Friday, 11 October 2013

Working with Anxiety

Anxiety is, to some extent, inevitable. There is much to worry about: death, illness, money, how we look etc. Some of these may be more realistic than others. Anxiety becomes troublesome when it creates a serious barrier to happiness and inhibits our ability to live creatively and courageously.

It is important to accept its naturalness, as an emotion which we are biologically and neurologically prone to experience.

Anxiety itself can be generalised, confined to certain areas of life, or funnelled into specific phobias. Whatever its form, there is usually serious insecurity. This has often begun in childhood, perhaps caught from anxious parents or the consequence of experiences that the young self finds hard to process such as bereavement or bullying. Abuse- physical, emotional or sexual- sends a message that   
people and the world cannot be trusted. Obviously, a lack of love and warmth implies a life in which needs may not be met. 

By sharing these experiences with a humane therapist, it is possible to feel less lonely in them. Unpleasant experiences can become a source of a sense of being understood. By re-visiting a childhood bereavement, you can be released from the sense of responsibility which, as a child, you assumed. If you suffer from a sense of guilt, anxiety will accompany it. I think it is helpful to become conscious of the sources of your insecurity. By reminding yourself of them, you will be placing some distance between your anxieties and your sense of the world.  You will become conscious of the contribution of your inner world to your anxieties.

Anxiety also seems prevalent in people who are very hard on themselves. Some people deeply feel that they are undeserving of happiness and so send themselves a never-ending series of anxieties as a sort of 'spoiler' or as a way of sabotaging themselves. It is possible to address a harsh interior voice and to learn to extend to oneself the compassion and understanding that you give to others. It is possible to work on a lack of self-esteem in therapy both through focused work and through a more free-ranging approach. I incline to the view that trying to identify what you like about yourself-and learning that-can be valuable in acquiring a sense of ego strength.

When feelings of guilt and shame are examined in therapy, they rarely seem proportionate to the offence and it can appear that anger at another person's actions might be more appropriate. This reduces fearfulness as well.

Especially, but not exclusively, when clients present with work stress, anxiety is often produced by having excessive expectations. One client would work weekend after weekend so that members of the team he managed could enjoy their spare time. Another insisted upon 'prepping' perfectly for meetings, involving reduced sleep. Realising that these self-sacrifices don't make for high performance  but often lead to depression, stress and anxiety can set a client on the road to a more personally satisfying life.

It is also possible to consider in therapy lifestyle factors such as eating well, scheduling sufficient sleep and rest, breathing deeply, and being aware of alcohol consumption and taking exercise, all of which can have implications for anxiety levels.

There can also be psychological mechanisms of a subtle and individual kind. 

There is a great deal to be said in favour of the attitude of 'facing the fear and doing it anyway'. An attitude of avoidance can intensify fears because it sends the unconscious mind the message that the fear is realistic.

There are many cognitive interventions which can reduce or even abolish anxiety. For example, if you think that a small mistake at work could lead you to be sacked, you may be doing what cognitive therapists call 'catastrophising'; replacing such notions with less extreme ones might impact directly upon anxiety. The tactic of 'graded exposure' may assist in dealing with a phobia.

In working with anxiety, it is important to be guided by the client in terms of the nature of the therapeutic relationship and the approaches employed.  In dealing with anxiety, it can become possible to live more confidently, bravely and truly.

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