Anxiety, Anxiety Attacks, and Prolonged Anxiety

Hello readers. I hope you are well. I imagine some of you are struggling and some of you are flourishing. Life consists of both. As humans, we relish pleasurable feelings and experiences and we tend to dislike uncomfortable emotions and experiences. I get it. I am just like you. We share this. I hope that provides some comfort.

What is human development?

Human development can be described as “systematic changes and continuities in the individual that occur between conception and death, or from “womb to tomb”” (Sigelman, De George, Cunial, & Rider, 2019, p. 3).

Human development involves the continuities (i.e., what remains consistent across time) and the systematic changes (i.e., patterns of change that are expected to come in order across time) that one experiences throughout the lifespan. Based on my education, there are three domains of continuity and change: 1. The physical and biological, 2. Cognitive (i.e., mind processes/thinking), and 3. Psychosocial and emotional. Let’s open these one at a time.

Physical development includes:

• Physical and biological processes (e.g., genetic inheritance).
• Growth of the body and its organs.
• Functioning of physiological systems (e.g., brain).
• Health and wellness.
• Physical signs of ageing and changes in motor abilities.

Cognitive development includes:

Perception: the sensing of stimuli in our environment (internal and external), sending that information to the brain to be identified and interpreted in order to represent and understand our experience of the world and give it meaning. All perception involves signals that go through the nervous system.

Attention: the ability to actively (and often, involuntarily) process specific information in the environment while tuning out other details. Attention is a very interesting cognitive process because when we bring mindfulness to our thoughts we become open to the direction and attention of our mind. Remember this: where attention goes, energy flows.

Language: very broadly, Language is a communication system that involves using words (i.e., sounds arranged together) and systematic rules to organise those words into sentences and meaning, to transmit information from one individual to another. I was never very interested in language when I was studying at university however that has changed. We used language and concepts to talk to ourselves, about other people, and it is open to misinterpretation, error, and oftentimes language can be used as a means to hurt people or … bring us closer together.

Learning: very broadly defined as a relatively permanent change in behaviour, thinking, and understanding as a result of experience. Experience is everything from formal education to unique personal experience. We learn from each other, the world around us, books, movies, self-reflection and education etc. All of which are experiences.

Memory: Memory refers to the processes that are used to gather, organise, store, retain, and later retrieve information. I’m sure you’ve all seen a tv show or read a book about a person with Amnesia or Alzheimer’s disease. Imagine what your life would be like if you didn’t have the function of memory. I wouldn’t be able to type this very well, I don’t think. I wouldn’t remember my loved ones or what was dangerous in my environment. I know we all have unpleasant memories too and that may feel like a negative evolutionary by-product – however it is actually designed to protect us. Memory is finite – we actually forget a lot of stuff, or perhaps more accurately, we do not have the capacity to store and recall everything we experience.

Intelligence: I would like to reframe intelligence from what might be a common belief. Intelligence does not mean academically gifted as is considered valuable in Western society. I think Olympians and caregivers/parents have an intelligence that I do not because I haven’t learned their skills. Intelligence involves the ability to learn (i.e., sport, academics, the arts, swimming, survival, interpersonal skills), emotional knowledge, creativity, and adaptation to meet the demands of the environment effectively

Creativity: I consider creativity to be an evolutionary gift of our imagination, providing humans with the ability to generate and recognize ideas, consider alternatives, think of possibilities that may be useful in solving problems, communicating with others, and entertaining ourselves and others. Creativity can be stunted when we are struggling or caught in reactivity to external pressures or perceived stress.

Problem solving: is a process – yes, a cognitive one but also a behavioural process. It is the act of defining a problem; determining the cause of the problem; identifying, prioritizing, and selecting alternatives for a solution; and implementing a solution. Problem solving can be both creative or stress driven. I like to say whenever I am solving a problem I am also making a decision. A decision of mine is a choice. At university, our problem solving lessons were coincided with decision making which is why I think of it that way.

Psychosocial development involves:

Aspects of the self (i.e., your identity – which may change over time), and social and interpersonal interactions which include motives, emotions, personality traits, morality, social skills, and relationships, and roles played in the family and in the larger society. This is a huge area to be explored. I will endeavour to elaborate on our psychosocial development in later blogs.

In the late 1950’s, a German-American developmental psychologist named Erik Erikson created a theory for human psychosocial development across the lifespan. His theory suggests that human personality develops in a predetermined order through 8 stages of psychosocial development. See the table below:

I was recently browsing some of the units I completed for my counselling diploma – for revision. The human memory has not evolved to store, organise, categorise and recall all the large amounts of information we collect every day, nor is our memory always accurate. It’s important for counsellors and therapists to keep up to date with new approaches to counselling, and it doesn’t hurt to read over learned materials from college days. I thought I’d provide some learning about Acceptance and Commitment Therapy for readers.

Just to acknowledge the work of others, most of what is written below, I have retrieved and paraphrased from ACCEPTANCE AND COMMITMENT THERAPY Published by: Australian Institute of Professional Counsellors Pty Ltd.

Acceptance and commitment therapy, known as ACT (pronounced as the word ‘act’), is an approach to counselling that was originally developed in the early 1980s by Steven C. Hayes, and became popular in the early 2000’s through Hayes’ collaboration with Kelly G. Wilson, and Kirk Strosahl as well as through the work of Russ Harris. You can look them up on Youtube or Google if you’re interested in what they might have to say about ACT.

“Unlike more traditional cognitive-behaviour therapy (CBT) approaches, ACT does not
seek to change the form or frequency of people’s unwanted thoughts and emotions. Rather,
the principal goal of ACT is to cultivate psychological flexibility, which refers to the ability to
contact the present moment, and based on what the situation affords, to change or persist
with behaviour in accordance with one’s personal values. To put it another way, ACT
focuses on helping people to live more rewarding lives even in the presence of undesirable
thoughts, emotions, and sensations.”
(Flaxman, Blackledge & Bond, 2011, p. vii)

ACT interventions tend to focus around two main processes:

• Developing acceptance of unwanted private experiences that are outside of personal
  control.
• Commitment and action toward living a valued life (Harris, 2009)

In a nutshell, ACT gets its name from its core ideas of accepting what is outside of your personal control and committing to action that improves and enriches your life.

Cognitive Defusion is the process of learning to detach ourselves from our thought processes and simply observe them for what they are – “transient private events – an ever-changing stream of words, sounds and pictures” (Harris, 2006, p. 6). I think this component of ACT is incredibly beneficial if we practice it daily. I like to say, just like the function of the heart is to pump oxygenated blood around the body, one of the brain’s functions is to have thoughts. We can observe thoughts without taking them to mean more than what they are. Some thoughts are automatic, some are subconscious, and some are unconscious or preconscious beliefs that we consider to be true and factual and “rules” about how the world operates and how we have to operate in it. If someone is defused from their thought processes, these processes do not have control on the person; instead the person is able to simply observe them without getting caught up in them or feel the need to change/control them.

Acceptance is the process of opening oneself up and “making room for unpleasant feelings, sensations, urges, and other private experiences; allowing them to come and go without struggling with them, running from them, or giving them undue attention” (Harris, 2006, p. 7). Practicing acceptance is important because it encourages the individual to develop an ability and willingness to feel uncomfortable without being overwhelmed by it (Flaxman, Blackledge & Bond, 2011). It’s important to acknowledge that to accept something doesn’t mean we like it or have a passive attitude. It is to accept something exactly as it is and then we choose what to do with it. Think of the Serenity Prayer: Grant me the serenity to accept the things I cannot change, courage to change the things I can, and wisdom to know the difference.

Contact with the present moment is the concept of being “psychologically present” and bringing full attention to the “here-and-now” experience (Harris, 2009). I’d also argue that to psychologically present, we must also be aware of our physical body and the sensations within it and outside of it. Because we have the ability to think about the past and about the future, sometimes it can be difficult to stay in the present (Batten, 2011; Harris, 2009). Having contact with the present moment is essential because that it where we find out anchor and power. We have the ability to pay attention in a flexible manner to the present moment and connect with that experience rather than ruminate on past events or future possibilities (Lloyd & Bond, 2015). Some of you might say “What if I can’t stand the present moment?”. True. If you have extreme emotional experiences or have a history of trauma, it may be functional for you to use distraction or talking to someone when the present moment is “too much to take”. What we want to work towards is using healthy coping strategies in the present moment mindfully, instead of behaviours that no longer serve us.

Values, and identifying them, (i.e., what is important to the individual) is a central element of ACT because it assists clients to move in the direction of living and creating a meaningful life. One of the central goals of ACT is to help clients to connect with the things they value most and to travel in “valued directions” (Stoddard & Afari, 2014).

Committed action is the process of taking steps towards one’s values even in the presence of unpleasant thoughts and feelings (Harris, 2009). Behavioural interventions, such as goal setting, exposure, behavioural activation, and skills training, are generally used to create committed action. The ACT model acknowledges that learning is not enough, one must also take action to create change.

Self-as-context, or what I prefer to call “the observing self” or simply just our self-awareness, creates a distinction between the ‘thinking self’ and the ‘observing self’ (Harris, 2009). The thinking self refers to the self that generates thoughts, beliefs, memories, judgments, fantasies, and plans, whereas the observing self is the self that is aware of what we think, feel, sense, or do (Harris, 2009). “From this perspective, you are not your thoughts and feelings; rather, you are the context or arena in which they unfold” (Stoddard & Afari, 2014). Being aware of the observing self allows an individual to have a greater ability to be mindful and in the present moment, as they can separate themselves from the thoughts, beliefs, and memories they have.