The Edge of Fear and Love

On my journey of anxiety to wellness, I learned something really valuable.  The opposite of love isn’t hate, it’s fear.  So, much of my treatment involved replacing my fear with love- whether it was comforting myself, valuing self-care, doing yoga or just connecting with and finding inspiration in the mystical and magic around me.

Another lesson I learned was that you can’t be brave without feeling a little bit of fear.  I started embracing a comfortable amount of fear.  At first, that was walking out the front door or getting within 20 feet of an overlook (I had agoraphobia), but eventually I worked through all that challenged me in my daily life.

One thing that still makes me fearful:  heights. This might be why I’m so mesmerized by Philippe Petit, the brave soul who attached a high wire between the Twin Towers and walked across (illegally).  Not only is it a fascinating story, but Philippe is an incredibly inspiring person.  Here’s a TED talk by Philippe Petit.  He inspires me to metaphorically walk my own tight wire, live beyond my dreams, unhindered by any fears.

It feels good to be at the end of this month, with less anxiety than I had four weeks ago.  I hope I’ll continue to find more balance in my life: more love and less fear.  Just enough fear to make me feel brave.

P.S. If you haven’t seen the documentary Man On Wire, you must! If you liked that, I love the children’s book The Man Who Walked Across the Two Towers.  I also enjoyed Let the Great World Spin, a fictional book with Philippe Petit’s walk at the center of the plot.

Guest Post: Journey of an Anxiety Specialist

 I’m so grateful for this post from my dear friend and anxiety specialist, Dr. Marianne Stout. 

(My apologies for the awkward line breaks; I’m still not very proficient with WordPress!)

In my training as a therapist I became interested in working with anxiety disorders
after encountering many clients with anxiety and having no idea how to treat them.
Simply talking about one’s fears or worries did not lessen their symptoms and the
worry, panic attacks, obsessions, and compulsions continued. Many people also
reported that it felt pretty good to explore their relationships with friends and
family, but that while this helped those relationships, it did not stop the anxiety. I
was doing something wrong and I felt incompetent as a practitioner since I could
not help. At the same time I had friends in other psychology programs who were
learning specific skills for treating anxiety and I wanted to know what they knew.
They were using cognitive behavioral therapy (CBT) to treat anxiety disorders such
as generalized anxiety disorder, obsessive-compulsive disorder, panic disorder, and social anxiety, but I did not know specifically how they did this.

CBT was developed by Albert Ellis and Aaron Beck and is a heavily researched
theoretical approach to treat a host of psychological disorders by aiming to change
behaviors or challenge maladaptive thoughts and thus influence emotions. The
theoretical premise is that thoughts, feelings, and behaviors are directly related and
thus someone with panic disorder may say, “I must sit in the back of the classroom
so I can easily escape if I begin to have a panic attack.” The belief is that sitting in
the back or escaping will keep them safe and avoid the embarrassment of having a panic attack in front of fellow students. The behavior is sitting away from others or
physically removing themselves from the situation when their heart begins to race,
their breathing increases, their chest tightens, they feel nauseous, or any of the host
of symptoms that occur during a panic attack. The subsequent feeling could be fear
of dangerous panic attacks, fear that they are “crazy,” or sadness that they cannot
enjoy a class they are interested in like other students. The work of a CBT counselor
would be to work with a client to expose them to anxiety inducing behaviors at
a gradual pace. This may mean having them sit in the second to last row in the
classroom and eventually lead up to them sitting in the front row or having them
stay in the room during a panic attack. A CBT approach would also challenge the
maladaptive thinking that panic attacks are dangerous (they are uncomfortable,
annoying, and tiring, but not dangerous) or that it would be embarrassing to have a
panic attack in front of others (classmates would likely be sympathetic).

In my fifth year of graduate school I began a practicum working under an anxiety
specialist, Diana Damer, PhD. While she used CBT to treat anxiety disorders, she
also incorporated an interpersonal approach exploring underlying relationships and
issues contributing to anxiety and explored the relationship between the client and
therapist. Research shows that regardless of theoretical orientation, the therapeutic
alliance, or relationship between therapist and client, is an important predictor of
success in treatment outcomes (Krupnick et al., 1996). This approach made sense
to me. Treating symptoms of anxiety as well as their underlying causes seemed very
effective and still acknowledged that the client was a relational being.

Since that time I completed my internship, post doc, and became a licensed
psychologist specializing in anxiety disorders. I have also come to include
acceptance and commitment therapy, which has a strong focus on meditation,
in my work as it can be difficult to ask someone to sit with the discomfort of
anxiety without giving them the tools to cope with said discomfort. I have begun a
meditation practice for myself and while I may go weeks without meditating, I find
that when I do life seems to make more sense. A wonderful book that understands
and treats anxiety in a way very similar to my own practice is Panic Attacks
Workbook by Dave Carbonell. Dr. Damer, another colleague, Thomas Smithyman,
PhD, and I recently opened a private practice focusing on anxiety disorders (http:/
/www.anxietyaustin.com) and it has been wonderful to work with like minded
psychologists who are as energized by the treatment and understanding of anxiety
as me. We welcome other professionals in the community who focus on anxiety
disorders to come to our Friday meetings and are always looking for new ways to
engage with the community on this topic.

References
The role of the therapeutic alliance in psychotherapy and pharmacotherapy
outcome: Findings in the National Institute of Mental Health Treatment of
Depression Collaborative Research Program.
Krupnick, Janice L.; Sotsky, Stuart M.; Simmens, Sam; Moyer, Janet; Elkin, Irene;
Watkins, John; Pilkonis, Paul A.

Journal of Consulting and Clinical Psychology, Vol 64(3), Jun 1996, 532-539.

Anxiety and Me

I’m giving myself a solid C on my efforts this month.  It’s that blasted sugar that calls my name like the luring sirens in the Odyssey.   Sometimes I win, sometimes it wins.  The great news is that I feel significantly less  anxious with just minimal effort, a little less caffeine, a little less processed foods, a little less sugar.  The buzzing of anxiety that I was feeling last month is dissipating.

Many of you know that I was challenged with anxiety attacks that began my sophomore in college.  Thinking back to this time, I realize that I created a perfect storm for anxiety:  not sleeping (I thought whoever came up with “I’ll sleep when I’m dead” was brilliant!) + alcohol (hello, #8 party school!) +terrible diet (why waste calories on nutritional food when I’d rather just eat dessert!) + probable genetic/temperament propensity for anxiety.  It was a really tough time.  My first anxiety attack was at a meeting for my sorority.  I felt like I was having a seizure or a heart attack.  I was so scared and had a friend take me to the emergency room.  They ran all sorts of tests, but of course I was completely healthy. When it happened again in class, I made an appointment at the KU Health Center.  This time I got the diagnosis right away- generalized anxiety disorder.  It was such a relief to get a diagnosis and know what was going on but also so overwhelming to have a “mental disorder.”

I’ve never really been one to take ibuprofen with a headache but I’m so grateful that I got on medication right away.  I started with Paxil and Xanax but neither were a good fit for me.  (Later, I took Buspar, until I got a handle on how to be more balanced.)   My low point was when I didn’t leave home for almost two weeks- not for class, not an errand, nothing. I was paralyzed by fear.  I remember feeling so alone, like I was going to be “crazy” forever.  Would I live with my parents?  The normal life I envisioned for myself was disappearing and I felt hopeless and miserable.

I made an appointment at the KU Health Center for a counseling session.  The person assigned to me made me feel so uncomfortable and anxious during the session (“Do your parents put pressure on you? Not really.  I’m the one putting pressure on myself.  Are you a Christian?  Do you feel pressured by Jesus?  Um, no. Can you help me deal with these panic attacks please?“).  I made an appointment with another therapist.  I learned about biofeedback and started taking baby steps out of the dark hole of despair that I thought I’d be in for the rest of my life. If I felt fearful of a situation, I pushed myself to the edge of my comfort level, embracing a bit of fear every day and dealing with it with the tools that I had learned- breathe, breathe, breathe.

Do you remember Mike Myers’ SNL character Linda Richmond of Coffee Talk fame? In real life, Linda Richmond was Mike Myers mother-in-law and she wrote a book about her life, which included suffering from panic attacks that kept her homebound (with two children! yikes!) for eleven years.  I remember this book giving me hope at a time that I was desperate for it.  I kept searching for answers, learning how to be a more balanced person and as you all know, I’m still on that quest.  I’m still not so good with heights or airplanes but overall, anxiety hasn’t affected my daily functioning for over a decade.

Overcoming my anxiety is right up there with childbirth on my list of proudest achievements.  I’m more grateful for the life that I have and more compassionate for those fighting their own battles.

I’ll give you a topic:  The Pwogwessive Ewa was neither pwogwessive nor an ewa.  Discuss.

The Anti-Anxiety Diet

I’m not sure if it’s the frantic business of being a mom of 2, my post-partum hormones, my lack of sleep, my sometimes horrendous diet (fast food is sometimes the only option…) or my sugar addiction (or all of the above?), but I’ve been feeling anxious lately. I experienced terrible anxiety attacks in college and I will do everything I need to avoid going back to that dark place.

So, my resolution this month is to put myself on a diet, an anti-anxiety diet:

• reduce sugar intake
• reduce processed foods
• reduce caffeine and alcohol
• exercise regularly
• daily meditation/checking-in spiritually
• adequate sleep
• giving myself space and boundaries (i.e. saying no, being easier on myself, etc.)

Am I missing anything?  What do you do to keep yourself balanced?