Carolyn Daitch - Anxiety disorders : the go-to guide for clients and therapists

Anxiety Disorders

The Go-To Guide for
Clients and Therapists

CAROLYN DAITCH

W.W. NORTON & COMPANY

NEWYORK LONDON

This book is dedicated to my clients,
whose courage and perseverance have
taught me so much.

Contents

I could see tomorrows headline: Anxiety Expert Bolts from Newsroom, Too Stressed to Give Interview. It almost came true. Nearly 20 years ago, I was contacted by a local news network. The winter holidays were approaching, and the network was hoping to do a segment on stress and the holiday season for their 12 P.M. news hour. Since I specialized in treating stress- and anxiety-related conditions, the station gave me a call. At first I was intrigued and flattered by the prospect of participating in a live newscast. Sharing tips for managing stress and anxiety with the general public seemed not only meaningful, but exciting. Ive never been stage shyon the contrary, I have always enjoyed public speaking. I didnt give the possibility of stage fright or performance jitters a moments thought when I eagerly accepted the invitation.

Fast-forward one month. I was sitting just to the left of the anchorman, my hair, makeup, and stress-management tips ready to go for the live broadcast. Just three minutes remained until the anchorman would segue to the holiday stress segment, and the camera would pan over to me. I was energized and collected. In only a matter of seconds that drastically changed.

When I shifted my glance from the anchorman to the camera, a spotlight caught my eye. It was as if the heat from the light flooded directly into my face. Startled, I glanced at my watch. Not enough time to step out of the light and cool down before it would be my turn to talk. I would have to stay in my spot. I started to take a deep breath, but it was interrupted by a swift thud from deep within my chest. And then another. And another. After what seemed like an eternity (in reality probably only 10 seconds), I understood that the pounding in my chest was my heart racing. Panic flooded every bit of my awareness. A debate raged in my mind:

I have to get out of here!

You cant just leaveyoure about to go on live television.

The heat in my face and the pounding in my chest were too intense. The urge to flee seemed to take over my mind and body. I had to bolt. I could feel my feet itching to burst into motion to carry me anywhere but here. Desperately, my eyes scanned the studio for the nearest exit. Hes a professional anchorman, I rationalized. He can cover for me. There are still two minutes to go before I go on; he can improvise.

But Im a psychologista psychologist who helps people with anxiety! I teach anxiety management! Hold on, what do I tell my clients to do?

I knew I had time to tense and relax the muscles in my upper body, a shortened version of a technique I often teach, so I began with this. Then I initiated a sequence of deep breaths with long, steady exhalations. This calmed my system enough for me to engage in some rational self-talk.

Whats the worst thing that could happen in this interview? I asked myself.

Well, some people in the Detroit metro area might see me as an anxious psychologist on TV.

Could I live with that?

Of course I can, I told myself. The pounding in my chest muted ever so slightly. And I dont even know anyone who watches the 12 oclock news! I smiled to myself as I thought about the absurdity of worrying so intensely about a performance that no one I knew would even be watching. My heart rate slowed even more.

I can do this, I thought. I will do this. Just then the anchorman introduced me, and I turned to the camera and spoke.

About a week later, the studio sent me a tape of my interview. I appeared calm and collected, and I spoke at a clear, steady pace. I had to laugh: in the interview, I outlined some of the stress-busting techniques that just minutes before I had been using on myself.

Anxiety and panic are universal experiences. In fact, anxiety, fear, and even panic have helped us to survive by mobilizing us to respond to and defend ourselves against threats. When seen in this light, anxiety is a gift, the presence of which can enhance our ability to not only survive, but thrive on this planet. But anxiety, when it crops up at inopportune times or when its intensity is too great relative to the current circumstance, can also be a hindrance. This was the case for me as I sat perched behind the anchors desk 20 years ago, anticipating my turn to speak. I was experiencing what you will learn in Chapter 5 is called a panic attack. Were I being attacked by a lion, that level of nervous activation would have been quite appropriate and would have helped me to escape from danger. But I was under no such threat as I sat in the newsroom. Luckily, I had many therapeutic tools available to metools that made the difference in allowing me to successfully cope with my anxiety rather than succumb to it. These are the very tools that I offer to you in this book.

Overview of Anxiety Disorders

Approximately 18% of adults (18 and older) in the United States suffer from an anxiety disorder in any given year (Kessler, Chiu, Delmer, & Walters, 2005). Thats more than 40 million people in the United States alone whose excessive anxiety interferes with their ability to function on a daily basis. Not to mention the countless others who, like me, have the occasional panic attack or are overly burdened by the stress of upcoming deadlines or commitments. Anxiety, and particularly anxiety-based disorders, are now recognized as some of the most common psychological disorders in this country. If you are one of the many who suffer from anxiety, this book contains information that can give you relief. I will describe the symptoms of and treatments for five of the anxiety disorders: generalized anxiety disorder, panic disorder, specific phobias, social anxiety disorder, and obsessivecompulsive disorder. Below are brief overviews of each disorder. Later in the book youll find a chapter devoted to each of them.

Generalized Anxiety Disorder (GAD)

If you have GAD, worrying may be your main pastime. Everyday occurrences give you more cause for concern than they do for those around you. A barrage of what ifs can ruin a simple activity like going to the grocery store, having a health check-up, or sending your daughter off on her first day of school. What if the car gets a flat? What if the doctor finds something wrong? What if my daughter doesnt like her new teacher, forgets her lunch, falls and scrapes her knee at recess... and then the kids laugh at her... and then her knee gets infected... ? The list can go on and on. Along with this chronic worry can come the chronic physical discomfort of stomach aches or other gastrointestinal upsets, tension headaches, and the fatigue that comes from constantly being on edge.