Peter Young Counselling

Articles

Tips for Managing Anxiety – lessons from my own treatment for my fear of flying. [PDF]

Grief and loss – a personal story of pushing the fish hook through. [PDF]

Finding Your Way - navigating through the uncomfortable feeling of not knowing what to do in your life. shim[PDF]

Lowering Background Anxiety - explores the idea of background anxiety, and suggests strategies for lowering anxiety levels to help reduce the risk of depression or developing an anxiety disorder. [PDF]

Changing Your Daily Habits - why habits matter and the importance of balance in your life [PDF]

Help with Addiction – learning to tolerate discomfort as a tool to break an unhelpful pattern [PDF]


anxiety tips textARTICLE – FEBRUARY 2016

Anxiety is the most common mental health condition in Australia.  On average, 1 in 4 people – 1 in 3 women and 1 in 5 men – will experience anxiety (according to Beyond Blue).  I am one of the 20% of men who have experienced anxiety. 

For many years I worked in a job that required regular air travel.  This job was fairly pressured, and I would describe myself at the time as having an elevated background anxiety level (see my other article on this topic, Lowering Background Anxiety). Having a heightened background anxiety level made me more vulnerable to a panic attack, which eventually happened on one particular flight out of Canberra.  Because I was already very anxious, a loud, unexpected noise after take-off pushed me over the line between manageable and unmanageable anxiety.  I remember what sounded like a deafening noise - at the time I thought it was the noise of the plane exploding - and a certainty that this was the end of my life.  I was convinced that I was dying, which is not uncommon for people who have a panic attack.   This was the beginning of my phobia about flying. 

Even though my job required me to continue to travel I was very resistant to seeking treatment for my fear of flying.  I had a suspicion (well-founded as it turned out) that treatment would eventually require me to get back in a plane, and this was something I was unwilling to face.  I recall that my fear was less about flying and more about having another panic attack.  My anxiety was about the fear of repeating that feeling of being overwhelmingly anxious, and understandably so.  Who wants to repeat the feeling that they are dying!  This fear of the feeling of anxiety is also very common amongst people with this condition.

I was fortunate at the time to seek treatment from a kind and wise psychiatrist who specialised in the treatment of anxiety.  He convinced me that anxiety is very treatable, and that even though the journey might at times be uncomfortable, it would never be unbearably uncomfortable, and eventually it would be successful and I would be able to fly again without having to fear having another panic attack.  I might even enjoy flying, he said.  The strategies outlined below are an adaptation of those that worked for me, and that I have subsequently used with others seeking help with anxiety.  I hope that you find them of help.

1. Understanding what anxiety is.

The starting point for my treatment was to understand that anxiety is a normal, helpful survival mechanism.  Anxiety in its most useful form keeps us safe.  It is the early warning feeling of unease that there is danger – a danger that we may not yet have consciously identified.  For example if you are about to walk down a dark and unfamiliar street at night, a feeling of anxiety might help alert you to possible risks that you had not otherwise thought about.

I also found it very helpful to understand the bodily aspects of anxiety.  When we sense danger our automatic bodily responses quickly prepare us to run, fight, or freeze as defences against that danger.  This automatic process happens more quickly than our conscious thinking process.  Before our brain has even made sense of the potential source of danger our breathing, muscle tone, blood supply system, and our vigilance (hearing and seeing) are all activated and ready to keep us safe.  This can be very helpful (life saving perhaps) in some situations.  But in other cases this hyper-arousal is not needed, and calming ourselves after being activated in this way can take quite some time.  Knowing about this bodily arousal process, that it is a helpful survival mechanism and that it happens quickly and unconsciously, was very important in understanding how I developed my fear of flying, and why calming myself physically was so important to fixing this problem.

2. Interrupting the process of becoming anxious due to an event such as an unexpected noise.

There are all sorts of potential triggers that can lead to the process of escalating anxiety.  For me this was primarily related to flying, but if we are in a very heightened state (if we have elevated background anxiety) even loud noises can trigger an anxiety response. 

When you notice yourself starting to become anxious it's possible to interrupt this process with a combination of physical strategies, and strategies related to your thoughts.  Of these two approaches, the physical strategies are often the easiest and most effective, which is why I give this aspect such a lot of prominence in this article.

Some quick and simple physical strategies you can use to interrupt the escalation process when you notice yourself becoming anxious are:

3. Lowering your background anxiety levels.

Interrupting yourself when you start to escalate (start to become anxious) takes practice, but the physical strategies listed above definitely help.  The other longer term work in the treatment of anxiety is to lower your background anxiety levels.  This is not a quick fix.  It may take weeks or a month or more before you start to notice any real improvements.  But I am very confident that these strategies will help if you can stick with them.  For me, incorporating regular aerobic exercise in my life has been the most helpful.  I am now very aware that if I have not done a 30 minute jog in the last two or three days I start to find it less easy to go to sleep at night.  This has become my key strategy for keeping my background anxiety level down.

I talk about this a more in the article on my web site (http://peteryoung.net/articles.htm#anxiety) but here are some simple reminders:

4. Dealing with anxious thoughts

In terms of strategies related to thought processes, the most common strategies are based on Cognitive Behaviour Therapy (CBT) and Mindfulness.  Controlling our thoughts is not as easy as controlling our bodies, and sometimes the easiest and most effective method of slowing our racing minds is to focus instead on calming our over activated body.  By calming our bodies using the strategies discussed above we will indirectly calm our thought processes.  One way of thinking about this is that our brain takes cues from our body.  If our brain sees that our body is activated for fight or flight it starts to look for possible sources of danger.  We start exploring possible scenarios – in my case scenarios such as a mechanical failure in the plane or pilot error.  And quite naturally these catastrophic thoughts result in us feeling more and more anxious.  Conversely by calming our body our brain gets the message that the danger must be abating, and we have fewer and fewer catastrophic thoughts.

As part of my treatment for fear of flying I developed a list of thoughts to counter my most common catastrophic thoughts.  An example might be, “Statistically the car trip to the airport was much more dangerous than this flight”.  I wrote these thoughts on a small card that I carried in my wallet.  On the other side of the card were reminders about the physical de-escalation tips discussed above.  This card was a critical factor in the success of my treatment.  I never needed to refer to my card – to take it out and read it mid-flight.  But I knew it was there, and I knew that the strategies on this card worked.  The card was my physical reminder that I was not in danger of spiralling into another panic attack – that I could interrupt this escalating process through a combination of physical strategies and reminding myself of alternate thoughts.

Treatment for a specific phobia such as a fear of flying can be a little more straight forward than treatment for more general feelings of anxiety.  In particular, identifying and refuting the contributing anxious thoughts can be harder with general anxiety, as there is not the same focus such as thoughts related to flying.  There are some good on-line programs that can help with this process of identifying and challenging the thinking associated with more general feelings of anxiety.  The following link is one such example: https://thiswayup.org.au/

I hope this article has been helpful to you.  I am aware that my story of success will give hope to some people, but for others it may have the opposite effect – particularly if you have already unsuccessfully sought help with your anxiety.  I was lucky in that the first person I went to for assistance was someone who was both skilled and who I felt comfortable with.  This second criteria (feeling comfortable with the counsellor) is critical in counselling generally, but even more so when dealing with anxiety.  When we seek help with the treatment of anxiety we are making a decision to face our biggest fear.  For me there was a deep worry that the counsellor would expose me to my fear in an uncontrolled or poorly timed way, and this would trigger a panic attack (my greatest fear).  And there was also a degree of shame involved, as I was wrestling with a fear that most people considered to be quite irrational.  I therefore had to trust the person I chose to work with on this important and sensitive topic.

Finding the person who is right for you may involve research, seeking recommendations from trusted sources, possibly a degree of trial and error, and ultimately a belief that this problem is fixable.  On this last point, please rest assured that there is solid research evidence that anxiety is very treatable.  Best wishes with your journey.


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griefARTICLE – FEBRUARY 2014

My mum passed away just over a year ago, and my dad died two years before that.  I’d previously read about grief, but the lived experience was unlike anything I could have imagined.
For months after my parents died I had a very strong sense of unease.  Sometimes I was sad.  Other times very irritable and short tempered.  And for much of the time I had an ill-defined sense that all was not well.  I knew I was out of sorts, and I also knew that this was a feeling that I had never experienced before.  It was unchartered territory, and very unpleasant in part because of this newness.
A few months after my mum died I had a very vivid and powerful dream.  In the dream I had a fish hook caught in my finger.  I pulled and pulled to get it out.  Pulling against it hurt a lot, and it didn’t seem to help at all – the hook was stuck.  I still remember the chilling awareness I had the moment I realised that the only way this hook was coming out was by me pushing it through my finger.  It was frightening to realise that I would have to cause myself more pain in order to be free of this hook. It seemed both counter-intuitive and terrifying (I’m not good with pain it seems).
I also realised that now was not the time to attempt this dreadful procedure.  My finger was swollen and tender from my attempts to pull the hook back out the way it had gone in.  I needed to let it settle for a bit, to let the swelling and soreness subside.  And I knew that I would also need a kind and wise helper to support me through this delicate procedure.  The prospect of pushing the fish hook through my finger was overwhelming, and I couldn’t imagine facing that task alone.
When I woke up I knew I had been dreaming about my grief.  The dream gave me permission to bandage up my grief for now, and attend to it later when the pain and swelling was less intense.  I also had an awareness that I couldn’t keep this painful injury bandaged up forever.  At some stage I would have to push the fish hook through.  But with a helper (or helpers) this was an achievable task – not pleasant perhaps, but also not unbearable.
In the early stages of my grief my “fish hook” throbbed, and if it got bumped the pain was terrible.  Bandaging it up gave some protection from these accidental bumps.  I stopped doing counselling work for almost a year.  I reduced my study commitments, and fortunately my employer also helped by scaling back my workload.  And when I felt stronger I organised more joyful things in my life. 
On writing this now (a year down the track) it feels like the fish hook is still there, but the swelling and soreness has largely gone, and I am slowly pushing it through.  I am grateful that the uncomfortable and ill-defined sense of unease has also largely subsided. 
I am conscious of the risk of giving advice based on my own experience.  Everyone is unique, and each of us have to find our own path.  But I wonder if there are some lessons about grief from my experience that might be applicable to others:

This last point is not intended to be read as an advertisement for counselling, although for some that might be helpful.  My experience is that gently revisiting memories of my parents (for example looking at family photos) has helped to slowly push the fish hook through, as has talking to family and friends.
If you are in the early stages of grief I hope my story gives you hope that the fog will slowly clear. 


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help with addictionARTICLE – OCTOBER 2013

Addiction can take many forms, and substance use (drugs and alcohol in particular) and sex are both common forms of addiction.  My sense is that addiction is similar to depression in that it is a pattern of thinking and behaviour that becomes stronger with repetition.  Like depression, addiction can be a harder problem to overcome if not identified and interrupted early.  Think of a car driving back and forth over soft ground.  Eventually deep ruts are created in the ground, and the capacity to turn the wheel and break out of these ruts gets more and more difficult (but not impossible!). 

In his helpful, simple guide to the managing anxiety, depression and addiction, Steven Melemis (2010) suggests that addiction has a strong genetic element, and that some people are much more susceptible to addiction than others because of this genetic predisposition.  In simple terms, if you have family members (in particular parents or grandparents) who experienced addiction, then you may be at greater risk yourself.

It sounds worrying I guess.  My point is not to alarm or discourage.  Rather, the encouragement is to do something once the problem is identified. 

Melemis provides a simple framework for the treatment of addiction.  He says that naming addiction (and acknowledging that one is an addict) is an important first step.   Our minds are good at playing tricks on us.  A person experiencing depression will at times be convinced that nothing good will ever happen in their life, and also that no treatment will be successful.  Similarly a person experiencing addiction will often have a story to support this addictive behaviour – that they need their addiction to manage, that they deserve a treat from time to time, that it’s not really a problem. 

Melemis goes on to propose a number of strategies based on an abstinence model.  He suggests that one needs to spot the early warning signs of relapse before one gets to the stage of toying with the idea of the addictive behaviour – early warning signs such as feeling tired, hungry, lonely and sad.  Once these precursors develop into ruminating about using drugs or having a drink (for example), the opportunity to interrupt this downward spiral is much reduced. 

Pema Chodron is a wise Buddhist nun who outlines what I feel is a very helpful, related framework to understand and treat addiction.  She uses the analogy of a child with scabies.  If the child gives in and scratches the itching scabies, then the scabies will spread and the problem gets worse.  The child has to be convinced to sit with the discomfort of the itch.  Pema Chodron encourages the use of meditation as a strategy to help learn to sit with discomfort.  She also uses a powerful and simple extension to this analogy – she suggests that you ask yourself, “Do I want to bleed to death?”  Continuing to scratch the itch can only end one way.

Similarly, one of Melemis’s strategies is to encourage people wrestling with addiction to be honest about where their addiction is taking them, and to have an alternate desired future goal - the future without addiction.  He suggests that one might need to lean on this as a motivator (that is, to think about what you are giving up long term) when tempted by thoughts of returning to the addictive behaviour.  He sees this long term perspective as a useful counter to the short term lure of addiction thoughts that wrongly suggest that “just once won’t hurt.”

The last part of the puzzle is to attend to the pain that sits under the addiction – the deep sadness that often fuels the need to self sooth.  Breaking out of an addictive spiral requires attending to this pain as well as treating the symptom of addiction.  It also requires being gentle with oneself about one’s addiction, as the shame of addiction is adding more pain to this underlying sadness.  Addiction is treatable - one step at a time.

Two great resources to help with addiction:

“I Want To Change My Life: How to Overcome Anxiety, Depression and Addiction,” by Steven Melemis (2010).  Available on-line from Amazon or the Book Depository for less than $20.

“Getting Unstuck: Breaking Your Habitual Patterns & Encountering Naked Reality,” audio CD by Pema Chodron, available from http://pemachodronfoundation.org/buy-cds-dvds/#unstuck

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findingARTICLE – SEPTEMBER 2013

One of the challenges facing quite a few people in the early to mid 20’s is an uncomfortableness of not knowing what to do with their lives, combined with a feeling that they should know. The feeling of being a bit lost and directionless can be hard to bear sometimes. But add to this a belief that there is something wrong with you for being in this situation, and life can be very difficult.

Navigating out of this situation takes a two pronged strategy. Part one is to normalise the situation. There is nothing wrong with you for feeling unsure about what to do with your life. Some people take longer than others to find their thing. There is no right and wrong. Being gentle and accepting of yourself is a good start in terms of moving forward.

The second part of the process is to recognise that the answer to the question, “What should I do with my life?” will be found through a form of trial and error, rather than by sitting and thinking. Adults learn through reflecting on experiences, identifying the lessons that emerge from this reflection process, putting these insights into practice, and then reflecting on what comes out of this new experience. This is called the Experiential Learning Cycle, or Kolb Cycle (named after David Kolb, who first wrote about this process).

Each of these steps are important in the learning process. 

Firstly you need to be doing something in order to create opportunities to discover what you like, what you are good at, what you don’t like, and ultimately what sorts of work (and work environments) you would and would not like to do in your next job. If you don’t do something (anything) then you won’t have any experiences (data) to reflect on, and this makes progress very difficult. Also, doing nothing can lead to social isolation, and to feeling bad about yourself. The sadness that can result from this can add another layer of hardship to an already difficult situation. 

Acting, however, is not sufficient. You need to take time to reflect on this experience. Some people reflect best by keeping a diary or journal. Others find talking a good way to reflect. The goal is to recall experiences – what do you like about your current job or study (and what are you good at – these are often the same thing), and what do you not like. Try to be specific. For example, focus on what aspects of a task might be most enjoyable, rather than simply naming the whole job as something you liked or didn’t like.

Step three is to identify the lessons that emerge from this reflection process. This involves noticing recurring themes or patterns that might help you identifying deeper truths about yourself. For example, if you notice through your reflections that the aspect of past jobs that you have enjoyed the most are the contacts with people, then this insight (that you get energy and pleasure from regular people contact) can help you when choosing your next job.

Lastly, act on these insights. Can you identify some paid or voluntary work (or perhaps an internship of some sort), a hobby, or a course of study that gives you more of the things you like and are good at, and less of the things that you don’t like? The key with this stage is not to see this as a search for the perfect answer (your “thing”). Rather, the goal is to take another step – ideally a step to a role that is more closely aligned to your skills, interests, abilities and passions.


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anxietyARTICLE – NOVEMBER 2010

Keys, check, wallet, check, mobile, check, anxiety, check. Okay, let’s go.

Each day as you head out the door to work, study, or have fun, you carry with you a level of background anxiety. This is the anxiety level that is your resting state – the base from which your anxiety will spike up when something stressful and/or unexpected happens. Anxiety is normal, but it is important to be aware of how much anxiety you are carrying. And if you are carrying a lot of background anxiety it is worth taking steps to lower this resting anxiety level.

So how do you know if you are carrying too much background anxiety? Why does it matter? And what can you do about it?

If your background anxiety levels are high then it won’t take much stimulation for your anxiety levels to spike up into the uncomfortable range. For example, if you are already anxious then a loud, unexpected noise like a door slamming will trigger a much more uncomfortable response than if you had a lower background anxiety level. Higher background anxiety levels can also make sleeping more difficult – either getting to sleep, or waking up during the night with your mind racing. And trouble concentrating during the day, lethargy, and heightened irritability can also be signs that you are carrying too much anxiety around with you.

There are risks if you have significantly heightened anxiety levels for long periods of time. As well as the day to day symptoms listed above, living with elevated background anxiety levels places you at much greater risk of developing an anxiety disorder (such as a phobia), and also can place you at greater risk of developing depression.

“Great, one more thing to worry about,” I hear you say. The good news is that understanding anxiety is the first step to taking control. And there are a number of simple strategies that will give you immediate improvements in lowering your background anxiety levels.

Anxiety is something that we carry with us in our mind and body, and the two are inter-related. Our minds and our bodies talk to one another. Anxiety is carried physically in areas such as tensed muscles (for example tight shoulders and neck, or knotted stomach); elevated heart rate; and shallow, fast breathing.

The physical manifestations of anxiety are the result of our fight or flight instinct. At the first hint of danger we release adrenalin in preparation for potentially life-saving action. Our bodies start responding to this chemical awakening in preparation to run or fight for our lives. We are alert and activated. During periods of activation (fight or flight preparation) our senses become hyper-vigilant. We notice noises and movements, and our brains race to make sense of our environment.

These physical responses to danger happen more quickly than our conscious thought processes. Our brains notice our bodies in this heightened state of activation, and start to search for possible reasons. Sometimes these explanations are accurate and helpful, but other times our brains add one and one together and get three. Once we are convinced that the danger has passed our bodies start to slow down again.

This process of stimulation, chemical release, body activation, and then slowly calming down, happens every day. The activation phase happens very quickly, and the calming phase happens much more slowly as the chemicals released during activation gradually wash through your body. If you get stimulated again before you return to your resting anxiety level, your body will spike up higher than before because you started from a point of heightened anxiety. The risk is that you continue to get re-stimulated before you get a chance to calm down, and over time your resting or default anxiety level becomes higher and higher.

The good news is that there are many things that can be done to lower your background anxiety levels.
Twenty minutes of vigorous exercise that elevates your heart rate can help to use up the chemicals released during your period of activation. This speeds your return to your resting anxiety level. Vigorous exercise means different things for different people. If you are new to exercise then a fast walk for 20 minutes will do the trick. If your body is fitter then you will need to run for 20 minutes to get the same anxiety reducing benefit. Massage and yoga (self-massage) are also great strategies to calm your body and lower your background anxiety levels. Cutting down on caffeine is another way to lower your background anxiety levels, but I’m not advocating coffee abstinence (that would be impossible!).

Calming your mind can also help to break the anxiety cycle, and regular, guided meditation can help. So can other pursuits that get you out of your head and into the moment. I find riding my motorbike has the same effect – you have no option but to live in the moment. And I’m told surfing works, too.

So in summary, we all carry with us a level of background anxiety. Over time our background anxiety level can ratchet up through repeated stimulation and not enough time to calm down between these spikes. Heightened background anxiety can create uncomfortable symptoms like difficulty sleeping, but over time can lead to more serious problems like anxiety disorders and depression. Exercise, yoga, massage, and reducing your caffeine intake can all help in lowering your background anxiety levels.

© Peter Young, November 2010


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habitsARTICLE – OCTOBER 2010

Where we will be in 10 years time will be determined not so much by big life decisions, but more from lots of little decisions that are repeated over and over – our daily habits. Decisions about when we go to bed, when we wake up, what we do when we wake up (exercise or roll over for another half hour of rest), what we eat for main meals, and what we eat for snacks. Another important (and often unconscious) habit is how we comfort ourselves when we are sad or stressed. Food (or drink, or smoking) can play a part here for some of us.

What are your daily habits when it comes to food, exercise, socialising, work and fun? And are your daily habits in harmony with how you see yourself, and where you want to be in 5 or 10 years time?

Knowing about the power of daily habits is a good start, but it’s not enough. Change depends on three key building blocks - knowledge, motivation, and the emotional capacity to make positive changes.

The knowledge you need is partly understanding the power of small daily decisions, and also knowing about your body. What to eat. How to exercise effectively and safely. How to care for your health. Attending classes or being trained by a personal trainer can be a helpful strategy to build your knowledge about caring for your physical self.

Motivation comes in part from having short and long term goals, and tracking your progress towards those goals. Long term goals might relate to your work, your financial position, your health, or your relationships. Shorter term goals might relate to changed behaviours (new habits) and stepping stone changes such as reaching a savings target, becoming fitter, or toning up your body. Knowing where you want to get to, having a plan of how you intend to get there, and monitoring progress along the kway are all part of building and maintaining motivation.

But having goals, having plans of how to achieve those goals, and measuring progress are not enough. Your emotional capacity will ultimately determine whether your best laid plans come to fruition. How many times have you started down the road of changed habits and then slipped back into old and ultimately unhelpful patterns? It’s hard to stay motivated when you are lacking in positive energy. And it can also be hard to stay motivated through inevitable and quite normal periods of melancholy, when old patterns often reassert themself.

So what is emotional capacity? Perhaps a better term might be emotional settledness. It is the extent to which you have made peace with the various bits that make up who you are – in other words, to become more integrated as a person. If you can spend less energy on these private, internal conflicts you will have more energy to pursue positive pursuits that ultimately help you towards your goals.

Similarly if you can learn to be more gentle and loving with yourself, you will have greater capacity to be forgiving of yourself during difficult periods. Self criticism for being sad, for example, can deepen and prolong periods of sadness, and can help to bring on unhelpful self-soothing patterns – some of the old and unhelpful habits you might be trying to change.

Different streams of counselling approach change differently. Gestalt therapy talks about achieving greater self-integration through self knowledge and self acceptance. This is what is called “the paradoxical theory of change”. People often come to counselling because they want to change an aspect of who they are. But change comes from better knowing yourself and through learning greater self acceptance. Self acceptance makes change less necessary and more possible (hence the paradox).

Where you are heading is ultimately a product of your daily habits. And reshaping these habits can be helped through knowledge, motivation, and emotional settledness. The last of these three building blocks is often the most overlooked, and might be the most crucial for some people.

 
If you are interested to explore this topic of the power of habits, have a look at Steven Covey’s great book, “The 7 Habits of Highly Effective People.”

 

© Peter Young, October 2010

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