High Anxiety

    For three hours the finger never stopped.  It grabbed a lock of dark hair, expertly spun it around four or five times, rolled it between thumb and finger for a few seconds, released it, and then began the process all over again.  I witnessed this strange behavior from my airplane seat, captive to the nervous antics of the passenger in front of me.  Only the top of his tortured head was visible, along with that relentless finger.

    The poor guy was in the throes of an anxiety disorder called Trichotillomania (use that in a sentence and impress your friends!), an irresistible urge to pull one’s hair.    And he wasn’t the only one with symptoms of anxiety.  We were all traveling on a recent day when yet another financial giant had collapsed, there was a general mood of uneasiness, and it seemed that we were all being pulled helplessly into very frightening territory.  At the airport the mood was somber, people were unusually quiet, and many stood around watching the television monitors broadcasting endless bad news and dire warnings.

    It seemed that Mel Brook’s joke about the very, very nervous really captured what we were all experiencing and it reminded me of some basic skills I teach patients to help them deal with anxiety.  I thought it would be useful to list a few of them here.
    

    1. What can I control?
     A great deal of energy gets consumed compulsively worrying about things in the past, things in the future, and generally things over which we have no control.  This is frustrating as well as emotionally and physically harmful. It is very useful to determine where you actually have some influence over any given situation.  It may be that choices are truly limited, but there is usually something we can do to assert a sense of empowerment.  Even the act of making lists to organize our plans can help us regain a sense of control.       

    2. Take action, then let go of the results
     Once you determine where you can be effective take deliberate action.  Don’t shoot from the hip, but also be wary of becoming paralyzed, a trap experienced by many people experiencing anxiety.  Remember that doing nothing is in fact an action, and the results may not be in your best interest.  Once you’ve done what you can do, monitor the results and re-evaluate where you go from there.  Twelve step programs utilize the Serenity Prayer which captures this beautifully: 

         God grant me the serenity 
         to accept the things I cannot change; 
         courage to change the things I can;
         and wisdom to know the difference.     

    3. Identify your safe place
 Think of this as your “safe word” when life’s scenes gets a little too intense.  Select a place you can imagine in your mind that is soothing, calming, and comforting.  It can be the beach, or the woods, or a mountaintop – whatever works for you.  Anchor this spot in your imagination with as many specifics as you can: What time of day is it? What is the season and the temperature?  Is there a breeze?  What colors do you see? Are there sounds?  Can you smell grass, or leaves, or the sea?  Once you have determined your safe place, practice going there until it becomes effortless.  It works because your mind can only focus on one thing at a time and it’s easily distracted.  Spending a few seconds there can have remarkable physiological and emotional effects, actually calming nerves, reducing blood pressure, even averting panic attacks.  I use this when working with patients who have experienced trauma – it’s powerful. 

     Like it or not, anxious situations seem here to stay.  The more tools we have to deal with them, the more we’ll be able to move through life with some sense of serenity, not to mention (at least for some) a full head of hair.