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Anxiety is not necessarily bad. It can motivate us to prepare
for a speech, or study for a test. It can make us cautious in dangerous
situations. Some anxiety is normal, though often unpleasant. But
anxiety can become a problem if it becomes so intense or pervasive
that it affects your health or your behavior; if it causes you
to avoid certain situations or limit what you do.
You may notice that situations that cause you
anxiety are those that raise “what ifs”, (“what if I can’t
perform well.” “What if there is a problem with the
plane?”) Anxiety is brought on when we become apprehensive
about some undefined future threat. It is the undefined nature
of the threat that causes us to become anxious rather than fearful.
We can’t define exactly what it is that we fear, so we feel
helpless. Threats that cause us to become anxious may be:
• Threats to our well being and safety (anxiety about flying, vague
fears of being attacked, concerns about being safe in our homes,
concerns about illness, accidents, etc.)
• Threats to our sense of self and fears of failure (concerns brought
on by job or family stress, public performances, or other performance
related events).
Our reaction to anxiety is often accompanied by physiological
changes such as sweating, heart pounding, or feeling dizzy, (our
fight or flight response) and these changes can exacerbate our
anxiety and discomfort. The discomfort that anxiety creates can
make us want to avoid the situation that we associate with this
uncomfortable anxiety, and this can create problems if we begin
to avoid situations or activities that are important to living
our lives. Some anxiety is normal, but if it begins to impact your
ability to function or your enjoyment of your life, it may be time
to seek help to find ways to better manage it.
Dealing with anxiety requires getting to the
root cause of our anxiety, finding ways to keep our anxiety from
limiting our activities
and dealing with the physiological reactions as well. The following
are some of the things I will work with my clients to do:
• Creating safety and trust—We will work
together to define the problem as clearly as possible, set goals
for our
work together, and decide together whether medications may be
a useful tool for them to use in addition to therapy. We may
decide
to use a number of different techniques to help with symptoms,
including EMDR, developing relaxation skills, doing desensitization
or cognitive work, improving self care including increasing exercise,
working on self esteem issues, and others. Therapy for each person
is different.
• Understand the client’s anxiety—We
will work to define the fear and other feelings that lie behind
the
anxiety.
Where do these feelings come from? Often we find that just developing
a better understanding of what lies behind the anxiety, begins
to provide some relief. Then we can work on the issues. When
there are identifiable fears I can help my client find ways to
respond
to or prepare for what they fear so that their feelings become
manageable. I also help the client to understand and resolve
any irrational fears that may be involved.
• Look at self esteem issues—Often low self esteem lies
at the root of a client’s anxiety. I will encourage clients
to pay attention to their “self talk”. Do you have
a habit of judging yourself harshly and assuming that others
see you in this same negative light? Do you go into situations
expecting
to fail, or expecting the worst? What would happen if you focused
on your strengths instead of your weaknesses, if you approached
a new situation with optimism, expecting a good outcome? How
do the messages that you give yourself affect the way you perform?
The way you are perceived?
• Work on Stress Management—Stress management
is an integral part of dealing with anxiety because it provides
techniques that
help people develop resistance to the physiological arousal that
can accompany anxiety and stress. This both feels better, helps
people become better able to resist becoming stressed and is
beneficial to their overall health. There are a number of things
you can do
to better manage stress.
1) Exercise! Take care of your body. Find ways to release tension
and stress that build up and may cloud your vision and use up your
energy, thus reducing your energy for coping. Physical exercise
is always helpful, but can be ignored when we are feeling stressed.
People often need encouragement to get the exercise that can help
them physically and emotionally.
2) Meditate and/or develop skills in progressive
relaxation. Finding
relaxation through meditation can be very helpful and healing,
but many people find when they most need the calming effects
of meditation, they are least able to use it, their anxiety
intrudes.
For these people, a relaxation tape that gives guided instruction
in progressive relaxation may be helpful. Often people have been
stressed for so long that they need instruction to relearn how
to release tension and truly relax their muscles. Instruction
tapes help people to stay focused on relaxing so there is less
chance
of their anxiety intruding. My clients have found that when they
listen to a tape and practice relaxation on a regular basis,
at least once a day, this makes a definite difference in their
ability
to deal with stress in their lives. They become better able to “roll
with the punches,” react less strongly to annoying situations,
not take things so seriously.
3) Practice serenity. The Serenity Prayer
taken from a prayer by Reinhold Niebuhr: “God, give us grace to
accept with serenity the things that cannot be changed, courage
to change the things
which should be changed, and the wisdom to distinguish the one
from the other” is excellent advice for managing anxiety.
Finding a philosophical or a spiritual stance that helps you
to face and come to some acceptance of the things you cannot
control
and that seem unfair or unjust, finding a spiritual center
or a way to feel connected to something larger than ourselves
is
very
helpful, as is finding a supportive community.
My goal in working with anxious clients is to help them to understand
and learn to manage their anxiety successfully so that they can
live more freely and comfortably.
www.nimh.nih.gov/anxiety/anxietymenu.cfm A good website sponsored
by the National Institute of Mental Health.
www.adaa.org Website of the Anxiety Disorders Association of America
www.anxman.org Website of the International Association of Anxiety
Management (IAAM)
Letting Go of Stress By Emmett Miller, MD
Available through his website www.DrMiller.com or it can be purchased
at the East West Bookstore on Roosevelt and 65th. Call 800-528-2737
for Dr. Miller’s catalogue of tapes.
Meditation for Optimum Health by Andrew Weil, MD and Jon Kabat
Zinn, PhD
Available through Amazon or Barnes and Noble
Mindfulness Meditation by Jon Kabat Zinn
Available through Amazon or Barnes and Noble or www.Nightengale.com
The Art of Meditation by Daniel Goleman, PhD
Available through Amazon and Barnes and Noble
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