About Anxiety

Why is the brain tour important?

When you experience a real threat to your safety – in specific cases such as in a car accident, or in general terms such as coping with long term raised stress, the ‘primitive’ part of the brain (brainstem) becomes active – triggering the fight/flight or freeze/flop response. This is why you might feel generally anxious, or have a specific anxiety – the brain has become stuck in a fear response. To overcome it you need to get the ‘higher brain functions’ working again. Understanding that you need to get the thinking part of the brain working again can help you to focus on how to do this.

The anxious brain - higher brain function impaired

Seeing red: when the emotional part of the brain rules and the logical side is shut down.

Window of tolerance:

Usually people have safe zones, places or environments where their anxiety is not as high as others. A window of tolerance is a way of thinking about what you can cope with before the anxiety becomes overwhelming. Within the window of tolerance life carries on relatively normally, but when you become hyper-aroused then your thoughts and feelings get overwhelmed – anxiety or panic sets in. If you become hypo-aroused then you do the opposite – you shut down, go numb, lose all energy, disconnect or become depressed. Trauma or long-term stress can cause your window of tolerance to become smaller, meaning that it is more likely that you will become hyper or hypo aroused – anxious or depressed. Increasing your window of tolerance will help you feel better, more often.

The answer to this is personal – if you ‘think about what you are thinking of’ then you can decide; the important thing is to understand that thoughts, feelings, behaviours and bodily responses can be linked together.

How does it work?

If you are anxious about doing something or going somewhere, consider what happens first – do you get to the door and then decide not to go further? Do you know what you feel or what you are thinking? If you think about how you feel (anxious) what are the thoughts that you associate with that feeling? This is really important; maybe write down your thoughts associated with the feelings and the thing that you were doing at the time, keep a record and see if a particular thought or thoughts are related to the anxiety. Once you have identified the thoughts then you can consider where that thought comes from, whether it is valid, you can challenge it, maybe you can think about what-if – what if you carry on out the door…?

What can therapy offer?

There are two aspects to consider in working with anxiety:

Working in the present context to manage and cope.
Looking at what is behind the anxiety – the deeper work to understand and reprocess our past experiences and memories.

There are many different, good and valid approaches to managing anxiety on a day to day basis, but remember that any ‘quick fix’ is unlikely to allow you to do the deeper work necessary to really reprocess those past experiences, working to leave your anxiety firmly in the past.

How I work with anxiety:

Everyone is unique and I will work with you to help you overcome your anxiety using an approach that fits where you are at. There are a number of coping methods that we can discuss and practice. When it comes to the deeper work of diffusing the anxiety I may incorporate in-vivo (gentle exposure) and visualisation techniques, as well as working together to process past events.

Past experiences shape who we are; we can’t change the past, but we can manage how it affects us in the future. There are many tools available to help us review and understand our past; I can walk with you on your journey to work on the present and to carefully, at your own speed, explore and perhaps find a new way of understanding past experiences so that your anxiety can be managed, reduced and perhaps even left in the past.

Get in touch:

If you are experiencing significant anxiety, phobias, or panic attacks then please do contact me to arrange an initial discussion about how I can help you and what approach we might use.

What is anxiety?

A feeling of unease, worry or nervousness. Anxiety can be normal – like before a test or a job interview.

When anxiety becomes a problem:

Problematic anxiety is a raised stress level that remains after a stressing event has passed. It can be associated with panic, phobias, post-traumatic stress, obsession - compulsion, or in a social anxiety context. Anxiety can be specific or it can be generalised; in specific cases, anxiety is triggered by something – you probably know if you have triggers – spiders, particular people, particular situations. In general cases you might be continually on edge, maybe unable to remember the last time you really relaxed. Social anxiety might leave you fearful of opening the front door to go out, worried about having to do the shopping, or scared about posting a letter.

A quick tour of the brain:

Let’s keep it really simple and think of the brain as having three parts – the Brainstem, the Limbic system and the Cortical area. These areas all work together, but have different functions:

Brain Stem – manages the autonomic nervous system – regulation of fight/flight, or Freeze/flop.
Limbic System – where emotions, meanings and arousal occur.
Cortical area – where ‘higher brain functions’ like reasoning, processing or perception happen.

This is a very simplistic overview and in practice there is lots of overlap of the functions.

Thinking about thinking…

What comes first – the thought, the feeling or the action?

Imagine a caveman about to be attacked by a sabre tooth tiger – he heard a rustle of leaves nearby and runs away (flight), now imagine a Jedi warrior coming across some storm troopers – she fights. Imagine an animal like a possum ‘playing dead’ to avoid being eaten – “playing possum” (flop). Or imagine the rabbit caught in the middle of the road in the car headlights – frozen, he doesn’t run off the road immediately (freeze).

What happens in each of these situations? Is there a thought, a feeling or just a behaviour? What order would the behaviour, feeling or thought occur in?

Small steps:

Don’t try to change the world in a single day – if you are anxious about social situations then work on it slowly; challenge your thoughts and make small steps – try going slightly to the edge of your comfort zone and experience the feeling. Be mindful of the feelings, accept them without judging, or deciding how to respond. It’s really important to try and notice and accept the feeling without responding. Next time, when you feel ready, go a little further to the edge of your comfort zone. Accept the feelings, notice the thoughts and challenge them – what is likely to happen? Why do you think that? Watch out for compensating or avoidant behaviour though - such as hiding under big coat with the hood up, or avoiding going to a particular place.

Overcoming anxiety is hard – it takes lots of effort and can raise hard feelings. Look after yourself. There are things that you can do to try and ease the process of overcoming anxiety – ‘grounding methods’ that help you keep safe, for example focussing on and controlling your breathing to lower your heart rate and get the ‘higher brain function’ going again. You can do these anywhere, it doesn't need to look weird.