What kind of anxiety?

Most people assume that anxiety is just anxiety … however the feeling can originate in different ways and it’s important to understand the origin in order to determine the best therapeutic strategy.

Traditionally most therapists have focused on challenging erroneous thoughts, beliefs and interpretations that lead to anxiety. However this is only really effective if you have the type of anxiety which originates in the cortex, that’s the part of the brain that we use for thinking, problem solving, planning and anticipating future occurrences. If you are aware of your anxiety beginning with your interpretation of situation as threatening or a thought or image anticipating a threatening event, then the chances are it’s originating in you cortex. This type of anxiety is usually in response to some sort of cognitive process such as worrying and ruminating though for more visual people the process may be more image based than verbal. The verbal thoughts or images will arouse the amygdala which is responsible for generating the actual emotion in a physical way. The positive intention behind worrying and rumination is to resolve issues and avoid threats. However in most instances it does not generate a solution. In fact the process of worrying and ruminating, only serves to strengthen the neural pathways that support worry. In other words it becomes a powerful automatic habit.

You may also experience anxiety coming up almost instantly and inexplicably in response to a stimulus that would not logically be interpreted as threatening. If you are responding to something as a threat and have no idea why, the chances are the anxiety originates directly from your amygdala which holds an emotional memory associating the object with some sort of threat, even though your conscious mind may have no recollection of such an event. This type of anxiety is exceptionally fast and powerful as it bypasses your cognitive brain and takes place at a more primal level. Many phobias and panic attacks fall into this category.

It’s important to understand the source of the anxiety as this affects the best choice of strategy. For example, for cortex originating anxiety, one of the main strategies is to identify and challenge any unhelpful thoughts and beliefs that contribute towards the anxiety. However if the anxiety originates and exists exclusively in the amygdala, then searching for a corresponding anxious thought could actually make the situation worst. Even though there was no original thought based cause behind the feeling, the creative process of trying to come up with possible matching thoughts will just serve to reinforce the anxiety with a previously non-existing verbal justification. So now you have amygdala based anxiety supported by an apparently rational reason. For this type of anxiety we need a behavioural solution. Your rational mind may understand a logical challenge to the fear, however your amygdala is deaf to rational argument, it only learns through direct experience. So you need to experience the very thing that stimulates the anxiety but in a calm safe way. This might sound like a tall order, and it certainly can be challenging.

Fortunately hypnotherapy has many tools to tackle this. During hypnosis it’s possible to experience initial exposure to the object of fear using one’s imagination only … where you can control the intensity of exposure and association in a very precise way to achieve the quickest results with the minimal distress.

Of course in many instances the situation is complicated by the fact that anxiety has, over time, acquired  components of both cortex based and amygdala based anxiety. This is why it’s important to choose a flexible versatile therapy than can draw from multiple strategies and disciplines to blend a treatment tailored perfectly to each unique case.