Stress, Anxiety, and Fear
For many years I have interacted with groups on the topic of stress. The discussion begins with asking people if they have ever experienced stress. If there is so much as one person that doesn’t raise their hand it is a great opportunity to interact and ask then for their secret. Stress is a universal phenomenon but is certainly not always negative – as in the case of the stress of starting a new job or moving to a new and improved housing location. It is a deeper dive into the definitions for anxiety and fear. After some participation I will often make the point that fear is real. This is not to say that anxiety is imaginary it simply highlights the fact that the innate fear response is activated in the face of a tangible threat – the proverbial bear in the woods. Anxiety by contrast often takes place in anticipation and is not necessarily triggered by a tangible stimulus – “what if there is a bear in the woods.”
There are several different ways in which anxiety manifests the first of which is simple phobias of things like dogs, snakes, and airplanes. Panic is more to do with the fear of fear and thus is triggered by a fear response to the sensations of anxiety in the body such as increased heart rate and chest compression/ hyper ventilation. Social anxiety has to do with fear of negative evaluation from others based on appearance (they will think I am weird/ creepy/ ugly) intelligence (they think I am stupid) or symptoms (they can see that I am shaking/ flushing/ sweating). Anxiety can also arise in response to real time sensations that conjure past traumatic events. It can also take place in response to unwanted intrusive thoughts (ie: did I leave the stove on/ will this burn down the house). Among the more frequent of anxiety related concerns is Generalized Anxiety which manifests as worry. Worry will glom on to all things in life in an ecompassing list: education, career, finances, health, and relationship. It operates differently than other anxiety related concerns as the intensity appears to be much less. In this way it is much more “death by a thousand paper cuts” relative to the heart stopping fear of phobia, panic, social anxiety, or obsessive-compulsive issues.
Overcoming any anxiety involves facing fears. People understand this intuitively if I ask them what they would recommend that I do if I were afraid of dogs to the point that I do not wish to leave home. While few recommend that I avoid dogs at all cost, many recognize the importance of leaning in even if the starting point is looking at pictures of dogs. They are describing the principle of prolonged exposure and may even include systematic desensitization (ie: start small, build up, and stay in the situation until your stress level acclimates). It seems counterintuitive to intentionally generate distress. I am reminded of the power of this type of intervention having just recently finished listening to Sara Polley’s moving autobiography in which her final chapter outlines the story behind the book title “Run Toward the Danger.” In it she described a riveting account of what it took for her to not listen to her body and instead overcome her fear of discomfort, nausea, and headaches associated with more than three years and many unsuccessful attempts to recover from post-concussion syndrome.
I would welcome the opportunity to work with you whether your situation is one that involves situational stress or more long standing anxieties. The work of leaning in and facing fears is challenging but extremely rewarding as you take steps toward doing things you never thought possible, feeling more like yourself, and living your best life.
October 19, 2022 by Dr. Nathan J. Cooper
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