What is Anxiety?

Anxiety is a general term for several disorders that cause nervousness, fear, apprehension, and worrying.   These affect how we feel and behave, and they can manifest real physical symptoms such as a panic or anxiety attack where the sufferer experiences immense fear, shaking, difficulty breathing and increased heart rate. 

There are many symptoms of anxiety and it is very personal and different for everyone.  Here are a few to look out for if you think you may be suffering from anxiety:

  • Feeling worried or uneasy a lot of the time
  • Having difficulty sleeping making you tired
  • Not being able to concentrate
  • Being irritable
  • Being extra alert
  • Feeling on edge or not being able to relax
  • Needing frequent reassurance from other people
  • Feeling tearful
  • Pounding heartbeat / Feeling faint
  • Breathing fast / Sweating 
  • Palpitations / Chest Pains
  • Feeling Sick / Butterflies In Your Tummy / Loss Of Appetite
  • Headaches

Whilst some anxiety and stress, for example before an exam can be normal and manageable, longer term exposure to stressful situations increases anxiety can lead to an anxiety disorder developing. 

There are a number of different anxiety disorders which include:

Generalised involves excessive, unrealistic worry and tension event where there is little or nothing to provoke the anxiety.

Panic involves feelings of terror that strike suddenly and repeatedly with no warning – known as panic attacks. This disorder can have other symptoms which are physical such as sweating, chest pain and often the person feels they are either having a heart attack or are going to die.   Often the sufferer feels the needs to escape or to run away – which is a classic fight or flight symptom which is instinctive in us all.

Social anxiety involves overwhelming worry and self-consciousness about everyday social situations centred around the fear of being judged by others

Specific phobia involves an intense fear of a specific object/situation (eg. Snakes or flying)

When we are anxious our bodies go into a heightened state of awareness and invoke the “flight or fight” response which will trigger a flood of stress hormones like cortisol designed to enhance your speed, reflexes, heart rate, and circulation to quite simply prepare you to either stand up and tackle the situation, or retreat away from it.

Even though the fight or flight response is automatic, sometimes it isn’t accurate particularly if you are in a perpetual state of stress.  Sometimes when the fight or flight response is triggered it is a false alarm – there is no threat to survival. The part of the brain the initiates the automatic part of the fight or flight response, the amygdala, can’t distinguish between a real threat and a perceived threat.

Specifically anxiety attacks relate to a sudden burst of acute anxiety usually accompanied by a number of physical symptoms (accelerated heart rate) and catastrophic thoughts – i.e “I fear I’m going to lose control”) and can last anything between 10 and 30 minutes, although for the individual experiencing them they can seem to last forever, once it does pass it leaves the individual feeling weak and exhausted.   The attacks can either occur unexpectedly and not associated with a situational trigger or when the individual is in a specific situation that they know will trigger an attack.

How can I help?

The first step after you contact me (either by phone or email) will be a brief telephone conversation with me. This is so you can raise any questions or concerns and share a little about your situation. Each and every telephone call is conducted in strict confidence.  If you feel uncomfortable with a telephone conversation, please express this on an email and we can organise your initial free consultation in person.

Following this, you can choose whether to book in sessions with me and we can discuss how and when these will happen.  The initial consultation is designed to give you freedom of choice and to ensure you are comfortable talking and working with me

Your first session will give you the chance to talk freely in a calm, quiet and completely confidential environment to explore your situation and how it impacts you day to day.    I look to understand what you hope to achieve from therapy and from this we can explore some techniques and ideas to help you to achieve improved health and wellbeing, so you are armed with a unique set of tools that you can use to continue to feel well.   Most importantly I work at a pace and frequency that feels right for you with regular check ins to see how you are progressing.

More information on my approach can be found here.

Case Study

Client “DC” came to me presenting with anxiety and specifically panic attacks.  He had been travelling on public transport and suddenly started experiencing panic, fear and a feeling of losing control and wanting to escape along with some other unpleasant physical symptoms.   A classic sign of a panic attack.   We explored what had happened, and I spent some time explaining what happens when we experiencing an panic attack, reassuring him that this is a normal response that is innate within us all (known as a fight or flight response and is triggered when the brain perceives we are in extreme danger).  DC had been experiencing some prolonged stress in his life when we are under continual stress the brain receives mixed messages believing that there is a threat and can trigger the fight of flight response.

We worked on some relaxation techniques to help begin to reduce some the stress that he was feeling, and calm the brain down of the continual racing thoughts and fear of experiencing another panic attack.  Often the fear of another panic attack can slowly begin to make you withdraw from partaking in any activities because of the fear of it may happening again is too much to bear.  

I introduced him to some other techniques I use with clients which, with practice, can also help stop the onset of a panic attack, or if one starts can help stop it in its tracks.    Below is a summary of just a few of the techniques I used with them:

The anchoring technique has a variety of uses, think of rugby players Jonny Wilkinson’s stance when he is just about to take a kick – clasped hands – he has been taught this technique to help him keep focus and confidence to hit the ball over the posts.   Our brains make associations through external stimuli which we either see, hear, feel or smell – think the smell of popcorn and your brain will have made the association of being at the cinema, think the smell of candy floss and you make the association of being at the funfair- or hearing a favourite song may conjure up memories of your wedding day or another pleasant memory.

Anchoring is a simple way to allow you to change an unwanted feeling to a resourceful feeling in a matter of moments. When you create an anchor you set up a stimulus response pattern so that you can feel the way you want to, when you need to.

With client DC I helped him anchor the feelings of calm onto a pebble asking him to illicit a strong feeling of when he felt incredibly calm, for him it was a a particular memory of an event when he felt calm and happy .  He kept the pebble in his pocket and every time he felt anxious he could reach into his pocket and feel the smoothness of the pebble, and instantly recall that memory which he had anchored leaving him calm and happy.

This is a great technique to implement when you either feel a panic attack coming on, or one has started.   Using the acronym STOPP:

S is for Stop – Dont act immediately – wait

T is for Take a couple of deep breaths slowly in and out

O is for Observe – what am I thinking about?  what am I focusing on? what am I reacting to? what am I feeling in my body?

P is for Pull Back –  Zoom out! See the bigger picture. Is this fact or opinion? Is there another way of looking at this?  What would someone else say about it? How does this affect others?  What advice would I give a friend in this situation?  How important is this situation right now?

P is Practise what works.   Consider the consequences.What’s the BEST thing to do? Do what will help most!

Client DC had a specific event (travelling on public transport) which had triggered an anxiety attack – he was naturally very fearful of repeating it in case it triggered another panic attack, he then became even more fearful of going out just in case he had another attack.  First we established what I call a “safe place” with the client, this means asking them to identify a place, a feeling or event where they felt completely safe just in case the next step felt too overwhelming they could relive that memory and feel safe and secure throughout the process.  Working with the original event I asked him to close his eyes and imagine playing out the scene of him getting on the bus, experiencing the anxiety from start to finish, watching the scene playing out on a TV screen like a movie with him being the centre of the movie.  Afterwards I asked him to imagine the movie of the event in reverse (like rewinding the movie), watching it backwards and forwards, then adding some silly music, or silly voices to the scenes.  The objective of this exercise is to have the client disassociated from the event to begin seeing the event in a different light, and start to reduce the feelings and desensitise himself from the feelings he was experiencing.  It is a very powerful technique to help clients with anxiety when there is a actual event where the anxiety first happened.

This technique you can do absolutely anywhere, and with any colour.   It flicks you out of stress-head mode and into your surroundings.    An it’s kind of a fun distraction from whatever you are worrying about.

  1. Choose your favourite colour.  
  2. Look around you to find the most obvious or closest example of something of your favourite colour.
  3. How many things can you see of your favourite colour – look for other things big things, little things, someones jacket, a pained door, a piece of rubbish on the ground.  Keep count.
  4. How many things can you imagine in your favourite colour?   If there is somewhere you can sit down quietly, try closing your eyes and seeing how many things you can imagine in your favourite colour.

I luckily found Karen while going through a difficult time, from the first session she gave me ways to start thinking positively and gave me different processes to help keep anxiety down. Through being able to talk to Karen openly I was able to work out what was causing my anxiety which was a big help in turning things around. I would recommend Karen at Mind Calm to anybody who feels they could benefit from therapy.

Client DC - Milton Keynes

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