The word anxiety has such broad connotations that I can’t help but feel like I’m using a very ambiguous title to this blog that doesn’t really give a sense of what I’m trying to say. Where do you begin to talk about something as monumental as anxiety and reduce it to a few hundred words in a blog post? (the irony of the fact that I’m anxious about the choice of title isn’t lost on me).
Everyone experiences anxiety. It’s an unconscious, instinctive response to fear that is our brain’s way of protecting us and telling us we’re facing danger. It’s also a pretty fundamental process and without it, our species probably wouldn't have survived. Our stone age ancestors would have had their fight, flight freeze response triggered when they were faced with life or death confrontations with wild animals. In our modern society, it’s unlikely we’ll have many situations where we’re facing down an angry wild animal (unless you get out of your car in the big cat zone at the safari park) but in my opinion, the fears that someone with an anxiety disorder is facing on a daily basis are no less threatening or emotionally debilitating than the experience of literally fighting for survival. I used the word ‘disorder’ in that last sentence and although there are many people diagnosed with anxiety disorders (OCD, panic disorder, generalised anxiety disorder, social anxiety), I believe there are likely to be very many people who suffer terribly with anxiety but who have no diagnosis and who have never sought help. Instead, they continue to use ‘avoidance behaviours’ or ‘safety behaviours’ as a way of tolerating the discomfort without even realising they’re doing it.
I witness anxiety both as a mother to a child with an anxiety disorder and as a counsellor. I have also experienced anxiety myself (I touched on this in a previous blog post 'Expectations') and I am all too aware of the relentless battle to keep it contained and to not let it impose too many restrictions on daily life. That’s not to say that everyone who has anxiety suffers in the same way. Like every experience, it is totally unique to the individual and discovering your particular trigger or sensitivity is the first step to addressing the issue. Anxiety is ‘set off’ by a part of the brain called the amygdala. As mentioned earlier, this is an unconscious process and is therefore pretty much impossible to stop, but having insight into what triggers it can really help with the process of being more mindful and ultimately perhaps more tolerant and accepting of it.
There is a theory that whilst anxiety and how it manifests is unique, the over arching fear for all of us is death. It’s the existential crisis facing us all that we are mortal, and living with that knowledge, albeit unconsciously sets of a fear of letting go of the past and a desire to control the future. It may seem slightly far fetched but I believe there’s something in that. Time seems to slip through our fingers and change is relentless and inevitable. This can be alarming when the anxiety trigger is perhaps a feeling of ‘have I done something wrong?’ ‘did I say the right thing?’ ‘was I ok there?’ ‘what if I forget that amazing day out I just had?’ ‘Is it too late to change things?’ and other reflections of past events which become an ongoing narrative that is utterly exhausting and usually very self punishing. Inevitably, an anxious person who is fearful of their own place in the world and whether it’s ‘safe’ or not will also embark on relentless ‘what if’ thoughts which are always future based: ‘what if I go to that party and I hate it?’ ‘what if I do something wrong?’ ‘what if my child gets seriously injured?’ ‘what if I drive and cause an accident?’ ‘what if my actions hurt someone else?’ ‘what if someone I love dies?’ ‘what if I die?’. These are just some of the many, many examples of cognitive ruminations that cause an anxious person to put the next stage in the anxiety process into place; the so called 'safety behaviours' or sometimes called 'avoidance behaviours'. These can be as obvious as literally avoiding going to the party that you think might be awful to more subtle behaviours such as putting conditions on a situation; I’ll go to the party but I’ll arrive late, leave early and stick to people I feel ok with. By carrying out these behaviours, the person is successfully distancing themselves from the uncomfortable thoughts although unsuccessfully attempting to control a future that is entirely uncontrollable.
To put it more simply, anxiety follows a process and that process is as follows:
· The amygdala is fired up because a person has been ‘exposed’ to a fear. This happens unconsciously and is impossible to stop.
· The part of the brain called the cortex takes over and makes a meaning out of that anxious feeling.
· The cortex drives the cognitive process and is when the worrying reflecting takes hold and the future ‘what if’ thinking is relentless.
· Compulsive behaviours are activated
· The anxiety evoking situation passes and the person feels relieved that they are through it.
This is an over simplified version of the process and for someone who experiences anxiety, it might be very difficult to identify with it. It takes a lot of time and practice to really understand the difference between the bodily sensations (light headedness, fast heart rate, knot in the tummy), the feelings of despair and the thoughts related to anxiety. Once these can be separated and differentiated, it’s much easier to feel less overwhelmed by the entire process. Ultimately, it’s about operating on a more mindful basis because the issue with anxiety is that a person is rarely in the moment. They are analysing the past or worrying about the future and in doing so, they are removing themselves entirely from the fear that brought them there in the first place but also away from where they are in that exact moment.
The safety behaviours are an understandable consequence of the intrusive thoughts and offer such a soothing quality that they are very hard to relinquish. Sadly however, safety behaviours simply don’t work. They maintain the fear and are the equivalent of putting a plaster over a wound that hasn’t been treated or looked at. The relief is temporary and people with anxiety disorders will often find that the behaviours that were once so effective eventually stop working so they’re forced to try new ones. This continues until the restrictions imposed on the individual’s life and the feeling of hopelessness attached to that causes secondary symptoms of depression and low mood.
One of the most important things in my opinion is to recognise that the anxiety might not go away and really the goal isn’t to obliterate it, but rather change the attitude towards it; to look at it through a different lens. We have to learn to accept ourselves as a whole. That means absorbing the good and the bad, the nice experiences, the horrible experiences and everything in between. Sometimes the pressure to eliminate the parts of ourselves that we don’t like is so great that we end up punishing ourselves for not being able to shrug it off. I passionately believe that we have to be allowed to be human, to be fallible, to own the bits of ourselves that we wish we didn’t have, to absorb the good, the bad and the ugly. If we try to deny that of ourselves then we are denying ourselves our humanity and that puts a level of expectation onto us that is simply unachievable. We can’t change the past and we have no idea what the future holds and that is the challenge facing us all. I believe that life isn’t about avoiding suffering. It’s not supposed to be an easy ride where we avoid the future slings and arrows and throw off the stuff from the past we don’t like. It’s all part of the rich tapestry and it’s how it’s supposed to be. Tolerating that is not easy but accepting it as part of the ‘deal’ can be incredibly liberating.
If you are suffering from anxiety, try talking to someone about it, someone that you trust to hear the stuff that may seem ridiculous or embarrassing or even shameful. Unpicking it can help separate and label the processes that are unfolding which in turn leads automatically to being more mindful. I sometimes hear clients talking about their safety behaviours with absolutely no idea that it is in fact a behaviour that’s designed to avoid the anxiety, it’s just so automatic and seems so inconsequential and that is why it is helpful to seek professional support. If that isn’t possible, one of the mantras I often repeat is ‘thoughts aren’t facts’. The cruel thing about anxiety is that it imposes so much suffering and angst onto situations that haven’t actually happened and may never happen. In actual fact, people with anxiety are often highly alert, intelligent, high achievers - all traits that serve them very well when faced with actual stressful situations.
I mentioned at the start that this is a broad topic and I really don’t feel I’ve scratched the surface despite this being one of the longest blog posts I’ve ever written! It is a subject I feel passionately about not least because it’s so ubiquitous and the suffering is so considerable. Please don’t hesitate to contact me if you would like to discuss this in more detail but in the meantime, here are a couple of books that I have found give a really good insight into anxiety and that you might find helpful: