Break Out from the Vicious Circle of Anxiety

by Windy Dryden, Ph.D., Dept. of Psychology, Goldsmiths College

I have worked as a counseling psychologist for over ten years. One of the most common problems that people consult me on is anxiety when the source of that anxiety is unclear to them. When people are anxious about specific things in the world, like dogs, spiders or other people’s negative reactions, then at least the person knows what he or she is anxious about. However, a lot of people are anxious about being anxious and this is so common and yet so frequently misunderstood that such lack of knowledge leads to more anxiety.

Anxiety about anxiety occurs when you first experience a fearful reaction, say, while shopping, riding in a lift, driving in a car or even in your home. Having experienced this anxiety (problem 1) you begin to become anxious in case you get anxious again (problem 2). This double-barreled situation is the breeding ground for the development of your vicious circle of anxiety from which you find it so difficult to escape. Understanding this process is the first step to solving the problem.

Let me explain this vicious circle in greater detail. Once you have experienced anxiety “for no good reason,” you then bring an anxious attitude to the prospect of getting anxious. You think something like “Wouldn’t it be terrible if I got anxious.” Thinking in this way actually leads to anxiety. You then notice your anxiety and think something like “Oh my god, I’m getting anxious.” This leads to increased anxiety which triggers a further thought like “Oh my god, I’m losing control. What if I faint (or panic, have a heart attack or act crazily); wouldn’t that be terrible!” Anxiety is again heightened which leads to more anxious “thinking” and so on. Now this pattern occurs incredibly quickly and you probably are only aware of a building sense of panic. In addition, you may be one of a large number of people who “overbreathe” when you get anxious. This means that you take in too much oxygen and feel, paradoxically, that you need to breath in more air, whereas you actually need less. “Overbreathing” leads to such sensations as tingling, faintness, giddiness and heart palpitations. Without knowing this, you may consider that these sensations are evidence that there really is something wrong with you and “that would be awful.” This though leads to more anxiety and the vicious circle continues.

Without the presence of the anxious attitude of “wouldn’t it be terrible,” panic would probably not occur even if you tend to overbreathe so it is this anxious attitude that you need to identify and change if the seeds of problem solution are to be sown. However, very few people understand this and therefore this explanation is not common knowledge. As such, what you may have done is to avoid situations where you fear you might be anxious. If you don’t avoid these situations you may continue to face the anxiety-provoking situation by using a number of common techniques which are designed to distract yourself from your anxiety (e.g. relaxation, counting to ten, drinking, etc). These can be helpful in the short-term but more often do not solve the problem and in the case of the use of alcohol to quell anxiety it is positively hazardous.

What can be done? First, distinguish between the attitudes of “uncomfortable” and “terrible.” Terrible probably means to you literally the end of the world. Anxiety is not the end of the world. It is uncomfortable, damned uncomfortable at times, but it is not terrible unless you define it as such. If you do define anxiety as terrible then you will take another trip around your vicious circle. So first if you get anxious you have to show yourself that anxiety is uncomfortable, bad, inconvenient but it is not dangerous and it is not the end of the world.

Second, show yourself this in the situation you have tended to shy away from. This sounds simple and it is BUT IT IS NOT EASY! Remember this distinction, it is an important one. You have trained yourself to think that anxiety is terrible and your body reacts to this definition. It is going to take some time for you to retrain yourself and think that anxiety is damned uncomfortable but not terrible. And it will take longer for your body to react to your new definition.

Third, I have found that the following principle I developed some years ago to be very useful. I call it “challenging but not overwhelming.” By this I mean that if you believe that a situation would be overwhelming for you, then it is perhaps better not to face it yet. But it would be a mistake to go very gradually and only do things that you can do comfortably. Overcoming anxiety means tolerating discomfort so it is important to face and not shy away from feeling uncomfortable. So choose to start with an experience you will find a challenge. If you don’t succeed with this, remember that is unfortunate, not “terrible.” Keep applying this principle of “challenging but not overwhelming.” Choose a challenging situation, face it and practice the attitude of “anxiety is damned uncomfortable but not terrible” while you are facing it. If you fear panicking remember that panic (or a “ten” as sufferers call it) lasts only for a very short time even though it seems endless at the time. So use the same attitude to panic. “If I panic, I panic, that’s damned unfortunate but not terrible.”

Now I want to cover one important feature which a large number of my clients have said is also involved in this circle. If you fear that you may act stupidly, crazily and will attract other people’s scornful attention as a result, first realize that this is unlikely to happen. However, a better solution is to imagine that this will happen and practice another anti-anxiety attitude. Now if you have this fear it is likely that you believe that if you act stupidly or crazily then this proves you are worthless (useless, stupid, a fool or whatever word you personally use to condemn yourself.) If other people then scorn you this is not the problem. It is your agreement with their reaction that is the problem. You think “If they think I’m stupid they’re right I am.” So, once again, it is your attitude towards yourself that is the problem here. Now what you need to ask yourself is this: “Am I worthless, useless, etc., for acting this way, or am I a fallible human being (and equal to others) with a problem?” I hope you realize that you are the latter. If a good friend acted stupidly in public would you condemn them, or would you adopt a compassionate attitude of acceptance towards them? Most probably you would accept them. But they are human like you. So you can practice the accepting attitude toward yourself. “If I act stupidly that would be bad but I’m a fallible human being with a problem.”

My clients report that this attitude helps them realize that first they are not that likely to act stupidly, etc; second, even if they did act stupidly, other people probably would not condemn them; and third, even if other people did condemn them then this would not be the end of the world.

If you do tend to “overbreathe” it is important that you gain control of your breathing. This requires a lot of practice and is best done initially under the supervision of a knowledgeable person such as a clinical or counseling psychologist. Controlled breathing involves your taking smooth, slow, regular and fairly shallow (not deep!) breaths. Breathe in through you nose and out though you mouth in regular (in-out) cycles. Twelve such cycles per minute is often helpful, but find your own comfortable breathing rhythm. These cycles regulate the amount of oxygen you take in so that you do not experience the tingling, fainting and giddy sensations (as well as palpitations, etc.) which are associated with “overbreathing.”