One of the maintenance factors for anxiety is when an individual does not fully go through the anxiety cycle and where their safety behaviour patterns kick in, such as avoidance behaviours, the suppression of thoughts and other safety seeking behaviours. We all know that avoidance, the suppression of thoughts and safety seeking behaviours just strengthen and maintain anxiety over the long-term and make real internal and life-changing behavioural changes much more harder over time.
So what do I mean by the anxiety cycle? Well in a nutshell, this includes the 'build-up' to an event that an individual focusses on and which is causing a sharp rise in anxiety related behaviours. This event itself may include specific actions such as taking a flight, travelling on the underground or sitting in an enclosed space that feels claustrophobic.
Part of the anxiety cycle will also include the event itself, though the degree to which an individual places themselves into that event will determine if their anxiety or their phobias related to their anxiety strengthen themselves and are sustained, or weaken over time through continued exposure.
This obviously depends on how long someone can feel comfortable, for example, by travelling on a plane or sitting in tunnels and carriages on the London Underground. The quicker they get off these modes of transport as a form of avoidance to their sharply rising anxiety, the more their anxiety and the phobic/intrusive thoughts will remain a driving force for their safety seeking behaviours. 'Cutting out' early or as fast as possible to anxiety causing situations simply re-enforces and embeds in the anxiety cycle to a much deeper level. This is key to understand and comprehend and it is ego-dystonic.
Research work has shown that such individuals should stay in their anxiety causing situation until the intensity of their anxiety drops below 50% from the start. This can be measured in the form of their pulse or their heart rate and provides somewhat of a measure as to how long the person should stay in that situation, and through which there will be some form of therapeutic gain as the body re-learns that the situation is not catastrophic.
So, anxiety sufferers should repeatedly place themselves into specific situations that are anxiety producing, and stay in those situations until their heart rates fall to below 50% of the frequency of their pulse before they started the activity. Consistency is key, as is repeating these exercises on a weekly basis.
The greater the frequency of these exposures and the smaller the time difference between these exposure events, the greater the chance of real long-lasting change in response to anxiety. Furthermore, the greater the chances the individual will have to be able to overcome any anxiety inducing events in a much shorter period of time. The positive knock-on benefits to this also include a higher level of self-confidence and self-esteem in individuals, which act as a counter-loop to the anxiety cycle.
So going through the anxiety cycle is one of the most essential of activities that anxiety sufferers can undertake. With that in mind, therapists need to be aware that sufferers will more than likely have a 'fear of fear'. Being curious with the client at the start of the counselling journey can ascertain this, before any exposure related behaviours can form part of any therapeutic planning process.
