Managing Anxiety

Introduction

Approximately 30% of the population suffers from some form of Anxiety. It is a serious and often debilitating problem that impacts a person’s quality of life as well as their performance at work. 

There is a number of types of anxiety disorders. I will exclude phobias and panic attacks and will focus on the patterns of how people worry about potential futures and what to do to manage or change anxiety effectively. This article will be a guide to managing anxiety in yourself or others.

I will be addressing the following topics critical to understanding and managing this problem.

• What is anxiety?
• The physiology of anxiety
• The structure of anxiety
• The thought processes that generate anxiety
• Language patterns and the perception of the future
• Self talk (Internal Dialogue)
• Managing Anxiety by changing physiology and breathing pattern

What is Anxiety?

There are different types of anxiety disorders in psychiatry, including generalised anxiety disorder, panic disorder, phobias and social anxiety..

I will be focusing on the common type of anxiety that most of us experience from time to time which is defined as a feeling of apprehension about a potentially unwelcome future event, an under planned future event or an unknown future. Anxiety is an emotional response to your thinking process and this is what makes it amenable to change.. 

An important and basic concept is that our emotions are states with names. A state that is common enough in any particular culture acquires a name. For those of you who are fluent in a second language you will be aware that there are emotions in one culture and language that do not have an equivalent in the other. 

The experience of apprehension about the future is a common enough experience to have been assigned a name. In fact that state is common enough to have more than one name, anxiety, worry, concern or trepidation for a start. It is certainly a common experience for many people.

The physiology of anxiety

Have ever been concerned or worried about a possible event in your future?

Have you observed others in an anxious state?

Remember observing someone who is in an anxious state. If you compare that observation with a time when they were obviously resourceful, comfortable and capable you would find some significant differences in how that person is using their attention, breathing and posture.

We refer to how a person is using their attention, breathing and posture as physiology. 

In examples of your own, if you compare a state of anxiety about a future event with a state where you are thinking about the future with resourcefulness or eager anticipation, note that your breathing is quite different. 

In resourceful states a person’s breathing has an even rhythm. In an anxious state it’s fast and uneven. In a resourceful state a person’s posture is upright and symmetrical and their peripheral vision is open. In an anxious state vision is tunneled (especially with intense anxiety) and the person may be hunched. 

Interestingly there are some resourceful states where the physiology is similar to an anxious state. When you have been excited for example. Do you pay attention to how you are using your physiology in different states?

Thought processes and anxiety

How you think about the future may generate anxiety.

When we examine and unpack how a person generates anxiety there are some common thinking processes involved.

One process is to run a mental movie of an undesired future event. For example you may be due to make a presentation at work. If you imagine a scenario of your presentation going wrong, this is likely to produce anxious sensations.

There may be other factors as well. If you have particular standards for yourself and your presentation and imagine violating those standards when presenting you are likely to be more anxious.

If you make the mental movie larger than life and spatially close to you then the anxious feelings are likely to increase in intensity.

Some people run a movie of an event with an undesirable outcome and as they run that movie, they have internal dialogue commentary about that event. The internal dialogue will have a particular tonality, rhythm, tempo, tonality and volume. Typically it’s an anxious sounding voice. The key to changing anxiety is to begin actively to change how you represent imagined future scenarios. If you experience anxiety, think about how you represent the future.

When the future is unknown

In the last paragraph I offered a way some people create an anxious state by imagining a specific future event with a scary outcome for themselves.

Another way some people generate anxiety about the future is to represent that future as unclear or simply unknown.

In the above example the key to reducing anxiety is to do active research about that future context and gather information about how it could unfold. This is followed by creating a congruent best case scenario for themselves. For more information please read my linkedIn article on Creating Compelling Futures.

For example a person loses their job. Their employment future is unclear and they experience anxiety. This is an opportunity for them to research the job market, to consider particular roles that they could do and how to find them. One of the most useful steps they can take is to imagine a future where they are gainfully employed doing work that fits their values. Gather information, build a plan to gain employment. Execute.

With this form of anxiety the solution is to consider what type of future that you want and take active steps to prepare for that future.

What have you been doing when faced with an unknowable future?

Running an anxious internal voice

Do you ever talk to yourself with an anxious internal voice?

Some people, when anxious, have an internal commentary about a perceived future scenario that provokes anxiety. Typically this internal dialogue has specific qualities that can intensify the anxious feelings.

The next time you are anxious, note if you are talking to yourself while in that state and explore the following qualities of that anxious voice;

• How loud is the inner dialogue?
• What is the tempo of the voice”
• Is the rhythm of your internal dialogue slow, medium or fast?
• Is there an even or uneven rhythm?
• Is there a particular pattern in tonality?
• Where is the voice located spatially?

Next ask yourself the following question. “What is the intention of talking to myself in this way”? or, “What am I trying to achieve by talking to myself like this”? Consider, “What can I do to fulfil that intention”? When you have one or more behaviours to meet that intention then make a commitment to yourself to do so.

You are now ready to change that anxious voice. One voice quality at a time, change that quality and note if that effects a change in your state. Now adjust any of the qualities that worked.

The man who made anxiety a way of life

Can anxiety run as a cycle?

A number of years ago I had an acquaintance staying with us and I witnessed him running a daily cycle of anxiety. 

He had multiple obligations which he had failed to meet, such as paying school fees for his children (he was divorced), doing his tax returns that were a few years late and actively seeking work.

Throughout the day as he thought about these and other obligations that needed to be met at some point in the future and he became increasingly anxious.

He was a disciple of a form of meditation. Just before going to bed each night he would use a meditation process and clear his mind of the anxieties of the day. Subsequently he would sleep well and then the next morning he would begin generating a state of anxiety again. Once again he would clear the anxious state through meditation before bed.

Rather than dealing with the matters that he was anxious about he misused meditation like a drug as a form of temporary relief.

The woman who played the pokies

Can anxiety create secondary problems?

I had a client who had developed a gambling problem playing the poker machines. She had a major problem with anxiety and found that the state she entered when playing the poker machines offered her temporary relief from the anxiety.

We focused on unpacking and changing the anxiety. 

The anxiety had increased in intensity over ten years.

She deconstructed HOW she generated anxiety. She would make a mental movie of an undesired future event. As she ran this movie she used an anxious internal voice to comment about what could go wrong for her in that event. The intensity of the unpleasant sensations would increase.

She learned to detach from the anxious state and examine it as if she were an outside observer learning HOW she generated that state. 

Her intention was to perform comfortably and well in the future situation. She reframed the anxious state as a signal to find and cultivate the resources for the future situation. 

The anxious feelings reduced in intensity and then only operated in a mild form as a signal to prepare herself for future situations. 

Have you considered anxiety as a signal to prepare?

A woman lost her anxiety on a walk

Can a person lose anxiety spontaneously?

I had a student who was so anxious she had a constant tremor in her hands! It was a course in Ericksonian Hypnosis. Ericksonian Hypnosis is based on the hypnosis and psychotherapy methods developed by the innovative Psychiatrist Dr. Milton H. Erickson. 

In one exercise I had the class in trance and told them to wake in an external focused state. Open peripheral vision, auditory attention on the external world with no internal dialogue. I sent them on a walk with instructions that their unconscious minds would draw their attention to something in the environment that was a symbolic representation for a significant learning for their lives.

One student was very late coming back and when she arrived told me the following story. Despite having lived in Sydney all her life and knowing the local area she had been completely lost. Instead of feeling anxious she felt calm and comfortable and so continued her walk. She said that after half an hour she ‘found herself’, knew where she was and came straight back. 

I could see that she was in a great state. The tremor had gone and she exhibited no signs of anxiety for the rest of the course. I met her about 10 years later and she said she no longer suffered from anxiety.

Preparing for the future

What do you do if you are anxious about a future event?

As discussed in a previous paragraph, one way that people make themselves anxious is through imagining a future event in which they have an undesirable outcome. They imagine what could go wrong which mismatches some outcome, value or standard that they have for that situation. 

Here is a simple formula that may make a difference;

1. Interrupt your state. Change your breathing and your physiology. If need be do something physical like going for a run or a swim.
2. Once in a resourceful state consider your outcome and intention/s for that situation
3. Ask yourself, ‘what resources do I require to achieve my outcome in that situation?’
4. Prepare yourself. Consider, ‘how can I get the resources I require for the future event?’
5. Mentally rehearse applying those resources to achieve your outcome in that future event.

Anxiety is often generated through the way we think about the future. Consider what you want and what you want it for. Then determine the resources you require to have the desired result. This will often reduce the intensity of any anxiety about a future event.

The women who needed to get some distance on her imagined future 

Do you imagine a future event from the position of being there?

I worked with a client who would imagine the worst result that could happen from the position of being in that future.

She would run a 3D, life size, clear and colourful movie of an unwanted outcome as if it were happening in real time. She would be gripped by intense anxiety in her chest.

The first thing I had her do was build a state of watching herself generate anxiety as a detached observer. Once she could do that I had her alternate between observing herself and reliving generating the anxious state. In effect she was training herself to get out of the anxious state.

Once she could do this I had her change the imagined event so that she could observe herself in the unwanted future further out in front of herself as if watching it on a screen. The image was represented as smaller than life, in 2D. She adjusted the movie size and distance until she could examine it comfortably. She was now in a position where we could work to explore the context, any function and the triggers that cued the pattern of anxiety.

Have you considered how you represent a possible future event?

Managing anxiety using ‘the breath of life’

You can change an anxious state using a simple breathing technique.

For anyone who has experienced intense feelings of anxiety you may have noticed the state has a fast tempo and an uneven rhythm. Contrast this with a deeply relaxed state in which has a slow tempo and even rhythm. In both examples of anxiety and relaxation this is reflected in the pattern of breathing. 

There is a breathing pattern that when employed rapidly reduces the intensity of an anxious state. It’s a simple breathing technique that anyone can use. When anxious do the following;

1. Breathe in through the nose for a count of four
2. Hold your breath for a count of four
3. Breathe out through your mouth for a count of four
4. Hold your breath for a count of four

Repeat the sequence ten to fifteen times. That should be enough to drop the intensity of the anxious state and in some examples the anxious state will completely go. Whatever your current state is, give it a go now.

What happened to your current state?

What questions do you want answered?

What else would you like to know about anxiety?

Anxiety is a state that many people have in varying degrees of intensity and frequency. It can be a mild nuisance for some and a significant problem for others.

Irrespective of the individual variation in anxiety there is a small number of relevant factors in when and where it occurs for a person and in how it operates within an individual.

I am currently designing a program to assist people in addressing anxiety and would appreciate input to assist me in refining the design.

What I would like to know is the following;

• What questions about anxiety would you like answered?
• What outcomes would you like to have as a result of doing our managing anxiety program?
• What are the most significant consequences of having anxiety in your life?
• What differences would it make in your life if you had a strategy for effectively managing or significantly reducing the frequency and intensity of anxious states?

Please comment with your suggestions.

What questions would you like to know about managing and changing anxiety?

© 2019 Chris Collingwood.

For more information you can contact me; +61 (0)425 298 176.