Anxiety is a Trick

“Fear is like fire. If you can master it, it can heat your house, cook your food. But if it gets the best of you, it can burn you. You control it or it controls you.” –Alex in the HBO series, “In Treatment.”

The gift of fear

Several years ago I read Gavin deBecker’s book, “The Gift of Fear."  The title refers to the intuitive ability of human beings that allows them to detect danger quickly, without conscious, logical thought. The evolutionary purpose of this fear, he explains, is to energize and motivate us to repel or flee an imminent attack by a predator. Fight or flight. The book encourages us to develop and listen to our intuition. Fear can be a friend, an important signal that something is wrong.

The broken fear barometer

That’s all well and good. But what about the person who’s fear barometer is broken? I’m referring to those unfortunate individuals who have unrelenting anxiety. Anxiety is fear, after all.  For them, the fear is excessive and operates inappropriately. Their anxiety sounds an alarm in the absence of danger. It’s a false alarm, a trick of the brain. For people with anxiety, the alarm comes to be treated as the danger itself, rather than as a signal of danger.

The worst part of anxiety...

The worst part of having an anxiety disorder is not the anxiety.  It’s trying NOT to be anxious. This anxiety comes to be seen as a threat. It motivates excessive self-protection. People with anxiety learn to avoid situations that may cause more anxiety.

How do you treat an anxiety disorder?

·    Not be protecting yourself from unrealistic threats. You'll need to learn to stop reacting to unrealistic threats.

·    Not by avoiding the anxiety. Anxiety, you see, won't really hurt you. When you learn to accept it and face it, it tends to diminish in intensity and power.

·    By learning to do the exact opposite of what you have been doing.

What do you fear?

·    Panic Disorder—you fear a breakdown in functioning, a permanent loss of control brought on by your inability to cope.

·    Generalized Anxiety Disorder—you fear that unlikely events could actually happen! (And you worry about endless possibilities.)

·    Phobias—The feared object or situation will do something to you or you will panic in response to that object.

·    Social Phobia—you fear you will disgrace yourself in front of other, never have their respect or trust, and be less able to interact.

·    Obsessive-Compulsive Disorder—you fear that some error, omission, or awful act of yours will lead to incalculable harm.

·    Post-Traumatic Stress Disorder—you fear that you’ll be overcome by horrific memories of terrible events.

But, it’s a trick!

All of these anxiety disorders have something in common: they all trick you by giving you false signals. The fears do not provide accurate signals of danger. It's more like a scary movie. You experience discomfort, even though you know it's not real.  I used to run out of scary movies as a child because I believed that I was actually in danger. As an adult, I know that I'm not in danger. It's just a movie. Still, I may not like the discomfort of a scary movie. I can either walk out or "talk myself down."  The anxiety disorders fail their evolutionary purpose of preparing you for real danger. The sooner you realize this, the sooner you’ll start to get better.

And the trick makes you think it’s real.

To complicate the matter further, your creative brain provides you with a false explanation. You either think that you are weak and defective, incapable of solving your problem OR you think that the problem just can’t be solved. Others are just taking a lot of foolish risks. Both of these views are obstacles to recovery.  When you're tricked into reacting inappropriately, your anxiety gains power. You have less and less control.

Give therapy a chance.

Do yourself a favor. Get into therapy and learn to eliminate anxiety. Learn to talk yourself down from anxiety. Anxiety is very treatable. Won't it be nice to not have to experience this trick ever again?

10 Thinking Errors That Lead to Anxiety

All of us have the ability to create our own negative moods.  We often feel that it's a negative event, something that happens outside of our control usually, that causes depression or anxiety.  But it's what we tell ourselves about that event that leads to feeling bad.  Negative thoughts lead to anxiety and depression. But the good news is that you can learn techniques to free yourself of these patterns and feel better. Here are some examples of distorted thinking.

• Catastrophizing--taking an event you are concerned about and blowing it out of proportion to the point of becoming fearful. Example: believing that if you fail a quiz then the teacher will completely lose respect for you, that you will not graduate from college, that you will therefore never get a well-paying job, and will ultimately end up unhappy and dissatisfied with life.

• Jumping to Conclusions: making a judgment with no supporting information. Example: believing that someone does not like you without any actual information to support that belief.

• Personalization: when a person attributes an external event to himself when there is actually no causal relationship. Example: If a checkout clerk is rude to you and you believe that you must have done something to cause it, when you may not have done anything at all.

• Filter: when a person makes a judgment based on some information but disregards other information. Example: Someone attends a party and afterward focuses on the one awkward look directed her way and ignores the hours of smiles.

• Overgeneralization: making a broad rule based on a few limited occurrences. Example: believing that if one public speaking event went badly that all of them will.

• Black and White Thinking: categorizing things into one of two extremes. Example: Believing that people are either excellent in social situations or terrible, without recognizing the large gray area in-between.

• Labeling: attaching a label to yourself after a negative experience Example: Feeling awkward at a party leads to the conclusion: “I’m an awkward person."

• Emotional Reasoning: You assume that your negative emotions necessarily reflect the way things really are: “I feel it, therefore it must be true.

• Should Statements: You try to motivate yourself with shoulds and shouldn’ts, as if you had to be whipped and punished before you could be expected to do anything. “Musts” and “oughts” are also offenders. The emotional consequence is guilt. When you direct should statements toward others, you feel anger, frustration, and resentment.

• Disqualifying the positive: You dismiss positive experiences by insisting they “don’t count” for some reason or other. In this way you can maintain a negative belief that is contradicted by your everyday experiences.

So, what do you do?

1. Know the patterns. Familiarize yourself with the these distorted thinking patterns. Look at them often. Memorize them.
2. Recognize distorted thought patterns.  Once you know the patterns, you can start to recognize thought patterns that may not be serving you well. Whenever you are feeling depressed or anxious, examine how you got yourself there.
3. Challenge your own thinking.   After you have learned to recognize your thought patterns that aren't serving you well, learn to challenge those ways of thinking.  Ask yourself if you could look at a situation differently. This is even more effective if you have a loved one help you to identify and challenge your distorted thinking patterns.

Sources:

Beck, J.S. (1995). Cognitive Therapy: Basics and Beyond. Guilford Press.

Burns, M.D. David (1980, 2000). Feeling Good

Burns,  M.D., David (1999).  The Feeling Good Handbook

Your First Therapy Session

Many people are unfamiliar with therapy and want to know in advance what it's like. If you've ever seen therapy sessions on tv or in the movies, please be assured that it's probably not like that.

There will be some paperwork to fill out. Arrive ten minutes before your appointment time to fill out the paperwork. You were probably informed about financial arrangements when you made the appointment. Bring your insurance card, your pre-authorization number (if required by your insurance), and your co-pay.

The initial visit is a period for you and your therapist to get to know each other and get an idea where to proceed.  You will probably be asked what brings you to therapy. The therapist will be assessing your situation. You will be asked what you feel is wrong in your life, and any symptoms you are experiencing (such as insomnia, nervousness, weight loss, etc.) You may also be asked to tell a little bit about your history. Feel free to bring notes.

Telling your story

Some people think that they need to spend an hour or more explaining their background and history. Not so. Your history can come out gradually, particularly if you want brief, solution-focused therapy. It's often better for you if you limit the amount of time that you spend talking about your history to no more than 15 - 20 minutes. This way you can spend part of the hour getting feedback from your therapist and developing a plan. Some people only have a vague idea of what is bothering them. That's OK.  We'll help you to put words to what's bothering you. If you are in therapy because a spouse or parent thinks you ought to go, we'll want that person in the first session with you explaining the problem from their point of view. Sometimes parents come alone the first time to give a lot of important background history.

Summarize your history

You'll want to spend the majority of your session (which lasts anywhere from forty-five minutes to an hour, depending on the therapist) developing a plan. So, it's important to tell your story briefly. Here are some examples:

"I've been depressed for at least six months."

"I've always been anxious, but it's worse when I have to take a test at school."

"I've been pretty lonely since moving here a year ago."

"My boyfriend and I got along well for the first three years that we knew each other. Now it seems like we're fighting all the time."

"My wife says she's going to leave me if I don't stop drinking."

Your therapist will ask for clarification on some points and then ask you what you want.

Creating a treatment plan

In order to change your life so that you're happier, we'll help you with a treatment plan that identifies your strengths, your problems, and your goals. This treatment plan is a highly individualized path to wellness. It's an action plan that also describes which methods will be used to help you to reach your goals.

Thinking about strengths

I know, I know. You hate to talk about your strengths. But the reason we need to know your strengths is so that we can use them to maximize your success in therapy. Perhaps you could have a friend or family member help you with a list of strengths that you can bring to your session. Let your therapist know that you've done this.

Establishing goals

One of the most important parts of the session is to establish goals. Goals help both the therapist and the client to focus on what the client wants. You may already know what you don't want. So, establishing what you do want is generally not too difficult.

For example, you say that you've been sad and unmotivated. You lack energy and are prone to crying spells. If we think about the opposite of those signs and symptoms, your goals might be:

1. Increase happiness

2. Increase motivation

3. Increase energy

4. Decrease crying spells

How will you know?

You may be asked how you will know if you have reached your goal. We want to put this in concrete terms. For example, if you're depressed, you will know that you're not depressed because....

1. You'll have the motivation to follow through with projects and assignments in your world.

2. You'll be crying less.

3. You'll have more energy.

4. Others will tell you that you're smiling more.

How do you feel?

You will be evaluating how you feel about your connection with your therapist that first hour. Do you feel like your therapist cares about your situation, and is invested in helping you? Do you feel comfortable asking questions and sharing sensitive information? If the answer to any of these questions is "no," consider trying someone else. In fact, most therapists honestly don't mind referring a client to someone else if that connection just isn't there. We want what is best for you. Good luck!

10 Myths About Therapy

I used to dislike telling people what I did for a living because of the myths associated with therapy. Some of these myths are still out there, so I'm hoping to dispel them with this post.

1.    Therapy is for crazy people.

Therapy is for people who have enough self-awareness to realize they need a helping hand. Therapy helps you  learn tools and techniques to improve your quality of life and intimate relationships.

2.    The therapist will fix my problems.

The therapist focuses on strengths while helping you to identify unhealthy patterns and symptoms in your life that you need to change. The therapist is somewhat like a personal trainer in a gym – they can make suggestions and be a guide, but you still have to do the work.

3.    If I go to counseling, everyone will know.

Therapy is confidential. We can't tell your family members, employers, or friends what you've said without your written consent. The exceptions to this are if you threaten to harm yourself or someone else, we're required by law to tell appropriate authorities. We are also required by law to report child abuse if it has occurred within the past eight years. Some people ask about reportable abuse by saying something like, "Suppose I had a friend who....    Would you report that?"  We can talk about your "friend."

4.    The counselor will judge me and my life.

We are actually trained to be nonjudgmental. And we've heard it all. We're here to help you, not judge you. A friend recently said to me, "If you really knew me, you wouldn't like me." That's a fear that she shares with a lot of people. And it just says that you're judging yourself harshly. If you stop to think about it, don't you love your friends and loved ones even more when they open up to you?

5.    The counselor will tell me what to do.

I heard it again just the other day. "Are you going to tell us to get a divorce?" We can't do that. You are the one who must make your important life decisions. If you're severely depressed, we may highly recommend that you see your doctor for antidepressants. But we're not going to tell you what you have to do. It's still your life, your path. And you must make your own decisions.

6.    Therapy takes forever.

That used to be the case many years ago. It's no longer the case today. Most therapists are trained in brief, solution-focused therapy. The average person comes six times. Some people only need one or two visits. Once they have a few suggestions and resources, they can handle things on their own.

7.    Therapy is too expensive.

Although it can be expensive, it doesn't have to be.  I regularly see clients whose insurance pays everything except a $10 - $20 copay. There are community resources that can help you if you need free or low-cost therapy.

8.    Therapy doesn’t work.

There's a lot of research that says therapy is a highly effective tool to guide you toward the physical, emotional, and spiritual place you’re missing. It is important to understand what therapy can and cannot accomplish. It’s also important to recognize your goals for therapy.

9.    Therapy is about being analyzed.

Most of today’s therapy is about working toward goals, not being psychologically dissected. It's very here-and-now. And, no, I don't sit and analyze people when I'm at a dinner party. I enjoy their company. I have the privilege of helping people to focus on their strengths, identify their problem areas, and help them to find solutions to problems.

10.    Going to therapy means that I am not strong enough.

We all need help now and then. And none of us can see ourselves in the way that an outsider can see us. And the problem with just talking to a friend is that your friend may not have the skills, training, patience, or courage to tell you what you really need to hear. Sometimes an impartial third party can give you feedback that your closest friends wouldn't dare say.

Now that you know the common myths about therapy, won't you give it a try? Your life will improve in so many ways.