm chemistry from the blood. In some cases, the "all clear" is never sounded because threat is ongoing. Anxiousness can be sustained for days. The individual wakes up anxious after a night of anxious dreams, is anxious throughout the day, and goes to sleep thinking anxious thoughts that result in anxious dreams.
Difficult to moderate. It is difficult, if not impossible, to consciously counter-act anxiety even with the greatest determination. Anxiety is controlled by mechanisms similar to those that control blood flow to particular areas of the body or saliva in the mouth. With work, some ability to modify anxiety is achievable but it is generally more difficult to modify anxiety than it is to modify the amount of blood flowing to one's hands or feet or the amount of saliva in one's mouth.
Not attitude, not lazy, not dumb. Many people react poorly to others who are contending with over-anxiousness. For that matter, most people contending with excess anxiousness react poorly to themselves -- and get pretty tired of themselves. Like with depression, the message from many is, "Get over it." But that is, as any sufferer knows, way the heck easier to say than do -- even though sufferers typically berate themselves for not being able to "get over it" sometimes even more than others do. "Getting over it" is almost impossible, however, because anxiety is mostly a problem of biology and mental mechanisms that are automatic and not conscious.
No user serviceable parts inside(?) Because anxiety is such an important system, our brains won't allow easy alteration of the settings or easy over-ride capability. That would be identical to owning a big building and making it easy for the staff to disable the fire alarm. Mostly the anxiety alarm comes preset from the factory with basically the right settings. The user, with the right tools, can turn the alarm trigger sensitivity and the alarm intensity up or down a little, but basically the user is stuck with that range. It is unfortunate for some that some of these alarm systems come from the factory with settings too low or too high for practical living.
Practical management of anxiety
The appropriate handling of anxiety involves first assessing if there is actually any danger and then deciding on and implementing an action plan. Though modern life more often requires clear-headed thinking than cave-living life, you can't just ignore a danger alarm any more than you should ignore fire alarms. You first check things out to decide if there is any danger. If there is danger, you need to deal with it. If there is no apparent danger -- if you're experiencing a false alarm -- you need to turn off, turn down or at least ignore the alarms. Either of these can be made tough by anxiety in any situation other than bears or the equivalent. Anxiety makes it tough to figure out an action plan for a complicated danger (like being close to making a fool of one's self socially, being close to losing one's job, being close to failing a test). Anxiety itself makes it hard to calm down without exerting a great deal of physical energy and without having a clear resolution to whatever made you anxious in the first place.
The inverted "U" function of anxiety. It's important to understand that too little anxiety results in poor functioning just like too much anxiety does.
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Self talk is a huge thing. In the same way a friend at your side telling you that you are in danger of terrible things can increase your anxiety and a friend reminding you of how tough and resilient you are can help keep you calm, it is important to monitor what you say to yourself. It is not silly to be careful about self talk. Parts of your mind respond to your self talk just as intensely as you respond to the words of close friends and loved ones. It is very helpful when a friend reminds us that we've been through tough times before and that he or she believes in us. It is just as helpful to be such a friend to one's self.
Medicines can help with both lowering the frequency of alarm and the intensity. There are a variety of medicines that provide some degree of help to many individuals. These medicines can be miraculous for some and worthless for others, but usually provide some degree of relief between all and none for most individuals. The art of medically changing such a basic mental process as anxiety, though, is still very much in its infancy. The mind is made up of billions upon billions of parts. There are only a few kinds of medicines useful in changing the functioning of those parts. Medicines are as widely useful in fixing problems of the mind's functioning as a ratchet set is in fixing problems that a car might have. Another limitation is the side-effects that some medications can cause, which for some people outweighs the benefits. Still another limitation is that many of the anti-anxiety medications are addictive or so new that no one really knows what long term use might do.
Self-care is an important issue in the handling of anxiety. Self-care would include, but not be limited to: 1) reducing or eliminating caffeine (coffee, sodas, tea, chocolate), 2) reducing or eliminating stressful situations, 3) checking out thinking about fears with trusted friends, 4) accepting the need for and getting into counseling/psychotherapy if anxiety is causing significant difficulties in your life, 5) getting regular exercise, 6) staying out of negative relationships, 7) avoiding coping strategies that are actually stress increasers (i.e., credit cards, spendy luxuries, gambling, alcohol, substance abuse, casual sexual relationships, over-work, over-taxing yourself with commitments to "good deeds").
Psychological treatments can also be very helpful in lowering the frequency of alarm, as well as the intensity. There are a variety of psychological interventions which, like pretty much all types of help, can provide somewhere from all to none of the relief a person might hope for -- with most people's response to such treatments being somewhere in between. Psychological treatments might include behavior modification, counseling/psychotherapy (talking, venting and re-evaluating ideas and attitudes), desensitization techniques, relaxation techniques, eye-movement desensitization and reprocessing (EMDR), guided imagery or hypnosis, and/or a variety of other interventions. Among other things, psychological treatments may focus on understanding the experience and its causes, strategies for deciding on whether anxiousness is a false alarm or not, strategies for reducing anxiousness, intervening in self-directed anger and frustration and finding a helpful spiritual or philosophical view on the struggle.
Altered states of mind can assist in dealing with anxiety -- which is itself, an altered state of mind. This is difficult for many people but many others find great relief and value from the focusing of thoughts and the accessing of certain apparently naturally occurring, inner resources. These can sometimes be very helpful in turning down the sensitivity of alarm mechanisms. They can also be very helpful in calming down an anxious physiology by both turning off the alarm and stimulating the re-uptake of the alarm chemistry in the blood. Not all altered states of mind are helpful (e.g., for example substance abuse may result in an altered state of mind that doesn't do anything but increase anxiety). However, altered states of mind characterized by profound relaxation and focused conscious attention are sometimes known to foster a therapeutic openness to new ideas and a "refreshing" of thinking that has been found very helpful by many people. Among the most popular of these are meditation, prayer, certain rituals and hypnosis. Not every instance of prayer, meditation, ritual or hypnosis necessarily results in this sort of therapeutic state of mind, but these are generally the means used to achieve these states of mind, thereby promoting enhanced self-controls and healing understanding.
A support system to lean on can help a great deal. We humans are social critters. That doesn't mean we all like going to parties. It means we all function better if we have someone to talk to that we can share feelings with. It helps to have someone to check thinking with, or ventilate to, or to just count on for a little encouragement -- no matter what you are dealing with. For some reason we are all vulerable to accepting very goofy ideas if we don't talk about them with someone else. Sometimes just in the process of talking -- even without getting any feedback from the listener -- we fine tune our own thinking. It's even more valuable if the listener gives us feedback we can respect and accept (two heads being better, as they say, than one).
A practical attitude and positive beliefs can be powerful help in dealing with anxiety. Attitude and beliefs can influence the inner mechanisms that moderate anxiety. It is helpful to think of the inner mechanisms of anxiety as if they were controlled by an "inner child" who is at the adrenaline controls and who is very simple minded, very opinionated and very stubborn but who also is always listening to what the rest of the brain is thinking. If a person approaches anxiety as a problem rather than a terminal disaster and accepts anxiety as a very tough challenge and does not engage in catastrophizing self-talk, there is less anxiety to deal with. Anxiety is bad enough without adding another layer of anxiousness on top of it by saying things to one's self like "I'm going to go crazy," "I can't take it," "I can't survive this," "I need to find someone to take over my decisions for me," "I can't do it, I can't take it, I can't take it, I can't take it!" etc. It adds anxiousness to tell one's self that the challenge of anxiety means God does not care or you are on God's Black List.
Imagine the reactions a child would have to a parent saying those things. On the other hand, imagine what you might say to reassure a child that is dealing with anxiety. It reduces that extra layer of anxiousness if you can remind yourself (and say to yourself) that you actually are a survivor, that you actually have survived everything life has thrown at you so far. It helps to have a positive attitude -- "I can do this," "I'm a survivor," etc. It helps to decide that maybe there is a purpose to challenges as part of God's Plan of some Cosmic Plan.
A formula for success. Decisions are best when one relies on anxiety as an alarm but does not routinely let it override thinking or Faith. Anxiety is a profoundly important part of being alive. It's there to help but like any alarm, it doesn't tell you much except that maybe there is danger. You get a brain with many functions -- feelings are only one category of mental function. Though it is often the case that going through traumatic experiences can mess one's thinking up to some degree -- trauma also messes up one's anxiety system and feelings. Probably because it was more adaptive in cave man days, our brains seem to want to give anxiety more credibility than logical thought. Maybe it is because many people try to think their way out of anxiousness and after failing they feel that their thinking is weaker.
Here is a highly recommended formula for maximizing mental resources for practical, happiest, healthiest, most in-control living: #1)It is important to listen to anxiety feelings. #2) Then remind yourself of your Faith in God and your faith in yourself -- unless you basically have faith that you are on God's black-list. #3) Then use your logical mind to think things through and make the final decision.
How hypnosis might help. Many individuals can benefit from hypnosis to reduce anxiousness, foster coping and relaxation strategies, and gain a better sense of self-control. Via hypnosis, there are ways to achieve a state of mind characterized by relaxation and calm that can be very helpful in communicating a sense of safety to those parts of the mind that may be responsible for unnecessary anxiousness. Hypnosis is also often helpful in fostering the ability of the parts of the mind that work to de-escalate anxiousness after it has been decided that it's okay to relax. It is also possible to establish relaxation triggers -- images one can think of or words one can say to one's self -- that can trigger physical and emotional relaxation and the re-uptake of adrenaline and other alarm chemistry in the blood. The "trigger" becomes "associated" with relaxation in memory in a way that allows the individual to consciously use the trigger at anytime s/he thinks appropriate. When the trigger is used, the body and mind turn off or down the alarm causing anxiousness and turn down or off the anxiousness itself -- without any need for being in an altered state. Triggers, once learned, get stronger and more effective with practice.
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