One of the more common referrals to us here at Counselling Connections from General Practitioners is for anxiety disorders and panic attacks. The symptoms are often very physical with a racing heart and shortness of breath and this is why we are likely to go to the GP for a check up as a first port of call. And it is important to first rule out a physical cause for these symptoms. Sometimes other factors such as drug use or alcohol intake can exacerbate the condition. These have to be dealt with as part of the treatment. Anxiety can be associated with depression and your doctor will check to see if you are feeling depressed as part of considering the next step. Sometimes anti anxiety medication is prescribed and a referral for counselling is made.

At the beginning of the counselling process your trained and experienced counsellor or psychotherapist will first ask you about your own personal details and the major landmarks of your life. These may include losses and childhood events that stand out for you as being significant. If nothing strikes you as being important at this early stage that does not prevent progress as looking for underlying causes is actually the second part of a two pronged approach. The first part of the treatment is a cognitive behavioural therapy or CBT approach. This has proved most effective in dealing with symptoms of anxiety and panic attacks.

The initial work of the CBT is to learn to tune in to your own patterns of thought. In this way we can collaborate in challenging some of these thoughts and checking to see of they are appropriate to the situation in which they occur. Often it turns out that our thinking is actually making our anxiety much worse as we tend to make everything seem worse than it really is. We see a catastrophe where one doesn’t exist. We may think that people are looking at us and judging us whereas they may not be. Challenging these thoughts and understanding the part they play in our anxiety or feelings of panic represent the beginning of changing the way we think.

It is a very empowering process to take charge of our own thought patterns and get on top of our fears. Sometimes we will set ourselves goals as part of strengthening our belief in our ability to cope with our environment. These may involve deliberately placing ourselves in a situation which would have caused us anxiety in the past. It is important to approach these tasks slowly and to be respectful of the fear of overwhelming ourselves. That said, to achieve some successes in anxiety provoking situations helps to give a sense of confidence in the process and strengthen our self belief.

There will be times where we may be faced with thoughts such as ‘I will never do this’ or ‘I am no good’. Oftentimes thoughts like these can be traced back to things that a significant person may have said to us repeatedly at times during our childhood. And moving into dealing with these represents the second part of the two-part therapy. Here we begin to get in touch with the root causes of our anxieties and the core beliefs which we have developed about ourselves. It is important to state here that core beliefs are learned and as such they can be unlearned and replaced with newer, more appropriate ones.

We are often asked how long this process takes and the truth is that it is difficult to say with any accuracy. Initially it would be expected that a therapy like this would last somewhere in the region of three months. As you move into the second phase of the therapy as we have described it becomes more of a journey and we would not attempt to put a time limit on that. You can take time take to explore areas of your life and to consider major events and relationships again and maybe re-order them in your mind and choose to respond differently to things in the future. In this way the practice of knowing yourself and your hopes and fears can become an integrated way of being for you. You wouldn’t expect anxiety or panic to become a feature of life again once this practice becomes established.
Counselling Connections, Dundalk.

Here at Counselling Connections this week we took time out to have a long look at our waiting room. It is a very attractive room, high ceilinged with original plasterwork and a large open fireplace. We have a few nice paintings and two comfortable couches. There is a long coffee table with an eclectic mix of reading from psychoanalysis through fairy tales to the local free advertiser. We sat for a few minutes to feel what the experience was like. We realise that a waiting room can be a place of anxiety and we are trying to make ours as welcoming and comfortable as we can. Quite apart from the reading material we place there we realise that one of the first things that someone does nowadays if they have to wait is to reach for their phone.

Whether it is on a bus or a train or waiting for a food order to be brought to your table in a restaurant those few minutes of being alone can make us feel anxious. With the mobile phone being so accessible it is often the crutch that we use to fill those awkward few minutes. It provides the illusion of not being alone; it serves to help us to deny our separateness. With so much information now available we can check the latest news updates for a while or log in to a social network to see what friends have been up to. Or if we feel like we really need to reach out to another we might choose a friend and send that great contemporary conversation opener; the ‘where r u?’ text. It seems to us that this is all about relieving the anxiety of being alone.

Imagine a baby who wakes after a short nap. On waking the baby wants to re-establish human contact and will usually call out for their mother. Depending on the age of the child this may be by making a range of different noises and movements or it may be by use of the word ‘Mammy’ once they have learned this. Just say that one particular day the mother is temporarily out of earshot and does not react to the baby straight away. In this instance the baby will experience a sudden rise in anxiety levels and will worry for a moment about being abandoned forever. A few short minutes can seem like an eternity in these circumstances. Depending on the placement of the cot and the accessibility to it this may happen a lot during infancy and this baby may grow up with a slightly higher than usual level of fear when it comes to being alone.

Fast forward now by twenty years or so and the baby of our example has grown to be an adult in our twenty first century world. Among their gadgets, indeed a necessity for their job is a mobile phone. They may have the addition of a wireless Bluetooth facility to make hands free calls on the go. Imagine then that with voice recognition dialling they had the ability to make a call while driving or walking along a city street. It is very convenient to be able to get in touch with their office base in this way. We feel that this ability also serves to keep at bay their fundamental anxiety about being on their own. They may even have made allowances for the occasional personal call and programmed in their mammy’s number so that she too can be reached simply by calling her name. Just like in their childhood dreams they can experience the soothing tones of their mother’s voice in an instant.

Mobile technology and internet access have made so many things so much more accessible and straight forward. They have also helped us to keep at bay the anxieties we feel abut being alone. It is a good exercise to watch these things in our selves. Sometimes, turning off our modern devices, even the radio and just listening to silence or the ticking of a clock can be very instructive. In those quiet moments we might get in touch with some things which we fear. By considering these things and reflecting on them and on their possible origins in infancy we can understand and placate our fears. In this way we can get in touch with feelings of confidence in our selves as separate from but still in relationship with others. We can learn to feel relaxed rather than fearful when things go a little quiet and we are left alone with our thoughts.

Counselling Connections, Dundalk.

Here at Counselling Connections we have been noticing that there’s a lot of anxiety about lately. It seems to be spreading like wildfire, fuelled by thoughts about the Economy, the Government and the state of the country. This has a ripple effect as we all know on personal circumstances like unemployment, financial difficulties and worries about the uncertainty of one’s future. This is turn can generate huge anxiety and can impact heavily on us and our relationships.
In an internet café in Drogheda yesterday I listened as a fellow customer conveyed her view of the current political situation. In summary it was her view that we are all doomed …. I was in good form, my mood lightened by the bright wintery sunshine, a crisp cold day. But as if without warning I started to feel anxiety creep up on me, feeling the impact of what she was saying and wondering if I should feel more concerned about these things…. Her anxiety about her future and that of this country was beginning to find a home with me…I decided at that point to make my exit and leave her with her Anxiety. I wasn’t going to take it on. I walked outside the shop and felt the cool air on my face reconnecting with the good feeling the bright winter sun had facilitated prior to entering the shop.
Anxiety can affect the way we think, feel and behave. It can also have a very physical impact on our body. The above example shows how our thoughts, feelings and behaviours all interact within a matter of minutes. It also shows how we have the power to monitor and control our thoughts. Cognitive (Thinking) Behavioural Therapy is a type of counselling that helps you to do this.
My thought as the woman in the cafe was speaking was “maybe I should be more worried….maybe she’s right…” This led me to start feeling anxious. I quickly made a decision not to give this thought fuel by taking it a step further. Instead I saw it as her anxiety and left it with her, which led to a positive behaviour of leaving the shop and feeling the good feelings I had felt earlier.
Anxiety is something we all experience from time to time. It is important to understand it is a normal response to any threat to our person. Being slightly nervous can help us to perform better or can help us to deal with danger. The body reacts to a threat by producing adrenaline, a hormone which prepares us for ‘fight or flight’ e.g. if you feel you are being followed on a dark evening in a lonely street, it is normal for you to feel your heart beating faster and your breathing becoming faster. These symptoms are caused by the adrenaline and is your body’s way of preparing, in the event that you need to run. When the emergency is over and you are safely in your car/ home or you realise it wasn’t someone following you, you experience relief but may feel shaken. This is a true reaction of your body; it is not imagined and is a direct result of adrenaline production.
Although it is normal to feel anxious when threatened or under pressure, some people feel anxious quite a lot of the time when they are not really under threat. Although the feelings anxiety produces are unpleasant, they are not dangerous. Anxiety can become a problem when it is severe and prolonged and when it interferes with what we want to do in our daily lives. In anxiety it is usual that a vicious circle is maintained between thinking and feeling (including bodily responses) and behaviour. The type of thinking fuelling your anxiety can be very immediate and even transient. You may not even be aware of those thoughts as you are so used to them. These thoughts are referred to as negative, automatic thoughts and the aim would be to identify what they are, so that you can challenge what truth they hold. The aim is to become good at hi jacking those thoughts before they take hold of you and send you spiralling into anxiety.
It is common for people who suffer from anxiety to avoid situations that make them feel anxious. This can become very problematic as the more you avoid something, the more difficult it will seem to overcome, which in turn will make you more anxious. It is necessary therefore, to keep trying to do things even if they make you feel anxious so that you can prove to yourself that nothing disastrous will happen. Continuing to practice this will eventually allay your anxiety.
There are many reasons for people to feel anxious in the times we live in. Stressful life events like coping with a death, separation/ divorce, losing a job, family problems and financial stress are all understandably worrying. Taking control starts with recognising what’s going on in your mind and body and follows through with taking positive steps to manage this anxiety. In this way anxiety can be seen as a normal response to life changing events but one that does not take over your life.