Anxiety and anxiety control

Sharon Bryan

Anxiety is something that can affect anyone no matter what age, background, sex, status, or social grouping. Mentally tough individuals are better able to deal with this.

This chapter describes some work carried out with young people in relation to stress management. It is a personal account and is deliberately written from a practitioner's perspective. I hope you find some of the tools and techniques helpful.

At some point in their life, many young people experience anxiety. This can vary from the classic “exam nerves” through to something as extreme as OCD (Obsessive Compulsive Disorder).

From our experience of working with both young people and adults, we know that many such conditions can go undiagnosed and unaddressed for years.

We all form our own unique “maps of the world” during adolescence. In this development period, our ability to deal with stress begins to be defined, sometimes for better, sometimes for worse. It can be argued that if we can learn how to be anxious, which is certainly part of the growing up process, we can learn how not to be!

When working with young people we have noticed that anxiety for some is a debilitating factor and a major issue. This is clearly linked to all four of the mental toughness aspects: control, commitment, challenge, and confidence. We have also observed that individuals often experience difficulty in expressing or discussing how problems relate to stress and anxiety.

Arguably, one of the key differences when working with young people, as opposed to adults, is a relative lack of developed awareness. Whereas most adults have learned what anxiety is, and how it affects them, some young people are cast adrift in a sea of confusion. This lack of understanding and self-insight can be hard to deal with and may eventually be an added cause of anxiety. A classic vicious circle!

Anxiety is perfectly normal. At some point, every one of us will experience it.

The presence of anxiety can be beneficial to us, for example, when a situation poses a threat of harm or danger.

The problem is, when anxiety is debilitating and has no potential beneficial effect.

We experienced this when working with one young girl who could not function if she came into contact with buttons—“button girl”. She suffered from a condition that was seriously hampering her ability to enjoy life.

The girl was fourteen at the time, and was finding school problematic. She was unable to take part in certain activities; simple things like going shopping with her friends were impossible. She had already received CBT therapy from her doctor but to her the situation was becoming untenable. She was feeling unhappy, frustrated, and upset. She had experienced the following issues and challenges:

• worry and upset

• nausea and vomiting

• becoming dizzy and starting to shake

• passing out

• thinking “really bad things” that she may do

• calling herself “mad”, “crazy” and “lunatic”.

All of the above frequently culminated in the onset of extreme panic attacks. Whilst this case was extreme, it shows the devastating effects of anxiety on some people.

What we have found to be universally beneficial in helping reduce anxiety is to help the person understand what was happening to them. Breaking this down takes care and considerable time. However, it is sometimes possible to take a more straightforward approach.

For example, our “button girl” didn't need to know why she had this particular challenge—she just wanted to stop the feelings of anxiety and the impact this had on her mentally and physically.

By understanding anxiety we can understand why we feel the way we do and this helps to change the cycle.

Anxiety is like anything else. The more we do it the better we get at it.

Think about that statement for a moment.

How would you feel if you thought about your anxiety for five minutes, then extend this to an hour … a day … a week?

The more we burden ourselves, the stronger the anxiety becomes unless we break the cycle.

It's the “fear of fear”. It can hold us back!

The more we avoid the issue the more our feelings grow and the more we think negatively. Next time we have to face our anxiety!

Understanding and familiarity are the greatest allies to dealing with anxiety and help us to learn how to control our feelings and reactions.

As an example I will briefly describe our work with two rock school students. One had anxiety issues that impacted on their performance; the other had issues which impacted on their ability to sing.

When working with these students we used the ABC strategy to start the process of controlling and understanding anxiety. This simple approach gives an insight into the individuals and allows them to begin to explore safely how to deal with the anxiety.

ABC simply means:

A—Awareness What causes the anxiety and how do you react?

B—Balance There is a fine line between positive and negative anxiety. How much can you cope with before it becomes negative?

C—Control What can you do to help yourself combat the negative effects of anxiety and stress?

For example, our two rock school students were very different.

Our performer had what a layman would call “stage-fright”. He was fine and had no issues whatsoever in rehearsals. However, at the point
of the dress rehearsal, knowing that the performance was imminent, the anxiety cycle started for him. The resulting anxieties transposed into him being “fixed to the spot”.

Dealing with his anxiety was about stripping things down and taking the ABC approach. For him, recognising when his feelings of anxiousness starting was critical (we actually did much more work to ascertain what was causing the issues which is something for another book!).

Once he knew when his anxiety started, he was able to work with us to set himself a “trigger” that he could fire whenever he needed to. Similar to anchoring in NLP, this involved setting up an alternative stimulus and response for him.

Whenever he felt the physiological triggers, described as a “black cloud starting in his stomach”, he knew when to fire his trigger. Using positive affirmation and visualisations he could disperse the cloud and thus reduce the physical symptoms. This then allowed him to keep anxiety to a level that was right for him.

For our other student, his anxiety was hampering his ability to actually sing. He would be affected by his anxiousness and quite simply he would lose his voice and ability to sing. This was a very different case and therefore we adopted different methodologies.

We used simple relaxation techniques linked to breathing and the use of biorhythms so that he could understand how his physical anxiety came about and impacted on him. By understanding this, he was able to use techniques to slow down his breathing to reduce, and actually stop the anxiety response.

There are a number of other techniques to aid anxiety control. These try to deal with three main aspects of anxiety:

• Physical arousal—the feelings that give the terror or panic

• Tension feelings—the tension that links and correlates to anxiety and stress

• Mental stress—we simply cannot stop thinking about what it is that causes the anxiety and all of those distressing thoughts and terrible things that go with it.

We can't list every technique but we have included some of the things that we have found beneficial when working with young people. LISTENING—self talk can be a fantastic tool.

The issue is—do we have the right channel tuned in?

With young people we find that negative self talk can overwhelm the positive to such a degree that the positive words simply get lost!

Understanding and challenging self talk helps to combat the anxiety that is caused by negativity.

To stop listening to the negative is, to some extent, a choice.

We have worked with one young girl who was suffering panic attacks leading up to her veterinarian nursing practical examination. After talking to her it was apparent that it was not her exam that was causing her stress, rather it was the thought of letting her grandfather down. We simply asked “How many times have you failed?” and, “How many times have you let your grandfather down?” She could give no examples of either of these.

After discussion she adopted a method of telling herself that her anxiety was simply her way of making sure she remembered everything and she could turn it up and down as she needed to.

SHOWING—quite often, and certainly with young people, we find that anxiety can get transposed very quickly into anger and a defensive stance.

One young man that we worked with found any challenge to his work unacceptable and would in effect “throw a tantrum”. He was working on an apprentice scheme and this was obviously not the best approach for him and was hampering the potential possibility of succession.

We used two techniques to help.

First, we used perceptual positions. This means the individual can explore a real situation and ascertain possible alternative situations which give different results. Second, to deal with the anxiety anger, we used a simple stopping technique. Each time he felt angry he, with agreement of lecturers and employer, would write down what he was angry about.

Transposing anger to written word changes the way an individual feels and the anxiety is reduced.

CREATING FUN—laughter is a fantastic way to make you feel better and to discharge tension.

For young people having something that makes them laugh or just feel good can discharge anxiety very quickly. This was one of the tactics
we used with “button girl”—making things funny helped her to cope with the contact.

TURNING OFF—we often fail to do this.

It's a bit like keeping a computer running all of the time with lots and lots of applications open. Stopping or just slowing down a bit, gives us chance to cool off. Relaxing, as well as holidays, having down time, hobbies and the like, are really valuable. We have found that using metaphor and simile with young people helps them to switch off for a time. Writing a story, or a song, gives a valuable recharge as well as developing focus.

Other techniques that are helpful include:

• planning techniques

• self-coaching

• understanding strengths—making worry work

• anchoring

• managing time

• relaxation

Progressive—relax your body and your mind will follow Applied—one muscle group after another Meditation—mind focused.

• Cognitive Behaviour Therapy—target unhelpful thinking

• Transactional analysis—personality and systemic growth (Parent–Adult–Child)

• EMDR—Eye movement desensitisation and reprocessing—stored memories

• EFT—Emotional freedom—negative emotion relief.

Anxiety is something that we will all experience in our life.

Understanding where this comes from for each of us, and learning which tools and techniques best suit us, is what aids in the development of mentally tough individuals.

Remember we learn to be anxious so we must be able to learn not to be!

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