Therapist Blog - Glenn Burdick, MA, LMSW - What Really Works: Powerful Methods of Psychological Healing and Spiritual Growth in the New Millinium

‘My Anxiety Treatment Toolbox’

January 8, 2010 – 8:47 am

This blog post is the eigth in a series of posts that are excerpts from my full length published article, ‘Five Simple Steps To Managing Anxiety’ available for immediate download from my website by this link: http://www.glennburdick.com/anxiety_help.htm

My Anxiety Treatment Toolbox

In addition to introducing The Five Steps, It is also important that I help my clients become skilled at deep relaxation. This enhances their ability to identify the thoughts that are worrying or scaring them while they are arising, and makes it much easier to let go of mounting levels of fear or anxiety at that moment.

For that reason, I like to teach my clients meditation, which can help them to both relax physically and mentally, and experience states of peace and calmness on a regular basis. This can help a great deal for people with generally high levels of anxiety or worry.

I also employ techniques that have become known as ‘energy psychology’. These techniques involve certain patterns of tapping on acupuncture meridian points (EFT – Emotional Freedom Technique) or bi-laterally stimulating the brain through particular eye movements (EMDR – Eye Movement Desensitization and Reprocessing), and can help reduce the influence of past experiences and memories on present coping, as well as helping to develop more powerful present moment coping abilities.

Finally, in some instances I will utilize hypnosis to help my clients to more readily reach deep levels of relaxation, and gain the additional benefit of the subconscious mind in helping make the move towards genuinely accepting your anxiety more rapid and automatic.

I have outlined the steps I consider to be essential to self-managing anxiety successfully. If you take these steps when you are experiencing anxiety, whether moderate or severe, you should see a real difference in how it progresses. Individuals’ ability to complete these steps on their own will vary.

A number of people find that anxiety management techniques are all they need to learn and they will be able to successfully implement the steps on their own. Others will require a brief period of support from a licensed psychotherapist, such as myself, who is very experienced in working with clients with anxiety disorders. This additional support will help fine tune the process and ensure that you implement the steps effectively.

It is highly likely that individuals suffering with Simple Phobia, OCD, & PTSD will require the support of a licensed psychotherapist. In the first instance, Simple Phobia, the anxiety is absent except in the presence of a particular feared real-life situation, for example, a snake, standing on a high platform, sitting on an airplane. While the general principles I’ve outlined above still hold, there are very focused and powerful techniques available to directly eliminate such phobias.

With OCD there will be the need to focus on both the anxiety that triggers the obsessive thinking & the compulsive behaviors, which is complicated enough to require additional therapeutic support.

In the case of PTSD an individual has typically had a real life experience in a very dangerous situation and experienced some of the highest possible levels of fear, often in the context where it was possible, or the individual believed it was possible that their life was at its end.

For many years there was little help available for individuals suffering from PTSD. However, in the last several years techniques have been developed that can be highly effective in permanently reducing the associated symptoms and memories. For this reason, the support of a licensed psychotherapist with the proper training is really essential.

Finally, in severe and persistent Panic Disorder, as well as OCD and PTSD, there may be potential additional benefit from taking certain medications at the same time that self-management strategies are being implemented. Many physicians will require their patient to be working with a licensed psychotherapist in order for them to prescribe these medications.

(photo credit: life serial)

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By GlennB | Posted in Anxiety, Therapy & Treatment Options | Tagged Anxiety, Hypnosis | Comments (0)

‘The Five Steps to Managing Anxiety’

January 6, 2010 – 10:43 am

This blog post is the seventh in a series of posts that are excerpts from my full length published article, ‘Five Simple Steps To Managing Anxiety’ available for immediate download from my website by this link: http://www.glennburdick.com/anxiety_help.htm

The Five Steps to Managing Anxiety

Now, with the physical exam out of the way, we can focus on what I consider to be the general principles for coping with anxiety. I have coined these as The Five Steps, as they are always involved in working effectively with anxiety disorders. I, myself, employed them for overcoming my social anxiety, and they form the foundation of my work with clients:

Be willing to feel your fear
Relax your resistance to the experience of fear in your body
Accept your discomfort as distressing but not dangerous
Regulate your breath, preventing hyperventilation and move your body
Begin to say ‘yes’ to what you have been avoiding all this time

Remember that what you resist persists. On the other hand, if you are willing to feel the very uncomfortable sensations of anxiety for a few minutes and not attempt to distract yourself, numb yourself, or run away from the experience, it will begin to level off and diminish within a few minutes. Remind yourself that the feelings are certainly distressing, but anxiety is not dangerous, so there is no risk in staying put, and there is no real need for alarm.

Now, quite often as anxiety and fear increase your breathing will start to become shallow and rapid. Lengthen your breath so that each inhalation and each exhalation takes 3-4 full seconds, and move your body to interfere with the tendency to move towards hyperventilation.

As you have some successes shortening the periods of anxiety that develop you must stop avoiding the previously avoided situations. Otherwise, each time you avoid or run from the feared situation, your fear and tendency to avoid the situation becomes a little stronger. Most people find it easiest to begin doing this in their imagination.

There is a process I employ with clients called ‘covert rehearsal’ in which you repeatedly imagine yourself in the feared situation, beginning to feel the anxiety mounting, and successfully employing the five steps. You then progress to putting yourself in the actual situation, a little bit at a time, while employing the five steps.

Next post in this series: “My Anxiety Treatment Toolbox“

(photo credit: TuTuWoN)

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By GlennB | Posted in Anxiety, Therapy & Treatment Options | Tagged Anxiety | Comments (0)

The ‘How To’ of Anxiety Self-Management

January 5, 2010 – 8:00 am

This blog post is the sixth in a series of posts that are excerpts from my full length published article, ‘Five Simple Steps To Managing Anxiety’ available for immediate download from my website by this link: http://www.glennburdick.com/anxiety_help.htm

The ‘How To’ of Anxiety Self-Management

Of course, what you really care about is the ‘how to’ of getting your anxiety under control, and not the academic typology and research on anxiety. To sum up the majority of research studies on treating anxiety disorders, what works best in most cases is: learning to be aware of and modifying the anxious thoughts that are telling your brain that danger is at hand; learn to increasingly tolerate the uncomfortable sensations that arise; gradually exposing yourself to the feared situation. That is the simple, but not easy, path that is usually the most effective approach to diminishing the grip anxiety has on your life.

Before moving on to my particular treatment approach for helping clients with anxiety problems I want to say that all anxiety treatment should begin with a good physical exam with your primary care doctor. This is because, while rare, there are a handful of medical problems & medication side effects that can cause high levels of anxiety or panic.

For instance, hyperthyroidism and hypoglycemia can cause panic attacks, as can deficiencies of certain minerals, and certain kinds of allergies. You don’t want to embark on a self-management strategy when an appropriate medical intervention might remove the cause of the anxiety or panic altogether.

Along similar lines, there is some pretty good indication that consumption of stimulating substances such as caffeine and sugar may contribute to higher levels of anxiety in certain individuals. You may want to cut back on these substances and notice the effects it has on you if you reintroduce them.

This would be a great topic to discuss with your physician, who may also recommend other lifestyle changes and nutritional suggestions. Please don’t skip this step!

Next post in this series: “The Five Steps To Managing Anxiety“

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By GlennB | Posted in Anxiety, Therapy & Treatment Options | Tagged Anxiety | Comments (0)

‘The Anxiety Disorders’

January 3, 2010 – 5:31 pm

This blog post is the fifth in a series of posts that are excerpts from my full length published article, ‘Five Simple Steps To Managing Anxiety’ available for immediate download from my website by this link: http://www.glennburdick.com/anxiety_help.htm

The ‘Anxiety Disorders’

For the record, there are officially seven main types of anxiety disorder, and as you’ll see, we have so far addressed elements that are common to all of them, and the general dynamics of the first four: Panic Disorder, Generalized Anxiety Disorder, Social Phobia, and Agoraphobia.

All of these are considered anxiety ‘disorders’ because there is no current life-threatening situation present when we experience the fear/anxiety. Nonetheless, it feels very much like there is, and therefore we engage in efforts to escape or avoid the feared situation, often disrupting the flow of our lives in a significant way.

Can you find yourself in these descriptions somewhere? Here is the official list:

Panic Disorder: characterized by sudden episodes of acute apprehension or intense fear that occurs ‘out of the blue’ without any apparent cause. Symptoms may include: shortness of breath or a feeling of being smothered; heart palpitations; dizziness, unsteadiness, or faintness; trembling or shaking; choking; sweating; nausea or abdominal distress; feeling of unreality; numbness or tingling in hands ad feet’; hot and cold flashes; chest pain or discomfort; fears of going crazy or losing control.
Generalized Anxiety Disorder: this is pretty much constant anxiety that is unaccompanied by panic, phobias or obsessions. Fears may relate to losing control, failure, rejection or abandonment, death and disease, going crazy.
Social Phobia: this involves fear or embarrassment or humiliation in situations where you are exposed to the scrutiny of others or must perform in some way. The fear is so strong that individuals typically avoid the situation altogether.
Agoraphobia: the word itself means fear of open spaces, but it pretty much boils down to fear of having a panic attack in situations where escape might be difficult, such as in a store. Fear of embarrassment plays a role, as in what other people will think of you if you are seen having a panic
Simple Phobia: this involves a strong fear and avoidance of a particular situation or object. It doesn’t involve fear of panic attacks or fear of being embarrassed or humiliated. Some such fears include fear of particular animals, heights, enclosed places like elevators or airplanes, fear of dentist or doctors’ offices, fear of thunder or lightning, fear of injury or illness.
Obsessive Compulsive Disorder: obsessions involve recurring ideas, thoughts, images or impulses that seem nonsensical but intrude in your mind on a pretty continuous basis. Compulsions are behaviors or rituals performed in an attempt to rid you of the anxiety brought up by the obsessions.
Post-Traumatic Stress Disorder: this is brought on after exposure to severe trauma that produces intense fear, terror, and feelings of helplessness, such as experienced in a car crash or in wartime. These symptoms can persist for years, and are typically, triggered by memories of the past situation arising in waking consciousness or in dreams.

Additional resources on anxiety & panic disorder:

http://www.adaa.org/AboutADAA/PressRoom/Stats&Facts.asp

Next post in this series: “The How To Of Anxiety Self-Management“

(photo credit: LunaDiRimmel)

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By GlennB | Posted in Anxiety, Therapy & Treatment Options | Tagged Anxiety | Comments (0)

‘What We Resist Persists!’

January 2, 2010 – 5:28 pm

This blog post is the fourth in a series of posts that are excerpts from my full length published article, ‘Five Simple Steps To Managing Anxiety’ available for immediate download from my website by this link: http://www.glennburdick.com/anxiety_help.htm

‘What we resist persists!’

As a clinician with 30 years of experience I have worked with a great many people struggling with uncomfortable levels of anxiety and even panic. I have great empathy for their plight, given my own personal encounter with a fear of public speaking, a form of social anxiety that plagued me all the way into my late 20’s.

The very thought of getting up in front of any size group of people (even six!) terrified me, and I almost always found a way to avoid such situations. If I had to give a talk, my heart would be pounding in my chest; I would be feeling a significant level of fear, palms sweaty, approaching panic, wishing I was anywhere else in the world at that time. I dreaded the possibility of embarrassing myself in front of others, or even being humiliated (both concerns of social anxiety).

As I’m sure you can imagine, I said ‘NO!’ to any requests of me to give a presentation, which reinforced my fear & feeling of being powerless in the face of it. However, when I accepted my first professional job, which I was very excited to begin, I was told that I would be giving public talks as part of my new job. The jig was up. I had to figure out how to overcome my public speaking anxiety.

Fortunately for me, I had studied the nature of anxiety disorders and their treatment and the related research in Clinical Psychology graduate school. I intellectually understood the facts that I am sharing with you in this article. Now I had to ‘walk my talk’.

I understood that I had to be willing to feel fear and feel like fleeing the event while at the same time beginning my presentation, and that by doing so the anxiety would begin to diminish. I knew that I could ‘take the edge off’ of the anxiety by regulating my breath and moving my body while speaking.

Most powerfully of all, I put my faith in the knowledge that accepting my discomfort and fear as distressing but NOT dangerous, and relaxing my resistance to feeling that way would stop the anxiety from escalating further, and would allow it to level off and begin to fade away. I began to say ‘yes’ to invitations to speak in public, knowing full well that I would have to endure several minutes of feeling afraid, but that I would then quickly grow comfortable.

Ultimately, I discovered a part of me I call my ‘inner ham’, a part that actually enjoys being up in front of a group of people. I went on to present at numerous medical conferences at highly prestigious institutions, each time being among the most highly rated presenters by the participants. Confronting my fear of being embarrassed or humiliated in front of the public led to my involvement in a weekly live radio show, and co-authoring a weekly health & wellness column in the Ann Arbor News.

Enough about me! I just wanted you to know that I can truly relate to what you are experiencing, and that I have personally put into practice in moments of intense anxiety the information and techniques I am writing about in this article.

So far in this article I have addressed the range of anxiety from helpful levels of worry, all the way to escalating anxiety and panic. You learned that anxiety is a normal part of our ‘fight or flight’ response (the ‘flight’ part), and that it is not dangerous. Nature meant for fear to be uncomfortable and to drive us into life saving activity.

You have also learned that if a high level of anxiety is experienced in the absence of an obvious clear and present danger, you can quickly escalate the level of anxiety, even to the point of panic or a trip to the emergency room thinking we are having a heart attack.

Next post in this series: “The Anxiety Disorders“

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By GlennB | Posted in Anxiety, Therapy & Treatment Options | Tagged Anxiety | Comments (0)

“Panic: When Anxiety Itself Is the Threat”

December 31, 2009 – 2:58 pm

This blog post is the third in a series of posts that are excerpts from my full length published article, ‘Five Simple Steps To Managing Anxiety’ available for immediate download from my website by this link: http://www.glennburdick.com/anxiety_help.htm

Panic: When Anxiety Itself Is the Threat

Depending on just how threatened a person feels about a situation, the level of anxiety triggered can be anywhere from ‘nagging’ or ‘annoying’ to outright panic. If your survival substances are released but you are not aware of any real danger at the time this can cause you to feel even more alarmed, thus releasing even more of the same. It’s as if the brain says, ‘with all of this fear there must be a real life-threatening danger at hand!”

Some people will fear that this feeling will continue escalating without end, and that they might pass out, or go crazy. Others focus on the physical sensations triggered, such as pounding heart, shallow, rapid breathing, tightness in the chest, feeling dizzy, etc.

Many people head for the emergency room when these sensations are present, fearing a heart attack or stroke is in process. In fact, some experts believe the symptoms of up to 50% of individuals visiting an emergency room concerned that they are having a heart attack are really caused by stress or anxiety and not any serious physical problem.

Everyone has a threshold of anxiety beyond which they get motivated to do something about it. The bottom line is this: If you believe your anxiety will keep escalating until you pass out, have a heart attack or go crazy, you inadvertently trigger a panic attack. Who wouldn’t be alarmed if they believed one of those outcomes was really about to happen?

Next post in this series: “What We Resist, Persists“

(photo credit: JAMALadi)

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By GlennB | Posted in Anxiety, Therapy & Treatment Options | Tagged Anxiety | Comments (0)

The “Work” of Worrying

December 30, 2009 – 12:25 pm

This blog post is the second in a series of posts that are excerpts from my full length published article, ‘Five Simple Steps To Managing Anxiety’ available for immediate download from my website by this link: http://www.glennburdick.com/anxiety_help.htm

The “Work” of Worrying

There was a very interesting research study conducted several years ago on children who required surgery. The researchers studied children who were scheduled for surgery and their pre-surgical and post-surgical style of coping.

They identified three types of coping style: the ‘macho’ child was characterized by the attitude, ‘I’m not afraid of anything, let me at it.’ The ‘terrified’ child was overwhelmed with anxiety, clinging to mom’s skirt and sometimes pleading for the surgery to be canceled. The ‘appropriately worried’ child wasn’t crazy about the idea of surgery, but was characterized by the attitude, ‘I’d rather not have to do this…do I really have to? OK, then let’s get it over with.’

The researchers studied which of the three types of children coped better with the surgical procedure and had a speedier and less complicated recovery. Guess which type of child did the best? Nope, not the ‘Macho’ child, contrary to common sense, they actually did the worst! Next best was the ‘terrified’ child. That’s right; the ‘terrified child’ coped better than the ‘Macho’ child! Best of all was the ‘appropriately worried’ child.

The researchers theorized that there is a level of anxiety that is required to engage one’s coping resources, and that too little anxiety/worry fails to engage effective coping, yet overwhelming anxiety/worry interferes with optimal coping. So there you have it…worry, though uncomfortable, may well be necessary for effective coping, but overwhelming anxiety or panic clearly interferes with it.

Next post in this series: “Panic: When Anxiety Itself Is the Threat“

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By GlennB | Posted in Anxiety, Therapy & Treatment Options | Tagged Anxiety | Comments (0)

“The Good News About Anxiety”

December 30, 2009 – 11:55 am

This blog post is the first in a series of posts that are excerpts from my full length published article, ‘Five Simple Steps To Managing Anxiety’ available for immediate download from my website by this link: http://www.glennburdick.com/anxiety_help.htm

The Good News about Anxiety

You are supposed to feel afraid. Honest! Under certain circumstances your level of fear is supposed to increase to uncomfortable levels. Every human being is ‘wired’ that way, and thank goodness.

Imagine how life would be if we had no internal warning system telling us when danger was at hand. That would be like not having a reflex that causes us to instantly pull our hand back from a hot stovetop.

Nature in its infinite wisdom has given us all a self-protective device alternately called the ‘fight or flight’ or ‘emergency’ response. This device dumps the equivalent of rocket fuel into our bloodstream and is meant to cause us to fiercely attack something dangerous or run away like a ‘bat out of hell’, in both cases saving our precious life.

These substances entering our system are not supposed to feel comfortable, or even tolerable. They are supposed to propel us, way faster than we can possibly think, into a short burst of life-saving activity. This has worked really well since the days of dinosaurs and saber tooth tigers. Feeling fear in the face of real danger is no accident. Read More »

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By GlennB | Posted in Anxiety, Therapy & Treatment Options | Tagged Anxiety | Comments (0)

“If we were right for each other we wouldn’t be having these problems and we should probably just get divorced!”

December 30, 2009 – 11:14 am

There are many myths about marriage that cause confusion and doubt. One such myth is that a ‘good’ marriage would be nearly conflict free and should be more or less effortlessly romantic, and require only minor tune-ups along the way. How many marriages do you know that work this way? In fact, some of the best research on marriages paints a different picture (more on the research in a future post).

Even in the best marriages there are behaviors and characteristics of one’s partner that you just have to accept, even though they frustrate, irritate and irk you. Then there are more general issues, like the fact that approximately 85% of the time it’s the wife that brings the emotional issues to the table, not the husband! That’s certainly not fair, even if it’s the way things typically work even in a good marriage.

The fact is there will always be conflict when two or more people live in close contact with each other. Each person has their own individual inner world of experience, their own perceptions, their own preferences, wants and needs. And there will always be disagreements as a result of this very healthy individuality. Therefore, the fact that a couple has conflicts and disagreements doesn’t actually ‘prove’ anything about them. In fact, sometimes the couples with the least amount of conflict have the least amount of intimacy and passion. Many couples lead ‘parallel’ lives as co-parents, co-owners of a home, etc. but don’t have a truly intimate and fulfilling emotional or physical relationship. Would you really prefer that?

If you are experiencing uncomfortable amounts of conflict in your marriage, I strongly encourage you to learn the art and science of turning conflict into feelings of connection and intimacy. There is a very learnable process you can use when conflict arises that will keep it emotionally safe and result in feelings of understanding and real empathy. A couple’s confidence grows a great deal once they experience the power and benefits from being able to do this consistently. I’ve seen this make all the difference in the world for couples, even couples headed for divorce.

If you are starting to think that your two choices are getting divorced or suffering endlessly from emotional distance in your relationship, I urge you to get professional help in establishing this kind of communication in your marriage. Most people (including mental health professionals!) will need professional help working through the most upsetting, ‘touchiest’ issues in their relationship in this way. Even if you are on the brink of divorce it’s not too late to attempt this. At very least it can help the process of separation and divorce to be calmer and more respectful. A significant amount of the time it can actually take couples back from the brink of divorce and give them an inspiring future together and a positive path forward into the kind of connection they’ve always wanted. In your heart of hearts, if you really want an emotionally fulfilling intimate relationship with a partner, learning to move from conflict to connection is definitely the way to go!

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By GlennB | Posted in Marriage & Relationships | Tagged marriage, marriage counseling, relationship communication, relationships | Comments (0)

“Our Marriage Problems Are All My Partner’s Fault & They Will Never Change!”

December 15, 2009 – 12:25 pm

It can be incredibly demoralizing to repeatedly approach your partner with your hurt feelings, disappointments, and frustrations, and just get a defensive reaction from them! If your partner seems to not care about your feelings, can’t listen deeply to you, and doesn’t seem willing to change the behavior you find so upsetting, what can you do about it…short of leaving the marriage? This is a question nearly every couple living unhappily or headed for divorce struggles with…and a very important one at that.

The fact is, we cannot make another person change. That is simply common sense. However, our partner can want to change in a lasting way if they really sense the suffering one of their behaviors is causing us. Our partner’s willingness and ability to change their behavior will typically only arise when we can both get past our defensive reactivity, and that requires the ability to communicate through conflict and arrive at genuine understanding and empathy for our each others’ experience.

Being able to put aside our defensive reactions and genuinely understand and be touched by each other’s suffering is a game changer. Many if not most couples cannot do this without professional help, but it is a common accomplishment of the right kind of marriage counseling.

I know, we were talking about your partner’s defensiveness, not yours, but the task is the same for all of us. Let’s take a moment and imagine what your partner is thinking and feeling that might explain why they are either oblivious to our needs or resistant to our requests for change. Are they feeling acknowledged, unconditionally loved, respected, and like their needs and feelings are being heard and appreciated by you? Perhaps they perceive your upset with them as a rejection, or a judgment that they are inadequate. Believing that would make most of us defensive! Therein lies the problem. In order to get through to our partner, we need to be able to express our needs to them in a way that doesn’t put them on the defensive, even though we are feeling mighty upset already. Not easy!

What can help to empower you in this situation? You can become a first-class communicator yourself! Once you learn how to much more effectively engage your partner in communication around your feelings and concerns your chances of having an impact will increase significantly. Just as importantly, you can learn to respond to your partner’s communication in a way that will cause them to feel accurately heard, validated, and cared about. This often has the effect of making them more willing to give you the quality of attention you need, and the heart-felt motivation to meet your concerns and needs in a way that works better for you.

It may not seem fair that you will have to take this on, and you may be right…it’s not exactly fair, but it may well get you what you need. It will require you to understand how your own behavior and communication style can improve. There actually are ‘ABC’s’ that you can learn about effective communication. This learning begins with finding the humility to realize that you have, perhaps without realizing it, also been contributing some to the problems in your marriage, even if your partner has been awfully difficult to live with. My mentor, Harville Hendrix, PhD, has often said, ‘you can be right, or you can be married!’

By the way, your partner may believe that all the problems in the marriage are your fault! Even in that case, learning to listen, validate and empathize with your partner can begin to reduce the distance between the two of you. Most of us will need the support of a relationship professional to accomplish this, but it is very empowering and satisfying to be coached in doing something that is actually working to turn the situation around. Ultimately both you and your partner will have to share this responsibility, regardless of who takes the first step.

Accepting that something of the greatest importance needs to be accomplished, regardless of who is ‘at fault’, is the first step. The next step is to learn what needs to be done and how to do it. Getting the right kind of help can make what seemed impossible, very doable!

(Photo Credit: bored-now) / CC BY-NC-ND 2.0

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By GlennB | Posted in Marriage & Relationships | Tagged counseling benefits, marriage, marriage counseling, relationship communication | Comments (0)