Thursday, February 11, 2010

What makes you anxious?

What makes you anxious?
In my capacity as an outpatient psychologist of over two
decades, I see folks who have all kinds of psychological disorders.
The most common is anxiety, followed by depression and then some
form of addiction (alcohol, drugs, sex). Anxiety touches
them all, but in many cases presents as the primary disorder.
The most common of all anxiety disorders is the panic attack.
Panic occurs when something sets us off. It is usually an
event that is threatening, like having to speak in public.
Getting audited is pretty stressful. Or, you hear a loud
"thump, thump" instead of a continuous "Vrooooooom" when you
listen to the car engine. These are lousy external events that
cause stress, usually in the form of tension or even a
full-blown anxiety response.
There are also internal mechanisms that elicit anxiety.
We usually do not know it, but there is a cue or trigger somewhere
in our midst that starts a kind of psychological chain reaction.
We are not aware of the exact stimulus but we sure know that
something got stirred up because we have some annoying symptoms
of anxiety. This usually starts with a pounding heart, followed
by sweaty palms. Maybe the next sign is a voice that cracks or
maybe we suddenly just cannot sit still. If things progress,
nausea usually sets in. Anxiety stimulates physical mechanisms,
which is when our adrenal glands dump adrenaline into our
bloodstreams. This accounts for almost all the physical symptoms
I just described.
But if there are no external events that cause anxiety, why
are we anxious? The answer has to do with how we handle feelings
and thoughts. Most of us shy away from negative subjective events,
which is normal. But there are some of us that make a habit of it
and are quite skilled at squirreling away most feelings. We
psychologists call these types "high suppressors." They probably
learned to do this early in life, but certainly in the present
they do not want to experience anything akin to a feeling, or even
a thought that associates
to a feeling. They "make it go away."
But these experiences do not go away. We just put them in a box
behind our left ear (not literally) where they fester and wait...
So, to answer the question of what makes you anxious, the answer
is, "anything." Anything is any psychological association to any
feeling you do not want to process (experience and deal with,
preferably consciously). I call these elicitors "cues" or triggers.
They are not the cause of the anxiety, which is what most people think.
The cues are the initial jolt to our senses that leads, by association,
to feelings that are forbidden, or at lease feared. It turns out,
any feeling can be paired through association to any event, which can
be cued by any association to either the event or the feeling. Huh?
We humans are so complex that virtually every experience we have
is associated with a zillion sub-associations. For example, if we
sit in a restaurant and order a burger, then the guy next to us faints
and then throws up, we have a predictably negative reaction.
What was not very conscious at that moment was the smell of the
waitress' perfume, the color of our seats, etc? What if in two
weeks we encounter an entirely separate person wearing that same
perfume, or go to a concert where there are the same colored seats?
We aren't usually conscious of these associations, but if suddenly
we have some rumblings of tension when encountering the perfume or
seat color, there is a reason. We make some associations and in the
back of our minds they lie.
Do this over and over and pair these secondary associations to
some trauma or really big negative event, and we can see how future
anxiety reactions start. Because we bury such events and their
associations, it is a mystery why in the future we should have a panic
attack when all we were doing was talking to a waitress. Because
these associations are almost random, anything that is negative and
associated to them can in the future call up the original stressful
experience. Thus, in fact, anything can make us anxious.

-Dr. Griggs

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