ANXIETY (AND FEAR) VERSUS PANIC ATTACKS

The purpose of this article is to distinguish between anxiety and panic attacks.

In thinking about how I wanted to present it though, I decided to add a third piece into the mix: fear. Let’s, in fact, start with fear versus anxiety. As with anxiety, fear is a feeling that every human being experiences, at one time or another. When fear or anxiety takes hold, we are all likely to experience symptoms like nervousness/jitteriness, racing and/or obsessive negative thoughts. Especially, “what-if” and worst-case-scenario thinking, impaired concentration, and to varying degrees, physical/bodily sensations like heart racing, shallow breathing, palms sweating, and tightness in the chest.

The key factor distinguishing fear from anxiety can be summed up as the likely rationality versus the likely irrationality of these sets of symptoms.
On the fear front, the symptoms listed above are triggered by the anticipation of what could be an actual danger or threat to physical or emotional safety. Examples include undergoing tests for a possibly cancerous lump in your breast, walking down a dark street and seeing a suspicious stranger walking toward you, being somewhere where you suddenly hear gunshots, or finding out that there are going to be a significant number of job layoffs at your place of employment in the very near future. All of these situations involve an anticipated worrisome event that has a real possibility of actually occurring, and therefore, the symptoms are rational.

In contrast, when the symptoms surround anticipation of an event that is not likely to happen (not an impossibility, but an unlikelihood), in this framework we are talking the irrationality of anxiety rather than the rationality of fear. Examples include: worrying that you are going to do poorly on an important exam when you are in fact an intelligent person who studied hard for the exam, feeling mild turbulence while on a plane yet worrying deeply that the plane nonetheless is going to crash at any moment, convincing yourself that your significant other is about to reject you in spite of all of your evidence to the contrary, and worrying that you are going to lose your job when you have been repeatedly reassured that you are performing very well and are important to the company you work for.

Now we move to panic attacks.

Simply stated, panic is the extreme of what can be either fear or anxiety. During a panic attack, all of the symptoms listed above can become so overwhelming that you can feel immobilized and frozen in place. Accompanying this can be the extremely disconcerting thought that you are “going crazy” or having a heart attack. A panic attack can vary in terms of its duration: it might subside in less than 30 seconds, or unfortunately, it may continue for many minutes or longer. The longer it lasts, the longer it will take to return to a normal level of functioning. In a state of anxiety or fear in contrast, as distressing as these feelings may be, chances are you will still be able to function sufficiently enough to not become overwhelmed and immobilized.

Last but not least, I want to emphasize that whether we are talking about fear, anxiety, or panic, what all of these feelings share in common is that they should never be judged as signs of abnormality or weakness. Instead, they all reflect a state of being HUMAN. They’re disturbing and very stressful feelings yes, but human nonetheless.

You can read further about how self-sabotage can actually trigger anxiety if not panic at times in my book, “Your Self-Sabotaging Inner Bully: Standing Up to It Once and For All!”

I look forward to connecting with you!

– Sid

On Addiction

Back in the 80’s, Nancy Reagan declared the semi-immortalized words “Just say no to drugs!” While Mrs. Reagan specified drugs as primarily the addictive substance to say no to, she presumably could have been referring to any other substance or activity which can become a form of addiction. What has always struck me most though–professionally and personally–about these words is that injecting the word “just” into the declaration implies it really shouldn’t take that much effort and self-control to not become addicted to something. Which of course in reality couldn’t be farther from the truth, i.e., for enough people it can take a great deal of effort and self-control to resist addiction in the first place, much less sustain it to conquer an addiction already in place!

In the sections below, I will cover four main topics related to addiction. First, I will offer a definition of addiction which allows for a wider range of behaviors to be defined as potentially addictive than just substances like drugs and alcohol. Then I list what that range of addictive behaviors can include. Next comes a summary of the reasons why it in fact is so difficult to stop an addiction, followed by a section addressed to the significant downsides to addiction. Finally, I will discuss the challenging process of controlling addiction so it no longer controls you.

DEFINITION OF ADDICTION

As noted above, the definition of addiction I use allows for a number of behaviors to become possible types of addiction above and beyond substances. That definition has two main parts: 1) any behavior basically in control of you rather you being in control of the behavior; and 2) as a result, the behavior causes you some type of harm, be it psychological, physical, financial, or relationship harm–or some combination of these. Clearly this definition typically fits for substance addiction. It also can apply though to addictions like, e.g., food, gambling, shopping, lying, sexual encounters, and electronics (especially video games, texting, and excessive use of social media).

On the psychological harm front, any type of addiction can especially take a toll on an addict’s self-respect and overall self-worth. Yet because someone with an addiction will typically deny having any addiction problem, they will also deny these two negative effects on their psychological well-being. Therefore the “benefits” of maintaining an addiction–to be presented below–will remain the conscious or subconscious reasons to continue with the addiction, while ignoring the various negative consequences of doing so–and for as long as possible.

“BENEFITS” OF HAVING AN ADDICTION

This section is mainly addressed to the reasons why it is so hard for so many people to “just say no” to commencing an addictive behavior, much less control it once it has taken control of you. Some of these reasons–i.e., “benefits”–may sound obvious, like excitement, relaxation, escape, and disinhibition. But let me propose a less obvious reason for keeping an addiction in place: “anesthesia.” Medicinally speaking, an anesthetic is of course something used to numb physical pain. Yet as we all know, human beings experience psychological/emotional pain as well, like depression, an anxiety disorder, deep grief, lonliness, or post-traumatic stress. And just as with physical pain, the worse this type of pain is, the more the emotionally suffering person may feel a need to numb it–at least temporarily anyway, just as with a medicinal anesthetic. Especially given the “benefits” just listed, you can see how an addiction of any type can therefore feel like–again, consciously or subconsciously–an anesthetic against painful emotions.

THE DOWNSIDES OF ADDICTION

As powerful as any “benefit” of any type of addiction may feel, there typically is a major price to pay for ongoing addictive behavior. That price–as noted above in terms of the possible types of harm that ongoing addiction can trigger–can be physical, psychological, financial, or in relationships. Physical harm to health can especially result from prolonged heavy use of addictive substances like alcohol or drugs. Psychological harm is manifested in that person’s significant loss of self-respect, for allowing their self-sabotaging addiction to possibly rule their life. Financial harm can result from uncontrolled spending, especially related to addictions like substance use and excessive gambling. Finally, addiction can sabotage important personal relationships, especially when the addiction is accompanied by significant irresponsibility, like law-breaking actions, unleashing of abusive behavior, or excessive withdrawal or isolation.

CONTROLLING ADDICTION

If we return for the moment to the simplistic “just say no” pitch, then you know–to put it mildly–how much easier said than done it is to prevent addiction from the start, much less control it once it is in full force. But if addiction is in fact to be eliminated, several things must come together to increase the odds of success and reduce the odds of failure or relapse. It starts with full acknowledgment by the addict of the reality of their problem, rather than continuing in the mode of denial. There also must come a clear conscious recognition of the psychological and/or physical and/or financial and/or relationship-sabotaging pain caused by prolonged addiction. Next, there needs to be a clear acknowledgment too of what is going wrong or badly in their life, be it, e.g., specific fears, loneliness, frequent agitation, deep sadness, boredom, excessive stress, or a sense of personal failure or shame. There also needs to be a commitment by the addict to do whatever it takes in their day-to-day lives to rebuild their self-sabotaged self-respect, especially in terms of behavioral self-control, goal-oriented productivity, and–where relevant and advisable–making amends to any significant other harmed by the in some way due to their addiction. Last but certainly not least, someone in the throes of some type of addiction must make–and keep–a commitment to themselves to actively and ongoingly pursue a combination of professional help plus involvement in a supportive community like 12-step.

POSTSCRIPT: SOME FOOD FOR THOUGHT

Is addiction a sickness or a disease, as many people define it? From my perspective anyway, it depends how you define those two related but not necessarily identical terms. If the addiction does not cause the person any significant degree of any of the four types of harm listed above, then for all the people out there who I know will disagree with me, I say it is NOT a sickness or disease, but more a very challenging personal problem to try and control. If on the other hand some type of significant harm to the addict does occur, then in my view those two categorizations apply.

But here’s another piece of thought on addiction I’m putting out there to the universe. In my experience, many people judge addicts–especially substance abuse addicts–as essentially “low-lifes” or second-class citizens. Many parents for example will in fact sound smug in their announcing that regardless of anything else their child may not do well in life–e.g., receiving relatively poor grades based on lack of effort, or being a bully–“at least my kid isn’t an addict!” Well, to the innumerable negative judgers out there in the world, I ask you to make a distinction on the judgment front. Specifically, I invite you to muster up as much compassion and as little negative judgment as you can for any addict who is mainly SELF-sabotaging, i.e., has a sickness or disease. In contrast, I totally get negatively judging someone whose addiction leads them to, e.g., often hurt significant others, and/or engage in physically harmful violence. THOSE are the addicts who can be a menace and a “low-life”–until and if they sincerely acknowledge their wrongdoing and seek professional help. But in the absence of these inexcusable behaviors, and on behalf of again primarily the SELF-sabotaging addicts out there in the world, I encourage you to make a distinction, and feel vs. judge accordingly!

On Anxiety Disorder

ANXIETY DISORDER: SUB-CATEGORIES

Many millions of people suffer from clinical anxiety. Sometimes the anxiety occurs in an extremely intense form–called a panic attack, and sometimes in an ongoing intermittent manner–called generalized anxiety. What these share in common is the personal and emotional distress they can cause you, in the short run and very possibly in the long run as well.

Suffering from either of these two types of anxiety disorder can make life less fun. You can end up worrying if not virtually obsessing about when your next episode may occur. This is especially true if during the time the anxiety hits you, it becomes much tougher to concentrate clearly, feel socially at ease, make good decisions, and generally feel free enough to laugh and enjoy yourself. Or to put this a bit differently, when you are in the throes of some significant if not overwhelming amount of anxiety, you can feel temporarily powerless at best, and outright paralyzed at worst!

What I will do now is expand upon the two categories presented above, and then add two more: phobias and post-traumatic-stress induced.

PANIC ATTACKS

For any of you who suffer from–or in the past suffered from–panic attacks, you know how terribly upsetting it is to be in its clutches. Your heart pounds, your hands sweat, your stomach churns, your breathing gets shallow, and you can feel frozen to the spot. As for your mind: it in all likelihood will go heavily into obsessing that you are having a heart attack, or going crazy, or both. If you are lucky–relatively speaking–the attack will subside quickly. But if you are not so lucky, it can last for minutes, if not many minutes. Which can actually feel like it’s hours more than minutes!

GENERALIZED ANXIETY DISORDER

Diagnostically speaking, generalized anxiety disorder is the clinical condition in which you can best be described colloquially as a “real worrier.” Often enough feeling jittery and nervous, you may nonetheless be able to overall go about your life in a reasonably well-functioning manner. But you still can expect to experience some very anxiety-filled moments on a good day, and many of those moments on a bad day, when all you can think about is any person or situation that has you worried and filled with anxiety.

PHOBIAS

As you may know, a phobia is an anxiety condition in which your often intense anxiety is connected to a specific object or situation. Examples of phobias you may be personally familiar with or have heard about include public speaking, small spaces, flying, snakes or spiders, needle injections, large dogs, or heights. The key piece about phobias is that the anxiety they trigger can be as intense as in a panic attack. Yet the trigger for these attacks may not be as clear as in the case of a phobia, and therefore cannot be outright avoided as is the case with phobic objects or situations.

POST-TRAUMATIC STRESS (PTS) INDUCED

In distinguishing PTS-induced intense anxiety from phobias and panic attacks, the resulting anxiety in the former case reflects the fact that sufferer has already experienced a major life trauma. Examples of these include being in war, or being the victim of any of the following: a natural disaster, a violent crime, an animal bite, a car or plane crash, or a significant medical mistake. In the case of phobias in contrast, the sufferer typically develops strong anxiety in ANTICIPATION of having a distressing experience in the presence of the phobic object, but in most instances without actually HAVING HAD that experience. In the case of panic attacks, these typically do not involve a previous major life trauma–although paradoxically it can sure feel like having one of these attacks is a trauma itself!

TREATMENT OPTIONS: SELF-HELP AND PROFESSIONAL

Managing or controlling any of these categories of anxiety disorders can be–as you may well know–a whole lot easier said than done. I therefore recommend you pursue both self-help tools as well as professional interventions in your efforts to tackle your particular type of anxiety problem. On the self-help front, you should consider, e.g., mindful meditation of some type, physical exercise, reassuring self-talk, diversionary/distracting activity, and prayer. On the professional intervention front, you can pursue counseling or psychotherapy, and possibly medication.

One last point. Many years ago, I published an article in a national magazine, entitled “Anxiety Attacks Can Be Guilt Attacks.” Especially if your anxiety problem is mainly of the generalized/worrying type, and whether it’s obvious to you or not, you can figure at least part of your problem is significant unresolved GUILT. So I highly recommend you face that likelihood, and get that guilt resolved to the best of your ability as part of your anxiety-reduction plan.

On Grief and Loss

GRIEF AND LOSS

What do all of the following share in common: 1) the death of a loved; 2) a relationship breakup; 3) a job layoff or termination; 4) a home being destroyed by fire or tornado; and 5) significant physical limitations resulting from a serious illness or injury?  Maybe it’s obvious, but they all involve a major personal loss, any one of which can be psychologically and emotionally painful.  The loss does not have to be a total one to be difficult to cope with.  What matters most is when the loss, whatever it may be, leaves you often feeling a mix of very sad and anxious, total loss or not.  The sadness connects with grief; the anxiety connects with fear of loss of security and/or self-confidence.

Elizabeth Kubler-Ross, in her 1969 book “On Death and Dying,” postulated 5 stages of grief connected specifically to the coping with the loss of a loved one via death.  Kubler-Ross named these stages denial, anger, bargaining, depression, and acceptance.  However, in my over 30 years as a practicing psychologist, it has been my professional experience that in enough instances, the grieving process is not as etched in stone regarding these stages as Kubler-Ross postulated.  In addition, so-called stages of grieving can occur every bit as much with the other four types of significant losses spelled out above as with the death of a loved one.

NON-DEATH VARIATIONS ON THE TYPES AND STAGES OF GRIEVING

Take 58 year old David.  David was recently was laid off from his job of 27 years.  For several months, David and several of his co-workers had seen the writing on the wall of an impending “unavoidable” layoff.  So there was no room for denial here, nor for bargaining, over this job loss.  In addition, the layoff did not outright depress David, nor could he accept it.  But one thing the layoff sure did make him feel was: angry!  Anger centering mainly on the fact that David had been a loyal, hard-working, productive company employee for more than 2-plus decades.  As a result, no matter how much he knew the company was justifying the layoffs as “unavoidable,” David felt convinced in his heart that he in no way DESERVED to be laid off.  So anger reigned supreme for David as a result of this loss; as did anxiety I might add, given the likely challenge now facing him of finding another job at his age.

Now take Jennifer.  Married for 7 years, she was by nature a trusting soul, and very much in love with her husband Ira.  Yet in the past year, Jennifer had been dealing with certain behaviors on Ira’s part that were increasingly causing her more and more angst.  These especially involved Ira claiming he was now required to work late a couple of nights a week (something he had never done before), and excessive unexplained phone texting.  Jennifer was upset by these behaviors yes, but she refused to believe what her mother and best friend were telling her: that they suspected Ira was having an affair.  Alas, one night Jennifer decided uncharacteristically to “snoop” into Ira’s computer.  And there in the trash she found an ongoing exchange of deleted emails between Ira and another woman, lurid and loving in detailed nature.

No longer able to remain in denial of the obvious truth, Jennifer did not go into anger mode, as her sadness simply overwhelmed her.  When she finally confronted Ira, he not only acknowledged the truth of his affair, but even more devastatingly to Jennifer, he informed her of his intent to divorce her.  Begging (bargaining) for even some marital counseling got her nowhere.  And then for many years after the actual divorce, Jennifer remained so sad and anxious at the core that acceptance of her marital loss remained extremely difficult for her to do.

The moral of the story regarding these two significant personal, non-death losses is that they are examples of how Kubler-Ross’ five postulated stages of grief by no means universally occur, nor do they necessarily occur in the chronological order she elucidated.  What does consistently occur though in the case of significant personal loss is any of a range of painful emotions, some of which go beyond those presented by Kubler-Ross.  These can include for example guilt, jealousy, abandonment, embarrassment, and as noted above anxiety/fear.  Keep in mind too that any of these emotions can realistically and humanly have no “statute of limitations” regarding the duration of their intensity and presence, consciously or subconsciously.

CLINICAL SYMPTOMS OF GRIEF AND LOSS

Moving to the clinical aspect of grief and loss, there are a variety of possible psychological problems that intense grief can trigger, in the short run and possibly in the long run.  These include depression, anxiety, post-traumatic stress, addiction, and eating disorders.  As with the  loss-triggered emotions listed above, there is no statue of limitations on the potential duration or intensity of any of these symptoms.

HEALING FROM GRIEF AND LOSS

Safe to say we all grew up hearing the expression “time heals all wounds.”  Well, now that most of us are grown up, I will at least speak for myself when I say I have learned that the idea that time heals all wounds–especially grief/loss wounds–is far from guaranteed.  Some important losses can leave us with long-lasting if not permanent feelings of any one or more of the powerful emotions listed above, from sadness, to guilt, to loneliness, to anger, to fear.  So to help yourself heal from these emotional wounds of grief and loss, you will need to DO some things over time to increase your healing potential.  Options here especially include becoming involved in a grief/loss support group, disregarding anyone who tells you to “move on!” or “get over it already!”, staying as busy and distracted as possible, tapping into religious or personally spiritual pursuit, or–if the clinical symptom piece does not subside–seeking professional counseling and/or psychiatric medication.

In closing, I encourage you to keep in mind that any significant loss–again, be it the death of a loved one, a relationship breakup, a change or loss of a job/school/residence, or suffering a physically debilitating injury or illness–can trigger a range of painful emotions, which can vary per person in intensity, duration, and chronological order.  Therefore, let me underscore, any of these emotions is called HUMAN, and not what too many people judge them as being: “weak!”

On Anger Management

Almost everyone has heard the term anger management. Some of you may have even seen the comical version of the term anger management, i.e., the movie by that name, starring Jack Nicholson and Adam Sandler. For the very most part though, need I say there isn’t much room in real life for thinking about it in humorous terms.

In addressing the subject of anger management, let me first focus on the word anger, or a little more specifically, “angry.” The key here is that for many people, hearing someone sound and look angry implies that that person is being judged as being out of control (i.e., “flying off the handle” or “flipping out”). Yet for other people, the word angry may NOT imply being out of control. Instead, it may imply being frustrated or irritated–feelings which even if strong are usually perceived as the person still being in control of themselves. There also are many instances in which a person is perceived by others as being out of control–i.e., angry–yet NOT out of control in the eyes of the “angry” person himself/herself. And when this becomes a pattern of behavior, others may perceive that person as having an “anger management” problem, but the person himself/herself may not.

One postscript here. I think it’s safe to say that when it comes to someone having a pattern of launching into full-blown RAGE episodes, even that person will have to acknowledge that that clearly reflects a major problem they have controlling their anger!

Psychological Factors Surrounding An Anger Management Problem

People with an anger management problem are likely to have that problem for a variety of possible psychological reasons. Let me break these reasons down into 4 main categories: 1) feelings of betrayal, injustice, and entitlement; 2) parental role-modeling; 3) “masking” of vulnerability; and 4) feeling empowered.

1) Feelings of betrayal, injustice, and entitlement–The definition of betrayal that I use in my work (as well as in my personal life) is: any significant feeling of letdown, by someone important to you, based on what you believed you had the right to believe they would never do to you. Connecting this to problems with getting a handle on anger, it’s safe to say that the more someone feels either one huge betrayal or a series of betrayals that add up to a huge one, the more that person is likely to develop a storehouse of anger. This especially applies, I will add, to the feeling of betrayal being triggered by severe abuse, severe neglect, or outright abandonment. The sense of injustice that typically accompanies deep feelings of betrayal, combined with a strong sense of entitlement that the injustice be undone or eliminated only adds to the size–not to mention persistence – of that storehouse.

2) Parental role-modeling–Simply stated, a person is much more to develop an anger management problem if they had at least one parent who presented with this problem themselves.

3) “Masking” of vulnerability–While I see this issue as generally applying to men more than women, there certainly are exceptions on both sides of the gender coin. The basic point here is: suppose someone is having difficulty dealing with strong vulnerable feelings like, e.g., fear or anxiety, guilt, hurt, or sadness. The more that person judges themselves as “weak” for having much less showing these feelings, the more automatically if not reflexively he/she may display strong anger. This display of anger then “masks” those weak–i.e, vulnerable–feelings.

4) Feeling empowered–Many people who have an anger management problem, whether they acknowledge it or not, experience a surge of feeling powerful when they are angry. This surge can behaviorally manifest in what could be seen or felt stereotypically as “macho” behavior or “attack mode.” In contrast, and going back to the “masking” concept, when someone is feeling any of the vulnerable feelings listed above to a strong if not overwhelming degree, accompanying that negative self-judgment of “weakness” can be the opposite of feeling powerful, i.e., feeling powerLESS (consciously or subconsciously).

Brain Physiology And The “Highjacking” Phenomenon

To help you gain a further understanding of why impaired anger management is such a complicated syndrome, we must also look inside the brain. To keep this as understandable as possible, there are two main structures in the brain that have a great deal of bearing on anger management. The first structure is called the AMYGDALA (a-mig-duh-luh). This is the part of our brain that is centrally involved in the universal “fight/flight” response, where “flight” refers to fear or anxiety and “fight” refers to anger and aggression. In brief, when someone is stressed and resultingly develops a good deal of agitation inside, the amygdala actively fires away. If the intensity of the agitation quickly becomes intense, the amygdala can quickly become not just reactive but, more problematically, HYPERreactive. If the stressor triggering hyperactivity in the amygdala is fear-related, the person will likely develop a very high level of fear or anxiety. If on the other hand the trigger is anger-related, then the person is likely to become intensely angry.

The other key structure in the brain involved in anger management is known as the PREFRONTAL CORTEX (PFC). This is the crucial structure in the brain that is the seat of rational and logical thinking, including good decision-making, concentration and attention, and impulse control. Connecting this to anger (as well as fear too), the brain-based physiological general rule of thumb here is: the more the person’s PFC is functioning at a normal–i.e., non-stressed/agitated–level, the more controlled and better managed will that person’s anger be in general.

Now let’s tie these two structures of the brain together as it relates to anger management problems. In a nutshell, when some stressful/agitating situation triggers significant hyperactivity in the amygdala, the process known as “high-jacking” occurs. Specifically, the amygdala essentially overtakes–i.e., high-jacks–the PFC, resulting in significant impairment in the person’s ability to think clearly, concentrate adequately, and control their self-defeating impulses. In anger management terms, this means that when the amygdala is triggered to become very hyperactive, and the PFC’s functioning is therefore limited, anger takes control of the person. Which in the extreme–such as in a state of pure rage–creates the proverbial “zero to 60” effect. The overall moral of the story here being: this high-jacking process in the brain does not excuse a person with an anger management problem, but it most certainly helps EXPLAIN the problem.

Strategies For Anger Management

Given all that’s spelled out above on the psychology and brain-based physiology of anger management, I hope you are clear–maybe clearer than you’ve ever been–just how much easier said than done it is to achieve. And yet: whether you’ve ever really looked at it this way or not, in the end there are two extremely important reasons to work on anger management. The first reason is an individual one: self-respect. Simply stated–and feelings of empowerment and masked vulnerability notwithstanding– if you let intense anger take control of you, you cannot possibly respect yourself for your pattern of “flipping out” and “flying off the handle.” But just like with addiction, and to put it bluntly, who the heck ever thinks about self-respect when you’re in the middle of being very angry or indulging in an addictive substance! Yet the psychological fact of life is: a pattern of a significant loss of self-control guarantees an accompanying loss of self-respect. And that’s, let me reiterate, whether you ever consciously think about that or not.

The second reason to work on anger management has to do with being challenged or confronted by significant others about their feeling that your problem controlling anger is in there eyes sabotaging your relationship with them. If that is their experience and perception, and your relationship with them truly matters to you, then I’d say it’s advisable you get to work on your problem for this reason too!

On that note, presented below is a “menu” of strategies I recommend for working on anger management. Like a real menu, you can choose the same item each time, or change around if you feel trying a different item would be better for you. Let me preface this menu though by saying that no matter which items on the menu you choose to try to help yourself manage your anger better, it is absolutely essential that you practice them as often as possible. Otherwise, you must face the music as they say: if you don’t practice them, there is virtually no chance that you will make any progress on this troubling–and trouble-MAKING–front.

The menu I recommend for anger management includes the following:

–mindful meditation (especially focusing on breathing, tension in the body, and visual imagery; more spiritual pursuit of some type can also be a meditative option )

–“get physical” (e.g., walking or more strenuous exercise, gardening, or something cathartic like pillow-pounding)

–“get vocal” (e.g., call a friend, or: go in the car, don’t drive anywhere, and yell your heart out)

–“get your journal” (emotional venting in written form)

–“get musical” (listen to whatever type of music you believe can help you reduce your agitation)

–“get perspective” (basically, force yourself to remember that you are allowing your anger to control you in a way that can be sabotaging to your self-respect and also potentially to the relationship with someone important to you; that perspective can leave you still feeling angry yes, but able to express it in a more reasonable and controlled manner)

–“get de-stressed” (do the best you can to cut down on the overall stress in your life)

Last but not least, given the complexity of the problem of agitation management and the big challenge it therefore presents, I highly encourage you to give yourself a big pat on the back each and every time you do something to keep your anger to a manageable and controlled level!

On Psychology & Spirituality

Personal Definition of Spirituality

The practice of some form of spirituality is for many people an important part of their daily lives. Yet the term “spirituality” itself can mean different things to different people. As you may recognize, for some people, spiritual practice automatically connotes having a theistic set of beliefs, in which the central focus surrounds a belief in God. Yet under the heading of the term theistic spiritual practice can be two sub-categories: a belief in God through involvement in a chosen religion vs. on one’s own, without any religious involvement.

But now let’s look at people who identify themselves as atheists, who of course disavow a belief in God or a God-like figure. “If you so choose, please feel free to replace the word God with words you may prefer, like Higher Power or Spirit. Just for consistency, I will stick with using God.” From the standpoint of a theistic bent regarding spiritual practice, it can almost be concluded that atheists do not do any type of spiritual practice. In order to dismiss this conclusion entirely, one can choose to define one form of spiritual practice in “earthly”–i.e., non-theistic–terms. Allow to me propose a definition of spiritual practice that cuts across theistic and atheistic belief systems. At risk of sounding glib or oversimplifying the matter, that definition is: anything you do that LIFTS YOUR SPIRITS. With the understanding that there is a range of how much lifting of your spirits a particular spiritual practice can provide you. So therefore, one type of spiritual practice you do may lift your spirits a small amount, another one a bigger amount, and a third one a very significant amount.

Taking this notion one more step, you can end up with two categories fitting this definition of spiritual practice. The two categories can be called theistic practice vs. in this case “personal/situational” practice. If you are a theist, your spirits can soar to varying degrees through some type of connecting to God, be it in a house of worship, or for that matter anywhere else you feel that connection to God, as for example looking out at the ocean, or walking in the woods. Yet truth be told there are non-theistic ways to make your spirits soar too– sometimes every bit as much as involving a theistic spiritual practice. Take the same two situational examples I just listed: staring out at the ocean and walking in the woods. Simply stated, many people can experience an uplifting in their spirits by doing either of these two things, without feeling any connection whatsoever to God. Spiritual uplifting can also occur from doing anything like, e.g., listening to or playing your favorite music, doing yoga, eating a wonderful meal, attending an event you find highly entertaining, reading an absorbing book, doing rewarding volunteer work, attending an inspiring class or workshop, watching a child play and laugh, or making love. And certainly these examples do not exhaust the the list of what any of us can find to be a spiritual practice to lift up our spirits–none of which requiring any belief in or feeling any connection to God!

Spiritual Practice Applied to Psychological Distress

People who seek professional help for psychological problems such as anxiety and depression may or may not view spiritual practices as a beneficial tool in their efforts to manage these conditions. In my experience, most psychotherapy techniques are not primarily spiritually-oriented. Instead, they are geared mainly towards efforts to, e.g., create more positive cognitions, manage stress and fear better, build up self-worth, and improve the quality of relationships. Mainly through talking things out with the therapist and then doing occasional “homeworks” to apply what is discussed in session is how these techniques are seen as hopefully helping people reduce their clinical symptoms.

I would like to propose here that there is room to bring spirituality into psychotherapeutic treatment. In this context of spirituality though, I am going to focus mainly on theistic spiritual practices. My main point is to very much encourage anyone who has a strong religious or personal belief in God to utilize this belief in a manner that maximizes its potential therapeutic benefit. More specifically, let’s suppose you are mired in the throes of episodes of depression or anxiety. As an alternative to attempting only to e.g., utilize more positive cognitions, practice specific symptom-management techniques, or do non-theistic mindfulness meditating–as many therapy approaches are geared towards–you might start utilizing some type of THEISTIC spiritual practice to better manage and control your clinical symptoms. Thus for example, when you are conscious of feeling overtaken by a bout of depression or episode of anxiety, as a spiritual practice try in your own way turning right to GOD, such as through some type of preferred prayer, or simply talking to God in a manner that makes you feel like you are turning to Him for, e.g., comfort, courage, inner emotional strength, and determination. All of which can, if your faith in God is solid, provide you with at minimum needed situational relief from your clinical symptoms, and at maximum more confidence that you can control these symptoms from taking control of you.

Yes, you can also psychologically benefit from non-theistic spiritual practices (or for that matter, prescribed medication for more intense symptoms). But if you can embrace theistic spiritual practice–without the necessity to have to practice it through involvement in organized religion–then my own personal/theistic belief is that God is always there inside you, anytime and anyplace you need to turn to Him. So you can if you choose turn to Him especially for help in dealing with your depression or anxiety–or for that matter any other stressful psychological challenges you are faced with. I therefore encourage you to give yourself the option of a spiritual practice involving going right to God as quickly and regularly as you can. By doing so, hopefully you can come to feel you have a strong and trusted ally inside you, to help you cope with your psychologically challenging problems.