The Anxiety Spasm

I have sometimes referred to anxiety as a spasm. I believe that this is an excellent metaphor. As a spasm grows, it only makes itself worse. The muscle can't pull out of it. The more it spasms, well, the more it spasms. Usually, there has to be some sort of intervention to make it stop, such as pulling the muscle.

My patients often find themselves in just the same situation. Anxiety focuses their attention on the problem, and the problem increases their anxiety, and the increased anxiety focuses their attention even more on the problem. They want the anxiety to go away. But strangely, they are often reluctant to go do something else which might distract them and make them less anxious. It is not clear why this is. Perhaps, they already feel at their limit, and they just want to rest somewhere away from any demands. However, physical rest does not bring mental rest when there is an anxiety spasm. It generally gives their brain the freedom to keep focusing on the problem, obsessing, and worrying.

The cure for many spasms is to pull the muscle so that the spasm gradually subsides. The cure for the anxiety spasm is often to pull away from the worry and get into another situation until the anxiety gradually subsides. This may involve an uncomfortable feeling at first, focusing the mind on something else when the mind seems keenly bent on dealing with the problem and only the problem. However, after pulling away and focusing on something else, many people start to feel better.

I sometimes suggest to my clients that they keep a chart of their anxiety, rating it from 1 to 100 over time. It can be useful to do this when they just stay home and don't do anything special, letting their mind think and feel what it will. And then other times, the chart can be done when they get out and do something else which pulls their attention away from the anxiety. This gives the client concrete data to work from. What is going to make me feel better? How long will it take for me to feel better? How much better will I feel?

Some clients have had antianxiety medication prescribed for them. Such medication can be useful, especially when it is combined with learning psychological ways of coping with anxiety. I do not believe in any client being tortured by anxiety, and severe anxiety is a type of torture. But I also believe that it is always important to combine anti-anxiety agents with psychological coping techniques so that in the long run, persons do not become dependent on the medication.