Disarming Anxiety. Presented by Sue Milne, Registered Psychologist WHAT S AHEAD..

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1 Disarming Anxiety Presented by Sue Milne Psychology Services Manager Injury and Occupational Health Presented by Sue Milne, Registered Psychologist WHAT S AHEAD.. What is anxiety Difference between useful anxiety and anxiety disorders How can CBT help Taste test of CBT strategies Connections between biblical and psychological wisdom Biblical wisdom about anxiety Anxiety and relationship with God

2 FEAR AND ANXIETY (ARTWORK BY KATSUSHIKA HOKUSAI) THE SCREAM (EDVARD MUNCH 1883)

3 WOMAN IN AN INTERIOR WILHELM HAMMERSHOI ( ) ANXIETY IS USEFUL WHEN. It helps us to survive It s proportional to the threat posed It triggers responses that are consistent with the demands of the situation

4 USEFUL SHORT TERM RESPONSES TO TRUE DANGER Focus on the threat Increased alertness Increased muscle tension and blood flow to the heart and long muscles Prepares the body for fight, flight or freeze EXCESS ANXIETY = OVER-SENSITIVITY TO THREAT (NOT USEFUL) Overestimates the degree (size) of a threat Overestimates the significance (likely consequences) of a threat Anxious brain asks...what if...? Is it possible.? Rational brain asks...how dangerous is that really? How likely is it that this bad thing will actually happen? All things considered, how probable is that?

5 EFFECT OF ALERTNESS/ ANXIETY/AROUSAL ON PERFORMANCE Designed for change.. Performance Very good Average Anxiety facilitates Anxiety debilitates Very poor Very calm Aroused Panic Anxiety Level PROBLEMS ASSOCIATED WITH ANXIETY CHANGED BODILY RESPONSES and BEHAVIOUR Increased heart rate/increased blood circulation/palpitations Increased muscle tension Increased breathing rate (hyperventilation, derealisation, depersonalisation) Blood flow away from the digestive system Sweating Urge to escape Avoidance Sleep disruption

6 PROBLEMS ASSOCIATED WITH ANXIETY CHANGED THINKING Focus on possibility of threat likelihood and significance overestimated What if. Loss of broad perspective Difficulty concentrating and remembering Jammed/going blank Other thinking patterns that amplify negative predictions Overwhelm Keyed up Detached Irritable PROBLEMS ASSOCIATED WITH ANXITY Heightened emotional sensitivity CHANGED EMOTIONS Loss of self-confidence, often a driver for unhelpful avoidance

7 WHY DO PEOPLE SUFFER ANXIETY? INCIDENCE (ABS MOOD ANXIETY AND SUBSTANCE USE DISORDERS) PROPORTION OF PEOPLE AGED WITH A MENTAL DISORDER(a) 2007!14

8 INCIDENCE OF MENTAL HEALTH CONDITIONS (AUSTRALIA)- POPULATION INCIDENCE OVER 12 MONTH PERIOD 9% Mood disorders 11% Anxiety disorders 13% Personality Disorder 6.5% Alcohol use disorder 2.2% Substance use disorder other than alcohol 0.4% Psychotic illness A high level of co-morbidity exists!15 ANXIETY DISORDERS Panic Disorder 2% Worry that panic will result in physical or mental collapse DISORDER NAME Agoraphobia 1.7% Fear of situations where in the event of a panic, it may be difficult to leave or access help Social Phobia 2.8% Fear of evaluation/scrutiny; fear of being shamed/rejected Generalized Anxiety Disorder Obsessive Compulsive Disorder 4.1% Persistent worry that disaster will occur (across various domains of life).8% Worry that fears of self-caused harm to self or loved ones will come true Specific Phobia 8% Fear of personal harm occurring if exposed to a situation or thing Posttraumatic Stress 1.7% Fear of the intrusive memories of past harm or threats of

9 COGNITIVE BEHAVIOUR THERAPY A SKILLS-BASED PSYCHOLOGICAL THERAPY Behaviour/Actions Thinking/ Beliefs Feelings/ Emotions SELECTIVE ATTENTION AND APPRAISAL Event Selective attention Anxiety Appraisal Global vs Specific Uncontrollable vs Controllable Time limited vs Never ending

10 ANXIETY CYCLE Fear provoking thoughts, images or situations Perception of threat Worry about physical, emotional and behavioural responses Fight Flight Freeze Response ABDOMINAL BREATHING TO REDUCE PHYSIOLOGICAL AROUSAL Breathe in: Belly pops forward as the diaphragm drops down Breathe out: Belly tucks in as the diaphragm rises

11 DEALING WITH CATASTROPHIC THOUGHTS WORST SCENARIO BEST SCENARIO MOST LIKELY SCENARIO FROM AVOIDANCE TO APPROACH Action directly confronts and powerfully disconfirms fears. Planned Graded Repeated Guided by habituation principles

12 MINDFUL OBSERVATION (ACT) Intentional focused awareness of the present Observation without judgement Focus on physical senses (or thought/emotions/surroundings) ( RCT evidence emerging) FRIENDS AND FAMILY RECOGNISE IMPACT- STATE WHAT YOU NOTICE OFFER SUPPORT- ASK DON T TELL WORK WITH THEIR PLAN SUPPORT THEIR EFFORTS GO AT THEIR PACE OFFER PRACTICAL OPTIMISM LOOK FOR WRIGGLE ROOM

13 THE FLIP SIDE OF ANXIETY MANAGEMENT- STRENGTHEN WELLBEING! (POSITIVE PSYCHOLOGY) Positive emotions Engagement Relationship Meaning Achievement Flourishing Sound evidence that resilience skills support mental health WORLDVIEWS Psychological Based on scientific enquiry Humanism Positivism Existentialism Christian Based on Historical Evidence Relational God Designed planet Humans precious & fatally flawed Forgiven by Grace not Graduation Blessed to be a blessing Bible as primary source

14 COMMON RECOMMENDATIONS Give thanks to God in all circumstances Practice gratitude in order to promote positive emotion and well-being COMMON RECOMMENDATIONS Think about. whatever is noble, right, pure, lovely, admirable, excellent, praiseworthy (Philippians 4:8) Mind your thinking Distorted thinking patterns trigger anxious emotions and actions. Thinking habits can be changed in order to reduce anxiety

15 COMMON RECOMMENDATIONS Love one another (1 John3:11) Bear one another s burdens but let each person carry their own load (Galatians 6:2-5) A person can only grow to maturity in community (1 Corinthians 12) Social support and social connection help us to buffer stress, broaden perspective and reduce perceived threat Interpersonal boundaries help us to be appropriately responsible COMMON RECOMMENDATIONS As God s dearly loved children, our primary purpose is to love Him and love others. So we have no need to worry (Matthew 6:25-34) Relief of anxiety does not equate to a satisfying life! Find a purpose for living that is greater than self.

16 ANXIETY AND BIBLICAL WISDOM Worry - daily needs - the future Peace during anxiety Savor what s good Our anxious hearts can falsely condemn us Matthew 5:25-34 Matthew 6:34 Philippians 4:4-7 Philippians 4:8-9 1 John 3:18-24 Don t worry Recognize God s care for creation Pray and ask Focus on a life that pleases God One day at a time Praising God for his goodness Giving thanks to him Ask Him to help Thinking about good things and putting them into practice brings God s peace Test our own accusing thoughts; measuring them against our actions. Be reassured God is greater than our thoughts/sins/mistakes Cast your anxiety on him, for He cares for you 1Peter 5:7

17 GOD S PEACE THROUGH CHRIST SURPASSES ANXIETY Significance Dearly Loved Children (1John3:1) Made in God s image (Genesis 1:27) A Purpose-filled life Blessed to be a blessing (Genesis 12:3) Valued- no performance pressure or image management needed (2 Cor 4:7) Security God accepts us into his family when we recognise our need to repent, place our trust in Christ and receive the gift of eternal life. (1 John 5:13) Promised God s presence always (Matt 28:20); Grace strengthens us, empty ritual does not (Heb 13:9) No matter how great the anxiety, we can t be separated from God s love (Romans 8:39) Where relationship with Father God is troubled by unhelpful beliefs it may be hard to trust God with our anxieties John Forrester Clack, The Child 1996 oil on linien 81 x 91cm NFS

18 FINALLY There is hope Psychological strategies help A fresh start with God helps Taking small steps to overcome avoidance can lead to big changes Get a cheer team and take the first step! There is no fear in love, but perfect love drives out fear 1 John 4:18