Richard Bloom MFT 09312
I clench my jaw. My neck and shoulders are always tense. I get headaches. I’m constantly exhausted.
I’m certain that I’ll make a mess of things. I feel as though I can barely breathe. The world is coming at me faster than I can handle and one more frustration will make me scream . . . but I dare not scream or cry or show anyone how anxious I really am. I know that being worried doesn’t help but I even worry about being worried. It would be funny if it didn’t feel so painful and persistent.
There are ways to manage anxiety. Some are rooted in the physiological response. When we are anxious, we tend to hold our breath, a mechanism that is automatic, a reflex rooted in DNA from the times that our ancient ancestors lived in the trees, when the safest reaction if a child fell was to curl up and hold its breath so that it would land safely on its broad back which would cushion the impact. That holding of our breath is the basis of all our feelings of anxiety. It’s why, when we are anxious and try to take a deep breath, we seem incapable of doing so. The diaphragm, the muscle that controls our deep breathing, is frozen, and we can’t catch our breath. Trying to take in more air doesn’t work. It may be counterintuitive but expelling all the air from your lungs and tightening those muscles as much as you can will help free up the diaphragm and give some instant relief. Try it sometime when you are feeling anxious. Take your time and do it more than once.
Anxiety is in part a physiological stress reaction, a sudden secretion of the hormone cortisol from the adrenal gland. Small increases of cortisol have some positive effects: a quick burst of energy when it is needed, heightened memory functions, lower sensitivity to pain, all the help you would need if you were under attack or in an emergency. Stress increases cortisol levels as does lack of sleep. And many people drink coffee to compensate for their lack of sleep but it too increases the cortisol levels. There are many things which will reduce cortisol levels but it takes a conscious effort to introduce them into your life if they are not a familiar part of your day: exercise, meditation, yoga, breathing exercises, music, sex, laughter and even activities like journaling, being in nature, and spending time with your pets.
But even if you are doing many of those things, there is one human organ that seems to be able to produce stress without any outside stimulus at all, the brain. The way we think shapes how we are in the world. If we are constantly imagining a fearful world, we are constantly experiencing it. Examining our pattern of thoughts and creating new ones can be helpful, as can living more in the present. There is a wonderful bumper sticker that reads: "Don't believe everything you think!"
I’m afraid that people will find me foolish, stupid, awkward. I worry that I’ll get sick, that I’ll be fired from my job, that my friends don’t really care about me. The world seems like such a dangerous place.
Anxiety, of course, has a proper place in human experience. It warns us of imminent danger and without it we would be extremely vulnerable. It helps us recognize when real dangers arrive, but it is a mechanism that can go wrong. How has it happened that so many things now seem dangerous?
The brain works by association, by recognizing familiar patterns. If I have never seen a car speed through a red light, I am not unduly concerned, and when my light turns green, I drive confidently into the intersection. But once I experience possible danger, I become more cautious. If I witness an accident or am in one, the impression will be powerful. A strong memory is rooted in an intense emotional experience. Perhaps over time if a similar incident does not occur again, my vigilance will recede, but recurring incidents reinforce my fears.
People who have had a secure childhood seem to handle trauma better than those whose early years were filled with turmoil. They may react just as strongly but they seem to recover more quickly. If I was a child who expected to be hit or criticized, belittled or abandoned, if I witnessed constant conflict or violence, if my parents were unavailable because of drugs or alcohol, I probably did not grow up with a calm place within me that was certain that events would turn out alright.
Some families create or perpetuate a culture of worry and sometimes not without reason. People have often fled to this country from persecution or abject poverty. Large groups were uprooted and transplanted. They lost a sense of home and community and had to rebuild it. The world felt like a dangerous place. If mom is constantly anxious, the children will sense it, may even experience it in the womb before they are born. It is like the air that they breathe. It feels normal. But children have a hard time sorting out the adult world. If mom is constantly upset, if dad often snaps at me, if mom continually frowns and withdraws, I may wonder if I have done something wrong. If the two of them are always talking about the lack of money, the horrible neighbors, the uncle or aunt who is selfish and mean, so and so who can’t be trusted, it establishes a view of reality that is frightening and difficult to manage. What if the car breaks down? What if it rains? What if they’re not home? What if you fail the test? What if, what if, what if. . .? Be careful! Don’t trip. Don’t slip. How can I separate the normal difficulties of life from a raging river of obsessive worry?
All of these can be the work of psychotherapy. In gaining perspective on the family and the community we were born into, in examining the relationship of our thoughts to our feelings, in developing a realistic outlook toward ourselves and the world which surrounds us, and in retraining our physiological response to stressful stimuli we can learn to manage our difficulties better and find joy where life presents it.
Richard Bloom, mft, is a psychotherapist with over 40 years experience helping individuals and couples. He has offices in Santa Rosa and Berkeley. Richard Bloom psychotherapy for anxiety.
For more information or to schedule an appointment call: 707-665-0846.