Most of us worry to some extent, and worry can be useful if it helps us arrive at solutions to problems. For example, if we worry that we might forget important items on an overseas holiday, we would be sure to double-check our packing. If we worry about passing a test, we would make sure we revise the material. The worrying is not pleasant at the time, but it may help things go smoothly.
However, consider a person who worries about everything. What if this person’s worry is unproductive, that is, no amount of worry helps him or her come up with a solution? What if he or she cannot stop the worry, even when the negative effect on his or her life, and the lives of significant others, is very substantial and obvious? This person might be diagnosed with Generalised Anxiety Disorder.
Signs of Generalised Anxiety Disorder
Generalised Anxiety Disorder, or GAD, is characterised by excessive anxiety and apprehension over multiple issues, and is associated with:
- Difficulty controlling the anxiety;
- Feelings of restlessness or being “keyed-up”;
- Poor concentration;
- Muscle tension;
- Sleep disturbance;
Clearly these symptoms are very different from those associated with panic, in which there is a marked nervous system surge, causing symptoms such as a racing heart and physical trembling.
GAD is one of the most common anxiety disorders, affecting over one in twenty people at some time in their life. It often occurs along with depression, and social phobia and other phobias.
It is clear that people with GAD will experience significant impairments in social and occupational aspects of their daily lives, have poor life satisfaction and an increased occurrence of distressing minor life stressors.
Psychologists have developed a range of models in attempts to explain the factors that cause GAD to arise, and the factors that keep it going.
There is growing evidence to support the idea that, simply put, people with GAD are thinking so hard that they don’t have any attention left to create distressing images of the things they are worried about, images that would produce even more distressing emotions and physical sensations. Worrying is therefore reinforced; it stops upsetting images occurring. In addition, when the feared events do not actually happen, the importance or usefulness of worrying may also be reinforced.
How Acceptance and Commitment Therapy can help
In recent years there have been a number of studies of treatments for GAD using ideas from Acceptance and Commitment Therapy (ACT). ACT is partly based on the idea that psychological problems and disorders result from attempts to avoid potentially upsetting feelings, body sensations, thoughts, memories and images, or attempts to change them. According to these ideas, people with GAD perceive emotions as threatening, and so try to avoid them, both in their behaviour and by worrying.
This avoidance reduces distress in the short term; however, in the longer term the avoidance diminishes the extent that people engage in valued or meaningful activities. This causes more distress, triggering more upsetting internal events to be avoided, causing more worry and so on.
Treating Generalised Anxiety Disorder
Treating generalised anxiety or chronic worry using ACT involves the person developing the capacity to “step back” from worry thoughts, and make room for, or allow, painful feelings and sensations.
A range of Mindfulness and other strategies can be used to help the person observe his or her thoughts coming and going without getting hooked into them or dwelling on them.
For example, thoughts may be seen as a series of cars going past the house or leaves floating down a stream. The mind may be seen as a radio broadcasting “doom and gloom”, or thoughts may be visualised as words on a computer screen, instead of being seen as true, as orders, or as always necessarily wise or important.
Painful feelings and sensations can be observed non-judgementally as a scientist would, with the aim of accepting and noticing their arising and passing, without needing to avoid, change or interfere with them.
By learning to “de-fuse” from thoughts and allow painful feelings and sensations, people with anxiety problems become more able to develop their lives in line with their values. Values-based goals can be developed to produce committed action, and the restrictions and limitations that GAD has placed on their lives are increasingly removed. The goal of ACT is the development of a rich, meaningful and values-based life.
If you experience ongoing problems with chronic worrying and generalised anxiety, please consider making an appointment with me, so that we can explore your difficulties and decide whether ACT would be an appropriate treatment for you.
Author: Bridget Hogg, B.Sc. (Hons), M. Sc. (Clinical Psychology)
Bridget Hogg draws primarily on Acceptance and Commitment Therapy, Dialectical Behaviour Therapy and Mindfulness training as part of treatment for a range of distressing thoughts, feelings and physical sensations.
It is an act of courage and self-care to seek therapeutic help for ongoing psychological difficulties, and Bridget respects and admires all clients who take the first step in that process by making their first appointment. She is passionate about helping people improve the quality of their lives, particularly those for whom life feels at times extremely difficult and painful.
To make an appointment with Bridget Hogg, you can freecall 1800 877 924 or book online now!