Overcoming Anxiety
11 July, 2013 Leave a Comment
Exposure: When it Does and Doesn’t Work
Many schools of therapy involve some kind of exposure to anxiety provoking situations in the interest of practicing strategies to feel more comfortable with these situations. For instance, if you have a fear of flying and you always avoid airplanes, you won’t have an opportunity to overcome this fear.
That being said, there are people who are confronted by their fears all the time and who report a steady increase of anxiety related to these fears over time. They’ve been exposed to plenty of anxiety provoking situations, but they haven’t gotten any more comfortable with the situations or with the anxiety within them. Why is that?
It doesn’t do any good to have a negative, horrible experience with something you already consider to be negative and horrible. For instance, what if a peer had pushed me off the high dive and I had fallen and injured myself? I can only imagine my anxiety would be higher the next time I found myself high off the ground, despite the exposure to this type of experience. I would also likely find myself avoiding the high dive and perhaps even develop a fear of heights.
What helps is exposure to potentially anxiety-provoking situations while also having some kind of a positive experience with them. In my case with the high dive, my fear only served to make the experience more thrilling and fun, leading not to avoidance, but to a desire to repeat the experience. Over time, even some very anxiety-provoking situations can be transformed into powerfully meaningful experiences.
Fear or Avoidance of Anxiety = More Anxiety
It’s one things to say that you’d like to have a more positive experience in situations that cause anxiety for you, it’s another thing to do it. Most people who come to therapy have had anxiety for awhile and have already tried many things to stop being anxious. Furthermore, most people who come to therapy with anxiety come to get rid of it or to at least substantially reduce it. Ironically, the more one attempts to avoid the experience of anxiety, the greater it often seems to grow. People trying to avoid anxiety fear that they will fail or that their anxiety will come back, which then causes more (not less) anxiety. It reminds me of one of those “Chinese Finger Traps” where the harder you try to pull your fingers out, the more they are trapped.
It’s difficult to get out of this vicious cycle but one method involves not trying to reduce anxiety, but trying to change one’s relationship to anxiety. What would this entail? It’s different for everyone and depends on your experience of anxiety, the situations that make it better and make it worse. One place to start is to build awareness for the different aspects of your experience of anxiety. Start becoming aware of the different physical sensations, thoughts, images, emotions that are a part of it, but try to do this without getting overwhelmed by, or totally sucked into the experience.
From there, you can explore which sensations are ok with you and which aren’t. A lot of people start out feeling that any part of anxiety is unacceptable and horrible, but after breaking down their experience find that certain parts are ok. For example, people have told me that breathing hard is ok after running, but not ok during a panic attack. In that case, even though panic attacks might feel unacceptable, breathing hard actually feels ok. This kind of exploration can start opening up your experience more and start changing your relationship to anxiety.
Therapists practicing ACT therapy (Acceptance and Commitment Therapy) have an extensive toolbox for helping people develop this kind of awareness and to begin changing their relationship to their anxiety. I highly recommend working with a therapist who practices this approach (wink). If therapy isn’t feasible at this time, I recommend working with a workbook that describes some of these techniques. My favorite is, “Get Out of Your Mind and Into Your Life”, by Stephen Hayes and Spencer Smith. (http://www.powells.com/biblio/9781572244252). That being said, applying these techniques is not a simple cut and dry “cure” and it can be very helpful to have an ally to support you through obstacles and confusion that can arise.