The Four Huge Mistakes Almost Everyone Makes When They Try to Cope with Anxiety

We all feel anxious time to time. Some of these common situations are exams, job interviews, financial problems, relationships, conflicts, etc. We feel under pressure when an anxiety-producing event forces us to make some adjustments to adapt to the new situation. We feel anxious and after our appropriate response, pressure subsides and we feel better.

Anxiety is necessary for survival because it acts as a warning signal to alert us to do something to protect our integrity. When anxiety appears you can use relaxation, meditation and positive thinking to feel better.

However, when the anxiety has become a chronic condition none of these strategies could help you cope with it effectively. They may help you feel a bit better but after a while the anxiety would kick in again.

What turns anxiety into major a problem?

What turns your ANXIETY into a major problem has little to do with your genetics, personality or the serotonin activity in your brain.

The key factor is what you do when you feel anxious!

So, here there are the four huge mistakes that almost everyone males when they try to stop their anxiety:

  1. Avoiding social situations
  2. Asking others to keep you company
  3. Trying to control your bodily reactions
  4. Talkig about anxiety

Let’s look at them one by one.

Avoidance makes you fell immediately good because it gives a feeling of relief. After all, you avoided a anxiety producing situation and didn’t have to deal with the symptoms. However, when you avoid, you weaken your resources because you give a very negative message to yourself: “I’m not able to handle this situation!”

Asking for help from family and friends feels good too because you get reassured that in case you felt anxious, there will be someone to rescue you. Although this may seem something positive, however, just like avoidance bears with it a negative message. When people help you out by keeping you company the message you receive is “I help you because you are not able to handle this situation on your own!”

Trying to control your bodily reactions is another huge mistakes. Many therapeutic techniques try to teach you how to control your physiological symptoms. They teach you how to relax, deep breathe and challenge your irrational thoughts in order to gain control. However, the reason that this strategy doesn’t work either is because anxiety reaction happens in a fraction of second by a surge of powerful hormones. The more you try to force yourself to calm down, the more you lose control.

Talking about your anxiety may feel good at first but afterward makes you feel frustrated because you repeat yourself. Be honest! After so many years of saying the same thing, do you have anything new to tell people about your condition? People listen to you because they love you as friends and relatives. This is the positive side of it. However, here too,  when they patiently listen to you, they will send you a negative message. The nasty massage you recive from them is: “you need me to listen to you because on your own you are unable to face your problem.

Therefore the main reason that you haven’t been able to banish your anxiety is because of these four common sense strategies. They seem totally logical but have negative effects on you.

 

The Iceberg Model of Human Behavior

In a previous post (Symptom Removal Vs. Psychodynamic Therapy), I explained the two major streams of thought in psychotherapy. In the first group that primarily focuses on working on the system, Cognitive Behavioral Therapy (CBT) stands out as the most well known approach. Psychodynamic approach, instead tries to get to the root causes of the problem hidden in the unconscious mind.

Symptom oriented therapists try to help people overcome their fears and anxiety in 10 to 20 sessions. However, psychodynamic schools criticize CBT as being a Band-Aid approach because the root causes have not been addressed properly. They argue that if you don’t solve the underlying issues, another symptom could appear in the future.

The unconscious oriented therapists; on the other hand, need several years to be able to explore all the deep root causes before helping the clients overcome their problems. They get criticized for their long therapy process because the clients keep suffering from the symptom until they are able to understand all the deep-rooted issues.

These two approaches have their strengths and their weaknesses. The first one may be faster but risks to be short lived. The second approach may help eradicate the cause but it takes a long time.

Is There a Better Approach? Yes! It is possible to combine these two streams of thoughts in order to get the best of each. For the last decades I have used an alternative method that combines these two approaches so you can get long lasting results in a short time. To explain it I will use the well-known iceberg model.

The Iceberg Model

Sigmund Freud (1856 – 1939), the most prominent figure of psychodynamic school, believed that much of the observable human behavior is caused by inner impulses beneath the conscious awareness of the individual. To explain this model Freud used the analogy of the iceberg. What we see is just a very small part of the iceberg; meanwhile, a giant portion is hidden beneath the surface of water.

According to this model, a symptom, like anxiety, is the tip of the iceberg. The psychotherapists that rely on the unconscious use the iceberg-model to split the human mind into two parts:

The conscious part includes what the individual is aware of. The person with phobia of flying would be conscious of certain thoughts (“What if the plane crashes and I die”), emotions (intense fear) and bodily reactions (perspiration, racing heart, muscle tension, dry mouth, et.).

2) The unconscious part includes images, forgotten or repressed memories, deep urges and existential fears and desires.

The approach I use has the power to address all the deep unconscious root causes. I seek this result working in a special way from top down: focusing on a apparently trivial portion of the symptom that can have a ripple effect downward toward all the deep unconscious issues. (Fig. 2)

All the cases you can read in my blog come from my private practice and my online sessions. For example when you read Katie’s story (I get anxious when my sister insults me) you realize that all I asked her was to do one apparently small and insignificant action. It looks as if what Katie did was not related to her problem. She didn’t have to talk with her sister; fight back; avoid her; etc. She had tried all of these solutions but none worked.

Katie’s small action started a ripple effect that in a very short time stopped her sister to insult her. As if by magic, her relationship with her sister improved and the older one began respecting her.

Although these changes may appear magical, there is a scientific explanation to them. You can easily call to mind the chaos theory or the butterfly effect that argues that a small cause can have large effects. This branch of mathematics has been applied to other fields such as biology, robotics and human behavior. It has proven useful to understand and predict phenomena such as abrupt climate changes, evolution, chemistry and other areas.

In summary, the iceberg model tells us that we have to take into consideration deep issues that are connected to the visible problem or symptom. However, none of the two extreme are efficient ways to solve human problems. Focusing primarily or exclusively on the tip of the iceberg or embarking on a long journey of deep unconscious issues, are both inefficient ways to help people solve their problems. An alternative method is to know exactly where to apply a small change that will have major positive consequences at a deep level.

Symptom Removal Vs. Psychodynamic Therapy

The field of psychotherapy offers a plethora of different and often opposing approaches. Hundreds of diverse schools of thoughts with their own techniques claim to have the solution to human suffering.

This fragmented and chaotic field appears to offer a vast selection of therapeutic approaches to choose from. However, when you observe them carefully, you realize that there are only two major categories, namely Symptom-Oriented Therapies and Psychodynamic Therapies. All schools of therapies fall under these two big umbrellas.

Cognitive Behavioral Therapy (CBT)

The most well known school of therapy belonging to the first category is Cognitive Behavioral Therapy (CBT). This approach overshadows the others mainly because it is dominant in the university setting, and also CBT-oriented research projects receive more funding. For these reasons, most professionals in the filed of clinical psychology receive their training in CBT or a modern version of it such as Acceptance and Commitment Therapy (ACT).

The main goal of CBT, whether in its classical form or its modern versions, is to reduce the symptoms. CBT therapists use techniques to help their clients gain control over their symptom. For example if you were afraid of flying, they would teach you how to control your physical reactions using relaxation techniques. They would also challenge your beliefs and irrational thinking that flying is dangerous, and teach you a technique to cancel your negative self-talk.

Psychodynamic Therapy

On the opposite side, you find Psychodynamic Therapies. The representative of this stream of thought is Psychoanalysis. This approach seeks ways to help the person to gain an insight into their core identity and unconscious desires. Psychoanalysts believe that you need to address the underlying causes of your problem before you can get rid of your problematic symptom. If the clients gain a deep understanding about themselves, they could overcome the symptom.

The chief goal of dynamic therapy is to gain insight first. This is accomplished through a long process of analyzing the unconscious defense mechanisms rooted in the first childhood experiences and exploring one’s neurotic traits and the relationships with one’s parents.

For example, if you sought their help for the fear of flying, they would investigate your past, seeking the root causes of your problem. They would ask you about childhood memories, your relationship with your parents, your fear of death, and other aspects of your core self.

To summarize, if the symptom-oriented therapists see the observable irrational fear as the problem, the unconscious-oriented therapists consider the underlying causes that are below your conscious awareness as the problem. I must also admit that in the past few decades the gap between these two opposing streams of thought has become less wide.

Which Approach is Better?

It is tempting to simplify a complex field such as psychotherapy. Nowadays, most therapists are eclectic and use a combination of approaches. So maybe this is not a good question to ask. A better question is: which therapist is most competent?

When you want to assess the effectiveness of a school of therapy, you must keep an important detail in mind. A therapeutic approach, including all its techniques, is like a toolbox. Simply owning a set of tools does not guarantee that you are a competent craftsman. Craftsmanship requires not only the most sophisticated state of the art tools but also the skills to use them. Thus, you can find exceptional therapists in either category.

As we said, the competency of a therapist is the key to make or break the effectiveness of a specific approach. Next to this ability comes the usefulness of the tools. Therefore, when you look for a therapist, you are better off focusing on their competency as a professional rather on their school of therapy.

I Feel Anxious When My Sister Insults Me

A young woman (let’s call her Katie) in her early forties sought my help for anxiety. After explaining in detail her problem, Katie told me that her major source of anxiety was her relationship with her sister. For the last several years, her older sister didn’t respect her and whenever she had a chance she insulted her. No matter what Katie did, her sister would belittle her with negative comments. As a result, Katie would go home and cry.

Katie had done everything to stop her sister’s negative behaviour. She had remained silent and tried to ignore her sister insulting her. At times she would argue with her defending herself that her older sister didn’t have the right to speak with her with disrespect. At some occasions, contrary to her character, Katie even had fought back by shouting and insulting. However, none of these strategies worked for Katie to stop her older sister’s verbal abuse.

As I talked to Katie I found out that she used to go to her mother’s coffee shop every day. Later in the afternoon her three children would also go to the coffee shop to see their grandmother and their aunt (Katie’s older sister) and have some snacks. Two details draw my attention. First of all Katie’s mother didn’t let her pay for her coffee and for children’s snacks. Secondly, the coffee shop was co-owned by Katie’s older sister.  These two important details gave me the information about how to stop her older sister’s verbal abuse.

I asked Katie to add up the costs of her coffees and her kids’ snacks for one month. She realized that it was an important sum of money. I told her that she could go to visit her mom as usual for coffee and chatting. She could also let her children drop by for snacks. However, from now on, she should pay for her coffees and the snacks. If her mom said that she was part of the family and didn’t have to pay, Katie had insist saying that she would not have coffee nor let her children have snacks unless she paid for them. When her mother saw that Katie was determined, accepted to get paid.

That day Katie’s older sister was not in the coffee shop. However, her mother must have told her the news because the next day Katie’s older sister stopped her verbal abuse. Katie told me that she was amazed because it was like magic. Without saying a word about the rude behaviour of her older sister or confronting her in any way, she stopped insulting Katie. This was a major breakthrough for Katie’s anxiety. We dedicated three more sessions to address other sources of anxiety in her life.

 

Why People Leave Psychotherapy Prematurely

counselling

Needless to say, most psychotherapists dislike when their clients decide to quit therapy prematurely. They have a variety of reactions. Some become upset when their clients complain about lack of results, and there are also those psychotherapists who throw a temper tantrum when someone informs them that they want to abandon therapy!

One of my clients (I’ll call her Joanne), a forty year-old woman, broke up with her partner because she caught him in bed with another woman! He kept contacting her on a daily basis. She felt attracted to him but was not sure about her feelings. Joanne told me that she was still in love with him but didn’t want to continue the relationship. She was anxious because her mind wanted to forget her ex but her heart desired him. She needed help to clear up her thoughts and emotions.

I asked her what she had done so far to solve her problem. Joanne explained that she had been seeing a psychotherapist for ten sessions without any positive results. She had spent about $700 for a therapy that wasn’t helping. For this reason, on the tenth session, she informed the psychotherapist that she decided to quit.

As soon as her therapist heard that Joanne didn’t want to continue the therapy, she became upset and threw a temper tantrum! The psychotherapist, a psychiatrist specializing in psychoanalysis, criticized her by saying things like:

“You can’t stop our therapy now because you are worse than you think you are.”

“You will continue your blind steps.”

“That trip you mentioned with your son, it’s just an excuse. Instead of spending your money on this trip, you should be coming to therapy twice a week!”

After few weeks, Joanne sought my help. It took Joanne three sessions to sort out her mixed emotions and clear up her thoughts. She overcame her anxiety and was congruent about her decision to avoid her ex and start her new life.

Most therapists don’t realize that they are selling a service. People have the right to hire and fire them. Clients bring a problem and want a solution. Competent therapists know this. First of all they are good at what they do and in most cases are able to make a difference in the lives of others. Secondly, they don’t get upset or blame the client for wanting to drop out prematurely.

It’s true that there are some clients that are difficult to work with and they sabotage the treatment. However, most people seeking help have a desire to cooperate, and if they show any resistance is because of fear of change. A professional therapist must have the necessary skills to help clients solve their problems, regardless of their degree of cooperation and resistance. Labelling a client as “resistant to change” denotes mediocre therapeutic skills.

References:

Ogrodniczuk JS, et al. “Strategies for Reducing Patient-Initiated Premature Termination of Psychotherapy,” Harvard Review of Psychiatry (March–April 2005): Vol. 13, No. 2, pp. 57–70.

https://uit.no/Content/418448/The%20effect%20of%20CBT%20is%20falling.pdf