Do you wonder...
Why am I so anxious?
There are four primary ways we develop clinical anxiety – we call these “vehicles of acquisition.“
We explore your vehicles of acquisition to create the most effective treatment path. Then, we get to work.
These vehicles of acquisition are relevant for a variety of anxiety disorders.
You experienced a traumatic event and learned firsthand that this thing should be feared. For example, you were in a horrific car crash and now find yourself afraid of riding in vehicles and anxious every time you hear a car’s horn.
You’ve learned vicariously (a process we call “modeling”) that this is a thing that should be feared. For example, you watched your parent avoid dogs because of their own specific phobia, and you learned that dogs should be feared. You might now find yourself avoiding encounters with dogs.
Information has been transmitted to you (think peers, parents, media, etc.) that this thing should be feared. For example, you learn that only sinners have taboo thoughts, and then when a taboo thought pops into your head, you become fearful and anxious that you are a bad person.
Those of us who were afraid of snakes, spiders, heights, and all the other naturally threatening environmental stimuli were more likely to avoid those threats, and thus, more likely to survive. We have been selected for this!
We will perform a comprehensive assessment and examine some of the historical contextual factors that may contribute to the persistence of your symptoms, but it’s nearly impossible to discern a single “why” you might be having this experience. In fact, no single reason here adequately explains the development of an anxiety disorder.
Fortunately, we don’t need to know exactly why in order to treat anxiety. Our treatment roadmap is present-focused and future-oriented; our work will target the processes of change that have become inflexible in the presence of anxiety, and our commitment is to help you show up in life in a way that’s meaningful to you, no matter how or why you feel the way you feel.
The process begins when a thought/image/feeling/impulse (event) arises and is interpreted as intrusive and inappropriate, and this interpretation causes marked distress or anxiety. In attempt to rid oneself of the anxiety, we perform compulsory behaviors – compulsory because we feel driven to perform this behavior in response to that thought/image/feeling/impulse in order to make it go away. Basically, we try to “cut anxiety short” so that we don’t have to feel it. But this is only a short-term solution and ultimately, these behaviors move you away from the life you want.
When we cut short of the emotion’s natural life span, we get stuck in a loop – we call this loop “Danger Learning” – which prohibits the learning that comes with the entire anxiety experience – we call this
“Safety Learning” (Check out “What Anxiety Teaches Us” here). Instead of safety learning, compulsory behaviors & avoidance reinforces the belief that the event was dangerous, and because these behaviors work in the short-term, we keep doing them. This is our default system.
Exposure and Response Prevention is a series of learning opportunities designed specifically to activate anxiety so you can practice refraining from the compulsive behaviors and avoidance while you move towards a meaningful life. We practice this a ton, because it takes a ton of learning to override that default system.
Much like OCD, maintenance of fear is a process. The process begins when we identify a threat or a possible threat (for example, driving). This automatic belief brings with it anxiety – the body’s natural response to a threat. In attempt to rid oneself of the anxiety, we tend to avoid the things we fear, or we endure them with intense fear and anxiety but using safety behaviors (for example, driving with someone).
Safety behaviors & avoidance cut short of the emotion’s natural life span and keep us stuck in a loop, which prohibits the learning that comes with the entire anxiety experience (Check out “Anxiety Is Our Teacher” here).
Instead, safety behaviors & avoidance reinforce the belief that the possible threat was dangerous, and because these safety behaviors work in the short-term (i.e. they do make our anxiety go down quickly), we often believe we need to keep doing them to stay safe.
Exposure and Response Prevention allow you to learn if the feared consequences come true, and that you don’t actually need all those safety behaviors to stay safe.
Post-traumatic Stress Disorder is not the development of new symptoms inasmuch as it is the maintenance of trauma symptoms that result from experiencing a traumatic event. The process begins when we experience that traumatic event. A trauma reaction is the body’s natural response to a traumatic event. However, when these symptoms are maintained, it’s largely due to two factors – We’re either avoiding the emotions/memories/images/thoughts about or places/or reminders of that traumatic event, or because we have faulty beliefs about why that traumatic event happened. We call these beliefs “Stuck Points.”
Avoidance and Stuck Points cut short of the natural recovery process from trauma and keep us stuck in a trauma response.
Similar to the byproducts of avoidance in cases of OCD and Phobias, avoidance reinforces the belief that we are in danger and until we allow ourselves to experience the emotional consequences of a trauma event, and we get a little bit of distance from those Stuck Points, trauma symptoms will maintain.
Exposure Therapy for Anxiety: Principles and Practice. 2nd Ed. By Jonathan S. Abramowitz, Brett J. Deacon, and Stephen P.H. Whiteside. The Guilford Press.
Cognitive Processing Therapy for PTSD: A Comprehensive Manual. By Patricia A. Resick, Candice M. Monson, & Kathleen M. Shard. The Guilford Press.
Written Exposure Therapy for PTSD: A Brief Treatment Approach for Mental Health Professionals. By Denise M. Sloan and Brian P. Marx. The American Psychological Association.
At West Coast Anxiety, we value learning and we believe opportunities for learning are available in all of life’s experiences, even the ones we don’t like. Therapy (and exposure work) is the ground upon which these lessons can be taught, and our aim is that you have the opportunity to learn – from your own lived experiences – one or more of the lessons below.
THE THREAT WASN'T A THREAT
It's a natural response to turn away from a perceived threat. But if we consistently turn away from the experiences in life that make us anxious, we don't have an opportunity to learn if these experiences are actually threats.
IT WAS A THREAT, BUT YOU SURVIVED
When we avoid all the stuff that scares us, we also avoid seeing what we are made of. Exposure to your fears allows you to learn how much you can survive - if the threat was actually a threat.
Anxiety itself is a totally safe experience.
While uncomfortable, anxiety as a physiological response and experience is entirely safe. Allowing it to run it's course without interfering may provide you with the opportunity to learn this.
We can live full & meaningful lives with anxiety
One of the most important lessons that often come from participating in ERP is that life - even with anxiety present - can be full and meaningful. We are not required to be stress, anxiety, and fear free in order to live rich and fulfilling lives.
This human experience is kind of like being at a bus stop. There’s a lot going on in these bodies we live in! Some of it we understand and seems predictable, some of it seems out of place and confusing. Our emotions are a lot like the buses that come into the stop – sometimes they show up on time, sometimes they are early or delayed. And how we respond to these emotion buses will largely dictate our experience of them. Some of us stand at the Bus Stop and watch the Anxiety Bus arrive and depart without batting an eye, and some of us get upset that it’s here, or we try to control where it goes, or how fast it drives. We might see that Anxiety Bus and have an automatic thought like, “NOPE! I don’t want this Anxiety Bus,” or “This Anxiety Bus shouldn’t be here right now!” Then, we might use different strategies to try to control the Anxiety Bus – these control strategies look different for different people: It might look like avoiding certain things, or repeating certain words. Control strategies can be things we’d categorize as “healthy” – like deep breathing, or progressive muscle relaxation, or things we categorize as “unhealthy” – like drinking a fifth of Jack Daniels, or popping a Xanax. These strategies reinforce unhelpful beliefs that we have about our ability to tolerate the experience anxiety. These beliefs might sound like, “I can’t handle this Anxiety Bus,” or “This Anxiety Bus is going to kill me!” And then BANG! Here comes the next Anxiety Bus. This is how we find ourselves stuck on the Anxiety Struggle Bus. And if you’ve been on the Anxiety Struggle Bus, our guess is that you’re not paying much attention to what else is going on at that bus stop, and life starts to feel smaller and smaller each day.
Now why do we get on the Anxiety Struggle Bus? It’s hard to say with certainty, but we know that we’ve learned from a variety of relatively innocent (but incorrect) sources that we “shouldn’t be anxious.” When the Anxiety Bus shows up, so does the automatic belief that anxiety itself is something that “might” be a threat.
So how do I get off this Anxiety Struggle Bus you ask? Well, the first step is to notice when it’s happening. You might say, “Ah! I’m on the Anxiety Struggle Bus!”
Once you’ve noted this process is unfolding, you’ll have a little bit more space to decide how you’d like to respond instead of listening to that automatic thought.
Your response to the Anxiety Bus will likely make your life bigger or smaller. Which response will you choose?
If you find yourself on the Anxiety Struggle Bus and want to hop off, set an appointment and we’d be honored to help you make your life BIG again.
There are four primary ways we develop clinical anxiety – we call these “vehicles of acquisition.“
We explore your vehicles of acquisition to create the most effective treatment path. Then, we get to work.
