You’re feeling anxious?
But – not completely sure why exactly? I hear this all the time from my clients who experience anxiety . They seem to hold this belief that their anxiety is “just there”. If you feel like this, I’d like to validate your feelings - you are not the only one feeling this way.
I usually try to figure out quite early on in sessions what types of situations/people/events/environments/thoughts/sounds and so on and so on may trigger clients’ anxiety. There is usually quite a unanimous answer that they have not recently experienced anything particularly stressful, traumatic or anxiety provoking; they feel that it usually doesn’t make much sense, that it comes out of nowhere and. that they have always had it with them. But having feelings of anxiety physiologically does not mean that there aren’t any triggers.
Having these feelings, and not being able to test our predictions on why makes us worry about not understanding why we have these feelings – it quite literally puts us in an anxious state where we then worry about our worrying, we stress about our stressing, we feel frightened of our fear, and we feel anxious about our anxiety. So instead of noticing our triggers, what we do notice is our anxiety, because it tends to be blaringly and glaringly loud. Thinking happens so quickly and automatically that we often don’t realise that we’re having stressful dialogues or creating catastrophic narratives in our own heads. Instead we become too hyper-focussed on these stimuli to notice what is happening in our heads; maybe we start focusing too much on the physiological reaction in our bodies, and then wonder whether other people are noticing it.
Even low-level anxiety triggers a natural response in our bodies. Anxiety serves a purpose, a healthy one in most cases. Physiologically it gives us quick energy, releasing sugar and fats into the bloodstream, tightening muscles to a state of readiness and focusing you on the perceived danger. This all happens in order to help you react through our flight, fight or freeze responses. This type of anxiety is helpful for most individuals who feel a normal amount of it, but still believe they are able to cope with it. It becomes more difficult once we overestimate risk and underestimate our resources available to cope with it.
Anxiety involves overestimating the risk of threat or severity of the consequences and underestimating one’s ability to cope with the threat. Other factors that contribute to anxiety disorders are:
- self-focused attention,
- over-attention to threats,
- misperceiving or incorrectly assessing threats,
- anxiety about anxiety and;
- using avoidance and safety behaviours as coping strategies.
It is NOT the situation that triggers abnormal anxiety but rather the THOUGHTS. We need to use our increased anxiety as a cue to identify interpretations or automatic thoughts. Our focus of attention moves, we become hypervigilant to help us notice risks but in clients with high anxiety, one may not notice the good in certain situations. For example, if Tom was giving a talk in front of his employees he may already be a bit nervous, spiking his hyper-vigilance. If he then notices someone in the crowd that keeps checking their watch and looking bored, he may end up noticing this as a risk and weigh this as more, while not noticing that the rest of the employees seem interested and not bored. Another focus of attention comes in the form of self-focused attention. We become hyper-aware of our own anxiety- provoking thoughts; the more we focus on these thoughts the more our physiological symptoms increase. For example: let’s go back to Tom, he has now noticed his anxiety spiking, he starts thinking that people will notice how nervous he seems, how much he is sweating or stuttering, The more he thinks about it the more his symptoms increase. This focus of attention can sometimes form into anxiety about anxiety. We have a situation that triggers anxiety symptoms --> beliefs about anxiety symptoms --> focusing on anxiety symptoms --> triggers more anxiety symptoms.
There are not many clients that I have seen in my practice that had not at one time or another formed anxiety about their anxiety. Sometimes, clients will make use of avoidance strategies. When clients start to overestimate risk and underestimate their resources to deal with it, they tend to run away and make use of avoidance strategies. This is not helpful because it does not allow you to test your negative predictions and enforces the belief you may hold. “What do you do to feel less anxious?” – this is often a question I ask clients, because it highlights what safety behaviours we may make use of. These are not always helpful, but they make us feel safe. Let’s imagine someone who fears not doing work well enough for their boss, They may feel that, to prevent that from happening, they have to do the work perfectly. This perfectionism is a safety behaviour. It prevents you from seeing the true risk in situations - your boss probably won’t fire you if you make a mistake. You are very probably not helpless and do have internal and external coping behaviours.
I always find it helpful to be able to see the process of formation of beliefs. One of the things I like to do is share these visual diagrams with clients (this also is something I like to give as homework tasks). Look at the following diagram (this is an example only):
The first step in overcoming anxiety is identifying our own automatic thoughts. Once we have made a list of these, we then start challenging them. We look for the evidence for and against the thoughts. We work on what is called “cognitive restructuring”. I highly recommend doing some CBT therapy if anxiety is something you struggle with. Here are some tips you could try at home:
1. Try identifying some triggering situations for yourself. Ask these questions:
- When or where is your anxiety most intense?
- Are there any situations that make you anxious? Which situations do you avoid, or partially avoid because of anxiety?
- Do you notice any bodily sensations that make your anxiety worse after you notice them?
- Do you have any thoughts, images, or impulses that are distressing to you?
2. Slow down your breathing
Breathe slowly through your nose for a count of 4 to 6 seconds, holding your breath for 1 to 2 seconds, then slowly breathing out through your mouth for a count of 4 to 6 seconds. I also highly recommend finding some guided breathing exercises on Youtube, they have some great ones!
3. Practise a grounding technique
When feeling overwhelmed, try and find five things you can see, four things you can touch, three things you can hear, two things you can smell, and one thing you can taste. This helps to shift our focus away from anxiety and helps us to reconnect to the present moment using our five sense.
4. Face your fears (I recommend doing this with expert help)
Avoidance only amplifies and strengthens our anxiety. Research has also found that individuals who try to avoid situations or thoughts, end up having more of them. Paradoxical, I know. Exposure in facing these fears, whether cognitively or through “in-vivo” exposure has been found to be highly effective.
If anxiety is something you struggle with, either recently or if it feels you have had it for as long as you can remember, please do reach out to make an appointment!