Some time ago a woman contacted me for online sessions. Her challenge was her loss of joy in life due to a series of health problems and anxiety.
In her own words, often her day would start well but someone would ruin it for her. She would get angry and then sad for not being able to respond to them in a serene fashion. She would feel frustrated because she would start the day with a positive mental attitude but someone would annoy her. She felt vulnerable and didn’t know what to do.
I told her to follow Seneca’s advice. According to this stoic philosopher “We are more often frightened than hurt; and we suffer more from imagination than from reality.” And the solution, according to Seneca, resides in the imagination. For this reason he recommends to start the day imagining the worse case scenarios. We can visualize that several people such as the neighbor, boss driver, colleagues, partner, and others or unexpected events ruin our day. Once we fantasize in our imagination our activities that could go wrong, our mind gets ready for in case it does happen in real life. It’s like vaccinating yourself against unexpected negative events.
Seneca called this exercise premeditatio malorum, which means the premonition of evil.
She decided to give it a try. After few weeks she wrote me this message:
“I write to you to tell you something exceptional! Today after almost four years I went to swim. And I did it! The feeling of immersing my head in the water was like a baptism.
It has been a long time that I wasn’t feeling so good!
I’m applying your advice on a daily basis. I begin to see results. I feel hopeful as well as thrilled. During a long time I had lost both of them.
I wanted to share it with you and thank you again.”
The two emotions that govern our lives are PAIN and PLEASURE. Pain makes us avoid unpleasant experiences while pleasure compels us to desire what is enjoyable. These two emotions are mother nature´s way for self-preservation.
All the other emotions are offshoots of these two primary sensations. The two other main powerful emotions that are related to pain are FEAR and ANGER. These two emotions influence our behaviour in a very powerful way.
Fear is the strongest of all emotions because it serves as a protective mechanism. Anger also has a positive function. It let us know when we, or others, are treated unjustly. Without fear and anger we would not survive in this world. Therefore, even if often we describe some emotions as negative, they are all useful in some context.
Our emotions become a problem when we are not able to manage them. Either we try to avoid the unavoidable or control the uncontrollable. Or worse of all, we delegate the responsibility of our emotions to others.
Our emotions are ours. Even if other people or certain life events cause us feel one of these unwanted emotions, ultimately, we are in charge of how we feel. We can always decide how to express them.
First we ought to recognize that what we feel is human. After acknowledging a certain emotion we must remember that it is fulfilling a purpose. For example, when you get angry, your mind and body is alerting you about an injustice. This injustice is, of course, according to your perception and belief system. This is a useful signal! The next step is to find a way to channel it in a healthy way without hurting yourself or anyone else.
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:
Avoiding social situations
Asking others to keep you company
Trying to control your bodily reactions
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.
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.
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.
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.