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Mon, April 1, 2013
The Truth about Anxiety
Rebecca had finally forced herself to call a therapist to help her with her anxiety. But as she drove to the first appointment she found herself frightened and did what she always did when faced with her anxiety. She picked up the phone and called the therapist leaving a voicemail that she was sick and would call back in the future to reschedule. "I'm such a coward," Rebecca thought, knowing that she would probably never call back.

Rebecca was surprised when her cell phone rang a few minutes later.  "Turn the car around and come to the appointment." The therapist urged her gently. “You know that it took a lot of courage for you to call me in the first place, and that you need to free yourself from the slavery of this anxiety. Don't let it control you, take charge of it.  You can do this.  I can give you some tools to make it easier.” 

Rebecca was a little embarrassed that a therapist who had never met her knew so much about her struggle; yet she found reassurance in his voice and in his awareness of what she was going through. She swallowed hard, took a deep breath and told him that she would turn the car around. 

Rebecca knew she had social anxiety, one of the several different forms of anxiety prevalent in our culture.  Rebecca hated the way she felt, she was uncomfortable, her heart was pounding, and her anxiety gave her what felt like the uncontrollable urge to get away from the demand of every social situation.

“Anxiety is your friend; it is your brain trying to protect you”,  the therapist told her in the first minute of their session. Rebecca felt like laughing in his face because anxiety did not feel like a friend.  The therapist continued, "Anxiety mobilizes your autonomic nervous system to get you ready to deal with a threat. 

The problem is that sometimes anxiety makes you view things as dangerous when they really are not. Sometimes your brain goes a little overboard by labeling something as dangerous when in reality it won't hurt you.

This alarm is sounded deep in a non-language area of the brainstem called the amygdala.  Once this alarm is sounded you feel an overwhelming urge to turn it off by getting away from the threat.   Fortunately, human beings can use their cerebral cortex (their language mediated thinking brain) to objectively evaluate whether or not there is a threat and override the alarm in the brainstem.”

The therapist put sensors on Rebecca's fingers telling her it would read her body's heart rate variability and electronic skin conductance and show her that how she breathed and what she thought affected the readings on the computer screen. 

He put her through specific breathing exercises….”Breath in on a count of 5, and out on a count of 5.”… "Purse your lips like you're slowly blowing out a candle as you exhale, notice how you feel inside….” Rebecca noted that within 5 minutes she felt peaceful. 

Soon Rebecca was easily able to see her heart rate variability and electronic skin conductance on the computer and keep them in the ranges that showed that she was relaxed.  The therapist instructed her to continue to breathe in this relaxed way, but then he verbally described some of the scenes that previously had caused her to feel anxious, "picture yourself dressing to go to your friend’s house for a small social gathering.” 

Initially, the readings on the screen indicated that Rebecca was experiencing anxiety but the therapist directed her to focus on her breathing and to move back into a calm and peaceful state. It was easy for her to do, and the anxiety was quickly reduced to manageable proportions.  Soon the description of preparing to go to a social event no longer overwhelmed her.

The therapist gave her the homework of breathing in the way that she had been taught at least four times per day for the coming week; and particularly when she was going to be in a social situation.

The therapist then had Rebecca complete the Amen Clinic Anxiety and Depression Questionnaire. He explained that Daniel Amen, M.D. had used SPECT brain scans to identify seven different types of anxiety and depression, each with their own treatment protocol (www.amenclinics.com).

This questionnaire could help predict her brain type and reveal which of the treatment protocols for lifestyle changes, exercise, dietary recommendations, and supplements which might help her brain be less prone to be stirred up by anxiety.

The therapist said that in future sessions they would focus on her "worry thoughts" and that he would give her more tools to talk to herself in realistic ways.  "There's always a kernel of truth in the bad thing that anxiety tells us is going to happen, but anxiety tends to exaggerate these and make them bigger than what they are." said the therapist, "We have to objectively assess how probable our worry thoughts are and talk back to our anxiety, directing it rather than allowing it to control us." 

The therapist also described LENS Neurofeedback, (www.ochslabs.com) an EEG treatment that could be added in the future if necessary to help make her brain less reactive and more flexible in problem solving.  "You may not want to eliminate all anxiety, that what you're feeling may be excitement because you'll be entering a stimulating situation. A little anxiety makes us feel alert and prepared,” the therapist told her.

He informed Rebecca that essentially, the treatment for anxiety was to face your fear.  The individual has to regain power over anxiety by showing the brain that it can deal with and master what it fears.  “You mean I have to make myself be with people so I am eventually comfortable socially?" asked Rebecca. 

"That's right”, answered the therapist, “modern technological approaches like the Amen Clinic protocols, LENS neurofeedback and HRV biofeedback can help dial back our anxious arousal, but ultimately the core of the treatment is facing what we are afraid of.”

Rebecca left that first session empowered by what she learned about anxiety and hopeful that she had found a place that could help her learn steps to address a problem that had plagued her for most of her life.

The truth about anxiety is that everyone experiences it.  The key is learning the tools to control it and make it work for us.

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