David Lechnyr, LCSW
Anxiety controls and dominates us. Most anxious person are aware that their thoughts are irrational but feel unable to stop themselves. Even the most rational person can become its victim. It affects our quality of life, limits our achievements and complicates our existing relationships. About 3 out of 10 people struggle with significant anxiety at some point in our lives. However, there are some shocking truths regarding how we mistakenly try to deal with our anxiety:
- How being intolerant of uncertainty in your life actually increases your anxiety – rather than reducing it
- The real reason “worrying about worry” feels productive
- Why we create more problems than we solve when looking for “perfect solutions”
- How distracting ourselves from worrying or trying to just “think positively” actually backfires in the long run
If you have ever been tempted to seek anxiety counseling, odds are that you might be struggling with worry. Worry is a pattern of thinking that is persistent, repetitive, and uncontrollable. Worry mostly focuses on the uncertainty of the future. This intolerance for uncertainty is actually one of the defining features of our anxiety!
Worriers tend to predict negative or threatening outcomes. They mentally rehearse various solutions to what they perceive to be a threat. But ironically, rehearsing these solutions doesn’t reduce their sense of uncertainty. In other words, worriers predict that bad things will happen. They have trouble accepting uncertainty, so they try to problem solve in advance. But they still feel uncertain and anxious because they can’t implement the solution immediately.
What Causes Anxiety?
It’s unclear whether the cause is genetic or environmental. Current research suggests that a combination of genetics and environment contribute to the development of anxiety. However, we do understand a little more of the biology behind anxiety than previous. The amygdala plays a significant role in our experience of fear and anxiety, as does the autonomic nervous system.
The neurotransmitters glutamate, gamma aminobutyric acid (GABA), serotonin (SE), adrenalin (epinephrine), norepinephrine (NE), beta-endorphins (BE), and dopamine (DA) seem to facilitate anxiety, although it is suspected that other currently unknown neurotransmitters may also be involved. Anxiety can be caused by other medical conditions. Substance-induced anxiety from drugs (prescription, over-the-counters, herbals, and illegal) is also possible.
What is it like to have Anxiety?
Intolerance of Uncertainty
Being intolerant of uncertainty is believed to predispose individuals to have mental health issues with anxiety, also known as Generalized Anxiety Disorder. Being intolerant of uncertainty also helps to maintain the disorder once it has developed. People without an anxiety disorder may not like uncertainty, but they generally tolerate it. They generally believe that if bad things happen, they’ll be able to cope.
People with Generalized Anxiety Disorder are different. They believe it is unacceptable to be uncertain or to experience ambiguity. They are afraid that uncertainty or ambiguity will lead to negative outcomes or cause problems in general. They may also believe that it is irresponsible if they don’t try to resolve the uncertainty or ambiguity.
When people who struggle with anxiety receive ambiguous or uncertain information, they use maladaptive coping strategies to try to guarantee certainty. Their major strategies are worry and avoidance. Another strategy includes using safety behaviors, where they seek reassurance from others, over-prepare, gather excessive amounts of information, or repeatedly check or verify the safety of the information or situation.
For example, if Susan is going to a social event with some new acquaintances, she might be thinking, “What if everyone finds out I’m shy and stops talking to me?” This thought reflects her uncertainty about what might happen. Her attempt to cope involved the use of worry and avoidance in order to try to gain certainty.
Unhealthy Beliefs About Worry
When we have excessive anxiety and worry, we tend to have several strongly held beliefs about worry itself. Some of these beliefs are positive, and others are negative. For example, “Worrying will help prepare me for danger (positive belief)”, or “Worry is uncontrollable and potentially dangerous (negative belief)”.
Even when we experience worries as uncontrollable, we continue to worry. We continue to believe that worrying is helpful. So it’s important to understand our specific beliefs about the advantages and disadvantages of worry. For example, we might feel that worrying keeps us safe and alert. However, it can lead to more worry, make our mood worse, and get in the way of our relationships.
Solving the Wrong Problem
When we experience constant anxiety, we tend to view problems as threats. We have low confidence in our ability to solve problems, so we expect a negative outcome if we try. As a result, we overcompensate in trying to create the perfect solution to our problems. Suddenly, instead of solving the real problem (our worry), we end up getting stuck and focused on solving what we are worrying about, and end up not solving the real problem.
In part, this happens because we keep trying to come up with a solution that we are certain will work. But if the problem we are concerned about is still in the future, we can’t immediately implement our solution. This means that we can’t be certain that our solution will work, so we continue to worry and come up with additional solutions without actually choosing one.
For example, if we’re not certain how to solve a problem, we might ask a friend what we should do. If we are given more that one solution to the problem, we might end up worrying about which one is the best solution. Even if we end up deciding what to do, we will continually second guess ourselves.
Avoidance of Thoughts & Feelings
Worrying can serve as a way to avoid threatening images, “Worst Case Scenario” thoughts, and distressing emotions. Worry is usually composed of verbal thoughts, such as, “What if my mind goes blank?” Worry tends not to be composed of images or visual pictures in the mind. We may try to think about something positive if we become aware of a negative thought or emotion, or attempt to “push” it away.
We may tell ourselves not to think about certain worries or criticize ourselves for worrying or having anxious thoughts. We may try to distract ourselves from our anxiety or negative emotions. These techniques tend to backfire and actually reinforce our worry and anxiety. We end up becoming addicted to avoiding the unpleasant emotions that stem from our worries at all cost. We fear that if we get too anxious, we’ll fall apart. Or we mentally tell ourselves not to worry over and over, and it’s no surprise that we end up worrying more, because we are still thinking about what we are worried about.
Stress is not Anxiety
Stress is what we experience when we feel pressure from ourselves, other people or an external situation. In reality, stress is any demand made up on the body. Not all stress is bad stress. What we often overlook is that it is the cumulative effect of stress that can transform our coping skills into those that help nurture and maintain anxiety.
One of the common ways a therapist might help you determine how much stress you’ve actually faced is the Holmes-Rahe Life Stress Inventory. The consequences of unanticipated stress can have a tremendous impact on your ability to live a healthy and happier life.
To understand stress, we must remember four important concepts:
- Some stress is important for growth and change.
- The lack of stress, therefore, is stressful!
- Too much stress is also stressful.
- What is required is that we find a middle ground where one learns to manage how they handle and encounter stress.
Pacing and Stress
We live in a fast-paced society where we feel that we have to accomplish things quickly. We also have the feeling that we might as well do it ourselves forcing us to take on more and more tasks all the time. This is accompanied by the feeling that others just will not do it as well as we do so we have no choice but to do it ourselves. Our impatience, desire to have things quickly, and the need to do it all over time becomes both intoxicating and exhausting. Beyond this, we enjoy the high we get from dealing with constant crises and the rush to accomplish everything as quickly. On top of this, we also have the need to experience, to do, and to always be busy and moving. When feeling good, we rush to accomplish as much as possible before we crash again. We work until we feel exhausted and overwhelmed and then wonder why we crash and suffer increased pain, fatigue, and exhaustion.
Stress and our Body
When we ignore how stress is affecting our lives, our body makes a decision that it will shut us down. Because stress goes to the weakest bodily part we will experience stress as an increase in back pains, headaches, stomach pains, allergies, Fibromyalgia, chronic fatigue, allergies, and related problems. Because we all have weak spots the body becomes an equal employment opportunity site for the over-stressed. What this means is that stress body symptoms have a purpose to help stop us–slow us up in our lives.
Perfectionism and the Need to Control
In our need to control life, we become stuck in the need to have everything perfect. This need for perfectionism is related to our mistaken belief that having everything in order will bring us control and comfort in life. Perfectionism comes out also as co-dependency where one tries to control everything, everyone, and every situation in an almost addictive fashion where one is focused on too much caring and too much helping. Out of perfectionism also comes a sense of guilt because one is never able to do enough or to accomplish it good enough. This leads to continuing frustration, the inability to sit still, and the need to be always on the go doing and accomplishing things.
The Unexpected Impact of Stress
Research has shown that stress is the single most important factor that can shorten one’s life and keep your mind confused and disorganized. Most of us know that we can look at others and tell that they have aged beyond their years because of the continuing pressures and stress that they have been under. However, what really matters is not how someone looks, but what is happening inside of a person’s body. The stress hormones that are released when one is under stress, or in a continual state of stress, impacts the body in adverse ways. When under stress chemicals are released into the body. These chemicals are released by the adrenal cortex, a pair of small glands perched on top of the kidneys, in response to stress. The released of these chemicals increase the physical and metabolic processes as part of the fight or flight survival response. Blood pressure goes up, sugar floods the circulatory system and the one’s heart rate increases. All of this causes a great deal of wear and tear on the body and our mind which over time starts to take it’s toll on functions such as memory, the immune response, the ability to deal with damaging free radical chemicals in the body necessary to fight off heart and cancer disease.
The Mind-Body Connection to Stress
Physical symptoms, stress, anxiety, and chronic health care problems are many times overwhelming and difficult to deal with. Such physical problems are exhausting and solutions many times are hard to find. Because we believe that doctors and other professionals should have the answers to all of our physical health concerns, we are many times discouraged and upset when such solutions are not found. It may be that we are looking in the wrong place for understanding what is wrong with us. Here are a few thoughts that are critical to understand. Though we many times do not want to admit it, there is a clear connection between our mind, emotions and our physical bodies. Our American culture has tried to make us believe that our bodies, and our psychological selves, are separate entities. Modern science has known for quite some time that there is a clear mind-body connection. However, we humans would like to deny such a connection because we think it makes things simple and allows us to avoid dealing with some of the more painful issues of our lives. None of this denies the reality of the physical problems that you may be experiencing. However, these problems are many times aggravated by the emotional issues that we try so hard to push away from our conscious awareness.
The Body Never Forgets
It is critical to understand that we all have a “body memory” that “contains” everything that we experience in life. If our early life was comfortable, safe, and predictable, we many times find ourselves feeling comfortable and relaxed in the world. In contrast, if our early life were full of pain, suffering, conflicts, etc., then we find ourselves “harboring” inner tensions and anxieties that seem to “rumble under the surface” of our lives. The body remembers everything that we have experienced in life–fears, anger, upsets, disappointments, hurts, abuse, loss, tensions, and issues of growing up in dysfunctional situations.
The Body Feels Our Daily Stress
Not only does our body remember stress from the past, it also reacts to daily hassles, upsets, conflicts, and problems that we deal with on a daily basis. It helps when we pay attention to our “physical-stress symptoms” because they are “messages” telling us something about our lives in the present. Many times, our body is telling us that we need to “slow down and pace ourselves better.” When we are stressed, in a panic, feeling anxious, our immune system responses are compromised and we are more open to illness and infections, physical problems, etc. Further, any physical problems are made worse when we are under stress, anxiety, panic, etc.
The Body Reminds Us Of Denied Issues
When we continue to deny problems, issues, and our need to “slow down” and respond differently in life, our body becomes “a friend that reminds us” of what we need to do in life. The more we continue to deny personal issues in our lives, the more our body will “stop us” until we “slow down enough to pay attention to what we have to do.” If we continue to deny problems, and avoid taking appropriate action, our bodily symptoms will increase, amplify, become much worse, and become more central in our lives. Many times physical problems are metaphors (or indirect ways of telling a story) for our inner rage and anger about the conditions of our lives.
The Body Reacts To Family/Relationship Stress
Family and relationship issues are critical to our emotional and physical health. When we experience problems in the family, our body reacts no matter what we do. If we deny problems and try to push them away we will find ourselves experiencing an increase in physical problems, sensations, pains, stress and suffering.
The Body & The Dysfunctional Rules Of Stress
The dysfunctional rules of the family, and life, are responsible for most of our human suffering. We as a society think that “the less said about problems and issues the better it will be.” We know that “talking about things will only make them worse.” The dysfunctional rules are (1) Don’t Talk About It; (2) Don’t Think About It ; (3) Don’t Even Feel Any Emotions About it; and, (4) Avoid Doing Anything About It At All Possible Costs! These rules only create more misery for us in life.
Learning from Stress
Sometimes, people do not overcome pain and other stress-related body symptoms, because one’s body needs to keep them down. There is a lack of trust that the person themselves will stop and pace themselves. As a result, the body becomes a friend that stops one permanently until one becomes mentally healthy enough to learn to be more self-regulating.
- We have to learn how to stop doing several things at once.
- We have to learn to slow down and take life less seriously.
- We have to stop looking for the one simple solution that will solve everything.
- We have to know that life is a journey where we are responsible for developing ourselves in new ways rather than just pushing harder.
We need to learn from all of this in order to avoid repeating our own personal history again and again. When stress is useful, we grow, adapt and learn. When we refuse to listen to it in the right way, it binds us, captures us and holds us hostage. Anxiety, tensions, panic anxiety, worrying, obsessive thoughts, all are difficult to control. Many times such feelings tend to overwhelm us and make us feel out of control. We wonder if we are ever going to be able to find a solution to these problems and “live a normal life.” One of the reasons we have so much trouble attaining comfort and happiness is that we don’t even know what it is. We try to annihilate our anxiety and other disturbing thoughts, traumas, sadness, loneliness, and other difficulties hoping that his will help. We confuse being happy with a life that has no feelings of anxiety, rage, doubt, anger, sadness, or problems. We want to numb ourselves from all problems with activity, chemicals, relationships, working hard, etc., so we won’t feel. We hope that if we “don’t talk about it; don’t think about it; don’t feel anything about it; and avoid doing anything at all possible costs,” then all the problem will go away. Research shows that diverting your attention away from the problem will only help for a while but it does not help in the long term. Happiness is the ability to receive the pleasant without dependent, desperate, grasping, along with receiving the unpleasant without condemning. Anxiety and problems signal a time that something is changing. We need to look inside to ask what are we not facing, looking at, or avoiding. What are my symptoms trying to signal to me? Is an opportunity to change coming up that I must pay attention to?
Learned helplessness is the basis for understanding the root causes of depression and panic anxiety. Early researchers discovered that when dogs were given electrical shocks that they could not control, they later showed signs of anxiety and depression. If the experiment went on for too long, the dogs didn’t even try to escape the shocks and instead just collapsed in a corner of their cage. If a “safe area” was made in the cage where the dogs could go to in order to not receive any shocks, they would act helpless and not move. If they were picked up and forcibly placed in the “safe” corner, they would voluntarily return to the side where they were continually exposed to electrical shocks, sitting and shaking in a helpless and anxious state. It was as if the dogs were saying that they were helpless and deserved the pain and suffering. Therapists refer to this anxious, suffering, response as one of having developed “learned helplessness.” When a lever was added so that the dogs could use it to stop the shocks, the dogs didn’t develop any anxiety response. This is an important element known as control. Knowing how to be in control of one’s environment makes for a great deal of difference in what responses we learn and exhibit. Occasionally some dogs didn’t master the ability to use the lever to turn off the shocks. This is not learned helplessness; instead, these dogs were “failing to learn to control.” Back in prehistoric times, our primitive minds didn’t have the necessary tools to deal with each threat. So, our brains treated any stressor as a threat. This ensured both protection and survival. As a result, the default (normal) position of the brain is to assume that stress is NOT controllable. Our “ancient” brain stem (located on the top of the spinal cord) is not smart enough to know whether stress is controllable or not; it just responds. In the face of stress, the brain stem just activates the body’s stress responses. In the experiments where the dogs were exposed to uncontrollable shocks, their levels of serotonin in their brains peaked. However, when they learned to control the shocks by pressing the lever, their serotonin levels dramatically dropped and the front parts of their brains were more active. Since the front parts of our brains help us to regulate impulse control, give motivation, and focus, it’s as if our brain is telling our brain stem, “Relax. We’ve got the situation under control”. So it is only with training that we can learn to relax when a situation is under control. We can think our way in, out of, and around a problem. Our minds give us tools that we can use to teach us, with practice, to calm down our gut instinct in the “fight vs. flight” survival response. However, this takes time and practice.
Dealing with Change
Change is something that is always happening around us. We cannot avoid it. Change can be exciting and stimulating. The lack of stress is stressful and boring. Change needs to be planned for, and anticipated, in our life. Planning helps us deal with it better. Change that happens too fast, and too frequently, can be overwhelming and emotionally draining. Change is something humans want to resist in favor of maintaining some type of stability. Change can be difficult. We want to maintain stability, uniformity, familiarity, routines and the comfort of “sameness” in life. Change feels like “Murphy’s Law:” Things seem to happen at the most inconvenient times and we wonder when it, if ever, will all end. Change makes us feel that we are always off balance emotionally. We long for things to just go along in a smooth manner without crises and stress.
Negative Aspects of Change
Change seems to happen more quickly in our present history. Change demands that people continue to learn new skills, techniques, and ways of doing things. Change demands that we have a “set” for new learning — never feeling we have learned it all. Change seems to happen much faster in our jobs, leaving us feeling vulnerable and lacking control. Change may keep us tense, wondering what is going to happen next. We ask if we will have a job, what changes will be required of us in a job, and how we might have to do more in our jobs because of the these “changes.” Change that is frequent, continuous, and unpredictable, can cause both emotional and physical health problems.
Adjusting to Change
Accept the fact that change is happening. In fact it will continue to happen. Stop asking when will it end. It won’t end. Change is going to happen at an ever increasing speed and nature in our world. Welcome change as an opportunity to move in different directions, to try new skills, and to challenge your beliefs. Invest in your support system, knowing that having family, friends, peers, church relationships, etc., all contribute better to our abilities to handle and face stress and change. These “social buffers” are critical to our health and well-being. We live longer if we have a positive support system. Let go of negative self-talk, blaming, “the sky is falling,” dramatic negatives in your life. Focus on Positive-Self-Talk — knowing you will get through it in time — whatever it is! See the positives in it and “go with the flow.” Small Changes, adjusting a little at a time, helps one handle what looks like an overwhelming big change: Focus on the little things you can do now rather than the “whole thing that has to be done.” Know that any change is hard for us to handle. We miss the familiar, the known, the routines, and the habits. When we face loss of old routines we also have a sense of grief. When we face change that we have no control over we feel upset and anger. Change and stress can create a “black cloud of heaviness” over our heads and minds that makes it difficult to think, function, or even know what to do. We feel trapped and helpless.
Surviving Change & Resilience
- Surviving change requires a positive attitude. It is never the suffering that is the gift. It is the changing and healing that is the real gift.
- When faced with change we have to know that our life’s path has been adjusted and we must adapt and function in an entirely new manner. If we are not flexible we will “snap.”
- There is nothing wrong with feeling overwhelmed in the face of rapid change, or any type of loss. Some losses will affect us more than others. However, they all have an impact on us.
- Admitting that is “OK” to feel overwhelmed and fearful is the real mark of a strong person. Those who do not acknowledge problems live a life of denial and dysfunction always wondering why they cannot get on with their lives.
- Know that the world is not fair and you have very little control over it! Logic means nothing when we are encountering change, stress, crises, etc.
- Strong people admit that they have problems, look to do something about it, along with being open to reaching for help if it is needed.
- Strong people know that it resilience in the face of crises mandates that we fall apart for a while. However, resilience also requires that we come to find new solutions and ideas that can carry us on to a new level.
- Strong people know that “difficult times do not last — however, strong people do endure, grow & change.”
- Strong people know that change presents both risks and opportunities. It is time to look for the new possibilities, opportunities, and directions that this change is demanding of us.
- Don’t expect the world to change. We spend too much time trying to control and change things that we have little, or no, control over.
- Lower your expectations: The gap between reality and our personal expectations of ourselves, and others, can create more stress for us.
- Focus on short-term goals: Live in the “precious present moment” not in the future.
- Relax and exercise: Take time to relax, breath, listen to music, stretch, and walk daily.
- Open yourself to others: “No man is an island!” However, we tend to isolate ourselves in order to be “strong” and not show emotions. This only brings us down faster. We need to “reach out and touch someone!” Listening to others reduces our blood pressure. We live longer if we have friends.
- Pace yourself, your activities, and watch what you are doing: Take breaks, rest, and don’t push until you are exhausted. Know your energy levels and reserves. Don’t always be on an “adrenalin rush.”
- Know that the work place is unpredictable: We tend to see the work place as “another family” were we act out our needs, desires, hopes, feelings, looking to supervisors as “new parents.” This creates stress as we try to understand, control and/or change them.
- Develop a personal life: Have a life, family, and social supports separate from work. Focus more of your energies in these areas. They can help when the “going gets rough.”
- Learn to say NO: Don’t accept everything asked of you. Pick and choose wisely. Set limits on what is possible. Trying to do everything will just wear you out and overwhelm you.
- Know the warning signs: When you see change happening, take a personal inventory of what it means to you, your present and future. Don’t use denial and avoidance until it is “too late.”
- Seek out professional help when excess stress & depression are noted: Early intervention and treatment can help one to refocus, restructure, and function better. It takes strength to admit problems and to reach out for help.
- Avoid addictive behaviors and substances: We tend to “self-medicate ourselves” with alcohol and drugs in order to avoid feeling and experiencing.
- We tend to avoid feelings by keeping busy: Rushing around is only another form of addictive behaviors which keeps us out of touch with our feelings and emotions.
- Optimism is the key to health: Looking on the bright side of things, figuring out how to do it better or different, looking for opportunities, all allow us to live better and more healthy.
- See the glass as half-full — not half-empty: When we see the potential in situations, rather than the draw backs, we become creative and move forward with more ease.
- Know that the more we resist change, the deeper we will go into the problems and exhaustion: Change offers us a chance to find new ways, ideas, directions, etc. We may not see them at first, but with time, talking, writing and using our imagination, we can come to see the opportunities that we face.
- Know that hardships may last longer than we want: We always want things to end and “get over with” as soon as possible. However, reality tells us that this does not always happen. Difficulties can take “time” to resolve themselves. “All good things happen to those who wait.”
- Use the time to explore alternatives and new directions: Use your imagination to think of what is possible for you. Think of new ideas, talk to others, and investigate everything.
- Analyze your strengths, secret hobbies, interests, etc: Take stock of your strengths, interests, talents, and issues of what you have always wanted to do.
Change can be difficult for all of us. Our world has been changing at a dramatic, fast, pace that is at times overwhelming, confusing, and exhausting. Learning how to handle change is critical for our long-term psychological health. Life does not always turn out the way we had planned. It is a journey that takes us in new directions and places, opening us up to new opportunities. Yes there is risk and problems along the way that we have to overcome. These are tests that “strengthen and toughen us” while preparing us for the new in life. This can be exciting.
Worrying As An Inherited Habit
Worrying robs us of being able to live in the present moment of life. Life gets focused on trying to control the future in some way while worrying that the worse things will happen. Many worriers say that they come from a family of worriers who have been like this for generations. Many people feel that worrying is productive and helps to find solutions to problems. The reality is that it only delays the solutions while causing the person much upset, energy and exhaustion. Many people are so use to worrying that they don’t even realize that they aren’t enjoying their lives until it is pointed out to them. Worrying is a habit pattern that reinforces itself by it happening over and over again making it a major part of one’s life and functioning. It increases one’s heart rate, increasing adrenaline rushes. After a while though it feels normal and the person feels abnormal only when they are not worrying. This all creates a habit of low grade stress in life.