AnxCalm - New Solutions to the Anxiety Epidemic

Today, I am very happy to have with me a former client of mine and he’s very brave to be willing to talk about fear of flying in a straightforward

John: This is Doctor John Dacey with my weekly podcast New Solutions to the Anxiety Epidemic. Today, I have an old friend of mine, by the name of Mark. He’s going o talk to us about his own experiences with Anxiety. Good morning, Mark. How are you?

Mark: Good, John. How are you?

John: Fine. First of all, I’d like you to tell us a little about yourself. What work have you done and where are you at today?

Mark: I was born and brought up in Massachusetts. I was in the family business, I became a truck driver for 35 years and most recently my company filed for bankruptcy.

A note to my listeners: When I interviewed Mark, I had no idea which of the 8 types of anxiety he would say he had a problem with. He alleged that he had no problems with the first 7, only a serious problem with the last one. So I’m going to skip that part of our interview and go right to the last type of anxiety: Post-traumatic stress disorder.

John: Having been through an extremely stressful situation and sometimes getting flashbacks from it.

Mark: Maybe.

John: Can you tell us a little more about that?

Mark: The death of a parent.

John: Oh, of course. And which parent was that?

Mark: Mother. 1973.

John: Ok. You say this was ] traumatic for you. Why was this such a hard thing for you to deal with, if you’d be willing to share with us?

Mark: Growing up without a mother I was just a young boy.

John: How old were you?

Mark: I was 13 years old.

John: Oh that’s really terrible. Can you tell us how she died?

Mark: She died in bed. She was a sick woman, but she died at the age of 49.

John: Oh, that’s really sad. It was more than just very sad for you. You think it might have been traumatic.

Mark: Yeah I think it was traumatic for me.

John: Is it still traumatic? Like, do you miss her terribly every day? Or have you gotten more used to it?

Mark: I’ve gotten used to it.

John: How do you think you got to the place where you felt pretty used to it?

Mark: Can I give you credit.

John: Sure.

Mark: When I met you, you were just a man at an AA meeting, and then when I was 10 years sober, then we talked.

John: You don’t mind saying that you were my client for a while.

Mark: Not if you don’t mind.

John: No I don’t. I’d love to take the credit. So we talked about your mother, didn’t we?

Mark: We did.

John: Can you tell us a little bit about — was that successful? Do you feel like you were able to do better after that?

Mark: I dealt with my pain with alcohol and booze and I was at a crossroads in my sobriety and you helped me through that without drinking.

John: That’s terrific. I’m really proud of you and I think 34 years is an incredible achievement. Do you have any children?

Mark: None.

John: Ok. Who is the person you are the closest to, would you say?

John: Hi, this is Doctor John Dacey with my weekly podcast, New Solutions to the Anxiety Epidemic. Today, I have a friend of mine, James, who’s going to be talking to us about his own situation and his own familiarity with anxiety. James, how are you?

James: I’m doing alright, how are you?

John: Good, thank you. I wonder if you could tell us a little something about yourself before we get started.

James: Well, I am currently a junior in high school. I’m 17.

John: How are you finding taking courses online?

James: Online? It’s presented its own set of challenges. I wouldn’t say it’s better or worse than regular school but, I think there’s less work but it’s a different kind of material. It feels a little bit less meaningful.

John: Yeah, I can understand that. People say that there’s such a thing as Zoom exhaustion. After you’ve spent a certain amount of time on Zoom that it’s much more tiring than sitting there and talking to somebody.

James: Yeah, I don’t do too many Zoom calls because of the way the school has set it up for us but I get that.

John: Today, what I would like to do is go over 7 of the 8 types of anxiety that there are and have you tell me, do you think that you have a condition in that area, the anxiety syndrome, and we’ll talk a little bit about if you’ve discovered anything that’s helped with you. Is that ok?

James: Sounds good.

John: I’m going to skip the first one which is called simple phobias because everybody has them, agoraphobia, afraid of falling from heights, things like that. We’ll start with probably the most common one which is social anxiety. Social anxiety is things like fear of speaking in public, feeling of not wanting to go to parties, that sort of thing. Do you think you’re bothered by any of that?

James: Not generally. Sometimes I’ll have a little bit in large groups but generally speaking, that’s not something that I tend to experience.

John: I remember some years ago watching you sing by yourself in front of probably 300 people in the audience and you seemed to be very calm about the whole thing and very confident. Is that typically the case?

James: Yeah that tends to be the case.

John: And you’ve been in some theater things where if you were going to have social anxiety, that’s where you’d have it.

James: Yeah, I’ve been doing theater from a very young age so it’s something that I’ve got pretty used to.

John: That’s great. Separation anxiety usually bothers younger people but sometimes older people. Separation anxiety is when you feel like if you’re not around a person who is very powerful, that knows how to take care of you, that you’re in trouble. Did you have any trouble starting school, for example leaving your mother?

James: No, I don’t think I did.

John: I don’t think you did either. The next one is called generalized anxiety. Just a general nervous feeling at least half of the time.

James: Yeah, that’s the one that I definitely have.

John: That usually comes about from a bunch of experiences that didn’t go so well for you, or  that you feel like they didn’t go so well for you, and you become sort of nervous, on the lookout and what we call “hypervigilant.” Do you know what I mean when I say hypervigilant?

I this is Dr. John Dacey coming to you with my weekly podcast dissolution study anxiety epidemic today Today I’ll be speaking to you  about how to deal with the problems teenagers are facing with the coronavirus. Many of my listen...

This week, I continue with my instruction in how to evaluate your anti-anxiety plan as you carry it out. As I said in an earlier podcast, such evaluation not only offers you an objective view of how well you’re doing, but also help...

John: Hi this is Doctor John Dacey with my weekly podcast New Solutions to the Anxiety Epidemic. Last time, we were talking with Doctor Biz Bracher about college students and social anxieties. Today I’d like to ask her to continue this, and talk about the difference between seniors and freshmen. She teaches both groups and I think it’s going to be interesting to hear what she has to say about that. Good morning Biz.

Biz: Hi. So the first-year students seemed to settle into distance learning and their new home situation over time. It certainly hasn’t been ideal. Any of us who have spent hours on Zoom and trying to teach a seminar on Zoom and have the same sort of energy and rapport in the classroom will know that this distance learning isn’t as easy as it might appear. But the first-year students have settled into it.

John: By the way, how about for the teacher? Is there anxiety for the teacher also?

Biz: Most absolutely. I think that for teaching a seminar course of 20 students when you’re looking at sort of what I call “the Brady Bunch” of squares across. I pride myself on my ability to draw students into the conversation. I notice their physical response to conversations and I can draw them in saying, “Suzzie, you look like you have something to say on this topic” or “John, what do you want to add to this conversation?” and it draws them in in a very comfortable way. It’s really hard to monitor that online.

John: But you don’t do that at random? You’re saying you pick students on the basis of what they’re presenting as to whether or not they want to say something, right?

Biz: Yeah absolutely.

John: And that’s harder to do with the Zoom?

Biz: It’s so much harder because first of all, my 50-year-old eyes can’t also see the detail on someone’s face but how do I know that their facial expressions are reacting to what I’m saying or are they watching something else online? Are they doing email? Are they really checked in or checked out of the conversation? There certainly have been many students who I don’t think were really giving me their full attention. And who can blame them? There are so many things happening around us that you don’t have them in a classroom so their attention is pulled away. Ultimately, I think the first-year students transitioned and the light at the end of the tunnel for this semester and going through exams and such, they still have three years of college left. While they’re sad about this semester ending, they’re hopeful that this is not the college of the future. Our seniors, they’re still not settled with it because — and this is my hypothesis of it — I often refer to our students or, as a parent, our children as the baby on board generation. They’re the playdate generation. College students these days and millennials, they were raised to have their days scheduled first by their parents. They came home from the hospital in cars that had a placard that said “baby on board” as if everyone else was going to drive around that car differently because there was a new life in that car, as if the other people driving around them didn’t matter. Why isn’t there a “70-year-old on board”?

John: I never thought about that before but that’s a terrific insight. I like it very much.

Biz: But why is there any more value? So there’s this idea of protecting them, right? And then push that out as they get older, having playdates. There’s lots of research and conversation about “free-range kids” and kids that are let out to go play and maneuver the streets of the suburbs by themselves. More than not,

John: Hi this is Doctor John Dacey with my weekly podcast New Solutions to the Anxiety Epidemic. Today, I am being revisited be one of my best colleagues and also respondents to this podcast. Her name is Doc...

This week, I continue with my instruction in how to evaluate your anti-anxiety plan. As I said in my last podcast, such evaluation not only offers you an objective view of how well you’re doing, but also helps you to do better.

Bio-Counting

One of the best things you can do is to design charts to track more objective data. Measurements such as pulse rate, blood pressure, oxygen-in-the-blood calculations, and galvanic skin response are also relevant, although the last three require equipment. For charting your relative pulse rate, press the largest two fingers of your left hand on your carotid artery at the side of your neck, and as the second hand hits 12, begin counting beats. As the second hand passes 4, stop counting and record the total number of beats you counted in 20 second, times 3. This will give you a good approximation of your actual heart rate. You can make these entries at various times of the day and/or before, during and after an anti-anxiety activity. One word of caution: as with anything else in life, it is possible to overdo chart making:

The Obsessive Pulse-Taker

I have advocated a number of evaluation methods that involve self-evaluation. I should warn you about a possible backlash, however. I once was asked to counsel a 21-year-old woman, Cassie, who was diligent in her efforts to monitor her anti-anxiety plan. She unfailingly took her carotid pulse before, during, and after each effort to confront her panic. She meticulously entered these readings on a chart that she had carefully designed.

Unfortunately, instead of getting lower and lower readings, her rates gradually ascended. She was very frustrated by this, finally to the point of tears. When her parents called  me, she had been experiencing the problem for about three weeks. When she and I discussed the situation, her plan made sense to me, and even more important, Cassie really liked it. Further discussion uncovered the core of her difficulty. She wanted too desperately to succeed.

Many anxious folks are perfectionistic. Whether that causes the anxiety, or the anxiety causes striving to be perfect, we do not know. At any rate, in Cassie’s case, she was so worried that her pulse readings would not drop, of course they rose. When anxiety is mixed with perfectionist leanings, it is probably best to de-emphasize evaluation and concentrate on keeping your nerves calm.

Now for a quick look at the other three techniques. Blood pressure, which is associated with anxiety in both its upper number (systolic) and lower number (diastolic), can be checked by a blood pressure meter available at your local drugstore for around $30. As with heart rate, you must be careful that your drive to reduce your anxiety doesn’t drive your blood pressure up. Two other bio-indicators of anxiety levels are blood oxygenation, measured by an oximeter and galvanic skin response, measured by a GSR meter. These can be obtained from any number of medical supply sources such as Amazon. It probably won’t be necessary for you to use either of these, but if you think you’d like to come read more about them online.

The next item on the agenda is a questionnaire about biological factors that affect your level of anxiety. When you have scored the test, I will give you data as to how you compare to the hundreds of others who have taken this test.

The Dacey Biological Factors Questionnaire

John: Hi this is Doctor John Dacey with my weekly podcast New Solutions to the Anxiety Epidemic. Today, I have a friend of mine, Patrick, who is going to talk about his own anxiety and what he’s done about them. How are you doing, Patrick?

Patrick: Very good, John. Great to be here.

John: Well thank you for coming. I’m just going to name the 8 kinds of anxiety and let’s start off with you saying which one has affected you the most. Is that ok?

Patrick: Absolutely.

John: Thank you. Those are simple phobias, which we won’t talk about those since everyone has them, separation anxiety, social anxiety, generalized anxiety, those are the 4 sort of lower ones, more common. A little less common are the 4 more difficult ones: agoraphobia, panic disorder, obsessive-compulsive disorder, and post-traumatic stress disorder. Do any of these ring a bell with you, Patrick?

Patrick: For me, it’d be a panic disorder. Yes sir.

John: So tell me, what does it feel like when you get a panic attack?

Patrick: Sure. I think to get a better sense of how it happened to me, what it’s been like, I’ll talk a bit about my experiences in recent years and where it lead me and where I’ve come since then.

John: That would be great Patrick. That’s just what we’re looking for.

Patrick: A little bit about me: I’m a senior neuroscience major at Boston College, almost graduated now, from Massachusetts. I love playing golf, love my friends, love my family, especially my pug, Charlie. For me, I had a very happy upbringing, very happy childhood.

John: Where did you grow up?

Patrick: Attleborough, Massachusetts. So not too far from Boston. My brothers, best two friends. Very loving and supporting parents. Middle school, high school, college, it was all very good. I loved it. Things for me came to a standstill in the middle of my junior year. So this is end of 2018 to 2019. This is when I started my experience with panic. So I never experienced anything like that before. At the time, when it first started, I really had no idea what to do. Everything was so unfamiliar and so unexpected. I didn’t think that there was any way that whatever was happening could possibly happen to me.

John: Can you describe it? What did it feel like?

Patrick: So I’ve thought a lot about it and what it’s like when it happens. As much as I describe it in hindsight, it’s always very different when it’s happening in the moment. It’s a lot of confusion. I can really never quite understand what’s going on when it happens. It’s a lot of overwhelming sensations. I really just lose any sense of control over what’s going on at the current moment.

John: Does it come on you all of a sudden?

Patrick: Yep and a lot of times for me it happened in recurring places so if I had a tendency to have a panic attack in one certain type of location, then anything that was similar or the same type of location, then I would feel that sense of panic again when I would return. So for me, my solution, early, was avoidance. I went on a pretty crazy string of avoiding things that did or may cause panic. I mentioned this to some people where I had times where I couldn’t go to certain classrooms. I felt like I had a few panic attacks in those classes and I would do anything to get avoid those classes and those places and I hated that feeling.

John: Who wouldn’t? It’s an awful thing.

Hi. This is Dr. John Dacey, with my weekly podcast, New Solutions to the Anxiety Epidemic. If you have started carrying out a plan to reduce your anxiety levels, and I hope you have, it’s time to lay the groundwork for evaluating your progrgess. I’m going to introduce you to the concept of formative evaluation. The good news about formative evaluation, that is, checking while your plan is in effect, is that once we learn to do it, this process alone can help to reduce anxiety. Evaluating progress in your plan as you are carrying it out offers several advantages:

It helps you gain perspective on the problem.

It takes you away from your worries about future dangers back to a concern with the present (called “centering,” as you may remember). Concentration on checking progress often also disrupts anxious thoughts.

Being self-aware tends to breed a sense of self-control.

Evaluation causes you to think of yourself as a person who "has anxiety," rather than a person who "is anxious." This allows anxiety to be seen as a part of you rather than the whole, and thus it becomes more manageable.

Formative evaluation encourages “how” questions (“How are you feeling right now?”) and “what” questions ("What is the most troubling aspect of your situation?"). These promote the sense of being a "self-observer." "Why" questions, on the other hand, only produce more worrying.

At its best, formative evaluation amounts to what has been called "watching myself watch myself." When you master this skill, your anxiety levels are always reduced.

In this section, I present activities that illustrate effective strategies: charting; using drawings; getting help from buddies or from a therapist; check listing; journaling; and photographing. I hope that as you learn the techniques I recommend, the beneficial outcomes of evaluation will become obvious to you. I feel certain that you will experience these benefits.

Checklists and Charting

A major problem with most anxieties is that they tend to build up to a high level of stress without your being aware of it.  Checklists and charts can help you keep track of the symptoms of your anxiety while you carry your out his current plan. They also inform you of the frequency of certain symptoms that may be reoccurring.

There are many ways to use charts to keep track of the effectiveness of your plan. For example:

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