Webb Therapy Uncategorized Effective strategies and techniques for moderate to intense anxiety:

Effective strategies and techniques for moderate to intense anxiety:

Managing moderate to intense anxiety often involves a combination of techniques that address both the mind and body. Here are some effective strategies:

1. Breathing Exercises: Practice slow, deep breathing to calm your nervous system. For example, inhale for a count of four, hold for four, and exhale for four.

2. Progressive Muscle Relaxation: Tense and then relax each muscle group in your body, starting from your toes and working upward.

3. Grounding Techniques: Use the 5-4-3-2-1 method to focus on your senses—identify 5 things you see, 4 you feel, 3 you hear, 2 you smell, and 1 you taste.

4. Mindfulness and Meditation: Engage in mindfulness practices to stay present and reduce anxious thoughts. Apps like Headspace or Calm can be helpful.

5. Physical Activity: Exercise, even a short walk, can release endorphins and reduce anxiety levels.

6. Cognitive Behavioural Techniques: Challenge negative thoughts by questioning their validity and replacing them with more balanced perspectives.

7. Healthy Lifestyle Choices: Maintain a consistent sleep schedule, eat nutritious meals, and limit caffeine and alcohol intake.

8. Journaling: Write down your thoughts and feelings to process them and identify triggers.

9. Social Support: Talk to trusted friends, family, or support groups to share your experiences and gain perspective.

10. Professional Help: If anxiety persists, consider seeking therapy or counselling. Techniques like Cognitive Behavioural Therapy (CBT) or medication prescribed by a professional can be highly effective.

When traditional strategies don’t seem effective for managing intense, chronic anxiety, there are additional approaches you can explore:

a. Therapeutic Modalities:

Acceptance and Commitment Therapy (ACT): Focuses on accepting anxious thoughts rather than fighting them, while committing to actions aligned with your values.

Dialectical Behavior Therapy (DBT): Combines mindfulness with skills for emotional regulation and distress tolerance.

Eye Movement Desensitisation and Reprocessing (EMDR): Often used for trauma-related anxiety, it helps reprocess distressing memories.

b. Medication:

Anti-anxiety medications or antidepressants may be prescribed by a psychiatrist. These can help manage symptoms when therapy alone isn’t sufficient.

c. Lifestyle Adjustments:

Explore dietary changes, such as reducing sugar and processed foods, which can impact mood and anxiety levels.

Incorporate consistent physical activity tailored to your preferences.

d. Support Groups:

Joining a group for individuals with anxiety can provide a sense of community and shared understanding.

e. Intensive Programs:

Consider enrolling in an intensive outpatient program (IOP) or residential treatment program for anxiety, which offers structured and comprehensive care.

f. Emerging Treatments:

Research into treatments like ketamine therapy or transcranial magnetic stimulation (TMS) shows promise for treatment-resistant anxiety.

g. Alternative Therapies:

Practices like acupuncture, yoga, or tai chi can promote relaxation and reduce anxiety.

Biofeedback and neurofeedback can help you gain control over physiological responses to stress. They are techniques that help individuals gain control over certain physiological and mental processes. Here’s a breakdown:

i. Biofeedback is a mind-body therapy that uses sensors to monitor physiological functions like heart rate, muscle tension, breathing, or skin temperature. The goal is to provide real-time feedback to help individuals learn how to regulate these functions consciously. For example:

Heart Rate Variability Biofeedback: Helps manage stress by teaching control over heart rate.

Muscle Tension Biofeedback: Useful for conditions like chronic pain or tension headaches.

By practicing biofeedback, people can develop skills to manage stress, anxiety, and other health conditions2.

ii. Neurofeedback, a specialised form of biofeedback, focuses on brain activity. It uses electroencephalography (EEG) to monitor brainwaves and provides feedback to help individuals regulate their brain function. For instance:

It can help with conditions like ADHD, anxiety, depression, and PTSD.

During a session, individuals might watch visual cues or listen to sounds that reflect their brainwave activity, learning to adjust their mental state for better focus or relaxation4.

Both techniques are non-invasive and can be effective tools for improving mental and physical well-being.

IMPORTANT NOTE: It’s necessary to consult with a mental health professional or medical doctor to tailor these options to your specific needs.

Related Post

The Weight of Belonging: Why Socialisation Can Make Morality Feel Like a BurdenThe Weight of Belonging: Why Socialisation Can Make Morality Feel Like a Burden

At first glance, the claim that highly socialised people find morality especially burdensome seems backwards. Socialisation is, by definition, the process through which people absorb the norms of their community until those norms feel natural rather than imposed. We would expect the well-socialised person to coincide with morality rather than strain against it. Yet a substantial line of thought in psychoanalysis, philosophy, and sociology argues the opposite: that the deeper a person’s internalisation of moral norms, the heavier the psychological cost of living up to them. Understanding why requires distinguishing several distinct mechanisms that produce this effect.

Freud: Civilization as Repression Turned Inward

The most direct source for this idea is Sigmund Freud’s Civilisation and Its Discontents (1930). Freud’s central claim is that civilised life requires the systematic renunciation of instinctual gratification, particularly aggressive and sexual impulses. Civilisation inhibits humanity’s instinctual drives, which can result in guilt and a lack of fulfillment. This is not a side effect of morality but its very mechanism: in order to live in a civilised society, humans must take their aggression and turn it on themselves in the form of a conscience, or super-ego, which takes the place of the pareent as the child matures.

This matters for the socialisation question because the superego is not a fixed quantity, rather, it is built up through the internalisation of external authority, and its severity scales with how thoroughly that internalisation has occurred. As civilisation evolves, the superego becomes stricter, intensifying feelings of guilt when individuals fail to conform. Freud makes the resulting trade explicit: a threatened external unhappiness, like the loss of love or punishment by an external authority, is exchanged for a permanent internal unhappiness, the tension of the sense of guilt. He defines this tension precisely: the tension between the harsh superego and the ego subjected to it is what we call the sense of guilt, and it expresses itself as a need for punishment.

Therefore, a highly socialised person has not simply learned the rules; they have built an internal enforcer that punishes them for infractions the outside world may never even notice, including merely wanting to transgress (break a moral ‘code’). The burden of morality, then, is not chiefly the effort of compliance but the permanent, low-grade cost of self-surveillance.

Nietzsche: Bad Conscience as Domesticated Cruelty

Friedrich Nietzsche’s On the Genealogy of Morals (1887) offers a related but distinct account, one that Freud himself drew on. For Nietzsche, “bad conscience” arises when a person’s instincts for freedom and aggression – no longer permitted external expression once society confines and pacifies them – are forced inward and turned against the self. The more successfully a person has been tamed by the “morality of custom,” the more violently their own instincts are redirected against their own psyche, producing guilt, self-torment, and a kind of internalised cruelty that Nietzsche regards as pathological rather than noble.

Where Freud treats this process somewhat neutrally, as the necessary price of civilisation, Nietzsche treats it as a form of sickness, that is, the herd’s revenge on the strong instincts it can no longer tolerate expressed outwardly. On both readings, however, the conclusion converges: socialisation does not simply align a person’s desires with moral norms; it manufactures an internal punitive apparatus, and the more complete the socialisation, the harsher that apparatus becomes.

Wolf: The Demandingness Objection – Burden Through Breadth

A different, less psychological route to the same conclusion comes from moral philosophy’s “demandingness objection,” most influentially developed against utilitarianism and explored by Susan Wolf in her essay “Moral Saints” (1982). Wolf’s target is the figure of the person whose every action is as morally good as possible – a person whose every action is as morally good as possible and who is as morally worthy as can be.

Her striking conclusion is that such a person would not be admirable but unattractive: the moral saint lacks the ability to enjoy the enjoyable in life, because full moral perfection edges out the non-moral commitments, tastes, and idiosyncrasies that make a life recognisably human. Commentators summarising Wolf’s argument note that a moral saint’s hobbies and passions survive only until they conflict with morality’s demands, at which point they must be sacrificed (Brainscape summary of Wolf, 1982).

A highly socialised person has internalised not just a few core prohibitions but an extensive web of obligations; to family, profession, community, and strangers alike. The more completely someone absorbs “you should help,” “you should be fair,” “you should not free-ride,” the more situations present themselves as morally loaded. The burden here is not guilt over transgression in Freud’s sense, but sheer coverage: an ever-expanding set of perceived obligations that leaves little room for permissible self-interest.

This is precisely the structure of the demandingness objection as it is standardly raised against consequentialism: if morality requires maximizing good outcomes, then almost every choice — how you spend money, time, or attention — becomes a moral test, and the well-socialized agent who takes this seriously is perpetually under evaluation.

Not every tradition agrees.

Aristotle’s Nicomachean Ethics offers the sharpest counter example: virtue is a disposition built through habituation, and the fully virtuous person acts well with pleasure, because their desires have themselves been trained to want the good. On this view, feeling like it’s a struggle means your character isn’t fully formed yet. Aristotle called this being ‘continent’ — doing the right thing, but only by fighting off the urge to do otherwise. That’s not the mark of a well-socialized person; it’s a sign the job isn’t finished. A well-socialized person should experience morality as second nature, not imposition. The “burden” thesis, then, may reflect a specifically modern, post-Freudian picture of conscience as an internal disciplinary agency, one foreign to Aristotle’s picture of virtue as integrated character.

Durkheim: Integration and Social Cost

Émile Durkheim’s sociology offers a structural variant. In Suicide (1897), he treats strong social integration as generally protective, but identifies conditions – cases where someone is so fused with their group’s identity that their own individual life stops feeling like it matters to them – under which near-total subordination to group norms turns self-destructive. For example, a soldier who throws himself on a grenade to save his unit, or a cult member who follows an order to end their life because the group’s cause has completely replaced their sense of self.

His concept of the “collective conscience” implies that deeper integration makes moral rules feel less like personal preferences and more like external social facts pressing in; obligatory precisely because they are so thoroughly shared and enforced.

Synthesis

Three distinct mechanisms emerge by which socialisation could make morality burdensome rather than easy:

1. Depth (Freud, Nietzsche): socialization builds an internal punitive structure (the superego, “bad conscience”) whose severity tracks how fully authority has been internalised, producing guilt even absent external sanction.

2. Breadth (Wolf, the demandingness objection): the more thoroughly someone absorbs moral norms, the more everyday moments start to feel like moral tests. Choices that used to feel free and casual (how to spend an evening, what to say in a small conversation) start to feel like they carry a ‘right’ answer you’re obligated to find.

3. Structural pressure (Durkheim): deep group integration makes collective norms felt as external, obligatory, and sometimes crushing.

Aristotle’s habituated virtue is the counterweight: none of this is a necessary feature of socialisation as such, only of particular pictures of how conscience forms. Whether morality feels like burden or ease may depend less on how much someone is socialised than on what kind of relationship to norms that socialisation produces – punitive self-surveillance, expansive obligation, or integrated character.

Sources: Freud, Civilization and Its Discontents (1930); Nietzsche, On the Genealogy of Morals (1887); Wolf, “Moral Saints,” Journal of Philosophy 79.8 (1982); Aristotle, Nicomachean Ethics; Durkheim, Suicide (1897).

Polyvagal Theory and Trauma – Dr. Stephen PorgesPolyvagal Theory and Trauma – Dr. Stephen Porges

Stephen Porges, psychiatry professor and researcher, on the polyvagal theory he developed to understand our reactions to trauma:

[Paraphrased] Polyvagal theory articulates three branches of the autonomic nervous system (ANS) that evolved from primitive vertebrates to mammals. First, there is a system known as ‘freeze’, which involves death feigning or immobilisation. Second, the ANS has a ‘fight or flight’ system, which is a mobilisation system. And third, with mammals, there is what Porges calls, a social engagement system (SES), which can detect features of safety, and actually communicate them to another. The SES may also be referred to by some as ‘rest and digest’, which Porges theory suggests is a function of the Vagus Nerve – the tenth cranial nerve, a very long and wandering nerve that begins at the medulla oblongata. When an individual experiences feelings of safety (within an SES state), the autonomic nervous system can support health restoration. In terms of dealing with a life threat, an ordinary person will most likely go into a feigning death, dissociative state of ‘freeze’.

Polyvagal theory in psychotherapy offers emotional co-regulation as an interactive process between therapist and client which engages the social engagement system of both therapist and client. Social engagement provides experiences of safety, trust, mutuality and reciprocity in which we are open to receiving another person, just as they are.

The following extract has been retrived from https://www.theguardian.com/society/2019/jun/02/stephen-porges-interview-survivors-are-blamed-polyvagal-theory-fight-flight-psychiatry-ace

Polyvagal theory has made inroads into medical and psycho-therapeutic treatment, but how should it inform how people treat each other?


“When we become a polyvagal-informed society, we’re functionally capable of listening to and witnessing other people’s experiences, we don’t evaluate them. Listening is part of co-regulation: we become connected to others and this is what I call our biological imperative. So when you become polyvagal-informed you have a better understanding of your evolutionary heritage as a mammal. We become aware of how our physiological state is manifested, in people’s voices and in their facial expression, posture and basic muscle tone. If there’s exuberance coming from the upper part of a person’s face, and their voice has intonation modulation or what’s called prosody, we become attracted to the person. We like to talk to them – it’s part of our co-regulation.

So when we become polyvagal-informed, we start understanding not only the other person’s response but also our responsibility to smile and have inflection in our voice, to help the person we’re talking to help their body feel safe.”

Clink on the link below to hear Dr. Bessel van der Kolk, one of the world’s leading experts on developmental trauma, explain how our long-term health and happiness can be compromised by prior exposure to violence, emotional abuse, and other forms of traumatic stress.

https://youtu.be/53RX2ESIqsM

Acceptance and Commitment Therapy (ACT)Acceptance and Commitment Therapy (ACT)

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.

Be Good To Yourself: The ACT Matrix | Therapy worksheets, Therapy quotes,  Psychology quotes