Anxiety bring more people to treatment than any other psychological condition. “The craze for anxiety” has made anxiety treatments a billion dollar industry. Type “anxiety treatment” in Google and you’ll find all kinds of “cures” and “solutions” of nearly infinite variety, from various forms of psychotherapy, non-traditional approaches such as hypnotherapy, courses, books and seminars, and of course, perhaps the most popular treatment, medication.
What really works?
In the quest for relief, many sufferers of anxiety will have tried many things with only minor benefits… and little or no understanding of the true nature of anxiety.
There is little evidence that the use of medication alone reduces the frequency and severity of symptoms. Many exhibit the same levels of fear and avoidance after treatment with drugs as before. Other methods may take years or provide only temporary relief. Repeatedly it is cognitive NLP-style methods for change that have proven to be most effective.
Anxiety: Mind or Body?
The way we think of a problem will determine how we approach it and how we attempt to treat it, and conceptions of anxiety may lead to either resolution of anxiety or persistence of symptoms.
The Medical Model
Popular conceptions suggest that anxiety is an illness requiring medical treatment. According to these ideas, the symptoms of anxiety are caused by a chemical imbalance, the brain’s hard-wiring or genetic inheritance. Yet, research does not support any of these claims. To attribute anxiety to a chemical imbalance is overly simplistic and does not account for the range of symptoms or cognitive biases displayed by sufferers of anxiety. Studies have shown that the role of genetics is only partial and may lead to a predisposition to develop anxiety symptoms, but not a full-fledged condition. Although brain scans of someone suffering from anxiety differ from other non-sufferers, scans after treatments will show that activation in certain areas of the brain has changed. This means that anxiety has a physiological counterpart, but not that anxiety is caused by physiology.
The medicalization of anxiety symptoms has a number of consequences. By defining anxiety as an illness or medical condition, many are left feeling that there is little they can do for relief. Sufferers may find themselves feeling like victims of their symptoms and may come to identify with their condition (I’m just an anxious person, there’s not much I can do). These views prevent individuals from resolving their anxiety and can lead to it becoming a life-long condition.
Is medication a solution to anxiety?
The medical model proposes that the solution to anxiety is medication. This is extremely profitable for pharmaceutical companies, attractive to doctors as it is simple and straightforward to write a prescription, and perhaps highly desirable by sufferers in search of rapid relief. But medication is not a solution. It does not resolve anxiety, it reduces the symptoms and provides relief.
The downside to medication as a treatment for anxiety, besides numerous unpleasant side effects, is that it does not help the sufferer resolve any of the issues underlying the anxiety symptoms. Anxiety is not the problem, it is the symptom of a problem. Medication does not solve the causes. Once medication is terminated, the severity of symptoms tends to return to previous levels. Also, medication doesn’t enable a person to learn new and more effective strategies for dealing with stressful life events, handle worries and challenges or acquire tools for taking charge of overwhelming emotions and planning for the future.
The Cognitive Model
More and more popular are cognitive approaches to anxiety. With the growing popularity of CBT (cognitive behavioural therapy) and methods such as NLP, and greater research into anxiety, cognitive models provide a more complete explanation for the variety of symptoms characteristic of anxiety. In addition, research consistently shows that cognitive treatments provide the greatest long-term benefits to sufferers of anxiety.
According the much recent research, anxiety is not an illness, but rather, a normal human ability that has become extreme and excessive. It’s normal to think of the future, consider what may go wrong and plan accordingly. Yet in cases of anxiety, this future focus and the consideration of what may go wrong becomes extreme and uncontrollable to the point where the fear and apprehension become overwhelming.
Cognitive approaches also emphasize that anxiety may be learned through normal learning processes and can be treated through learning-based approaches (the basis of behavioural therapies).
What is Anxiety?
Cognitive models see anxiety as caused by biases in Information processing:
Excessively negative predictions of the future
Sufferers of anxiety become convinced that unavoidable negative events will occur.
Attention directed to threatening stimuli
Focus is upon danger and the avoidance of danger and unwanted events and circumstances.
Individuals with anxiety focus excessively on their own feelings, responses and bodily sensations, often to the exclusion of external stimuli.
Misinterpretation of bodily sensations
Individuals interpret ambiguous bodily sensations as indicative of a heart attack, panic attack, fainting or other unwanted consequence.
In short, we could say that the anxious person is highly focused on what could go wrong in the future, convinced it will happen and then highly focused on their own bodily reactions which are seen as evidence that something is wrong or will go wrong. These biases lead to a vicious cycle of fear and apprehension that is difficult to escape.
Sufferers of anxiety may often have been told, “It’s all in your head.” Actually, it begins in the mind and then moves to the body. The mind produces powerful signals of danger which the body responds to by activating the autonomic nervous system (fight or flight response). The individual is then left overwhelmed by perceptions of danger, the release of adrenaline and other chemical changes and feeling helpless to do anything about it. Often, the best advice others can give is “relax” or “think positive,” each of which the sufferer find it impossible to do. These are overly simple solutions to a complex problem.
Anxiety can be defined as a self-reinforcing cycle of constant fear and apprehension resulting from unconscious and automatic patterns of thinking that have emotional and physiological effects. It is by correcting these cognitive biases and altering the structures that are holding the cycle in place that anxiety can be resolved.
Anxiety and NLP
The NLP approach to anxiety begins by viewing anxiety as a unique skill. In the NLP model, problems are seen as learned responses that demonstrate the rapidity with which the mind can learn. The implication is also that since the problem was learned and probably learned quickly, we can learn to do new things with our mind rather quickly.
In a transcript of a therapy session in which Richard Bandler (one of the co-founders of NLP), helps a woman resolve her symptoms of panic he states these ideas overtly:
Richard: You’ve obviously mastered this. By the way, do you know this is an achievement?
Susan: You mean to master the panic?
Richard: I bet you a lot of people here couldn’t panic.
Susan: Probably not. Not like I do, I’m sure.
Richard: It’s like everything else. It’s learned. There is a real difference between my view of people which is that one of that one of the things about people is that they are such exquisite learners. I’m always amazed at how people can learn things so quickly. A lot of what they learn is not worth having learned. Think about how many futile things you’ve learned. But the fact that you can learn all those things is really impressive. (Magic In Action, 15-16)
Bandler goes on to help her uncover how she produces the panic and helps her see that she is doing something with her mind that others in the audience may not be able to do. Then he helps her to resolve the panic completely with an NLP intervention (verified by a follow-up months later in which she reports that since the session, she has had no episode of panic).
The Strengths of Anxiety
The NLP model views problems as skills and this means that each unique problem takes unique skills.
If you wanted to have a problem with anxiety, what skills would you need?
Anxiety takes creativity, imagination and energy. To produce the symptoms of anxiety one needs to be able to vividly imagine future scenarios, and so vividly that it is as if they are real. Not everyone can do this! I have suggested to clients, especially those looking for a new career path, that they may be well-suited to write horror novels or produce horror films (which is usually follows by a giggle of recognition). Are the skills involved in anxiety any different from those that Stephen King has used to earn millions? He spends his time imagining worst case scenarios and frightening events… the difference is that he imagines them happening to someone else!
In the above-mentioned transcript, Bandler points out to Susan that she requires a photographic memory to be able to produce her symptoms and suggests that she use that ability for a more constructive purpose:
Richard says: “You could use that, for example, imagine if you could see pages of books and focus in that closely you could read them again. Have a whole library there. What you use to create panic is what I use to check stubs and things like that.” (Magic In Action, 18)
This approach to anxiety is more effective than any attempt to “cure” the client because instead of trying to change things, the individual’s unique abilities can be utilized and directed to help them accomplish their goals.
Perhaps even more importantly, NLP approaches view anxiety and other problems as made up of building blocks. One of the basic ideas of NLP is that every experience has a structure. By uncovering the psychological pieces creating a problem and understanding how they work (as opposed to why they are there), we can determine how to intervene to create a change. NLP methods aim to alter the structure of thinking.
Another important aspect of the NLP approach to anxiety helps to turn the client from a victim into an expert. As the sequence of mental events that produces the symptoms of anxiety is unconscious and automatic, sufferers feel that anxiety is something that happens to them. From this view point, the sufferer is a victim of their own mental processes. Statements such as “I had a panic attack” imply that panic is some sort of alien force that takes over. When clients use this statement I will ask, “So you were sort of walking along and panic stepped around the corner and attacked you?” From this slightly humorous response, individuals can see through the trick of language here and learn a more useful way of perceiving their symptoms.
The NLP approach helps people view anxiety and it’s symptoms as something they do with their mind and helps them learn how they produce this result. As one learns how they produce the symptoms the mystery of “Why is this happening to me?” ends and more choices become available.
NLP methods emphasize that “treatment” involves learning to use the skills of anxiety in their appropriate context and to learn new and more effective ways to use one’s mind. Through this learning process, individuals gain the ability to think of the future while remaining calm and resourceful. They then feel more empowered to deal with possibilities, and in a calm confident state, can determine what actions to take to achieve their objectives (instead of the only option they use to have which was to panic).