Anxiety gets a bad rap. We avoid it, retreat from it, or even deny it. To reduce it we merge and fuse with a variety of persons, places, behaviors, or things such as partners, the couch, acting out, or chemical substances. Despite the negative implications surrounding anxiety, it is a beneficial experience for us. In fact, we need it to stay alive, just not in excess amounts.
Before we can apply helpful strategies that will help us manage unneeded and unwelcome anxiety we need a basic understanding of what’s going on under the scenes. Anxiety is a normal and basic human emotion built into us for protection to keep us safe. Our subcortical limbic brain is like our very own threat detection system, akin to a 911 dispatch center. To help keep us alive, our brain vigilantly scans the environment for potential threats as we go about our day. As we experience life, the limbic threat detector quickly and crudely interprets information in a very black and white manner based on our varied personal history (more about history later) to determine if we are either safe or not safe. If a threat is detected, the limbic system triggers a release of adrenaline into our system that produces a state of hyperarousal. Simultaneously, our higher-level cortical brain, the one which helps us organize our monthly bills, plan a trip to Schlitterbahn, or make predictions on who will win the NBA finals; is also consciously processing this data. If our cortex sends back a confirmation of danger to the already alerted limbic brain, then the fight-or-flight response, essentially our brain’s swat team, is dispatched by the 911 limbic brain call center. This swat team includes “multilevel neurochemical and hormonal reactions designed to mobilize the body and mind during times of potential danger” effectively keeping us alive by creating a state of hypervigilance and excitation in the brain and body. Under normal circumstances, this threat detection system works quite well. The brain detects a threat and prepares our bodies to get to safety by either fighting or fleeing. This tool is exceptional for threats that pose an immediate danger such as being attacked by someone or something. However, it doesn’t function as efficiently in strained social or intimate relationships, traffic jams, or crowded gatherings.
Consciously, we define this experience as “anxiety” and we feel it as trembling, muscle tension, restlessness, rapid heartbeat, light-headedness, nervousness, nausea, and feelings of de-realization amongst many others. Anxiety can be generalized or specific, include panic attacks, concern questions of who we are and what is our place in the world, or manifest as a potent mix of all of the above. For trauma victims, the terror of the past intrudes upon the present creating a chronic state of hyperarousal and hypervigilance. Our threat detection system has been a key survival adaptation that has helped in keeping humans alive throughout our history on earth. However, there are some hang-ups and some challenges that can make this system malfunction. As previously mentioned, the limbic brain can get initially activated in by quickly determining “not safe” based on our personal history. The limbic brain, specifically, the amygdala is a warehouse of emotionally laden memories from our lives, including ones in which we were terrified, and similar stimuli in the present can trigger intense reactions1. The key word is similar, not exact. Remember, the limbic brain is not polished or precise. A stick on the ground can trigger a panic attack if you were once frightened by a snake. Think about it, your distinctive fear and anxiety history includes your entire lifetime of knowledge and events that are idiosyncratically perceived and stored. These memories are just waiting on high alert to be triggered to send you into a storm of intense anxiety in an effort to keep you alive. Not only can the limbic brain malfunction on its own, but its conscious friend, the cortex can tell it all kinds of campfire lies to get it stirred up. Like a baseball hitter unable to pick up on the difference between a pitcher’s fastball and hard slider, the limbic brain can’t distinguish between real or imagined threats. That’s right, just as we can help ourselves by imagining success when we plan on asking the boss for a raise we can also trigger an anxiety laden stress response by imagining tanking it and getting fired in the process. We attempt to survive in the best way we know how at the given time; it just so happens that “the best way” is not always the most helpful or productive. For this reason, people will unite forces with a vast array of unhealthy and neurotic strategies in an effort to soothe their anxiety such as retreating to their bedroom, hiding in the arms of an unhealthy lover, or lashing out at a friend or family member. It is hard to see but people are often less evil or messed up than we assume. Instead, realize that they are most likely anxious.
What we can do about this tricky system designed to keep us alive that can also can make us miserable? Well that is where a personalized combination of skills training via case-management, psychotherapy, and possibly psychotropic medication management comes in. Skills training is a strengths-based intervention designed to help build resilience and develop strategies for life. Psychotherapy helps by processing difficult emotions, exploring new perspectives, and navigating the challenging conditions of existence. Finally, medication management can help stabilize individuals, so they can do the work needed for positive life change.
As a psychotherapist, many of my clients struggle with a debilitating amount of anxiety. I use a variety of methods and strategies to enhance their capacity to manage it based upon a foundation of a close therapeutic relationship. A few of these strategies include:
– Acceptance of self, others, and life as is, in the present moment
– Challenging and changing unhelpful and unproductive rules, expectations, and irrational thinking
– Creating healthy mental space between self and thoughts & emotions to respond rather than react
– Increasing one’s comfort with uncertainty while letting go of fear, attachment, and the perceived need to control
– Calming the nervous system to induce the relaxation response
If you would like additional resources or want to talk to someone about case-management, psychotherapy/counseling, or psychiatric services please contact us and one of our specialists will reach out to you. We look forward to working together!