Anxiety

Did you know anxiety is the most commonly searched for word in counselling? Yes, even more than depression. Anxiety is defined as a felling of unease which can range from mild to severe, it can include feelings of fear and worry as well as physical responses.

You may not realise that there are a number of different forms anxiety takes as well, some people will suffer from more than one. The following is a very simple summary of the main forms but if you want more detailed information there is loads out there to research. Over the next few weeks I’m going to go into more detail on some of them, what it’s like to have, what other people might find useful to know and how counselling can help.

Generalised Anxiety Disorder

Generalised Anxiety Disorder (GAD) is worrying excessively and often irrationally about events or activities. People who get defined as “worriers” without a specific issue may well be suffering from this. Its overthinking every situation and possible outcome, no matter how extreme.

Social Anxiety

Social Phobia is really focused on interactions with other people and worrying about what they think of you. It can lead to planning conversations and then analysing them afterwards. It can be minimised as shyness, but at its roots are very low self esteem.

Panic Disorder

Panic Disorder is having panic attacks regularly and maybe for no apparent reason. This may include physical symptoms such as nausea, sweating, palpitations of the heart and trembling. It can be incredibly distressing to experience and hard for other people to witness.

Agoraphobia

Agoraphobia is commonly thought of as being scared of leaving home. It can be more complex than that and it is linked to feelings of being unsafe so some people may be ok in a car but not on a bus or able to visit a corner shop but not a big shopping centre. Being in the places that are perceived as unsafe can mean the sufferer experiences a panic attack.

Phobias can also be associated with panic attacks which may be brought on my encounters with a specific object or situation. These can be animals, a place or situation such as heights or flying, blood or injury or something like a clown.

Post-Traumatic Stress Disorder

Post-Traumatic Stress Disorder (PTSD) is caused by a very distressing or frightening event. It’s symptoms can include nightmares and flashback. It is now well know that military personal can experience it after being in war zones but it is also very common with civilians. Abuse, robbery, road accidents and even natural disasters can be some of the events that cause it and the symptoms may not appear for several years.

It also is very common in those who have suffered abusive childhoods. There is a separate category called complex PTSD for this when people have experienced repeated traumatising events.

Obsessive-Complusive Disorder

Obsessive-Compulsive Disorder (OCD) does get shown quite a lot in media now so you may have an idea of what it is, rituals and repetitive behaviour such as hand washing. What you may not be aware of is the obsessive thoughts/images aspect that some suffers experience and the fact that they may NEVER have the sort of behaviour that you might assume would happen. Hoarding also comes under OCD and the need for symmetry and order.

 

Hyperviligance

I really like this video on hypervigilance as it explains it far better than I ever could.

So much of anxiety is rooted in not feeling safe, even when we haven’t been able to recognise that is what is going on.

It takes work to ease the symptoms and reduce them. Of course, the paradox is that the more useful it may be to find a counsellor the hard it is to reach out to one.

I know how difficult first contact is. How difficult it is to express what your struggles are. I hope you can find the strength to get in touch so we can work on your resilience together.

Social Anxiety and counselling

What is social anxiety?

Social anxiety can be a crippling condition for those who experience it.

Can you imagine what it’s like to try and anticipate every social interaction you have, from the person you walk past in the street, to the man on the bus sitting next to you, to the woman in the shop. Not only are you anticipating what they might say but also what they think of you and what you could say to make them think differently and what they might then do and how you will look and what will they think of your voice and ….. breathe

Breathe

The thoughts have got out of control. It’s as though they have taken on a life of their own. You don’t want to be like this, but you are trapped.

Suffers may find it’s different groups of people or situations that trigger the anxiety and the thoughts. Having to give a presentation or a big meeting at work.

But it can just as easily be a casual invitation to a pub for a night out with friends.

Social interactions

If you are friends with someone who is suffering this, you may not realise just how hard it might be for them. They want to be with you, but sometimes their thoughts stop that happening. They want to have fun and relax in your company, but it isn’t always possible. If it feels sometimes like they aren’t being the friend you want, please don’t assume you don’t mean much to them. It might be because you mean so much, that your opinion is so valued that they worry about letting you down.

It can be really hard to get to know someone with social anxiety as they may be so busy trying to be who you want them to be that who they are gets lost. Or their thoughts will stop them being able to show you who they really are as they might be telling them how uninteresting and boring they are compared to you.

How to improve social anxiety

The thing is things can improve, the horrible irony is that it may mean doing the thing that they find most difficult which is engaging with someone new. Those first steps to contact a counsellor might be agonising.

And make no mistake, counselling can help. It’s not a magic bullet, it’s not going to wash all the problems away. But the experience of giving voice to anxiety with (hopefully) a therapist who is empathic, congruent and non-judgemental can help ease them. Being accepted, having your anxiety accepted is a good place to start finding ways to reduce it.

If you want to contact me but are finding it difficult to take that first step, just use the contact form or click the email button and mention social anxiety. I will understand how hard that has been for you and will get back to you as soon as possible.

 

Generalised Anxiety and counselling

Are you a worrier?

What is that like for you? Is it everyone now and again, or does it happen most or all of the time?

Yes, its normal to worry, that’s true. But for some people that worry becomes excessive and uncontrollable. Lying in bed worrying about where you are going to find parking for the car when you go out at the weekend is the sort of things that might be deemed excessive and uncontrollable, especially if it happens every night of the week.

People who are suffering from generalised anxiety disorder may not even recognise it as that. You may always have worried and not realised how much more you do it to others. Worrying when something stressful is happening in your life is bound to happen, but if you worry as much when you don’t have a much going on might be a sign of anxiety.

Example of GAD

For example, parking the car above, if you are going somewhere new and don’t know the roads you might choose to check before you go. Once you have checked you can be content with that, or if you suffer from anxiety it might go something like this.

  • I’ve checked, but what if I misread the map.
  • I need to check again…
  • and again.
  • But what if all the spaces are full. What do I do then?
  • Is there a car park?
  • How much does it cost?
  • What if there aren’t any spaces in there?
  • Or I don’t have change for the machine.
  • How do I get change?
  • What if all this means I am late for my appointment?
  • What will I do then?
  • Will they wait for me?
  • What if they don’t.
  • Does that mean they resent me for messing them around even if they do wait?

And so on, as you can see one worry about knowing where to park can grow and more and more worries get added to it.

So, what can I as counsellor do to help?

One of the first things I do is exploring what anxiety is for you as it can be different for everyone. Some people will be having a lot of physical symptoms along with the thoughts, others won’t, or won’t necessarily realise they are.

Recognising your anxiety is important, understanding what you are worrying about and how often allows you to acknowledge what is really going on. A lot of anxiety is a bit stealthy and sneaky, we have thoughts we don’t even notice and I will work with you to shine a light on them.

I do this because it is easier to work on what we know than what we don’t.

I may then look at some coping strategies to use when you notice your anxiety growing to help you manage it when it is happening.

In the longer term, we can start exploring some of the reasons and beliefs you have that underlie your anxiety.

However, each client is different so I might adapt depending on what they are bringing.

I do know that counselling can have a long-term impact on reducing anxiety, for some people that can be achieved in a short timeframe of 6-12 sessions, other people need longer. It can be hard work but worthwhile.

 

Separation Anxiety

You have probably heard of separation anxiety. Your child or a child you know may have found it difficult being away from their parent, it may have caused problems for them going to nursery or school. It may be something you feel is a normal part of growing up and becoming used to being more independent and some children just take longer than others.

Did you know though that it can still apply to adults?

For both adults and children, the diagnostics criteria are the same, but for adults the symptoms have to be persistent for a longer period of time. Typically, it is 4 weeks or more for children and 6 months or more for adults.

For adults, the symptoms may have been something that began in childhood and weren’t addressed but more often they are not. I’ve found a study that says approx. 77% of adults developed it in adulthood.

They can still be anxious about separation from a parent figure or caregiver, for example finding it difficult to take the steps needed to leave home and live alone for the first time. It can also though be about separation from a partner or even from their own child who may have moved away.

Exploring the fears that these adults are experiencing and the way they are limiting their ability to function is key to treatment. They may be coming across as controlling, dependent or overprotective and it could be having a negative impact on their relationships. Working on the issues in therapy can help develop healthier and more fulfilling relationships.

Social Anxiety

This article has some interesting points on social anxiety. I’m particularly pleased to see mention of Acceptance and Commitment Therapy (ACT) as I recently underwent some training on this. 

Even though I am a person centred counsellor and ACT is a variant of CBT I found some elements of the training really useful.

Firstly, as the article say The fundamental premise of ACT, then, is that you don’t try to squash your feelings but are able to notice and accept them while committing yourself to a pathway toward change.” Acceptance of ones feelings is very compatible with the Person Centred Approach (PCA). The more aware we are of them the more we can accept them and ACT has a strong element of mindfulness and self-awareness. 

The other part of the training I had that I found very useful was to focus on what our values are. For each of us as individuals, we have the values we are expected to have but don’t always focus on what is truly most important to us. For an individual with social anxiety, they may realise that it isn’t interfering in what they hold most dear, only with what they think they “should” hold most dear. 

Noticing our true feelings and accepting them can be hard, yet it can also be liberating if we can avoid the “should’s” that we tend to carry with us.