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Which is worse, the pain or the anxiety?

A client came to see me recently for physical pain. I asked her how long she’d had it and she replied

Well, it started after the anxiety attack I had in January and since then it’s just got worse and worse. It’s spread up both my legs and into my hips, and it keeps me awake at nights’.

Woah. Rewind there. You had an anxiety attack? Let’s talk about that.

Well balanced, emotionally easy people do not have anxiety attacks. Yet for her it was just something that had happened and was hardly worth mentioning. Certainly not as important as the pain in her legs. If my client had had a heart attack it would have been treated – rightly – as a medical emergency but because it was ‘only’ an anxiety attack it was something to be shrugged off and ignored.

Did you know that some medical conditions can cause anxiety? According to the Alvarado Parkway Institute in San Diego, heart disease, diabetes, seizures, thyroid problems, asthma, drug abuse and withdrawal, rare tumors that produce certain “fight or flight” hormones, and muscle cramps or spasms are all possible medical causes of anxiety. This is why what I do is so effective, because the combination of counselling and Bowen therapy - or even just Bowen therapy on its own - helps with both anxiety and physical pain at the same time.

What are you afraid of?

Fear, like stress and many other emotions, can be a good thing. We’re given it for a reason and that reason is to keep us alive. You would probably avoid standing in the middle of the outside lane of the M4 for fear of being run over and killed, which would be extremely sensible. The outside lane of the M4 is a dangerous place. The supermarket is not. So if the thought of going to the supermarket is as terrifying as standing in the outside lane of the M4, your fear has gone beyond being a useful survival mechanism and into being life constraining.

You know that already, of course. And because extreme fear can cause panic attacks, which are in themselves no fun, some people are so afraid of having a panic attack that they become the source of the fear. A potentially self-fulfilling prophecy and at best a vicious circle that can leave the poor individual too afraid to leave the house.

There are people who enjoy fear and this is why extreme sports, horror films and roller coasters are so popular. We have a whole holiday – Hallowe’en – devoted to the concept of being afraid. Moderate quantities of fear (and what is a moderate quantity is a very personal thing) releases hormones and endorphins which are designed to make you run away faster, but which also produce some rather pleasant sensations in the body. Too much of them and you start to feel sick, panicky, overwhelmed, breathless and shaky. This is what many people would describe as a panic attack.

Anxiety is the ‘official’ term for out of control or disproportionate fear, although ‘blind panic’ may feel more appropriate. It’s extremely common. When exactly it becomes a problem is more difficult to define and again will vary considerably from person to person and situation to situation.

Nervousness before giving a big presentation at work is normal (in the sense that most people feel it); you may find this easy to deal with or you may not. A few deep breaths before you start may be enough to control it or you may find yourself in the loo doubled up with pain, vomiting and unable to breathe. As giving a presentation is not in fact a life-threatening situation, the latter response is disproportionate. But simply telling yourself that won’t help.

How to combat the fear.

The trick in this kind of situation is working out what you’re REALLY afraid of. Nervousness about giving a presentation, discomfort in gatherings of strangers, and crippling social anxiety can actually all be variations of the same thing – fear of what other people might be thinking of us. What other people are thinking of us is not generally life threatening either, so why does our body and our brain behave as if it is?

One reason could be that we’ve been taught to think it is. We may have been taught by others; perhaps we were punished or humiliated as children for not living up to the expectations of parents and teachers. This is also why what's fun for one person can be terrifying for another. Or we may have taught ourselves. We’re a lot better at teaching ourselves things than most of us think – in fact we can do it without even realising it.

Anxiety and shame.

Some psychologists believe that anxiety and shame are closely related. Nobody likes being shamed, so if we were regularly shamed as children (or adults) by caregivers or authority figures that can be enough to set up a pattern of social anxiety. We fear being judged and shamed, so our brains tell us to avoid situations where that might happen. From our brain’s point of view that’s very sensible; its main job is to keep us safe, after all.

You may have heard that we only use 5% or 10% or some other very low percentage of our brains. This is of course nonsense. We use all of our brains all the time. What is probably more true is that we only consciously use about 10% of our brains. The other 90% or so is running around keeping our hearts beating and our spleens doing whatever it is spleens do, and at the same time listening, recording, analysing and assessing everything that is going on around us. It also judges everything we do, say or think.

What do you say to yourself? The impact of self-talk

When you forget something or drop a saucer, do you think ‘Oops’ or do you think ‘Stupid! That’s typical of me – I’m always dropping/forgetting things!’ Do you over-dramatise? ‘The traffic was a nightmare!’ Unless the traffic comprised flesh-eating zombies it wasn’t a nightmare. But your subconscious doesn’t know that. It registers that you experienced a nightmare and it knows they’re bad. So we go about telling our brains that not only is our environment is filled with hazards like ‘nightmare’ traffic and ‘horrific’ weather, but also that we’re stupid and always doing things wrong. No wonder it’s afraid to let us out unaccompanied.

I don’t mean to suggest that if we only bucked up and talked more positively to ourselves our anxiety would be cured. There are lots of possible causes of anxiety and unhelpful self-talk may only be one of them. My point is that after years of negative self-talk and negative input from other people – usually influential people like parents, teachers and supervisors – our poor brains can become overwhelmed by the seemingly impossible task of keeping us safe in a world it’s told is increasingly dangerous.

Life events can ‘trigger’ anxiety, whether childhood trauma or a steady build-up of stressors as an adult such as overwork or money problems. Just as we can train our brains to think the world is dangerous, we can also train them to think we’re incapable of handling things that happen to us.

If that sounds to you as though I’m trivialising anxiety, then I apologise. That’s not what I’m trying to say. Anxiety is very serious. But hopefully you can see that just as our brains have been trained to see the world as full of dangers and we hopelessly ill-equipped to survive it, we can also train them to see things differently.

In America about 40 million people have anxiety and only about a third actually seek help, which is a great shame because it is eminently treatable.

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