I want to talk about a history of anxiety- mine!
My first memory of anxiety was being asked to take a leading roll in the infant school nativity play, playing Joseph, which obviously meant delivering lines. I managed to persuade everyone that I wasn’t suitable and managed to escape the play altogether. I still get a sense of the relief felt. This would perhaps have been my first taste of feeling good via avoidance.
This then became a habit in my life. Another clear memory was in secondary school having a history teacher that made every student read out loud several pages of the book we were learning. I had a hanky in my pocket and would blow my nose at the moment he was choosing, or else I would ask to go to the toilet having predicted the moment when he would choose. Amazingly it worked like a treat and I never had to give a reading in 3 years! Brilliant. Except I was further setting myself up with increasing avoidant behaviours. In preceding classes my mind would be on the upcoming history lesson and the grave consequences of being made to read out loud; the heart in my mouth, the laughter of my school mates, the shame of fumbling through the passages of words that tumbled from the page.
There was something else. As a child, and even today, I would always get powerful reactions in my body, to excitement or fear. The strong emotions play havoc on my physiology. If the F.A cup final was on (it was a big thing in the 70’s and would feel this even if it was not my team), I would become freezing cold, my teeth would chatter and I would be shivering on a warm May day, wrapped in a blanket. Watching the rugby world cup final in 2019 I was still getting this same reaction. I have spent many important sports matches, not watching- in the garden asking people what was happening.
From an interoceptive (the awareness of bodily signals in the brain ) standpoint, the understanding of anxiety is that my threshold for becoming aware of sensory data arriving from the body was set too low. This meant that information from my heart that it was beating fast, that my stomach was knotted and that my body was shutting down and becoming cold, was arriving at too great a level for the actual need for a response.
Perhaps this was how I was born (in my genes), or perhaps I had an early, unremembered traumatic experience. My mother told me that I did, as a toddler, somehow get out of the front of the house and was very nearly run over. Who knows. Whatever the reason, my body was super sensitive to information. We also now know that we are predictive machines, basing our understanding of what is going to happen next on our collected history and preparing the body before the event unfolds. This means if I have had these bodily responses before, the brain will predict that this is what will happen again, in effect creating the response. A research paper I read on pain made the startling statement we experience pain because our brains predict we are in pain!
Avoidance can be a useful tool in life. Sometimes it can be useful to protect yourself from a situation that you know will cause you discomfort or pain. BUT if this becomes habitual, then trouble arises, as needing to deal with things in life becomes harder and harder, and therefore you become more and more prone too avoidance.
But there is another, perhaps more profound price to pay. As Steve Hayes, the founder of Acceptance And Commitment Therapy (ACT) states, that if you avoid the unpleasant, you also loose the ability to fully enjoy the pleasant. You in effect emotionally numb yourself. This is the case with my journey. Although I do find pleasure in life, I believe I exhibit “anhedonia” (the inability to experience pleasure, in normally pleasurable activities). I sometimes feel distant from the crowd. I sometimes don’t understand what people are deriving their pleasure from in a social setting. I am unsettled in big groups of people and find myself stretching or picking at something around the dinner table as a guest, trying to let go of some nervous energy. Likely most of this goes unnoticed, but I experience myself experiencing this.
During reading Lisa Feldman Barrett’s book “How Emotions Are Made” I had a slight epiphany. She states that the body has a budget from food and fluid going in and an expenditure of energy released. We are in the business of balancing our budget as a deficit can lead to health issues. This was vital in our ancestry, but with the availability of food here in the first world, not as important. It was all in the name of survival.
What if my avoidance was actually a good thing. That my system knows my outgoings and strain on the system was too great when in a high arousal setting. Maybe avoidance has been keeping me from system issues? Stephen Porges Polyvagal Theory works on these lines.
However the price has been quite high. I have avoided interviews for positions of interest and many other goal related things in life, in order to avoid the felt overarousal of what is my autonomic nervous system, the part that relays messages to and from the body (a sort of accelerator or brake system).
CBT has a great method of dealing with this, that I now use a lot in physical therapy, called exposure. It basically means fully facing your fears. It used to be thought that you need to get the body relaxed, then gradually introduce the feared stimulus (say in my case giving a speech), but recent findings suggest to go full whack and expose hard. The nervous system, it is known, cannot continue the highly aroused state for and once calm and with the stimulus still in place, the brain alters it’s predictions, not to extinguish the old fear, but to add the hopefully new dominant belief that we do not need to respond like that anymore and the more we confound our expectation, the more we form new, healthier neural connections.
I found for myself, that when I took up meditating and using mindfulness techniques, that it did not just calm the body, but acted as a kind of exposure as you begin to study these feelings and accompanying thoughts, and not get fused to them, to find a healthy distance or to see them as passing clouds. Everything is impermanent, things change, but we (I) often have a feeling of anxiety, that might then give rise to emotions such as shame, guilt, embarrassment, sadness etc, thereby continually stoking the flames. The act of letting go of strong feelings I find harder than letting go of strong thoughts, though they tend be circular. But I did start to notice myself becoming calmer in situations I know would have caused greater bodily reactions.
I started to teach and during my teacher training in mindfulness, I coped. What else I noticed was everybody else reported being extremely nervous even though they seemed to me the height of confidence. I asked a tutor at break, to honestly tell me how I came over, skip the encouragement, give me the hard truth. She said that although I found it hard to give good eye contact to the group, I sounded fine. I thought people would be hearing my heart in my mouth. This boosted me.
So even though I still leave the room when watching embarrassing tv, I can also stay in the room far more. I still get very strong bodily feelings, but I cope and instead of turning away from them, I have learnt through mindfulness to turn towards them and allow them to be. If my worst anxiety is a ten and my best anxiety in a difficult setting is say a 5, I now hover more time in the 5 and 6. This is progress. Perhaps my genes or past experiences, will never allow me to get all the way down the ladder to zero, but I will take a five. Anyway, a five gives you juice in the machine. I also practise self compassion and as stated can see that I have been trying to protect myself, which can be hard for men I think, but I realise we share a common humanity, and people generally wish you the best. Boosting my dopamine using savouring and other positive psychology practises has also helped treat my anhedonia. The filling in of body maps similar to the chart above as well as mood labelling, helps you delve into the body to better understand the messages your body is attempting to convey. I have truly been my own guinea pig for my course. These elements of M.A.P has also helped me, as Steve Hayes says, let go of the rope, in my tug of war with my anxiety monster.
Graham uses M.A.P to help others suffering with pain and anxiety in Deal and hopes to expand into Kent and London.