Anxiety disorders, which include everything from generalized anxiety, to social phobia (aka, social anxiety), to obsessive-compulsive disorders, are the most commonly diagnosed mental health problem in the US. In fact, according to the Anxiety and Depression Association of America, anxiety disorders affect 40 million US adults. More disheartening is that less than half of those with anxiety disorders receive help for their struggles.
When I work with clients who have anxiety, I often discuss with them the cycling and self-reinforcing patterns that anxiety tends to induce. This three-part series will review common ways that we give in to, and therefore worsen, our anxiety
Part 2: Give Into It
By far the most common anxiety mistake I see people making is giving into it. As I reviewed in Part 1, anxiety often boils down to a misapplied fight-or-flight response to a threat that isn't truly life-or-death. It is a good thing that we have fight-or-flight, as it keeps us from harm through readying our minds and bodies for action or escape. However, sometimes that response can get linked up with things we face in life that are not actually threatening enough to warrant such a strong neurobiological response (e.g., meeting new people, public speaking, spiders, unknowns, compulsive behaviors, being imperfect, etc.), resulting in a state of anxiety. When we are in an anxious state, our minds and bodies are basically screaming at us to get ourselves OUT of that situation through trying to find things to control (hello, perfectionism!), numb the anxious feeling (hey there, comfort food), or avoid the threat altogether. This post focuses on the danger of avoiding the anxious trigger.
What happens when we listen to our screaming brain and simply avoid the trigger? Avoidance often gives us immediate relief from anxiety, but it does us no favors in terms of making our anxiety better. In fact, it seems to make it worse. By giving in and avoiding the trigger, we reinforce our brains, telling ourselves that yes, this threat I am facing truly is life-or-death, and we give our fight-or-flight response a pat on the head (brain?) for a job well done. The next time we face the same trigger, our brains will respond as actively, if not even more so, as the first time we faced it because we reinforced the fear by giving in.
So what should we do instead? Face the fear directly. Anxiety lives on a bell curve (see below) - it builds up with those initial signs (the red zone) and continues to grow in intensity (the orange). Often, we look for ways to cut those anxious feelings before it crests - we become afraid of our own anxiety - through avoidance, numbing, or control. However, if we can muster our inner strength to sit in the discomfort of anxiety, it will subside. The acute anxiety state does not last forever, and the more that we face the threat, breathe, and ride the wave, the less intense our response will get every time we face our fear.
I experienced success with facing fear head on when it came to public speaking. Back in high school and college, I would be an absolute mess when I had to present a speech in front of my class. Shaking hands, quivering voice, cold sweat, that gripping, hollow feeling in my stomach like when you miss the last step on a staircase - all that good stuff. However, I kept pushing myself to face, acknowledge, and ride out those anxious feelings every single time. Over the years my discomfort became more manageable, and I have since completed some pretty big milestones, including conference presentations, my dissertation defense, and currently teaching graduate students for the sixth semester in a row. I still get butterflies, but my fight-or-flight response is far more subdued and manageable - and I fully attribute it to facing my public speaking fear and telling my brain over and over, "This makes me feel some stress, but I know I will be okay. Let's channel these nerves into excitement and get on with it."
Something to Practice: Identify a trigger for your anxiety response. Sticking with my anecdote above, we will use public speaking for an example.Then, think about a step towards conquering that fear. The first step should be anxiety-provoking enough -- but not overwhelmingly so. For example, one step towards conquering public speaking fear might be raising your hand in class. Then, schedule 3-5 times this week to practice facing that initial step without avoiding it. Keep track of your anxiety symptoms before, during, and after - and notice how they will decrease in intensity with repeated exposure. Once you get to the point where raising your hand no longer elicits substantial anxiety, move to the next step, such as attending a networking event or job fair, or taking a lead role for a class presentation. Work your way systematically through these steps and watch the anxiety drop.
More about fear exposure for social anxiety
Treating phobias with fear hierarchies
More on anxiety and fight-or-flight
Have you been able to conquer any of your fears? Share your success stories in the comments!
Dr. Bethany Detwiler is a psychologist practicing in Allentown, PA. She specializes in mood and relationship struggles. She also is an adjunct professor of counseling at Lehigh University.