Q & A – Anxiety

General Anxiety Issues

Q: Why do some people feel anxious?

Anxiety is a normal feeling. It is something that everyone feels during various times in their lives. We are all designed to feel anxious in response to situations that we see as being threatening in some way. These may be

– External situations – events, people, objects that we see, hear, feel, taste or touch that appear to be a threat; or

– Internal situations – worrying thoughts or feelings.

Anxiety helps us prepare to deal with danger through our body’s production of adrenalin. This energises our body by increasing our heart rate and increasing the amount of oxygen in our blood. This in turn prepares us to deal with danger through either fight (dealing with the threat), flight (avoiding the threat), freezing or fainting.


Q: What are the signs that a person is feeling anxious?

For each person the anxious feeling and its intensity can vary at different times. We experience anxiety as a result of being aware of some of the following:

– faster heart beat

– cold sweats

– confusion

– tension in body parts

– panic

– hot flushes

– nausea

– sweaty palms

– fear

– thoughts of doom

– feeling out of control

– worrying

– butterflies in the stomach


Q: Why is anxiety sometimes a problem?

People generally experience anxiety as a problem when they have difficulty managing their thoughts, feelings or behaviours when they are anxious. We have all experienced times in our lives when we have been particularly anxious – before an exam or job interview, going on a date, being involved in a heated argument etc. Many people can cope with their anxiety by using a variety of techniques – slow breathing, eating, exercising, drinking, talking, drugging, yelling etc. Some strategies work better than others, and some can lead to further problems. Some people, however, have fewer coping strategies than others, or some people may experience new anxieties that they are unprepared for.

These people can feel overwhelmed by their anxiety and respond by trying to switch off their anxious thoughts and/or feelings. They can withdraw into themselves away from the situation, or, go shopping, drink alcohol, gamble, have an argument, clean the room, listen to music, watch a movie etc. We have all done some of these in our lives as an escape. Escaping from reality is sometimes very necessary. However, some people can lose their ability to choose when to escape from reality, and they act in default mode, “on automatic pilot”. Whenever these people feel an uncomfortable level of anxiety, they try to escape. They can become obsessive in their need to escape from anxiety, and compulsively repeat certain actions to switch off their anxiety. The more a person acts “on automatic pilot” the more likely they are to lose control over their behaviours.

For example, a person who typically responds to uncomfortable levels of anxiety by having an alcoholic drink, may tend to rely on alcohol to “calm their nerves”. As the body gets accustomed to a certain quantity of alcohol as a relaxant, that quality will slowly lose its effect. The quantity of alcohol will need to be increased to achieve the same calming effect. The person drinks more, creating the potential for a second problem.

Their first problem is their difficulty in managing their anxiety, while the second problem results from their loss of control over the method used to protect themselves from their uncomfortable levels of anxiety. They may become dependant on, or even addicted to, alcohol. Their defense against anxiety has become a problem in itself.

Anxious people often come to see me because they have realised that they have lost control over their defense against anxiety. I work with them to develop more positive defenses that they can make choices about and so have better control over the way they deal with their anxiety.


Q: What is a useful psychological way of managing problematic anxiety.

One important way of managing anxiety is through becoming more aware of how our thinking can cause us to have increased anxiety levels and then changing the problematic ways of thinking.

Some of the main ways of thinking that increase anxiety are:

– black and white thinking (eg “my relationships are always great or destructive, and I don’t think that this one is great”);

– over-generalisation (eg “I always drop things, I’m so clumsy. I really worry about what might happen if I carry that plate”);

– mind reading (eg “I just know she doesn’t like me. I can tell by the way she looked at me.”);

– fortune telling (eg “I’m sure I will fail the exam, no matter how hard I work”);

– via the tyranny of the shoulds (eg “I should be happier. What’s wrong with me?”);

– I am always in the wrong (eg “It is my fault again that my partner is so unhappy, I must have done something really bad”);

– negative thinking involve emphasising the negatives while ignoring or undervaluing the positives (eg “I can’t enjoy a movie without being stoned” vs “I have previously seen movies without having my mind altered and I have enjoyed myself”, or “I will start the movie and delay my first intake to see what happens”).

Our challenge is to become aware of when we think in one (or more) of these ways, realise the negative effects of the thoughts and then work to change the thoughts. Negative thinking leaves us feeling negative. If we can make ourselves feel bad by thinking negatively, we then have the ability to make ourselves feel better by thinking positively.


Q: Are there any other psychological ways of managing problematic anxiety?

Sometimes our feelings themselves can make us feel anxious. Sometimes we learn that certain feelings are bad. For example, some people grow up in homes where expression of anger by children is unacceptable. In such a home, any expressed anger may be responded to by sarcasm, cold indifference, a yell or a slap. Regular punishments teach a child to be very careful in the way they express their anger. Such a child learns to worry about anger and to be very uncomfortable with their own anger, as well as the anger of others. Eventually the child feels anxious, even highly anxious, in response to their own feelings of anger. All they are aware of is the anxiety, with the anger buried beneath their anxiety. Their response to anger (in themselves or others) is anxiety – the greater the anger, the greater the anxiety.

Similarly, people may feel anxiety in response to their sadness, as well as to other emotions. Such a person then needs to develop the ability to see what is going on “beneath” their anxiety, and respond to the lower layers. For example, if a person becomes aware of sadness beneath their anxiety, allowing themselves to cry can remove the anxiety.

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