Relationship between Stress, Anxiety, Habit, and Phobias - Essay Example

Discuss the relationship between Stress, Anxiety, Habit and Phobia and their treatment with Hypnotherapy. INTRODUCTION Why are human beings programmed to become anxious and experience different psychological states both under normal as well abnormal conditions? This has prompted much speculation among philosophers as well as psychologists. For more then 80 years from now we have come to know that our organisms become more active and vigilant, learn more quickly and perform better both intellectually and reflexively, when we become anxious. Keeping this in mind, we learn that anxiety can be very adaptive i.e. its purpose is to plan and prepare for the upcoming challenge or threat. Many emotional theorists have come to the conclusion that anxiety is a construct that differentiates itself from other related emotions such as anger and fear. Theorists as diverse as Carol Izard (1977; Izard & Blumberg, 1985), Richard Hallam ( 1985 ), Peter Lang ( 1979, 1984, 1985 ), and neurobiological theorists such as Robert Cloninger ( 1986 ) and Jeffrey Gray ( 1982, 1985 ) have concluded that anxiety is a blend of different emotions and cognitions or perhaps a diffuse affective network stored in memory that is very difficult to define. Fear and anxiety play important roles in the everyday lives and in the survival of animals and humans. Despite their biological significance in human behaviour, and in medicine, our knowledge of their physiology and pathophysiology remains limited. Why should that be so? Anxiety and other related emotional states such as stress, phobias, OCD, etc are the phenomena that are difficult to induce, control, and measure experimentally. For that reason, the major emphases in this essay is on studying each of the above mentioned disorder in detail. Anxiety has been called by Klein (1981) a key word in psychiatry and to some extent it is also quite an ambiguous one. For the common person, it means a feeling of uneasiness, worrying about what might be and not necessarily what has been. Whereas the experimental psychologists refer to it as an avoidance conditioning (Carey & Gottesman, 1981).Personality readers’ call it as subject distress or changes in heart rate. Historically it has been referred to as nervous exhaustion, irritable heart, effort syndrome or “neurocirculatory asthenia”. For the modern psychopathologist anxiety is defined by a set of symptoms implying dysfunction and producing impairment, In any of the above mentioned references it is clear that fear and anxiety play important roles in the everyday lives and in the survival of animals and humans. Anxiety is said to be an internal signal anticipating danger: It is experienced as an unpleasant sense of foreboding, alerting the person to defend against or avoid it. When contrasted with fear, which is a realistic reaction to actual danger, anxiety is generally related to an unconscious threat. The physiological symptoms of anxiety are: 1) increase in pulse rate and blood pressure, 2) accelerated breathing rates, 3) perspiration, 4) muscular tension, 5) dryness of the mouth, and 6) diarrhoea. Freud postulated that anxiety was a result of repressed, pent-up sexual energy, but later came to view it as a danger signal alerting the ego to excessive stimulation and causing repression. The disorders of anxiety are observable, whereas overt anxiety, phobias and other conditions where a defence mechanism are set up in a such a way as to disguise the anxiety from both the sufferer and the observer. In generalized anxiety, the individual experiences long-term anxiety with no explanation for its cause; such a condition maybe called free-floating, since it is not linked to a specific stimulus. The stimulus causing anxieties are such stimuli as enclosed space, heights, and crowds. Severe anxiety can lead to Obsessive-compulsive disorders (OCD) that are characterized by obsessions (mental quandries) and compulsions (physical actions) and this engages the anxious individual excessively. Extreme anxiety is resulted if person does not carry out the compulsion or attempts to ignore the obsession. Post-traumatic stress disorder occurs to an individual having recurrent dreams, flashbacks, or panic attacks after a particularly traumatic experience. CLASSIFICATION OF ANXIETY DISORDERS The seven anxiety disorders listed in DSM-III (American Psychiatric Association) are divided into three major categories: (1) phobic disorders, which include agoraphobia, social , phobia and simple phobia (e.g. acrophobia), (2) anxiety states, including panic disorder, generalized anxiety disorders and obsessive-compulsive disorder, and (3) post-traumatic stress disorder, which is characterized by the presence of excessive anxiety and distress following a traumatic event. Unlike DSM-II, this classification emphasizes descriptive aspects of the disorders. Agoraphobia is fear and avoidance of being alone or in public places without help or ability to escape. Simple phobia is irrational fear and avoidance of a situation or object other than social situations and public places. Social phobia is a persistent fear of and desire to avoid social situations in which the individual is afraid of scrutiny and embarrassment. Common to phobias is some identified external source of anxiety (e.g., social situation, supermarket, snake) and its avoidance. In addition, descriptions of both social phobia and agoraphobia include fear of anticipated loss or catastrophe. The agoraphobic anticipates incapacitation (e.g., heart failure, fainting) and avoids situations from which escape is impossible or help is unavailable. The social phobic avoids public humiliation and embarrassment. On the other hand, occupation with future harm is not a diagnostic requirement for simple phobia. The second class of anxiety disorders is the absence of avoidance behaviour which can be helpful in diagnosis and generalized anxiety disorder are apparent by heightened physiological responding and the absence of a circumscribed source of anxiety. Obsessive-compulsive disorders are recurring unwanted thoughts or repetitive stereotypical behaviours that can be recognized as senseless. Experiences that are re-evoked by an identifiable traumatic event, numbness or withdrawal from the external world following such an event, are the hallmarks of post-traumatic stress disorders. The term "Phobia" is known to medical writers from the fifth century onwards and was first used by Celsus. Its nuance has always been similar to the present-day meaning of the term i.e. referring to "irrational" or disproportionate fears (phobos = "terror") attached to particular objects or situations. Patients with social phobias express the same central concerns i.e. they fear that they will make fools of themselves in public. Normally all of us share this fear to some degree and occasional social anxiety is normal. But the duration, intensity, and disabling effects of the deep fear of humiliation separates real social phobia from shyness. Both the sexes’ i.e. male and female appear to be equally affected, although males are more likely to seek help than females. Although all social classes are affected middle- and upper-class patients are the ones seeking more help then the lower middle and lower classes. Early adolescent age is the age when social phobia commonly arises but here are variations. Some patients describe themselves socially anxious throughout most of their lives, while some believe that their disorder originated only in later life. Most sufferers first seek help when they reach a critical point in an occupation, profession, or in their hopes for a relationship or family. The fear of speaking or performing in front of a group, is the most common specific social phobia which is also known as performance anxiety. Again, many people experience a certain level of nervousness about situations where they have to deal in public, but they are still able to perform satisfactorily. But in most cases the anticipatory anxiety leading up to the presentation generally regresses as soon as the person commences his speech. But alternatively the phobic person with this fear, however, is overcome by the intense which is all-consuming and all this starts long before the actual performance and is unremitting during it. And the fear neither decreases as the event proceeds nor does it wane in subsequent performances. Therefore the person with this kind of performance anxiety is deadly terrified of humiliation, and degradation especially of being evaluated and judged negatively by the audience. Commonly, the suffering person believes that he or she will show embarrassing signs of anxiety such as choking, blushing, or sweating, vomiting to the point of making the performance intolerable. So horrible is the possibility of failure that the person can only hope to gather the strength to bolt and run. Other specific social phobias concern drinking or eating in public (for fear that one's hands or head will shake visibly or that swallowing will cause choking), writing in public (out of fear that the hand might tremble, revealing one's anxiety), and urinating in public restrooms (for fear of being heard or observed). As life is always under a constant process of change and ups and downs, some people cope well with all the changes and phases that life brings but there are individuals who find it difficult to adept themselves to this changing pattern and succumb to stress. Stress in normal life is experienced by everyone but the amount of resistance to it depends on the individual strength and capability. It also depends upon the inheritance and environment. We all need a certain amount of stress to stay motivated and perform well both in personal and professional life. But the excessive amount leads to burn out and fatigue as well as emotional disorders and illnesses. It has been proven by studies that women suffer greater amount of stress than men owing to their domestic as well as professional demands. Stress is characterized into different categories: Hypostress. This occurs when a person is unchallenged and not motivated. Eustress: also known as positive stress. It enables a person to achieve the set targets and it occurs when a person has increased physical or creative activity. Acute stress: Generally identified as real stress is felt through physical disturbances and tensions and it can be treated in weeks or so. Episodic acute stress: The damaging stress having symptoms associated with hypertension, migraine, stroke, heart attacks and gastrointestinal disorders. It is treatable with medical along with psychological intervention. Chronic stress: A serious state having no end and characterised by an increase in the incidence of serious diseases from cancer to and diabetes etc. This type of stress can be treated but it takes a longer period of time. A lot of people display little or no anxiety over the stresses in their lives. In fact, their method of coping with stress is characterized by hard work, continual focus on achievement, and remarkable confidence in their ability to handle problems. “It is well-known that these individuals are at risk for cardiovascular disease. But what investigators such as Chesney ( 1985, 1986 ) have demonstrated recently is that it is not hard work or sense of being "driven" that puts these people at risk, but rather their aggressive, angry outbursts.” Stress and Anxiety are very closely related. Both are characterized by high negative affect and an unpleasant valence. This is also seen in the emergency reaction where flight is paired with fight. The one characteristic that differentiates them in factor-analytic studies is the sense of control or lack of it. Anxiety is characterized by a lack of control, stress by a sense of control and mastery. Thus, these individuals might be over responsive to stress or challenge. Stress patients never lose their illusion of control, even over their emotions (Alloy, Abramson, & Viscusi, 1981). Therefore, a more accurate term for these periodic angry outbursts can be said to be anger disorder. Keeping this in light, anger disorder might be analogous to anxiety and mood disorders as yet another emotional disorder. As with anxiety and depressive disorders, the close relationship between anxiety and stress disorders ensures that individuals may present with considerable overlap between the two. Habit is something we do without thinking about it. It is actually the input of our brain that has been accumulated over the years and thus follows a routine pattern. For e.g. laying a table for dinner, driving a car etc. Most of these habits are positive but there are some which we have adopted from the surroundings and environment turns out to be detrimental and harmful not only for us but for others around us. Case study: I) Sara, a brilliant student of science, a smart young lady, was a gem! She was the best student of the department of the university she studied in and was considered by her professors to be the next great contributor in her chosen field. But hardly anyone could guess that Sara had attempted suicide not only once but twice and was anticipating another attempt before forcing herself to seek psychological help. She was they most shy child in her family and hardly mixed around with them and mostly avoided social gatherings and busied herself in studying and reading all the time all the while shut in her room. She found it difficult to interact with teachers and fellow students and when she had moved to the university, she had found it difficult to talk to her landlord as well who were a nice family as well. She had also kept a bottle of cyanide which she had stolen from the lab and always kept it in her cupboard for use i.e. her suicidal attempt. As she was crossing her professional ladder on the up it was increasing becoming difficult for her to play her disappearance tactics and finally she succumbed when she had to present her final thesis to her professors who had been waiting for it for more than a year. It took immense amount of courage on her part to abandon the idea of suicide once and seek the intervention of psychiatrist. She took a couple of sessions to relax and openly discuss her dilemma. The diagnosis made was extreme state of anxiety coupled with social phobia that she had been developing gradually since childhood and had reached its extreme in her youth. II) Susan always thought of herself as a rational person and not stressed easily. She began to realise that even she didn't see a cockroach, she was looking for one. She would always scan the room for cockroaches before entering. She always reasoned that if ever there was a cockroach it would target her. Thus in short she had made life miserable for herself. The diagnosis made was that Susan suffered from arachnophobia. Treatment: Both the cases mentioned needed psychological help and the best treatment suggested was hypnotherapy as conventional therapy was time consuming and these two patients needed urgent aid. Screed I) a) Sara………..relax yourself ……. loosen yourself………….. relax your nerves…….rest your hands on the sides……..close your eyes and just relax…………. feel the calm and quietude around you……………nobody is watching you at the moment…….. you are all by yourself……………calm and content……………enjoying your relaxation……………….feeling the difference………….. your body is not tight and stiff…………..its loose and you can feel the blood flowing in your veins……….its lively……… b)let your eyes stay close and see your parents sitting by your side and having a good time with you talking and drinking tea………….. imagine yourself in their company………….; they mean no harm to you………….. you love them and they love you……….they want you to achieve the best and you work hard to prove that you are the best………..you are in the company of your parents and friends…….. smiling……………. laughing and enjoying with them………………..its some special occasion……………….you have done well in the class and they all are happy……………you are also enjoying with them. c) you are enjoying being with people………… being appreciated…………everyone is in awe of you………they want to be admired the way your being admired now……….. you are given a special attention by everyone around you……….your are showered with praises………….. you feel confident………. you thank them in return………………… d) you crave being around people………….you like the attention they give you………your feel confident of your work……….. you look eye to eye with people around you and talk to them confidently ………..you have defeated the fear of facing people…………. You have conquered……….. CONCLUSION Without treatment, any psychological problem is a torturous emotional problem; with treatment, its bark is worse than its bite. Once the patient realizes that they have some kind of psychological disorder, treatment can substantially reduce their problems. Getting over psychological problem is not an easy task, but now there is a heightened awareness among people and they pursue it. "Life is just one gut-wrenching anxiety problem after another," says Ph.D. Thomas Richards. The standard definition of social phobia matched Sara’s problems i.e. a persistent fear of one or more situations . . . in which the person is exposed to possible scrutiny by others and fears that he or she may do something or act in a way that will be humiliating or embarrassing. People like Sara, who have generalized social phobia, may experience some or all of the particular fears just discussed, but they also fear meeting new people in any context, formal or casual. They are particularly anxious in encounters with "authorities" or with members of the opposite sex. To protect themselves against painful experiences, they adopt behaviours of deferral, avoidance (often by silence), withdrawal, and escape. Because these sufferers worry that others might notice their physiological fear responses, such as blushing and trembling, they become excruciatingly self-conscious. They are usually inwardly focused, convinced that others think critically of them; they are viewed as extremely shy by others. Not surprisingly, confidence and self-esteem are notably low, and over time they may become deeply lonely, hopeless, and depressed. Many people who enter treatment for specific phobias are found to be suffering from these more generalized social fears. Hypnotherapy has been preferred over other conventional mode of treatment of phobias because the aim of therapy is never to completely eradicate the fear since a certain amount of fear is usually adaptive since it allows the patient to take sensible precautions to avoid danger. Rather the aim is to help the patient to manage their fear. This is where hypnotherapy comes in. Hypnotherapy has other beneficial applications in the treatment of phobias including: 1 Self-hypnosis can be taught to address anxiety and to repeat the therapeutic suggestions and help increase self confidence and self-esteem. 2 Suggest and help the patient in controlling their breathing, slow their heart, and achieve a relaxed state of mind when faced with the phobic stimulus. 3 To teach the employment of dissociation in order either to provide a safe place of relaxation or to negotiate with the ‘part’ responsible for the phobic reaction 4 to make the patient receive permission for change, to create dissociation and to establish change without conscious interference 5 to help the patient go back in time to re-examine the event that initially triggered the fear from an objective point of view thus re-establishing control; it can also be employed to access positive feelings such a s self-confidence, calmness and assertiveness 6 employment of pseudo orientation in the future so that the patient can visualise themselves coping effectively when faced with the phobic stimulus References: 1) The Epidemiology of Anxiety Disorders: Rates, Risks, and Familial Patterns Myrna M. Weissman, Ph.D. Yale University School of Medicine Connecticut Mental Health Center 2) The Psychobiology and Pathophysiology of Anxiety and Fear Herbert M.D. Weiner 3) Disorders of Emotion Journal article by David Harrison BArlow 4) Diagnostic and statistical manual of Mental Disorders (4th edition) 5) Empirically Supported Psychological Interventions: Controversies and Evidence. by Dianne L. Chambless , Thomas H. Ollendick 6) Understanding Panic and Other Anxiety Disorders Benjamin A. Root 7) Fighting the Flight Response by Karen Campbell M.A. (Hons), D.HYp. MBSCH (Assoc) Read More