Psychiatrist Robert Leahy begins one of his books on anxiety and worry asking the readers quite a particular question: if you had to explain to a martian what anxiety is and how an anxious person resonates, how would you do it? 

Usually we are so trapped by our worries and anxieties that we tend to get hooked on a sense of danger and urgency, not thinking about the thoughts that are causing and/or maintaining this psychological state.

Let’s see which are the common “rules” of thought that anxious people usually obey and that can be themselves, as a matter of fact, anxiety traps. These traps are considered by cognitive behavioural therapists the main constructs of anxiety, thus targeted by treatment.

1.  Personal responsibility: “if something bad could happen, it is your responsibility to prevent it”. Very often anxious people perceive an excessive sense of responsibility, stronger than the actual one.
2.  “Uncertainty is intolerable and there is no space for doubt”. Anxious people tend to avoid situations characterised by uncertainty, as usually they forecast negative outcomes out of it. Getting control over situations is very often the preferred mean to overcome uncertainty.
3.  “Negative thoughts are true and real facts”. This is the so-called thought-action fusion; a cognitive bias where thoughts can be confused as actions and facts, and not as just mere interpretations and subjective constructions of reality. People using this bias often believe that having a negative thought may have a strong (and unrealistic) impact on the actual realisation of that thought in the real world.
4. “If a negative thing happens, it reflects me as a whole person”. Anxious people usually tend to negatively judge themselves generalising a single bad result or behaviour to their person as a whole.
5. “Failure is unacceptable”. Failing, instead of being perceived as a possible source of learning, is seen in a very rigid way, often with no alternative explanations. Making it scarier than what it could be.
6.  “You must get rid of negative emotions straight away, because they are dangerous and you are not able to deal with them”. Painful emotions are often considered as useless and source of further negative emotions. As a consequence, one of the aims of anxious people is often not to feel negative emotions, locking down such important information about their inner world.

If you suffer from anxiety and you recognise yourself in obeying these “rules of thought”, you may start questioning how useful they are and start to change your approach.

Cognitive behavioural therapy may help you change the way you resonate and cope with anxiety in a different way.

References:

R. Leahy, “The worry cure: seven steps to stop worry from stopping you”, 2006.

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Health anxiety is very often underestimated. Let’s see what happens in the mind of an hypochondriac.

A little tingling in our cheek, an anomalous heart beat, maybe slightly faster then usual, a pain in our back that doesn’t seem to leave, a particular ache in a muscle… and in a blink of an eye we are immediately alerted, fully focused on our bodily signals scanning any potential change.

So many worries come to our mind: what is this? Am I having a heart attack? Is this cancer? Or maybe an aneurysm? All raised by a tremendous amount of anxiety.

If it happened to you, how would you behave?

It would be quite normal to gather information from books or the Internet about signs and symptoms of the disease you think you may have and very probably you will urgently book an appointment with your GP asking him/her to run several medical tests.

But what happens to some of us is that books and the Internet will provide much information and many negative scenarios that will scare us even more, and very likely we may focus only on the information that confirm our worries. Moreover, even if test results will show that nothing is wrong with our body, we will feel reassured only for a short period of time, until the next strange body signal appears, which will prompt us to request other specialist exams. And so on…

What is happening?

What was once a normal and understandable way to react to possible abnormal symptoms has become a pervasive and exaggerated way of dealing with our body, which creates intense distress in the person experiencing it and hence several negative consequences and limitations to their everyday life.

This is the so-called hypochondria or health anxiety, a distressful condition where a person’s beliefs and worries are often considered by others as imaginary or fake, making the person feel even more misunderstood and lonely.

On the contrary, health anxiety is a real problem, the person’s symptoms are real and the worries are extremely distressful.

Health anxiety treatment

The good news is that health anxiety can be treated and cognitive behavioural psychotherapy is the most recommended form of therapy in these instances. CBT can indeed help you in acknowledging and changing the cognitive misinterpretations that maintain the problem and in finding new coping mechanisms to better deal with anxiety.

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Suddenly your heart beats fast, like a drum; it’s difficult to breath and you have air hunger. Your stomach hurts, like if someone punched it. Your head is spinning, the world around you or your body seem suddenly unreal, weird.

You feel an intense fear or anxiety, that is increasingly worsening moment by moment. You are worried about going crazy, losing control or that something really bad could happen, maybe you are even afraid that you could die and you feel the sudden impulse to go out, breath new air.

After about ten minutes, everything goes back to normal. But worries about what has just happened still remain: did I have a heart attack? Am I getting crazy? Will this happen again?

What is a panic attack

If you have experienced something similar, probably you have had a panic attack.

Panic attack is an intense anxiety episode, that reaches its peak in around 10 minutes and then it goes back to normal.

Panic attack is accompanied by intense physical symptoms, as described above, that are suddenly and unexpectedly experienced, and that cause great distress, fear and worry about the chance of a second attack.

Having a panic attack is such an intense and fearful experience that it’s almost impossible to forget the first one.

Experiencing a few panic attacks during our lifetime is normal. Many times they are just symptoms of living stressful periods and they naturally disappear after a while.

Usually, in the six months before the first panic attack we have experienced an event that has represented what we call an “invalidation”  of our beliefs. In other words, we had an experience that undermined what we strongly believed.
It’s not always easy to identify it but try to think about this: when you had your first panic attack, did something happen in the months before? Probably if you reflect about it, your answer will be “yes”.

As written above, experiencing a few panic attack is normal but when they become recurrent, distressful and they bring you to organise your own life in order to prevent them, thus avoiding all the possible triggers, then it’s important not to underestimate the problem and seek for psychotherapy and counselling to get your freedom back.

Suffering from unexpected and recurrent panic attacks, accompanied by strong worries (lasting at least for one month) about their recurrence and adopting behavioural changes, are the key symptoms of Panic Attack Disorder.

Panic Attack Disorder can also be accompanied by Agoraphobia, that is an intense distress/anxiety  experienced when the person is in a crowded or open or not familiar place and where, if in distress, seeking help could be difficult.

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