Anxiety is, in many ways, a normal reaction to certain life events. It is not uncommon to feel some nervousness before speaking in public, or to be a bit anxious in situations of uncertainty, or when challenging life circumstances strike. Shocking, or life-threatening situations may cause severe anxiety or even panic reactions. However, when anxiety becomes pervasive, interfering with everyday functioning, or is simply more than a person is comfortable with, then perhaps it is time to seek help.
There are many ways that anxiety can manifest including anxiety over social interactions, specific phobias, anxiety that feels generalized over the course of a day, obsessive thinking patterns of worry or fear, and compulsive behaviors that become ritualized over time. Traumatic events can cause acute stress reactions and can, at times, lead to post traumatice stress disorder, in which flashbacks and even dissociative experiences can be triggered.
In an attempt to avoid anxiety, some individuals may reorder their lives and develop ways to avoid situations as a way of coping. Unfortunately, restricting one's lifestyle creates its own set of problems. Avoidance behavior diminishes one's quality of life and can negatively impact family and friends also affected by these choices.
The good news is--there are proven methods for managing and overcoming anxiety and panic. Cognitive-behavioral therapy includes a number of different approaches for helping individuals manage and overcome anxiety and panic reactive patterns. Systematic desensitization pairs the anxiety-provoking situation with relaxation methods in a hierarchy from the least anxiety-provoking situation to the greatest, allowing the person to gradually acclimate to and tolerate the feared situation. Exposure therapy protocols help do the same.
While some psychotherapists utilize one particular methodology, I have found it useful to incorporate a number of anxiety-reduction techniques. Different modalities work for different people and situations.
While I utilize cognitive-behavioral approaches, including systematic desensitization paired with relaxation techniques, I also incorporate body-centered mindfulness approaches, such as EMDR, Brainspotting and The Basic Mindfulness System into the work. If appropriate, I might also include the Emotional Freedom Technique which works to de-escalate the anxiety response by activating certain acupoints on the meridian system.
I teach my clients a number of relaxation and mindfulness techniques they can use on their own to de-escalate anxiety when it arises. I utilize reality therapy by giving assignments in the real world to help clients experience greater comfort and confidence in previously fearful situations and to move out of avoidance behavior patterns.
While de-escalation of high anxiety and increased feelings of relaxation in previously distressful situations are important treatment goals, additional work on prior traumas that shaped an anxiety reaction may also be important.
In addition to body-centered mindfulness approaches to trauma, I might utilize hypnotherapy for situations that need additional work beyond these body-centered approaches.
AMY WINTERS, LCSW
PSYCHOTHERAPY FOR ADULTS