Anxiety is a common and debilitating condition. A doctor acquaintance recently told me that one in three patient appointments in his surgery were anxiety related. This is staggering when you think this includes all consultations.
Anxiety is a normal consequence of overwhelming stress and fear of the future. You could think of it as a design feature intended to make us take precautions or actions to prevent danger. If you were holding the hand of a toddler, or the lead of your excitable dog, by a busy road, it would be quite natural for to feel anxious about avoiding tragic outcomes. This then prompts us to take action that avoids danger.
Humans, like all other animals, have a system for detecting threatening situations. A part of our brains known as the amygdala responds to dangerous situations, such as being chased by a predator, by sounding an alarm in the body providing the stress response – also known as fight-or-flight. The body is flooded with adrenaline and cortisol which raise the heartbeat, increase blood supply to the muscles and away from non-urgent processes such as digestion. We are readied for action in a flash of a moment at light speed. It is a wonderful tool for self-preservation.
Nowadays of course, not many of us are in physical danger very much, if at all. The protection system, lying dormant, is used for other apparent threats. If we lose a job, get a worrying phone call from our child’s school, receive a dressing down from the boss, spill coffee on our laptop, the amygdala interprets this as a significant danger and so kicks off the stress response. This means that an exceptional process, used for genuinely threatening situations, becomes our default state.
The opposite of the fight-or-flight, otherwise known as the Sympathetic nervous system response, is sometimes known as rest-and-digest (the Parasympathetic). These terms might seem odd, but if you think of their origins – ‘sympathetic ‘ comes from the Greek, syn – meaning ‘with’ and pathos – meaning ‘emotion’- then this makes sense. When the nervous system is in this mode, we are certainly more emotional than rational or logical. The Parasympathetic is the opposite state, when we let go of needing rapid life-saving action and can rest, relax and heal. If the balance of our lives leans towards the sympathetic fight-or-flight, then our nerves become frayed, leading to more anxiety.
Anxiety is a double-edged sword. It can keep us safe because of self-preservation leaning, but it can also prevent us from enjoying life to the full. The issue comes when we start to overuse this state of being. It becomes a habit and a crutch to lean on. It can even become a friend.
I know that sounds strange, but anxiety comes in many forms. Generalised anxiety disorder is the persistent worrying about everyday things. It can be accompanied by exhaustion and physical symptoms such as muscle tension, as the body is almost permanently in a mode where it is preparing to fight. Anxiety also causes panic attacks, a deeply upsetting state caused by an exaggerated fight-or-flight response, triggering extreme physical reactions such as high heart rate and shallow breathing. Agoraphobia is a disorder where anxiousness leads the sufferer to be afraid of being in situations from which they cannot escape - such as on public transport or being in open spaces such as marketplaces. The answer is usually to avoid these scenarios, so the person stays at home in a state of avoidance – avoiding life itself. In social anxiety, we would prefer not to be meeting new people or going to parties for fear we will embarrass ourselves.
All of these situations mean that we will do our best to avoid potentially triggering situations. It means we also avoid living life, missing out on a lot of the best parts of it. I heard a top-class medical doctor and hypnotherapist, Dr Brian Roet, describe it like this. A medieval knight might have worn a suit of armour which protected them, but they would have been hardly able to move. And so it is with the mind. Our anxiety is trying to protect us, getting us stuck in a misguided pattern of behaviour which will keep us safe, even though we rarely feel that we are. It leads us into negative thought patterns which creep into other areas of our lives and erodes self-esteem and confidence. We start to believe in only the negative aspects of our personalities, exaggerating them, and adopting a narrative which is quite frankly, dare I say it, Fake News! We end up being imprisoned by it, unable to move.
When people come to me as a hypnotherapist and mindfulness coach, they often have problems which have manifested as a result of anxiety, directly or indirectly. What I mean by that is that the problem may clearly be anxiety-related such as a phobia of needle injections, or anxiety may be preventing recovery from some other condition. I have had older clients come to me because they can’t seem to recover their confidence after a fall, and their legs may not feel as strong as they have once been. Sometimes these conditions are purely physical, such as weakened muscles, or a neurological condition, where the nervous system is compromised, which leads to abnormalities in the brain and body. The nervous system is also either a friend or a foe when it comes to healing in the body, and anxiety will hinder this process as it places the nervous system in a place where it is facilitating fight-or-flight, rather than rest-and-digest – the opposite sides of the same coin.
Clearly, not being a physician, I can’t help someone who is struggling physically with their legs which appear to be weakening, but I can offer support in managing the anxiety and fears which surround these problems. I also help them make progress in their physical goals of walking longer distances, for example, by teaching them self-hypnosis and meditation, which relax the nervous system and allow for confidence building rather than internal fearmongering. The mind can be a useful ally when we think of where we want to go, and a dreadful hinderance when we think of the opposite.
I had a client who came to me with a problem exactly like this. She is over 70 years old and has been active all of her adult life. You can see the years of healthy living in her face and eyes. In the last year, however, she has had a couple of falls which appeared to come out of the blue, and these have really affected her confidence. Nobody seemed to know why this was happening, and at the time of writing this blog, the cause is still not really understood, despite months of consultations and tests. This has led her to having high levels of anxiety, which is why she came to see me. She naturally was worried about falling over unexpectedly whenever she went out, which then led her to fear of going out at all – avoidant behaviour which then compounds the fear.
What was really getting to her, however, was that this anxiety had spread to other areas of her life. She was getting irritable and indecisive, worrying about taking journeys in the car, even to places only a few miles away. She didn’t find pleasure in her other hobbies, ones that didn’t even require walking or a lot of physical energy. Her whole life had been affected. If only I could help her manage the anxiety, then that would give her a much better chance of living a normal life and recovering well enough physically to start becoming more active again. And if there really was something wrong with her legs and she had to accept this as the inevitable ageing process, then at least she could learn to live with it, compensating with other joys in life - basically, by being at peace with herself.
Anxiety is experienced in so many different ways by people that when I first started treating them, I tended to follow the paths of their stories and find myself meandering around looking for the nugget of truth which would eventually come out that would also indicate the magic solution to their problems.
I have learned two main lessons from these early encounters. The first is that magic solutions are rarely found, and that often the client will eventually become equipped with tools which help them come to terms with their anxiety and live alongside it. This may sound disappointing but if you had a phobia of spiders and were able to overcome it by just accepting that they lived near you, but did not mean you any harm, then that would be fine, wouldn’t it? Wouldn’t you prefer to be able to co-exist with them rather than run screaming from the room? The hypnotherapist can teach the client how to respond in such situations, interrupting old patterns and installing new ones.
That is not to say that anxiety cannot be overcome. It depends on the cause as well as the treatment and the true desire of the client to overcome it. Is it down to one traumatic event or is it a consequence of a constant grinding of the nervous system? It could be a memory or experience buried deep in the subconscious, that once identified, can be released leaving the individual free and unburdened. This doesn’t always happen, so acceptance of anxiety, a befriending if you like, can be empowering and liberating. To reframe our thinking so that anxiety seems like a voice on your shoulder – or coming from your gut – is a paradigm shift which means that anxiety need not drain the life out of us but allows us to keep a useful side of our personality which may serve us if we can only learn to harness the power. If, for example, you are anxious about taking exams, you could reframe your thinking to know that this is a natural sign that your mind wants to protect you from failure and will make you focus better on your final preparations. Even just noticing your anxiety, where you feel it in the body, and then getting into the habit of saying something to yourself like, “I have noticed that I am feeling anxious. I wonder what that means.” will give you a sense of inquiry rather than the dread of worry and doom. Managing anxiety can almost be more powerful than removing it. If you can channel the feeling, you may end up with better exam results in this instance.
The second learning is to use a cast iron, easy to follow, logical process. Although anxiety comes in many forms, some being more visible outwardly than others, then nevertheless, generally the same pattern occurs.
There is always a cause or collection of them. It may be down to one event, or it may be multiple, compounding inputs. These causes have an effect, just as the sun going down causes the sky to go dark. A pattern develops, and once exposed, is generally quite predictable and needs to be interrupted. When I explain this to clients, I see their eyes light up in that way that suggests they have just got it. If anxiety follows a process or a pattern, however diverse the variables might be, then it makes sense to approach it with a reliable and structured method.
And this is what the 6-week anxiety program does. It’s six constituent parts follow a procedure of, first of all, setting a stable base for the nerves. Since anxiety sufferers spend a lot of time in the fight-or-flight mode, the mind needs to be trained first that we are not in as much danger as it too often predicts.
When these tools have been learned and practiced, then the client needs to rebuild their self-esteem, as anxiety has surely eroded it. Confidence building is huge part of hypnotherapy, and this is done early in the programme to build a foundation.
From here on, we look to release negative emotions, which, if not faced will linger and hinder the recovery. This is often the most impactful part of the programme as clients start to overcome the biggest hurdles, further increasing their confidence. Then we look at a better future, leaving behind the old habits and installing the new, based on a solid bedrock of positive tools and inner confidence.
What is most important of all though, is the willingness of the client to put the work in, to practice the self-hypnosis recordings in between sessions, and have the belief in themselves that they can overcome their fears. We measure anxiety levels week by week, and it is motivating for the client to see tangible improvement. This is part of the success too. When we see progress, we can start to believe in the process. Belief is paramount.
Here is what that lady said…
When I first met Alan, I was struggling with high levels of anxiety. Over the last few months, he has taught me to manage and control this problem through mindfulness and breathing techniques. I have learnt to be kind to myself, not push myself so hard, accept and adjust to change and reflect on progress over perfection. His meditation tapes are part of my daily coping strategy and after listening to his calming voice I always feel better. I can’t thank Alan enough for his patience and support.
If you feel you are struggling with anxiety don’t delay. There is help available, and this six-week programme has been shown to deliver results time and again.
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