Healthcare Training Institute - Quality Education since 1979
CE for Psychologist, Social Worker, Counselor, & MFT!!
Many times when a client experiences anxiety, he or she may not believe that they are suffering from an anxiety disorder. The common conception of anxiety is that it gives him or her the extra drive he or she needs to get the job done. However, there is a great deal of difference between normal anxiety and abnormal anxiety, would you agree?
Understanding Three Manifestations of Anxiety
Dr. Thomas P. Hackett stated, "I think that not only psychologic morbidity, but also physical morbidity is lowered in individuals who have ‘appropriate’ anxiety before surgery." As you can see, normal anxiety can be a useful tool in aiding a client throughout stressful periods. Because anxiety is an associated feature of many other psychiatric disorders, it becomes difficult to discern whether the acute anxiety that the client feels is the disorder itself or an associated feature of another disorder.
Also, the symptoms of anxiety may be confused with physical illnesses. For example, how many times have you heard of a patient rushing into the emergency room for a heart attack and it was found out that they were only having an anxiety attack?
Manifestation #2 - Unadaptive Anxiety
To determine adaptive from unadaptive anxiety, many physicians use three factors: if the severity of the anxiety bears little relationship to the situation, if the anxiety interferes with the capacity to experience satisfaction or pleasure, and if the anxiety restricts normal activity.
Peggy was a 53 year old client of mine. Her entire life, she had been generally known as "high-strung" and "nervous". Peggy tended to have trouble relaxing, was often restless, and felt shaky inside. She worried a lot, particularly about her children, finances, and about how others saw her. Peggy usually always felt better if she was active and busy. Peggy stated, "If I sit down, all my fear catches up with me, and I hate that feeling. I’d rather be productive than be overwhelmed by my worry."
However, as the day began to wind down, it seemed harder to avoid her problems and keep her feelings in check. As a result, Peggy had trouble falling asleep at times. She knew that when she was tense and under stress, the muscles of her neck contracted, and she had terrible headaches. Not only that, but Peggy was also prone to gastrointestinal ailments, such as indigestion, nausea, and diarrhea.
When feeling overwhelmed, Peggy’s physical and emotional symptoms escalated and she experienced vague feelings that something terrible was going to happen. Frustrated and alone, Peggy feared going crazy or losing control. As you can see, Peggy’s anxiety had reached such a pitch that she could no longer feel satisfaction in her life. Obviously, Peggy was suffering from unadaptive anxiety that began to inhibit the other aspects of her life.
Technique: Sit, Don’t Run
After completing this exercise, Peggy stated, "Incredibly, I don’t feel that feeling as much anymore. Well, it still comes and goes, but I don’t have to be doing anything to avoid it. I can just sit down and accept it." As you can see, by allowing herself to feel the panic and not let it control her, Peggy could more effectively begin to address her anxiety.
Manifestation #3 - Agoraphobia
Stewart was an agoraphobic client of mine who had developed a fear of a certain busy street on which he had had a panic attack. During this panic attack, Stewart had severe hyperventilation, dizziness, and chest pain. Even though the street had been full of people, no one had helped him. Finally, Stewart had been able to find his way back home, despite the overpowering symptoms.
Because of this incident, Stewart had developed a fear of that specific street and had maintained this fear for several years. We will discuss agoraphobia and techniques for treating it more thoroughly on another track.
On this track, we discussed the three basic manifestations of anxiety, which were adaptive anxiety, unadaptive anxiety, and agoraphobia.
On the next track, we will examine three gradations of anxiety intensity, which are spontaneous anxiety; situational anxiety; and anticipatory anxiety.