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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Today was an ending and a beginning. My darling girl finished year 12. The final year at school is tough enough, but this year was seismic. Our teens have moved through this year with the most outstanding courage and grace and strength, and now it is time for them to rest and play. My gosh they deserve it. 

It is true that this is a time of celebration, but it can also be an intense time of self-reflection for our teens. (I can remember the same feelings when my gorgeous boy finished so many years ago!) My daughter has described it as, ‘I feel as though I’ve outgrown myself but my new self isn’t ready yet.’ This just makes so much sense. 

There is a beautifully fertile void that is waiting for whatever comes next for each of them, but that void is still a void. At different times it might feel exciting, overwhelming, or brutal in its emptiness.

We also have to remember that this is a time of letting go, and there might be grief that comes with that. Before they can grab on to their next big adventure, they have to let go of the guard rails. This means gently adjusting their hold on the world they have known for the last 12+ years, with its places and routines and people that have felt like home on so many days. There will be redirects and shiftings, and through it all the things that need to stay will stay, and the things that need to adjust will adjust. 

To my darling girl, your loved incredible friends, and the teens who make our world what it is - you are the beautiful  thinkers, the big feelers, the creators, the change makers, and the ones who will craft and grow a better world. However you might feel now, the lights are waiting to shine for you and because of you. The world beyond school is opening its arms to you. That opening might happen quickly, or gently, or smoothly or chaotically, but it will happen. This world needs every one of you - your voices, your spirits, your fire, your softness, your strength and your power. You are world-ready, and we are so glad you are here xxx
When our kids or teens are in high emotion, their words might sound anxious, angry, inconsolable, jealous, defiant. As messy as the words might be, they have a good reason for being there. Big feelings surge as a way to influence the environment to meet a need. Of course, sometimes the fallout from this can be nuclear.
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Wherever there is a big emotion, there will always be an important need behind it - safety, comfort, attention, food, rest, connection. The need will always be valid, even if the way they’re going about meeting it is a little rough. As with so many difficult parenting moments, there will be gold in the middle of the mess if we know where to look. 
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There will be times for shaping the behaviour into a healthier response, but in the middle of a big feeling is not one of those times. Big feelings are NOT a sign of dysfunction, bad kids or bad parenting. They are a part of being human, and they bring rich opportunities for wisdom, learning and growth. .
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Parenting isn’t about stopping the emotional storms, but about moving through the storm and reaching the other side in a way that preserves the opportunity for our kids and teens to learn and grow from the experience - and they will always learn best from experience. 
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To calm a big feeling, name what you see, ‘I can see you’re disappointed. I know how much you wanted that’, or, ‘I can see this feels big for you,’ or, ‘You’re angry at me about .. aren’t you. I understand that. I would be mad too if I had to […],’ or ‘It sounds like today has been a really hard day.’ 
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When we connect with the emotion, we help soothe the nervous system. The emotion has done its job, found support, and can start to ease. 
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When they ‘let go’ they’re letting us in on their deepest and most honest emotional selves. We don’t need to change that. What we need to do is meet them where they and gently guide them from there. When they feel seen and understood, their trust in us and their connection to us will deepen, opening the way for our influence.
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#parenthood #parenting #positiveparenting #parentingtips #childdevelopment #neuronurtured #anxiety #anxietyinchildren #childanxiety #motherhoodcommunity #parenti
When they are at that line, deciding whether to retreat to safety or move forward into brave, there will be a part of them that will know they have what it takes to be brave. It might be pale, or quiet, or a little tumbled by the noise from anxiety, but it will be there. And it will be magical. Our job as their flight crew is to clear the way for this magical part of them to rise. ‘I can see this feels scary for you - and I know you can do this.’ 
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 #mindfulparenting #neuronurtured #parentingteens #neurodevelopment #braindevelopment #positiveparenting #parenting #parenthood #childdevelopment #parentingtip #adolescence #positiveparentingtips #anxietyawareness #anxietyinchildren #childanxiety #parentingadvice #anxiety #parentingtips #motherhoodcommunity #anxietysupport #mentalhealth #heyawesome #heysigmund #heywarrior
When our kids or teens are struggling, it can be hard to know what they need. It can also be hard for them to say. It can be this way for all of us - we don't always know what we need from the people around us. It might be space, or distraction, or silence, or maybe acknowledging and being there is enough. Sometimes we might need to know that the people we love aren't taking our need for space, or our confusion or anger or sadness personally, and that they are still there within reach.
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What can be easier is thinking about what other people might need. Asking this when they are calm can invite a different perspective and can give you some insight into what they need to hear when they are going through similar. Don't worry if you just get a shrug, or a disheartened, 'I don't know'. They don't need to know, and neither do we. The question in itself might be enough to open a new way through any sense of 'stuckness' or helplessness they might be feeling.
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#parenthood #parenting #positiveparenting #parentingtips #childdevelopment #parentingadvice #parentingtip #mindfulparenting #positiveparentingtips #neurodevelopment #parentingteens
Give them space to talk but you don’t need to fix anything. You’ll want to, but the answers are in them, not us. Sometimes the answer will be to feel it out, or push for change, or feel the futility of it all so the feeling can let go, knowing it’s done it’s job - it’s recruited support, or raised awareness that something isn’t right.

Sometimes the feelings might be seismic but the words might be gone for a while. That’s okay too. Do they want to start with whatever words are there? Or talk about something else? Or go for a walk with you? Watch a movie with you? Or do a spontaneous, unnecessary drive thru with you just because you can - no words, no need to explain - just you and them and car music for the next 20 minutes. 

The more you can validate what they’re feeling (maybe, ‘Today was big for you wasn’t it’) and give them space to feel, the more they can feel the feeling, understand the need that’s fuelling it, and experiment with ways to deal with it. Sometimes, ‘dealing with it’ might mean acknowledging that there is something that feels big or important and a little out of reach right now, and feeling the fullness and futility of that. 

Part of building resilience is recognising that some days are rubbish, and that sometimes those days last for longer than they should, but we get through. First we feel floored, then we feel stuck, then we shift because the only choices we have we have are to stay down or move, even when moving hurts. Then, eventually we adjust - either ourselves, the problem, or to a new ‘is’. But the learning comes from experience.

I wish our kids never felt pain, but we don’t get to decide that. We don’t get to decide how our children grow, but we do get to decide how much space and support we give them for this growth. We can love them through it but we can’t love them out of it. I wish we could but we can’t.

So instead of feeling the need to silence their pain, make space for it. In the end we have no choice. Sometimes all the love in the world won’t be enough to put the wrong things right, but it can help them feel held while they move through the pain enough to find their out breath, and the strength that comes with that.♥️

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