Delaying Tactics And Why They Help.

Anxiety comes upon you in different ways depending on what type it is. Separation anxiety never really quite goes away; it's somehow always there in the background. Existential anxiety suddenly deals you a hammer blow. Situational anxiety, on the other hand, sneaks up on you. It begins so small you may not even notice it. Then it grows. I'm reminded of something I once heard about cooking a live frog, assuming you would ever want to do such a thing. If you simply take a pan of boiling water and drop the frog in, the frog's reflexes will kick in and propel it straight back out again. No, what you have to do is put the frog in a pan of cold water and then slowly heat the water up. The frog doesn't notice the heat at first, later it may but it also starts to feel drowsy before passing out and you can now cook it just how you like it.

Take a less gruesome situation. When you get a puppy you need to teach it obedience. The earlier you start, the easier your life will be later. Even though it may be hard work to get the message across, it's nowhere near as difficult as if you start with an adult dog. Anxiety that starts small is much easier to overcome while it is still small. And if you keep it small, it stays easy to overcome. With some made up figures, here's what I mean:

If you make a dentist's appointment this Monday for next Monday, and you really don't like dental treatment then the blue line shows what happens to your anxiety level in the meantime. Anything over 80% and you'll probably cancel. If, on the other hand, you acknowledged from the outset that you were likely to become increasingly anxious over the week you would be able to decide to devote time to reducing the anxiety every time it gave a little flutter. You can usefully use two strategies side by side.

1. Visualising yourself arriving at the dentist's feeling calm and remaining calm, using the techniques I've described, practising feeling calm, in other words, and taking that practice into the waiting room and then on into the surgery when you actually go.

2. Not ignoring the part of your mind that says "I'm bound to worry. I hate the dentist's" and not arguing with it, because you'll lose. Instead, agree but put off the start of worrying; "Of course we'll worry about it but not today. It's a whole week away". And later, "Yes, I promise we'll worry, but let's leave it until the weekend. That's plenty soon enough." With a bit of luck there'll be something to distract you from worrying across the weekend, and then you've only got a bit of Monday to deal with. The green line illustrates how that can pan out.

One final thing here. Notice that nowhere is it actually suggested that you should relish the visit; simply that unpleasant as you may find it, you can do it.

It's For Your Own Protection

Right at the beginning of this blog I referred to anxiety as the bastard offspring of fear and imagination.I also  talked of fear giving us the means to deal with an actual, present danger, and thus the means to protect ourselves from harm. Anxiety performs the same function with regard to possible, imagined future threats, threats which don't exist but which anxiety treats as if they do.

I've also mentioned Freud's belief that emotions too powerful to express get buried in the subconscious part of the mind where they fester, perhaps for very many years. Freud also said something else which I have found helpful. He said that at a deep level people resist being cured of their neurosis, because, bad as it may be, what it is protecting them from is even worse (as they see it).

How does this relate to existential anxiety? Very simply, your mind will offer you all kinds of good reasons why you should shrink from tackling the problem *now*.

This is not the right time. Your protective mechanism will always tell you this; there is no absolute right time.

I can deal with it myself, slowly. Sorry, if that were true you would have dealt with it long ago - or even at the time these things happened.

I don't want people to think I'm making it all up or exaggerating. Mental health professionals won't think this at all. They have long experience of people imprisoned by distress like yours (though the causes may be different).

It would be better to walk away now so that someone more worthy may have the benefit of their expertise. No it wouldn't. You have been assessed by people who know what they are doing and have judged that you need and deserve the benefit of their intervention.

I don't want to have them lose patience with me and discharge me before I'm ready. They won't. They are in this for the long haul and they know it will be a lengthy and difficult process for you. They are prepared for it to take as long as it takes.

It's going to hurt too much. I would do better just to learn to live with it. Well at least there's some truth in that; it will hurt and that's why your mind shies away from dealing with it. But, it will not be more than you can endure, and you will be worse trying to live with it, not better. You survived the process that damaged you so badly; you will survive the painful process of healing.

An infected appendix requires surgery which leaves a painful incision wound. Rejecting surgery leads on to a ruptured appendix which results in peritonitis, shortly followed by death.

Have I missed any of your 'reasons' off my list? Tell me what they are and I'll explain why they too are excuses. 😄

Varieties Of Anxiety

The different types of anxiety that I wrote about also differ in the way that they manifest themselves. Separation anxiety is the consequence of deep distress at being separated from someone, which makes sense. This is why obstetric and paediatric practice these days is to ensure that mum and dad have the maximum possible access to their child when a hospital admission is necessary, so that feelings of abandonment are avoided as far as possible, and there is little or no long term effect in most cases. But separation anxiety is also common in everbody's life; it is a major component of that complex web of emotions which we call grief. A much loved partner, parent, grandparent, child or important other is snatched away by death and there is no hope (in this life) of reuniting. It may also come about as the result of a miscarriage or a marriage or relationship breakdown. The main way in which it is likely to manifest as a continuing problem in adolescent or adult life is in inappropriate behaviour to avoid a repetition of the experience. I'm thinking particularly here of people who have a pattern of breaking off relationships or friendships which to an outside observer seem to be developing well. They are, and therein lies the threat. So, get your retaliation in first; that way the pain is less. I am the eldest of three brothers. Six years ago, not yet sixty, my youngest brother fell ill and very shortly died. It came out of the blue. My other brother, once the funeral was over and we were all setting off for our various homes suddenly looked at me and only half-jokingly said " Right. i'm going to die next. I couldn't go through that again." I suppose I should be touched that my death would hit him that hard. Instead I thought, "typical of the selfish bastard!"

Existential anxiety is different. It hits you out of nowhere coming at you like a Formula 1 car going flat out. Why? Because in your past, probably in your early years something or things happened to you, or more likely, were done to you that were way too big to let go of, but way too big to handle. So your mind - the part Freud labeled the subconscious - stepped in to protect you. It buried them where you couldn't feel them, or only vaguely and tolerably, and you were able to survive. But at a price. That pain, anger, shame, guilt, despair festered and fermented, if you like, a build-up of emotional magma that one day would erupt. In the contemporary world events occur which trigger potentially dangerous memories and emotions; the eruption must be stopped at all costs. The result is blind panic, everything gets bottled up again and life, such as it is continues.

There's a problem here. I like analogies, so I'll turn to one here from my hiking days. You're out in wild country and you come across a river in full spate. It's not that deep but the power of that rushing water is tremendous. Your destination requires you to get to the other side. It's too wide to jump across and then is no bridge for miles in either direction. The hard fact: you can't go over it; you can't go under it; and you can't go round it. You have to go through it to reach your destination. The same is true of those buried traumas. There's no way over, under or round them. The only way to health is to go through them and it's going to be no easier and no more pleasant than wading that ragining torrent.

That's why you need skilled, experienced professionals; they are the walking poles that will allow you to keep your balance and get to the other side. That and a load of friends shouting support and encouragement.

There's more than enough to chew on there, so I'll pause now. Next time I'll say a little bit more about this, and then we'll turn to the easy one, situational anxiety.

Flat Is Good

Every person who suffers from a phobia of flying knows lots of people who really enjoy flying. So they see that as their ultimate goal; to get on a plane and recognise that it's fantastic. You can look out of the window and down below is a patchwork of green fields with cows and sheep, maybe caravans in some fields. And then as you leave England behind there's the beautiful blue of the sea, and the boats and the ships to look at.

You know what? At thirty eight thousand feet you can't see the animals or the boats. Which is no bad thing because probably what you're looking down on is the top of a blanket of cloud that most of the way down to Spain. And anyway, you might have an aisle seat. The welcome truth is that flying is like any other form of transport, tedious and time consuming. Oh there's the exhillaration of actually doing it for the first time, but pretty soon after that it's boring. That is your goal, to be bored by it instead of terrified.

There's another thing, too. My friend Jenasaurus of blog fame discovered that the way to overcome anxiety was to confront it; to say, "Go on then, do your worst!" And when she said that anxiety slunk off into a corner and refused to come out. But that challenging attitude is high maintenance. It burns up enormous amounts of energy and leaves you exhausted. What she hasn't noticed is that she has won - because I don't think she actually expected that. She thought that she had found a way to control anxiety, whereas in fact she had defeated it.

Jen, that battle is over. You've won. No need to go for walks to challenge anxiety any more. Go for exercise, for fun time with K, to get stuff from the shops, or keep appointments or drop in on friends for a cup of tea and a ciggy. There will be other, different things to overcome save uour energy for them.

Oh, and well done.

Distinguishing Between Different Types Of Anxiety

As often happens, it is reading or hearing about other people's experiences that clarifies my own thinking, so once again the credit for this post lies elsewhere. It's several years now since I retired from therapy and my memory needs jogging from time to time. I have been writing about anxiety here as if it is a single, unitary thing and it's not. Just as there are different types of arthritis, diabetes, dementia and autism for example, so there are different types of anxiety. When I was working with clients on a daily basis I was aware of this even if not consciously, and I adjusted my approach according to the apparent source of their anxiety; I had forgotten that, so it's good to be reminded. On reflection I would say that there are three main types of anxiety, which I shall refer to as situational anxiety, existential anxiety and separation anxiety. My posts here have been entirely concerned with situational anxiety and how to deal with it. In the early days of psychology the belief was commonly held that anxiety was the manifestation of a subconscious, unresolved conflict; Freud and his followers developed the psychoanalytic technique of using free association and stream of consciousness to encourage the patient to uncover the trauma that was at the root of their condition. In its own terms it was highly successful; it made an awful lot of psychoanalysts very rich, especially in America. Unfortunately, by the time the money ran out the patient was no better. Then in the 1960s when I was training, along came Behaviourism. In a nutshell this argued that deep seated trauma didn't exist. Anxiety was caused by faulty learning; something unpleasant happened and you associated your reaction with the situation in which it happened and subsequently felt anxious if confronted by a similar situation. What you had learned, you could unlearn. From developmental psychology we learned that a baby or young child will become anxious if separated even briefly from those it looks to for nurture. An example of this is my youngest granddaughter. From time to time her mother has to travel on business and may be away from home for as long as ten days. At nine years old, N finds this hard to cope with. The solution she has found to make life easier is to take an article of Mummy's clothing out of the laundry basket and have it in bed with her; it smells of Mummy and provides some comfort. What I concluded in my own work with clients was that these three types of anxiety were each quite different in origin and required a different approach in treatment. Situational anxiety arises out of wrongly attaching threat to a particular situation or activity and then having to avoid that situation or activity. Or your imagination paints a scary picture for you of a situation you haven't experienced - flying to Florida on holiday, for instance, and you develop a phobia about flying. This type of anxiety fits the Behaviourist model and is best dealt with by learning to react differently towards the focus of your anxiety. I've already written quite a lot about this, so I won't labour the point here. Separation anxiety, which usually has its origin in early experience, can persist in some cases up to and throughout adulthood. A lady in her sixties consulted me because she felt constantly vaguely anxious 'for no reason'. This free floating anxiety was something that went back as far as she could remember; she had somehow never felt quite comfortable in the world. This type of anxiety has a root cause, which is more than faulty learning. Something happened to cause an anxiousness that never went away. I saw her in the 1970s, so we are talking of someone born in the early part of the last century. We used hypnotherapy as an aid to finding the trigger. It went all the way back to birth. Jane was born prematurely and was taken straight from her mother to an incubator where she spent the next several weeks under nursing care which met her physical needs but left her floundering emotionally. There was no skin to skin contact with someone who smelled right, when she moved her limbs they never came into contact with anything, above her only emptiness to look at. We did make some progress, but really it should have been dealt with years before to be successfully resolved. And so that leaves existential anxiety. What is it? It is a terror that has no external object, and is probably the closest to what Freud had in mind. Past experiences generate emotions too dangerous to be expressed - or so it seems. For people with existential anxiety the threat is that something may burst the lock on the door behind which they had put the emotions of those experiences, and their escape threatens that person's continued existence, literally. The floodgates once opened will let everything out and overwhelm them. I'm becoming increasingly convinced that when I see a blog post with a TW flagged up, I am reading the story of someone in the grip of existential anxiety. This is not an area for amateurs; this needs the sustained support of a team of professionals, and it will need a great deal of time to find safe ways of dealing with what has been suppressed. In conclusion, it's probably the case that existential anxiety will be accompanied by situational anxiety where the upsurge of anxious feelings is wrongly associated with the external situation rather than the internal pressure, so whilst professional help, guidance and care are needed to deal with the existential anxiety, the sufferer can safely tackle any problems with situational anxiety, using the kind of things I've written about previously. I apologise for the length of this post, but I felt that it was better to treat the subject in some detail rather than cut corners to keep it brief.