I recently heard a sentence that summed up something I've been trying to get across with far more words:
"Anxiety disorders have more to do with our reaction to anxiety than to anxiety itself".
So it’s important to keep in mind that everyone experiences feelings of anxiety at times, and that anxiety is just one of a range of feelings that are part of the experience of being human.
However, some people have particular problems or difficulties relating to anxious feelings and that is the subject of this page. Anxiety problems can be short-term, perhaps focused on a particular event, like an exam, or longer term, with raised anxiety levels lasting for years. Anxiety may arise only in relation to a particular type of situation, such as flying, when speaking in public, or when encountering a spider, or it may arise in a variety of social situations. Alternatively, anxiety can also be more generalised, and might be reflected in repeatedly being drawn into worrying about future events, or feeling on edge much of the time, as though something awful might be about to happen at any moment.
There are a range of symptoms which may be associated with anxiety (many of which might also be related to other causes), these include:
Excessive worry about a number of different events or activities
Difficulty controlling the worry
Inability to relax
Difficulty in making decisions
Any of these symptoms can be experienced as unpleasant, therefore it's quite natural that we want them to go away, and not come back. Quite often, when we notice them appearing, we become anxious about them getting worse, and of course, this extra level of anxiety makes them get worse, which creates yet more anxiety, and so on, in a vicious circle that can culminate in a panic attack. In this way the fear of the feelings can often be worse than the feelings themselves. Incidentally, I do wish we could rename 'panic attacks'. If you're feeling anxious your threat system is engaged, and the idea of an 'attack' happening to you hardly helps it disengage! A much better name I heard suggested is 'panic episode', which at least highlights the fact that these things come, and they pass too.
So, why do we feel anxious?
First, it’s helpful to consider three of the emotional regulation 'systems’ the brain has, at least in a simplified way (based on the work of Jaak Panksepp and Paul Gilbert, amongst others, if you want to explore this further).
Consider the following three systems:
Motivation; a system mostly involving positive emotions, which drive us to do things which then activate the brain's dopamine circuitry, giving us feelings of achievement and pleasure.
Affiliation/Soothing; which allows us to feel calm, safe, relaxed, and contented, feeling connected to others and caring/cared for. This system is particularly connected with endorphins and the neurohormone oxytocin.
Threat; which leads to the well-known fight or flight (and freeze) response. The main hormones connected with this system are adrenalin and cortisol, and the emotions include feelings of anxiety, anger and disgust. Although these emotions are often experienced as negative, the system itself has evolved to protect us. It's there to help us survive immediate threats, most obviously by giving us the physical resources we need to fight or run.
These systems all interconnect, for example, if we are prevented from fulfilling a goal driven by the motivational system, the threat system may be engaged, and we might feel angry. Ideally, these three systems would be in balance over any period of time, each engaging when needed, but none dominating. Paul Gilbert argues that our society tends to overwork the Motivation and Threat systems, and the Soothing/Affiliation system can get out of balance. Certainly, we don’t usually face the kinds of threats that our ancestors faced during evolution, however we experience our world through the interactions of the same brain systems, so difficulties at work, or in relationships (for example) can trigger threat responses, which may be experienced as anxiety. In effect, our social structures have evolved far faster than our physiology; we still have hunter-gatherer brains, living in very different environments.
Whether or not anxiety becomes a problem for someone is down to many different factors, which may be a combination of biological, psychological or social factors. Also, someone could experience anxiety as a problem even if their symptoms did not fit into a particular diagnostic category.
What can help with anxiety?
There are a variety of approaches to treating anxiety, and as a therapist, I tend to focus on two methods: Hypno-psychotherapy and Acceptance and Commitment Therapy (ACT), a mindfulness-based behaviour therapy, (although I do use other methods such as EMDR when appropriate). Sometimes one approach or the other is more helpful to an individual, but quite often elements of both approaches can be utilised in tackling anxiety problems.
Psychotherapy can help you to understand what is happening to you, and why it’s happening: Anxiety often feels as though it comes from ‘outside’, we even describe it this way when we say something such as ‘crowds makes me anxious’. ACT is particularly effective at building skills and psychological flexibility that enables you to work more skilfully with the anxious thoughts and feelings that are pushing you around, (there’s more information on ACT if you follow the link at the top of the page).
Hypnosis can help in several ways. Firstly, as a relaxation technique; the state of relaxation, calmness and safety is oppositional to the aroused fight or flight state of anxiety: The two cannot exist at the same time. Even a brief period of hypnosis can ‘reset’ the mind/body state from anxious to relaxed, and the hormonal balance will adjust accordingly. This is a very good starting point when it comes to bringing the emotional regulation systems into balance, even if it’s not a long-term solution. But it is a good starting point from which to do further therapy work; you’re working from within the state you want to achieve. Additionally, self-hypnosis can be taught and used when needed, to produce the same deep relaxation and calmness. Also bear in mind that our thoughts and feelings are usually in sync. If we're feeling anxious, we're likely to have anxious thoughts, and if we have anxious thoughts, we're likely to feel anxious. Thus being able to switch into a relaxed, calm state can also alter the pattern of thoughts that are present.
Secondly, hypnosis is really helpful in psychotherapy as a way of ‘getting the message where it’s needed’. Consider this: You may have felt anxious/angry/sad and told yourself 'this is silly, I’ve got no reason to feel this way, I just need to get a grip…’. But how often does this work? It’s very difficult for those logical, rational areas of the brain (largely located in the outer hemispheres) to get through to the more emotional regions, (deep within the brain). Put simply, hypnosis seems to facilitate this process, which is why it’s often so helpful in modifying habitual behavioural problems. It can also help with the reprocessing of memories that are triggering patterns of anxious responses in particular situations. (For more about Hypnosis, please follow the link above to my page on the subject.)
Please note that, as with any talking therapy, results may vary from person to person.
Call me directly on 07831-693684 to make an appointment, or send me an e-mail (there's a 'contact me' link below).
Sessions are at Delta House, near to London Bridge station, SE1, and cost £75.00.
Background information on Anxiety disorders:
A doctor or psychiatrist may diagnose a particular condition relating to anxiety symptoms, depending upon the types of symptoms, their causes, and how long they’ve been present. Typically a diagnosis would be within one of the following anxiety related conditions:
Generalised Anxiety Disorder (GAD)
Social Anxiety Disorder
Obsessieve Compulsive Disorder (OCD)
Body Dysmorphic Disorder (BDD)
Post Traumatic Stress Disorder (PTSD)
Some links that might be helpful:
Anxiety UK - hypnotherapy information.
I'm an Anxiety UK Approved Therapist providing therapeutic support to the charity’s members and partner beneficiaries, (as a hypnotherapist). I am subject to Anxiety UK’s regular monitoring of my professional qualifications, supervision, continual professional development, insurance and professional body membership in addition to complying with the ethical framework and professional standards set down by my registered governing body.
Full details of the Anxiety UK Approved Therapist scheme can be found here.
Details about becoming a member of Anxiety UK to be able to access therapy via the charity can be found here.
NHS page on Generalised Anxiety Disorder (GAD) in adults
Mind - Anxiety and panic attacks