Resource on ANXIETY from “Choose to be Happy”; Froggat, Wayne; HarperCollins What are you really afraid of? Fears are educated into us, and can, if we wish, be educated out,' wrote Karl Menninger in The Human Mind. And who better, I would add, to do the re-educating than we ourselves? Fear is a way of thinking. To say that you are afraid means you believe that something bad is going to happen. Fear is usually followed by a number of symptoms known collectively as anxiety. The more common of these include feeling shaky, getting short of breath, sweating, heart pounding, increased pulse rate, headaches, upset stomach, muscles tightening up (tension), poor concentration and restlessness. Fear and anxiety are two sides of the same coin. Fear is the thought, anxiety is the feeling which results. Anxiety is like a warning bell. Unfortunately, it often goes off when there is no real danger. When this happens, we call the fear irrational. You can learn how to handle your fears without the anxiety alarm taking oven Fear, as we have seen, is a way of thinking: if you analyse your thoughts when you feel anxious, you can uncover and change the beliefs which make you uptight. Know when your fear is irrational Not all fear is irrational. When it is in response to real danger and keeps you careful and alert, it can be functional. Suppose that someone is about to attack you: fear could help by preparing your muscles for defence or flight. Fear can get out of hand, however. Too much fear could freeze your muscles: then you would be less able to protect yourself. Furthermore, our fears are often out of proportion to any real physical dangers. Many of the things people fear involve social situations - performing badly, being rejected by other people and so on. Irrational fear often shows up as worrying. You are afraid of something in advance and keep mulling it over without doing anything constructive. You may have little evidence that it will ever actually occur. It could even be something you cannot do much about, but you still worry. Irrational fear can also show up in a more extreme fashion: as dread directed toward a specific object or situation. In such cases the fear is well out of proportion to the actual danger, and is sometimes called a phobia. People can develop extreme fears toward all sorts of things: closed spaces, open spaces, high places, being alone, being in a crowd, animals, the dark, blood, contamination or germs, thunder or lightning, pain, fire - to name but a few. One out of every ten New Zealanders has suffered from a phobia at some time in their lives. To pick out your irrational fears, watch for reactions like the following: a. You mull a concern over and over instead of doing something about it. b. You pile more and more worries on top of the one you started with. c. You experience symptoms of anxiety when there is no real physical danger d. Your anxiety disables you. Keep an ABC diary for a while. IF not setup for you please ask the Online Counsellor to do so This will clue you in to the extent of your worrying and help you become more aware of what tends to trigger it. Look for fear-inducing beliefs It is not always easy to get rid of irrational fear, because often we don't realise what it is we are afraid of. We think, for instance, that we fear rejection, violence or losing a loved one. But this isn't quite correct. what we really fear is how we will feel if we are rejected, assaulted or bereaved. In other words, we are often afraid of our own emotions. There are many feelings we might want to avoid, but two in particular seem to account for all our fears: discomfort and self-devaluation. The fear of discomfort Discomfort anxiety occurs when we perceive some threat to our physical or emotional comfort (or even our existence). Many things can trigger this fear. Some people worry about their children. Others feel uncomfortable at the thought of financial insecurity or the possibility of having plans and hopes frustrated. Many fear specific objects and situations. They expect to feel highly upset if faced with such things as heights, dogs, flying, earthquakes, water, fire, crowds, being alone or being trapped. Many people dis14ke physical pain, to the extent that the drugs used to control it are a multimillion dollar business. Many are so afraid of the dentist they won't go until it is too late to avoid extractions or other extensive work. Poor health and growing old are events we often associate with discomfort. Perhaps the final fear is of death: some people are so bothered about dying they don't enjoy living. What kind of thoughts create the fear of discomfort? They arise from a mixture of demanding and catastrophising: 'It is terrible when I don't perform well.' 'Life must be secure, orderly and predictable.' 'I must get what I want.' 'I must have the things I think that I need.' 'I must not get what I don't want.' 'I must not experience discomfort.' 'I need to avoid situations in which I feel uncomfortable.' 'I should be able to live my life as I want to.' 'I must prepare for anything that may possibly go wrong. 'It is disastrous when I don't get what I need.' 'I can't stand it when things go wrong. Do not underrate the power of demands to create anxiety. If we kept our values and desires as preferences, we would be just disappointed or concerned when they were not met. Turning them into absolute needs is what makes frustration seem catastrophic. It also creates an interesting phenomenon: the fear of fear Because anxiety and its symptoms can be unpleasant, we get anxious about becoming anxious! This kind of 'secondary disturbance' can upset us even when nothing is going wrong. It can also lead us to avoid situations in which there is any risk of anxiety being triggered. The fear of self-devaluation Self-evaluation anxiety occurs when we think that our view of ourselves or our personal 'worth' is in question. Events or circumstances that may trigger this fear include: failing; criticism or disapproval from others; losing control (not being able to cope with everyday tasks, needing help, becoming insane or behaving in ways which leave one feeling humiliated); being unattractive or overweight, or showing signs of ageing; having a disability; Anything else which we think might lead to rejection or self-downing. The fear of self-evaluation is based on the idea that we must meet certain expectations of ourselves in order to justify our existence. This may lead to thoughts like the following: 'To be happy, I have to see myself as a worthwhile human being.' 'To be worthwhile, I should do well at whatever I try and succeed with my life generally, and must get approval and recognition from other people.' 'Because love and approval are needs, it is awful when I am deprived of them.' ‘If I don't perform well or if I fail at something important, then I will be a failure.' 'Other people must not see me in a bad light.' 'I could not stand to fail at something important, have others disapprove of or reject me, or for any reason at all end up feeling that I was not worthwhile.' You might find it hard to admit to beliefs like these. Because self-rating is so unpleasant, people often deny to themselves that they are doing it - so be brutally honest about those labels you are putting on yourself. Watch out for another type of self-labelling, too. If you think of yourself as a '-phobic', worrier or 'neurotic', you set yourself up to feel and behave accordingly. Instead of saying, 'I fear being in public places, doing something stupid and being put down by other people', you say, 'I am an agoraphobic.' This diverts attention from working on the problem itself (the disruptive avoidance behaviour) to rating the person. Understanding the fear of your own feelings Often both types of fear overlap. You may, for example, fear the discomfort involved in going to the dentist, but also worry about looking a coward in front of others at the surgery and putting yourself down for this. In addition, as we have seen, both types represent a fear of our own feelings. We are not afraid of such and such happening: what we are afraid of is how we will feel if it happens. How do we become afraid of our own feelings? Self-rating seems to come naturally. Learning adds to it. We soon pick up, for example, the fear of guilt - supposedly as a way of keeping ourselves under control. Humans also have an innate desire to predict what goes on around them. We want to control our environment to get more of what we want and less of what we don't want. Social and technological advances fuel this tendency. We enjoy increasing standards of living, and medical science becomes progressively more able to help people avoid physical and emotional pain. As a result, we have come to expect to feel good all the time. Emotional comfort no longer seems just desirable: in our minds it has become a 'must'. Specific episodes of irrational fear can be triggered by misinterpreting events and circumstances. Distortions of reality like the following are commonly involved in anxiety: 'Everything's going wrong', 'There's no hope.' (overgeneralising) 'I'll never be able to cope', 'Things are going to get worse', 'I'll faint, and people will think...' (fortune-telling) 'It scares me', 'She gets me upset when she stays out so late', 'If I'm worrying there must be a good reason.' (emotional reasoning) One common distortion involved in irrational fear is the idea that if you worry about something you can stop it happening. The converse of this is that if you don't worry, bad things will creep up on you. This belief is one of the reasons many people find worrying difficult to give up - the thought of doing so induces anxiety! When you are in a state of fear, ask yourself, 'What am I imagining might happen?' Look for a 'chain' of thoughts like, 'She's late home... She's had an accident... She could be dead or maimed for life... I could never cope with this... I'll be unhappy for the rest of my life... and so on. Fearful ideas often run in sequences like this, with one thought leading to another (usually more extreme) thought. Be honest. Uncover those distortions - even though you are tempted to deny them when you realise how exaggerated they are. Identifying your fears Sometimes you may be anxious but find it hard to identify what you are thinking. Here are some strategies to use: ·Try getting into the situation you are afraid of This will help you become aware of the thoughts involved. You can sometimes get a similar effect by using your imagination: see yourself in your mind's eye, as vividly as possible, going to the place or event you fear or doing the thing you have been avoiding. · Look for the consequences. Keep in mind that when you are afraid of an event, what you are really concerned about is what will happen and how you will feel if it occurs. A dread of heart attacks, for example, represents a fear of discomfort (pain, suffering, restricted lifestyle and possibly death). If you fear going to the supermarket, the real alarm is probably that you will collapse and need help, and that other people will think you are a mental case. Make a point therefore, of asking yourself, 'what do I fear will result if such and such happens?' Look for the fear of discomfort and the fear of self-devaluation. Be as specific as possible, and don't forget, as we have seen, that worrying thoughts often run in chains. · Look for the meanings. Remember: misinterpreting what is happening will not by itself make you anxious. It is the irrational ratings that do the damage - those catastrophisings, demands and self-ratings - so make sure that you go beyond your surface interpretations (e.g. 'People will think I'm a mental case') to these underlying meanings ('I'll feel awful', 'It would prove I'm a hopeless case', 'This would be dreadful', 'It must not happen to me', 'I couldn't stand it', and the like). From fear to rational concern How do you overcome the fear of your own feelings - and, in turn, the fear of specific events and circumstances? Here are four self-treatment aims which will help you get there: 1. Learn to accept discomfort as unpleasant rather than awful and unbearable. 2. Learn to accept yourself regardless of your performance or how others view you or treat you. 3. Work on the things you fear -by confronting rather than avoiding them. 4. Adopt the principle of 'rational concern' in your approach to life and its hassles. Fear and discomfort are a normal part of life. They are only irrational when they disable you, which is more likely to happen when you tell yourself you cannot stand them. Of course you don't like discomfort -who does? But thinking that you must avoid it at all costs will itself make you uncomfortable! Give up the idea that you should be able to feel good all the time. Learn to tolerate unpleasant feelings. Find out how to change them but without demanding you avoid them entirely. When you are confident that you can handle bad feelings and know that you can stand them, they will bother you less in the first place! Value security, for instance, but accept you can survive when the unexpected occurs. Try hard to get the things you want, but don't tell yourself that you need and must have them. Try to do well at whatever you set your hand to, but without demanding that you always succeed. See failure or disapproval as facts of life you can live with. Ask, 'Why is such and such terrible, rather than unpleasant?', 'What makes this a disaster, rather than a disappointment?', 'Would it be so awful if...?' Don't pretend that everything is wonderful. Acknowledge that some things are unpleasant, uncomfortable and inconvenient -just don't make them into anything more. If you are afraid of specific things, such as giving talks, speaking to strangers, sitting exams or flying, try the 'blow-up' technique. Exaggerate your fear out of all proportion, to the point where you cannot help being amused by it. Laughing at your fears is a good way to control them. This worked for Rick. He worried about making a fool of himself in front of the selection panel for a job he wanted, so he imagined being late for the interview, rushing into the room, tripping and falling flat on his face, standing up to discover his belt had broken and his trousers fallen down, being arrested for indecent exposure, and having his name on the front page of every newspaper in the country. Going to the interview with this absurd scenario in his mind helped counter his anxiety. Observe that while you dislike them, you do stand unpleasant events and feelings. Witness the fact that you are still alive to tell the tale! Note, too, that if you learn to live with something rather than try to avoid it, most often it will bother you less. If you have suffered a loss you think you cannot survive, try using 'time projection' (see Chapter 12) to get the future into perspective. If there is something specific you are afraid of, a useful technique is to do a full analysis, then imagine yourself facing the thing you fear Be aware of the feelings and irrational beliefs involved. See yourself replacing them with more rational thoughts, experiencing the more helpful emotions which follow, and acting more in the way you would like. Audrey found this helpful. Her job as a consultant advising on business restructuring involved some public speaking, which she had always found hard. She did a self-analysis and devised some good disputes to her main irrational belief (that she must never make mistakes and be seen as incompetent). She then imagined speaking to a large group of people, standing in front of them, thinking her fear-inducing thoughts, disputing these using the new rational ones she had devised earlier and handling her talk in a calm and competent manner After practising this daily for several weeks, she became less fearful. As you challenge exaggerated thinking don't fall into the trap of so-called 'positive thinking'. Telling your self that everything is all right won't work for long. In the real world there are negatives and bad things do happen, so acknowledge unpleasant realities - just keep them in perspective. Keep yourself in perspective, too. As long as you believe that you have to be a 'worthwhile' person, you will be at risk of worrying about the chance of something happening which might lead you to think that you aren't one. Unless you are an unusual human being who can somehow succeed at everything you try and constantly meet your own and others' expectations, sooner or later you will fail at something or someone will disapprove of you. What is the best way to deal with this fear of self-devaluation? Give up the idea that you have to be worthwhile! If you have already studied Chapter 7, this won't sound such a strange idea. Remember, also, to dispute any self-rating that perpetuates fearfulness: learn to see yourself not as 'a worrier', but rather as a person who sometimes worries (and who is going to learn how to worry less in the future). Although your interpretations won't be the main cause of your anxious episodes (your ratings will be), it is still worth checking them out. Query your beliefs about what is happening. How much, in reality, is going wrong for you? What is the worst that could happen? What evidence is there for believing this? How likely is it? A good way to get things into perspective is to rate the chances on a scale of 0 to 100 per cent. The 'So what if' technique can also be useful. Write down your worry, using the words, 'What if I make the wrong decision/am criticised/don't get a pay rise?' Then change the 'What if' to 'So what if' and answer the question. Helen did this. At first she was relieved when her unhappy marriage of twenty-four years ended, but then began to worry about coping: 'What if I can't handle a cheque book? What if I feel lonely at nights? What if men start wanting to get involved? What if the car needs repairing?' She then asked herself, 'So what if I can't handle a cheque book? The worst that could happen is that I face the inconvenience of paying cash, or maybe getting someone to show me how.' It may be useful at times to remind yourself that worrying isn't worth it. If you are reluctant to give up your worry habit because you think that it somehow helps you, run through the disadvantages involved: 1. Fear will limit your lifestyle if you make a habit of avoiding anything which might lead to anxiety. Furthermore, if you worry about your own performance, you increase the chance of failure! Anxiety can disrupt many activities: sex, examinations, acting, to name but a few. Forty-three per cent of New Zealanders restrict their lives out of fear of becoming a crime victim: over one third of this group say fear restricts their activities a lot. 2. Worrying about a problem also blocks you from solving it. Instead of doing something you just keep stewing. 3. Fear may lead you to avoid important realities. Getting early medical or dental treatment can save you pain, whereas leaving it may cost you. It might be comfortable now to put off the pain of changing your diet and exercising, but it won't be comfortable in the long run. 4. Consider what anxiety and tension do to your body. They can cause stomach ulcers, heart problems, breathing difficulties, high blood pressure, loss of energy and other physical problems. Worrying can keep you awake at night -it drains emotional energy. Your fear won't do anything to make tomorrow better but it may disable you today. This is one of the main drawbacks of worrying about the future: it disturbs you in the present, whether or not the things you fear ever come to pass! Is it possible, though, to stop worrying without putting your head in the sand when it comes to life's realities? Yes: by developing the attitude of being concerned rather than afraid. Ignoring real problems is not a wise idea, but neither is fretting over something while doing nothing about it. Rational concern gets around both situations. It means facing life's troubles directly, but without adding bad feelings. Instead of worrying about a problem, you take three practical steps: First - check out how real the problem is; Second - dispute any irrational ratings about it; third - choose a solution and get into action. Getting into action This brings us to the final step. Here are some suggestions for combining rethinking with action, a powerful way to break the anxiety habit. 1. If you can, do something about it. Is there any way to reduce the chance of the thing you fear happening? If not, accept this reality and adjust to it. If there is, stop stewing and do it. Check, for example, that you are using your finances sensibly. Get budgeting advice if you are unsure. Enrol in a pension plan to protect your financial position in the future. To be sure, these things are more important than ever in New Zealand with changes in our economy and the benefit system; but after you have done what you can to prepare, get on with life now. Teach your children to recognise and avoid real dangers or foolish risks; but as they get older, don't overprotect them from life's important lessons, or - worse still - try to restrict and control their lives to make yourself feel more secure. When they are adults, put them out into the world to get on with their lives. Apart from being ready to help (when they ask for it), get on with your own life - whether or not they are making the most of theirs. Prepare for the future as far as you can. Take care of your body now to reduce the chance of disability later. Plan financially for retirement. Change any tendencies to get depressed or anxious which might get worse as you grow olden But remember that worrying won't stop you from growing old, so learn to live now. If you don't enjoy your present moments at this stage in your life, you are not likely to learn how when you are older. 2. Dealing with difficult problems. If you are faced with a problem to which you cannot see any solution, use a step-by-step method like the one described in Chapter 18. Another strategy is to take a break. When you leave a problem for a while, the subconscious mind will often work on it and come up with solutions. Sleep on it; or leave it for an hour, a day, or for as long as you find helpful. Consider using outside help. Talk things over with someone who can listen without always giving advice. Using another person as a sounding board can help you explore new ways of solving problems. 3. Look after yourself physically. Tiredness can make you scratchy, irritable and likely to misinterpret things that happen. Keep yourself physically fit to help maintain a good energy level. Get the sleep you need. Watch your diet: are you consuming a lot of foods and drinks that boost your energy level then leave you flat? 4. Learn to relax. If tension is a problem, consider doing a training course on deep-muscle relaxation. You can obtain tapes, although sometimes it's better to have a therapist tailor a programme for you. Choose a method that will train you to relax in the actual situations where you tend to feel uptight, e.g. when the pressure is on at work or the children want your attention. This will be more useful than one which requires you to go and lie down for half and hour and listen to a tape every time you feel uptight. Identify the things you find most relaxing, such as going for a walk, reading a novel or watching TV. Do them regularly. Haven't got time to relax? Recheck your priorities: whether we do it consciously or not, we all allocate our time to the things we believe are important. Keep in mind that anxiety uses up a lot of time and emotional energy anyway. 5. Learn to manage your time. Do you often find yourself overloaded with tasks? If so, learn how to set priorities and do the most important items first. Those left over will then be lower priority ones, so you will be less likely to worry about them. Remember, too, that urgent things aren't always the most important. Consider getting a good book on time management or doing a training course. Confront the things you have been avoiding One of the most effective ways to deal with fear is to get into the specific situations you are afraid of. If you fear being alone, for instance, organise a weekend by yourself. If you are worried about how you look in a bathing suit, buy one and wear it at the beach. If you are afraid of getting into lifts, go and stand in one and deal with the thoughts that come up. If you avoid talking to people at parties, go to more parties and talk to more people. To tackle the fear of failing, take on a new challenge. If you fear losing control in public, go into public places. If you feel used, but worry the other person might stop liking you if you say anything, take a risk and assert yourself. Face the fear of rejection by approaching someone and asking for a date. Do it now. Make the appointment with your doctor or dentist, sign up for that exercise programme, give up smoking - or whatever it is you have been putting off. This direct approach is useful in many ways. It will help you identify the irrational thoughts which make you anxious and dispute them 'on the spot'. You will realise that the event is not as bad as you had feared and that you can face it and survive. You will learn techniques which will help you cope with anxiety in the future. Most importantly, you will discover that if you cannot control the circumstance itself, you can still control your reaction to it. Start by making a list of feared situations. Decide which to work on first. Be sensible about what you do - don't take foolish risks. (Make sure, though, that you aren't exaggerating the risk as an excuse to keep avoiding it.) Next, carry out a self-analysis. This will prepare you, by reducing your anxiety and giving you new, rational beliefs to use when you are in the situation. When writing down your beliefs, use 'What if' questions to identify the worst possible outcomes you can foresee and how you would deal with them. For example, 'What if I enter the situation? What will happen, what will I feel, and what will be the result?' when disputing your beliefs, estimate the chance that what you fear will happen. Get rid of any ideas that you must cope perfectly, avoid looking foolish or hide your anxiety. Remind yourself, too, that you are not afraid of the situation itself, rather of the anxiety you think Will result. Note some facts about anxiety: (a) it won't kill you (even though it sometimes feels that way!), ~) it is uncomfortable rather than awful (c) you can stand it even though you dislike it, and (d) you will do better to accept anxiety than to fight it. In addition, don't tell yourself that you have to do these things -demanding will only make you more anxious. Keep in mind, though, that people can do things they don't feel like doing. Now get into the situation. If possible, remain until your anxiety diminishes (the longer you stay, the more likely you are to change irrational beliefs and reduce your fear). Focus on what you need to do to cope rather than on what you feel. Recall the rational beliefs you worked out earlier in your self-analysis. If you wish, take someone along with you (although only at first). Afterwards, do another self-analysis to deal with any new irrational beliefs you uncovered while in the situation. Compare what you expected to feel with how it actually felt. Then plan your next assignment. From worry to rational concern Here is a collection of typical anxiety-causing beliefs and some rational alternatives: Worry Beliefs converted into a more livable rational alternative - Concern Beliefs If I worry about things that might be dangerous, unpleasant or frightening, I can stop them happening. Worrying about things that might go wrong won’t stop them happening, but it will upset me now! Better I do what I can about the future, then get on with living now There are certain things in life which I just can’t stand Certain things are uncomfortable or unpleasant, but it’s wrong to say that I ‘can’t stand’ them. If that were true, I wouldn’t be here to tell the tale! I need love and approval from people significant to me, and I must avoid disapproval at all costs. It’s good to get love and approval, but I can survive when they don’t come. And although I don’t like it, I can stand the discomfort of disapproval. To feel worthwhile, I must do well at everything I try and avoid making mistakes. It’s unrealistic to demand unfailing success and competence. It will only make me down myself, feel anxious and paralysed, and avoid doing anything. Better I just accept myself as a person and stop connecting ‘self-worth’ with performance. My circumstances have to be right for life to be tolerable. It’s disappointing when things aren’t the way I’d like them to be, but it’s not awful – and I can stand less than the ideal. I should worry when other people have problems or feel unhappy. I can’t change other people’s problems and bad feelings by getting myself upset. Because I can’t stand discomfort and pain, I must avoid them at all costs. Total avoidance would mean a very restricted life. Though I don’t like discomfort and pain, I can tolerate them. Every problem has an ideal solution, and I should not relax until I find it. Problems usually have many possible solutions. It’s most functional to select the best available and to get on with it. Learn to live in the here and now Worry about the future can disable you in the present. Why not turn this tendency on it's head? Rather than dwelling on what might or might not happen, practise being aware of what is around you. Savour the things which are pleasant to observe, touch, smell, listen to and taste. There was a time when I would rush to work in the morning, thinking and worrying about the day ahead. Now I enjoy my walk through an old reserve. I make a point of seeing the beauty around me, observing the trees, birds, and the way the sun rests on the bushes. This sets the tone for the whole day. Putting from my mind all thought of what is ahead helps me cope better with it. I am not suggesting you ignore the future, or what has gone before. If you want to stay happy through the years ahead, it is important to prepare now. It is also wise to keep in mind what you have learned in the past. But, having done that, make sure you live in the present -today.