Wednesday, January 29, 2014

Fight or Flight Response: The Paradox of Anxiety Recovery

Pic: pd breen
My feet tap insubstantial, fleeting, on the narrow city pavement. Past closed stores with quirky displays shrouded by dark; car park entrances emitting the endless chug and smell of vehicles; the plaques of narrow, pretentious galleries; and the sleek miniature lobbies of boutique hotels. The human scale of this laneway is comforting in the early evening but my aloneness beats furious in my chest.

I am small but carry with me a scrambling, sabotaging energy. It’s a boiling liquid that threatens to bubble and spill over the situation I’ve so meticulously set up – an online date.

It is this anticipatory anxiety that I remember so well from my dating days. Those walks to the groovy little cubbyhole city bars were far easier to endure than the nauseous, low-level misery of the tram or train ride into the city, as once on foot my adrenalin had a limited outlet in the forward momentum of my limbs. (Trains were worse for some reason, perhaps the larger scale of the stations compared with the more human streetscape of the tram.)

For years I would fight this anxiety, through breathing exercises and ‘self-talk’. We’ve all heard of the fight or flight syndrome. Once you’ve used your will to deny the urge to run, there seems no choice but to do battle with the remains of that urge, to use every tool at your disposal to calm yourself down.

But I slowly realised that trying to damp down my fear was just increasing it. Fear denied has a way of making itself known. Why not try to harness this energy instead of fighting it? Why not run into the situation instead of away from it?

This is hardly a new idea. Back in 1962, in the quaintly titled Self Help for Your Nerves, Dr Claire Weekes used the terms ‘floating’ and ‘masterly inactivity’ to describe her remedy for anxiety, explaining it this way:

it means to give up the struggle, to stop holding tensely onto yourself trying to control your fear, trying to ‘do something about it’ ... It means to by-pass the struggle, to go around, not over the mountain ...

More recently, experienced sufferers and therapists alike urge a general acceptance of the brute fact of anxiety before we can hope to lessen it. On the HealthyPlace.com site, Tanya Peterson writes:

When we fight against anxiety, we inadvertently promote the belief that we’ll feel better, be better, once we’ve conquered anxiety – but not before. This puts pressure on us, makes us feel worse about ourselves, and it serves to increase anxiety ... Accepting ourselves for who we are, anxiety (or other mental illness) and all, is crucial for well-being.

When we react to anxiety with further anxiety, a vicious cycle is created. If we can stay with the initial anxiety and accept it as part of the totality of experience, it becomes easier to manage.

Or does it? In fact, there’s a very big caveat to this. If the anxiety is so overwhelming that you can’t breathe, speak or walk, the idea of going with it in the way I’ve suggested above is a bit insulting. The anxiety needs to be brought down to a level where it is manageable first. And this is a gradual process, not something that can be done in a few minutes, hours or even days. It’s the stuff of daily work and practice, and often outside help in the form of therapy.

Reducing anxiety is a long-term task

Bringing the anxiety down to a manageable level could require anything from medication and a course of CBT to simple breathing exercises in front of the tele. Mindfulness in the form of meditation or mindfulness exercises is a great way of doing this, because it fosters the very acceptance that anxiety sufferers struggle with.  or And unless you’ve been floating around in orbit for the last twenty years, you’ll know that exercise can also be helpful.

For years I had a very bad problem talking with clients on the phone. It was so severe that the kinds of advice you get on the internet for treating panic attacks were laughably useless. The irrational terror was so extreme I wanted to scream. Anything I could do in the situation itself was impossible, because the raw, visceral fear that eventually even the sound of the phone ringing provoked was just too high. Sometimes the only sensible thing to do was not answer the phone at all.

In the end, drugs were the only thing that helped. They gradually gave me a level of confidence that has remained to some extent even though I’ve now stopped taking them. (Which is not to say it’s fun, or easy – it’s just do-able now, most of the time anyway.)

Some basic CBT has also helped. I understand better now how sensitised anxious people become to our reactions. We become hyperaware of every bodily reaction and thought, and frantically try to interpret them. We react as if every sign of anxiety is inherently dangerous. This happens so quickly at the neuronal level it’s impossible to stop, but just being aware of the process has helped me become a bit more detached.

There’s another reason why riding with the anxiety isn’t as easy as it sounds. Often part of the anxiety itself is a fear of what others think, and the imperative to hide our discomfort sometimes seems to be a matter of life and death. I get annoyed at how scared I still get, in social situations, of looking scared, and the high standard I demand for my level of confidence. But at least I don’t respond to these expectations like I used to – in the past, I would either put on a show of extroversion which was painfully transparent anyway, or withdraw further into myself, horrified, if I could not hide my fear.

All this is to say that the very basis of recovery for me is that it is always provisional, always incomplete. (I don’t want to suggest that I’ve conquered my anxiety – there are plenty of situations that I still avoid, although I have made progress.) Recovery involves a major contradiction – a fundamental acceptance of the impost of anxiety, and a willingness to harness its energy, along with a long-term plan for reducing it. Embracing this contradiction is a daily challenge.


4 comments:

  1. Hi Catherine,

    I thought I would share with you a technique I have been using in the past few weeks. I guess it's my version of 'defusing' from my anxiety-provoking thoughts, as per acceptance and commitment therapy. I imagine that the thought is being voiced by a muppet. It helps to externalise the thought and make it a bit comedic. It seems to be helping, particularly when I am lying in bed at night (a particularly intense time for me and my thoughts).

    As you say though, this is a long-term process, and there are many situations in which any effort to accept/minimise anxiety can further provoke it, in my experience. Painful, huh?

    For many years, I got panic attacks when shopping or on public transport. And, yes, these were driven, and fed, by the idea that someone might notice how uncomfortable I was feeling. I don't seem to get the panic attacks in these circumstances, these days (thank the holy goddesses!!!!). But, the fear of being seen to struggle largely remains. Why do I think that it is so not ok for someone to see me struggling (not that they necessarily ever do)? How did I come to embrace this idea so fully? To what degree does this idea underlie and feed my anxieties, more generally?

    When I sense that others are anxious, I feel great empathy. Perhaps, eventually, I'll learn how to channel the same empathy to myself. I imagine that this would do me some great deal of good ...

    I hope that the temps down there have settled. And, oh - I hope that you met an interesting and compassionate person on the evening you alluded to :)

    On with the show .... (man, didn't they used to say that on "The Muppet Show"??!!)

    Kate

    ReplyDelete
  2. Hi Kate,

    Love the idea of the muppet technique - it made me giggle - a great way to detach and lighten things up :)

    Fantastic that the panic has lessened, but I know there's always another hill to climb :) I agree about the judgemental aspect of anxiety. Can't help thinking that for me it had something to do with being brought up to be 'polite', or just modelling parents unconsciously - (l know I bag my parents all the time, and am trying to get out of this habit (!) but it wasn't intentional on their part.)

    Melbourne weather has calmed down a lot, with a run of temps that are more typical for summer, although tomorrow will be a scorcher!

    Don't start me on dating stories - they could keep me in blog entries for years to come:)

    Catherine

    ReplyDelete
  3. Yeah, Catherine - I can't help but look to the influence of my upbringing either. When I look back as an adult, I can see that I was never taught how to acknowledge and manage my insecurities in a particularly effective way.

    My parents were never taught how to do this themselves. They truly DID want me to feel ok, though. But, this is a huge skill (I suspect) that requires pretty constant tuition. And, yeah, I too suspect that consistent parental modelling during early years is VERY informative to the young thinker/feeler.

    Sometimes I wonder whether feeling 'normal' (if there is such a thing) would drive me bloody batty with boredom, particularly now that I am pretty accustomed to anxiety. Kinda funny ...

    Kate



    Regardless, here we are and this is what is, for now :)

    Kate

    ReplyDelete
  4. Absolutely - may as well work with it :)

    ReplyDelete