Unfortunately, through everyday work, psychologists hear from the anxiety patients that they deem life not worthy of living if the symptoms will control their lives.
Why does anxiety make individuals so eager to get rid of it? Sufferers’ feelings of impending doom, fear, or terror are overwhelming—the same feelings that a human would have if the worst were to happen. Too frequently, these dreadful, nauseating feelings lead customers to seek immediate relief from medicine, which is easily accessible and considered the first line of therapy by many insurance companies. And what decent doctor would advise a patient to forego medication if symptomatic relief can be obtained quickly?
But what clients don’t realize once they begin taking medications is the hidden cost of depending exclusively on prescription drugs: they’ll never learn how to manage or eradicate their symptoms without them. They never learn how to manage their anxiety, which will most likely resurface anytime they experience excessive stress or major life changes. What patients should be informed is that the proper psychotherapy, which teaches people to manage their worry, may provide relief from anxiety in as little as a few weeks—roughly the same length of time that an SSRI takes to become effective.
Of course, therapists understand that treating symptoms isn’t the same as treating the underlying cause. Anxiety’s psychological origins or triggers, such as trauma, are not addressed by management methods; they need longer-term treatment. Anxiety-management methods, on the other hand, may provide relief quickly.
There are different methods applied by anxiety counseling Dubai, designed to address the unpleasant symptoms that are most likely to be improved by medicine. If the therapist understands which of these strategies work for which symptoms and how to apply them, a therapist equipped with ways for treating these clusters may give her worried patient the hope of healing for a lifetime.
1. Take Care of Your Body
It’s a common “prescription” to tell anxiety-prone clients to take care of their bodies by eating well, avoiding alcohol, tobacco, sweets, and caffeine, and exercising, but not doing so may impair the efficacy of other anti-anxiety methods. A patient, for example, had almost completely eradicated her anxiety over the summer before starting college by practicing deep, quiet breathing and learning to halt her catastrophic thinking. She’d even been able to wean herself off the anti-anxiety medicine she’d been using for years. Her panic episodes returned with a fury two months after she started college. She returned to see me but soon informed me that she would be calling her doctor for a new Xanax prescription. I recommended that she maintain a “panic profile”—a diary documenting when and under what conditions she had panic attacks—for a couple of weeks before making the contact.
She reappeared at my office a few weeks later, beaming. She grinned as she showed me her fear profile and said, “I worked it out.” She’d linked her panic attacks to days when she’d consumed a lot of alcohol and smoked cigarettes—neither of which she’d done during the summer at her parents’ home. Her coffee use had also increased significantly while she was in school, presumably to help her get up for classes after a night of partying, and her diet had degraded to pizza and doughnuts. She didn’t want to give up these routines, but maintaining a diary had reminded her that her anxiety symptoms are physical and that relaxing her body has previously defused her panic attacks. The patient got back on track without resorting to medications after taking extra precautions to avoid CATS (caffeine, alcohol, tobacco, sugar, and Nutrasweet). The basic guideline of body management must remain a top focus throughout anxiety therapy. When the patient stopped taking care of herself regularly, she suffered a severe relapse.
Therapists who remember that people have bodies, as well as brains, are more likely to ask about continuing self-care, such as sleep and exercise, regularly. They’re also more ready to assist customers in overcoming their aversion to self-care. Consider hormonal shifts if you have female customers who are seeing a recurrence of symptoms even though they are controlling their bodies. Anxiety may be exacerbated by pregnancy, postpartum changes, hysterectomy, and cycle disruptions. Another issue to consider is the gradual onset of menopause, which may occur at any age. Thyroid function changes may also lead to anxiety changes. They may affect people of any age, although they are more common in women. When a client who was previously doing well begins to have problems, therapists must be especially aware of what is going on in the body.
2. Mindful Awareness
The patient had started to worry that she would always be frightened since her panic episodes had returned. “I believed I was healed when I went back to school,” she said, “and now look at me!” I’m always concerned that I’ll have another panic attack.” She’d begun to assign fatal meanings to every little bodily feeling, thus generating fear out of insignificant changes in her physical condition. All it took was a little cold or a flutter in her tummy for her to start hyperventilating in dread of terror, which, of course, brought it on. She needed to stop thinking about the worst-case scenario and focus on anything other than her body.
She, like most nervous individuals who worry, was preoccupied with the future and not with the now. Her body felt in control of her, so she had to be on the alert for symptoms of fear. She’d never thought that regulating what she did or didn’t pay attention to might help her regulate her body and avoid fear. However, by shifting her attention, she may be able to reduce the chance of another panic attack. This basic “mindful awareness” exercise includes two simple stages that may be performed many times.
1. Clients shut their eyes and breathe deeply, observing their body, including how the air intake feels, how their heartbeats, and what feelings they experience in their stomach, among other things.
2. Clients deliberately transfer their focus away from their body to anything they can hear, smell, or feel via their skin while keeping their eyes closed.
Clients learn tangibly that they can influence what parts of their world—internal or external—they notice by shifting consciousness back and forth many times between what’s going on in their bodies and what’s going on around them. This provides them an internal center of control, demonstrating to them, as the patients discovered, that if they can disregard bodily feelings, they can cease forming the catastrophic interpretations that cause fear and anxiety. It’s a simple approach that helps people feel more in control while being aware of the current moment.
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3.Take a deep breath
The patient and I then went through how she used diaphragmatic breathing to calm herself down. She’d forgotten how beneficial breathing was when we first began working together and had stopped practicing it. Not only was she suffering from panic once again, but she also believed it was too strong to be alleviated simply by breathing deeply. She’d started to feel anxious simply thinking about feeling anxious.
When customers claim breathing exercise “doesn’t work,” it’s usually because they haven’t learned how to do it properly. Alternatively, they may have learned it and then abandoned it when they felt better, thinking that they no longer needed to perform it. They’re persuaded that anything so basic can’t possibly be helpful by the time their worry returns. As a result, therapists must highlight and re-emphasize that if the client just breathes, the stress reaction will be slowed or stopped.
The time it takes to practice breathing until it becomes a habit is the greatest roadblock to making it beneficial. Most relaxation books advise customers to practice breathing for 10 minutes once a day, but I’ve never met a client who learned how to do it from this one, daily dosage. I don’t teach people to breathe for long amounts of time unless they’ve done it many times a day for very short lengths of time.
Every time they find themselves waiting for something—the water to boil, the phone to ring, their doctor’s appointment, the line to move at the bank—I urge them to perform conscious, deep breathing for approximately one minute at a time, 10 to 15 times each day. This will help children connect breathing with all of their surroundings and activities in the long run. They’ll be more likely to remember to breathe when their anxiety levels rise this way. To get back on track, the patient required a refresher session in breathing.
4. Don’t Pay Attention When Worrying Calls
When the patient stated, “I’m afraid you’ll think I’m insane,” she was afraid I’d think she was crazy “It’s as if my anxiety has a personality of its own. ‘Worry now,’ it says, even when I have nothing on my mind. Then I have to figure out what’s wrong.” And she had a knack for finding something wrong to be concerned about.
She was a busy executive with a lot on her plate, and there was no lack of tasks that required her attention. She might be concerned about whether a report was right if anticipated numbers were accurate, or whether a contract would produce revenue for her company on any given day. She was expressing that visceral, pit-of-the-stomach feeling of dread that comes on for no apparent cause and then demands an explanation for why it’s there. Most GAD patients have a sense of dread and tension, which is a condition of low-grade fear, which may also produce physical symptoms such as headaches, TMJ discomfort, and ulcers.
Few people understand that fear is just the emotional expression of physical strain. By combining a choice to disregard the voice of concern with a signal for the relaxation state, the “Don’t Listen” technique reduces tension. GAD patients are taught progressive muscle relaxation early on in therapy to help them relax. I always teach them how to cue up relaxation throughout the day by taking a deep breath and recalling how they feel after the relaxation practice. To reinforce connections with muscular relaxation and make it simpler to cue the feeling at will, we typically associate that profoundly relaxed state with a color, picture, or phrase.
The capacity to relax is then used to combat the voice of concern. Clients must first understand that worrying is a behavior with a neurological basis. An anxiety-prone brain may generate a feeling of dread even when a person isn’t especially concerned about anything, leading to hypervigilance as the individual attempts to find out what’s wrong. While I told her that when she was in this condition, it was as if her brain had switched to radar mode, scanning her horizons for issues to fight against, she grinned. When I urged her to pay attention to the sequence of events, she immediately saw that the dread came before the anxiety. “However,” she said, “I always seem to discover something that might be the cause of doom, so I suppose I had a legitimate reason to be concerned without recognizing it.”
She assumed the sense of impending doom/dread had a genuine reason and was pleased to discover that her desire to identify the cause (when there wasn’t one) was due to a brain function. This cause-seeking portion of her brain, activated by dreadful alterations in her physiology, effectively screamed, “Worry now!”
“It’s simply my worried brain firing incorrectly,” I offered to her as a way to avoid listening to that order to worry. This would be the signal for her to start relaxing her breathing, which would cease the dreadful bodily feelings that set off the radar.
5: Anger, Knowing, and Not Showing
Anger may be so anxiety-inducing that a client may not even realize he is furious. Clients with GAD often have an undiagnosed fear of becoming angry. Bob was a good example of this. His grin was almost grimacing, and his headaches, tight facial muscles, and persistent TMJ issues all indicated he was biting back comments that might lead him into trouble. He felt burdened in many areas of his life, such as losing a promotion and his wife’s persistent inability to stay within their budget, but he thought he was “putting a nice face” on his difficulties. The acute anxiety was powerful enough to dominate the treatment time, as it had been with previous anxious clients, and it would have been easy to overlook the rage link. However, the worried client’s symptoms will persist as long as anger is not addressed.
When a client is afraid of anger because of a previous experience—for example, when she recalls a parent’s frightening fury or was harshly chastised for expressing any anger at all—the mere sensation of anger, even if it is unconscious, may create anxiety. The key to reducing this kind of anxiety is to reduce the client’s feeling of tension and stress while simultaneously increasing the client’s awareness of anger so that it may be addressed in treatment. Simply being able to experience and acknowledge anger in sessions, as well as begin working on how to properly express it, has helped me to feel less anxious. “To know you’re upset doesn’t mean you have to express it,” I remind clients.
The method is straightforward. I tell my clients that the next time they feel anxious, they should sit down and write down as many responses as they can to the question, “If I were furious, what would I be angry about?” Â I urge them to keep their responses to a few words or sentences. The hypothetical aspect of the inquiry is a crucial element, as it allows them to remain open to the possibility that they are furious. They may either trash the list or bring it in for debate, but I ask that they at least tell me how they felt while making it. This practice has consistently helped some of my anxious clients gain insight into the relationship between their anger and their anxiety, paving the way for deeper levels of psychotherapy to address long-standing anger problems.