"Anxiety is a normal, if unpleasant, part of life, and it can affect us all in different ways and at different times. Anxiety can make a person imagine that things in their life are worse than they really are and prevent them from confronting their fears. Often, they will think they are going mad, or that some psychological imbalance is at the heart of their woes. What is important is the recognition that anxiety is normal and exists due to a set of bodily functions that have existed in us from our cave-man days." AnxietyUK website 2018
Anxiety – how will it affect me?
We all need to be anxious – it allows us to function. Anxiety helps us to push ourselves outside of our comfort zones allowing us to move forward.
When anxiety becomes problematic we start to respond in negative ways – there are two types of anxiety disorders, the main one is recurrent panic attacks which occurs when a person is not expecting it, we call this panic disorder.
Criteria for a panic attack
A discrete period of intense fear or discomfort, in which four, or more, of the following symptoms develop abruptly and reach a peak within ten minutes:
In the second type of anxiety disorder, generalised anxiety disorder, the main defining feature is excessive anxiety and worry.
Diagnostic features of generalised anxiety disorder
Excessive anxiety and worrying, occurring on more days than not for at least six months, about several events or activities, such as work or school performance.
At least three out of the following symptoms:
The anxiety, worry or physical symptoms must lead to significant distress or impairment in important areas of functioning.
The basis of your treatment plan is your understanding of the underpinnings of your anxiety. It is really important that you understand what is going on for you so we can normalise it. We need to identify what is triggering attacks in the here and now and identify any associated problems.
Catastrophic misinterpretations of bodily symptoms result in panic attacks. Educating you on what is normal anxiety and normal bodily responses will be explained within your first few sessions.
I would invite you to identify thoughts associated with concerns of your physical symptoms, so we can begin to develop alternative perspectives on the same symptoms. Educating you about the true nature of anxiety is a good starting point for you to develop alternative perspectives. It is important that you elicit these alternative views as we must rationalise them for you to prevent future attacks.
For example, if your view of a palpitation is that there is an imminent risk of a heart attack you need to understand and accept, that in truth, the additional adrenalin into the blood stream is the reason for your palpitation.
Unfortunately, once panic attacks have become established we develop further responses to them which only serves to maintain the problem. As part of your therapy we will focus on how much you are watching for physical symptoms which then activates the panic cycle. We will develop safety behaviours to prevent the catastrophic consequence from occurring. Once you start to prevent them you can accept the alternative explanation and thus change your thinking, the panic attacks will lessen. Once we understand better the underpinnings of your attacks we can learn avoidances thus avoiding contact and therefore attacks.
If you suffer from generalised anxiety disorder, then we will look at the type of worry that you are experiencing. These are in two categories, the external in which we worry about others and day to day events. The second are our internal thoughts, in other words, we worry about worrying!
We genuinely believe that our worrying will never stop, we will go crazy with worry. We will address your worry and rationalise it and address the inappropriate responses which maintain the problem. We will also look at how your thoughts focus on control and how reasonable those thoughts are. Worry triggers behaviours, emotions and thought control, we need to work together to understand how you respond to your worry and what underpins it.
Panic attacks and worry are very frightening and life changing. Being in therapy will allow you a space to share your deepest concerns and be acknowledged. Many of my clients have found our therapeutic relationship with its raft of theoretical knowledge and genuine caring was the springboard for their long-term change and subsequent removal of their abnormal anxiety.