Anxiety, the technical name of Worry, has been a friend I grew up with. She first showed up when my dad’s business plunged into bankruptcy. My worried Dad would mumble, most times too loud not to notice, `the wok will not be working today.’ Though he meant there would be no food for the family, there was at least without fail, plain porridge well-mixed with black soya source to savor. As a toddler, it was yummy enough for me, so Anxiety was just a shadow rather than a force to reckon with.
At age 5, I witnessed Anxiety at work hand in hand with Panic when my younger sister was taken seriously ill with white spots in the throat. Two days later, parents returned home from the hospital sobbing their hearts out. I lost a sister and I contracted the same sickness. As mum shoveled the powdery medicine down my throat, I saw Anxiety magnified a thousand folds.
Maternal grandmother was a compulsive gambler who abhorred the sight of a crying child, especially just before she stepped out of the house for her gambling routine. She nicknamed me `flat-nose’ and used unkind words when she spoke to me. My teary protests spurred on by the anxiety welled up within me were in grandma’s eyes – the jinx. I detested visits to grandparents’ home for I would end up feeling hurt and humiliated. It was a great relief when mum eventually decided to spare me the ordeal by leaving me at home.
Anxiety was a constant companion when we were living next to a man with a mental condition. He would always peek out of the dark window to `spy’ on his neighbors. Whenever he threw a tantrum he would throw stones at passers-by. I was often apprehended with fear and insecurity especially when returning home at dusk. However, as I grew older and got used to the environment, the intense fear and hostility subsided.
Anxiety loomed large most time due to financial difficulties in the family. Fortunately, life took on a better turn after I was married. However, 4 years into my marriage, I lost two babies due to spontaneous miscarriages. Naturally I worried about losing another. But by God’s grace I had 2 successful pregnancies subsequently despite an incompetent cervix. However, little did I know the two boys would turn out to be hyper-active. My coping mechanism was rather poor as my energy was sapped trying to keep up with them.
Over the years Anxiety had affected me mentally, emotionally and physically (I recalled the last time I did a course of study in the late 90’s, I was so overwhelmed with anxiety to perform well - which I did - I had to see the dentist not less than 10 times due to chronic gum infections.) Perhaps I was born with a certain level of anxiety at birth but the environment I was in and the nurturing I received were definitely contributing factors in shaping my outlook.
I will be lying if I say I have overcome the tendency to worry. The truth is I was battling with it even after I became a Christian. God in all His wisdom admonishes His People `not to worry for it’s a sin to do so’ and `be not anxious about tomorrow for I take care of even the sparrows’. I can try not to worry or be anxious so long as my mind is stayed on Him. But it is humanly impossible to be wholeheartedly and steadfastly focusing on Him 100% of the time.
Anxiety level escalated sporadically after my children came along. For many years in my struggle to be a good parent, I suffered from Ego Anxiety. My children’s academic and behavioral performance determines the kind of `Report Cards’ I churn out for myself. People around me seemed to be monitoring my progress and I was concerned I might let them down. I seemed to have low frustration tolerance when things did not go as expected for e.g. when children’s academic results dived or when they misbehaved in public. Emotional outbursts became a regular feature in the house especially before and during exam period. Some days I became worried that I had become overly worried. I knew I could trust God more to help me cope but my actions were not in line with my belief and knowledge. Then I suspected it had some thing to do with hormonal effects in my body. I seemed to behave more anxious on certain days. It didn’t help when I became more restrictive with my leisure activities during anxious period. It felt as though the world had stood still when my children were going through major exams. Everything else was put on hold. Although I felt the need to talk about it with a church pastor but when I looked around me I realized I was not alone! Some parents were worse off than me. They had sleepless nights and loss of appetite!
Perhaps I could have been more regular with my exercise routine. But then again it was a troubled anxious state that went in cycles week after week, month after month and I was barely coping. One thing I found helpful is the Osim Massage chair I invested in. I feel a lot calmer and relaxed after each massage. Siesta helps too.
The 3-day Intro to Counseling Psychology which I chanced upon turned out to be the flickers of light at the end of the anxiety-laden tunnel for me. I sensed that I might be able to get some help either directly or indirectly in the learning process.
I learnt that there are many different theories as to the development of anxiety and its causes. Generally, it is a combination of factors - genetic, psychological, behavioral, environmental, physical and sometimes medical. I understand that everyone experiences anxiety which is a normal emotion. The difference is that some people develop and experience high levels of anxiety on a regular or daily basis, and over time this can lead to the onset of an Anxiety Disorder. I am aware that while Anxiety Disorder may have developed due to particular reasons, there are also things I may be doing that are maintaining it. Based on what I was taught, I believed I had experienced different types of anxiety at different stages of my life. I would identify them as Neurotic, Intense, State and Trait.
Based on what was taught, I would consider applying the following Anxiety and Stress Management techniques:
A. Cognitive Therapy is a very effective way of understanding how i think, and therefore feel. Cognitive Therapy helps me to explore my underlying belief patterns that result in negative, irrational and unhealthy thoughts. It then allows me to explore my thoughts and replace them with more useful ones in order to manage my emotions effectively.
Cognitive Therapy is based on the following process:
Beliefs LEADS TO Thoughts LEADS TO Emotions LEADS TO Behavior
I identified 2 main major irrational beliefs of mine:
1. I must be completely competent, make no mistakes and achieve in good time.
2. It is dreadful when things aren’t how I want them to be.
Reference: Davis, M., Eshelman, E., & McKay, M., (1999), The Relaxation and Stress Reduction Workbook, 4th Edition, p. 145 - 147 passim.
Such beliefs are unhealthy. I need to remove the `musts’ and `shoulds’ in my belief system. If i can change my unhealthy beliefs and thoughts and replace them with more healthy and realistic beliefs and thoughts, i can therefore change my emotions (Anxiety) and hence my behavior (emotional outbursts etc).
Even REBT recognizes that i may be strongly influenced by events in early life and that the past is with me in the form of beliefs that i carry in my head in the present. REBT homes in on the beliefs that are harmful in my current emotional life and behavior. I know I cannot change the past but I can change how i let the past influence the way I am today and the way I want to be tomorrow. In this sense, REBT is an optimistic approach to living and to solving problems.
B. I learnt that at the basis of most Anxiety Disorders is often a low self esteem or a lack of self worth. I need to develop a sense of self worth, to like myself and acknowledge the many important aspects and qualities I have. I have special qualities that are unique to me. I need to recognize them and nurture them. There are many ways I can develop a sense of self worth and self esteem. I can read books on self development; I can do courses on self esteem or talk to a therapist.
Below are some helpful ways that can help me develop my self esteem.
Take full responsibility for my life, stop blaming others. Consciously generate rational thoughts and feelings of approval for myself and acceptance in place of old thoughts of inferiority and inadequacy.
Be willing to create a lifestyle that generates, nourishes and maintains sound self esteem (associate with others who have high self – esteem)
Watch what i say, avoid self put-downs, stop being critical of myself and others.
Keep my awareness (thoughts) focused in the present time instead of living in the past or future. Give myself the simple pleasures in life.
Acknowledge my strengths, qualities and accomplishments frequently.
Invest money in myself – go to seminars, workshops. Give myself permission to do nothing, periodically. Schedule time by myself.
Avoid comparing myself to others – see myself as being of equal worth.
Stop trying to change others.
Whenever I have a thought that starts with "I have to…" "I ought to…" I need to…" "I should…" "I better…" change it to "I want to…", or, "I choose to…"
Frequently take deep breaths – discover the benefits and pleasures of breathing fully. Be willing to laugh at myself, and with others. Stop taking myself too seriously. Set goals, make plans and look for the opportunities that can help me get the results i want in life.
Acknowledge others frequently, tell them what i like and appreciate about them. Make a list of 10 – 20 things i enjoy the most and do them frequently.
Be assertive, speak up for myself, ask for what i want, express my feelings, preferences and opinions and accept "No" as okay.
Be respectful of others’ feelings and opinions.
Ref: New Farm Clinic Brisbane, Australia, Therapy Department Workbook, July 1997
C. I have learnt that a regular exercise program is a powerful and effective method for reducing generalized stress and overcoming a predisposition to worry. I have since embarked on it and am getting the benefits of keeping a regular routine.
SOME GOOD REASONS FOR EXERCISING INCLUDE:
- I feel good after exercising, LESS stressed, anxious or depressed.
- Exercise triggers feelings of calmness or happiness from a few minutes to hours afterwards.
- It boosts physical fitness and helps control weight, which in turn affects self esteem.
- It helps regulate sleep cycles - leaving me feeling more rested and more energetic.
- Increases energy levels and therefore I am better prepared to tackle the day
- I become more health conscious and make healthier nutrition choices.
- Helps increase concentration and mental alertness.
- Exercise is nurturing to body and mind.
- It does give me a sense of accomplishment.
- It can aid in taking my mind off my worries by giving me something else to focus on.
- Decreases excess adrenaline in the bloodstream
- Improves circulation, digestion, utilization of food and elimination processes.
- Decreases cholesterol, blood pressure and weight.
C. To overcome high levels of anxiety I need to learn how to relax. I need to release the tension stored in my muscles that is contributing to the experience of anxiety.
Bourne,E.J., in his book, 'The Anxiety and Phobia Workbook', (1995) suggests the best relaxation that makes a difference in dealing with anxiety is the regular, daily practice of some form of deep relaxation.
Bourne also suggests a regular practice of deep relaxation for 20 – 30 minutes on a daily basis. I would indulge in Natural Abdominal Breathing when I go for morning walk at the park. I can practice Progressive Muscle Relaxation, a well known and very popular technique used to achieve a deep state of relaxation. The technique involves tensing a particular muscle in your body for a short period of time, and then releasing it. For example, clenching your right hand in a fist for about 15 seconds, then releasing it very quickly will assist in releasing the tension in your hand.
It’s not easy to uncover or pinpoint the causes of anxiety. And it can be psychologically contagious, hence counseling an anxious person can be challenging.
As a counselor I have to be alert to my own feelings. If I become anxious while counseling, I need to check if I have taken on the anxieties of the counselee and make them my own.
To counter the tension existing in the counselee, I need to stay calm, caring and reassuring. On the other hand, the anxious counselee is encouraged to sit quietly, breathe deeply, and try to relax the muscles. (Or do a PMR) Counselee may find it helpful to close their eyes and imagine they are relaxing on a beach. However, none of the above or the soft music at the background can remove the underlying causes of anxiety. At the least the counselee is better able to focus on the sources of anxiety. Showing love mixed with patient understanding may help reduce the fear and anxiety in the counselee.
Essentially, I have to assist the counselee in the difficult task of uncovering the sources of anxiety thru observation of counselee’s reaction towards certain topics discussed; thru the counselee’s own insights or reflection into the reason for his/her own safety & thru contemplation – raise some issues pertaining to causes of anxiety such as threat, conflict, fear, unmet needs, physiological disorders, etc.
Once the sources of anxiety have been identified, I will need to make intervention according to the unique set of symptoms exhibited. There are 3 broad approaches I can adopt.
One form of intervention is behavior therapy. Based on the assumption that anxiety responses are learned, counselee is taught to be more relaxed in the presence of anxiety-producing situations. Once he or she has achieved a calm state, the feared objects will be brought in. Next I will help counselee see that facing up with his or her anxiety is far better than allowing the painful inner tension to persist.
Biological intervention may be necessary in some cases. As a counselor, I have to work with a physician who is cautious about the overuse of tranquillizers but who is willing to prescribe and monitor the use of such medication when anxiety seems high.
If the living environment of the counselee is the `culprit’, I would encourage the counselee to deal with anxiety by changing the existing life-style that is promoting the unhealthy stress. Such intervention may be more direct and most effective.
In some cases, if counselee cannot take action against the source of his or her anxieties, I will have to continue to show my caring support and remain warm and patient.
