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I find that the idea of “Locus of Control” often comes up in treatment. (1)
A person with an Internal locus of control is said to believe that they have control over their own decisions and things that happen in their lives. A person with an external locus of control, believes that their personal decisions and things that happens in life, are determined by external factors (the situation that they find themselves in).
So, very often, in treatment, it is important to establish what things a person has control over, and what things a person does not have control over. I’d say in probably 70 to 80% of the people I see, there are distortions in their notions of control. Sometimes, they feel like they should be able to control everything. Even those situations which we have no control over. Other times, they don’t feel like they have control over anything, including any aspect of themselves.
An exaggerated notion of external locus of control is often associated with depression. An exaggerated notion of internal locus of control is often associated with anxiety and anger. The point is, that there are some things you can control in your life and within yourself, and there are other things that you cannot. As with many things in life, the point is finding the most realistic balance between the two. This is not something that is easily done, and will be a continual balancing act for almost everyone.
Fear and anxiety have to do with the future…something that has not yet happened. With fear, the danger is real…something bad could very likely happen. With anxiety, the imagined event is extremely unlikely to happen. Fear and anxiety feel different. If you’ve experienced both emotions intensely, you may know what I mean.
When a tiger is snarling at you, and looks poised to pounce, you don’t feel anxiety…you feel FEAR. It’s not a fear of snarling tigers, it’s a fear that the snarling tiger is going to maul you to death. It’s adaptive…it prepares you for action…to run away or to fight (Gavin De Becker’s Book, The Gift of Fear is a very good explanation of the purpose fear plays in our lives–minus the evolutionary psychology aspect).
Some examples of anxious thoughts are, “I’m going to make a complete fool out of myself.” “I’m going to be so embarrassed.” “I just have a feeling something horrible is going to happen.” “I think there is something wrong with my mind.” “I must be going crazy.” “This plane is probably going to crash.”
Some examples of fear-related thoughts are, “Uh oh! If I fall, I’ll probably die! [standing on the edge of a roof]“ “That dog is going to bite me! [snarling dog running at you]“ “This might be it. [car careening out of control]“
So both fear and anxiety share things in common. They are both ‘danger signals’ as Freud called them. And they both serve a purpose. Anxiety and fear both tell a person, “something is wrong be careful or be ready for action.” Just like physical symptoms are a communication, “I’m hurt…Something is wrong with my foot…[and so forth].”
Anxiety may not seem to serve any consciously identifiable purpose, but it does serve a purpose. The purposes are many and varied. Sometimes, it serves a purpose of keeping a person’s rage or anger in check. In other words, if they were to really speak their mind, there would be very negative consequences. Sometimes it is to force a person who is overly independent, to start to depend more on others. Sometimes, it is to maintain a less than mature way of dealing with the world. Sometimes, it is purely a communication about something traumatic that happened in the individual’s past.
Again, it is very specific to the individual. Sometimes the anxiety is organized around a traumatic event. Such as a person who had an early trauma with their testicles, might have unusual anxiety about their eye “balls.” They might have frequent dreams that involve balls (Chinese eggs, basketballs, footballs, and so forth). All of these concepts are connected on an unconscious level. That’s just an example, and the forms it can take are unlimited.
But to reiterate, anxiety is about things that are very unlikely to actually happen, and fear is about things that very likely could happen. Anxiety can develop in the vastly different experiences of human beings. Fear has to do with something that very well may happen.
Now, an interesting thing is that a moderate amount of anxiety is adaptive. ALL normally functioning human beings have some anxiety. It actually makes you work harder, and prepare more for the future. It becomes a problem when it starts to interfere with your ability to function. At that point, you want to seek some help.
We hold these truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty and the pursuit of Happiness. (1)
It’s so poetic, inspiring, and true. So, for the 4th of July, Independence Day, I’ll write a little about the effects of anxiety. What?? What does anxiety have to do with the Declaration of Indepence? Quite a lot in my opinion.
I teach my patients that the fundamental factor of anxiety is that it limits freedom. Freedom to choose to go where you want to go, or freedom to be in certain situations, or freedom to pursue life’s dreams, or freedom to stand up for yourself and say ‘no,’ or freedom to take risks in life, and so forth. That is the essential nature of anxiety….it limits freedom. I view my work as helping people get to a point where they can pursue the American Dream most effectively. Anxiety is one of the biggest limiting factors on this pursuit. Depression, though not always, can be an expression of the lack of this pursuit.
The thing to keep in mind about anxiety is, IT CANNOT HARM YOU IN ANY WAY. Folks who are anxious often believe that it can, “if I have just the right thought I’ll be permanently crazy,” “I’ll have a stroke,” “I’ll be permanently damaged,” “I’ll have a panic attack that will last the rest of my life.” The reality is, these things NEVER happen. If you are worried about going crazy, you won’t. Not ever. Even if you stop worrying about it. Folks who actually go ‘crazy’ never worry about this occuring. It never occurs to them. So, if you’ve ever worried about going ‘crazy,’ you probably aren’t.
Now sometimes, folks with apparent anxiety have a genuine physical problem. You should consult with your physician to rule out heart problems, thyroid problems, or other problems that may result in apparent anxiety. Make sure you ask a lot of questions when you see your physician, and that they run a thorough set of tests. Don’t just tell your physician that, “I think it is probably anxiety.” Just describe the symptoms that you are experiencing, and ask what the possible explanations for the symptoms could be.
After it is certain that there is no physical abnormality causing your difficulties, you should consult with the most qualified therapist, psychologist, or counselor that you can find or afford. Don’t immediately consider medication for your difficulty. Although, I must tell you that if you go to a mental health center, they will automatically refer you for medication. That is a given fact. Some psychologists may automatically do this as well. If that’s ‘okay’ with you then, go ahead and do it. Some folks are not ‘okay’ with this, and prefer to work on their anxiety without medication. There is some evidence that you will benefit more from psychotherapy than medication for anxiety. Again, you MUST find the right shrink for you. You’ll know if the shrink you see is the right one within just a few sessions. Don’t hesistate to find another shrink if yours doesn’t seem to understand you. Now, that doesn’t mean that the right shrink for you won’t make you uncomfortable, angry, anxious, or other difficult feelings. Because the right shrink definately will. I guarantee it. You have to consider whether your shrink seems completely clueless. Now, I know that’s not very politically correct to say, but frankly, there are a lot of clueless shrinks out there.
Okay….after you rule out physical possibilities, you are ready to work on regaining your freedom. Keep in mind, anxiety cannot harm you in any way. It may take you quite some time to truly believe this. But, this is one of the most important aspects of overcoming anxiety. Once you know this, you can begin to put yourself, at your own pace, in situations that provoke your anxiety.
As an example….Let’s say you have a snake phobia. You are intensely terrified of snakes. Even the thought of one, send your into a panic. In order to treat this, it could be done with the aid of a great big building. All the way on the other side of the building, on the inside, is a snake in an aquarium. First, we’d just get you used to standing on the outside of the building, knowing that there is a snake all the way on the other side of the building. After you stood there long enough, you’d get more comfortable, and we’d move closer. Through the door. Ten feet inside of the door. Half way across the building. One quarter of the way from the aquarium. Standing in front of the aquarium. Putting your hand on top of the aquarium. Watching another holding the snake. Touching the snake’s tail. Touching it in the middle. And eventually, holding the snake yourself. This could all be done in the space of a few hours.
Now…some fears are so intense and complicated that it may take an experienced shrink several years to fully treat your anxiety condition. You may have to work very hard to achieve this. Now, many have said, that the United States of America is founded on ideals of hard work and rugged individualism. These factors will help you achieve your goal of overcoming your anxiety, and helping you to gain the freedom that the anxiety has taken away from you. Sometimes, you have to take the “long view” and give yourself credit for small improvements. Some folks are such high achievers that anything less than incredible progress….is not progress. You have to dispense with this idea, and give yourself credit for small gains. In all probability you can do it, and with the help of an experienced shrink, you can do it even faster, and not alone.
I hope that you can find the freedom you have been seeking if you suffer from anxiety, and that you are able to truly pursue, “life, liberty, and happiness.”
Happy 4th of July!
(1). http://www.ushistory.org/Declaration/document/index.htm
Does it mean you’re crazy??? That’s what everybody wonders….they’re afraid they’ll be seen as crazy. This is extremely rare to happen for those who are in treatment. And frankly, if you’re worried about it, you’re probably not ‘crazy.’ People who are seen by others as ‘crazy’ rarely seek treatment from a psychotherapist. They are usually forced into treatment by their families with a psychiatrist to get medication.
So, what kind of person seeks treatment?? A person who is having difficulty coping with their life situation, a person with anxiety, a person who is disatisfied or depressed, a person with anger problems, a person having relationship problems, a person who has suffered a traumatic event in the past or in the present, a person who wants to improve their life in other ways, a person who has self-destructive patterns, and many other reasons. If you feel like you could benefit from treatment, you should try it. Don’t let your fears that you will be seen as ‘crazy’ get in the way. Chances are, this will never happen to you.
A common fear of people who have anxiety is that they will “go crazy.” They’ll be permanently crazy and locked up in a psych ward for the rest of their lives. The truth is, that people who have such fears, do NOT actually ever “go crazy.” People who, “lose their minds,” in the schizophrenic sense, do not worry about going crazy. They talk about that colony of martians that has taken up home in their armpit, as my mentor likes to say. So, if your worried about going crazy, you most likely just have anxiety. And anxiety cannot harm you permanently in any way. This is a hard thing for people with anxiety to learn. Once they learn it, they can realize that they have control, and can put themselves more freely in situations that provoke their anxiety. They can begin to take control, and fight against their anxiety. Avoidance of feared situations, is actually what increases, and maintains anxiety. If you repeatedly expose yourself to the situation that causes anxiety, and you make that choice to do so, your anxiety will decrease. You may have to start out with a situation that provokes a moderate amount of anxiety. After you master this situation, it will be easier for you to tackle more difficult situations. If you can’t do this on your own, you can enlist the help of a trained psychologist to help you do so. With my approach, I like to find out what purpose the anxiety serves before working on removing it. That way, you can work on replacing the purpose the anxiety serves with a better option. A way of coping or adequately dealing with the unconscious aspect of the purpose the anxiety serves.
Emotions are expressed one way or another. They are either expressed directly, or indirectly. In graduate school, they teach that the cathartic theory of Freud is completely incorrect with respect to anger. In other words, they teach that expressing anger always increases anger problems. While they are right for people who have genuine problems with managing their anger, they are incorrect for people who “over manage” their anger. Some people learn that anger is dangerous, prohibited, wrong, and should not be expressed in any direct way. As I said before, they way that people express their anger is largely learned.
People who overmanage their anger tend to be anxious, and/or experience a number of physical difficulties (pain, headaches, worries, obsessive thoughts, compulsions). One of the roles of anxiety is inhibition. It inhibits aggressive impulses. I have seen a number of people become socially anxious as they begin to manage their anger more appropriately. This social anxiety serves a positive purpose, and that is to inhibit the expression of anger. People may experience several years of social anxiety as they learn different ways to express themselves appropriately. I don’t try to take this away when it occurs, because I recognize the beneficial purpose. That is, inhibiting agression. A person often has to learn how to express themselves in appropriate ways in order to overcome a significant anxiety disorder.
That said, when a person feels anxious, there is often an unconscious anger component. When this component is identified, the person no longer feels anxious. The fact of the matter is, a person cannot feel anxious and angry at the same time. They are incompatible emotions. The idea of cathasis was around before Freud, but I will focus on the the famous case explored by Breuer and Freud…Anna O.
It was eleven years later that Breuer and his assistant, Sigmund Freud, wrote a book on hysteria. In it they explained their theory: Every hysteria is the result of a traumatic experience, one that cannot be integrated into the person’s understanding of the world. The emotions appropriate to the trauma are not expressed in any direct fashion, but do not simply evaporate: They express themselves in behaviors that in a weak, vague way offer a response to the trauma. These symptoms are, in other words, meaningful. When the client can be made aware of the meanings of his or her symptoms (through hypnosis, for example) then the unexpressed emotions are released and so no longer need to express themselves as symptoms. It is analogous to lancing a boil or draining an infection. (1)
Now, what I have found is catharsis only works with repressed emotion. Those emotions that are blocked from awareness. This doesn’t work with people who have insufficient repression (aggressive individuals). This works with individuals who inhibit or block awareness of their emotions. Academic researchers have overgeneralized from research that show that for angry individuals expressing anger…they become more angry and practiced at expressing their anger. However, in my experience, cartharsis applied to emotions that are blocked from awareness through repression….it resolves the symptom.
Most often, people need to learn that it is ok to say “no” and to express that they are angry. This is for people that have learned that anger is unacceptable. Once they learn this, there is often a reduction of anxiety and psychophysiological complaints that take the place of the expression of anger.
(1). Retrieved from wikipedia (http://webspace.ship.edu/cgboer/freud.html).
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