Psychotherapy- An Affective Way Of Dealing With Anxiety FOR GOOD

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What is psychotherapy? How does it differ from psychology and psychiatry? What is anxiety? What are the signs and symptoms? How is it diagnosed? How is anxiety treated/managed? How can psychotherapy help in the management/treatment of anxiety?

Generally, the term psychotherapy can refer to any type of formal, professional counseling process where the focus is usually upon the patient’s issues, mental disorders or emotional suffering. It's a difficult term to define because there are over 400 different types of psychotherapy practices. The dominant practice is psychoanalytical or psychodynamic and that's what I'm referring to here.

To become a psychiatrist, you become a medical doctor first and then undertake specialist training in psychiatry. Training includes both psychology and psychotherapy. Psychiatrists work in different ways but only psychiatrists can prescribe medications. Psychologists are university-trained, and the term psychology usually refers to Cognitive Behavioral Therapy and the scientist-practitioner model. Psychology is based on research and research determines general trends or ways that people are the same. Therefore, psychology is a one-size-fits-all method. Its usual focus is trying to change the way we think and behave.

Training for Psychotherapy and the practice operates in a different way. One difference is that psychotherapy trainees are required to have therapy for themselves. This is essential for working with people with mental/emotional issues to be safe and effective. Psychotherapy practice is based on individual difference and focuses on each person’s way of experiencing their world and themselves in it. We may particular attention to feelings and to each patient’s history and how that affects their present situation. We also focus upon the dynamics of interpersonal relationships, on family of origin experiences and on recurring patterns. Psychodynamic psychotherapy makes use of the professional relationship that's been shown as a primary agent of healing and of change; it is specifically a personal development process.

Anxiety refers to nervousness, worry, apprehension, arousal of the nervous system. It's a fearful state characterized by mental preoccupations, agitation, angst, edginess, tension, trepidation or foreboding — people often speak of ‘what ifs’. What if this happens or that happens? What if I hurt someone? There is stress and suspense, I refer to anxiety as a feeling as if your finger was plugged into the electric socket. There are corresponding physical sensations such as hot and cold flushes, tingling sensations, racing heart or palpitations, tightness in the chest, difficulty breathing and when anxiety amps up to panic, people have wondered if they're having a heart attack.

There is a range of intensity of feeling anxious but at its worst, it's a highly distressing mental and physical state. And it's very difficult to get on with things, to concentrate, to focus and to think about anything else when you're anxious.

The need to diagnose is more important for psychiatry and practices that need to answer to insurance companies. As psychotherapy is more concerned with experience, then the focus is on how a patient feels. Patients are commonly anxious one day and not the next with established anxiety disorders. With others, anxiety dominates them for years. The experience of anxiety is powerfully evident and usually presents no mystery as to whether or not it's there. I don’t use scales or questionnaires because they don’t take into account essential variables, personal differences or properly consider the way we feel changes over time.

Many mental health practices try to manage anxiety with techniques or exercises to help people to relax and feel better. And of course, this can be helpful. There are breathing exercises, mindfulness and meditation practices – all good stuff. Similarly, there are anxiolytics, that is anti-anxiety medications that lower arousal and help to feel better. Again, the trouble – or more accurately, the limitation of these approaches is that they don't address the underlying reasons for anxiety. This is where psychotherapy can be more effective in both the management and treatment of anxiety and especially the recurring tendency toward anxiety.

Anxiety often happens because there's something we cannot bear to think about or to feel, perhaps to suffer. So, for example, one young patient who had a lifelong anxiety disorder would be constantly checking her phone, looking over her shoulder, feeling nervous, agitated and distracted, couldn’t concentrate of her studies and also needed to self-medicate with alcohol and other substances just to relax and to sleep. Psychotherapy explored her childhood and also current relationship with her parents. Her mother was often extremely critical of her and she could be in trouble sometimes for nothing at all. She said to me that she felt she was always in trouble, always in the wrong, and about to be punished. She was checking her phone for an angry spray from her mum that happened on a regular basis.

It helps to know what you're anxious about but psychotherapy also must help people to grow, to move on and to realize how you are affected by things. She needed to develop a greater sense of separateness from her mother from her childhood self. Being in her twenties there was a need for assistance in growing up and not feeling quite so vulnerable and sensitive to the scolding and disapproval. She had an identification with naughtiness and so had to develop a sense of herself as not automatically ‘bad’. She worked well in psychotherapy and could understand these dynamics and she grew to feel more solid and stronger in herself. She took responsibility for what she did that was wrong but also stood up for herself and felt clear of conscience. Her anxiety dissipated and when it was triggered she could assess whether or not there was a valid reason for her to feel concerned.

Medications and techniques can be useful but psychotherapy works to resolve the underlying reasons and psychological susceptibilities to anxiety for long-term improvement.


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