Cure your Emetophobia and Thrive – Chapter 10 preview..
Chapter Ten: Anxiety and Stress
‘Anxiety’ and ‘stress’ are two of those medical terms that have become weakened to the point of almost being meaningless by their over-use in the general press and on television. Though often the words ‘anxiety’ and ‘stress’ are frequently used interchangeably, as they mean similar things and often overlap, there are some subtle differences. For the purposes of this book, I will clarify the terms.
Generally speaking, the term ‘anxiety’ is used to describe a fearful state of apprehension, worry and doubt. Anxiety encompasses the thoughts, worries and feelings either behind or resulting from, a physical response or symptom.
The word ‘stress’ is more often used to describe the physiological response that occurs within your body in response to a perceived difficulty, threat or danger. This response could occur due to anxiety, or other pressures and situations in life.
Anxiety can cause stress, and stress can cause anxiety. Simply creating anxiety and worrying about something can easily cause your body to make physiological changes in order to deal with the perceived threat. For example, brooding about the fact that you have to go to the dentist next Thursday is likely to make you quite stressed. Alternatively, imagine you are happily walking down a country lane in the sun, when suddenly a farmer’s dog starts barking and chasing you. Your body instinctively initiates a ‘fight or flight’ stress response allowing you to run away. This stress response will quite probably also result in anxiety. You may find that even when you have escaped the dog, you keep worrying and looking round to check you are safe. An anxious, apprehensive mood has replaced your happy relaxed one. You can have a situation where a person creates anxiety about something, leading to a stress response, which then increases anxiety.
One thing to bear in mind is that the causes of anxiety and stress don’t need to be real; they can be perceived or imagined.
Let’s look at anxiety in more detail.
Anxiety
Anxiety encompasses the thoughts, worries and feelings a person creates in relation to a perceived threat. Holding the three primary limiting beliefs and engaging in any of the unhelpful thinking styles can lead to anxiety. In particular, people’s perceptions of control are key factors in determining whether or not they will create anxiety about a scenario. As famous psychologist Bandura (1988) stated:
“People who believe they can exercise control over potential threats do not conjure up apprehensive cognitions and, hence, are not perturbed by them. But those who believe they cannot manage potential threats experience high levels of anxiety arousal. They tend to dwell on their coping deficiencies and view many aspects of their environment as fraught with danger.”
There are two ways in which people can feel in control of potential challenges. Firstly, they can have a high sense of primary control, believing that they can prevent a potential threat from occurring. They could, for example, be certain that they have the skills to complete an important work assignment on time. As a result, they do not worry about the possibility of not getting the work done, as they are sure that this will not occur!
People can also have a strong sense of secondary control, believing that even when a potential threat is outside their primary control, they have the skills and resources to respond positively, cope and bounce back. They could, for example, be confident that if they didn’t finish their assignment on time they would be able to manage the consequences. So, again, they do not create anxiety about the assignment.
In relation to anxiety, a person’s sense of secondary control is particularly significant, since, although many outcomes are within people’s primary control, there are events that are not always controllable. People who create a lot of anxiety, or have specific fears or phobias, always have a low sense of secondary control. They do not believe that they have the skills to cope with certain situations, so they worry about them! When actually faced with a challenging situation these individuals can feel very panicky and powerless and they may turn to external sources for help, because they have no faith in their internal coping skills.
Anxiety is best broken down into two component parts:
- Real-Time Anxiety
- Anticipatory Anxiety
Real-Time Anxiety is just as it sounds. It’s the anxiety experienced in real-time, when you are physically in an anxiety-causing situation for example: on an aeroplane, driving on the motorway, near a frightening barking dog, in court for speeding or walking home late at night. These can all be Real-time anxiety-causing situations for many people. Real-time anxiety means that the event is actually happening NOW and that you are experiencing some anxiety during the event. It may be that there is some genuine inherent danger during the event so it is entirely appropriate to feel anxious (driving on an icy road, the dog has its teeth bared and is growling menancingly) or that the event is symbolically significant, as in a phobia (spiders, darkness, cancer, germs etc.). The essential point about real-time anxiety is that it occurs in the moment – there is no build-up to it, and you weren’t necessarily expecting it.
Anticipatory Anxiety is also quite self-explanatory. It is the anxiety experienced when ‘anticipating’ (thinking, worrying or brooding about) a stressful, dangerous, frightening or challenging experience. For example, when you are: worrying about a dentist appointment next week, thinking about an aeroplane flight that you are taking soon, imagining what the magistrate is going to say to you when you appear in court for speeding next month.
Basically, the sufferer is thinking and worrying about a future event, imagining that the event is going to be stressful, unpleasant, frightening or otherwise challenging, and that they are going to: either die, feel very panicky, be in great pain, feel out of control, or look stupid. By focusing on this feared event (and catastrophising about it), the sufferer magnifies the sense of anticipation, and the fear and the dread get stronger.
The more anxiety (either Real-Time or Anticipatory) or stress a person suffers, the more focused they become on it. This has the effect of ‘zooming in’ on it. When you zoom in on something, you lose focus on what else is happening around it; you get ‘tunnel vision’. Therefore, the more anxious or stressed a person becomes about something, the less they are able to think logically, clearly, and practically about it, and therefore actually DO anything about it.
Some people experience more anticipatory anxiety than others. The ‘Brooder’ personality is prone to excessive worry – the hysterical ‘Dramatiser’ type is used to amplifying emotional situations and making them bigger and bigger. Those with social anxiety are also prone to suffering greatly from this type of anxiety. The bottom line is this: for some reason you brood/worry/anticipate what you imagine might happen ‘on the day’, and this creates intense amounts of anxiety.
As if this isn’t bad enough, this anticipatory anxiety makes you feel more apprehensive of the real event. You begin to really expect that the whole event is going to be terrible. You experience a heightened state of awareness and agitation, your heart beats fifteen to the dozen and there is a sense of impending doom. Then you get to the airport (or walk into court, or lie down in the dentist’s chair) and the event happens and, surprise, surprise, it is indeed incredibly anxiety-causing. Were it not for the build up of tension due to the huge sense of anticipation, the event would have been much less significant, much smaller, much less frightening, and much easier to deal with.
So, it is the prior build up of this anticipatory anxiety, which often makes events particularly frightening and unpleasant. Many people do not particularly enjoy flying, but for most of these it does not cause significant problems. If, however, you spend the three weeks before a flight worrying and brooding about it, creating lots of anxiety and apprehension, imagining everything that can go wrong (like the wheels falling off, having to crash-land in the sea, suffering incredible turbulence or being hijacked by terrorists) you will find your flight terrifying! If you have been imagining the plane crashing and are in a heightened state of awareness, when the plane jolts slightly on take-off you immediately think, ‘Oh my God, I’m going to die!’ When the seatbelt sign is switched on mid-flight you assume it is because something has gone wrong with the plane or you are about to encounter terrible turbulence, but actually it is just that the captain wants to leave the cabin to go to the loo! You think you detect the smell of burning, ‘Shit the plane is on fire!’, when really it is just the smell of the in-flight meals being reheated! You have built up a huge amount of anticipation that something will go wrong, and so normal flying experiences are instinctively interpreted as being frightening and threatening, just like wearing the belief-tinted spectacles I mentioned in chapter one…
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