Viewpoint: How to bring anxiety levels under control

Managing unmet needs is the key to resolving anxiety, say Ivan Tyrrell and Denise Winn

All forms of anxiety arise because people’s essential physical or emotional needs are not being met or our innate resources to help us meet those needs are being used incorrectly.

These needs and resources — the ‘givens’ of human nature — are at the heart of the ‘human givens’ approach.

If all of our needs are met in balance, making us confident about our place in the world and about how we go about in it, we do not suffer from disabling anxiety and stress.

This is a powerful idea to work with in therapy. Human givens therapists help people to build up effective ways to meet their needs, at the same time as teaching them how to handle high anxiety.

Anxiety may be something that happens gradually, starting, perhaps, with loneliness after the loss of a loved partner, or inability to make new friends because of overwhelming shyness or feeling loaded with more responsibilities than we can cope with — all cases of unmet needs.

Alternatively, it may be something that happens suddenly, as on those tragic occasions when people whose lives were working well are caught up in a natural disaster or become the victims of violence — and their lives become ruled by fear.

Anxiety may take the form of obsessions and compulsions, phobias or a perpetual, low-grade, debilitating sense of foreboding — all attempts to ward off perceived threat.

Crucial in dealing with abnormal anxiety is an understanding of the brain’s emotional alarm system because this explains so much of what goes wrong.

Human givens therapists explain to people how the anxiety mechanism gears us up to fight or flee, when facing stressful circumstances. Whatever the anxiety’s cause, it helps people to learn that their anxiety was serving them well when it first went on full alert. It was trying to keep them safe. But if it remains in overdrive when the job has been done, it does more harm than good — just like taking antibiotics for life to clear up a throat infection, instead of stopping after just one course.

Internal alarm

Panic attacks and phobic and post-traumatic stress reactions can all be explained in these terms. The amygdala, a small powerful structure in the emotional brain, acts as our alarm system. It stores all of our emotional memories and learned responses and its job is to be alert to any possible danger to us by matching new events to patterns in its store and, from that, judging whether we might be at risk.

The amygdala’s pattern matching is very crude. For example, if a woman has a panic attack in a supermarket because she is overloaded with stress and reaches saturation point when she is in a hurry but stuck in a long queue, the amygdala will file away the fact that there were bright lights and lots of people queuing.

Next time she is queuing in the supermarket or the post office, the amygdala may decide she is unsafe and trigger another panic attack.

Another major cause of anxiety is an unintentional but gross misuse of the imagination. If people are always lying awake at night worrying about ‘What if?’, imagining ever more dire outcomes for themselves or those they care about, they are generating vivid negative fantasies that keep them in a constant state of fight or flight arousal.

If someone is fearful of spiders or cats or bird feathers or mirrors or metals, they may spend a lot of time imagining scenarios in which they might come across them and imagining the panic they will feel.

Unhelpful processes

Imagining a panic attack may be sufficient to trigger one. If people carry out compulsive rituals to ward off bad things from happening, they spend a lot of time imagining the bad outcomes that the rituals are intended, however vainly, to prevent. And so forth.

Because the amygdala’s pattern matching is a crude process, it looks for broad similarities, not distinctive details. Thus it cannot tell the difference between an event that we have been worrying about in our imaginations and one that has really happened. It sets off the alarm bells regardless. When sensing danger — whether real or imagined — it is so powerful that it can shut down our higher intelligence completely. High emotional arousal makes us stupid.

Counselling and psychotherapy are best thought of as a specialist branch of education. The first thing we teach people to do is to learn to relax so that they can bring their own arousal and stress levels down. Then we teach them how to use their imaginations positively, to rehearse successful outcomes instead of bad ones.

If a memory is traumatic, and thus deeply etched, human givens therapists will use a simple visualisation procedure, known as the rewind technique, to take the emotion out of the memory, thus lowering the associated arousal and enabling the memory to be stored as a deeply unpleasant but no longer emotionally arousing one.

Speedy resolution

This technique works swiftly and reliably for phobias and post-traumatic stress disorder, even the most extreme of cases.

Anxious people have to learn to think differently too. The ways in which we explain the negative events that happen to us and to others in the world have a considerable bearing on whether we are likely to suffer from excessive anxiety.

Three particular types of limiting thinking are especially connected with the development of anxiety and depression: how personally people take events; how pervasive they think the effects will be; and how permanent they think the effects will be.

By helping people to change their self-talk and challenge catastrophic thinking, we can lower their stress levels and encourage them to focus outwards on fulfilling activities and the well-being of others as well as themselves — excellent ways of getting their own needs met.

Mr Tyrrell is a human givens therapist and principal of MindFields College, Chalvington, East Sussex.

Miss Winn is a human givens therapist and editor of the Human Givens Journal

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