Anxiety Toolbox: The Complete Fear-Free Plan

Anxiety Toolbox: The Complete Fear-Free Plan Gloria Thomas This edition does not include a CD.Gloria Thomas, whose methods are highly recommended by The Sunday Times, Red and Zest, brings you an extremely practical book to overcome your fears, phobias and anxieties. Using her skills as a master NLP practitioner, hypnotherapist and Reiki master she shows you how to take control of your fears even in the most demanding trigger situations.• 70-80 per cent of the population suffer from an anxiety-related condition in the form of fear, phobia or panic attack. These can have a devastating effect on people’s lives, holding them back and making them feel isolated and depressed.• Using her unique combination of skills as a master NLP practitioner, Thought Field Therapist, Hypnotherapist and Reiki Master, former sufferer Gloria Thomas gives readers the tools they need to take control of their fears in even the most knee-trembling situations and banish them forever.• Covers specific trigger situations, such as crowds, air travel, conference speaking, visiting the dentist, agoraphobia, being on your own, the dark, etc, as well as first aid ‘what to do during an anxiety or panic attack’.• Gloria’s techniques include thought field therapy, cognitive/behavioural techniques, visualization, affirmation, self-hypnosis scripts, breathing, anchoring, Reiki methods, etc.• Morale-boosting real-life storiesPlease note that this edition does not include a CD. Anxiety Toolbox The Complete Fear-Free Plan Gloria Thomas Do you put your life on hold to avoid the situations that scare you? Copyright (#ulink_f4c04cd4-4cb0-5a65-8fad-b12c1cfb1fcb) Thorsons An Imprint of HarperCollinsPublishers 77–85 Fulham Palace Road, Hammersmith, London W6 8JB www.harpercollins.co.uk (http://www.harpercollins.co.uk/) First published by Thorsons 2004 Copyright © Gloria Thomas 2004 Gloria Thomas asserts the moral right to be identified as the author of this work A catalogue record of this book is available from the British Library All rights reserved under International and Pan-American Copyright Conventions. By payment of the required fees, you have been granted the non-exclusive, non-transferable right to access and read the text of this e-book on screen. No part of this text may be reproduced, transmitted, downloaded, decompiled, reverse engineered, or stored in or introduced into any information storage and retrieval system, in any form or by any means, whether electronic or mechanical, now known or hereinafter invented, without the express written permission of HarperCollins e-books. HarperCollinsPublishers has made every reasonable effort to ensure that any picture content and written content in this ebook has been included or removed in accordance with the contractual and technological constraints in operation at the time of publication. Source ISBN: 9780007170227 Ebook Edition © March 2010 ISBN: 9780007372270 Version: 2014-10-20 Contents Cover Page (#u8d6965df-df21-5d28-b00f-a7795534d484) Title Page (#uef2b8fa9-7075-5455-a31e-9a655047e1d1) Copyright (#u74de5778-db8f-56a3-b2a8-85e0921f13dd) Foreword (#u98baded3-159a-5b2a-995f-5d3c7817fd7a) Introduction (#u1625a4f5-c48f-5b1b-92c4-82aa4c3c06d9) How to Use This Book (#uabcd16ec-0b3a-5061-b427-08d8e075d7aa) 1 What is Anxiety? (#ud8ae76d4-3023-5618-8e9c-06b03475dace) 2 Specific Anxieties (#uecb6ed66-4bbb-52c2-af3d-c89ebe018b45) 3 The Anatomy of Anxiety (#ued81c2de-3751-5378-a1b0-024809224984) 4 Your Mental and Emotional Anatomy (#litres_trial_promo) 5 Power Tool 1 – Thought Field Therapy (#litres_trial_promo) 6 Beliefs and Behaviours (#litres_trial_promo) 7 Power Tool 2 – Self–Hypsis (#litres_trial_promo) 8 More Tools for Change (#litres_trial_promo) 9 Putting it all Together – Your Anxiety Toolbox (#litres_trial_promo) 10 A Final Word – Lifestyle, Drugs and a Few of My Favourite Remedies (#litres_trial_promo) Appendix: A Letter from Kosovo (#litres_trial_promo) Bibliography (#litres_trial_promo) Further Reading (#litres_trial_promo) Resources (#litres_trial_promo) Index (#litres_trial_promo) How to Contact the Author (#litres_trial_promo) Acknowledgements (#litres_trial_promo) About the Publisher (#litres_trial_promo) Foreword (#ulink_6cf2172c-0906-5c5e-805c-1cbb7e468d85) Anxiety is a very common problem. Anxiety, fears and worry can severely disrupt your life and cause much needless suffering. Research with Heart Rate Variability (HRV) at Harvard – HRV is a placebo-free, objective measure of your state of health – also shows that phobias, worry and anxiety can shorten life expectancy. Like many people, you may have tried conventional approaches to overcome your fears and phobias and received little or no help. You may feel that you simply do not know what to do to help yourself. This book provides some important answers. The common motivation to get help and overcome anxiety or phobias is that a cure can radically change your life for the better. Freedom from anxiety makes life much easier, as you can devote your energy to enjoying your family and friends and dealing with everyday challenges, instead of being overcome by crippling fear. With her book, Gloria Thomas has provided a concise but meaningful guide to various unconventional approaches. She takes a rare, serious, competent and balanced look at some of the lesser-known options that are available and offers an invaluable introduction to them. Reading Anxiety Toolbox is a powerful and appropriate beginning to a new life free from anxiety and fear. ROGER J. CALLAHAN, PHD FOUNDER, THOUGHT FIELD THERAPY LAQUINTA, CALIFORNIA, USA Introduction (#ulink_926bc52b-356e-55e6-ac41-89b7c458f496) When I was in my twenties and thirties I suffered long periods of anxiety and depression due to a combination of post-natal depression and other life events. Like most people, I sought the advice of my doctor, who prescribed anti-depressants and suggested psychotherapy and counselling. However, much as this was helpful, I wanted to find alternative methods of combating the depressive and anxious states that I was experiencing. My search for those alternatives uncovered some surprisingly simple countermeasures and some truly astonishing ones. I discovered how beneficial physical fitness is for fighting depression and anxiety, and the surprising extent to which food can affect your mood. I also discovered the benefits of healing and acupuncture, as well as forward-thinking psychologies such as Neuro-Linguistic Programming and hypnotherapy. More recently, I have discovered Thought Field Therapy, an amazingly effective therapy for anxiety. All of these strategies or complementary therapies – call them what you will – have become part of my life and, as a result, I find myself at 40 feeling youthful, much stronger within myself and with a much more balanced view of life – it’s a bit like a giant jigsaw puzzle finally falling into place. Such has been the transformation that I am now incredibly thankful for that period of suffering, for had I not gone through it I would not be equipped to do what I do today. I now have an incredibly strong sense of purpose and, one day, would like to look back on my life knowing that I have contributed to humanity. Given my experience, I feel that the best contribution I can make is by helping people let go of their self-limiting fears so that they can be the best that they can be. That is why I have written this book. It may sound a little cheesy but it’s my way of expressing my love for humanity. There is, I believe, a need for major transformation in this world – a need to get back to more balanced ways of thinking and being. Everybody’s anxiety is, of course, unique to them and there is no magic solution for eliminating it completely. However, I believe that we have the most amazing ability to manage our anxiety levels and achieve more resourceful states of mind. By reading this book, you have hopefully made the decision to begin to let go of fear and anxiety and work towards greater balance in your life. The tools it features are treatments and therapies that are suitable for commonly experienced anxieties, as well as those of a more serious nature. However, I would like to emphasize for those suffering from chronic anxiety or depression that these tools do not take the place of medical advice. They are tools that have worked for me and now I offer them to you. I hope they will help you achieve greater happiness and equilibrium. How to Use This Book (#ulink_efc9ac82-6080-5e55-82b0-1119063ad0ef) Whether you suffer anxiety in a very mild form or you have a specific disorder, this book will be an enormous help to you. The intention is to bring your levels of anxiety back under control. You have the potential to achieve states that are more useful and beneficial to your health and wellbeing, and this book can help you achieve this. I suggest that you begin by reading the book right through to get a feeling of what it is all about and how it can help you. On first reading, do not do any of the assessments or exercises – simply think about what applies to you. Having learned a bit more about anxiety, you can then focus on your own area of anxiety and use the exercises that are appropriate for you. You will need a notebook to do some of the exercises and to record and explore your experiences. There are appropriate exercises and therapies throughout the various chapters of the book, so work through it at your own pace. In chapter 9 you will also find an invaluable summary of exercises and therapies for each anxiety discussed. 1 What is Anxiety? (#ulink_ec9a208e-ba39-5053-8340-fbd65bd22b62) Anxiety is a state of mind that we all experience from time to time. I’m sure every one of you can remember having feelings of nervousness and tension in your body at some point in your life – think back, for instance, to your first day at school, your first date or your last vital job interview. Anxiety is a symptom, a response to a potentially challenging or threatening experience. When the threat is not acute, and we have time to contemplate it, worry and nervousness create anxiety. Anxiety is closely linked to fear, a primary emotion that helps us deal with danger. In an acute emergency we experience fear, and that fear triggers an automatic response in the body that prepares us to stand and fight or head for the hills. However, this natural instinct – which undoubtedly was of great use to our ancient ancestors – is not always useful in today’s society, when threats are more often psychological than physical. This means that our bodies prepare us for a physical emergency that rarely occurs. The only thing we have to fear is fear itself FRANKLIN D. ROOSEVELT Anxiety Can Be Positive It is important to recognize that some degree of anxiety is unavoidable and indeed can be useful in the short term. It is the body’s way of saying ‘do this right’ or ‘pay attention’. In potentially dangerous situations, a lack of anxiety could have disastrous consequences. Imagine walking across the road in the face of oncoming traffic without feeling any anxiety at all. Anxiety ensures that we pay attention to what is important. It is what spurs us on to be more vigilant so that we are prepared for life. Anxiety can also be a positive experience. Think of a challenge that you have looked forward to in great anticipation – I’ll bet you felt some degree of anxiety. You may have called these feelings either butterflies in your tummy or nervous excitement but, either way, they are normal and natural expressions of anxiety – and such feelings can help you to excel. ANXIETY ENSURES THAT WE PAY ATTENTION TO WHAT IS IMPORTANT The Anxious Society Living in today’s world can be a bit of an emotional roller coaster and the sort of positive stress that can stimulate and motivate can often be overridden by negative anxiety. The pressures of living in modern society mean our lives are fraught with negative anxiety. Mental distress has now become very common – to the extent that anxiety has been sighted as the most common psychological condition in the UK and US. There is no doubt that the pace of life these days can be fast and furious. We live in a society that focuses on human ‘doing’ rather than the human ‘being’. We find ourselves on the go all the time and for many of us it’s very much the norm to experience ongoing feelings of worry and anxiety as we face the challenges of daily living. We have so much choice and freedom in so many ways yet we seem unable to exercise that choice in a way that is good for us. We may be wealthier in terms of material possessions – such as nice homes, cars and computers – but we have little time to truly enjoy that wealth because we constantly strive for greater goals and never seem to be totally satisfied with what we have. We have indoctrinated ourselves to live at a pace that falls in with societal expectation. This can bring about anxiety in many different forms. We may be juggling a career with bringing up a family and feel that we must be great at our job, have perfect kids, a good marriage, great social life, great clothes, a good figure…With such expectations, it’s hardly surprising we feel anxious! We live by the rules of ‘should do’, ‘have to’, ‘must do’ and seem unable to acknowledge that our anxiety levels are directly affected by how we live our lives. This sort of pressurized existence, where we are all striving for ongoing individual goals, has also meant that we communicate less with each other. With this comes greater selfishness and intolerance in relationships and increased confusion between the sexes. This adds yet another layer to our anxiety levels. There are also indirect factors that compound the problem. We are heavily influenced by the media, which constantly portrays the world as a scary place to live – just think of all the headlines about rising crime rates, child abductions, acts of terrorism, war and famine. We are also a society that tends to focus on what does not work, rather than what does work, so it’s easy to become hypnotized on a daily basis by the negativity around us. This isn’t just bad for our mental health – when anxiety levels rise inordinately it can have a toxic effect on both body and mind. Worry Worry is at the very heart of anxiety and is one of its biggest contributors. Anxious feelings often come from worrisome, automatic thoughts combined with the physiological responses that such thoughts cause. Obviously, having the odd worrisome thought is perfectly natural. However, ongoing or intense worry that is repetitive in nature can have a detrimental effect both mentally and physically. When feelings of worry escalate and everything in life is seen as a potential catastrophe, this will start to sabotage an individual’s performance in many areas of life. If you are continuously finding yourself fearful – you are constantly irritable with an ongoing feeling of life being out of control – then you need to begin addressing your anxiety levels. If you don’t, constant worrying will increasingly interfere with your life. WORRY AND ANXIETY CAN STOP YOU ACHIEVING THE LIFE THAT YOU WANT Individual Attitudes Given what I have said about the pressures of modern-day living, you could be forgiven for coming to the conclusion that anxiety is a natural response to the society that we live in. However, your levels of anxiety are very much dependant upon you and how you live your life. The way you perceive and interpret events in your life has a profound effect on your state of mind. Your anxiety levels are determined to a great extent by the beliefs and assumptions that you have about yourself and the world around you. Those beliefs influence how you respond and deal with threats and challenges and hence how anxious you become. Some people seem to ‘wear’ an underlying state of anxiety every day. For others, certain triggers will create anxiety. For others still, anxiety can come about for no reason at all. Your attitude is crucial to how you deal with situations. If you have an optimistic outlook on life, you have empowering beliefs and you deal with situations in a positive way then you are likely to experience less anxiety on the whole. If, in contrast, you have a pessimistic outlook, with limiting beliefs and negative assumptions, then you are more likely to experience anxiety. Age and Anxiety Anxiety knows no boundaries and can affect anyone, irrespective of age. Many anxious states are rooted in childhood experiences, particularly some of the more serious ones, but anxiety can manifest at any time or can be related to whatever stage an individual is at in his or her life. Teenagers, for example, commonly have anxieties about their self-image, exams or early relationships. When we reach our twenties and thirties, anxieties about career aspirations, marriage and parenthood can manifest. Our forties and fifties can also be particularly trying, as this time of transition invariably brings anxieties about getting older and all that this entails. When we reach our sixties and seventies, we worry about the challenges of retirement and our vulnerability in terms of health, security and mortality. In addition, throughout our adult lives, most of us are also subject to financial worries, together with anxieties concerning our children and parents. Now, whilst all this may have just depressed you, it shouldn’t. Instead it should emphasize how important it is to develop a healthy attitude to the unavoidable stresses of life. As I’ve said before, if you deal with situations in a positive way then you are likely to experience less anxiety. Specific Anxieties Individuals experience anxiety in different ways, at different levels and in response to a wide variety of stressors. For example, some people appear to have an anxiety about life in general and view most things, no matter how insignificant, as a potential source of anxiety. For others, the source of anxiety may be more precise – for instance, social situations, their health or a trauma that they have suffered. When we come to very specific sources of fear, the list can be endless – spiders, injections, heights, the dentist… The point is that our anxiety, and the extent to which it affects our lives, is very individual, therefore it pays to tackle it in a specific way. (In chapter two, we examine the various types of anxieties in detail.) Anxiety Disorders An anxiety becomes a disorder when it is consistent, intense and debilitating, to the extent that it disrupts your life. If you have an anxiety disorder, it is likely that you closely associate an experience or an object with danger and fear, and fixate on it. For many, that possibility of danger is exaggerated out of all proportion to the actual threat. As well as having psychological roots, anxiety disorders can also be caused and exacerbated by physical and energy imbalances in the body (we will look at this in more detail in chapter three). The result is anxiety and behavioural responses related to that anxiety. When anxiety reaches the stage of becoming a disorder, fear can keep the body in a constant state of emergency, causing abnormal physiological functioning and malaise in both mind and body. So how do you know if you may have an anxiety disorder? The following symptoms are common (though by no means offer a definitive diagnosis): Ongoing sleeping problems or feelings of exhaustion and fatigue Consistent over-worrying that seems to wear you down Ongoing difficulty in concentrating, and becoming increasingly forgetful Feeling continuously tearful or panicky Ongoing feelings of intense anxiety that won’t go away, no matter how hard you try You may also experience ‘somatic’ symptoms such as headaches, breathlessness, rapid heartbeat, holding of the breath or even physical complaints such as skin disorders or irritable bowel. We will look at the effects of anxiety in more detail in chapter 3, but for now suffice it to say that the growing prevalence of anxiety is undoubtedly having a knock-on effect on our health in general – it is estimated, for example, that around 70 per cent of people who turn up at their doctor’s surgery are suffering from stress and anxiety. Anxiety can manifest in many forms – phobias, panic attacks, general anxiety, health anxieties, body anxieties, obsession and compulsions, and depression. In the next chapter, we will begin to explore the different types of anxiety that people typically suffer from. 2 Specific Anxieties (#ulink_f50463f3-435c-59a1-ba3a-b1c203c65342) In this chapter we will be exploring the different types of anxieties that people suffer from. The aim is to increase your awareness of any anxiety that may be affecting you. By becoming more aware, you can be more specific about what you are feeling and hence begin to work on managing or eliminating your anxiety forever. The anxiety disorders featured are the most prevalent in society today. However, I strongly suggest that you do not give yourself the luxury of a label. Although the anxieties we will be examining are labelled ‘disorders’, suffering from symptoms of one of them does not automatically mean you actually have a disorder. It simply means that you suffer from a certain level of anxiety in that particular area. Remember, an anxiety becomes a disorder when the anxiety is chronic and completely disrupts the sufferer’s life. This is very different from having a mild anxiety about a specific area of life. Before we look at the various types of anxiety, let’s examine the methods you will be using to measure your anxiety levels. Measuring Your Level of Anxiety I have included two methods of measuring anxiety. The first indicates your level of anxiety and is called the SUD (subjective units of distress) scale. This scale is very well known to the therapeutic community and is used to measure levels of anxiety in the moment, as well as to monitor feedback over time. The method measures levels of distress on a scale of 0 to 10: 0–1 indicates no anxiety, 2–3 indicates slight anxiety, 4–6 indicates moderate anxiety, 7–8 indicates marked anxiety and 9–10 indicates extreme anxiety. The scale is used to indicate the intensity of specific symptoms and overall anxiety levels. As well as measuring your level of anxiety, you will also be recording how often you experience anxiety. This is done simply by noting if you experience the anxiety not at all, a little, some of the time, a lot of the time or all of the time. These two straightforward measures provide a clear indication of where there is a problem and the depth of the anxiety. Rather than discard any particular anxieties out of hand, I suggest that you read about each one. You may have a good idea which type of anxiety you are prone to – and, of course, you may feel no anxiety in many of the areas discussed – but reading about them all initially will help clarify what is appropriate to you and may pinpoint a few other areas that you need to pay attention to. I suggest you invest in a note pad or a journal, and, as you work through the sections in this book that are appropriate to you, write down your findings as you go along. Anxiety/Depression It is quite common for an anxiety disorder to combine with another disorder, and top of the list and most prevalent in the UK and US is the combination of anxiety and depression. A survey by the charity Mind found that 11.2 per cent of women and 7.2 per cent of men in Britain suffer from this condition. Those who suffer from it generally experience a cocktail of emotions, such as hopelessness, sadness, low energy, an inability to concentrate, anxiety, worry, agitation, irritability and restlessness. Although this book is mainly about anxiety, depression is such a prevalent condition, and one that is so often combined with anxiety, that it cannot be ignored. It is estimated that one in five people will suffer from depression at some point in their lives, and the World Health Organization estimates that by the year 2020 depression will be the biggest health burden next to heart disease. Naturally, all of us have the occasional day when we feel fed up and pessimistic, but, rather like having mild bouts of anxiety, such moods pass. With depression, however, these moods don’t pass and there is a tendency to look at the down side of life most of the time – the cup is always seen as being half empty as opposed to half full. The medical profession defines depression as an illness of both mind and body in which the symptoms are mental and physical. There are obviously different levels of depression and, like anxiety, the seriousness of the condition is determined by how much it affects the sufferer and their ability to cope with life. The Symptoms of Depression When someone is suffering from mild to moderate depression, they will feel low physically, mentally and emotionally. They experience feelings of hopelessness and persistent sadness and will often feel they are trapped in a vicious circle that they’re unable to escape from. Low energy, tearfulness, a lack of enthusiasm and low motivation are also common symptoms. On the whole, someone who is depressed will view the world negatively and only focus on the bad things in life, and this negative state of mind will be reflected in their body language. The symptoms of mild to moderate depression are: Inability to sleep Sleeping too much Tears and crying Low mood Loss of interest in things that you usually enjoy Low sex drive Feelings of pressure Concentration and memory problems Feeling muddled Emotional tiredness and fatigue Low energy If you were to experience the feelings outlined above for more than two weeks then a doctor would almost certainly diagnose mild to moderate depression. With this type of depression, people are often not aware that they are suffering until it is pointed out to them. Do be aware, however, that sometimes such depression can come and go. If you find it extremely difficult to function properly and your thoughts seem so completely dark that you are almost suicidal then you are suffering from a severe depression. In both cases – and particularly the latter – you should see a doctor. Self-Assessment – How often do you experience depression? – Not at all/a little/some of the time/a lot of the time/all of the time. – Go through the list of symptoms above and, on a level of one to 10, how much do you experience those symptoms today? (0–1 = no depression, 2–3 = slight depression, 4–6 = moderate depression, 7–8 = marked depression, 9–10 = extremely depressed) Different Types of Depression There are a number of different types of depression, and a number of causes. Reactive depression can occur in response to a stressful or traumatic event, such as bereavement, a stressful job or a relationship problem. An endogenous depression, in contrast, appears to come on for no apparent reason, which can create a great deal of anxiety to the individual, as he or she never quite knows when it will come on again. Bi-polar depression is another name for manic depression, which appears in the form of extreme mood swings between mania and its opposite, severe depression. Seasonal affective disorder, or SAD, is a seasonal depression that is caused by lack of daylight in the winter, especially around January and February. Another common depressive illness is postnatal depression, which is caused by imbalanced hormones. However, postnatal depression can be psychological as well as clinical, as the mother has to adapt to lifestyle changes as well as the physical changes brought about by motherhood. As I mentioned before, a large number of people who experience depression also experience symptoms of anxiety. Anxious feelings make you more alert and jittery, whereas if you suffer from depression you are likely to feel that it is an effort to do anything. Anxiety usually precedes depression. However, when anxiety and depression combine, the symptoms overlap. Symptoms of Anxiety/Depression Feelings of helplessness Feelings of hopelessness Up and down feelings – one moment anxious the next low and depressed Loss of interest in things that you enjoy Low energy and motivation Worry about the future Feeling of being stuck in the present, unable to focus on the future Tiredness Difficulty sleeping Inability to concentrate Self-Assessment – How often have you experienced anxiety/depression? – Not at all/a little/some of the time/a lot of the time/all of the time. – Go through the above symptoms and on a level of one to 10 how strongly do you experience these symptoms today? CASE STUDY for Anxiety/Depression Viviane was a beautiful 19-year-old who moved to London to make her mark on the modelling industry. She had won all manner of beauty competitions in her home county and it was expected that she would have no problem finding an agent. However, when she got to London, she discovered that life was much harder than she’d imagined it would be. The agency that had been recommended to her turned her down and she found it very hard to get accepted anywhere. After each rejection she found her self-esteem becoming lower and lower. Viviane also had never lived away from home, and she began making do with fast food rather than home-cooked food. The worry about being rejected by agencies was taking its toll on her health. She slept badly and quickly slipped into an anxious depression. To counter this, I used the anxiety algorithm and the algorithm for depression (see chapter five), both of which worked very well. Viviane and I also worked on her beliefs about herself and she began to learn not to take agency rejections personally and instead see them as simply part and parcel of being a model. General Anxiety Disorder General Anxiety Disorder, or GAD, is an anxiety disorder that is characterized by consistent, chronic worry. The American Psychiatric Association has described the condition as excessive anxiety and worry occurring for a minimum of six months. It is estimated that between 2 and 5 per cent of the population of the UK suffer from GAD, while in the US it is estimated there are around four million sufferers. GAD affects both men and women, although statistics show that a considerably higher percentage of women suffer the disorder. Genetics can play a part in GAD, though childhood and life experiences seem to be the bigger contributor. GAD is a non-specific anxiety, therefore it is not often possible to pinpoint where its roots lie. Excessive worry seems to be present in relation to absolutely everything in life – health, money, job, relationships and even worry about worry itself. With this kind of worry – often referred to as ‘meta’ worry – life becomes distorted with anxieties about everything. Day-to-day concerns, such as turning up on time for appointments or obsessing over something said or done, are often compounded by daily events on the news and events on a global level, such as the terrorist attack at the world trade centre. With GAD, worries start internally; the individual starts with negative, limiting and often irrational thoughts about themselves, which develop into an exhausting spiral of negative internal dialogue. Experiences become exaggerated out of all proportion, as the anxiety is always more intense than the situations ever warrant. To make matters worse, not only does the individual with GAD worry about himself or herself, they also worry for their loved ones and anyone else around them. GAD, at its extreme, escalates to the extent that it causes crippling distress to the sufferer. It can last for weeks or months and seem never ending. To the worrier, it feels as if there are threatening situations and disasters around every corner. If you experience this sort of anxiety excessively then you are likely to suffer other physical symptoms, such as general aches and pains, headaches, light-headedness, nausea, lack of concentration, memory loss and sleeping difficulties, all of which can then create even more anxiety. Like all anxieties, you can suffer from GAD to varying degrees. Symptoms of GAD Excessive worry about life circumstances Feeling constantly on edge, restless and irritable Inability to disengage with object of anxiety Difficulty concentrating Constant tension in the body Shaking and trembling Being easily fatigued Trouble sleeping Nausea Dizziness Pressure on the chest Sweating, cold clammy hands Self-Assessment – How often do you experience general anxiety? – Not at all/a little/some of the time/a lot of the time/all of the time – Do you find it difficult to control your anxiety and worry? – Not at all/a little/some of the time/a lot of the time/all of the time – On a scale of one to 10, how much do you suffer the symptoms of general anxiety in your life today? (0–1 = none, 2–3 = slight worry and anxiety, 4–6 = moderate anxiety, 7–8 = marked worry and anxiety, 9–10 = chronic worry and anxiety) CASE STUDY for GAD Ross, an attractive 24-year-old Australian, was on a travelling trip around the world. Whilst in London, he found himself suffering from severe bouts of anxiety and worry that appeared to be causing on-going migraines and stomach cramps. Ross had a belief that he couldn’t cope. These disempowering thoughts were the result of consistently failing exams in childhood and the learning disability dyslexia. When he was in Australia, he was supported by his mother and sister and felt able to manage his life. However, when abroad, he found it very difficult to communicate his fears and anxieties for fear of ridicule. He seemed to suffer from worry and anxiety about absolutely everything and the slightest thing would cause a negative spiral. He worried about getting a job then he worried about the people around him. He worried that he couldn’t get a girlfriend; he worried about his health. Underlying Ross’s worry was a belief that he couldn’t cope, so we worked to change this by using some of the beliefs exercises featured in this book. I also used the TFT algorithm for anxiety (see chapter five), and exercises on worry, which allowed him to put his problems into perspective. Ross returned to Australia feeling a lot better. Social Anxiety A large number of people have suffered from social anxiety at some point in their lives. Think back over your own experiences and I’m pretty sure you’ll be able to recall a period when you were shy and anxious with particular people or groups, or in certain social settings. To a certain extent, we are born with our personality already mapped out and with an ‘emotional’ biology that is thought to determine our temperament. Consider babies for a moment – they all have such different personalities. Children born to the same parents also usually have characters that are completely different: one child may have a placid temperament, while another is more robust. Of course, there is little doubt we are affected by our environment and social anxiety often has its roots in childhood experiences. However, studies examining whether the temperaments of young children changed in social situations over time found that the robust, confident individuals stayed that way in groups of people. The children who were fearful and nervy at an earlier age were more likely to be anxious in social situations, though some did improve. It is perhaps during adolescence that social phobias and anxieties really begin to manifest and become most apparent. At this stage, children may be breaking some of the bonds with their parents and becoming more aware of themselves as individuals, but they have a strong need to fit in with their peers. As a result, anxieties emerge about being judged or rejected – or indeed doing anything that might conceivably lead to embarrassment or humiliation. Social anxiety can occur on many different levels. When it is mild, the sufferer usually experiences discomfort and anxiety in particular situations. In cases of extreme anxiety, the individual is consumed by thoughts of their inadequacies and feels quite overwhelmed and panicky. Following a stressful event they will spend hours obsessing about how they could have behaved differently. It is also possible to have phobic reaction in social situations (see here (#ulink_e6c841bf-b9ee-53dd-8fbd-52b91d4d2f13)). While the lucky ones grow out of their anxiety, others simply learn to manage it. For some, however, it can stick, causing them to become fixated with self-doubts about social situations. Patterns like this can run the whole of a lifespan and can have an incredibly negative effect on a person’s life, making it difficult for them to make friends and get on in social situations. For an unlucky minority, this becomes so fraught with anxiety that they will avoid such situations and hence become reclusive and lonely. High-tech, Low-value Communication The computer has patently not helped us to interact with others. Instead of communicating face to face and developing relationships within the family and at work, many of us – kids, teenagers and adults – spend hours in front of the computer, cut off from genuine human contact. Today, you can, if you choose, virtually lead your life via the Internet – you can do your shopping, click on to chat rooms for conversations and even have a relationship over the net. Dating anxiety is very common, as the insecurities we have about ourselves can negatively affect the way we communicate. Using the Internet can make the initial process less stressful, but of course it throws up many other problems, not least of which are the expectations both parties have built up before they meet. Social anxiety is often based on perception rather than feedback from others. People with social anxiety become very conscious of the signals that they are giving out and can easily find themselves blushing, tongue-tied or unable to eat, drink or talk; or the opposite – eating or drinking too much to cope with the situation. And, not surprisingly, this can often exacerbate an already difficult situation. Social Phobia Social phobia is an extreme type of anxiety (see phobias page 35) in which a phobic reaction can occur at even the thought of being in a social situation. This can escalate into chronic, excessive fear that is deeply distressing to the individual – especially as they are aware at a rational level that the very thing that is making them anxious is harmless. To be diagnosed as a social phobic you must have had the problem for at least six months and the phobia must interfere with your life. Men and women can suffer equally from social anxiety. In the US, it is estimated there are around 5.3 million sufferers. Symptoms of Social Anxiety Do you suffer any of the following symptoms of social anxiety in one or other areas of your life? Worrying about what others think of you Your mind goes blank and you cannot think what to say Thinking about all the things that are likely to go wrong Worrying after the event Feeling inferior to others Self-consciousness and painful awareness of all that you say and do Feelings of panic – heart pounding, sweating and nausea Holding one’s breath Speaking quickly, getting words mixed up or mumbling Avoiding catching people’s attention Self-Assessment – How often do you get anxious and worried in social situations? – Not at all/a little/some of the time/a lot of the time/all of the time – Do you avoid the situation that you are anxious about? – Not at all/a little/some of the time/a lot of the time/all of the time – Are you afraid of public speaking, giving presentations, and groups of people? – Not at all/some of the time/a lot of the time/all of the time – On a scale of one to 10 how strongly do you feel you suffer social anxiety in one or more areas of your life? (0–1 = none to very slight, 2–3 = slightly, 4–6 = moderately, 7–8 = marked social anxiety, 9–10 = chronic anxiety) CASE STUDY for Social Anxiety Angus, a 37-year-old marketing executive, works for a well-known mobile network company. Seen as the golden boy of the company, he had amazing sales and marketing skills that brought in a large amount of money. For this he was rewarded with a promotion to the board of directors. One of the responsibilities his new role entailed was holding group meetings and giving presentations to his colleagues. However, Angus had always had an anxiety about his height – he was only 5ft 5 inches – and this seemed to be becoming worse every time he did a presentation. He felt powerless and inadequate, with the result that he mumbled, tripped over his words and behaved in a defensive manner. In response, I used Thought Field Therapy (see chapter five), a powerful NLP exercise called The Biology of Excellence (see here) and self-hypnosis on building confidence in group meetings. And the feedback? According to Angus, the techniques worked a treat. Panic Disorder Some people experience anxiety through the feeling of panic. Panic disorders affect 0.7 per cent of the British population and 2.4 million Americans, and are twice as common in women than men. The attacks of anxiety that are usually experienced with panic disorder can be very scary and can last from 5 minutes to 30. An individual can feel fine one minute and the next find themselves in the grip of extreme fear and anxiety for no apparent reason. An attack is usually preceded by a feeling of something being not quite right. This then quickly escalates into sheer panic, absolute terror and a feeling of being out of control. The catastrophic thoughts that follow the initial sense of foreboding cause a powerful physiological response, which then reinforces the thoughts. It is this feedback loop between thought and sensation that exacerbates the condition, causing anxiety to spiral out of control. At the height of an acute panic attack the sufferer feels completely powerless and really believes that this time the worst is going to happen – i.e. that they are about to die or go crazy. (Thankfully, this never happens.) Some people may only experience one or two panic attacks in a lifetime but others are plagued with panic attacks on a weekly or monthly basis. Panic attacks can, of course, be mild and therefore will not have a huge impact on a person’s life. However, when they are acute and debilitating they can restrict the sufferer’s life in many areas. This is due not only to the fear of causing an attack but because of the uncertainty as to when and where the next one is going to occur. Hence sufferers avoid certain situations, places and people that could bring on an attack or where they would feel vulnerable or embarrassed should one happen. Unfortunately, fear of an attack can often bring on the condition itself. Fear makes us more alert and hypersensitive and we can then begin to look out for any bodily sensations that indicate a panic attack is going to occur or any situations that could bring one on – for example, being in a lift or a crowded room or in an aeroplane, anything that is a reminder of the original attack. Panic attacks can also occur during sleep. The sufferer will waken up gripped with fear, and panic that they are going to have a heart attack. Like most other anxiety disorders, if you suffer from panic disorder you are also likely to suffer from anxiety in other areas. Depression is closely linked to panic disorder, as is agoraphobia, claustrophobia and social phobia. What Causes Panic Attacks? The causes of panic attacks are varied. Personality type can be a contributory factor, as people who are naturally prone to anxiety are more likely to have a panic attack. Sometimes they are born from childhood events, such as separation from parents or one parent. A study showed that rat pups separated from their mothers had greater levels of anxiety than those whose mothers were not removed. Associating something with other uncomfortable and stressful experiences from the past – for example mental, emotional or physical abuse – is also a common trigger. Panic attacks do not always have their roots in childhood. Panic attacks can suddenly come on for no apparent reason in adulthood. Life changes and worries about impending life changes are often at the bottom of this, although it has to be said that the possible psychological causes of panic are endless. There are also possible physical causes for panic attack. These include unstable blood sugar levels, hyperventilation and food allergies. It is important to treat panic attacks, otherwise they could become worse or develop into other disorders. There are a number of different therapies for treating panic attacks so the condition can be managed or overcome – it’s just a matter of learning how. Symptoms of a Panic Attack Do you suffer from any of the following symptoms at any one time? Churning stomach Heart palpitations Floating feeling Sweating, trembling hands Lump in the throat Nausea Blurred vision Pressure in the chest Self-Assessment – On a scale of one to 10, how strongly do you suffer the symptoms of panic attack? (0–1 = none, 2–3 = very slightly, 4–6 = moderately, 7–8 = marked suffering, 9–10 = severely) – How often do you experience panic, panic disorder or panic attacks? – Not at all/a little/some of the time/a lot of the time/all of the time – Do you worry about having another attack? – Not at all/a little/some of the time/a lot of the time/all of the time CASE STUDY for Panic Attacks Deborah is a 32-year-old mature student with a history of panic and anxiety-related conditions. These had prevented her from completing her education and she had left school with no qualifications and low self-esteem. Having eventually realized her true potential, she decided to study design. However, as Deborah was waiting to sign up for her course, she suddenly felt vulnerable – there were people in front and behind her and she felt so much older than everyone else. Her heart began to palpitate and her stomach began to churn – she felt completely trapped and unable to escape. Her panic levels rose as she became more and more anxious. Although she had always been nervous, this was completely unexpected. Rather than give up her new-found determination to study she decided to seek help. I treated her panic using the thought scrambler exercise (see here). I then used the new behaviour generator exercise (see here) to begin to train her brain to work in a new direction. Lastly, I taught her self-hypnosis for confidence and how to visualize her goals for the future. Obsessive Compulsive Disorder If you experience ongoing anxious thoughts that cause you to repeatedly engage in time-consuming rituals, then you may be suffering from Obsessive Compulsive Disorder or OCD. According to the mental health charity Mind, 1.2 per cent of the UK population have an obsessive-compulsive disorder at any one time. Other research suggests that somewhere in the region of 3 per cent of the population have experienced OCD. In the US, it is estimated that 3.3 million suffer from this intrusive disorder. It strikes both men and women equally and often has its roots in childhood. One third of adults with OCD say that their obsessions began when they were children. A key feature of OCD is the repeated compulsive behaviour that occurs as a result of dwelling on a perceived threat. Confronted with a particular threat, the OCD sufferer will become anxious and unable to disengage from the object of concern. Fear becomes too much to bear and this then leads to compulsive behaviour. This behaviour reduces the severity of the anxiety or the obsession. However, the relief is only minor and so a vicious circle of more anxiety, worry and obsession can occur, resulting in the need to do the compulsive behaviour repeatedly. Common obsessions are with dirt and feeling contaminated or the fear that some sort of disaster will occur because you have failed to do something – for instance, turn the lights off or lock the doors. Rituals involve things like washing hands, showering, cleaning, checking light switches and turning off taps. With severe cases of OCD, people have been known to wear their skin away or spend hours turning on and off light switches. Again, like other anxiety disorders, there are degrees of OCD. It can be mild or it can completely disrupt daily life, as hours each day are spent going through the same ritual repeatedly. Even though sufferers realize their behaviour is bizarre and a product of their own mind, they often cannot stop themselves. With milder cases, the symptoms can improve over time without outside intervention but often those with a more serious condition will find it grows worse and completely takes over their life. In an attempt to calm the situation down, some sufferers will resort to using alcohol or drugs – however, this just creates a whole new set of problems. OCD can also lead to other disordered behaviours, such as obsessions with food, which can lead to eating disorders, other anxiety disorders and depression. The Symptoms of OCD Recurring intrusive thoughts that make you anxious Engaging in any repetitive behaviour – washing hands, cleaning, switching off lights, showering, praying etc. Feeling unable to control both thoughts and behaviour Fear of catastrophe to one’s self and others Depressed mood Addictive behaviours Hoarding A need for order and symmetry Repeating words silently Obsessive worries or anxious, disturbing images Self-Assessment – How much do you suffer from obsessions or compulsions? – Not at all/a little/sometimes/a lot/all the time – Do you have any of the above symptoms or behaviours? On a scale of one to 10, how much do you suffer from these symptoms? – On a scale of one to 10 how strongly do you suffer from OCD today? (0–1 = none, 2–3 = slightly, 4–6 = moderately, 7–8 = marked, 9–10 = severely) CASE STUDY for OCD Graham was a 30-year-old graphic designer who worked for a number of large websites. He had been diagnosed with OCD in childhood. At an early age, he developed a fear of contamination and used to clean himself and his surroundings obsessively. His obsession and anxiety was so great that he would take his clothes off to eat his meals because he believed that otherwise his food would be contaminated. The last straw came when he and his family went to friends for dinner and he stripped off and sat in his underpants throughout the entire meal. In a regression, we discovered that Graham’s concerns about contamination stemmed from an experience that he had when he was 9 years old. He found a snake and started to play with it. However, an adult screamed at him that the snake was poisonous, took it from him and duly killed it. Graham felt a great sense of responsibility for that snake and developed a belief that in some way he had been poisoned because of it. Graham responded well to the TFT algorithm for OCD (see chapter five) and we intervened in his OCD strategy and installed a new way of thinking so that he felt satisfied with his cleaning rituals. Body Dysmorphic Disorder People’s preoccupations are largely dictated by the society that they live in so it’s hardly surprising, given western society’s preoccupation with appearance, that Body Dysmorphic Disorder (BDD) is becoming more common. This disorder is characterized by a fixation with perceived flaws in physical appearance and the belief that these are in some way repulsive. Like all anxiety disorders, individuals can suffer in a mild or chronic way, although to receive a diagnosis the sufferer has to experience a great deal of distress and disruption to their daily life. The disorder is thought to affect around one per cent of the population and both men and women can suffer from it. Although it often starts in the teenage years with hypersensitivity about self-image, it can also begin in midlife when we begin to age. We construct our image of ourselves largely from what we see in the mirror. Of course very few of us like everything we see and may worry to a certain extent about the bits we don’t like, but we can usually interpret what we see fairly honestly. However, those with BDD may construct an image of themselves that is hugely distorted. With the more chronic forms of this disorder, the sufferer is preoccupied with their self-image and develops a heightened perception of their ‘deformity’. This can be intensely painful, to the point where their life becomes dominated by self-consciousness. Anxieties about the body typically focus on unhappiness at the shape or size of body parts and can include anything from the feet to the stomach, breasts and hands. However, most anxieties apparently concern the face – noses, eyes, eyebrows, mouth, teeth and lips. Bodily hair is another preoccupation, as are birthmarks and other such imperfections. It is thought there are a number of causes for this condition. Genetic disposition is one possibility, as this can make an individual more hypersensitive to the disorder – this is likely if another member of the family suffers in a similar way. In more general terms, the roots of a disorder like this lie with the societal expectations that we should all look a certain way. In buying into this and striving to reach those ideals, people often fall short of them and begin to look on themselves with dislike and self-loathing – and this can grow into obsession and preoccupation with the body. The only ones to gain from this are the beauty, health, fitness and dieting industries, which make a fortune out of our anxieties. Worries and anxieties about self-image can become irrational to the extent that the person develops behaviours such as mirror checking, excessive grooming or shaving, ritual washing, skin picking and wearing wigs, sunglasses and camouflaged clothing. Undergoing plastic surgery is another aspect of this, as are disordered eating behaviours such as food aversion (which can result in anorexia) or binge eating and vomiting (bulimia nervosa), or simply binge eating that results in obesity. Men Suffer Too It isn’t just women who are anxious and preoccupied with their appearance. A study in the British Journal of Sports Medicine claimed that, with the increased acceptance of physical exercise as a desirable activity, men are generally only motivated to exercise to improve their physical appearance rather than their health. A common anxiety for men is being puny and this can develop into muscle dysmorphophobia. This dissatisfaction with the body leads to frequent workouts in the gym in order to achieve a more ‘masculine’ size and shape. However, although the individual may become highly muscular, they still see themselves as puny. When they feel that they can no longer develop, steroids are taken to boost physique. Other common male concerns are about penis size and receding hairlines. BDD can take over an individual’s life to the extent that they become self-loathing, living in torment that others will notice their ‘flaws’. This makes them more susceptible to developing other disorders, such as OCD, depression and social phobias, and as a result such people can completely isolate themselves in order to avoid anyone seeing their perceived deformity. They believe that true happiness and self-esteem can only be possible if they change their defect. This anxiety disorder is considered delusional, as it is often only the person who is suffering that is aware of the defect – although they are convinced that it is obvious to others too. The Symptoms of BDD Refusing to accept compliments about yourself and only backing up comments that feed your concerns Anxiety over perceived flaws Preoccupation with body parts Dissatisfaction with body parts Needing constant reassurance about your appearance Believing that something is wrong no matter what anybody says Frequent mirror checking and body grooming Concealment – using wigs, hats etc. A history of visits to a cosmetic surgeon Self-Assessment – Do you suffer from BDD? – Not at all/a little/some of the time/a lot of the time/all of the time – Do you find yourself obsessing about your self-image? – Not at all/a little/some of the time/a lot of the time/all of the time – On a scale of one to 10, how strongly do you currently feel anxiety about your self-image or certain parts of your body? (0–1 = no anxiety, 2–3 = slight anxiety, 4–6 = moderate anxiety, 7–8 = marked anxiety, 9–10 = severe anxiety) CASE STUDY for BDD Roalh is a 29-year-old physics teacher who works in a tough inner city school. He had always been self-conscious about his body size and height but, on taking up his first teaching job, he quickly became concerned that many of his teenage pupils were bigger than him and could physically intimidate him. Unfortunately, his worst fears were realized when he was taunted and bullied by a group of teenage boys and their girlfriends. He was so ashamed that he was unable to stand up to them that he became overly conscious of his size and took up martial arts and bodybuilding. Even though he reached a size that would have been foreboding to the most ferocious youngster he was not satisfied and turned to steroids and other methods of making himself look stronger. In order to treat his obsession with his body I carried out the appropriate TFT treatment (see chapter five). We then explored his beliefs and focused on working towards self-acceptance. Phobias A phobia is an intense and persistent fear or aversion for a specific object or situation that poses little or no danger. It is estimated that 1.9 per cent of adults in the UK and around 6.3 million Americans experience phobias, with women suffering more than men. When an individual has a phobic reaction, they are likely to experience an extreme paralysing fear along with symptoms of panic and nausea. People who suffer from phobias know that their reaction to the object in question seems irrational to the rest of the world – and often they see it as such themselves. However, knowing this makes no difference and, in fact, often only increases the emotional distress and embarrassment the sufferer feels. Phobias are very easy to identify because of the intense irrational response to the normally harmless, perceived threat. Specific phobias can be about spiders, snakes, escalators, lifts, blushing, visiting the dentist, particular kinds of food, insects, birds, injections, exams, animals, flying, water, blood, needles, heights, tunnels…The list is endless. There are also more complex phobias, such as agoraphobia, which can be made up of a number of fears. Like all anxiety disorders, phobias differ in their degree of severity. Some people can manage their phobia simply by avoiding the object or situation that they are phobic to. This is straightforward enough if you have a fear of something very specific that isn’t part of your everyday life – i.e. a fear of flying or a phobia about needles. However, certain types of phobia can interfere with life on a day-to-day basis. A water phobia could, for example, not just prevent you swimming but also washing; a phobia about germs can prevent you from ever going outside your house; and a social phobia could have an impact on career choices and relationships. The cause of most phobias can be found in childhood. Often a state of high emotion is linked to an event or an object or situation, so that whenever the individual finds himself or herself in a similar situation they have the same phobic response. Even the thought of the object or a similar situation can bring on a strong phobic response in the body. Phobias can lead to personality disorders, avoidance behaviours and other anxieties such as OCD. Symptoms of a Phobic Reaction Intense fear Nausea Hot and cold body temperature Trembling legs Avoidance behaviour Aversion to a specific object or situation Self-Assessment – Do you experience extreme fear of one specific object or situation, for example, flying, heights, water, animals, insects, injections? – Not at all/a little/sometimes/a lot of the time/all of the time/ – Do you feel worried or anxious when you even think about these objects/situations? – Not at all/a little/sometimes/a lot of the time/all of the time – Do you avoid the object of your fear? – Not at all/a little/sometimes/a lot of the time/all of the time – On a scale of one to 10, how strongly do you currently feel about the object or situation that you feel phobic about? (0–1 = none, 2–3 = slightly, 4–6 = moderately, 7–8 = marked, 9–10 = severely) CASE STUDY for Phobias Lesley is a 28-year-old homemaker who has two young children. The children were taught to swim by their father but they were keen for their mother to join in on the fun too. Lesley, however, had a phobia about swimming pools. As a child, she was thrown in at the deep end but, as she couldn’t swim, she had to be pulled from the water – much to her shame and humiliation. Lesley never got over her aversion to swimming pools and even the smell of chlorine seemed to paralyse her with fear and nausea. She was terrified that she would not be able to cope if one of the children got into trouble and got upset just at the thought of taking the children to the local pool. Thankfully, the TFT phobia cure (see chapter five) got rid of Lesley’s phobia about swimming pools and she was able to enjoy an outing to the pool with her children. Health Anxiety (Hypochondria) Another very common preoccupation of individuals is worrying about their health. Of course we all think about our health at times, but if you experience on-going anxiety about it or obsess about bodily sensations then you may well have hypochondria. Both men and women suffer from it and it can be found in all age groups. Hypochondriacs are constantly on the alert for oncoming illness and are therefore hypersensitive to bodily sensations and any symptoms of illness. Once they become aware of any symptoms – and they often do find ‘symptoms’ because they are always engaged in body checking – they blow them out of all proportion. Those who suffer from severe health anxiety are constantly on the look out for reassurance from the medical profession and are convinced they are physically ill, despite medical reassurance to the contrary. The hypochondriac will pay frequent visits to doctors and often go from one professional to another, never quite convinced by the diagnosis. Often, if the diagnosis is confusing or conflicts with another, they become even more anxious, convinced that there is really something serious wrong with them – a headache becomes a sign of a malignant tumour, a tummy ache could be cancer and so on. There is a very mixed reaction to this type of anxiety from the medical profession. Some doctors recognize it as a condition in itself, while others are completely intolerant and dread the familiar face of the hypochondriac in their practice. Health anxiety is more prevalent in western society – which, perhaps, is not surprising. When all your needs are taken care of, you have more time to be introspective and anxious about your health. However, when each day is a battle to achieve a basic standard of living, there is little time to be concerned with irrational worries. Expressing Vulnerability Research suggests that anxieties about health are a means of expressing vulnerability. This process, called Somatization, occurs when emotions that we find difficult to express are transformed into a physical expression of the psychological pain. It is now well established that mind and body act as one. Everything you think and everything you feel produces chemical changes in the body. Hence, anxious and worrying thoughts can be expressed through the physical body. It is thought that this is a very common way for men to express their feelings. Whilst many men refuse to recognize that they are worried or anxious, because they see it as being indicative of weakness, they are much more open to accepting physical illness as a sign that something is not quite right. According to Dr Lipsitt, professor of psychiatry at Harvard Medical School, most of us somatize but people with hypochondria clutch at their physical symptoms to explain why their life is so painful. It isn’t the ‘illness’ that is painful, but the underlying psychological conflict that manifests in physical symptoms. Some anxiety disorders, such as depression and OCD, develop as a result of somatizing. Illness is also a very useful way of getting support, attention or time out. If, as children, we got away with using a tummy ache or headache to get out of something that we didn’t want to do, then we may well use this strategy in adulthood (consciously and unconsciously) to avoid things we don’t like or have difficulty confronting. At such times, we can develop aches or pains or suddenly become incapacitated by nausea or a feeling of faintness. People can also sometimes hold on to or develop an imagined illness because it is a good excuse to stop them getting on with their lives. Of course, the problem with health anxiety is that powerful, worrying beliefs can lead to poor health – they are often a self-fulfilling prophecy. High levels of anxiety and stress create wear and tear in the body. One study, which assessed how the immune system responds to anxiety and stress, found that of the healthy individuals subjected to the cold virus those who were suffering from high anxiety developed a weakening of the immune system and were far more susceptible to the virus than those with lower anxiety levels. The Symptoms of Hypochondria Spending hours obsessing and worrying about health Never being quite convinced by a doctor’s diagnosis Using illness to avoid the challenges of life or to get sympathy from others Thinking that an ache or pain means the worst is going to happen Bodily checking Frequent visits to the doctor A medical cabinet full of pills and potions Frequent hyper-alertness to bodily sensations Fixation and selective attention to bodily events Imagined symptoms of headache, gut pain, dizziness, nausea and fatigue Self-Assessment – On a scale of one to 10, how much do you suffer the symptoms of health anxiety? (0–1 = none, 2–3 = slightly, 4–6 = moderate anxiety, 7–8 = marked, 9–10 = severely) – How often do you suffer from health anxiety? – Not at all/a little/some of the time/a lot of the time/all of the time CASE STUDY for Hypochondria Amanda came to see me because she was convinced she had a life-threatening stomach disorder. She had come back from travelling with a tropical disease that affected her stomach, yet despite being cured of this, some symptoms began to return. Her doctor did endless tests, but he could find nothing wrong with her. Amanda travelled from expert to expert, never feeling that she was getting an answer. When she showed me her medical notes there were repeated statements from her doctors that she was ‘catastrophizing’ her condition. We spent a few sessions working on her beliefs, as it took some time for her to realize that her illness was a figment of her imagination. I then used TFT for anxiety (see chapter five), and self-hypnosis and visualization to enable her to become more balanced physically, mentally and emotionally. Post-Traumatic Stress Disorder (PTSD) Whilst phobias and panic attacks are usually based on distorted or irrational fears, Post-Traumatic Stress Disorder, or PTSD, is caused by exposure to a real-life event that has a traumatic effect on the psyche. When traumatic situations deal your nervous system a real shock, the effects can last for years following the event. PTSD has been described as a normal human response to an abnormal condition. It is estimated that it affects approximately 1 per cent of the UK population and 5.2 million Americans. Women are more likely to develop it than men and it can occur at any age, including during childhood. The original event that is at the root of the disorder can either be witnessed or experienced. Any reminder of this event triggers flashbacks and severe worry and anxiety. Such experiences can be very traumatic indeed and can be related to everything from witnessing the death of a loved one, to being involved in a car crash or a mugging, or seeing a natural disaster such as an earthquake or an avalanche. It is now accepted that people who suffer from bullying can also have PTSD. People suffer from PTSD at different levels. If the trauma is mild some people can quickly recover. However, more disturbing recollections and persistent flashbacks and nightmares can take some time to recover from. Any ordinary everyday experiences can remind the individual of the original event, causing them to relive the trauma all over again. It has been suggested that genetics can play a role in PTSD and this could go some way to explaining why it is that some individuals exposed to trauma will suffer only a mild reaction while others develop full-blown PTSD. Symptoms of PTSD Reliving the traumatic event through flashbacks Ordinary day-to-day experiences remind you of the original event Ongoing nightmares Outbursts of anger and being easily startled Memories of trauma causing significant distress and suffering in day-to-day life Self-Assessment – Do you experience any of the above symptoms and, if so, how often do you experience them? – Not at all/a little/sometimes/a lot of the time/all of the time – If you have experienced a frightening or traumatic event in your life, on a scale of one to 10, how much anxiety do you suffer every time something reminds you of that event? 0–1 = not at all, 2–3 = very slightly, 4–6 = moderately, 7–8 = markedly, 9–10 = severely CASE STUDY for PTSD Sunni, a lovely 23-year-old Muslim girl, came to see me in a very distressed state. She had witnessed her mother dying before her very eyes of a heart attack. There was nothing that anybody could do to help her. She felt traumatized by the whole event and was having recurring dreams about what happened. I performed the TFT trauma algorithm (see chapter five) on her. The effect was incredible – one week later, she came to see me and said she felt completely different and much more able to cope. I then worked on helping her to manage her grief and cope with life in general. The purpose of the self-assessment sections in this chapter is to help you identify where your anxieties lie and at how intense they are today. Irrespective of whether your anxiety is mild or more intense, it can be helped if you carefully follow the instructions in this book. However, this book is not intended to take the place of your doctor – if you are suffering severely, please visit a doctor. 3 The Anatomy of Anxiety (#ulink_5c7a084e-324d-52ac-b7d6-4f70a3a4a85c) So where does anxiety come from and why is it so inherent in everyone to varying degrees? It is clear that we all have a biological disposition to feel anxious, nervous or stressed in response to perceived or actual threats. I have already touched on this subject but by examining it in greater detail, this chapter will help you gain a better understanding of why and how you become anxious. Your Biology The Central Nervous System Each of us is a human processing system made up of neural networks that reach every part of our body. These networks are all part of the central nervous system, which consists of the brain and the spinal cord. The brain contains 1,000,000,000,000 individual neurones and can be likened to a computer that controls the workings of the body. The spinal cord, which is made up of nerve tissue and runs from the base of the brain down the spinal column, is like a tunnel running down the backbone. It is not separate from the brain but acts as a highway on which messages travel between the brain and body. The Limbic System – Your Emotional Generator The fear response originates in the limbic system, which is towards the back of the brain. This centre, amongst other functions, generates basic emotional responses. These responses are unconscious – in other words they operate out of your awareness. The limbic system is the part of the brain that initially decides whether we should be fearful, angry or loving. It passes this information to the frontal cortex, which is the part of the brain that consciously registers emotion and floods it into our consciousness. The limbic brain is responsible for the feeling of fear and out of fear comes anxiety. Other primary emotions are love, anger and disgust, sadness, joy, shame, grief and surprise. These emotions are, at their most basic, survival mechanisms that have evolved to help us to run from danger, stand and fight, or move towards more pleasurable states. Although there are a number of primary emotional states, a number of others has developed – for example, frustration, resentment, excitement and so on. Our emotional states can change from moment to moment depending on what we are thinking at the time. This means we are constantly creating some kind of emotion, whether it is a negative or a positive one. Emotions just seem to happen and it appears impossible to stop them or catch them in the act. Try to control them at a conscious level and you are likely to find it difficult. Emotions are powerful things and at times your emotions can override reason. The limbic system is made up of a number of structures that work in conjunction to make sense of, and respond to, the incoming information from the world around you: the thalamus organizes the data and information that comes in from the senses; the amygdala, brain’s main alarm system, signals and generates emotion; the hippocampus is responsible for storing your memories; the neo cortex is the conscious, thinking part of the mind, whose job it is to make sense of information; and the hypothalamus is the master gland that regulates and controls involuntary functions. Your Sensory Receiver Your thalamus is primarily responsible for receiving sensory information and then relaying it to other areas of the limbic system. At any one moment we are bombarded with vast amounts of information. We filter that information through deletion. Can you imagine what would happen if we didn’t have a filtering system to erase information? We would suffer sensory overload and very likely go nuts. The information is filtered according to our experience to date. My recent experience of buying of car illustrates how this works. I had never really paid attention to the cars on the road. However, in the car showroom, I was shown a brand new Volkswagen Beetle and instantly fell in love with it. I was amazed that I hadn’t seen this car before. I gave myself some time to think about whether or not I should buy it and what happened? I started seeing different coloured beetles everywhere. My new awareness of the Beetle changed the way I was filtering information. Information That Has Emotional Impact Information that comes through the thalamus can take two pathways to achieve an emotional response. One pathway leads to the neo cortex, the conscious, thinking part of the mind; the part that explains in detail what is happening – for example, this person is talking to me about a controversial topic. It searches through the stored knowledge for such a thing happening in the past. Stored memories can either come from the hippocampus, which searches through long-term memory banks to make sense of a situation, or the amygdala, which holds emotional information and memories. There is a ‘dialogue’ about the information and if the brain perceives that a situation calls for an emotional reaction, the amygdale quickly and automatically signals what it perceives to be the appropriate emotional response. In this instance, if you were to have an emotional tie with the topic being discussed then you may react, for example, with apprehension or anger. However, there is a second route to the amygdala, a much quicker one that can be more useful in times of crisis. With this pathway, the information comes straight from the thalamus to the frontal cortex and amygdala and tells you that you should ACT NOW THINK LATER. This clearly makes greater sense as a survival mechanism, as we don’t often have time to have a dialogue with ourselves when confronted with a very real threat, such as an oncoming bus. The amygdala is the emotional regulator – it decides how much emotional impact each thought carries. Whilst this is excellent in a situation that calls for an instant response, i.e. removal of oneself from path of oncoming bus, there are times when the amygdala can produce completely unnecessary responses that trigger ongoing anxiety. This process, referred to as ‘kindling’, occurs when repeated stimulus encourage the neurons in the brain to fire excessively, even when the stimulus is not potentially dangerous (see Sensitization, page 61). This response can cause havoc, as stress hormones are constantly pumped into the body, affecting all its major systems – the cardiovascular system, the endocrine system and the elimination system. We can see that some people are naturally more reactionary and will quickly respond to an experience with fear and anxiety, while others are able to think a little before responding. However, the point is that we can make choices and as long as the perceived threat is less frightening than imagined then, through the use of language and other strategies, you can change your attitude or perception to dissipate a situation. In contrast, if you continue to repeat the response of reacting with fear when it isn’t warranted, the result can often be a more permanent state of arousal and higher levels of anxiety. The Autonomic Nervous System There is very much a physical reality to our anxiety levels. Anxious thoughts create high states of arousal that have an effect on the natural mechanisms of the body. As you read over the following section think about your own experience and the mixture of physiological responses that occur as a result of your anxiety. The autonomic nervous system regulates our involuntary bodily functions – i.e. those we are unconscious of. It is divided into two systems that work in opposition to each other – the sympathetic and the parasympathetic nervous systems. The Sympathetic Nervous System One of the prime objectives of the sympathetic system is to do whatever is necessary to mobilize the body to handle danger. It is the chief mediator of the body’s immediate alarm reaction. Sympathetic nerves originate from cells in the spinal chord and branch out to the rest of the body’s organs and tissue sites. If the amygdala senses trouble, it sends a message to the hypothalamus, a vital part of the sympathetic nervous system. This small but powerful gland is the link between the autonomic nervous system and other endocrine glands (glands that secrete hormones directly into the bloodstream). The hypothalamus is the controller of the involuntary functions of the body, regulating your digestive system, respiratory system, endocrine system and reproductive system. It regulates the hormones involved in governing peristalsis (the natural movement of the intestinal tract), breathing and balance, as well as the heart rate, blood pressure and temperature. In event of a threat, the hypothalamus relays alarm to the pituitary, another ‘master’ gland, and the pituitary then tells the other glands what to do – its job is therefore to help produce the hormones that are needed to respond to different situations. The Three Stages of the Stress Response The sympathetic changes that take place in response to stimulus are referred to as the stress response. This response was discovered by Canadian endocrinologist Hans Seyle, who demonstrated that the body reacts in the same way to a challenging situation irrespective of whether it is a loud bang, a charging bull, or an extremely pressing deadline. Selye suggested that there are three phases to the stress response. The first stage is the alarm reaction – your reaction to a given challenge or threat. In response to a stressful event, the pituitary signals the adrenal glands – a small pair of glands that sit at the top of your kidneys – to release the stress hormones adrenaline, noradrenaline and cortisol. Adrenaline and noradrenaline prepare the body to deal with certain conditions and are excreted in times of fear, danger or sexual excitement. The Effects of Adrenaline and Noradrenaline Your heart begins to beat faster and more strongly Blood flow to the heart is increased Your pulse quickens Blood is diverted to the muscles so that your muscles become tense and ready for action Blood is diverted away from the skin Your breathing becomes shallower and more rapid Glucose is released from the liver into the bloodstream and your blood sugar levels are increased for energy output Digestion slows down to allow the other areas of the body to do their work – i.e. to fight or flee from the situation at hand The pupils may dilate to allow more light into the eyes If the threat is brief and can be resolved quickly then the parasympathetic system will kick in to reduce stress levels and return the body to normal. However, if stress is ongoing, you are likely to reach the second stage – resistance. This is when stress becomes detrimental to our health. When stress is ongoing, the result is excessive and prolonged release of cortisol. Cortisol Cortisol plays an important part in the stress response and is a key hormone in many other ways – it maintains resistance to such things as trauma, infections and temperature extremes; it assists in the conversion of carbohydrate to glycogen; it stimulates the release of fatty acids from adipose tissue, which can then be used for energy; it helps to retain the correct water balance in the body; it also counters inflammation and allergies. However, excess cortisol can have detrimental effects on both the mind and body. The Detrimental Effects of Cortisol Excess cortisol can counteract the body’s natural sleep cycles by interfering with the circadian rhythm – the 24-hour schedule that our bodies run to. Normal cortisol levels vary over this period, peaking early in the morning and gradually reducing during the day. Excess cortisol can therefore stimulate the body when it should be asleep. If the level of cortisol is elevated whilst we are asleep, this can also interfere with the body’s ability to repair and maintain itself. Elevated cortisol primes the body to use resources; therefore many of the tasks that usually occur during sleep, such as bone and skin regeneration, are postponed. This can lead to poor bone growth and repair, and accelerated ageing. Excess cortisol has a detrimental effect on the immune system, making us more susceptible to viral infections. Cortisol plays a role in depression. It does this by affecting the levels of neurotransmitters in the brain. Neurotransmitters are chemical messengers that are thought to underlie all brain function by carrying information direct to and from the cells. One of the main neurotransmitters is serotonin, which has a positive effect on your mood. If normal levels of serotonin are interrupted by excess stress hormones then you may find yourself feeling blue. Excess cortisol also has a toxic effect on the brain, affecting memory and concentration. One of the functions of cortisol is to break down muscle and convert it into energy when necessary; therefore excess cortisol can lead to muscle loss. Elevated cortisol levels can also lead to excess body fat. When we are stressed the body responds by thinking it is in a crisis situation and stocks up on stores for the future. If you are suffering from ongoing anxiety, you don’t eat much and yet you are overweight, excess cortisol may be to blame. Last but by no means least, excess sympathetic arousal of the body, and elevated cortisol, depletes the body’s energy reserves. Anxiety uses up more energy than a balanced, relaxed state. If you feel constantly tired, have difficulty getting up in the morning and experience energy slumps throughout the day, this may be the result of excess cortisol. If stage two of the stress response continues for a prolonged period, with inadequate rest and relaxation to counterbalance it, then the body will eventually reach stage three – exhaustion. At this stage, your adrenal hormones will have been depleted to the point where your tolerance to stress is decreased. In addition, your resistance level will drop and you will experience mental and physical exhaustion. Read the Signs You now have an idea of how the stress response can affect you internally – but it also has a marked external effect. Muscles become tense, hence we jut our head forward, hunch our shoulders, frown and may clench or grind our teeth. We acquire different sitting, standing and sleeping postures. We also develop different breathing patterns, often either holding our breath or breathing in a very shallow way. Pause a moment and pay attention to your physiology. Are you experiencing any tension in your body right now? Are all the muscles and joints relaxed and at ease? Physical Expressions of Anxiety Tension in the muscles Over-breathing Holding the breath Shallow breathing Tension in the chest Neck aches Backaches Heart palpitations Irritability Suppression of the immune system Decreased sex drive TO CHANGE YOUR STATE YOU NEED TO CHANGE YOUR PHYSIOLOGY The Parasympathetic System The parasympathetic system is the other half of the coin that makes up the autonomic nervous system. It is an inbuilt mechanism for counteracting the sympathetic system – it’s nature’s way of bringing the body back into balance. It does this by, for example, slowing the heart rate down, slowing the flow of air into the lungs and stimulating the activity of the digestive tract and digestive juices. It is also responsible for releasing tense muscles and counteracting the effects of adrenaline. This re-balancing of the body is often referred to as the relaxation response. Конец ознакомительного фрагмента. Текст предоставлен ООО «ЛитРес». 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