How to Track Anxiety and Help Resolve It
Ruth Shidlo’s new series: ON BECOMING A PERSONAL SCIENTIST
How to Track Anxiety and Help Resolve It
Is there anyone out there who hasn’t felt anxious at one time or another? Like most things, such as chocolate, a little bit is good for you, whereas too much …
I imagine that whenever possible, you allow yourself ‘time-out’ from the anxiety-provoking situation you’re inevitably faced with during life’s stressful events. Perhaps you go take a walk, or get those endorphins humming by finding a tune to jig to, or focus on housework and clean that kitchen cabinet that’s been asking for it, or go catch a movie.
And sometimes, just being able to share your feelings with someone you trust may clear your mind enough for you to become more creative in your problem-solving. As they say, friends can be good medicine.
But when going to the gym, having a good cry, or talking things over with your partner or friend is not enough, perhaps it’s time to try something new.
What is anxiety?
Anxiety is a feeling. It is a normal response to an event, environmental stimulus or experience perceived to be a potential threat, that leads to stress. When we orient to potential threat or danger, anxiety helps us deal with the stressor—by motivating us to do something about it. We need our ‘signal’ anxiety, because otherwise, we’d be more vulnerable to danger. When we cannot elicit the help of a calming and helping presence, our instinctual response to threat is one of ‘fight or flight.’ When these instinctual responses are blocked or incomplete, as a last ditch attempt we may ‘freeze’ into immobility, perhaps ‘fold and collapse’ in the face of mortal threat. These are all innate responses to stress—the best one is the one that works for you.
Anxiety involves the release of stress hormones (e.g., adrenalin, cortisol, norepinephrine.)
If we were to analyze our anxious feelings, we would find that (1) they are compromised of physical sensations of arousal (activation) and (2) these sensations are usually accompanied by thoughts, images, and certain behaviors or behavioral patterns.
A panic attack is when you experience a sudden surge of discomfort or intense fear. It is accompanied by various cognitive and physical symptoms, such as:
heart palpitations or racing heart
chest pain
shortness of breath or a smothering sensation
a sense of choking
feeling dizzy, unsteady, lightheaded or faint; sweating
hot or cold flashes
nausea or abdominal distress
paresthesias, such as tingling, numbness or itching
a fear of dying, losing control or going insane;
trembling and shaking (but see below)
feelings of detachment or unreality
Occasional panic attacks are common and do not necessarily mean you have a panic disorder.
This activation or enhanced arousal means your sympathetic nervous system is ‘coming online’ in order to help you deal with the stressor or danger situation. Contrary to what you may think, trembling and shaking indicate the body is releasing or discharging surplus arousal energy, and should thus be welcomed until it spontaneously abates—it is a good thing.
What is the difference between signal anxiety and anxiety disorder
As we saw, signal anxiety is a healthy response to danger. It keeps us on our toes, signals us to be on the alert, prepared for come what may.
When anxiety becomes frequent and excessive and there is a fear or dread of everyday situations, the stage is set for what may be referred to as an anxiety disorder. This means that our nervous system is dysregulated. We respond to internal cues or physical sensations of danger, evoked by a seemingly minor event or stimulus. Chances are this event is linked to other events that preceded it. Sometimes these cues are subtle or even unconscious, and it may seem as though our panic attack came ‘out of the blue.’ Perhaps we were unable to complete a ‘Fight or Flight’ response to threat, and our trapped arousal energy is manifesting as anxiety and its discontents. It is often possible to trace these missing links, but sometimes they elude us.
Phobia and agoraphobia
One may have a panic disorder without agoraphobia, or agoraphobia without a history of panic disorder.
A phobia is present when you fear something when no real danger exists, for example, spiders.
Avoiding situations from which escape (flight) may be difficult or help unavailable if a panic attack and/or other physical symptoms manifest themselves, is called agoraphobia, from the Greek word, agora, or marketplace.
Agoraphobia’s defining feature is being anxious about uncomfortable physical symptoms in situations where it seems difficult to cope with them or the attendant feelings they bring in their wake—we may feel trapped and without recourse to help.
Such situations may include: waiting in lines, escalators, elevators, crowds, stores, restaurants, theaters or auditoriums, traveling by public transportation, driving, flying, boats, closed-in spaces such as basements or caves, wide, open spaces. They also include being home alone or being far from home.
We may, however, be anxious about or even avoid these situations for other reasons, not necessarily because we are concerned with distressing physical symptoms. An example might be someone who fears flying because the plane might crash, or being alone because they might be mugged. This would not qualify as agoraphobia.
Practical Tips for Tracking Anxiety & Shaking it Off
Although we tend to be oblivious of this fact, physical sensations have a beginning, middle and end—they do not linger on indefinitely. They can be elusive—it takes practice to ‘capture’ them by entering one’s physical ‘felt sense’ and noticing what it is we actually feel, in its complex totality. This is true for both ‘positive’ and ‘negative’ sensations and nuanced feelings. Often, it is easier for us to notice we feel ‘good’ or ‘bad’ about something in a more global kind of way, without necessarily taking the time to identify the myriad sensations that may underlie these feelings. For example: you feel sad. When you start paying attention to how you know this, or if asked where in the body you feel this, you might notice that your eyes are full of unshed tears, your heart is heavy, and that you are sinking into the couch and unwilling to budge.
By definition, we may assume there are always good reasons for seemingly ‘out of the blue’ panic attacks. They are not really out of the blue. Often, there is a pairing or coupling of two or more things, such as an inner bodily sensation (e.g., an elevated heart rate) and an affect (e.g., intense fear).
For example, a man in his mid-twenties goes jogging during the day, an activity he normally enjoys. He is training for an inner-city marathon, and the practice run is more strenuous than usual; his heart beats wildly. Suddenly, and with no apparent reason, he feels as though a hand were gripping him from inside. Scared, he wonders what’s wrong with him. Is he about to have a heart attack? Later, during his SE session, he realizes that the physiological state while jogging (e.g., pounding heart, sweating) was associatively linked to another time when he felt similarly—it was when his shoulder bag was swiped from him by a frenzied motorcyclist at the airport parking lot in Barcelona, just as he and his wife were picking up their rental car. In the session, he is able to complete the thwarted ‘Fight or Flight’ response that had left him with unused arousal energy from that traumatic incident, and discharge it via a spontaneous inner trembling, accompanied by deep diaphragmatic breaths.
This is sometimes referred to as ‘interoceptive conditioning,’ a conditioned fear of internal cues, in this case, between one’s heart beat and fear. The palpitations are taken as a sign that something bad is about to happen (meaning), manifested in the thought, “I’m about to have a heart attack.” This misinterpretation has been termed a “catastrophic misappraisal” because a catastrophe is feared based upon the meaning we have attributed to something we feel. Energetically, panic attacks are thought to involve arousal energy trapped in the body with nowhere to go.
A self-perpetuating cycle may develop, consisting of sequences of Sensations, Images, Behavior, Affects, Meaning (what Peter Levine, the creator of somatic experiencing, refers to as SIBAM). Make a point of looking for the missing piece. It may be best to do so in the context of therapy, when you have the emotional support of the therapist.
Another example:
I feel my heart beating wildly (A), think I may be having a heart attack (M) and call emergency services to undergo an ECG reading (B). The possibility something is wrong with my heart makes me even more anxious (A). How will I function at work tomorrow? Will I ever return to my usual self? (M, A) I start sweating profusely (S) and interpret this to mean something is terribly wrong with me (M), and I become even more anxious (A). Now I become nauseous (S), and call my partner to ask for help (B). I envision myself lying there helplessly (I), and pray he comes quickly (A).
Look for your internal cues by tracking how you’re feeling
It is helpful to remain aware of the following components of your response to stress—
Physiological – What is my physiology doing? Where in the body do I feel it?
Affective – What am I feeling?
Cognitive/imaginative – What am I imagining or thinking?
Behavioral – What am I doing? (observable behavior)
These components tend to become linked and may enhance each other.
Notice what you do, think or feel as you become anxious and panicky
Do you feel nervous or avoid situations which make you anxious, or where panic attacks and anticipated physical symptoms are likely to occur?
Try and analyze your response.
What is the first thing you notice?
What is your first reaction to what you just noticed, and what happens next?
Choose one sensation or symptom to work with at a time, and simply notice it and see what happens next. How would you describe the specific sensation? As you track it, see if you can locate it in a specific body area, and whether it spreads. Does its intensity change? Is it coupled with other aspects of the SIBAM? In other words, what feelings, thoughts, images, sounds, patterned behaviors come up with the sensation you’ve focused on? You may wish to rate it on a scale form 0 to 10, where 0 is neutral and 10 is the most distressing; after you’ve worked with it a bit as described above, see whether you might now rate it differently.
This question of what happens next is very important—once you become aware of the sequence in question you may be able to restore innate bio-rhythms and flow, processes that tend to get disrupted upon feeling anxious and panicky. This is the idea behind what Peter Levine calls pendulation. Just like a pendulum moves back and forth, we move back and forth between feeling some sort of constriction (e.g., butterflies in your stomach, a tightening of your chest, a heaviness in your heart) and expansion (e.g., facilitating the spontaneous breath and intake of more air into your lungs, feeling lighter). The awareness of this movement helps restore our innate rhythms.
Consider keeping a journal of how you feel
If you become a neutral observer of your thoughts and feelings, and perhaps take a moment to jot down their sequence as you begin to feel a twinge of anxiety, this can help you channel your anxiety constructively. Are there any patterned sequences you can identify? While the original precipitating event/s or triggers may not always be evident, you can learn to break up a sequence or cycle that maintains your anxiety. When you do, you have negotiated the challenging situation. Doesn’t that feel good? Provide a sense of control, mastery? Savor this hard-won good feeling, it helps create a new neural pathway in the brain, an alternative to the pattern you knew so well.
The more you practice the art of pendulation, of going back and forth between feelings and sensations in which you feel constricted, and those where you feel freer and more You, you will be more regulated, and less prone to being overwhelmed by life’s inevitable stresses. It is important to practice when you feel good and are only mildly activated, so that when you become more upset, the mind/body knows what to do. By practicing on an ongoing basis for a few minutes at a time, you are investing emotionally for the long term.
In parallel, we all need to learn how to increase our capacity to tolerate difficult and unpleasant, so-called ‘negative’ feelings without becoming overwhelmed or bowling over, a topic for a future article.
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For more information about the body/mind connection, click on the author’s name (above) and visit her website at www.ruthshidlo.com
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