Anxiety

Firstly, a simple reminder that anxiety is not a disorder.  Anxiety is a normal feeling, rather uncomfortable, but one that we need to be able to experience in order to stay healthy.  Without anxiety, blowing the rent money on restocking your fish tank becomes really easy.  We need to be able to anticipate feeling really bad or injured when assessing certain future scenarios so we can take steps to avoid them.  Anxiety is, after all, entirely future focused.  (If we are anxious about having cheated, it’s really an anxiety about what happens in the future as a natural result.)

So why do we often refer to feelings of anxiety as being bad for us?  Why do we go out of our way to stop those feeling, to repress them, avoid them, drink or drug them out of existence?

In most cases, this comes about when our brains mistakenly learn to treat more and more non-threatening situations as threatening, or to over-emphasise the danger.  This is further exaggerated in people of low self-esteem since their assessment is ‘I don’t have the ability to deal with this situation or these feelings’.  Under these circumstances anxiety becomes a chronic (persistent over time) condition and is worsened by simple day-to-day challenges.  This is when anxiety becomes a disorder, or Generalised Anxiety Disorder (GAD) to give it its proper name.

Common experiences that can lead to GAD are earlier traumatic experiences where the person was unable to deal with the situation and became highly emotional and unresourceful.  For instance, being embarrassed in front of a classroom at age 8 can lead to severe anxiety in the office whenever called-upon to present material.  This creates avoidance behaviour, such as calling in sick or not taking promotions which might require speaking to groups.

In this instance the exaggerated response is irrational.  The adult knows the material, knows how to stand and talk at the same time and knows that with a little good humour mistakes are easily tolerated.  The exaggerated emotional response, however, is not governed by logic, the response is triggered automatically when a certain environmental pattern or stimulus is present or anticipated.  Rationally, the adult knows he has the information and skills required and that he knows that no physical injury will result from his failure to recall last quarters sales figures.  Unfortunately, the Limbic system, which manages emotional responses to threats, literally doesn’t listen to reason, it’s not part of the same brain structure and nor does it use the same methods of internal communication.  It’s like two computers with no connection between them, each coming up with a different assessment.  Logical new brain: fine, whatever.  Emotional old brain: you’ll be humiliated again like before, stay home.  The result is always the same, a win for the emotional brain, since this is the part evolved to protect us from urgent threats (spears, tigers, fire).  The logical brain doesn’t even get the information once the fight, flight and flee mechanism is triggered.  It’s left to assess things only after the immediate threat has past.  Evolutionarily, it’s better to over-react to a threat than to not react, certainly when spears, tigers and fire were more of a problem…. it’s less well suited to the Facebook generation who only have to worry about being de-friended.

Catastrophisation is a feature of GAD.  Small problems become huge in the mind of the GAD sufferer.  There also tends to be over-generalisation, so from a small car accident, the GAD sufferer might believe all transport is dangerous and become home-bound.  Or the one-time threat from a large aggressive dog becomes an anxiety towards all animals all of the time.

Cognitive Behaviour Therapy (CBT) is one system of treatment that helps sufferers to understand how they mis-assess their surroundings and try to gradually train their emotional mechanism to be more ‘reasonable’.  This process works for most but can be a slow process.

Cognitive Hypnotherapy uses a number of different methods to treat anxiety sufferers, primarily looking to remove the damage done by the initial traumatic memory so that it no longer serves as a base to launch negative emotional assessments.  We also work to reset the brain’s natural filters to ensure that attention is used productively; focusing more on positive environmental activity and less on counter-factual scenarios that can cause irrational fear.

Recent research indicates that Cognitive Hypnotherapy achieves as good or better results than CBT and does it in fewer treatment sessions.

If anxiety is ruining your life and you’re ready to tackle it, book a session with me so we can put it behind you.

 

Suicide and Young Gay Men

There’s a disproportionate number of young gay men committing suicide. Very disproportionate. If the figures from Stonewall’s 2011 study of gay and bisexual men is to be believed 27% of gay and 38% of bisexual men said they had considered taking their own life in the previous year – this compares to just 4% of heterosexual men. And this was a big survey – 6,861 respondents from Britain. It gets worse.

Of the respondents, 3% of gay men and 5% of bisexual men had actually taken steps to take their own life in the previous year. Apparently the comparable rate is 0.4% of all men. It gets worse.

What if we look at just the young men? 10% of gay and bisexual men aged between 16 and 19 actually took steps to take their own life in the last year. 1 in 10. If you go to a gay bar with lots of young gay men, look over into one corner – proportionally – all the gay men in that corner took action to kill themselves last year. If that doesn’t shock you, there’s something wrong.

We could spend hours debating the real reason for this: coming out early, coming out late, permissive society, disapproving society, too many rules, not enough rules, too much drugs/alcohol, not enough, too much internet use, not enough, freedom to be gay, not enough freedom to be gay, too many gay role models, not enough,  too selfish, too selfless, being able to marry, not being able to marry, too much coddling, too little, too much religion, not enough. I hope that clears things up.  Certainly, I’ve heard arguments for all the above.

We could ask those young men what’s wrong but most people aren’t good at giving you reasons when they’re an emotional mess.  Frankly, it could be your phone running out of charge that can push a vulnerable person over the edge.

Here’s what I think.  Think about the changes that most of these men are going through in their teenage/early adult years (most of which only apply to young gay men):

  • they are coming out (to mixed reviews!)
  • they are going through the difficult years that follow from puberty
  • they will likely have their most emotionally charged relationships and break-ups in this period
  • they are becoming independent and usually separated from their usual unconditional emotional support
  • they are more likely to have moved from home (young gay men move to the cities, actually they run…)
  • they are experiencing drugs and alcohol for the first time.
  • HIV infection, or constant fear of infection

It’s a lot to deal with for people without enough life experience.  These young men haven’t learnt yet about how to be emotionally resilient. The people they are attached to emotionally and provide emotional support (friends, parents, teachers, lovers) can, and do, suddenly remove that emotional support and even reject them.

Drugs and alcohol are huge problems for young gay men.  They lead to risky behaviour that leads to guilt and regret.  But worse, they lead to huge ups and downs, often days later.  So a normal day might feel like an unbearable weight, for no apparent ‘reason’.

Generally, we all learn to be emotionally resilient over the years – at least to some extent.  The question is whether we manage to do this in time and without too much damage along the way.  Thankfully this emotional resilience can be learnt through CBT and/or Cognitive Hypnotherapy. These are also good ways of dealing with excessive drug or alcohol use, as can issues of identity and self-worth.

And sometimes, people just need somebody to talk to.