Anxiety can be a message that danger is about.
It can be useful for coping (fight or flight).
But anxiety can interfere with the ability to deal with danger.
- Prolonged tension may produce physical problems ulcer, high blood pressure in susceptible people.
- “Freezing” in the presence of a threatening situation.
When anxiety is high it has a disturbing effect on the coping mechanisms (making a plan).
An explanation of a fear involves a tendency in a person to view a specific set of conditions as a threat (of danger in the future) and to react with a panic attack when these conditions occur (in fact or fantasy), e.g. trams – entering / visualising the tram.
Understanding your Automatic Thoughts (AT) are essential for a change in thought processes.
Thought – “I’m trapped” (danger). First AT
Lots of mental pictures of past tram disasters and / or Panic Attacks.
“I’m fearful or afraid of trains or being closed in; crowded in” “trapped”
Emotions flood the brain.
Rising anxiety and warning signs of the start of panic.
Behaviours (to protect).
“Too hard, too dangerous”
“I can’t do it. I will not go on the tram.” (avoiding again)
Anxiety then lessens.
Secondary AT in response to avoiding. I’m a bad or worthless person, then emotional responses (sad, anger, tense) and then withdrawal or negative behaviour.
An alternative fear is to be afraid of the consequences, e.g. what will happen if I do that, “what if”
A fear of bridges or cliff – means the person may fall off and be injured.
The fear of using the telephone means making foolish comments, ie. social phobias or speaking in public.
What can turn on the alarm system, i.e. the fear button:
- A movement closer to the threatening event.
- Talking about the threatening event.
- Thinking about the threatening event.
- Imagining the threatening event.
- TV or newspaper describing the threatening event.
Rumination about the threatening event can also create problems.
- Dwelling on the event brings the fear out of the past, from the brain’s memory.
- Then the event is seen as a “mental” image or picture. People have described it being as if there is a giant TV screen with terribly bright colours and the sound is always turned up. The person is in the scene.
- Then thoughts and images turn on the disaster with Panic Attacks and disturbed behaviours.
Fear can be normal and rational, e.g. fear of snakes.
Fear can be based on faulty reasoning and incorrect assumptions.
- An unpleasant or emotionally painful event may occur in the future. There is anticipation.
- Recollection of past events (memory) or news articles reinforce. This is seen as “true” but to another person it is seen as “false” reasoning. The potential danger is then reinforced by repeated thinking; and more thinking.Both rumination and “flashbacks” contribute to the faulty logic.
Fear of loss of control can be common. The patient may believe that no-one else ever has such a fear. These types of fears include going “crazy” or being violent.
Consider the fear of death.
- The patient with chest pain may visualise that experience as the beginning of an unpleasant event. That is the fearful thought – a mental picture may be one of being in a coffin or in the ICU of a hospital. Then the Panic Attack occur and passes. The person is emotionally upset.
- Others (doctors, relatives or friends) may not “tune in” to the patient’s thoughts. They see that the pulse is high, the patient is anxious, but the other tests and the general examination is normal.
- To the person with the fear, the explanation that they are fit and healthy, is rejected with heated thoughts. (“they don’t believe me – I’m afraid”).
These fears are based on faulty reasoning.
- Faulty interpretation of the chest pain, or the danger sign.
- Experiences from inside or outside the body are processed incorrectly, leading to incorrect (the worst) conclusions.
- Focusing on an event or system due to past experiences or incorrect beliefs.
- Making a general conclusion from one fact (faulty evidence).
- Using false links then false conclusions
Credit: This resource was handed during my dr sessions. It has been transcribed with approval from psychiatrist but is the property of him