If someone is chronically anxious about murderers, then it is almost certain that they are also acting in a defensive way, such as checking for possible murderers (under the bed), or avoiding situations where there may be murderers (dark alleys). It is this constantacting as if you are in danger that makes our anxietyworse.
Anxiety is a primitive defense mechanism that does not understand the world, but guesses from our actions whether or not the world is safe.
If you keep acting as if there are murderer around, your anxiety gets stronger to help you do a good job of checking for murderers.
Consequently, if you stop looking for murderers, the anxiety initially will get stronger, just to remind you that you are supposed to be checking.
But if you continue to check less often, (and survive!), the anxiety will eventually get weaker, as you keep acting as if you are relatively safe.
This means living for a while with a mismatch of feeling a little anxious, but acting as if you are safe.
If you work on this approach daily, the anxiety has no choice but to eventually go to sleep, as you act as if the world is not full of murderers.
As most writers suggest, you need to this very gradually, otherwise the anxiety will get too strong, and you will end up checking again.
This technique is called Graded Exposure and Response Prevention, and has been researched by neuroscientists and behavior therapists for the last 60 years. There are many self-help descriptions on the internet of how to do use this technique successfully. This technique is extremely effective in any area where one’s fear is out of line with reality.
A few further points about anxiety:
I am saying that there is nothing wrong your anxiety mechanism.
It is not disordered.
You, through your defense behaviors, have taught it that the world is full of murderers Andit believed you!
Now, you have to surprise the anxiety by acting as if the world is safe.
Through your new behaviors, you have to show it that murderers are very few and far between.
With time and gentle persuasion, it will eventually believe your new behaviors. Remember to look at anxiety as your friend.
Here’s my guess of why psychiatrists do what they do. Medication is the quickest way to block fear.
When a psychiatrist first meets a new patient suffering from acute stress, fear or anxiety, he or she is quite likely to prescribe fast-acting medications, such as Xanax or Klonopin. For most psychiatrists, this is the first line of defense for helping distressed people begin to gain some control over their emotional problems . They prescribe it because it works. The distressful feelings magically melt away, at least temporarily.
(It is recommended that these types of medications should be discontinued after two months, as longer use can result in chronic addiction).
At this point, the psychiatrist, if following protocol, will slowly taper the patient off the benzodiazepines, and probably switch to alternate medications such as a long -lasting antidepressant with less addictive qualities. If the second type of medication works, all well and good.Some patients can live comfortably on this second class of drugs for years. Many fail on the second medication, and so a third is tried, and so a fourth……
The problem with this approach is that medicines do not cure the uncomfortable emotion. They simply block it. If the medication is stopped, especially too quickly, there is emotional chaos, with most people experiencing more fear than they felt before they started the medication regimen. It is extremely important that you very gradually come off these medications, as any self-respecting psychiatrist is likely to emphasize. The slower the taper, the better.
So medications work well for about one-third of the people who try them. They are the lucky ones, as long as they never need to come off the medications, and as long as the medications continue to work.
I used to worry about dying when I was quite young. All I know is that my worrying about death has decreased over the years, even though I am obviously closer to death now than earlier. Many people don’t seem to be unduly worried about death, while others are absolutely terrified about it. There is a way of learning how to not to be so worried about it.
You can stop worrying about death once you understand how the “worry mechanism” works.
Let me explain.
Worry is part of our survival mechanism found in all people. Worry, anxiety, fear and panic are all tied together in a primitive part of the brain.
This mechanism is constantly on guard, watching what you do, and it becomes very active when you perceive danger in your world.
It helps you escape from danger, and remembers all your past defensive responses. so that it can prepare you to defend yourself in similar future dangerous situations.
Worry is quite useful for helping to make rational decisions about long term goals, such as looking for a good paying job, trying to choose the right partner to live with, choosing the right vacation, and hundreds of other things where we have to plan for the future.
However, worry gets us in serious trouble if you give it an unsolvable task, such as finding out what happens when you die.
Your worry mechanism will not stop looking for an answer, as long as you demand an answer.
If you want to stop the worrying, you have to stop demanding an answer!
The only way to stop demanding an answer is by practicing facing the fear that you will never know the answer.
Eventually, you can get peace by accepting the uncertainty of life and death.
How do you tell this “worry mechanism” to stop looking for an answer?
First, need to look at how this primitive worry mechanism works.
This mechanism is so simplistic that it can’t tell the difference between a thought and reality.
It simply watches what your do, and if it sees you trying to escape from a thought, it will activate all sorts of escape mechanisms to help you to literally run away.
But you can’t run away from a thought!
The panic mechanism eventually gets exhausted, and subsides.
But the next time you get the thought, the survival mechanism remembers what you did the last time, and repeats the whole process.
Repeat this process enough times , and before long you are suffering from a phobia.
So how do you stop this vicious cycle?
Remember, the worry remembers what you did in the past, and helps you to try to escape again.
So if you begin to act as if you are not in immediate danger, (which you are not), your worry mechanism will fight you initially.
But if you DO survive, ( which you will), the worry mechanism is surprised and a bit confused.
If you keep letting the thought be there and NOT escaping, the worry will learn that a thought is not dangerous, and give up trying to protect you.
This technique is called Imaginal Flooding, the most powerful technique for getting rid of phobic thoughts.
If you can work with someone well-versed in the technique, I would strongly recommend it. But if you are left to your own devices, here are the basic steps.
Lie down and get relaxed for about 5 minutes.
Now bring to mind one of less scary thoughts about death.
Keep the thought in mind as vividly as possible, feeling the fear.
But stay completely relaxed and breathe very gently as you feel the fear. It is extremely important that you show as little physical reaction as possible.
( If you can’t stay still, try the process again with a less scary thought.)
Now keep the thought in mind for 10 minutes.
Take a break for 5 minutes.
Now repeat steps 2, 3, and 4 for another 10 minutes.
Chances are you scared yourself each time, but you gave a message to the worry center that you no longer run away from this type of thought. That is the major point of this exercise.
Now, each day:
Repeat the above procedure, but simply do everything in one 20 minute session, staying completely relaxed through the whole time while trying to scare yourself by making the thought as vivid as possible.
You will find that the thought gets less and less scary each day. As it becomes less scary, try to introduce other more scary thoughts, scaring yourself as much as possible, while staying relaxed.
In a couple of weeks, you will begin to find is more and more difficult to scare yourself. And with further exposure, you will begin to get bored with the whole process.
It is living with the mismatch of feeling scared, but refusing to run away from the thought, that teaches the worry mechanism that these thoughts are not dangerous.
We can’t completely stop being afraid if we want to survive in this world. If we had no fear, we would be as careless as a two year old playing with a loaded gun.
Without this primitive defensive mechanism, we would not last very long. We use it automatically every time we cross the street, when we avoid dark alleys late at night, when we startle to a loud noise, or when we accidentally fall.
Fear is our most powerful emotion:
It takes dominance over hunger, thirst , sex, and anger.
It is our tireless bodyguard who is constantly on the alert, except when we happen to fall asleep.
Even then, it is likely to arouse us if some unexpected noise occurs.
There is no way we can just turn off fear the way we can turn off the water from a dripping faucet.
It is not under our direct voluntary control.
Fear is all about staying alive.
This fear mechanism has been around for ever, and it is found in the simplest of animals. All animals have some sort of fight or flight mechanism deep inside their brains.
In human beings, it is fully developed even before we are born!
It remembers from the beginning all these little insults to our comfort, so that the next time we are in similar situations, it remembers what we did in the past, and it tries to escape before the insult happens again.
Well before we have anything that vaguely looks like intellegence, this primitive system has developed an enormous catalogue of what to approach, and especially what to avoid.
This system is absolutely wonderful for surviving in a world of anarchy and chaos. And most animals still live in such a world. Most of the world is still a very brutal place, where many animals need to kill other animals in order to survive. Developing good escape and avoidance skills is absolutely essential.
This modern world is fortunately not as dangerous as complete anarchy.
In this modern world, and with the addition of a very sophisticated cerebral cortex which takes the first 20 years life to fully develop, we have partly left that chaotic world of being a small fish, who is spending most of its time trying not to be eaten by a bigger fish.
Using our verbal and non-verbal communication skills, we have learned how to get things that we want in life without having to kill our neighbor in the process.
We do not need such a constantly active fear mechanism. And the fear can get in the way of interacting with the world in a more carefree way.
Our fear get out of hand especially in social situations. It was never meant to handle situations where we are afraid of being stupid, or avoiding taking important exams, or being worried about our finances in the future. It was designed to literally run away from physical danger.
So when we literally start avoiding social situations, the fear assumes there must be something life-threatening about that situation. It thinks it’s doing a good job of saving us from certain death. It is too primitive to know any better.
Retraining our Fear Mechanism
So how can we train this fear mechanism to stay alert for some situations, such as crossing streets, but not to be so active in situations where we feel we may appear stupid?
Graded Exposure and Response Prevention (ERP) is the most efficient way to teach this fear mechanism what we need to avoid, and what risky situations we need to approach in order to survive in this modern world,
Using ERP, we learn to put in new behaviors that are incompatible with what the fear is preparing us to do, which is to run away!
We have to gradually practice walking towards the situations that we really desire to do, and which we know are not life-threatening.
Initially, the fear mechanism will automatically try very hard to get us to run away. That is because we have trained it to run away in the past, and it simply remembers our old instructions.
But if we hold our ground, the fear will be very surprised at the result, (Hey, we are still alive!), and will gradually learn through further trials that the situation is not life-threatening.
It is essential that we start of with easy confrontations. If we try to face too much fear at any one time, the fear will win, we will run way, and we have made our fear little stronger.
The main point to remember is that fear is a slave to our past escape responses.
As you stop escaping from non-life threatening tasks, the fear has no choice but to change to match our new non-defensive behaviors.
But we have to be prepared to face the mismatch of living with increased fear for a while, before the fear gets the message that social situations are not life threatening.
And the more often you take these risks, and occasionally feel embarrassed, the sooner the fear will begin to go to sleep.
Actually, if you can’t calm down, its because you are acting is if you are in danger! If you want to get rid of anxiety, you must first act as if you are safe! Only then can the anxiety go to sleep.
Ask someone “How do you know you are anxious?” They will usually mention sensations such as feeling butterflies in the stomach, tightness in the chest, racing thoughts, shortness of breath, trembling, inability to think clearly, pacing, feeling frozen, or having an urge to run away. Obviously, your anxiety is actively preparing to do something!
It is simply preparing you to run away.
Anxiety is part of a very primitive survival mechanism found in the majority of animals.
Anxiety is your bodyguard:It is an early warning system, to help you escape physical danger.
And whenever you run into a situation that looks similar to a past uncomfortable situation, your bodyguard immediately revs you up to help you escape again to a safe place.
When you reach a safe place, you automatically relax and act as if you are safe.
Your bodyguard observes you relaxing and acting as if you are safe.
It declares “Mission Accomplished”, and goes back to sleep until you meet your next threat.
How is this related to depression? In the anxious person, this defensive mechanism is working overtime! And chronic anxiety leads to depression. Get the anxiety under control, and the chances are you will get the depression under control! This anxiety mechanism is fully developed at the time you are born.
At birth, your first response is fear, as you are suddenly dragged into a hostile world of lights, noise, cold, and uncertainty, as you struggle to breathe for the first time.
Gone is the serenity of that safe, relaxing, womb.
As a newborn, you suddenly have to face a lot of discomforts that you never experienced before: hungry, discomfort of a messy diaper, loud noises, horrible glaring lights. Your reaction is to go back to your safe place. But that has gone for good.
Somehow you have to make the new world safe, but you have no control over your environment. However you soon learn that crying usually results in some response from the world, where your discomforts are somewhat relieved.
So the next time you are in a similar uncomfortable mess, your bodyguard remembers what you did the last time, and gets you crying again, hoping to get similar magical relief.
Before long, you are using these types of agitated responses to escape from all sorts of discomforts.
This is the one point you need to remember about anxiety
When you feel anxiety, your are feeling a primitive part of your body preparing to escape from where you are, and to help you find a safer place.
And the strength of that anxiety is directly related to how often you have escaped from similar situations in the past.
So what is a safe place?
It is any place where you where you can relax, and act as if you are no longer in danger.
Once you are relaxed, your bodyguard believes it has done it’s job, and the whole defensive mechanism goes to sleep.
Unfortunately this primitive anxiety mechanism has little else to offer in terms of survival. It simply prepares you to run away, and find a safe hiding place. That’s it!! But in this modern world, running away is the wrong response if you are:
Feeling trapped in the boardroom.
Worrying about your financial future.
Feeling uncomfortable in social situations.
Being afraid of flying,
Working for an angry boss.
Giving a speech,
Taking an exam.
Anxiety is actually counterproductive in these situations. So how do we stop these rather mentally bodyguards from pressing the panic button in these situations?
The only way you can do this is by acting as if you are safe! Easier said than done! After treating anxiety patients for many years with a variety of techniques, I find the most effective way of teaching people how to feel safe in stressful situations is by using Exposure Therapy, or, to use its full name:
Graded Exposure and Response Prevention (ERP)
This technique has been around for 65 years, and it teaches you how to gradually walk towards slightly anxiety-provoking situations, where you increase the anxiety a little bit, but practice tolerating the discomfort.
Your bodyguard will fight you initially, because it is still trying to get you to run away.
However, if you keep acting as if the situation is safe, your bodyguard will eventually get the message, and then it actually has no choice but to go to sleep.
So how would you use this ERP technique with an angry boss?
It is helpful to learn some good relaxation and breathing technique before you start the procedure, as these skills can help you to act as if you are safe.
This is why there are so many disciplines that emphasize the importance of relaxation, whether it is meditation, mindfulness, yoga, Zen, Buddhism, just to name a few. Obviously, these disciplines know that there is some connection between having a relaxed body and gentle breathing that can counteract fear and anxiety.
So, if possible, try to learn some basic relaxation and breathing skills as mentioned above. These are useful lifetime skills to help you find your safe place.
Next, ERP in imagination:
Then, do this simple ERP exercise in the safety of your own home.
Imagine yourself at work, with your boss is in his usual bad mood. Create the image as strongly as you can, trying to scare yourself as much as you can, while staying as relaxed as possible despite the fear.
Do this imaginal exercise for several days in a row, for about 20 minutes each time!
This can feel quite scary the first couple of times you do it. But after about 7 days, you will notice that it gets more and more difficult to experience the anxiety.
You bodyguard is beginning to get bored.
Then, use ERP in the real world:
Now start trying to relax in the work situation.
Start with easy situations, where you practice relaxing when your boss is not around.
As the workplace begins to feel a little more safe, try deliberately holding that relaxed state when your boss is around.
Later you practice the same behavior when he is ranting and raving.
With time, you will notice that the anxiety is getting weaker as you act as if you are not in physical danger.
At the same time as you are practicing the above exercises, you will probably notice that you have other defensive behaviors going on. Use the same ERP strategy with these as well. For instance, use the strategy to:
practice making eye contact with your boss;
looking for ways to approach him, rather than hiding and avoiding;
talking to him earlier, rather than delaying:
standing up straight when you are around him, and so on.
Each day, try to approach some slightly scary situations, feel the bodyguard suggesting that you avoid the situation, but just relax and walk towards the discomfort. Notice that with consistent practice the anxiety gets weaker and weaker, and that you feel more and more secure. In general:
Behave in a way which is the opposite to your old defensive way.
Make the tasks relatively easy.
This technique take patience and perseverance.
You need to win most of these battles.
If you fail too often, you are pushing yourself too hard, and the bodyguard will not be convinced that you are in a safe place, and begin to take over.
Finally, watch how your other colleagues act around your boss. If some are acting in a more relaxed way, perhaps you can learn from their techniques.
In summary, if you keep acting as if you are safe, and not pushing yourself too hard, your bodyguard all eventually get the message that you are in a relatively safe place, and will stop preparing you to run away.
All the items you mention fall into the same category, – some kind of internal sensation or unexpected mark on your face that makes you suspect there could be something terrible happening inside your body. And you seem desperate to find ways of getting rid of these scary thoughts, and to get reassurance that there is nothing terribly wrong.
These types of concerns are found in many anxious people. And as long you don’t have an answer, the anxiety will bug you until you find one. I think most people will agree that your problem is the ANXIETY about the sensations, NOT the sensations themselves.
I have experienced all the sensations you mention, with increasing numbers as I get older. They puzzle me too. But I do what I believe most people do: Just let the sensations be there, and go about my business. Yes, I get the occasional thought that it could be something really dangerous, but I wait several days, and only do something about it if it doesn’t go away, or if it gets worse.
In other words, I practice tolerating the anxiety for a few days, rather than seeking immediate relief.
This strategy has kept me alive for many years without having to go through the type of emotional agony that you seem to be undergoing. I promise you that you will get these odd “twinges” for the rest of your life. I’ll also promise that the more anxious you are, the more you are likely to notice these twinges.
If you want to reduce your overall anxiety level, you need to do what many others do on this world.
You need to delay seeking immediate relief, and practice tolerating the uncomfortable feelings.
There is overwhelming evidence that the anxiety, with time, has no choice but to weaken.
It normally takes about 2 weeks of consistent practice for people to notice a significant drop in their anxiety level.
