New ways of understanding fear
„When I'm no longer afraid, I can organise my own life again, look for a new job and open up to a new partner“.
I heard this sentence this week from a forty-year-old client, Ms H., who came to my practice with a psychiatric diagnosis of „generalised anxiety disorder“ and recurring panic attacks.
She did not want to take psychotropic drugs prescribed by a specialist. As a yoga fan and vegan, she was looking for natural ways to overcome her anxiety and associated symptoms. These include sleep disorders, exhaustion and dizziness as well as intermittent palpitations, trembling, sweating, flushing and diarrhoea.
When I asked her what she wanted, she replied: „Freedom from fear. Energy. Inner peace. And self-confidence.“
--
Emotional goals versus behavioural goals
My client's wishes are completely normal and understandable. We all want to be happy and feel good.
The problem with this is that we don't have an on/off switch for thoughts and emotions. These are not so easy to control.
What we can control, however, is our behaviour. What we eat, when we sleep, who we meet, where we work, how we move, what we read, which films we watch, where we continue our education and much more.
Thoughts and feelings are the result of the experiences we have made through our behaviour. They arise in the mind, take place there and also dissolve there again. They are therefore transient.
--
Controlling fears - a dead end
We try to get rid of or at least control unpleasant inner experiences as quickly as possible.
Mrs H had her yoga teacher show her some relaxation exercises that she uses every day. She also learnt breathing techniques to control panic attacks. She avoids caffeine and alcohol and eats a snack every two hours to prevent possible hypoglycaemia.
She read about anxiety-relieving plants on the internet and has been taking ashwagandha, brahmi, passion flower extract and valerian ever since. She has also tried acupuncture and most recently learnt about the Ayurvedic therapy Shirodhara (forehead oil pouring).
„Without all my calming measures, I would probably already be dead,“ she says, visibly moved. To avoid anxiety, she increasingly avoids anxiety-inducing encounters, places and events. As a result, her circle of friends has decreased by 80% and she rarely leaves the house.
How successful are her various measures, which after all take up a large part of her day, I ask. They help in the short term, but unfortunately not at all in the long term - on the contrary, her anxiety has unfortunately increased over the last 12 months despite all her efforts to remain calm and composed.
At this moment, I pause for a moment. Then I summarise: You have put so much time, energy and money into fighting your fears - with the result that they have become stronger. How does that feel? At this moment, Mrs H. bursts into tears.
--
Let it be - give up the fight
Fears cannot be controlled, on the contrary. The more we fight against them, the stronger they become. Special attention and identification lead to reinforcement.
The solution cannot therefore be to find an even better recipe, to live even more disciplined, to allow even less stress.
Anxiety disorders are behavioural avoidance disorders that severely restrict our lives. It is not the anxiety that is the real problem, but our reactions to it.
Mrs H. had to come this far to realise that the path she had chosen was hopeless. She answered my question as to whether she was now ready to take a fundamentally new path with a sobbing yes.
--
Redefining the therapy goal
Our first step was to reformulate Mrs H's wishes and switch from emotional to behavioural goals in order to improve the quality of life she had lost.
Who is really important to you in life? What is close to your heart? What qualities do you want to develop and realise? What do you want your life to stand for? What do you want your loved ones to remember when you no longer wake up one day?
With these questions, we activate the appetitive motivation system and switch from „away-from“ to „towards“ mode. Mrs H. can thus develop greater clarity of values and align her daily activities accordingly. The focus is not on reducing anxiety symptoms, but on experiencing psychological flexibility.
--
What to do if the fears return?
They will return, that much is certain. We cannot guarantee that our reorganisation will lead directly to an alleviation of anxiety.
What we can guarantee Mrs H., however, is that by consistently focusing on her values and engaging with the present moment, she will regain her life.
If the fears return, we can recognise them, name them, normalise them and take them with us into our activities - like a rucksack that feels very heavy at the beginning but becomes lighter with every step we take.
The results of the last three decades of psychological research provide impressive proof: if we give up the fight against fears and allow them to be overcome through inner acceptance, they diminish.
--
Our goal is not just to feel good, but to lead an eventful, valuable and meaningful life - fears are allowed to come and go without controlling our thoughts, words and actions.
Neither is our goal, free from any fears. We help our clients, with deal with their fears in a freer, healthier and more effective way and not to from from their fears. When the time is right, they will leave of their own accord.
My favourite sentence gets to the heart of this idea:
Sometimes fear doesn't go away - so you'll have to do it afraid!
