The following article appeared in the Chiswick Herald on the 1st February.
Sometimes people with anxiety start to withdraw and avoid things, people and situations where they experience heightened anxiety. Avoidance is a valid coping mechanism and a tool that can facilitate recovery from trauma but if you or someone you know is gradually withdrawing with no decrease in anxiety then maybe its not the most helpful one!
In fact this might be considered as “colluding” with anxiety, and collusion ultimately leads to greater anxiety.
Anxiety is a heightened state that is identifiable through a combination of physical, psychological and behavioural experiences. Anxiety is different to stress in that it is a longer term condition and it is for this very reason that it can be harder to identify and therefore to treat.
It is not uncommon for people to be unaware that they suffer from anxiety until they realise that other people do not feel like them and again, being able to identify anxiety can depend upon its cause. Where there has been a significant life event it can be easier to spot than if someone has been anxious since a very early age. Again it is common for people to not recognise anxiety because the way they experience life has never been any different. For people who have this type of anxiety it can be helpful to think about a persons early years and any childhood traumas.
And of course anxiety is linked to a wide range of other unpleasant experiences such as panic attacks, agoraphobia, other phobia’s, obsessive compulsive disorder etc. Long term anxiety may also result in clinical depression or other mental health conditions - so once recognised it is really important to start developing ways to manage and hopefully recover from anxiety.
Returning to colluding with anxiety, a common experience is for sufferers to be anxious about being anxious and this is contrary to how anxiety can be alleviated. This cycle which can only result in an escalation of the anxiety must first be broken. We need to recognise that the anxiety has a message for us - one that we need to understand and to do this we must adopt a “kindly curiosity” towards the experience of the anxiety.
Imagine someone who cannot travel on the Underground, how might you apply the idea of kindly curiosity? Here are a list of questions that might be helpfully worked through.
- What is the impact on the person of not being able to travel on the Underground? Answers may be practical for example the cost of having to get taxis or more personal for example feeling unhappy with oneself or a combination.
- Has something happened on the Underground? If yes then traumas that have resulted in an unwanted change are something that people take to counselling.
- When did this anxiety first appear?
- Was there anything else going on in life at the time?
- What has been tried to manage or treat the anxiety?
- What hasn’t been tried?
- Have you looked for information on using the underground, anxiety and how other people cope?
- What do you think and feel about what you have found out?
- What would you like to do about it?
- What might you find supportive / helpful?
- Who might you find helpful / supportive?
- Is there any reason why you do not try to deal with this or why it is hard to get help?
- If a person you cared for was in your situation what would you say to them, or how would you help them?
In therapy, one of the approaches to overcome an anxiety linked to a specific situation is firstly to talk it through, secondly to talk about information that might be helpful and then thirdly to draw up a plan of action.
A plan of action in terms of travelling on the Underground will be tailored to the specific person, based upon what they want to do, what has worked for other people and what the therapist and the person senses to be manageable.
For example, the sufferer might first of all watch videos of underground journeys, they might then go to visit an Underground station, then they might take a train just one stop on an overground section before taking longer journeys. They might have a therapist or friend / relative travel with them the first few times, drop them at the station or meet them at the other end. They might take their mobile phone with them and have someone lined up who they can call. They might take a book or listen to music, carry food or water….. As you can see so many options.
The important thing is to be kind, take small steps and listen to what feels manageable.
The Underground is a fairly common example and one that can cause anything from mild to debilitating anxiety. If either yourself or someone you know is struggling with anxiety remember this is a very common problem and it is treatable.