Anxiety: how to relieve an acute episode and exhale

This month I worked with Natalia, who suffers from GAD, a generalized anxiety disorder. The woman applied during an exacerbation that happened after she was fired from her job. Unsettled personal life, fear of the future, fear of being without a livelihood .. For a person with GAD, any such circumstances will cause not just excitement, but anxiety of such a force that it is almost impossible to calm down. After all, a person with GAD seems to be walking through enemy territory all his life, waiting for a shot.

 1. Coherent breathing.

To remove the physiological manifestations of “anxious spasm”, we started with circulatory (coherent) breathing. Fast shallow breathing is used to weaken feelings, body sensations, if they become too strong. After ten minutes of breathing without pauses, when there is no delay between exhalation and inhalation, the client’s emotional pain reached a peak and then almost disappeared. In this process, it is recommended to “inhale” through the strongest feeling, and also learn to enjoy the sensation of an intense manifestation of energy.

 2. What are you avoiding because of anxiety?

There were several answers to this question. Natalia avoids looking for a new job, communicating with men and even making phone calls to her friends. Anxiety seems to freeze her, gradually turning into depression. At the same time, she began to show symptoms characteristic of GAD: insomnia, tension, irritability, overwork.

Anxiety is a way to avoid the intense emotions that lie behind fear. Therefore, in working with Natalia, we investigated her worst fears and trained her ability to endure the worst scenario. The client learned to clearly visualize herself in a frightening situation and described it to me in detail. Gradually her anxiety subsided. Once she can overcome her biggest fear, there will be no point in worrying about avoiding it.

3. Set aside 20 minutes a day to experience anxiety.

To begin with, I invited Natalia to sit down and write down everything she worries about. Then it was necessary to put the sheet aside and begin to intensely worry about the problems that worried. To do this, you can use your imagination or repeat negative thoughts in your head that create anxiety. Surrender to them completely, worry, savor your anxiety and despair. It is likely that soon you will get tired of this and the excitement will subside.

4. Anxiety is a lonely person who has no friends at all.

A wonderful metaphor that Robert Leahy gives in his books helps to cope with any obsession. You can think of anxiety in the form of a character who goes shopping with you, goes for a walk, sits next to you at work. Greet this guest instead of trying to get rid of him. When you stop feeding your anxiety with your attention, it will become ghostly and begin to melt away.

5. Do what worries you.

You can only learn to swim in water – so let yourself get wet. In small steps, Natalya went to meet her fears: get an interview, call her friend first, ask a man on the street “what time is it?”. Anxiety became a signal for her: the “terrible” should not be postponed, but done right now. To train her self-confidence, the client made a plan to sign up for any pair dances, throw a party for friends (which she never did), send a resume to the 5 best companies in the city.

6. Recognize the uncertainty and chaos of life.

At this stage of the work, we discuss the topics of control and expectations. Often we do not understand how the general tension increases due to the feeling of responsibility for everything that happens and the need to do something about it. We take on an extra burden when we think that we can somehow “earn” the love of another person, to rush traffic in a traffic jam or a queue in a store. But reality remains as it is, and almost nothing depends on our attempts to control it.

At one of the consultations, Natalia formed new thoughts for herself:

“I cannot demand love and attention from other people: if they give it, it’s good, if they don’t give it, I’ll find something to please myself with”,

“I cannot control the course of events: everything is going the way it should be. Thy will be done! “

“I stop fighting the situation. I do my best and then let go. “

“Uncertainty is beautiful and mysterious. Without her, life would be boring and predictable. Life is a great mystery, and I watch as it unfolds in front of me with the surprise of a small child. “

7. Relax as often as possible.

People with GAD often have a profound inability to relax. This tension is felt both in the thoughts and in the body: when the mind signals danger, the body prepares for a fight or flight. Effective and high-quality relaxation of the body helps not only swimming, soaring in the bath, but also the always available progressive muscle relaxation. In this technique, sitting or lying down, you need to slowly walk through all muscle groups, tensing and then relaxing them. While straining the muscle, inhale, hold it in tension for about 5 seconds, and then relax with exhalation. A great way to understand through the body what it means to tense up, and then let go of the situation and feel relief.

Dealing with anxiety requires patience and consistency. As a rule, in therapy, we come to the deep conviction of the client or his primary trauma, which trigger the anxiety-depressive mechanism. However, just understanding this depth is not enough. You need daily practice at the level of the body, comprehension, behavior.

event_note October 3, 2021

account_box Winona Tse MD

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