Ask Andrea - Anxiety

Looking for a little advice about your relationship? Perhaps you have questions about parenting? Ask Andrea! Our social worker, Andrea Liss will pick one question a month and answer it in our mid-month bulletin. You can submit your questions anonymously to her at https://forms.office.com/r/F3rxQKvTdQ

Dear Andrea,

I heard you know a lot about anxiety. Can you share a few pointers in the CFMWS OUTCAN Mid-Month Bulletin this month?

- Anxious to Hear What you Have to Say About Anxiety

Dear Anxious to Hear What You Have to Say,

I started my career in the early 1990s as a research assistant for one of Canada’s most professionally prolific, kind and funny psychological scientists- Dr. Marty Antony. Marty developed the Anxiety Treatment and Research Centre in Hamilton, Ontario. The clinic is a thriving specialty program receiving several hundred referrals per month. In the early days, we only treated Obsessive Compulsive Disorder, Panic Disorder, and Social Phobia but the clinic has expanded to treat Generalized Anxiety Disorder as well as Post Traumatic Stress Disorder and treats many other related problems including substance use in anxiety and perfectionism. Back in the day I learned to treat Ophidiophobia. For those of you who detest snakes, don’t look up the meaning of this word! I feel blessed to have had such great training and such wonderful mentoring. Anxiety is a topic that I am very familiar with. I decided that I would share a few key concepts that I have learned about anxiety over the years. Let’s start with establishing a shared understanding of anxiety.

The American Psychological Association (APA) defines anxiety as follows:

“Anxiety is an emotion characterized by feelings of tension, worried thoughts, and physical changes like increased blood pressure”. What stands out about this definition is that it describes anxiety as having several components: physical sensations, cognition, and physiology. A key fourth component, behaviour (eg avoiding shaking hands for fear of getting germs), is also a significant component of anxiety. The APA definition continues: “Anxiety is not the same as fear, but they are often used interchangeably. Anxiety is considered a future-oriented, long-acting response broadly focused on a diffuse threat, whereas fear is an appropriate, present-oriented, and short-lived response to a clearly identifiable and specific threat”.

Anxiety is anticipatory and characterized by the possibility that something “bad” or scary might occur in the future. It’s not always specific (the word “bad” doesn't tell us much for example) and thus the description of “broad and diffuse”. What strikes me as interesting is that fear is considered “appropriate” but there is no such mention for the definition of anxiety. What this implies is that anxiety has some element of unreasonableness to it. Anxiety can be capricious. It can sometimes be illogical. When intense feelings of discomfort get paired with beliefs that don’t always make complete sense, it’s like an oil fire- hard to extinguish unless you know what is fuelling it and have the right tools to dismantle it. Anxious beliefs are often characterized by two types of distorted thinking: overestimating the probability that bad things may happen and assuming the worst. In a nutshell, anxiety is not altogether based on reason. But neither is a delusion, so what’s the difference and why is this important in our understanding of anxiety?

A delusion is a firm, fixed belief. It is unmovable. It is unable to be challenged or changed. No doubt creeps into a delusion. Some doubt is important. There is no questioning of a delusion by the person experiencing it because the person does not possess the capacity to “see” their thinking. This is called insight. The person with a delusion is unable to examine the feasibility of their thought. They can’t objectify it which would help them to observe their thoughts and come to learn that thinking sometimes lacks reasoning and sometimes requires a “reboot”.

Anxious thoughts however do have the capacity to be shifted. The very anxious person who seeks help realizes at some point that their anxiety causes problems. They can come to understand that their thoughts are distressing, impairing, even interfering. A significant aspect of managing anxiety involves correcting misinformation and errors in reasoning. This is the hallmark of Cognitive Behaviour Therapy and Acceptance Commitment therapy which are gold standard treatments for anxiety disorders. These treatments target the various components of anxiety (sensations, cognitions, fight-flight, and behaviours) by challenging the idea that the world is full of dangers and that the anxious person cannot manage. Fact checking, updated information and self -encouragement help the anxious person to rethink their tendency to want to avoid and to look at things through a distorted lens. Facing anxiety involves experimenting with uncomfortable activities that have been avoided.

A final important fact about anxiety is that though unpleasant, it is not dangerous in and of itself. The key to overcoming anxious thoughts, sensations, and behaviours is to radically accept them as slightly off base and then actually befriend them. Success in the treatment of anxiety problems is not based on achieving idealized outcomes or how good you feel as these are not always within our control. Valued action that is able to occur through being courageous, regardless of how it makes the person feel, is a great measure of success. Over time, what has become uncomfortable to the anxious person gets challenged and later will be discovered to be non-threatening. Eventually, what happens is the anxious person, after lots of hard work says to themselves “I don’t even know what the fuss was all about! That was easy!” If you or a loved one, whether child or adult, is experiencing significant anxiety, please consider this wonderful Canadian self-help resource and contact your CFMWS OUTCAN Social Worker www.anxietycanada.com

If you would like to pose a question for the Ask Andrea column, please send your anonymous question to https://forms.office.com/r/F3rxQKvTdQ and Andrea will do her best to share some of her ideas.

Andrea has a master’s degree in Social Work and is a Registered Social Worker (Ontario) with over 20 years of experience. She maintains a faculty appointment at McMaster University where she teaches in the Masters of Science in Psychotherapy program. Andrea is your MFS OUTCAN Rest of World Social Worker.  If you are a CAF family member and would to speak with her or join the spousal support group for all OUTCAN spouses that she runs please email her at liss.andrea@cfmws.com.