5 things I’ve learned about anxiety from a bunch of anxious peeps

I’ve recently finished co-facilitating two rounds of a 12 week therapy group aimed at helping anxiety sufferers conquer their fears. The ‘self help’ group, as it is called, is basically an exposure based 12 week program which encourages members to face their fears by gradually ‘exposing’ themselves to the source of their anxiety bit by bit. It’s called the stepladder approach and is based on basic behaviour therapy.

The aim of the group is to guide members, after explaining what exposure is and how to construct a stepladder, towards conquering specific fears or phobias. It’s not really structured for those who are diagnosed with GAD (generalized anxiety disorder), PSTD or depression for example. There is only so much you can do in a group context. That was the theory behind the group, however, the reality proved quite different. We had a few members that had a specific phobia or fear such as public speaking, or a specific social phobia such as fear of eating in public, but most of the members’ anxiety was not that specific. Most seemed to be suffering from a general malaise and in some cases extreme uneasiness in public, social phobia in general or just a case of debilitating shyness. Some had depression as well.

It soon became clear that the prescribed ‘stepladder’ technique was not going to work with these people. One could still go over the basic idea of the stepladder, that is, expose yourself to your fears, little by little. Take baby steps. But a definitely rigid approach was not going to do. So, I did some research and also, concurrently, I started an online course on ACT (Acceptance and Commitment Therapy) but mostly, I learned from the group members themselves. Hearing their stories week by week, their awkward to embarrassing moments, their small and seemingly tiny triumphs and major breakthroughs…they taught me more about how to manage this thing called anxiety, which we are all faced with to some degree, than any text book or peer reviewed article I have read.

So here’s what I learned about how best to deal with anxiety from my research and from those that know best:

1. Accept anxiety as part of life.

Most people who come to a group such as the one I have just described have been struggling with anxiety for a long time before seeking help. Some for years. What they want most when they first come to the group or seek help is for a ‘cure’ that will somehow make their anxiety ‘go away’. But what is most freeing or a revelation for some is when we explain that anxiety is a normal part of being human, and that it will always be present to some degree. Struggling with it only makes it seem stronger and bigger than it really is, ignoring it doesn’t make it go away either… However, acceptance of anxiety is something altogether different. Acceptance allows for dialogue, it allows for a two-way exchange between the person suffering from anxiety and the message that anxiety is trying to convey. It is the first step towards healing, it signifies a willing to listen, to engage.

2. Face and then embrace your fears.

Whatever it is that makes you most anxious, that is where you need to start.  Jumping in head first is not a good idea, however a measured, stepladder if you will, approach really does work if done consciously, with self-awareness and with self-compassion. A step is still a step, no matter how small….however, there is a qualifier and the qualifier is as follows:

2a. Face your fears, only if they serve your greater good. That is, face and accept anxiety only if it serves your values. There is no point putting yourself through all that pain and anxiety for no good reason, if it serves you however, and helps you to achieve your goals or be the person you really want to be, then there is a very good reason.

3. Know your values.

One session, after learning about the importance of values in ACT I asked the group members to share with me their reasons for coming to group in the first place. They looked at me blankly at first, as if it was a silly question but then I explained… Yes, I know it’s because you wanted to get help with managing your anxiety but WHY? Why does that matter to you? Wouldn’t it be easier to just stay home, live with your anxiety to a degree and not push yourself to come here, or go on working through your stepladders each week? There is a reason why you do that, come to group each week, something you want to achieve or a way you’d like to live, and that reason should give you a big hint as to what your values are. Values guided action makes anxiety meaningful. It adds another, very powerful dimension to the how of exposure based therapy. The why.

4. Listen to what your anxiety is trying to tell you.

Anxiety is not always blind fear and anxiety is not a one size fits all broadcast. There are different types of anxiety. There is helpful anxiety and not so helpful anxiety. Sometimes, it is steering you towards something, sometimes it is telling you your off track. There is the anxiety that comes with moving forward, and the anxiety that comes with staying stuck. Only the individual can know what their anxiety means to them, or what it is trying to say. Mindfulness is one way of getting tuned in to what your anxiety is trying to tell you by displacing some of the static that most of us walk around with every day, without realizing it most of the time.

5. You are what you do most.

All the skills and techniques broached in the 12 week course (and in most CBT based therapies including ACT) are all pretty sound, yet none of them will work if we only pay lip-service to them. There is no magic pill or cure for anxiety or any other mental illness. Medication helps to a degree but it really only treats the symptoms, or helps with balancing out chemicals that have become imbalanced in the first place because of what the individual has experienced, reacted to and consequently how they have been behaving for many years. It takes dedication, practice and conscious choice to over-ride what have become automatic behaviours or ways of responding for many anxiety sufferers. The more you practice these new behaviours, thoughts, techniques and ways of being, the more they will seem natural.

 

So that’s pretty much it. (Well not really it, but a sizeable chunk, and besides, I’m getting sleepy!)

All good things take a little time, but like all good things, they are truly worth it in the end. As has been my journey towards becoming a qualified counsellor…it’s been a long 3 and a half years and in a few weeks I will be done with this first long stretch of road. Yes, in just a few weeks I will be qualified! However, while I feel I have learned so much, it gives me a certain amount of anxiety to realize that I have still sooo much more to learn. But, I’m pretty sure it’s the good sort of anxiety…

I forgive you.

We are not our mistakes

 

I recently posted a rant of Facebook, something I very rarely do which I now regret in a way but in another way it has actually brought up some issues which I think are worthy of further investigation. Forgiveness is something that is often overlooked as a form of therapy these days. The power of simply being able to say, with sincerity, “I forgive you” is perhaps the most powerful form of healing there is.

Being able to acknowledge and say sorry for past transgressions is one thing, but being able to forgive someone who has done you wrong is an entirely other proposition. Sometimes, it’s not possible to say sorry to someone, for various reasons, but if you do and they are gracious about it then that is when true healing starts.

But if it is possible, if the person is still alive or contactable should you? Well, that’s up to you. But if you do, should you expect their forgiveness? Well, no, of course you shouldn’t. It depends what has transpired and every case is different. However, if someone does apologise to you for something they have done that may have been hurtful to you, if you are able to forgive them then in the end, it is you who will receive the greatest gift. For being able to let go of hurt, suffering, pain, resentment and our attachment to these feelings can be the most liberating experience of a lifetime.

Maybe there is someone out there that really hurt you. Someone you blame, rightly perhaps, who did the wrong thing by you. Maybe they have never apologised. Maybe, and most likely, they never will. Should you still forgive them? Could you? Maybe your parents were jerks or outright abusive. Maybe a past partner has wronged you, hurt you and made you cry. Maybe an ex boss was a complete bitch to you and made you feel 2 feet tall and you have moved on from those times but the hurt is still there. The resentment, the anger is still lurking in the background waiting for a chance to ruin your day yet again.

Or maybe you’re the one who was hurtful to someone else. Maybe you have made mistakes and done things you just aren’t proud of and have never really been able to forgive yourself. Well, chances are that’s a good place to start.

What’s important to remember is that we are not our mistakes, for one thing. So much bad blood gets thrown around because we fail to separate the actions from the person, especially when it comes to ourselves. So, instead of saying, I did a bad thing, we say… I am a bad person because I did a bad thing. And over time we reduce that even further to, I am a bad person, or just “I am bad”.

Narrative therapy calls this a “meta-narrative” – stories we tell ourselves over and over again so that they become our way of thinking about and describing who we are . CBT calls them “core beliefs” – messages that we continuously and subliminally tell ourselves which become part of our definition of who we think we are. Whatever you decide to call them and whatever therapeutic modality or theory you choose the effect is essentially the same. We become what we tell ourselves is true. 

So in essence, perhaps the place to start is awareness. Separation of your self from your past acts and behaviours is the first step, and then just saying to yourself, I forgive you. That could be a pretty good place to start. Why not try it?

 

 

 

 

Anxiety – Facing the enemy within

Recently, I’ve been thinking a lot about anxiety. Part of the reason is because I have just written an essay about it, and part of the reason is because I have been living with anxiety in one form or another for most of my life.

At times, I have been the at the centre of the storm, and at other times, I have watched others wrestle with this demon or demons as is often the case.

I think, I know a lot more about anxiety than I did only a few months before. And, based on my research and observations, the following is a short list (in no particular order, hence the bullet points) of what I know about anxiety, the enemy within.

  • Anxiety disorders affect about 14 per cent of Australian men and women at some point.
  • Anxiety affects the brain and the body. It may start in your head but pretty soon, your whole body is involved. See this infographic:

Affects of anxiety

  • Anxiety isn’t all bad. It’s what makes you get up in the morning, when you’d rather stay in bed, it’s what forces you to go to work so you can pay your bills. A little anxiety is a good thing. It gets things done. (It gets most of my essays done, that’s for sure!)
  • Anxiety gets stronger, the more you avoid it. Like any school yard bully, the more you try to ignore it, the more persistent it gets. But also like any classic bully, it is better at dishing it out than taking it.
  • Anxiety feeds on negativity. It can take a lifetime of therapy to undo the damage of one negative idea. Negative ‘what ifs’, ‘catastrophic thinking‘ and ‘inner critics‘ are anxiety’s friends and partners in crime. If anxiety is the ring leader, than these troublemakers are definitely in its posse.
  • The best way to rob anxiety of its strength is to do the opposite of what you instinctively want to do which is run in the opposite direction . In-fact, ACT (Acceptance and Commitment Therapy) which is one of the so called ‘third wave’ of CBT, actually encourages clients to ‘accept’ their anxiety as a part of the lives, kind of like an annoying yet unavoidable family member or uninvited guest.
  • Fear is a formidable enemy. It’s no wonder it has been used as an effective weapon on the battlefield in days gone past. However, for anxiety sufferers it may be helpful to remember, it’s not your fears which are the problem, it is fear itself.

Johnny Depp

If you or someone you know is suffering from anxiety, the following websites may be of help. The Mental Health Association offers free anxiety support groups and Beyond Blue has a lot of information on anxiety and depression as well as free telephone or internet based counselling.