Anxiety Control by Stamford Psychotherapist

Introduction

Anxiety control is a skill any of us can acquire through counselling and practice. In this article I set out my understanding of the basic root causes and strategies to manage our anxiety. Most importantly I make the point that we can grow through our anxiety response. Control is an anxiety provoking word in my book, so you’ll notice that I prefer the term anxiety management. Another point I want to clarify before we embark on this reading is that I’m not suggesting everyone in crisis experiences uncontrollable anxiety. If we take our current circumstances for example, some studies would suggest that there are people, approximately 7% of people measured in over 40 studies, who are experiencing hardly any stress as a result of the COVID-19 pandemic. 

Context

One of the mental health challenges we face in a complex globalised world, is that some stressors just keep broadcasting with no end date. Take two examples, environmental degradation and pandemics. Both these phenomena are well documented as posing fundamental risks to the very survival of the human species. Our lives and those of our children are literally at risk, and if we do survive, our economies and quality of living will be impacted irrevocably. The problem is that we feel helpless to change anything about this. 

Case study

COVID-19 is a good example and doesn’t require much explanation as all of us have first-hand knowledge of this opportunistic virus. We had to listen to specialised scientists and elected politicians telling us how our most intelligent response was the bluntest of measures: ‘stay at home and wash your hands, we don’t know enough about this virus.’ The uncertainty bewilders us on many levels – finance, mobility, relationships and naturally our very survival. From the outset the news was clear and bad, namely that a new normal will only arrive once we have a vaccine and in the 50 odd years that we have known about Corona viruses, we haven’t come up with one such vaccine…In other words, the only certain expiry date in this picture is my death, not the extermination of this virus. Furthermore, if we do find a vaccine there will be more novel Corona viruses coming. Humanity’s expansionism has now started ‘Shaking the Viral Tree.’ Anxiety runs unbounded on an open timeline. 

Processes

At best it’s like sailing in unchartered waters with a foggy mind. It’s futile waiting for an unknown future event to dissolve our anxiety as it may never arrive. We need to take control by managing our anxiety.

Anxious response

The first step is to understand the processes involved in an anxious response. Simply put, our more advanced brain functions give way to our predominantly primitive brain when we receive the message that a stressor is approaching. We briskly move into survival mode, shutting down all processes that don’t seem to contribute directly to our survival, such as reflection and abstract thinking. Now our thinking becomes foggy. This means that the limbic brain is alerted and the pre-frontal cortex goes offline. The limbic brain is those regions of our brains that control our basic emotional responses and memory. The Amygdala, one of the pivotal areas of the limbic brain, plays a big role in engaging our fight or flight mode. It’s our smoke alarm. 

Traffic control

The pre-frontal cortex which is as the name suggests the foremost region of the brain situated behind our brows. It regulates our most advanced functions such as emotional intelligence and other advanced executions. It’s a bit like a flight deck tower at an airport from where incoming and outgoing aircraft are directed to ensure safe landings and departures. This is where we hold the bigger picture, process layered information and make complex decisions in line with our priorities, ethics and values. Now imagine the smoke alarm alerts us to a fire downstairs. Situations of high stress require quick decision making and our evolutionary biology has learnt that the pre-frontal cortex basically asks too many questions and offer conditional observations in return. The limbic brain has ensured our survival over the ages by moving us into quick action without much deliberation. A brief comparison between the vital statistics of the approaching ‘predator’ and one’s own chances in the situation makes the decision simple: will it be fight or flight? We also have freeze and fawn as options if those first two strategies fail. 

Controlling anxiety

Why do we want to control anxiety and how will we go about doing this?

Why do we want to control anxiety?

Bad for us

My first response is that it simply is an unpleasant and limiting state of mind. It impacts our mood negatively and very soon leads to bad decisions. In the complex 21^st century, we know there is a difference between a rude text and a car approaching on the wrong side of the road; the limbic brain makes no distinction, it reads everything as sabre tooth tiger. It is a feeling of unease, sometimes mild and often severe. Anxious feelings consist of inner turmoil, fear, worry and/or ruminations, irritability, restlessness and feeling on the edge. These feelings drain our energy and distracts our attention. Often anxiety robs us of the joys of life. It is also associated with headaches, stomach aches, shortness of breath, excessive sweatiness and insomnia. Anxiety is closely related to depression and the main symptom of Post-traumatic stress disorder and panic disorders.

But we can grow through play

Secondly, neuroscience is showing that there is an interplay between the primitive and advanced regions of the brain; they learn from each other. In other words it is not as simple as we thought at first with one region switching off and the other coming online. The interplay is a learning process with the brain as a whole creating new neural pathways, ever changing to new environments. This growth is slowed down drastically, even inhibited completely, if we drown in anxiety. Yet, if we manage anxiety, our brains learn which impulses to respond to and how best to do it. Bottom line is that managing my anxiety this time leads to less anxiety in future.

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How to control anxiety

As I mentioned at the outset, I am weary of thinking one can control anxiety. I have encountered anxiety in my own life and observed it in the lives of my clients and I know that ‘controlling’ anxiety is a draining pursuit. Once it has entered your system, it is easier and more productive to manage it, than to try and put a lid on it. 

In order to manage it, we need to firstly understand its underlying energy. This entails understanding the effects of stress on our brains that I have mentioned above.  The second thing we need to do is to delay our response to that stressor.  So even though environmental, emotional and /or physical stressors trigger our limbic systems we still have the ability to slow down the chain of responses. If we manage to create this delay, our pre-frontal cortexes receive just enough time to re-activate and grasp the situation at hand. Managing our stressors to activate considered responses, rather than trigger instinctive episodes of anxiety, enhances our mental health. We grow.

Ways of managing anxiety

Work with a psychotherapist. You could do a lot of independent reading, employ apps and other self-help options with good results. Nothing beats the ear, skill and experience of a psychotherapist when it comes to understanding your own, often submerged causes of behaviour though. I engage with a few therapeutic schools of thought. Our therapeutic relationship and your needs will determine which approach suits you best. Acceptance and Commitment Therapy is one such a therapeutic approach. Here founder Steven Hayes speaks about ‘Mental Brakes to avoid Mental Breaks.’ 

I have had good results with externalisation exercises

I will mention just three here:

• Name your mind: Give your mind a name. Whenever it prods you to anger or panic, address it by name in order to build a relationship. An example could be: Thanks for looking out for my safety George. So you’re saying this rude comment I have just received on my post has the potential to kill me off if I don’t eliminate the troll? In what way does this threaten us George? How would it be for you if I rather just post a little smiley face as response?
• Street noise: If George does not feel like playing by the rules of relationship, imagine his voice (if your inner voice is male like mine) is in the background like street noises. We can’t bring the entire street to a standstill before we start our day, can we? The noise becomes arbitrary when we choose not to respond thereto. It moves into the background as we focus on that which matters.
• Keys on a ring. Look at the keys in your pocket. You can carry them around all day and use only one or maybe two. Identify each of your anxieties with a key on that keyring. If you want to think that anxious thought, you have to physically walk to the lock that fits that key. Think that thought, entertain it as much as you can for that period of walking to the lock. Once you have opened the lock, in other words used the key, you stop thinking the thought.

More ways of working with anxiety

• Exercise.
• Limit your use of stimulants such as coffee, alcohol, smoking, online games, news channels and social media.
• Learn to relax. Yoga or tai-chi.
• My preferred method of insight and integrative relaxation is meditation. My all-time favourite on the subject is still Full Catastrophe Living. Ask me about meditation and mindfulness, if I don’t suggest it first.
• Medication prescribed by your GP.

Conclusion

In this article I suggested that we slow our stress reflex down in order to learn, adapt and respond more meaningfully. I hope it will assist you in understanding and managing your anxiety better. Please see this as an invitation to contact me if you would like to discuss ways of managing your anxiety in therapy.