Anxiety Therapy and Counseling|Folsom/El Dorado Hills | Sacramento Valley

Strategic Therapy for Anxiety • Folsom, El Dorado Hills, and Sacramento Valley

Defining Anxiety Have you ever felt nervous, panicked, vague feelings of doom, or worried? You are not alone!  Such words broadly describe anxiety but what is anxiety? The question is interesting because anxiety lingo is everywhere. Often, we get a sense of the term but defining anxiety may be more challenging. To empower my client’s in taking a stand against “Anxiety” let’s begin with my definition of the term: 

The mind and body’s automatic response to real or perceived threat.

Notice how I said “real or perceived?” That’s because the part of your brain linked to anxiety, the amygdala cannot distinguish between real or perceived threat. Simply put, the amygdala automatically activates a series of reactions (feelings, thoughts, and behaviors) designed to protect you from any experience of threat, regardless of how “real.”

Understanding the Complexity of Anxiety

Anxiety paradoxical by nature. The paradox is that Anxiety always seems to strike when we attempt to avoid it or fight it, but rarely attacks when we accept it or dare I say welcome it.

To illustrate this point, let’s imagine anxiety as a bully. A bully’s gains a lot of power when we run or resist them. The more we engage in these perfectly normal behaviors the more power the bully wields over us. Quickly, a self-feeding pattern develops where running away and resistance fuels the bully’s power and persistence. I may make attempts at “giving in” to the bully hoping they will stop, but the reality is, no amount is ever enough to “satisfy” the bully.

True victory from the anxiety “bully” requires a radical shift in how we perceive and react to the bully. The shift begins by developing a paradoxical mindset centered around the idea of “feeling worse to feel better.”  

Strategic therapy (Nardone & Balbi, 2015; Nardone & Watzlawick, 2004) is an advanced, evidence-based anxiety treatment that utilizes the anxiety paradox. Although the strategic protocol varies by the type of anxiety, this cutting-edge treatment begins by developing a paradoxical mindset. 

The paradoxical mindset asks examines important questions. What happens when we stop running or resisting? What if we welcomed the bully? What if we actually begged the bully to give us more? How might the bully respond if every day we went and sought them out?

Chances are the bully would be confused!! They would protest, “It’s not supposed to work like that!” The bully would likely increase fear to scare us back into our old patterns of running and resisting, but what happens if we use very specific skills and techniques to keep this mindset firm?

If we maintain our paradoxical mindset and continually seek the bully out, begging them for more, and thanking them, something funny would happen.

The bully would eventually stop and likely go find someone else to pick on. Initially, facing this bully would feel worse but over time, a spontaneous shift occurs and we feel better. Notice that this shift is spontaneous, it cannot be forced. It must develop organically and naturally.

Anxiety is just like this bully. The more we avoid it or resist the worse it gets which is why it is difficult to treat. Generally, there is no other cluster of ‘disorders’ that require a feeling worse to feel better mindset. 

Understanding Helpful vs Unhelpful Anxiety

Anxiety has a right to be in our life. Believe it or not, without some level of anxiety we would not be capable of staying safe or engaging in behaviors that move our lives forward. Consider for a moment a world without any anxiety. We would be walking off cliffs, petting rattle snakes, never meeting deadlines, and would not be equipped to respond in safe ways. Anxiety therefore is helpful but within limits. There are two types of anxiety, helpful and Unhelpful.

Anxiety relief requires the ability to determine if the anxiety you or a loved one experiences is helpful or unhelpful. Take a closer look: 

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Types of Anxiety Disorders

Anxiety Disorders are classified according to criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5). The information below is an excellent staring point to understanding anxiety but is not a substitute for diagnosis by a licensed mental health professional such as a Couple and Family Therapist or Clinical Psychologist. With that in mind, an easy way to understand the types of anxiety disorders is to identify the focus of the fear.

Generalized Anxiety Disorder (GAD) consists of periods of frequent worry most of the day. The worry is sometimes called racing thoughts or rumination. The content of the thoughts  frequently revolve around negative consequences in school, work, money, health, relationships, and an inability to cope. The person suffering from GAD often worries about their relationships with others and fears not being accepted, good enough, or living up to others expectations. Frequently, the person suffering from GAD suffers physical symptoms such as muscle tension, increased heart rate, gas, diarrhea, fatigue, or restlessness.

Obsessive Compulsive Disorder (OCD) is a fear sparked by uncontrollable thoughts, ideas, and/or images that produce feelings of extreme anxiety, danger, distress, and/or shame (Foa & Wilson, 2009). With OCD, the focus of the fear is largely exaggerated, almost absurd “what if’s.”

OCD is an anxiety disorder characterized by repetitive rituals (compulsions) performed in response to disturbing thoughts or images (obsessions).

A phobia is an irrational fear of object or situation. Living life can be risky. Going to the store, work, traveling, and even stepping out the front door has some level of risk. In order to do any of these activities requires basic acceptance of this reality. 

Phobias often exploit and distort this reality. Phobias convince people that something catastrophic could or will occur (driving, flying, elevators) and have them over focus on that danger.

Panic Disorder is characterized by a persistent fear of having or suffering negative consequences from a panic attack.

A panic attack is a sudden, unexpected rapid escalation of uncomfortable physical sensations such as rapid heart rate, sweating, light headedness, dizziness, feeling smothered or hyperventilating, tightness in the chest, feeling dizzy, numbness or tingling, terrified, like one is having a heart attack or “loosing it.” Often people who suffer from panic attacks believe they are dying and have lost control of themselves.

Social Anxiety, or social phobia is an excessive fear about being noticed and negatively judged by people. Social anxiety is like an allergy some people have to being seen in the eyes of the other as bad, mad, crazy, or stupid. 

Agoraphobia is a fear related to going out of one’s “comfort or safety zone.” Example include avoidance of using public transportation, being in open spaces, enclosed places, standing in a crowd or line, or being outside the home. Additionally, Dr. Reid Wilson notes that a major fear within agoraphobia is “loss of control.”

Separation Anxiety Disorder is excessive worry when anticipating or experiencing separation from a parent, partner, family member, friend, or any other attachment figure. People affected by separation anxiety disorder fear that their major attachment figure(s) may suffer unexpected illness, accident, or death.