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Nov 11

Little Lessons About the Big Problems Caused By Anxiety, Social Anxiety, Panic Disorder and Agoraphobia | Ch. 21 – 30

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It’s Our Genes and Our Scenes

Lesson 21: THERE IS AN INHERITED COMPONENT TO ANXIETY AND PANIC, PHOBIA AND OCD. I believe in most cases genes play a role in causing anxiety disorders. My father was very nervous and self-conscious as were two of his sisters, my aunts. My mother was a nervous person too. Her mother, my grandmother, was probably agoraphobic. She “hid” in the kitchen rarely sitting down with the family for a holiday meal. In those days, it was appropriate and acceptable for the matriarch to be a Btchen- slave. She preferrea iil-serve-anirde-ai- thereby staying clear-oCinteraction or being “stuck” at the table.

My maternal grandfather worried a lot and obsessed about money matters. Clearly, I was surrounded by nervous people whose genes I carried and whose scenes I experienced. Similarly, my oldest son appears to have inherited my panic potentials.

Usually, when I meet with people dealing with anxiety issues at least one parent, a sibling or-two,-aunts–or–uneles-r-efleet–anxietyand-weHY7-Very–often-peeplewith anxiety problems have alcoholics in their families. The link between anxiety and alcoholism will be discussed in the next lesson.

The interactions between genes and scenes are obvious. If Dad was an alcoholic because he was masking anxiety you experienced the impact of his genes along with the scenes of his drinking. If your parents split because of Dad’s drinking and if Dad hardly parented you as a result, the scenes became even more traumatic. What about observing Mom as a chronic worrywart or obsessive cleaner? In most cases it is impossible to assess whether scenesorgenesrule. Allwecansayisthatinmostsituations,bothdo.

Curious is the despite a significant genetic influence in our experience, panic and anxiety are completely resolvable. This should be a source of relief and encouragement to those who worry that they are stuck in their prison of fear. Given my strong genetic load, my being able to completely escape Anxietyville without meds attests to the power and influence of resolving the scenes. Programmed as I was by protective parents to panic, insight and relearning allowed for debugging. Clearly, whatever brain and body chemistry had gone array during those painful panic years, returned to healthy and balanced operations. The power of psychotherapy to achieve its goal in overcoming anxiety problems is truly impressive. Equally impressive is the power of the mind to potentate genetic and neurochemical predispositions and cause anxiety disorders or inhibit and eliminate them.

Prior to my panic attacks I functioned at high levels despite a variety of stressful and demanding conditions. The genetic potentials existed, but were suppressed, probably by a series of successes. When I came to Florida and experienced all the transitional trauma (think Dad here), commingled with some work failures and financial insecurities(think Grandpa here), my genetic potentials came roaring out. A long, but helpful therapy along with a better adjustment to Florida repaired the damage and returned me to my previous

state of confidence and comfort. I was actually healthier by the end of this experience than I was before it began. The same will be true for you.

Anxiety and Addiction
Lesson 22: PEOPLE PRONE TO HIGH ANXIETY ARE OFTEN ALCOHOLICS, DRUG-A-HOLICS, OR BOTH. There is clearly a high correlation between anxiety and addiction. It is often a spiraling vicious cycle. Alcohol and drugs are a blessing and a cursefortheanxietyandpanicperson. Thereisnodenyingthatachemicalbuzzreduces, if not eliminates anxiety for most people But it is only temporary. When the chemical wears off the anxiety returns. In addition, the chemicals irritate sensitive brains and interfere with sensitive brain chemical balances. Alcohol plus an SSRI med like Prozac or Lexipro can equal nothing.

So a person feels agitated or anxious and uses alcohol, pot, Xanex, .or all three to reduce or eliminate the uncomfortable feelings. The next day there is a little more agitation and anxiety so they need a little more chemical. So it goes until a full blown addiction takes hold. I once observed someone who started drinking at eight or nine AM by putting shots in his coffee and didn’t stop till he passed out about twelve hours later. This is why some need therapy for their anxiety and AA or NA for their addiction.

So called dual diagnosed people are testimony to how entrenched these habits of mind and body become. Often, these habits exist along with cigarette smoking, coffee drinking, and overeating making for a most unhealthy situation. Sometimes the wake-up call of anxiety and panic motivates people to clean up their acts by eliminating alcohol, pot, benzos, cigarettes, and junk food from their regimens. This is a healthy response, especially for anxiety prone people whose “Jewish Grandma” parts needs to feel safer and more in control. ‘

Powerlessness is a Powerfully Painful Feeling

Lesson 23: ANXIETY DISORDERS FEED OUR HELPLESSIPOWERLESS FEELINGS Power is a complex issue. People’s needs vary in terms of having power. Some crave and covet it like politicians or wealthy entrepreneurs. Others avoid it and prefer simpler lifestyles. All people, however, seem to need to feel a sense of personal power. This involves being able to afford themselves, be reasonably healthy, be able to get from point A to point B, work, enjoy a relationship, engage in intimacy, have some fun and be reasonably comfortable in doing all of that.

Anxiety problems interfere with those basics and rob us of a sense of personal power. We feel weak, invaded, intruded upon, unable to do or to enjoy almost anything. We feel

powerless. Anticipatory anxieties are the opposite of power as well. With a sense of power we assume we can take care of the basics. Of course we can go to a meeting or party or host one. Certainly we can give a presentation or talk, calIon customers, go to dinner with a client, see a movie with our partner, take our kids to a football game, drive, etc. We don’t think twice about the basics. With anxiety,we think twice and more about everything. We obsess, ruminate, agitate, and deflate. Deflation is not a powerful feeling. It’s the pits!

Slowly, we need to reclaim lost territories, silence the Voice of Self-Doubt and regain our

personal power. Every time we take a step in the direction of doing something we have

not been able to do, we add to our bank of power which adds to our pride bank. Power

and pride are intimately connected forming the basis for a positive cycle instead of a

••
VICIOUS one.

Think of the person who is powerfully swimming through the water at the Hall of Fame olympic pool. That image is a better one than her wading through her cesspool, generating powerful feelings of shame and blame. That power has also spread to many other areas of her life. Power and pride can be just as infectious as anxiety and panic. By committing to an appropriate therapy you are taking an important step in regaining your personal power and your life. By taking control of that which you can-diet, exercise, eliminating hurtful habits, doing relaxation, etc.-not only will you convince your “Jewish grandma” that all is safe, but also begin to feel more powerful and efficacious. Your growing sense of personal power will beget more of the same until you are finally

{lositioned-to -exit Anxie1y¥ille. -Believ£~ewhen Ltel! you_whenthat happens it is a most triumphant and empowering feeling.

Inner Voices
Lesson 24: THE VOICES WITHIN CONTROL OUR THOUGHTS, FEELINGS, AND BEHAVIOR. I have made reference to various voices within and discussed the VSD,VRVA and VOD.Other voices are also important. I strongly believe that we all have these voices ru;td that they guide our thoughts, feelings, and behaviors. Often times, many voices talk at once leading to a confusing chorus of conflicting influence. Other times clear and consistent words direct us along helpful paths.

During anxiety problems, dark, negating voices emerge in a complex sequence. First we feel painful anxiety for no reason. Then words reinforce and cement them in place. If your first anxiety occurred in a restaurant, a highway overpass, or a plane, the words warn us about an anxiety rerun. These words start generalizing as “what if’ questions that keep us in limited space. Our “Jewish Grandma” would rather we stay home where it’s “safe.” Before we know it we’re not making much sense and not doing as much as before. What we do do is preceded by anticipatory anxiety and experienced with discomfort. Soonwedon’tfeelquiterightmuchofthetime.

It is this self-negating Voice of Terror(VOT) that also keeps us stuck in Anxietyville. It comes from our child parts, but has a powerful influence none-the-Iess. This voice was here first and derives irs strength from that seniority. It is the very voice that promoted

Ybuggymen” in the closet, fears of parental abandonment when they left the room or went out on a Saturday night or any of the other terrors of our youth. To override such fears we must harness the power of our adult voice of choice. We need to neutralize our frightened child with words that better correlate to reason and reality. Our adult knows that we have nothing to be afraid of in these areas. Our adult knows the “Jewish grandma” has nothing to worry about. We need to use his/her voice to help them to see that clearly so we can respond and react accordingly. It takes hard work to override the distorted voices of our youth. It is, however, an achievable goal to which I urge you to commit.

Secondary Gains
Lesson 25: MOST OF THE TIME OUR ANXIETYVILLE LOSSES HAVE SOME HARD TO UNDERSTAND GAINS. This is as difficult to understand as Lesson 2 which deals with not all of us wanting to get better. People take offense when we question their motives. “How dare you imply I’m not totally committed to overcoming this nightmare!” “How dare you iiilplythatmy anxiety pains yields any gains.” I’m sorry. I’m not questioning your sincerity, integrity, motives, or desire to leave Anxietyville on the next jet plane out. I am addressing the complex contours of our minds and the multiple levels on which they operate. Your adult parts want to leave. Other parts do not agree.

Simply stated our minds play tricks on us. All is not as it appears in our conscious state.

Mindsareparadoxical. Thebestofourintentionscanquicklygostray. Ifmindlymatters were logical-and rationaL all.of.us..would beJllLppy,.comfQrtable, and fulfilled and there would be no need for mental health professionals. Truth is, we are needed more than ever before. All the meds, therapists, books and kings men, don’t seem to be able to put our mental humpty back together again. That doesn’t mean you can’t escape from Anxietyville because you can and will. I’m just not as optimistic when I take a global

view ofthe depth and breadth ofemotional defaults. What are some gains, you ask? Here is a brief summary:

• • • • • • • •

• •

.

Attention
Control (i.e., I can’t/we can’t go…) A voidance o f responsibility Dependence on others

Staying in complex, but needed relationships
Waiting for previously unfulfilled needs to be met
“Acceptable” reasons for things not going well
A voidance o f that which is threatening (i.e., relationships, school, work, intimacy, travel, etc.)

A voidance o f experiencing and feeling painful emotions
A voidance o f behaving in hurtful, hateful, inappropriate, embarrassing, dangerous, self-destructive ways.

Let me be very clear here. I don’t believe you woke up one day and decided to opt for these secondary gains in exchange for living in Anxietyville. I don’t believe you chose to stay in Anxietyville because of these secondary gains. You didn’t volunteer for this assignment. I do believe you would be happy to exit Anxietyville in a flash and leave

these secondary gains behind. But I do believe in the complex calculus of the mind, secondary gains play a significant role in the drama and trauma of anxiety related problems. In many ways these so called “gains” are losses~ In all ways they are illusions rather than realities. Yet, they are a force to be reckoned with as you find your way out

of Anxietyville.

Fantasy vs. Reality
Lesson 26: ALL OF ANXlETYVILLE IS BUILT ON FANTASY. When we are stuck in panic and Anxietyville we are not being realistic. We are caught in a warp of twisted

thoughts and concocted feelings. Not much makes much sense!

Thinking back I was terrified lI.boutmany”things that weren’t terrifying, except in my own mind. I could give a speech or teach a class as well as anyone, yet I panicked at the thought and the deed. There was nothing particularly dangerous leaving my house, but I had spasms of anxiety every time I did so. I was intelligent, capable and responsible, yet I felt every task was a guaranteed failure. I lived in a fantasy and that kept me stuck in Anxietyville. The fantasies seemed as real and compelling as any reality I had ever embraced. Slowly, but surely, the fantasies became my reality. The prison offear is built

upon the spot where fantasy and reality intersect.

“” -“-

This same exaggerated and distorted reality is seen in phobias and OeD problems. Yes, germs undeniably cause disease and occasionally planes do crash. To the anxious these can become the basis for extreme avoidance. We don’t need to wash our hands 20 plus times to fight germs or burn our clothes. We don’t have to avoid flying, given that driving in a car is far more dangerous. Many fear tunnels, bridges, or overpasses even

though they present no serious realistic danger.

The powers of these fantasies over clear realities have their origins in the primary process, magical thinking of our child based parts. Reality comes late to our developing child. Even the teen maintains an unrealistic sense of their importance, invincibility, deservance, persecution, loves, etc. that are based in fantasy. Note how they cross a busy street. The infant, toddler, and young child spend much of their time in that unboundered

world.

When we move into Anxietyville we’ve had a regression to an earlier time. Our adult bodies and minds are invaded by our kid parts. This is precisely why what we experience seems so dumb and ridiculous. It all makes no sense to our rational adult, yet is quite reasonable to our younger parts. The tug-a-war goes on painfully, until our adult finally takes charge of the rope.

In a flash I became my hysterically over protective father and my agoraphobic grandma. Yes, she was Jewish and she loved me a lot, but that didn’t help one bit. I was stuck in a

yarp of time and reality and so are you. Whatever trauma caused this regression can heal. Reality will dawn a new. Your healthy adult self will guide you out of this nightmare once and for all. In the final analysis reality rules. In Anxietyville it takes a while to get there.

AM Anxiety
Lesson 27: MORNINGS ARE THE WORST FOR ANXIETY! The majority of those who live in Anxietyville complain that the mornings can cause anxiety to peak to very high levels. I certainly experienced that, although afternoons and evenings weren’t much fun either.

To explain this experience I refer to my dam/cesspool model ofthe mind. When we sleep. our dam is being recharged. It stops operating as our director of consciousness. This allows our pool to spill out allover our heads. Today, yesterday and yesteryear all converge on a single point oflig1:t:-Wn:u:lhharpoint-drearns. These dance through our heads many times a night. They are necessary for our sanity and survival.

When we feel OK, our dam snaps back into place promptly upon awakening. Our entry

back into consciousness is seamless and automatic. When we are dealing with emotional

issues, our minds are more fragile and sensitive. They work less well. Upon awakening,

our dam is sluggish and doesn’t fully snap into place. A gap is left through which cess

continues to leak. It is that leakage that causes the anxiety to flow heavily in the •

~-.–.—.

Another way of understanding this problem is to know that magical, child based thoughts are strongest upon aWakening. It is a time of confusion as the mind emerges from unconsciousness. Semi-consciousness is most like the primitive fantasy full mind .of a child. From that little boy/girl twilight can come much apathy and anxiety. Most people say they don’t want to get out of bed, can’t seem to organize or slow down their thoughts and are floating along on angst.

Get out of bed! Any mind engaging task will help close the gap. Most people indicate that when they get to work they feel better than upon aWakening. Instead of staring into space and feeling uncomfortable try a simple task. Fold clothes, work on a puzzle, read a magazine or do something else that will engage your dam. You will be pleasantly surprised to see that the anxiety will diminish or disappear. Avoid staring into space. It is the worst position you can be in.

The Paradox of Sleep
Lesson 28: A T A TIME WHEN WE DESPERA TEL Y NEED SLEEP TO RECHARGE OUR BATTERIES IT ELUDES US. For some with anxiety, falling asleep is not easy as their minds race on uncontrollably. Others in Anxietyville fall asleep easily, but awaken a few hours later unable to fall back to sleep again. Others awaken in

the midst of a panic attack hard pressed to understand why it happened. Anxiety, panic, and a good night’s sleep make for strange and often strained bed fellows.

..mornmg.

I vividly remember anticipating how I would feel that day based on my sleep the previous night. I could literally panic in the AM about my fretful sleep in the PM. Worse yet, I would keep myself awake in the PM fearful of not sleeping in the PM and how lousy I would feel in the AM. It quickly becomes a vicious cycle. Typically how I felt was correlated to how I slept so one was an accurate predicator of the other. There are clear reasons for that as described in the previous lesson.

Try to be patient with erratic sleep experiences. Focus on how you can increase conditions for a more peaceful sleep. Begin to wind down a half hour to an hour before you lay down. Listen to a relaxation tape or soft music. Take a warm bath or have a warm drink. Tell yourself to stop negative, agitating thoughts. Put them on your mental

shelf till tomorrow.

Accept sleep as a necessity, despite the “out of control” feelings associated with it. We are sl.lpposedto relinquishcontrol and subniifto sleepmorderto recnatgethose parts that help us to feel more in control the next day. Realize as well that we can still function on sleep-lite. Youmayfeelabitrougharoundtheedges,butyou’llstillgetthroughOK.

Know that as you exit from Anxietyville progresses, your sleep will improve as well. Peace of mind leads to more peaceful sleep. You will be amazed that what previously bothered you doesn’t anymore. You have the same mind, are the same person, but with different processing, a different focus and different frame of mind everything changes for the better. These shifts are testimony to our resilience as people and to our ability to leave Anxietyville despite all of the obstacles.

We Shall Overcome
Lesson 29: I WANT YOU TO FINALLY BE FREE. You deserve it. You need it. You can achieve it. I’m reminded of the early 60’s and all the FREEDOM NOW! songs, protests, marches, speeches, etc. We were a repressed and suppressed group of angry folks, just learning about our liberating influence and personal power. You can leam from that time as well.

It’s time to escape from Anxietyville and your personal prison of fear. It’s time to see things more clearly and realistically. It’s time to chant in voices of reassurance, affirmation and most of all, determination.

It will take longer than you like. It will take work on your part. It will also take your total commitment to all of the cognitive behavioral tools and techniques that will support your mission and finally provide an exit strategy.

There is no reason to stay stuck in Anxietyville. It is an exceedingly problematic way to live. We all deserve comfort and freedom from fear as we navigate our world. We need to feel safe and secure without unnecessary conditions, restrictions or exaggerated

boundaries. Life is tricky enough without superimposing fantasy onto complex realities.

I vividly remember anticipating how I would feel that day based on my sleep the previous night. I could literally panic in the AM about my fretful sleep in the PM. Worse yet, I would keep myself awake in the PM fearful of not sleeping in the PM and how lousy I would feel in the AM. It quickly becomes a vicious cycle. Typically how I felt was correlated to how I slept so one was an accurate predicator of the other. There are clear reasons for that as described in the previous lesson.

Try to be patient with erratic sleep experiences. Focus on how you can increase conditions for a more peaceful sleep. Begin to wind down a half hour to an hour before you lay down. Listen to a relaxation tape or soft music. Take a warm bath or have a warm drink. Tell yourself to stop negative, agitating thoughts. Put them on your mental shelftill tomorrow.

Accept sleep as a necessity, despite the “out of control” feelings associated with it. We are supposedto relinquish control and subniiHo sleep Til. “Ofder to recliargethose parts that help us to feel more in control the next day. Realize as well that we can still function on

sleep-lite. Youmayfeelabitrougharoundtheedges,butyou’llstillgetthroughOK.

Know that as you exit from Anxietyville progresses, your sleep will improve as well. Peace of mind leads to more peaceful sleep. You will be amazed that what previously bothered you doesn’t anymore. You have the same mind, are the same person, but with different processing, a different focus and different frame of mind everything changes for the better. These shifts are testimony to our resilience as people and to our ability to leave Anxietyville despite all of the obstacles.

We Shall Overcome
Lesson 29: I WANT YOU TO FINALLY BE FREE. You deserve it. You need it. You can achieve it. I’m reminded of the early 60’s and all the FREEDOM NOW! songs, protests, marches, speeches, etc. We were a repressed and suppressed group of angry folks, just learning about our liberating influence and personal power. You can learn from that time as well.

It’s time to escape from Anxietyville and your personal prison of fear. It’s time to see things more clearly and’realistically. It’s time to chant in voices of reassurance,

affirmation and most of all, determination.

It will take longer than you like. It will take work on your part. It will also take your total commitment to all of the cognitive behavioral tools and techniques that will support your mission and fmally provide an exit strategy.

There is no reason to stay stuck in Anxietyville. It is an exceedingly problematic way to live. We all deserve comfort and freedom from fear as we navigate our world. We need to feel safe and secure without urmecessary conditions, restrictions or exaggerated boundaries. Lifeistrickyenoughwithoutsuperimposingfantasyontocomplexrealities.

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