Margalit Eren-Rabinovich, LICSW
Psychotherapy & Consultation
The world is a dangerous place, but we can’t spend our whole lives thinking about it. When there is just a possibility of danger, and you can’t be sure if it’s real, the emotion you feel about it is called anxiety. My goal in writing this article is to empower you to take charge of your anxiety so it serves you rather than impairs you. I will help you recognize it, understand it, accept it and learn how to manage it.
Anxiety is one of many emotions we all have. Emotions are our tools for survival in life. When we are young and helpless, they help us communicate with other people to ensure we will be taken care of. Later, they help us marry, have children, work and collaborate creatively. They also help protect us from danger and make sure we achieve our biological goals.
When our emotions are adequate for the situation, they do their job. But when they are too strong or too weak, they stop helping us and may interfere with our ability to function. In these situations, our emotions become a problem.
“Anxiety” is a word for an emotion, but it is also a clinical term. When it is used clinically, it describes a situation where the emotion of anxiety becomes a problem because it is too strong. Clinical anxiety can cause other conditions, such as panic attacks, phobias and stage fright.
Most of us experience too much anxiety at some point in our lives. We live in an era of anxiety fostered by the flood of information and increased competition resulting from explosive growth of the population. As a result, it feels much harder to achieve our biological goals, and therefore it is much harder to manage our brains and regulate our sense of self.
All feelings are events that happen to us involving our body and our brain. This means that they involve both sensations in our body, caused by the release of hormones, and words or thoughts we use to describe these feelings. When we are anxious, we become more alert, energetic and tense. Depending on the situation, we also have certain thoughts about the anxiety. For example, if there is an important meeting, we might have thoughts of fear of failure, or rejection, or wanting not to go. We also have thoughts about instructions on how to deal with these feelings: don’t pay attention, you must do it, it will be over soon, and so on. Most of the time the bodily sensations and the thoughts are subconscious; we are not aware of them and act upon them automatically. Developing an awareness of our body’s responses and the thoughts that accompany them at times of stress and anxiety is the first step towards managing the anxiety, as well as other emotions and the automatic responses to them.
Anxiety is an important and powerful feeling. It is an alert system. Its job is to protect us from danger in our surroundings, like pain is the alert system that protects us from danger within our body when we are sick or physically injured. Although anxiety is often a pain in the neck, we need it. Therefore, being knowledgeable about it, aware of it and able to manage it is an important tool in life.
Recognizing the signs of anxiety
There is probably some tension in your body right now. If you can locate it, that is a good start. But if you can’t, let’s try a small exercise: close your eyes and give yourself a moment to turn your attention to your body and your breathing. Try to deepen your breaths for a moment or two. Now, try to remember a time when you were anxious. When the memory emerges, stay with it and try to remember it as best you can: where you were, who you were with, what was happening, and so on. Now try to remember what was happening in your body at the time; or, do you feel changes in your body right now as the result of the memory? Focus on these sensations in your body and describe them with as many words as you can. Now turn your attention to your thoughts at the time: what were you saying to yourself about the situation, and about your ability to handle it? It might be helpful to write these down (both the sensations and the thoughts). The area in your body where you felt the anxiety right now is probably the area where you usually feel tension when you are anxious. In the future, try to pay attention to these signals you just identified. The body usually responds faster than our thoughts. Therefore, paying attention to your body can enhance your ability to detect anxiety or tension and to manage them before they make you react with unhealthy patterns of behavior.
So how does it work?
There are two mechanisms involved in the formation of anxiety: the limbic system in our brain, and the autonomic nervous system in our body.
Our brain contains three main parts: The stem brain, which is the most primitive structure of the brain and is responsible for the basic functions that keep our body alive; the limbic system, which is also called the feeling brain, that is responsible for our survival; and the cortex, which is also called the thinking brain, that is responsible for adapting to a changing environment.
From the day we are born, the limbic system stores all the ‘dangerous’ events we experience to prevent us from being hurt again. You have probably noticed that ‘bad’ memories are much more present for you than happy ones.
When we receive information about potentially dangerous situations through our senses, the information goes to a center in our limbic brain that decides whether or not there is danger. If it decides that the situation is not dangerous, it will transfer the information to the cortex to decide what to do about it, while our autonomic nervous system gives the brain an order to release calming hormones. But if the limbic brain decides that the situation is dangerous, it will skip the cortex (no time to think- you act on your instincts and your HABITS) and the autonomic nervous system will release hormones that enable your body to protect itself by FIGHT, FLIGHT or FREEZE. At this point there are physical changes: increased heart rate, quick and shallow breath, sweat, tension in our stomach and limbs and sometimes racing thoughts. Our feelings now might change depending on what response we make: If we are in the Fight reaction, we might feel anger and frustration. If we are in the Flight reaction, we might feel fear, suspicion and defensiveness. If we are in Freeze, we feel paralyzed or dissociated.
Although there is much in common to how we all react in these situations, we each have our unique way of reacting to anxiety. How do we form these unique reactions?
Attachment and the formation of emotional and behavioral patterns.
The term attachment refers to the unique interaction each baby forms with her parents. This interaction is a process in which the baby and the parents teach each other how to ensure the baby’s survival; parents feed the baby, see her reaction to the way they do it and adjust it so the baby will be content. At the same time, the baby experiences how her parent holds her and responds to her cry or smile, and adjusts her reactions accordingly. This is one example of how an attachment pattern is formed and how the baby learns how to behave so she is safe. Now, if the parents are calm and the baby is healthy and good tempered, this interaction will go well and both the baby and parents will feel good. But often this is not so smooth; the baby might have stomach aches, the parents might be nervous or have outside stress in their life. Then some issues might emerge as the stress of the parents and the difficulties of the baby interact to create a pattern of attachment involving tension, resistance and stubbornness. As the child grows up, her needs change and so does the interaction with her caretaker; the baby needs to learn to wait for her needs to be satisfied, or sometimes to give them up (toilet training is a good example). Parents need to find a way to help the child increase her ability to sustain frustration and to adjust to her environment: they need to be able to SOOTH her and CALM her while she is learning how to manage these new demands. Of course, if the parent is unable to sooth herself, and she does not have support from a partner or others, she herself will experience stress and will have difficulty soothing her child.
Most of these survival lessons are taught in the first five years of the child’s life, as parents and other caretakers teach the child how to behave in society, shaping her habits and her personality.
As you may have noticed, relationships have a very important role in the formation and management of emotions: our first relationships are the tools that form our brain, and our later relationships help us continue to manage emotion successfully. Whether we are aware of it or not, our interaction with other people is partly about being soothed by others, or soothing them. The better we are at soothing and regulating our self, the better we are at soothing others, and in return are better soothed by them. This is a very important roll we play in both parenting and marital relationships. When we are calm, we can think and react in a measured way that will likely bring about positive results.
Managing your anxiety
The first simple tool to help calm down is to notice when you are stressed or anxious, and then to make a note of it to yourself (like saying, “I am tense right now”). Then take a deep breath and tell yourself to calm down. Usually this will help reduce the stress. If you want to further calm yourself down, change the position you are in. For instance, if you are sitting, get up, take a few steps and go back; or, take a few more deep breaths. You can also take your self to a Time Out area and stay there until you feel less upset. This is also a good idea for anger management.
For this to work best, a regular daily meditation routine is key. It can be any kind of meditation; there are many techniques. They can be learned in classes or in books, or you can develop something on your own that works for you.
I find it is helpful to combine a daily routine of deep breathing with keeping a journal of positive thoughts: what you are grateful for in your life; and goals: the small daily ones, like doing the best that you can today, and the big ones, like overcoming anxiety.
Possible daily breathing routine:
First find a comfortable place to sit or lie down. Make yourself as comfortable as possible. Then inhale as much air as you can, filling up your abdomen, hold your breath for few seconds, and exhale slowly. While breathing, try to focus your attention only on your breath, pushing aside interfering thoughts. Keep breathing as long as you can. Start with 5 minutes a day, and try to increase it up to 20 minutes a day. It will take a while for you to be able to completely focus on your breath, so don’t despair- it will get easier with time. It is also helpful to start and finish the exercise by reciting your goals. For example, “I am taking care of myself so I can be the best that I can be, so that I can enjoy what I have and share it with the people I love.” You can build upon this basic routine and modify it in any way that helps you.
Physical exercise is another very good way of reducing stress and anxiety. You can enhance the benefits of exercise by reminding yourself of your goals. Maintain awareness of your thoughts with your actions.
If self-help is not enough, seeking professional help is recommended.
A few thoughts about therapy and medication.
When I discussed attachment, I explained that the main vehicle that forms our habits is a relationship with our parents or caretakers. As we go through life, relationships continue to be important to our well-being and they can also be a toll for our healing. This fact explains the power of good therapy. Of course, a good relationship with the therapist on its own is not enough for therapy to be helpful. The therapist’s solid knowledge and experience, and sometimes the use of psychotropic medications, are also important. Research confirms that medication works best when combined with psychotherapy. When you choose your therapist, make sure you feel comfortable with him/her: that you can trust him/her, that you feel respected and understood, and that you will be able to take risks with his/her help.
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