Chances are some have had a smoke alarm that is too sensitive. Every time you take a hot shower, boil some water or toast some bread the thing goes off as if there was a pending three alarm fire. Some are tempted to remove the battery, and then forget to put it back while others to get rid of the thing all together. Of course most know instinctively this isn’t the route to take. The alarm is there for our protection and we want it there in case a fire and the threat to our life.
Persons who experience excessive anxiety can consider the above analogy. We have biological systems that intricately prepare us to react in the face of danger. However, sometimes those systems get over reactive in response to our internal thoughts, repeated stressors or some traumas experienced in the past.
There are a number of ways anxiety can become a problem. Specific phobias or fears about certain situations, ongoing levels of anxiety and worry that last for an extended period of time, or sudden onset of fear and panic arising out of the blue with no clear reason for the reaction. And panic attacks sometimes lead to secondary fears and avoidance of going to public places that in reality pose no threat.
Some of the more common anxiety related complaints I hear in my office are awakening at night with racing thoughts and feelings of impending doom and worry. Others report intense states of tenseness and nervousness all the time. Often they have forgotten what it feels like to be in a calm and relaxed state, experiencing much of their life obsessing about the past or worrying about the future.
Physically, a nervous and hormonal system on high alert most of the time can translate to medical problems. Chronic anxiety can lead to elevated levels of cortisol which is associated with weight gain, high blood pressure, inflammation, heart disease and other ailments. It can also effect cognitive functioning making it difficult to concentrate and organize thoughts. Resulting ongoing fatigue and stress sometimes can lead to depression and other mental health problems.
A competent therapist will review the person’s history and rule out medical or conditions that may contribute to anxiety. For example a mismanaged thyroid condition may lead to anxiety like symptoms. Anyone suffering from excessive anxiety should inform their primary care physician.
Fortunately treatments for excessive anxiety can be very effective. Sometimes when anxiety is related to coexisting mental health problems the treatment may take some time. But often a person can see results fairly quickly. Especially when the treatment involves learning skills to self soothe and regulate the physical symptoms of anxiety.
Clinical hypnosis is one tool this therapist uses to help the client elicit a state of relaxation. This approach treats anxiety at the source, tapping into those same biological systems that moderate the anxiety response. A person learns hypnosis in the session and sometimes is provided with a CD to use at home.
Once a client has learned to calm their nervous system post hypnotic suggestions can be given to recall that state when they need to. Sometimes this is done with a physical cue such as taking a relaxing breath, or perhaps pressing a forefinger and thumb together. Often this cue can be a behavior the person is already familiar with or using. Often the hypnosis session involves using imagery to regulate anxiety. Think about becoming engrossed in a book or film. Often we drift into a hypnosis type state that can be very relaxing. We are engaging the imagination and gift for imagery, using those parts of the brain that naturally soothe and relax the body. Likewise we can use the imagination while in hypnosis to lower the overall state of arousal and to moderate levels of anxiety in session. After all it is the imagination that elicits or exacerbates anxiety states. By imagining what may go wrong in the future, replaying old scenes in our minds and expecting the worse we are using the imagination in a counterproductive way. And with this realization comes the knowledge that if we can use our mind to cause anxiety, then we can use it to alleviate it. Another tool is to become aware of and use the breath as a bridge to a calm and relaxed state.
While inducing hypnosis a client can use the breath to achieve focus and to elicit a relaxation response. It is a tool that can be very therapeutic as the breath typically mirrors our body and mind states. For instance a client who is tense or anxious may notice the breath feels constricted, becomes rapid and irregular, and rises mostly from the top of the chest. A person who is chronically anxious may breathe this way all the time unconsciously contributing to the state. Infants and young children naturally breathe from the abdomen and chest in a wave like fashion. Over time some begin to breathe paradoxically compressing the abdomen during the inhale. Re-learning abdominal breathing so it happens automatically can be very effective in reducing chronic anxiety and stress. To relearn abdominal breathing simply lie on the back and stabilize the chest area. Fold your hands on your abdomen and noticed the hands moving up with each inhale and settling with the exhale. If this doesn’t happen naturally consciously raise the hands using the abdomen with each inhale and settle them with the exhale. When practiced regularly your body will easily remember the natural breath serving to reduce chronic stress and anxiety in the body.
When a client is dealing with anxiety and fear around certain situations, we can desensitize the nervous system to the situation that triggers the anxiety. This can be done by imagining the situation in a state of hypnosis and pairing it with the relaxed state. Using imagery the client rehearses new ways to react to the situation strengthening the new response and weakening the old. Sometimes people develop secondary fears or “anxiety about anxiety.” In a seemingly paradoxical way a therapist will use hypnosis to help a person safely tune in to physical sensations related to anxiety; perhaps a racing heartbeat, shortness of breath or a sinking feeling in the stomach. Gradually the client learns to adjust and decrease those feelings while increasing feelings of empowerment and control. Another treatment used is Cognitive Behavioral Therapy. The therapist teaches the client to alter their reactions by becoming aware of and challenging any self defeating or irrational thought patterns and beliefs.
A therapist helps a person to “reframe” or adjust beliefs and perceptions that may be triggering anxiety. Learning to challenge the beliefs they begin to alter the reaction. One reframe anyone of us can use when met with an anxiety provoking situation is “we have all managed anxiety before and can do so again.” Often the physical experience of anxiety can be synonymous with feelings of expectation and excitement, positive states that give us an edge when we try new experiences, learn new skills and take some necessary risks. Some of the activities that we enjoy presently were at first anxiety provoking. Experiences such as driving a car, riding a bike, going on a first date, or the first day on a new job are anxiety provoking. By meeting the challenges despite feelings of anxiety we’ve already practiced regulating those protective systems in a positive way. This realization can be empowering and cause a shift in perspective, making the client aware that, yes, I have managed my anxiety in the past and have the inner resources to do so again. Our intuitive and protective selves have systems in place that alert us when we need to be vigilant and to react when we need to protect ourselves. Sometimes these systems become over-reactive and over sensitized to react in self defeating ways.
For an individual struggling with excessive anxiety and fear psychotherapy using clinical hypnosis and other approaches can get the client back in control of their reactions. Ideally a person will honor the protective quality of those systems, recognizing their value while learning to self sooth and regulate them effectively. Like the smoke detector we want keep those systems in place and even develop a sense of gratitude for them.
John Mondello is a psychotherapist and licensed health care professional who specializes in using hypnosis as a therapeutic tool. He can be reached at (845) 752-3377 or firstname.lastname@example.org. For information on a free coping with anxiety workshop check out his website at www.counselingforanxiety.com