William Gaultiere,
Ph.D.Director of New Hope at the Crystal Cathedral
"Don't
worry. Be happy!" It's not that easy, is it? Many people
struggle with worry. Even at night they can't seem to slow down
and relax. Their minds just won't let them rest. Why did I say
that to him? ...What will they think about me? ...How am I going
to pay my bills? ...I have to get over this and be stronger.
You don't have to live with worry like this! You can experience
more of God's peace.
God Understands
Many
years ago as a young adult I read in the Bible, "Do not be anxious
about anything" and immediately I felt more anxious! I thought,
What's the matter with me? I shouldn't be so anxious all the time.
I must not be a good Christian! Maybe you've struggled with thoughts
like this.
Later, I realized
that I had committed what I've come to call a "Biblical blunder
that bruises and confuses." I had misinterpreted the Bible and
harmed myself in the process. I began to understand what God
was really saying to me in His Word when I read the passage more
carefully and in context:
The Lord is
near. Do not be anxious about anything, but in everything, by
prayer and petition, with thanksgiving, present your requests
to God. And the peace of God, which transcends all understanding,
will guard your hearts and your minds in Christ Jesus. (Philippians
4:5b-7)
Oh! I discovered
that the Apostle Paul is encouraging me to rely upon God's care
when I start to worry. He wasn't shaming me or encouraging me
to deny my feelings. The comforting truth in this passage is
that God is near me and when I'm anxious He offers me His peace,
a peace that will protect my soul and body from the destructive
effects of continual anxiety. My part in experiencing God's peace
is to ask God for what I need and to thank Him for the good things
He provides. (More on this later.)
What is Anxiety?
To be anxious
is to worry or fixate on troubles. You're restless, agitated,
or burdened. Your body is uncomfortable and your mind won't slow
down. It's hard for you to relax, sometimes even at bedtime.
You may have fears, nightmares, or flashbacks. You may have trouble
saying "no" to people.
To test your
anxiety levels you may want to take my self-test "Do
You Have A-N-X-I-E-T-Y?"
HOW ANXIETY
PROBLEMS DEVELOP
People who
struggle with anxiety perpetuate their problem without realizing
it. Let me explain. Anxiety is a "secondary emotion" that is
the result of conflicting tensions between "stressors" that elicit
emotion and "repressors" that deny that emotion. (See diagram
, "How
Anxiety Problems Develop.")
Before we
feel anxious two things happen. First, we experience stress or
an injury and feel hurt, afraid, angry, sad, guilty, or needy.
And then we deny or avoid that feeling, even though it's a natural
and healthy response. We're too busy to pause and feel our feelings.
Or the feelings don't fit our expectations of who we should be.
The combination of the elicitors and repressors is like a chemical
reaction that creates anxiety. If the anxiety is intense or chronic
then there will be an explosion, likely in the form of an anxiety
disorder.
As a Psychologist
I talk to many people struggling with anxiety and I tell them
that they're fighting themselves. It's like they've got one foot
on the gas and the other on the brake and so they're spinning
out of control and damaging their engine. It's appropriate to
feel scared when someone or something threatens your well-being
and so your body instinctively gears up into the fight-or-flight
response, but the anxious person tries to shut down the fear,
creating anxiety that over time can damage their soul and body.
To use another
analogy, anxiety occurs when you hold the lid down on your pot
of boiling emotions. Eventually, the pressure becomes too great
and the lid blows with a panic attack or other anxiety disorder,
an angry outburst, or "acting out" with compulsive behavior (e.g.,
alcohol, overeating, sex). As we'll discuss later, instead of
holding the lid down we need to let off some steam (verbalize
our feelings and needs) and turn down the heat (set our limits).
I Grew up
With Anxiety
I think every
member of my family has had problems with anxiety. In my family
people worried and worried. Intense discussions, continually
analyzing problems, complaining about what's wrong, and obsessing
about possible solutions to fix things were continual. Looking
back, it seemed like problems were everywhere. Family members,
extended family, other people, the church, my dad's job, politics,
and many other issues all seemed to have problems to worry about.
As a child
I took in too much stress by listening to and being concerned
about the things that upset my Mom, Dad, and others. I took on
too much responsibility and lived with burdensome expectations.
And I didn't release the pressures and pains because I didn't
talk about my feelings. I didn't even feel my feelings. Instead
I worried and I worked to solve my problems, and everyone else's
too!
By the time
I was a young adult I developed what I later learned is called
Generalized Anxiety Disorder. This means I experienced
persistent anxiety and worry about stressful situations. I spent
a lot of time worrying intensely and my worry was out of proportion
to what was realistic for the situation.
It took me
a number of years as an adult to learn helpful ways of dealing
with anxiety and to experience inner peace. I used psychotherapy,
educating myself, relaxation exercises, physical exercise, lifestyle
changes, prayer and other things to find some relief. Today I
still struggle some with anxiety at times, but it's so much better.
Now because I have better boundaries to limit the stress I intake.
And I've learned how to process my feelings with a caring friend
and experience peace.
Panic Disorder
According
to the National Institute of Mental health, Anxiety Disorders
are the most common mental disorder, affecting one in eight Americans
between the ages of 18-54. That's nearly 20 million anxious people!
The most common anxiety disorder is Panic Disorder.
It's frightening
to experience a panic disorder. You feel like you're being smothered
and can hardly breathe. Your heart pounds and hurts and you're
afraid you're having a heart attack. You tremble or feel tingling
or numbness in your hands and feet and you're afraid you're going
to faint. You start sweating or have hot and cold flashes. You
feel like you're not all there; it all feels so unreal. And worst
of all, you're afraid that you're going crazy and that you're
going to die!
Once someone
has had a panic attack they develop "anticipatory anxiety,"
in which they're afraid of having another attack. Of course, this
makes the anxiety worse! Panic Disorder also can become associated
with Agoraphobia. People with Agoraphobia restrict themselves
to "safe places" because of a fear of having a panic attack in a
public place and not being able to escape.
Three Examples
of Anxious People
Some time ago I helped a man I'll call Jon. (Names and identifying
information have been changed in each case.) Here's how panic disorder
developed for him. (See "The Development of a Panic Attack" below.)
He'd catch a cold, get an infection, or have an allergic reaction.
(Initiating circumstance.) The congestion would make breathing
a little more difficult. (Unpleasant bodily symptoms.) He'd start
worrying that he wouldn't be able to breathe. Then he'd sniff compulsively.
His sniffing and worrying would keep him from falling asleep. (Increased
focus on symptoms.) Then he'd tell himself that he'd be up all
night, and he wouldn't be able to function at work the next day.
He'd even think that he was going to suffocate. (Catastrophic interpretation.)
Then he'd have a panic attack. The
Development of a Panic Attack
Initiating
Circumstance -> Unpleasant Body Symptoms -> Worry ->
Catastrophic Interpretation -> Panic
Carrie
was afraid of introducing herself in her church small group.
She had Social Phobia, overwhelming anxiety with avoidance
of social situations out of fear of embarrassment. Her anxiety
escalated as people were introducing themselves around the circle.
Her heart started racing, her breathing became shallow, and she
became sweaty. She was terrified that people would see her blushing
or that she'd stutter and that people would laugh at her. Before
it was her turn to speak she got up from her chair and went to
the bathroom. Then she went back to the group when she knew she
wouldn't have to introduce herself.
Jim was 25
years old on 9-11-2002 when the terrorists attacked the World
Trade towers and rocked his world. For three months three months
he busied himself in his work until he found that anxiety was
overwhelming him. He couldn't concentrate. He was exhausted
and yet he couldn't sleep. He was full of fear and felt like
he was living outside his body. He worked near an airport and
whenever a plane flew overhead he had frightening flashbacks to
being a boy in New York City and watching the planes fly over
his head. Then the image would morph into the planes crashing
into the towers and he'd start crying and shaking. He had Post
Traumatic Stress Disorder.
Learning
To Be Patient
Anxious people
like these that I talk to hate the word patience! They want their
symptoms - panic attacks, phobias, obsessive-compulsive behavior,
trauma reactions, or chronic worry - to go away now. They're
frustrated with themselves that they can't make them stop and
don't realize that their attempt to control (deny) their anxiety
is part of their problem. Paradoxically, the quickest route to
cure (not just eliminating symptoms, but experiencing peace) begins
with accepting your problem and being patient with a therapeutic
process.
Why patience?
The effects of continual stress and denial of feelings is cumulative.
Each additional pressure or injury that is not responded to with
care exacerbates previous unresolved stresse and lodges itself
in your body and soul. This is why people are often surprised
when they discover they have an anxiety problem. It seems to
them like there's no reason for it! In actuality, they experienced
"the straw that broke the camel's back" and only then did they
realize that they needed help!
So undoing
the negative effects of chronic build-up of anxiety takes time,
not time alone, but time with treatment, care from others and
yourself, setting boundaries, and using relaxation techniques.
Reading
the Indicator Lights
You wouldn't
drive your car without checking the gauges. You ask yourself,
- Do I have
enough gas?
- How fast
am I going?
- Do I need
to take my care in for an oil change?
Yet, if you
struggle with anxiety you probably don't monitor your soul and
respond to it's needs. Anxious people typically neglect to fill
their tanks with care, push themselves beyond reasonable speed
limits, and hesitate to ask for help.
For
some people, their anxiety gauges are obvious. For Jon it was
his obsessive worries about his breathing. Carrie had her fear
of groups and Jim had flashbacks. For each of them their challenge
was accepting that their symptom wasn't a problem as much as it
was a warning sign of a deeper problem
missing a
sense of peace (comfort, self-acceptance, well-being) inside.
For
you, reading your soul's anxiety gauge probably begins with listening
to your body. When you're anxious it'll show up in your body
with shortness of breath, heart palpitations, tightness or pain
in the chest, discomfort in your stomach or bowels, twitching,
shaky hands, sweaty palms, or tingling. These symptoms are
warning signs that you need to slow down, relax, feel, and talk
about your feelings.
It's harder
to do, but ultimately you want to respond the same way to your
feelings. Whenever you feel angry, scared, or sad it means your
soul needs caring attention.
Facing
Your Fear
The first
time I was asked to be a keynote speaker at a conference a number
of years ago I was afraid. Don't get me wrong, at first I was
excited, but later I started thinking about it. Maybe they don't
really want me. I'm just filling in for someone who had to cancel.
The other keynote speaker is Archibald Hart and I'm not in his
league. I got more and more scared.
Then I told
myself, You can't be afraid. You'll make a fool of yourself in
front of 2,000 people! If you can't calm down then you just need
to cancel. Of course, this harsh treatment of myself and denial
of my fears only made me more anxious. Eventually, I woke up
to what I was doing - I had reverted back to my old, destructive
ways of coping with anxiety - demands on my self, denial of feelings,
and avoidance of what scared me!
Instead,
I accepted that as a speaker I didn't have to be perfect, but
was a "work in progress." I started processing my feelings with
my wife and a friend to find comfort. And I determined not to
avoid my fear of public speaking, but to face it. What if I had
chosen to reduce my anxiety by not giving the keynote address?
Unfortunately, it's easy for anxious people to make choices like
this, hiding their gifts and shrinking their worlds. To face
your fears, as I learned in this situation, helps you to gain
confidence, which over time helps to reduce your anxiety.
Learning
to Set Limits
Most people with
anxiety problems expect themselves to be super strong. They think
that they should always be "calm, cool, and collected." Control
is their operative word. They do too much, take on more responsibility
than they can handle, try too hard to please other people, and deny
their feelings and needs. Eventually it catches up to them in bouts
of anxiety. They need to learn to acknowledge their limits and
say no sometimes.
This was a
big part of my generalized anxiety disorder. I had to accept
that I couldn't do everything I wanted to do, but I need to prioritize
more and let some things go. I learned when I needed to say no
to someone's request because I didn't have time or energy or had
another commitment to keep. I spent more time relaxing (I'm still
working on that one!) and I gave myself permission to feel, to
need, and to struggle. Limits like these were an important part
of helping me to feel more peace.
You know you've
developed strong boundaries when you're able to be with people that
used to agitate you or "make you" anxious and now they don't. You're
able to be in relationship and to be separate at the same time.
What a relief! What a confidence builder!
Using Positive
Self-Talk to Cope with Anxiety
People
with anxiety problems typically experience an escalation of fear.
Their fear feeds on itself, getting worse and worse. Let's get
inside the mind of the anxious person to see how their negative
self-talk is a part of this viscous cycle and then let's consider
how using positive self-talk can help to stabilize and calm the
person who is anxious:
The
Effects of Positive vs. Negative Self-Talk on Anxiet
Negative
Self-Talk Escalates Fear
|
Threat >>
|
Negative
Self-Talk
>>
|
Body
Symptoms
>>
|
Negative
Self-Talk
>>
|
Panic |
|
(1st
Fear)
|
Repression
|
(2nd
Fear)
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Catastrophic
|
(3rd
Fear)
|
|
|
|
Hurt
|
"I'm
too sensitive."
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Racing
heart
|
"I
can't stand this!"
|
|
|
|
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Conflict
|
"I can't have needs."
|
Shallow
breathing
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"I'm
losing control."
|
|
|
. . . . .
|
|
Stress
|
"I've
got to be strong."
|
Sweaty
|
"What will others think?"
|
|
|
|
|
Demand
|
"I
can't show feelings."
|
Twitches
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"I'm going to die!"
|
|
|
|
|
Violation
|
|
Tingling
|
|
|
|
. . . . .
|
|
Criticism
|
|
Dizziness
|
|
|
|
|
|
Upset
stomach
|
|
|
Positive
Self-Talk Calms Fears
|
Threat >>
|
Positive
Self-Talk
>>
|
Body
Symptoms
>>
|
Positive
Self-Talk
>>
|
Coping |
|
|
Affirmation
|
|
Accepting
|
|
|
|
|
|
"It's normal to feel."
|
|
"I
can handle this."
|
|
|
|
|
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"My
needs are ok."
|
|
"Let it pass. Ride it out."
|
|
|
. . . . .
|
|
|
"It's courageous to
|
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"My
friend accepts my fears
|
|
|
|
|
|
"I
can share with a friend
|
|
"I've
survived this before."
|
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Responding
to the fear that may accompany stress or hurt with affirming self-talk
(instead of denying your feelings) is calming. Accepting the
reality of anxiety symptoms in your body (instead of reacting
with catastrophic thinking) is also calming. In other words,
rather than fight against your feelings and your body you seek
to understand, validate, and comfort your feelings. The way you
learn to do this is by internalizing caring messages from people
(like a counselor, friend, or support group leader) who listen
to your anxiety.
Let
me illustrate by referring back to three of the examples we discussed
above:
- Jon learned
to cope with his panic by saying to himself, "It's scary for
me when my breathing is more difficult. I've survived this
before. I won't suffocate. I'm just anxious because I have
a lot of feelings I need to talk through."
- Carrie
was able to face her fear of introducing herself to groups of
people by thinking, "It's ok for me to be nervous meeting new
people. Blushing doesn't make me a bad person. Besides, most
people like me when they get to know me."
- Jim went
back to his job near the airport with the mindset, "It's natural
for me to be scared and saddened by the terrorist attacks.
If I have flashback I can ride it out until it subsides and
then talk about my feelings later with my friend."
Entrusting
Your Feelings to God and Others
This
is at the heart of any antidote for anxiety. Earlier I said that
anxiety is a secondary emotion. We feel anxious when we deny
our fear or hurt or anger. So it makes sense that we feel less
anxious when we talk through the underlying feelings with someone
we trust.
What's
the magic in verbalizing your feelings? What makes this helpful
for people who are anxious? Sharing feelings with a listener
is cathartic or relieving of tension when you "let go" of what's
troubling you by letting someone else feel what you feel and help
to carry your load. The turmoil becomes less intense and more
manageable. Putting words to what you're feeling gives you perspective
on your struggle, helping you to understand your situation more
clearly and to think through any decisions. It helps you to realize
that your feelings are valid, real, and understandable. Realizing
that someone cares enough to listen and to understand and to struggle
with you is comfort for your hurt and encouragement for getting
through your problem. In time you realize that you feel more
peace.
In
the Psalms of the Bible, David, the author of most of them, gives
us a model for sharing our troubles with God. By writing out
or simply praying our own psalms we too can experience more of
God's peace. Like David, we tell God just what we're feeling,
even if it's anger at Him, and He listens and is concerned and
responsive. David also shows us how to receive God's care by
thanking Him for his provisions, starting with the smallest of
blessings.
Learning
to Relax
There
are many helpful relaxation exercises that help to reduce your
anxiety and increase your peace.
- Physical
exercise and progressive muscle relaxation (tensing and relaxing
different muscle groups) are helpful because anxiety accumulates
in your body.
- Deep breathing
is important because when people are anxious they breathe shallow.
This is easy to do at any moment and you'll find immediate help
with just a few repetitions of breathing in deep, holding your
breathe in for at least seven seconds, and then slowing exhaling.
- Meditation
is another tool. My favorite is to go through Psalm 23, visualizing
the scenes and forming specific prayers around each of the healing
principles in this psalm. There are many other passages in
the Bible that offer soothing or insight for dealing with anxiety.
- Prayer
has been scientifically proven to induce states of relaxation.
You can pray by asking God for what you need, thanking Him for
particular blessings, or pouring out your heart to Him as David
did in the Psalms.
Additional
Resources
Here
are some other resources I've prepared to help people with anxiety:
-
"Antidotes to Anxiety" is an article
that highlights 26 strategies for reducing anxiety.
- "How
do I Overcome Anxiety?" is my answer to someone's "Ask Dr.
Bill" question.
- "How
do I Learn to Relax?"
is a written out relaxation exercise that you can do for yourself.
It combines deep breathing, progressive muscle relaxation, and
prayer
For
more information and help on treating anxiety consider these referrals:
- Anxiety
Disorders Association of America, 1-301-231-9350, www.adaa.org
- TERRAP
treatment programs for anxiety, www.terrap.com
- Overcomers
Outreach, nationwide Christian support groups, 1-800-301-3001,
www.overcomersoutreach.org
William
Gaultiere, Ph.D. is the Executive Director of the New Hope Crisis
Counseling Center at the Crystal Cathedral and a Clinical Psychologist
with a part time private practice in Irvine, California.
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