Anxiety: the myths and the realities

Kinsale CBT therapist Linda Hamilton's Southern Star column on anxiety myths and realities.
If you treat yourself as if you are fragile, your self-belief will suffer.

In last week's Southern Star, I explored the myths and the realities surrounding the treatment of anxiety. The column is reproduced below.

 

When it comes to the treatment of anxiety, there are a lot of myths out there. Think positive thoughts, reduce stress levels and avoid stressful situations, get reassurance from loved ones – many folks think these steps will help people kill their anxiety, but such advice tends to be ineffective or even counterproductive.

 

Myth 1: Suppressing your anxious thoughts is good.

People often want to run from their thoughts and try to train themselves out of negative thinking patterns by, for example, snapping a rubber band on their wrist every time they have a “bad” thought. However, studies actually show that suppressing your thoughts “makes them stronger and more frequent”, notes the Anxiety and Depression Association of America (ADAA). Think of it this way: if I asked you not to think of a white bear, what do you think you’d start thinking about?

 

Myth 2: Avoid stress and situations that make you feel stressed.

We need to be careful here. Obviously, everyone wants to minimise their stress levels. However, a certain amount of stress is unavoidable in life. Not only that, it’s important for your confidence and self-esteem that you feel able to handle stressful situations. If you treat yourself as if you are fragile, your self-belief will suffer and you will become demoralised. “Avoiding anxiety tends to reinforce it”, says the ADAA. “You can be anxious and still do whatever you have to do”.

 

Myth 3: You should carry a paper bag in case you hyperventilate.

“Paper bags can serve as safety crutches that keep you anxious about being anxious”, the ADAA points out. “Hyperventilation, while uncomfortable, is not dangerous”. Safety behaviours are central to the maintenance of anxiety in all its different forms. For example, a socially anxious person might clench a glass in social situations to prevent their hand from shaking; they might wear a polo neck or wear their hair in a certain way to cover blushing; they might sit in the back of a room to avoid being noticed. Like carrying a paper bag, these actions only reinforce the idea that the situation is dangerous, thus perpetuating the person’s anxiety.

 

Myth 4: Anxiety often begins in childhood and is triggered by negative early experiences, so therapy should focus on this period. 

Yes, anxiety often begins early in life. Negative and invalidating experiences can make a child fearful. Other times, anxious parents unintentionally teach their children that the world is an unsafe place. However, there’s a big difference between apparently discovering the origins of a problem and solving that problem. Irrespective of the origins of one’s anxiety, it tends to be maintained by current thinking and behaviour patterns. That’s why effective anxiety treatment “focuses on the here and now”, notes the ADAA, “including new skills to manage thoughts, emotions, discomforts and behaviour”.

 

ANXIETY AND STRESS

Myth 5: Cure anxiety by eating right, exercising, avoiding caffeine, and living a healthy lifestyle.

In reality, these steps may help reduce anxiety but they will not cure an anxiety disorder. The ADAA points out that anxiety disorders are sensitive to stress, but they are not caused by stress. Accordingly, reducing your stress is not enough: “you may need to face your fears, learn new facts about your symptoms, stop avoiding, learn tolerance for some experiences, or change how you think, feel, and behave with respect to other people”.

 

ANXIETY AND REASSURANCE

Myth 6: Someone with anxiety needs constant and compassionate reassurance from family and friends as well as help in avoiding stressful situations.

Well-meaning family and friends often give the anxious person the reassurance they crave. Furthermore, they may bend over backwards to help the anxious person to avoid dreaded situations. However, this only maintains the problem by preventing the person from facing their fears and learning to tolerate uncertainty.

 

Cognitive behavioural therapy (CBT) is the most successful psychological treatment for anxiety precisely because it addresses these factors, helping people to gradually expose themselves to challenging situations. Accordingly, don’t confuse compassion with appeasement. Instead, remember that the compassionate and kind action is, as the ADAA puts it, to encourage and support the anxious person to “move through anxiety and doubts, rather than avoiding them”.