Saturday, December 06, 2008

Solid Ground and Treatment for Anxiety

On PostMo, Draconis wrote:

Now speaking of having the ground yanked out from under me: While talking to my psychologist she suggested that when I am starting to feel anxious I need to focus on something grounding- something I know will bring me peace and comfort; something "solid."

The trouble is, I can not think of anything solid to ground myself with. "Rocks" that I've clung to all my life have washed away as mud into the sea. Every piece of flotsom that looks promising seems to carry the risk of decaying as well. Nothing appears solid to me anymore. I can't find solid ground. I have a hard time having real faith in anything or anyone-- not even in myself. How can I feel grounded when everything in my life has become uncertainty?

What do you all find "solid" since you left behind the paradigms of TSCC? I wish I could have faith in things like love, friendship, myself, my family, "God," Superman; almost anything really. I just can't think of anything to keep myself anchored to anymore. Will it just take me time to regain the ability to trust? Have any of you gone through this and found the ability to trust again? Or have you just become so familiar with uncertainty that it no longer bothers you anymore?


Draconis,

If you are talking bedrock solid ground, of which no scientific discovery will ever turn on its head, and no human will ever change its mind about, or death cannot take away, then the only thing I know of that is that certain and stable is the knowledge that "something is happening". It is the one thing that is impossible to doubt and that we must be sure of, even if we are in the Matrix or are characters in someone else's dream, we can at least (and at most) know that something is happening.

Everything else is probability. We assume the earth and everything else actually exists. We thirst for patterns in behavior (such as the laws of physics). We crave congruence (when our sight, hearing, touching, tasting, smelling, sense of balance, etc, all agree). Those things give us more confidence to estimate the probability of those things existing as higher. We observe others watching for predictability in behavior (i.e., stable personality and character) so that we can gain confidence that we can trust that others will behave a certain way in the future that is similar to how they have behaved in the past. Now, that method is not perfect as people can change, but generally people behave fairly characteristicly.

I kind of feel bad saying this to you because I know your wife left you, but one great source of stability and reliability in my life is my wife and kids. They give my life meaning and purpose because I choose to care about their feelings and well-being and they would be quite upset to lose me and I, them. Yet, they are not my only source of meaning and stability. If they all died at once, I believe I could go on, living for the good I could do for others. You all, on this PostMormon site give my life and make my life worth living. I mean something to you, as you do to me.

I also look at the power and stability of reason and the philosophy of science. They are something I can count on and turn to help me make sense of the chaos of life. Now their findings may change, one can count of new paradigms overturning previous ones, but the method is sound.

Now as for how to deal with your anxiety, the state of the art treatment for all anxieties from phobias, to PTSD, to Panic Attacks, to Obsessive Compulsive Disorder, to Generalized Aniety Disorder, is some variation of systematic desensitization. The one thing that psychologists treat more effectively than anything else (I dare say we have nailed this one) is the treatment of phobias. We can cure (and I don't say that lightly) any phobia through systematic desensitization.

Suppose you had a fear of snakes. We'd put a snake inside an aquarium and put him in the fall corner of the gymnasium. We would bring you into the gym and start you off as far from the snake as possible. We'd instruct you to approach the snake until your anxiety is about a 4 out of 10 (uncomfortable, but manageable), and then have you just stand there focusing on that snake and not using any kind of relaxation technique. It might take up to 30 minutes or an hour. Eventually, your body will become acclimated and return to homeostasis and your anxiety would go back down to a 1 or 2. It happens naturally. Then we would have you move closer to the snake until your anxiety rating was again a 4 and have you stay there until it is a 1 or 2. Repeated until you are able to handle the snake. With a few refresher sessions, you will be over your fear of snakes.

We do the same sort of thing for the other anxiety disorders, except this time the feared thing is not an object in space, but a thought. So, again we get you to approach your thought and hold it until the anxiety drops. Now, just as we would not just throw a snake on you at the beginning of treatment because that would do nothing but retraumitize you by sending your anxiety level to a 10, we also cannot allow you to rush headlong into your thoughts. So, the therapist may slow you down or use thought-stopping techniques if she or he notices that your anxiety is getting too high. But, this is why talk therapy works when confronting thoughts you are afraid of. People naturally do this when they tell a friend about a rafting accident they had earlier that day, or whatever. The main thing is to not be retraumitized, as that will turn you off to therapy and make you not want to return.

Use meditation techniques, visual imagery, or progessive muscle relaxation to address acute anxiety episodes and/or for daily maintenance. But, to really take care of the underlying anxiety problem find a therapist who is comfortable and trained in doing what I described above. Edna Foa, Ph.D. is the leading developer of these sorts of treatments for: OCD, PTSD, and social anxiety disorder, but the techniques apply to any anxiety disorder.

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