Dealing With Anxiety: Exploring the Patterns that Fuel the Anxious Process

Dealing With Anxiety: Exploring the Patterns that Fuel the Anxious Process

Anxiety is everywhere.  It’s an epidemic. An estimated 40 million adults (18 and older) or 18% of the population endorse symptoms of anxiety (not to mention 1 out of 8 children). Treatment of anxiety is a 1/3 of the $148 billion dollars spent annually on mental illnesses in America. In other words, we spend $42 billion a year on treatment of anxiety disorders in America.

Women are 60% more likely to develop an anxiety disorder than our male counterparts. The average age of onset is 11 across genders. Add to these statistics that nearly half of the 40 million adults with anxiety also suffer from depressive symptoms, which is the leading cause of disability in the US for ages 15-43. These numbers are terrifying to me as a clinician, a woman and a mother.

But is there anything we can do to slow these statistics from what seems to be an endless climb north? Or, is anxiety simply something you catch or that you get from your genetics? Are the intergenerational symptom patterns that emerge within families simply a case of genetic destiny and bad luck or can we influence the severity and the way we cope with our feelings such that we can influence the trajectory of these statistics?

This article is designed to strip anxiety down to the studs and reveal the intricate scaffolding system that provides structure and fortitude to the anxious process. This is not an exhaustive list of the prodromal symptoms of anxiety by any means, but we will explore several of the key components that contribute to the vast majority of all anxiety patterns.  Namely, we will examine the role of avoidance, rumination, and speculation in the eventual onset of a full-blown anxiety disorder.

At the center of anxiety is a neurobiological dis-regulation, affecting most notably the central nervous system.  This dis-regulation is most readily obvious in the form of panic attacks.  But the more subtle aspects of anxiety, the patterns in thinking that are often the unrecognized participants in an ongoing anxious process are the inflection points we want to understand in therapy in order to rework your unconscious patterns and mitigate the more severe symptoms.

Dealing with Anxiety: How it holds on and how to loosen the grip.

Anxiety moves in circular motion, although you are constantly spinning you are never truly gaining traction and moving forward. Perpetual loops of speculation, avoidance, rumination, and worry will hold you hostage to growth and internal contentment. But here’s the good news, anxiety is amenable to intervention and change.  The only requirement is that you have to want it badly enough to work for it.  You have to be willing to expose yourself to things and circumstances and (most importantly) feelings you have been avoiding, often for decades. And, you have to be willing to do the work to re-route neural patterns that have become dominant over the years, but no longer helpful in promoting a sense of internal equilibrium.   

Let’s break down a few of the styles or patterns at the epicenter of the larger anxious process namely rumination, speculation, and avoidance.

The Ruminator.

Rumination is a prolonged state of cyclical worry and negative internal dialogue about your self, others, situations, or all three combined.  Rumination is when you start to brood on an event or interaction. Usually this brooding takes on the flavor of having done something wrong or having been wronged (usually the former). Rumination is the “thing” you cannot seem to turn your mind’s eye away from.  As you observe this style of thinking, notice that ruminations almost never take on a positive flavor. Ruminators will often also exhibit interpersonal styles that are marked by a propensity to be the victim and/or have other co-dependent dynamics that entangled them in a web of disempowerment.  

The Speculator.

The speculator is constantly looking into the future to source out the possible signs of danger ahead. These people forecast about the future most often with a flavor of doom, suspicion or dread. The speculator views the untapped horizon with apprehension, suspicion, and sometimes paranoia.  At a clinical level, when I see non-psychotic features of paranoia I pretty much know I have a speculator on my hands.  The speculator is most vulnerable to catastrophic thinking patterns, which are universally at the epicenter of more acute anxiety disorders. I urge you to view this style of thinking as a component of anxiety.  If you read this and find that you too exhibit these traits, I’d encourage you to begin to observe when you shift into the speculator role and explore why you are using this style of thinking at this moment in time. 

From a therapeutic standpoint there are reasons you have snuggled into this style of thinking vs. another style.  By allowing yourself to observe that you are doing it, without necessarily going down the rabbit hole, you have a fighting chance to tap into real freedom of choice and free will.  Previously, when you were unconsciously engaging this thinking style you weren’t actually making empowered decisions.  You were living out neurobiological attachment patterns that had unknowingly hijacked your ability to make choices about the trajectory of your own mind and brain.

Avoidance.

Avoidance is a complicated and highly effective defense mechanism, which cannot be fully explored in the scope of this blog.  So please, if you identify with an avoidant style of intra-and-inter-personal dynamics, seek more information. 

That being said, avoidance operates paradoxically.  On the one hand, it is highly effective in reducing or discharging the feeling(s) the person is trying to distance him/her self from.  The act of avoiding the uncomfortable feeling or situation results in an immediate reduction in the discomfort. That’s why I refer to it as effective.  But don’t mistake effective for healthy. 

On the other hand, avoidance is a crippling style of coping.  Left unchecked it usually results in significant emotional and interpersonal limitations. Here’s the fine print on the avoidance contract.

First, you have to continue to narrow your aperture of focus to accommodate the ongoing avoidant pattern.  In other words, in order to maintain distance from the feelings you are trying to avoid, you have to engage in more and more avoidant behaviors.  This how compartmentalization comes into play in the anxious process and how, in the most extreme expression of avoidance you see people struggling with overt phobias. Like the aperture on a camera lens the scope narrows proportionally on the left and right as it closes in on a more myopic view, avoidance follows the same philosophy when it comes to managing your feelings.  As you effectively protect yourself from any of the unpleasant feelings you wish to escape, you simultaneously and proportionally narrow your ability to feel and absorb intensely pleasant feelings. That’s just the price of employing this defense mechanism.  Over time, you will feel less discomfort, I suppose, but you will also feel less love, less bliss, less deeply connected to people in your life.  The aperture closes proportionally until you are left with a narrow and often myopic emotional scope. You will be comfortably numb.    

This brings us to your second fine print item: The more you narrow your emotional aperture to accommodate the avoidance, the more you participate in atrophying your ability to tolerate your feelings in general. The ability to tolerate feelings is a muscle. It’s an achievement that starts with an intricate and delicate dance between infant and caregivers and continues throughout our lives as we adapt and re-adapt to our changing environments.  The more you exercise this muscle, the stronger and easier it gets.  The more you avoid your feelings, the more the muscle atrophies and the harder it is to tolerate any sense of emotional discomfort or un-ease. Eventually you will be walking an emotional tight rope that is pulled taught with your internal friction.

So what can you do? How can you shift these long held patterns?

Anxiety has physical, emotional and cognitive expressions that can be mutually exclusive or present as a symphony of symptoms.  The overwhelming part about anxiety is that it impacts so many different and intersecting parts of our human experience.  But that is also its greatest asset and part of the reason why it is often the most amenable to change in a therapeutic setting.  Anxiety can be approached and massaged at various levels. In other words, we make good habits the same way we make bad one-we just keep doing a behavior.

Be curious, and grow your awareness.

Start to become aware of how your mind and brain works and what kind of thought patterns emerge before, during, and after you feel acute levels of anxiety. Try to view these anxiety episodes as neurobiological.  They are hardwired at this point.  But do not confuse this with assuming it’s “genetic.”  It’s not that simple or linear.  There are fixed cognitive and emotional patterns that you can observe, understand, and eventually influence.  As the patterns move from being unconscious to conscious, you will be better able to insert influence and choice over these central nervous system patterns that had previously held you emotionally hostage.  The power to observe your mind from this neutral stand point allows us the possibility that we might eventually be able to slow the perpetual loop enough to reroute the course of motion.

Understand that the goal is not to feel happy all the time.

The goal isn’t to avoid your unpleasant feelings. The goal is to learn how to stay present in them. Just simply tolerate the feelings. They will pass. They have a beginning, middle, and an end. Like a wave, they will crest and then receded and crest again. Train to your weaknesses. Build the muscles that need strengthening and allow the ones that are too robust to soften. This how we achieve a sense of balance and emotional equilibrium.  It’s also how we extract peak performance from ourselves. So remember, train to your weaknesses.

Mindfulness

Commit to doing mindfulness for twenty minutes a day for one month. Try breaking it up into two ten-minute segments. I’ve written else where about my preferred style of mindfulness. Click here to read more. 

Seek outside support.

Work with a skilled clinician to gain more insight and observance of how your mind works. Initially, all you have to do is observe your process. Try to view therapy as the emotional equivalent of working out.  It’s your opportunity to train your mind and brain. Remember, if we want to get better (healthier) train to your weaknesses.  Don’t train to your strengths. You are already proficient at the things that come easily to you. I encourage my patients to observe the parts of their experiences that are difficult for them to tolerate. I provide the space for people to increase the bandwidth you have to tolerate your feelings. I am purposely using the word tolerate because that is the threshold I want you to (re)-calibrate your interior world to. 

And to all the parents out there raising small children. 

Now is the time you can influence these intergenerational patterns and change the trajectory of your shared history by helping your child to be better equipped to metabolize, tolerate, and react to his/her own feelings. 

Don’t help your children avoid difficult feelings.  Don’t try to narrow or alter their reality so they do not have to feel difficult, sad, or intense feelings. Allow them to navigate these situations and build the muscles to be better prepared to handle the complex world of adulthood. Yes, we all want to protect our kids.  But we are not doing them any service by passing on these patterns of avoidance. 

When you inadvertently pass on these style of coping you are, ultimately, creating limitations in their interior world. It’s not intentional.  But it does happen.  Help your child learn to increase their tolerance for discomfort by modeling your own capacity to manage your feelings without excessive avoidance, denial, etc.  Encourage and applaud them when they feel intense emotions and remind them that feelings have a beginning, middle, and an end.  This too shall pass.   

In conclusion.

I want to re-emphasize I am not suggesting you try to clear your mind.  Or think positively. Or even regulate your breath.  You are simply being still in your body, mind, and brain.  Observe. Breath.  Voila.

[irp posts=”2090″ name=”What Butterflies Can Teach Us About the Mind/Body Connection: A Shrink’s Guide to Listening to Your Gut (by Dr Sarah Sarkis)”]

[irp posts=”2283″ name=”Circling the Storm Drain – The Origins of a Narcissist (by Dr Sarah Sarkis)”]


About the Author: Dr Sarah Sarkis

Sarah is a licensed psychologist living in Honolulu, Hawaii. Originally hailing from Boston Mass, she has a private practice where she works with adults in long-term insight oriented therapy. She works from an existential psychology vantage point where she encourages her patients to “stay present even in the storm.”  She believes herself to be an explorer of the psyche and she will encourage you to be curious about the journey rather than the destination.  She emphasizes collaboration, partnership, and personal empowerment.

She approaches psychological wellness from a holistic and integrative perspective. Her therapeutic style is based on an integrative approach to wellness, where she blends her strong psychodynamic and insight oriented training with more traditionally behavioral and/or mind/body techniques to help clients foster insight, change and growth. She has studied extensively the use of mindfulness, functional medicine, hormones, and how food, medicine and mood are interconnected.  Her influences include Dr.’s Hyman, Benson, Kabat-Zinn and Gordon, as well as Tara Brach, Brene’ Brown, Irvin Yalom and Bruce Springsteen to name only a few.

Please visit her website at Dr SarahSarkis.com and check out her blog, The Padded Room

 

4 Comments

Holly

Hi Sarah,
Ruminator is what I most commonly see myself as. I definitely go down the negative path based off of small interactions.do you have any tools to help after recognizing myself in the moment as doing this, and how to calm the negative thoughts and reinforce positive ones?

Reply
Em

Howdy! Great article.

Can you speak more about The Speculator style of anxiety? This is me to a T! And worrying about non-existent future problems can sometimes become a self-fulfilling prophecy.

Aside from awareness when you begin to spiral into this anxiety, is there a better way to redirect your thoughts? Is it through self-reassurance? Or practicing telling yourself you’re making a mountain out of a molehill?

Warm regards from Toronto!

Reply
Sarah Sarkis

Hi there:
Thanks for the comment. In terms of interventions to interrupt the spectator role I’d first really focus on observing when you are doing it and what you are feeling, both emotionally and physically. Just draw that awareness. this will allow you to begin to put together an understanding of what and why and when you employ this style of thinking. Then you can map out thought blocking techniques, and other tools to interrupt the neuro-linguistics loop.
First, we must wrestle with stillness and observation in order to allow the patterns to emerge.

It would also be helpful if you aren’t already to work with a skilled clinician to help you implement specific tools once you have gained insight around the pattern.

You can check out my blog, The Padded Room, for more articles that might prove helpful.

Thanks again for connecting.
dr. sarkis

Reply
sam

I think you’re a wonderful therapist Karen. You’ve been so helpful in my recovery from anxiety. I’m about 98% cured. I did have a relapse recently remembering a situation I felt I had no control of (one which felt shameful, embarrasing and feeling injustice) but I came out of it by learning more about myself and journalling. It forced me to stop ruminating and get into clear thoughts. I couldn’t trust anyone with my thoughts. I didn’t trust my medicare based psychologist. He just didn’t get me and my female issues plus I felt I would be judged or laughed at.

But anxiety forced me to look deeply at myself if I wanted to escape that horrible feeling and the answer isn’t just sitting with a feeling till it passes (but which has it’s merits too). Its much greater than that which you touch on in many other of your posts.

I have learned I had avoided most emotions at all costs caused by selfish and neglectful parents. I had to stuff my emotions and be the mother from a very young age. From my mother I learned to hate and distrust people and from that came my aggression and lack of empathy and lack of emotional (social) intelligence. I had no idea how to engage with other women and would get rejected often (subtly of course). That lead to my big-I-feel-I’m-about-to-die anxiety as well as experiencing trauma cause by friends who were boys when I was just a teen. I had nobody to share the shame that I put upon myself for what THEY DID TO ME. That experience only compounded my avoidance even further.

Despite being an athiest, something I learned is that our situation is there to teach us something. Call it energy or mother nature or God if you believe in him trying to shine a light on what you have been hiding or running away from.

What I found that worked the most was learning about emotions by signing up to newsletters like yours and most of all the feeling of having no control is what’s spurring the feeling of being unsafe. Find your belief that this is unfolding exactly as it should despite what you’re making of it. Just keep that belief and you’ll come out of the panic, the fear, the anxiety and the depression. There is something out there watching over you. You are where you should be. You will look back at this horrible time and you will say “aha I get it, thank you so much whatever you are”.

And most importantly be super kind to yourself – google self love.

Those 7 years were the toughest most scariest time of my life. The harder the feeling, the closer you are getting to the source of your pain. Let it come out with the sitting with your feeling or journaling it if meditation is too hard right now and you’ll find you’re happy again (in time) Something you think is never going to happen again, will return. You just forgot how good life can feel. It will return. I promise!

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‘Brave’ doesn’t always feel like certain, or strong, or ready. In fact, it rarely does. That what makes it brave.♥️
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#parenting #mindfulparenting #parentingtips
We teach our kids to respect adults and other children, and they should – respect is an important part of growing up to be a pretty great human. There’s something else though that’s even more important – teaching them to respect themselves first. 

We can’t stop difficult people coming into their lives. They might be teachers, coaches, peers, and eventually, colleagues, or perhaps people connected to the people who love them. What we can do though is give our kids independence of mind and permission to recognise that person and their behaviour as unacceptable to them. We can teach our kids that being kind and respectful doesn’t necessarily mean accepting someone’s behaviour, beliefs or influence. 

The kindness and respect we teach our children to show to others should never be used against them by those broken others who might do harm. We have to recognise as adults that the words and attitudes directed to our children can be just as damaging as anything physical. 

If the behaviour is from an adult, it’s up to us to guard our child’s safe space in the world even harder. That might be by withdrawing support for the adult, using our own voice with the adult to elevate our child’s, asking our child what they need and how we can help, helping them find their voice, withdrawing them from the environment. 

Of course there will be times our children do or say things that aren’t okay, but this never makes it okay for any adult in your child’s life to treat them in a way that leads them to feeling ‘less than’.

Sometimes the difficult person will be a peer. There is no ‘one certain way’ to deal with this. Sometimes it will involve mediation, role playing responses, clarifying the other child’s behaviour, asking for support from other adults in the environment, or letting go of the friendship.

Learning that it’s okay to let go of relationships is such an important part of full living. Too often we hold on to people who don’t deserve us. Not everyone who comes into our lives is meant to stay and if we can help our children start to think about this when they’re young, they’ll be so much more empowered and deliberate in their relationships when they’re older.♥️
When we are angry, there will always be another emotion underneath it. It is this way for all of us. 

Anger itself is a valid emotion so it’s important not to dismiss it. Emotion is e-motion - energy in motion. It has to find a way out, which is why telling an angry child to calm down or to keep their bodies still will only make things worse for them. They might comply, but their bodies will still be in a state of distress. 

Often, beneath an angry child is an anxious one needing our help. It’s the ‘fight’ part of the fight or flight response. As with all emotions, anger has a job to do - to help us to safety through movement, or to recruit support, or to give us the physical resources to meet a need or to change something that needs changing. It doesn’t mean it does the job well, because an angry brain means the feeling brain has the baton, while the thinking brain sits out for a while. What it means is that there is a valid need there and this young person is doing their very best to meet it, given their available resources in the moment or their developmental stage. 

Children need the same thing we all need when we’re feeling fierce - to be seen,  heard, and supported; to find a way to get the energy out, either with words or movement. Not to be shut down or ‘fixed’. 

Our job isn’t to stop their anger, but to help them find ways to feel it and express it in ways that don’t do damage. This will take lots of experience, and lots of time - and that’s okay.♥️
The SCCR Online Conference 2021 is a wonderful initiative by @sccrcentre (Scottish Centre for Conflict Resolution) which will explore ’The Power of Reconnection’. I’ve been working with SCCR for many years. They do incredible work to build relationships between young people and the important adults around them, and I’m excited to be working with them again as part of this conference.

More than ever, relationships matter. They heal, provide a buffer against stress, and make the world feel a little softer and safer for our young people. Building meaningful connections can take time, and even the strongest relationships can feel the effects of disconnection from time to time. As part of this free webinar, I’ll be talking about the power of attachment relationships, and ways to build relationships with the children and teens in your life that protect, strengthen, and heal. 

The workshop will be on Monday 11 October at 7pm Brisbane, Australia time (10am Scotland time). The link to register is in my story.
There are many things that can send a nervous system into distress. These can include physiological (tired, hungry, unwell), sensory overload/ underload, real or perceived threat (anxiety), stressed resources (having to share, pay attention, learn new things, putting a lid on what they really think or want - the things that can send any of us to the end of ourselves).

Most of the time it’s developmental - the grown up brain is being built and still has a way to go. Like all beautiful, strong, important things, brains take time to build. The part of the brain that has a heavy hand in regulation launches into its big developmental window when kids are about 6 years old. It won’t be fully done developing until mid-late 20s. This is a great thing - it means we have a wide window of influence, and there is no hurry.

Like any building work, on the way to completion things will get messy sometimes - and that’s okay. It’s not a reflection of your young one and it’s not a reflection of your parenting. It’s a reflection of a brain in the midst of a build. It’s wondrous and fascinating and frustrating and maddening - it’s all the things.

The messy times are part of their development, not glitches in it. They are how it’s meant to be. They are important opportunities for us to influence their growth. It’s just how it happens. We have to be careful not to judge our children or ourselves because of these messy times, or let the judgement of others fill the space where love, curiosity, and gentle guidance should be. For sure, some days this will be easy, and some days it will feel harder - like splitting an atom with an axe kind of hard.

Their growth will always be best nurtured in the calm, loving space beside us. It won’t happen through punishment, ever. Consequences have a place if they make sense and are delivered in a way that doesn’t shame or separate them from us, either physically or emotionally. The best ‘consequence’ is the conversation with you in a space that is held by your warm loving strong presence, in a way that makes it safe for both of you to be curious, explore options, and understand what happened.♥️
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#mindfulparenting #positiveparenting #parenting

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