Crisis, Anxiety or both?

Crises generate anxiety. That anxiety, however, is likely to be ‘right’ for that moment. It is ‘situationally appropriate’, as people like me say.

The anxiety that arises for no apparent reason is another thing. This is termed ‘generalised anxiety’ and, as it persists, it can become a disorder. The experience you have in your body may be much the same for both anxious experiences, but the safe experiments that are required to work with crises and generalised anxiety are very different.

Let’s examine some of the similarities and differences:

SIMILARITIES

• Although anxiety will tend to make us feel bewildered, unreal, or unsteady, these feelings are normal bodily reactions to threat.

• Having these sensations does not mean you are ill. They may be unpleasant and even frightening but they are not a problem in the short-term. Usually, nothing lasts for ever.

GENERALISED ANXIETY

• In this situation, we experience our anxiety as, indeed, lasting for ever. This arises when we magnify our feelings – unintentionally or not. Often this happens out of context – there is no obvious reason for the feelings and sensations. This rather normal reaction is often labelled ‘catastrophising‘. In common language, we talk about getting things out of proportion. However, to an anxious person those words can be an irritant; their feelings are real and reassurances do not ease the discomfort.

Catastrophising here and there need not be a problem; newspapers do it all the time. However, when the sensations you experience in your body persist, it has the potential to do emotional and even physical harm over the longer term.

Why is this?

The anxiety created when our alarms goes off is intended to last only a short time; the time it takes us to kill off a threat, or escape from it or, sadly, to be killed by it. When those reactions persist and do not decay, then physical and emotional harm is feasible, e.g. making us withdraw from company, argumentative and difficult to live with. Unfortunately, the thoughts racing around our smarter and younger sibling can keep things going after the threat has diminished. We are able to generate a virtual reality of woolly mammoths and sabre-toothed tigers.

CRISES

The big difference about crises is, indeed, a real threat to our safety and security. It will create an immediate need for action. Anxiety exists to give us the energy to act; to move instantly with a laser-like reaction. However, it can tempt us into actions that, in the cool light of day, may be regretted. In the section on Flight, Fight and Freeze, I have made a virtue out of action. That said, some actions will be impulsive – not always under conscious control – and this can create unwanted and unintended consequences. I use the example of domestic abuse – in which some-one hits out – as just one such unwanted outcome.

Therefore, in developing your safe experiments, be aware of different forms of action:

  1. those that are immediate, impulsive and seemingly outside your control; they may or may not get you to a safe place.
  2. the temptation to act impulsively after the event because you are remembering the receding threat.
  3. a considered action based on evidence that the action is likely to have a preferred and valued result.

An obvious example is the temptation to leave a job or home because it seems the ‘only’ solution. Keep in mind that you can still leave home and job if, indeed, it proves the considered thing to do. Even so, in the immediate aftermath of any incident, take time to think this through and, preferably, talk it through with some-one who is trustworthy and discreet.

PLEASE NOTE: this is not a recommendation for NOT running away in certain situations. If you feel unsafe, running away to a safer place is likely to be the right course of action. The point here is: can it lead you to explore other safe choices, rather than up a cul de sac from which it is difficult to escape..

SOME PRACTICAL SAFE EXPERIMENTS

• Don’t run away from your experiences after the event. Can you ‘look them in the eye’? Notice what is really happening to your body at the moment, and what it is telling you now. Just notice your thoughts and experiences. Say ‘hello’ to any of the self-critical messages without dwelling on them.

  • In particular, notice the sensations, however uncomfortable they may be. If necessary, talk to them as ‘part’ of you (they are part of you – like it or not, even if not your best friend!)

• When you feel anxiety: use breathing exercises to relax, and let go. Make yourself as comfortable as possible. Sit for a while. Do not drive or be prompted into hasty actions. Take your time.

• If necessary, describe the outside world. What you can hear and see, or what is going on it. Do it in the first person, that is, “I see … I hear ….”

• As you wait and watch just notice that things can change. How do they change and in what way? Use the Subjective Units of Discomfort (SUDS) on a scale of 1 (for little) to 10 (the very most) to monitor how the strength of feelings go up or down. Less often they may stay the same.

• Be curious and do lots of safe experiments. What do you learn from the things that seem to go wrong as well as the successes in your life.

• Be aware of ways in which you can be in control of your body and your situation. You may surprise yourself and find some controls you did not know you had.

• When catastrophising, use the diversions and distractions you have designed for yourself. These are less likely to work in the moment of crisis. Indeed, the strategies can become a disappointment to you because they appear not to work. This may deter you from using these strategies at all Diversion and distraction seem best suited to changing your habits (and so need to be practised several times a day in a random fashion, rather than in the heat of the moment). In particular, I would want you to very aware of the outcomes you obtain from your experiments. Clarity of thinking is one things that tends to vanish in a crisis!

With a following wind, we can learn from small defeats and further experiments can increase our confidence in our ability to respect our fears and anxieties.

Flight, Fight and Freeze

As I specialise in trauma management, I am often asked about how treatment works. The short answer is that often we do not know!

There are many leading therapists who get good results and this seems to arise because they are well informed and skilful (one reason why I have written the commentary on Person-centred therapy).

I’ve mentioned a few already, but I will focus here on Peter Levine having revised some of his material recently. As with Bessel van der Kolk, Peter looks at the responses of our body and he asks how we can work therapeutically with the body in different ways.

One thing of particular importance is the idea of the flight/fight response. The responses of the lower brain, and the amygdala in particular, can help us run or fight in a threatening situation. We can recover and escape, possibly without long-term physical or emotional damage.

However, if we do not run, the primitive circuits of our older and not so smart sibling can persist and take over. Our ability to function will deteriorate. The potential for post-trauma starts to be set up.

If you can’t fight or flee – you may end up frozen and helpless. You have to work through that unpleasant experience if the trauma is not to to be retained in your body. Therapy can help us to find a place for the experience that makes sense – to place it at the ‘back of our mind’ – rather than pre-occupying us by obstructing the front!

In his writings, Peter talks about the body as a container that embodies all our experiences – everything we think and feel. Simply appreciating that we live in a body, and not in our heads, starts to give us therapeutic opportunities to build a safe environment.

The bodily events happening one after another provide both the story about what is happening and the visceral exponent that ‘glues’ the event in our matrix memory. The story we tell rather depends on the workings of our younger and smarter sibling, This may provide one part of our recovery but only if the way in which we once felt inside is ‘unglued’ – that is, experienced, not avoided.

Once we regard the body as a source of information, and tune into what is happening in the body at any given moment, we may be able to release ourselves from some of the trauma held in the body.

Another way to view this Flight, Fight and Freeze response is to study Stephen Porges’ account of the Polyvagal system. This is so important that I have written up more details at:

https://your-nudge.com/2017/11/30/control-breathing-to-keep-calm-is-it-really-that-simple/:

Polyvagal theory is a large and complex subject to research. It does demonstrate how modern therapy and modern neurology appear to be coming together. It is not a study to take on lightly!

How can we use these ideas in a practice?

When body scanning, just notice the thoughts, feelings and sensations, as described in the main body of my blog. When it feels right, focus on the sensations and stay with the body experience. Start to just notice the intense sensations and feelings as moment-to-moment experiences. Do not divert or distract yourself with starting something different. To do so would take you into a different set of experiments.

Just noticing these responses in the present can become very freeing, even if they seem to invite freezing as well. However, those feelings can transform themselves on their own – without action or the need to play them out.

Compare this with the mid-20th century approach of Alexander Lowen and Wilhem Reich. They recommended that therapy work with feelings by discharging them in some fashion; by acting them out. Today, we are aware that we are able to stay with the feeling and not necessarily express it outwardly. Feelings can still transform; indeed, the neurology of how feelings grow and subside rather require them to transform.

This leaves the issue: when might acting out work or, indeed, leave us stuck with more to come. When is this acting out, or cartharsis, as it is known, not required for healing to take place?

The general answer is that acting out will work in the here-and-now. When it is ‘situationally appropriate’. That is, when the threat is present and immediate. If I find myself in a circumstance that is potentially overwhelming, then it is usually better to act. The alternative to fight or flight is to freeze. It is this state of freeze that can foster stuckness – like the bunny caught in the headlights. Freeze works best when we need to be anaethesised or prepared for death.

I do some work in the area of domestic abuse. Here I notice how angry people do act and may do damage. Often they will speak remorsefully afterwards, but most often, this belated apology appear non-genuine. Furthermore, they are likely not to feel their anger after the event. They have acted; their feelings are dispersed. That action, anti-social though it may be, is defensive. Instead of just feeling the anger, it is enacted and minimal residual feelings are left. It would be handy if some genuine shame could survive, but with some people this does not happen.

So, in brief, how do you develop a sense of the body as a source of safety, rather than a repository of threat? Everything keeps changing but the body is still here; awareness is still here. We can tap into that. The body is a source of information – by tuning into what is happening in the body by body scanning we can look our fear in the eye – not as our best friend, maybe, but as a powerful tutor.