We get pulled into anxiety disorders when we catastrophically misinterpret our primitive ‘freeze, fight or flee’ stress response reaction. This stress response reaction has two very powerful aspects; it wants to both physically mobilise us and emotionally motivate us to escape the physical threat it erroneously thinks we are facing because we have been behaving (thinking and/or acting) so apprehensively. OCD sufferers are in the highest echelon of anxiety sensitivity and so are even more vulnerable to catastrophically misinterpreting higher levels of anxiety than the average anxiety sensitive who constitutes up to 20% of the population. The catastrophic misinterpretation takes place when the sufferer assumes that what they experience from anxiety means that the intrusive thoughts/obsessions they are engaging in are important/true. As a result, the sufferer will engage in apprehensive rituals and/or compulsions to help relieve their anxiety, although this ultimately results in the reinforcement of their anxiety and the creation and reinforcement of their OCD cycle. The more powerful this OCD cycle becomes, the more powerful the experience of anxiety becomes, pulling the sufferer into an anxiety distortion where the sense of risk is blown completely out of proportion and there is an ever-escalating loss of rational perspective. Once a catastrophic misinterpretation has taken place, an irrational belief system is formed that results in irrational feelings which trick the sufferer more and more into believing that their OCD fears are true. Trauma (usually childhood) also compounds this catastrophic misinterpretation. Here are some examples: Harm OCD The emotional experience of anxiety: A dark sinister dread feeling, like something bad is about to happen. The physical experience of anxiety: Tingling in the hands. Intrusive thoughts: “What if I lose control of my hands and harm somebody?!” Compounding childhood trauma: Being physically and psychologically abused by caregivers and thereby falsely believing that ‘I must somehow be bad’. Catastrophic misinterpretation/irrational belief system: I’m a danger and should be locked up! Irrational feelings from the irrational belief system: Shame and guilt. Transgender OCD IMORTANT NOTE: Transgender OCD is a sub-category of OCD and characterized by persistent, intrusive thoughts, distress and doubts about gender identity. This has nothing to do with actual gender dysphoria, the diagnosis associated with being transgender. In actual gender dysphoria someone has a natural drive and need to transition because their body and brain don’t feel right in the gender package they received at birth. The emotional experience of anxiety: Feeling like something is off and not right. The physical experience of anxiety: Not feeling in body (depersonalisation). Intrusive thoughts: “What if not feeling right in my body means I want to be another gender?!” Compounding childhood trauma: Neglect resulting in a loss of sense of self. Catastrophic misinterpretation/irrational belief system: I want to be another gender and I’m in denial! Irrational feelings from the irrational belief system: Fear that my life is about to completely change. Relationship OCD The emotional experience of anxiety: Whooshes of doom. The physical experience of anxiety: Stomach drop, feeling sick. Intrusive thoughts: “What if this relationship isn’t right!”, “What if I don’t really love them!” Compounding childhood trauma: Emotional abuse and neglect resulting in a core belief ‘I’m not good enough and will be abandoned’ fuelling an intense fear of being vulnerable in a relationship. Catastrophic misinterpretation/irrational belief system: I must leave this relationship! Irrational feelings from the irrational belief system: Resigned feelings of sadness. Paedophilia OCD The emotional experience of anxiety: Whooshes of doom and a feeling like evil is looming. The physical experience of anxiety: Hot and flustered with heart flutters. Groinal response (e.g. pulsing, twitching, vibrating, erection, increased lubrication, even orgasm). IMPORTANT NOTE: Groinal responses in OCD don’t indicate true arousal or sexual desire. They occur because the sufferer is anxious about the idea of a sexual attraction and hyper fixated on the groin area as a result which results in sensations in that area. Then more the sufferer notices the groinal responses, the more they occur. Excellent information here: Groinal Responses in OCD: What They Are and Why They Happen - Impulse (impulsetherapy.com) Intrusive thoughts: “OMG what if I’m attracted to this child!”, “What if I’m going to harm them!!”. Compounding childhood trauma: Extreme exposure to all things bad from physical, emotional and sexual abuse ready to hook onto in times of high anxiety. The trauma resulting in a core belief ‘Nobody loves me, I don’t fit in, and I will be abandoned’ fuelling an extreme fear of being singled out and abandoned. Catastrophic misinterpretation/irrational belief system: I’m a paedophile and should avoid all children! Irrational feelings from the irrational belief system: Terror, shame, guilt, my world is over. This is just a small handful of OCD themes people can experience. In fact, there’s no limit to the number of OCD themes we can experience because we can create an OCD cycle in whichever way we feel compelled by fear and anxiety. Recovery from OCD requires breaking the OCD cycle of apprehensive obsessions, rituals and/or compulsions that pull us into an anxiety distortion where risk is blown completely out of proportion, and we lose all rational perspective. We do this through Exposure Response Prevention (ERP). This requires Exposing ourselves to situations/people/places/things that trigger the disturbing emotional and physical experience from anxiety and changing our Response – i.e. we work on not engaging in the obsessions and we systematically drop the rituals and/or compulsions. By breaking the OCD cycle over time, risk starts to feel more and more proportionate, and we regain more and more rational perspective. Exposure requires facing extreme fears, so it definitely isn’t easy but the rewards for this short-term pain are freedom from debilitating anxiety and OCD. © Amanda Morgan Here are examples of some of the apprehensive behaviours that keep us trapped in anxiety…
APPREHENSIVELY DISTRACTING FROM ANXIETY: Trying to apprehensively distract ourselves from anxiety and its symptoms and sensations is often one of the first strategies we desperately deploy to try and get rid of anxiety. However, trying to apprehensively distract from anxiety ultimately only reinforces it. This is because whenever we behave significantly apprehensively, our primitive ‘freeze, fight or flee’ stress response concludes we are facing a physical threat, and so then it works to physical mobilise and emotionally motivate us to escape that physical threat it erroneously thinks we are facing, giving us all those frightening symptoms and sensations we call anxiety. And so, although apprehensive distraction may bring some temporary relief from anxiety, we remain on high alert behind the scenes, reinforcing the anxiety and also building fear associations (e.g. if you continuously try and apprehensively distract from anxiety when you go outside or go on transport you will build a fear association with going outside or going on transport). Instead, we must learn how to accept and stay calm in the face of anxiety, thereby allowing it to pass in its own time and for our nervous system to slowly recover. FEARING THE SYMPTOMS AND SENSATIONS OF YOUR ANXIETY: No matter how bewildering and frightening the symptoms and sensations of anxiety may initially seem, they are simply the symptoms and sensations of our body’s primitive ‘freeze, fight or flee’ survival stress response. If we allow ourselves to get frightened by them then we perpetuate and exacerbate the problem because anxiety is caused by apprehensive behaviour (thinking and acting). Instead, we need to learn to accept these symptoms and sensations and remain calm as we experience them, thereby allowing them to pass in their own time and for our nervous system to slowly recover. APPREHENSIVELY SEEKING REASSURANCE ABOUT YOUR ANXIETY: Apprehensively seeking reassurance is another strategy we might deploy to try and solve our distressing anxiety. We may apprehensively seek reassurance through our own inner voices, Google, social media, books, and from others. At first, reassurance seems to help, and our anxiety goes down a bit and we feel a sense of relief. But then the doubts come back in the form of ‘yes…but what if…’ and then we have to find some new reassurance for that new ‘what if’ question and so on which can result in our anxiety spiralling out of control. Instead, we have to learn to see anxiety for what it really is; simply our body’s primitive survival stress response designed to help us ‘freeze, fight or flee’ in the face of danger, which we will trigger less and less as we start to systematically drop all the apprehensive behaviour feeding it. ENGAGING IN SAFETY OR AVOIDANCE BEHAVIOURS: To get some level of temporary relief from the frightening experience of anxiety and the situations, people, places or things we have come to associate this anxiety with, we may engage in safety and avoidance behaviours. For example, we might make sure we are with someone else in a public place (safety behaviour) or avoid public places completely (avoidance behaviour). Or we might make sure we are always driving when in a car (safety behaviour), or we might avoid being in a car completely (avoidance behaviour). However, safety and avoidance are ultimately apprehensive behaviours that reinforce anxiety and train our ‘freeze, fight or flee’ primitive stress response to associate those situations, people, places or things we are putting safety behaviours around or avoiding with a physical threat. And so, when we think about or engage with these places and situations our primitive stress response is immediately triggered, resulting in anxiety and its emotional and physical symptoms/sensations we fear, keeping us trapped in a vicious cycle of anxiety. Ultimately, we need to systematically drop all safety and avoidance behaviours through the process of exposure and see that anxiety isn’t dangerous and passes when we stop fearing it. TREATING UNWANTED INTRUSIVE THOUGHTS LIKE THEY MEAN SOMETHING/ARE IMPORTANT: Everyone gets unwanted intrusive thoughts from time to time (e.g. “What if I can cope!” or “What if the worst happens!!”). We are particularly vulnerable to them when our anxiety is heightened. However, thoughts are just thoughts and not reality and if we start having a conversation with these kinds of thoughts, we trigger more and more of them. All this apprehensive thinking then triggers our ‘freeze, fight or flee’ primitive stress response which gives us disturbing emotional feelings (e.g. feelings of dread and doom or a feeling like something bad is going to happen, etc.) to try and emotionally motivate us to escape the physical threat it erroneously thinks we are facing. These feelings can then make us feel like our thoughts are true or going to come true (though feeling fusion) and so we get sucked into the thoughts and anxiety more and more and lose rational perspective. Instead, we need to recognise unwanted intrusive thoughts as just harmless thoughts and not engage with them, letting them drift out of our mind in their own time. We also need to practice not getting tricked by the disturbing emotional feelings from anxiety; they are just the result of our primitive stress response believing we are facing a physical threat and trying to emotionally motivate us to escape. © Amanda Morgan When we have low self-esteem we can often experience high levels of fear and anxiety with regards to certain people and situations. To get some level of temporary relief from this fear and anxiety we might start to engage in safety and avoidance behaviours. For example, given we are afraid and anxious what people might think about us in a social gathering and how they might consequently react, we might make sure we are with someone else in a social gathering (safety behaviour) or avoid social gatherings altogether (avoidance behaviour), rather than engage with those people and situations authentically. What happens next is our continued safety and avoidance behaviours reinforces our fear and anxiety. This is because our safety and avoidance behaviours prevent us from habituating or, in other words, becoming accustomed to those people and situations that make us fearful and anxious, and therefore relaxing with them. Consequently, those people and situations remain novel and fearful to us, and therefore arousing and fear/anxiety provoking. Furthermore, avoidance tends to generalise over time and this may also be our experience – for example, we might have started to avoid the café at work and then, over time, we began to avoid all cafes, and then perhaps all buildings with cafes. Moreover, when we avoid something that scares us, we experience a sense of failure. Thus, every time we put an avoidance or safety behaviour in to place, our fear and anxiety gains strength, whilst we lose some. The more we do this the more we accumulate experiences of failure, which we take as another piece of evidence attesting to our inability to overcome the problem. Furthermore, safety and avoidance behaviours also eliminate practice. Without practice we cannot gain mastery, and without mastery confidence is less likely to rise. Consequently, our attempts to avoid fear and anxiety through safety and avoidance behaviours only serves to magnify and reinforce it to the point where it has reached the level of phobia. At this level, our fear and anxiety gets so high when we are faced with the person or situation we have conditioned ourselves to fear and avoid, that we lose all perspective and rational thought. We also go to such extreme lengths to persistently avoid this situation, event, person, place or thing, so much so that our fear and anxiety significantly interferes with other areas of our life – e.g., even when we are removed from the person or situation, there is always an undercurrent of fear and lack of personal power/confidence/control. Exposure is key in the recovery process. Exposure involves experimenting to see if your fears are really true. By finding out the truth you can break free from the cycle of fear once and for all. You do this by gradually and repeatedly exposing yourself to what you fear in a safe and controlled way. During this exposure process, you’ll learn to ride out your anxiety and fear until it inevitably dissolves. Through repeated experiences of facing your fear, you’ll begin to realise that the worst isn’t going to happen; your catastrophes/disaster predictions won’t come true. With each exposure, you’ll feel more confident and in control and your fear and anxiety will begin to lose its power and eventually dissolve. © Amanda Morgan Becoming aware of our feelings and constructively dealing with them is crucial for our personal healing and recovery. If we grew up in a family that was to some degree dysfunctional the likelihood is that we didn’t get all our healthy needs met. Not getting some of our needs met hurt us and created painful feelings. Since our parents and possibly other members of our family were unable to fully listen to us, support us, nurture and accept us, we often had nobody with whom we could share these painful feelings. We consequently shut these feeling out, away from our awareness (meaning we shut aspects of our True Self out, away from our awareness). Doing this allowed us to survive and function in the world, however, it came at a price. The price is that, as we have continued this behaviour in to adulthood, we have become progressively numb and out of touch with aspects of who we truly are (our True Self). The aspects of our True Self that we have lost touch with have been unable to grow and evolve. Growing and evolving enables us to feel alive, satisfied and fulfilled. Consequently, because some aspects of our True Self have been unable to grow and evolve, we feel stifled and un-alive; and consequently frustrated, confused, empty, low, depressed, and sometimes distressed. Our feelings are incredibly precious and important. They enable to understand what we truly need and want and what we don’t need and want. They also enable us to make sense of the world around us and process and assimilate our experiences, so that we can move forward, grow and evolve. Getting in touch with them and talking about them is therefore healthy and an essential part of our recovery. Although getting in touch with them for the first time may feel incredibly painful, and sometimes frightening and overwhelming, soon enough these feelings start to become our friends. They become our friends because we need them to feel whole, real and alive, and to enjoy a healthy relationship with our Self and others. Our feelings can be both joyful and painful. The spectrum includes: unconditional love, bliss, joy, compassion, empathy, enthusiasm, contentment, fear, hurt, sadness, shame, guilt, anger, confusion, emptiness, numbness. The way out of a painful feeling is through it. We may have buried many painful feelings and therefore, as part of our recovery, we need to carefully uncover and process them. This process includes sharing our feelings with safe others. © Amanda Morgan How do we get in the anxiety trap/become tricked by anxiety?
Four phases of experience can lead to us getting caught in the anxiety trap. PHASE 1 We experience overwhelming stress. PHASE 2 The overwhelming stress we experience causes us to behave (think and act) apprehensively, triggering our body’s freeze, fight, flee stress response to such an extent that the symptoms and sensations we experience are so bewildering and terrifying for us that we come to fear them. The fear we feel consequently perpetuates and heightens the activation of our body’s stress response and its accompanying symptoms and sensations and thus we get trapped in the fear and stress response cycle that goes like this: stress response – fear, stress response, fear, stress response – fear, stress response - fear, stress response - fear, stress response and so on. Rather than understanding right at the beginning that the anxiety symptoms and sensations we are experiencing are simply the symptoms and sensations of our body’s stress response and that they will eventually go when the stressor(s) that triggered them passes, or when we deploy better strategies for managing stress more effectively, allowing time for our body to recover and re-balance, we get caught in the anxiety trap/become tricked by anxiety. "Many people are tricked... A sudden or prolonged state of stress may sensitise adrenaline-releasing nerves to produce the symptoms of stress in an exaggerated, alarming way. This state of sensitisation is well-known to doctors, but so little known to people generally that, when first experienced, it may bewilder and dupe it's victims in to becoming afraid of it. If asked to pinpoint the beginning [of problematic anxiety]… I would say that it is the moment when the sensitised person becomes afraid of the sensations produced by severe stress and so places himself in a cycle of fear-adrenaline-fear. In response to this fear, more adrenaline is released and his already sensitised body is thus stimulated to produce more and more intense sensations, which inspire more fear. This is the fear-adrenaline-fear cycle.” (Dr Claire Weekes, ‘Self-Help for Your Nerves’ (1997), page 8) "Sufferers from these symptoms... are quite sure that there is something seriously wrong with them and cannot believe that anyone else could have such a distressing experience. Many feel convinced that they have a brain tumour (at least something 'deep seated') or that they are on the verge of madness. Their one wish is to be, as quickly as possible, the person they used to be before this 'horrible thing' happened to them. They are often not aware that their symptoms are nervous in origin and follow a well-recognised pattern shared by numerous others like themselves, the pattern of continuous fear and tension". (Dr Claire Weekes, ‘Self-help for Your Nerves’ (1997), page 11) It is incredibly easy to get tricked/caught in the anxiety trap given that most people are not sufficiently informed about the physiology of anxiety. Even when we are informed, the actual experience of acute anxiety – its symptoms and sensations - can take us by surprise and be so bewildering, frightening and terrifying that, at the time, the only context we feel the experience warrants is a catastrophic one. Examples of catastrophic thinking we might attach to the bewildering, frightening and terrifying symptoms and sensations of anxiety include:
The more we engage in catastrophic thinking, the more apprehensive and fearful we become, further heightening our body’s freeze, fight, or flee response and its symptoms and sensations setting up a vicious cycle of: stress response – fear, stress response, fear, stress response – fear, stress response - fear, stress response - fear, stress response, and so on. Furthermore, if we experience acute anxiety and catastrophic thinking when engaging with a specific type of situation, event, person, place or thing, we might come to associate that situation, event, person, place or thing with the sense of fear we felt. This is called fear association. For example, if we experience the symptoms and sensations of a panic attack in a in a public place we then might associate public places with a panic attack (this is how agoraphobic develops), or if we experience the symptoms and sensations of panic attack in a car we might then associate being in a car with a panic attack. PHASE 3 To get some level of temporary relief from the unpleasant experience of our nervous system hyperarousal, the catastrophic thinking we engaged in as a result, and the situations, event, person, place or thing we came to associate all this with, we engage in safety and avoidance behaviours. For example, we might make sure we are with someone else in a public place (safety behaviour) or avoid public places completely (avoidance behaviour). Or we might make sure we were always driving and on our own in a car (safety behaviour), or we might avoid being in a car completely (avoidance behaviour). PHASE 4 Our continued safety and avoidance behaviours reinforce our fear of the symptoms and sensations of our body’s freeze, fight, or flee response/nervous system hyperarousal, and the situations, events, persons, places or things with which we associate them with. This is because our safety and avoidance behaviours prevent our nervous system from habituating or, in other words, becoming accustomed to those symptoms and sensations, and the situations, events, persons, places or things we associate them with, and therefore relaxing with them. Consequently, those symptoms and sensations, situations, events, persons, places or things remain novel and fearful to us, and therefore arousing and anxiety provoking. Furthermore, avoidance tends to generalise over time and this may have also been our experience – for example, we might have started to avoid using the escalator at work and then, over time, we began to avoiding all escalators, and then perhaps all buildings with escalators. Moreover, when we avoid something that scares us, we experience a sense of failure. Thus, every time we put an avoidance or safety behaviour in to place, our fear and anxiety gains power and control, whilst we lose some. The more we do this the more we accumulate experiences of failure, which provide more and more evidence of our inability to overcome the problem. Furthermore, safety and avoidance behaviours also eliminate practice. Without practice we cannot gain mastery, and without mastery confidence is less likely to rise. Consequently, our attempts to avoid our anxiety through safety and avoidance behaviours only serve to magnify and reinforce it to the point where it has reached the level of phobia. At this level, our nervous system hyperarousal is so high when we are faced with the situation, event, person, place or thing which we have conditioned ourselves to fear and avoid, that we lose all perspective and rational thought. We also go to such extreme lengths to persistently avoid this situation, event, person, place or thing, so much so that our fear and anxiety significantly interferes with other areas of our life – e.g., even when we are removed from the situation, event, person, place or thing, there is always an undercurrent of fear and lack of personal power/confidence/control. © Amanda Morgan www.amandamorgancounselling.com Read more about recovery from problematic anxiety on my website |
AuthorAmanda Morgan is a counsellor practising online, UK. She is passionate about supporting adults (18+) to recover from low mood, anxiety and low self-esteem and enjoys writing about these subject areas. Archives
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