What is Anxiety?

The feelings of anxiety are real and physical, similar to what one might feel when encountering a grizzly bear, or another real, physical threat. Our bodies automatically react with the “fight, flight, or freeze phenomenon.”

The physical sensations we may experience with anxiety include:

  • rapid heart rate
  • fast, shallow breathing
  • increase in blood pressure
  • stomachache
  • dry mouth
  • tightened muscles

We react this way because it is more important for our hearts to pump blood to our muscles so that we can fight or run away from the bear than to digest what we had for lunch! It is like pressing the accelerator in the car.1

The freeze response is a common, but often misunderstood, reaction to stress. It occurs when we’re feeling threatened or overwhelmed, and our body becomes completely still. You may be familiar with the term “playing possum.” These animals would pretend to be dead in order to preserve themselves from predators.

When we freeze, our body becomes still, our heart rate slows down, and we stop breathing for a short period. This response is thought to have evolved as a way to avoid detection by predators, as many animals have a keen sense of movement.

However, the freeze response can be triggered in non-life-threatening situations, such as during social interactions or work-related stress. When this happens, we may feel stuck or unable to take action, often leading to feelings of frustration, helplessness, and shame.

How often have we been in a difficult conversation and we froze and were unable to even speak? And later that day, or night, we came up with the perfect reply. And we tell ourselves, “Gee, I wish I had said that then!”

It is important to realize that the freeze response is a natural response to stress and not a sign of weakness or cowardice. It is a survival mechanism that can be helpful in certain situations. However, if the freeze response becomes a chronic problem, it is essential to learn how to regulate our nervous system and manage stress in healthy ways. (2,3)

Of course when we’re relaxed:

  • our heart rate is slower
  • we breathe slowly and comfortably
  • our blood pressure is down
  • our muscles are looser

It’s like having the brakes on in the car.1

The problem is, our brains and bodies react the same way whether we are encountering a grizzly bear or being nervous before taking a test (test-taking anxiety), giving a speech (public speaking anxiety), performance anxiety such as at a musical recital, or competing in a sporting event (sports performance anxiety).

Anxiety has 2 driving forces: 4

  1. The person overestimates the risk or challenge
  2. The person underestimates his or her internal strengths and resources.

Anxiety is always future-oriented and involves the question, “What if…” 4

What if I:

  1. forget my lines?
  2. double-fault?
  3. miss this shot?
  4. get a bad grade on this test?
  1. Personal communication, Pamela Kaiser, PhD
  2. Porges, SW. The Pocket Guide to the Polyvagal Theory: The Transformative Power of Feeling Safe. WW Norton & Company
  3. Van der Kolk, BA. 2014. The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma. Penguin Books.
  4. Personal communication, Michael Yapko, PhD

Mental Imagery & Muscle Memory

Of course, we are all taught about muscle memory, and that it works from the bottom up. Well, it turns out that MENTAL IMAGERY ALSO CAUSES MUSCLE MEMORY! So that when you visualize yourself kicking a soccer ball well, the same areas of the brain are working as when you are actually kicking the soccer ball. 

By visualizing, you can create new neural pathways in the brain, new connections, neuron to neuron, thereby creating muscle memory from the top down. This is called “Neuroplasticity.”  The brain actually restructures itself!

Visualization, also known as mental imagery or self-hypnosis, is a skill that needs to be learned and practiced. And, just like kicking a soccer ball or playing the piano:

  • The more you practice, the better you get at it.
  • The more you practice, the easier it gets.
  • The more you practice, the faster you get at it.

Cognitive Behavioral Therapy (CBT) has been shown to be extremely effective for anxiety of all sorts, and Dr. Lazarus has found that by using a combination of medical hypnosis and CBT, his patients not only learn some extremely powerful tools, but they also have significant improvement after only 1 to 3 visits.

CBT involves teaching patients to recognize when they have negative thoughts and how these thoughts affect how they feel. 

Patients then learn how to understand how their cognitive distortions (also known as irrational thought processes or thinking errors) contribute to their problems and how to talk back to the negative thoughts. And, once they are able to take control in this fashion, their feelings change.

To summarize in one sentence: “When you change the way you think, you change the way you feel.”

This is the cognitive part of CBT.

CBT: Behavioral

The behavioral part involves actually changing one’s behavior. Of course, when we are anxious about doing something, we tend to want to avoid it.

For example, for people who are afraid of flying on an airplane, the easiest thing for them to do is to drive, or take a bus, train, or boat. In order to overcome this fear, eventually they have to get on a plane.

 This can be done through a series of small, more manageable steps (called desensitization), or it can be done quickly.

The analogy that Dr. Lazarus likes to use is: “When you have to remove a band-aid, do you prefer to do this slowly or quickly?”

With this type of work, called exposure therapy, the slower one goes, the easier it is for the patient, and, of course, the longer it takes. When one goes quickly, it is a lot harder, takes an enormous amount of courage, and the results are a lot faster.

The use of medical hypnosis can speed up the process of getting over phobias quite dramatically.

When Dr. Lazarus sees patients, he incorporates not only hypnosis techniques, but also cognitive behavioral techniques. 

Where can I find more about Anxiety?

My colleagues, Reid Wilson, PhD and Lynn Lyons, LCSW, are the authors of a book entitled Anxious Kids, Anxious Parents: 7 Ways to Stop the Worry Cycle and Raise Courageous & Independent Children. It outlines a practical step-by-step approach to help families dealing with anxiety.

Fear of public speaking is one of the leading fears people have.  Strategies and skills to combat this anxiety can include self-hypnosis, visualization, guided imagery or mental imagery.

Athletes who perform well during practice may “choke” under the pressure of important games or carry past failures with them. Medical hypnosis has been proven to help athletes perform to their abilities.

Sometimes, even though a performer has all the skills needed to wow an audience, her or she experiences a fear as real and physical as one might feel when encountering a bear or another real, physical threat.

It is a perceived threat, and can be dealt with if the musician is given performance anxiety strategies and skills to perform confidently.

Test Taking Anxiety

Even students who have strong academic capabilities can succumb to anxiety when taking an important test, and they fail to reflect their actual knowledge and abilities.

Social Anxiety

It’s one thing to be shy, but social phobia or social anxiety takes this to way beyond the next level. Some kids may be so worried about being with their peers that they will avoid them by sitting alone at lunch time.