Medication for anxiety disorders can be helpful in emergencies, if you really, really think you can't cope for another minute, or you haven't had any sleep for nights. But sleeping pills (which are just reformulations of tranquillisers) induce lower quality sleep and we quickly habituate to them. After three nights, they don't work any more, and we get at best only 15 minutes more sleep with them than without them.
As for other tranquillising drugs or antidepressants, they may appear to calm us down for a while but, more often than not, the dosage has to keep being upped, because they soon cease to do the job so well.
Plenty of studies have compared the effectiveness of drug treatment and psychotherapeutic treatments for different anxiety disorders and these have overwhelmingly shown that drugs offer no long-term answer. One found that there was no advantage to adding drugs to effective behaviour therapy but that effective behaviour therapy added to drug treatment could increase effectiveness by half. Unfortunately, despite the research findings, both tranquillisers and antidepressants are still being prescribed for anxiety.
And that's on top of the excess of drugs, such as caffeine, alcohol, cigarettes and cannabis, that many people already use in a vain attempt to cope with stress. But taking drugs for anxiety is not nearly as effective as finding out what is causing the anxiety in the first place. By looking at what is missing from our lives, and then learning how to get back on track by doing something about it, we can make real, long-lasting changes.
This is what the following articles are about.
Human needs and resources
Every living thing needs the right nourishment from its environment to be healthy. And every living thing knows how to get that nourishment. Plants 'know' they must turn to the sun, to be able to produce the chlorophyll they need to make their food; their roots 'know' to suck up moisture from the soil. Babies know to seek the nipple (or bottle teat) for food; they know how to build rapport with their main carers (by being responsive, smiling, etc.), to ensure that they are taken care of, and so on. All living things have an innate 'guidance system' like this to help them get their essential needs met. Our essential needs and the innate guidance system we were gifted with to help us meet them together form 'the human givens'.
Essential emotional needs
We all need food, water, warmth and shelter from the elements in order to survive - these are basic 'givens'. But there are many other needs, emotional rather than physical, that are equally crucial for our wellbeing - and sometimes even for our survival too. Decades of health and social research have shown that these include:
- security - a sense of being safe, which enables us to lead our lives without undue fear
- a sense of autonomy and control over our lives
- attention - receiving it from others, but also giving it
- emotional connection to other people - friendship, love, intimacy, fun
- connection to the wider community - being part of something larger than ourselves
- privacy - to reflect
- a sense of status - being accepted and valued in the different social groups we belong to
- a sense of our own competence and achievement -which ensures we don't suffer from 'low self-esteem'
- a sense of meaning and purpose - which comes from doing things that mentally and/ or physically stretch us.
Our innate guidance system
To help us find ways to meet our needs, nature has given us a wealth of resources, such as:
- the ability to add new knowledge to our innate knowledge: to learn and remember
- the ability to build rapport, empathise and connect with others
- a powerful imagination, to aid problem solving
- the ability to think things out, analyse, plan and adapt
- the ability to understand the world unconsciously - through pattern matching
- the ability to step back into our 'observing self' (our self-awareness) - and be objective
- the ability to dream and thus discharge any unexpressed emotionally arousing expectations, so that we can face each day afresh.
These needs and resources together are in-built patterns, or biological templates, which direct our actions and responses.
If a person is thriving and having their needs met, in appropriate balance, they cannot suffer from anxiety disorders or any other mental disorder. What, then, could prevent us from getting our needs met? There are only three possibilities, and all mental distress is due to one or a combination of these.
Possibilty 1: The environment doesn't provide the nourishment needed
For instance, children that are emotionally or physically abused by their parents, or whose parents are emotionally distant or too authoritarian or too liberal, or constantly critical, cannot be mentally healthy in that setting. They are harmfully conditioned by the experience. Likewise, adults that are bullied at work or stressed by unrealistic targets and dead-lines cannot be mentally healthy in that work environment.
Possibility 2: The innate guidance system has become damaged
This could be because of genetic damage or physical damage (for instance, a head injury) but most commonly it is because of psychological damage: trauma. This could take the form of PTSD or be less extreme, yet still affect the way we function in the world. Addictions, too, can corrupt the way that the guidance system works - substituting destructive impulses for life-enhancing drives.
Possibility 3: The innate guidance system isn't being used properly
The more complex an organism is, the more learning is involved in operating the guidance system correctly. For instance, babies may have the ability to build initial rapport, by the very fact of being endearing, vulnerable little creatures that inspire love and caring in the adults connected with them. But that isn't enough. As they grow into children and then adults, they need to know how to be social animals - to make the right social responses, to make friends, to build intimate and professional relationships, to develop the ability to learn and use information, to make shrewd judgements, to trust wisely, to be self-assertive, to manage stress, and so on.
If we don't have these life skills, albeit through no fault of our own, we cannot get our needs met fully. For instance, if our parents were cruel or uncaring, we may find it hard to trust others or create close relationships. If we were laughed at when we made a mistake at school, we may not develop confidence in our abilities.
Sometimes we use aspects of the guidance system incorrectly. As we have seen, imagination, which is a powerful aid in problem solving, is heavily misused (unwittingly, of course) by people with anxiety, who spend so much time imagining dire outcomes of one kind or another (worrying, in other words) that they may prevent themselves from being able to problem solve at all.
But whatever the reason for your own high levels of anxiety (or that of whoever you are trying to help), there is much that can be done to relieve the distress and take back control of your life. When therapists and psychologists work with people suffering from anxiety disorders, they first look to see which important needs are not being met in their lives and/or which of their innate resources are either not being used or are being used incorrectly. They then help each individual to build up effective ways to meet their needs, at the same time as they are learning how to handle high anxiety.
These are the techniques we are going to share with you in the next section (Part 2).
Continued in this article: Overcoming anxiety