Your Anxiety: Friend or Foe?
What exactly is anxiety? Is it something to be dreaded or avoided? Is there anything useful or important about anxiety? Is anxiety a friend or a foe? Technically anxiety is a form of fear. Fear is a universal emotion, experienced in all cultures and across time throughout human history (all animals experience it too). Like all emotions, fear and anxiety serve useful functions even if the experience is not comfortable. Positive emotions like love and joy create pleasurable, engaging feelings that we typically want to hold onto. Difficult emotions like anger and fear typically create uncomfortable, distressing experiences that we want to get out of. But if you fearfully avoid situations habitually or too frequently, then you end up making fear your foe—and it can become a relentless one until you learn to face it (fortunately effective therapy for fear, anxiety, and stress is available). First let’s look at how fear, at its very core, when functioning naturally and effectively, is actually your friend.
While at times very uncomfortable, fear and anxiety is not usually your enemy. Fear and its related emotional states are responsible for the survival of the species because they warn you to avoid danger. If you did not have this evolutionary warning system, then when something truly dangerous presented itself, you would be at increased risk of getting harmed, injured, or even killed. This is because fear jolts the nervous system, kind of juices it up, to make your mind and body quickly take emergency measures to avoid getting harmed. So in this sense fear is a true ally, a true friend. Fear also has other positive values. It not only alerts to the presence of danger out in the world, but a bit of anxiety can accompany bodily responses as well. When you get anxious about various unexpected aches, pains, tingles in your body, then fear is alerting you to the possibility of disease or physical injury to possibly get needed medical treatment. Fear also can accompany your thinking, and manifests as worry or apprehension. In this case it causes an intense inner focus on thoughts and ideas: You may feel vague apprehensions and worries because you have forgotten something important, and your anxiety is pulling you inward to try and remember it. You may feel the tug of anxiety as you turn over thoughts about an important project, an issue in a love relationship, or are inwardly reflecting about a difficult dilemma. The fear is helping you to probe, think, and ponder all the different dimensions of the inner problem you are trying to solve.
Fear can also be your friend when it causes you to look at your life in a broader way, taking on an existential quality—am I leading the right kind of life? This can happen when one day you wake up and really take stock of your life direction. What am I moving towards in my life that is meaningful, important, and makes life worthwhile? If in fact you haven’t really examined your life and are on “autopilot”, your fears, worries, and apprehensions about your life direction can cause you to reflect deeply on what makes life worth living. In essence, you become concerned and worried about habitual, deadening modes of existence that rob you of a sense of purpose and meaning in life (e.g. too much TV, video, media, food, alcohol, and other distractions). Such reflection can then lead to taking meaningful action to attain a life worth living.
Our fear is a tricky critter though and has another, all too familiar side. Normal, helpful or friendly fear can appear to turn on you, causing torment and despair. When this occurs fear has you in its grip and is no longer helpful or “friendly”. The turning of fear upon the self happens when you lose track of the helpful and positive messages in fear and start viewing situations, thoughts, inner feelings, and outer circumstances in an overly threatening, scary manner. You actually contribute to this process through habitual avoidance of situation and activities that are not truly dangerous, which heightens your fear response, and leads to more avoidance. This progression is helped along by failing to understand the positive function of “friendly fear or anxiety”. Life inevitably has ups and downs. The downs inevitably cause some pain and are distressing. When you seek to avoid life’s inevitable pains, then the pain becomes more than just pain—you begin to fear it, start avoiding it, and never learn to accept and confront it. Life is bearable when you accept its inevitable ups and downs, but becomes truly unbearable, when you fear and automatically seek to avoid.
Here fear is no longer your friend, and is now becoming your foe or enemy. Essentially you are now overreacting to life’s expected flow of difficulties and you have given your power away to your fears. Because fear now involves intense suffering and does not easily go away when outer and inner circumstances are actually safe, it seems intolerable, insurmountable, and you want to escape this horrible situation at all costs. Fear or anxiety then inflects or turns upon itself and you may develop fear of having fear itself. When you are afraid of your natural fear response, a vicious cycle of fear and avoidance can develop: since you do not want to feel fear, you avoid it at all costs, but when you avoid something that is not truly warranted by the circumstances, you never learn to figure out that there is nothing to be afraid of. Unfortunately irrational, unwanted fear can attach to just about anything: specific situations (driving, heights, bridges, enclosures, etc), social situations (ranging from small talk to speaking up in a group), being out in public, and you may even fear your own emotions (e.g. rather than accept emotions like occasionally getting angry or frustrated, you fear your own emotions—you may be afraid to show or even feel anger; some people are even afraid of positive feelings like love, because they fear getting hurt),
Fear can now become quite irrational and persistent. The end result is getting locked in a vicious cycle of fear and avoidance. If fear were compared to a dog, it is chasing its own tail. At this point your exaggerated fear response may become a full blown Anxiety Disorder. However, thankfully there is actually a very effective and direct method to overcome your irrational fears: you can slowly learn to confront them (yes, they will actually go away the more you do so) and accept, without avoiding, life’s inevitable ups and downs. Actively seek to learn from your fear. Clarify if there is anything important it is trying to tell you (fear as friend) or does it have you in its grip, coloring and twisting your thoughts and perceptions (fear as foe). To confront ones fear by not avoiding the feared situation, you take your power back and return it to its natural state as just one emotion among many that are there to serve you.
If you are struggling with anxiety, fear, stress or other important unresolved issues, you deserve to get the help you need to lead a better, more fulfilling life. Feel free to call me anytime. It can be a great relief to open up about your concerns to a trained professional.
Thank you for reading this article and I hope it was helpful. Good luck! Please post your comments or reactions on my website. To get more information on important wellness and mental health issues please go to The Ryan Review.
Are You Depressed? What is Depression? What is Major Depression?
Everybody gets sad or down from time to time. But how do you know if you are experiencing “clinical depression”, how is it diagnosed, and what does “clinical depression” actually mean? Technically there are several forms of “clinical depression” based on different considerations and patterns of symptoms. “Clinical depressions” includes (from least to most severe), but is not limited to: Adjustment Disorder with Depressed Features, Dysthymic Disorder, Major Depressive Disorder and Bipolar Disorder (formally known as Manic-Depression). In addition, some physical illnesses like diabetes and heart disease can cause symptoms resembling “clinical depression”. Also, difficult losses, like the death of a family member or friend, can make you very sad, producing a natural grief reaction resembling “clinical depression” but is a normal reaction to loss that eases over time, often referred to as bereavement.
Mental health professionals diagnose your depression based on the pattern of symptoms you describe to them listed in the DSM-IV (the medical manual that is used to diagnose all mental disorders). Surprisingly, unlike almost all other fields of medicine, mental health diagnoses (with few exceptions), are not made by determining causes, using brain scans, or other medical tests (e.g. there is no blood test for depression)! Since depression diagnosis is based exclusively on a set of symptoms, how you became depressed and what caused your depression, (often involving complicated environmental factors), are not required to diagnose “clinical depression”. In terms of what causes “clinical depression”, it most frequently originates by your reactions to unpleasant life situations, where your normal ability to cope is overwhelmed. Oddly, despite the absence of the need to identify a clear cause to make the diagnosis of depression, “clinical depression” is often viewed as a “chemical imbalance”, even though diagnosing depression, through a blood test or brain scan, is currently impossible.
The diagnosis is established by how you describe your depressive symptoms to your healthcare provider, and regardless of why you became depressed, drugs are almost always offered as the primary treatment (as if all cases of depression are due to “chemical imbalances” in your brain when in reality only a small number of cases are entirely due to such an imbalance). Unfortunately most types of depression are treated predominantly with drugs even though the very best science indicates that the causes of depression are multifaceted, usually due to problems in your environment, and in a smaller subset of cases purely to genetic and biological factors. Most commonly the reason for your depression involves pronounced stressors or difficult life circumstances that overwhelm your normal ability to cope, resulting in distress, feelings of helplessness or hopelessness, demoralization, and finally depression. Therefore the starting point for understanding and resolving your depression should be talking to a trained mental health professional to learn skills to work through and sort out your feelings, rather than take a drug. As described in prior articles, depression can be a sign or symptom related to complicated feelings and life dilemmas (see “The False Self Syndrome Depression Syndrome” & “Moving Through Depression, Anxiety & Stagnation by Finding a Path With Heart”.
Unfortunately over the past decade studies have shown that psychotherapy and counseling are recommended less and less often and drugs more and more, even for very common forms of depression with clear psychological precipitants! As a general rule, you should always request a careful rationale by your healthcare provider as to what she or he thinks is causing your depression (the type of depression you have holds important treatment implications). If your provider cannot give you a clear rationale, give serious consideration to seeing a specialist, such as a clinical psychologist.
If you are struggling with depression or other important unresolved issues, you deserve to get the help you need to lead a better, more fulfilling life. Feel free to call me anytime. It can be a great relief to open up about your concerns to a trained professional.
Thank you for reading this article and I hope it was helpful. Good luck! Please post your comments or reactions on my website. To get more information on important wellness and mental health issues please go to The Ryan Review.
PTSD, Traumatic Stress, and You!
What is trauma, how does it affect you, and what can you do to overcome it? If you or a loved one has experienced a recent or past trauma, been abused as a child or in a current relationship, you may have Post Traumatic Stress Disorder (PTSD) or a related trauma based response. Trauma causes reactions like PTSD but also depression and other anxiety disorders like panic, phobia’s, chronic worry or Generalized Anxiety Disorder, hypervigilance, numbing of normal responding, mistrust of others, social anxiety disorder, and many other concerns, especially substance abuse. Generally speaking if you successfully resolve the trauma, it will also help to reduce or eliminate other related symptoms!
Approximately 15 to 25% of any traumatic event leads to the development of PTSD and especially severe traumas called “high magnitude trauma” may double this rate! Interpersonal violence, such as torture and assault, and prolonged and/or repeated events such as childhood sexual or physical abuse, are more likely than natural events (like earthquakes or natural disasters) to results in a traumatic response. PTSD involves a cluster of three key symptoms:
- re-experiencing (nightmares, flashbacks, or intrusive thoughts/images)
- increased arousal (feeling on edge, easily startled, chronic tension or worry)
- avoidance or numbing of responsiveness (avoiding situations related to the trauma, like where it happened, or learning to numb out your normal responsiveness to life)
The type, amount or duration, and age at exposure to trauma all play a role in its development. While psychological trauma can occur at any point in the lifespan, trauma has its most profound impact when it occurs during early childhood or adolescence and becomes less pervasively damaging with later onset. Trauma that occurs during these developmentally vulnerable times can lead to PTSD, and/or an array of other difficult conditions and symptoms.
The term “complex PTSD” was coined by Dr. Judith Herman in 1992 to describe the effects of early trauma. “Complex” traumas often involve parents, siblings or caretakers as perpetrators, and tend to occur multiple times while the emerging self is forming. These types of traumas cause disruptions in fundamental relationships. When trauma occurs during childhood, is frequent or prolonged, and/or involves interpersonal abuse (such as childhood sexual or physical abuse), other distressing symptoms in addition to PTSD may develop. These symptoms include: disturbances in emotional development, problems with clear thinking, physical illnesses, and potentially serious disruptions in your relationships or ability to connect with others.
Successful Treatment of Trauma and PTSD: There are effective, therapeutic approaches to address past trauma based on rigorous scientific research: Prolonged exposure therapy, cognitive processing therapy, and EMDR. All of these therapies are helpful in that they allow you to process traumatic material in various ways. For any therapy to be truly effective you need to develop a solid, trusting relationship with your therapist and be ready to work on these issues. Since trauma, especially when encountered in childhood, can affect your connection with others, the link formed between your therapist and you is very important. The degree you feel connected to your therapist will help you gradually confront what happened to you. Disclosing and processing traumatic material (memories, images, related thoughts and feelings) is the primary way of recovering from Trauma and PTSD. The goal is to confront rather than avoid traumatic material and also to create a coherent life history that contains both the trauma story as well as your personal successes. Successful treatment would gently encourage you to feel and engage the emotions associated with the trauma as you progress in therapy. By doing so you can move beyond your trauma and into a life worth living!
If you are struggling with trauma, PTSD, anxiety and depression or other important unresolved issues, you deserve to get the help you need to lead a better, more fulfilling life. Feel free to call me anytime. It can be a great relief to open up about your concerns to a trained professional.
Please post your comments or reactions on my website. Thank you for reading this article and I hope it was helpful. Good luck! To get more information on important wellness and mental health issues please go to The Ryan Review.
Creating a Timeline for Growth, Healing & Development
Do you ever look at your life and consider where it is going? According to Socrates, “The unexamined life is not worth living”. In this sense knowing yourself, where you came from (and where you are headed), leads to a “life worth living”. One special technique to understand your life involves creating a therapeutic Timeline, described below. Examining your life means understanding the personal history involved in your story or narrative, helping you establish and define your unique individual identity. Personal identity leads to a greater sense of integrity and even success. According to Dr. Lila Swell, “Your identity and your success go hand in hand. Many people sacrifice their identities by not doing what they really want to do and that’s why they’re not successful”. A Timeline, such as the one described below, is a detailed exercise to enhance self-awareness, self-definition, and promote your sense of personal identity. Also, by taking a really close look at your life and its direction, you may identify times where you got stuck that prevent you from moving forward. By using a Timeline, you can work through these blocks and make better choices for a successful life aligned with your unique individual self.
Instructions: Each year of your life starting with your birth (0-1 years old), write out a detailed description of the following to create a map of important life experiences. The purpose of a Timeline is to chronicle your personal history to gain a coherent picture of you: where you were, where you are, and to make better choices about where you may be going. A thorough Timeline can take dozens of hours to complete! It is important not to hurry and to take your time. View the formation of your Timeline as a process and try to write something as often as you can, like a couple of times a week or even more.
Try to go in chronological order but it is OK to go out of order if you want to focus on a particular period. Be sure to fill the gaps in eventually. Early years (0-18) are particularly important, especially childhood and puberty, but later years are important as well. Be thorough in your descriptions and know that you may encounter various emotions as you revisit important events. Once you have worked on a period of time, deeply reflect on this period in your life. If you are in therapy, bring it in to talk to your psychologist or therapist.
Age: Your age. Try to go in increments of one year (e.g. years 0-1, 1-2, 2-3, 3-4…)
Residence and Description: Describe in detail where you lived, what the neighborhood was like, how you felt about the residence and neighborhood or any other important detail that stands out. This can provide a physical context for the events that you experienced.
Important people in my life: Who were the important people in your life at this time? Be sure to include parents, siblings, key friends, other important relatives, teachers, etc. Think carefully about your relationship to each person (or if too young to recall, what you know about your relationship from others).
- Describe both positive and negative qualities in that relationship. Be honest and refrain from editing out negative qualities and only focusing on the positive ones.
- Comment on any problems in the relationship and how you felt at the time.
- Comment on how you feel now as you look back.
School/Work: If it applies, where did you go to school or work at the time?
- Describe the place and your feelings about it, both good and bad.
- Did anything important happen at school or work at that time?
- What was your typical day like?
Important Events and my Reaction to Them: During this time in your life, what important events stand out? For instance, did you have any special achievements or were there any challenges or difficulties?
- What were the difficulties like losses of family members, accidents, medical illnesses, etc?
- What were the special achievements or surprises?
- What was your reaction to these important events and most importantly, what impressions have they left on you? Comment on how they shaped you.
My Observations of This Year: Look back on the year and ask yourself, “What stands out?” How did these events affect you at that time?
- In looking back, what do you currently make of your experiences at that time in your life?
- Are there any lessons you learned or patterns that got set up at this time?
If you want to explore your life, enhance self-awareness, and develop a healthy sense of who you are, then you should begin a Timeline right away! Appreciating significant, impactful life events can help you tune into yourself, producing better life decisions, and understanding your unique self (see article “… A Path With Heart”). Keep in mind that if you are completely honest with yourself you will encounter both positive and negative experiences that shaped who you are in both positive and negative ways! Do not ignore or minimize the negative influences, even if they are painful to look at. True growth is not possible without at least some pain. At some point it can be very helpful to open up about your feelings to a trained professional. In this capacity, as a psychologist with an appreciation for the importance of feelings, emotional growth, and tuning into your unique self, I would be happy to help. Feel free to call me anytime.
Please post your comments or reactions on my website. Thank you for reading this article and I hope it was helpful. Good luck! To get more information on important wellness and mental health issues please go to The Ryan Review.
Moving Through Depression, Anxiety, & Stagnation by Finding a Path With Heart
Are you on a path with heart—one with meaning and purpose? Are you struggling with difficult emotions like depression and anxiety? Are you numb and tuned out? Some emotional pain is unavoidable as you travel through life’s many directions and try to figure out your unique way. Sometimes it is painful when you are doing the right thing. Other times you may encounter anxiety and depression because you are off track. A more basic question is: are you even trying to find a path with heart, one that leads to your full potential as a unique human being, or have you given up on yourself or lost touch? The great Mahatma Ghandi once said: “He who loses his individuality loses all”. Frequently people settle thereby diminishing themselves and what they have to offer to others. They end up doing what was expected of them by their family, friends, or community—or they take the easy way out, resulting in suffering and diminishment of the human spirit.
A path with heart is living in harmony with your unique inner spirit. It is that sense of aliveness that gives your life purpose, meaning, and direction. Hence, it is a deeper, more encompassing process related to being alive in all the different aspects of living: work, relationships, family, hobbies, interests, drives, etc. It is both the deepest sense of you as an individual as well as your distinct way of connecting with others. Some people describe the process of finding a path with heart as “the individuation process”. Dr. James Hillman, well known Jungian Analyst, writes about individuation using the metaphor of the acorn. The mighty Oak Tree originates from the tiny acorn—the full potential of that tree is contained in its seed, the acorn, which can grow into a unique tree (no two oak trees are exactly the same). If the acorn is not planted in the right place, attended to properly, given enough sun and water, it will never grow. The same is true for you—there is an inner kernel or acorn that is unique to your own spirit, your own self, your own identity, that needs caring and nurturing to develop. That kernel is in a way like a blue print for your life, except it is not totally fixed or fully determined, and develops with proper care—but if you do not follow it, your life will not develop as it should—you become out of balance and do not become true to your distinct inner nature.
Tuning into the unique rhythms of your inner self is the task of a lifetime—it is never too late (or early) to start and it never truly ends. Sometimes emotions like depression and anxiety are clues that you are missing this path, out of sync, as if a part of you knows you are off course and objects, sending neurotic waves of anxiety and depression. Other times you may feel numb and detached. Are you “checking out” with substances, like alcohol or drugs, or through other numbing pursuits like excessive TV viewing, gaming, overeating or other soul killing activities? Sometimes being true to yourself can feel like you are betraying others, thus bringing up guilt and more anxiety. Never forget the famous words: “to thine own self, be true!” If you are not true to yourself, who else is going to do this for you? Being true to yourself is not always easy.
Finding a path with heart or consciously following the individuation process can be facilitated by making a deliberate decision to do so. To better help you tune into your inner process, here are a few suggestions. First, value yourself enough to put a priority on YOU. Joseph Campbell used the phrase: “Follow your bliss!” In other words, find out what moves you, look inside at what is important to you and START doing those things immediately. This is your one and only life. Do not cheat yourself or sell yourself short.
Second, and related to above, ultimately you must realize that a path with heart is specific to you and no one else—you must find your own way. Do not let other people define this path for you—if you listen closely, attending carefully to your own experience, eventually you will connect with an “inner voice”, an inner sense of your own conscience, apart from what “society dictates”.
Third, start writing down your dreams. Keep a dream journal. Your dreams are more important then you may realize and represent parts of you that emerges when your defenses are down, expressed in their own symbolic language. By writing down dreams, you connect with your deepest inner self. Just making this connection is important, regardless of whether you understand your dreams or not. Eventually they will begin to make sense to you as you develop a kind of dialogue with your unconscious psyche. Fourth, in order to tune into a path with heart, you must understand the life that you have lived, what it is, as well as the major influences that formed who you are—this will allow you to make better choices about where your life is going and how you would like it to form. One technique for facilitating this process involves writing out a detailed Timeline or Lifeline to help you get started (click here for instructions). In a previous article, The False Self Depression Syndrome”, I have made other suggestions that are useful here as well—be honest in your interactions, meditate, and engage in some creative endeavor.
Finding and then living a path with heart can involve making difficult choices and requires carefully turning inward to really look at your life. Sometimes painful feelings are encountered during this process. In this capacity as a depth oriented psychologist, having integrated a variety of healing techniques into my therapeutic approach, I may be of assistance. Please feel free to call if you or someone you know could benefit from my help. Thank you for reading this article and I hope it was helpful!
To get more information on important wellness and mental health issues please go to The Ryan Review.
