This is an article in my Catholic Healing Series, where I talk about the most prevalent mental health issues of our time, who the best thinkers are, what the theory is, and how to heal the issue. If you enjoy this, feel free to check out other articles or videos!
The Issues
Recently, I had the pleasure of getting certified in healing anxiety. Additionally, I have worked with countless people to heal from this extremely prevalent issue. Anxiety impacts many people. These are anxious times. People have many external pressures due to broken relationships, financial struggles, and health issues. There is concern over the general decay of society and natural disasters. In America, anxiety abounds! What are we to do about anxiety? The real key to answering that question lies in the reason why a person struggles with anxiety. There are many different types of anxiety, and many of them require different healing tools. The healing process needs to include a diagnosis of the underlying reason for anxiety and then the application of the appropriate tools to heal.
The Thinkers
Kimberly Morrow and Elizabeth DuPont Spencer both have written some of the most popular books on healing from anxiety. They both have healed countless people and are industry leaders. In terms of what they are like, they are on the detail-oriented and structure focused side of the profession. This tells us a lot about what is required to heal from anxiety. The approach often needs to be systematic. Additionally, they are delightful human beings. I would describe both of them as positive thinkers who act as cheerleaders while at the same time using gamified interventions to push people beyond their comfort zones. To interact with them is to feel encouraged, and at the same time, to feel challenged to be the best version of oneself. As for success stories, they both have plenty. A wide variety of people have been mired in the depths of paralyzing anxiety, have worked with them, and now have a new lease on life. I am about to share their secrets for how that has worked.
Healing Anxiety
Disclaimer: these are just some of the tools that can be used to heal Anxiety. Also, I cannot guarantee healing or benefit. This entire article represents my opinions and applications of the tools, nothing more and nothing less. This article does not constitute medical, mental health, psychological, or other advice.
Before diving into specific types of anxiety and specific tools, I want to present some of the principles that drive the healing process. In the case of anxiety, a few sound principles constitute the difference that makes the difference. The first principle is a reframing of anxiety. Anxiety should not be viewed as a problem. It should be viewed as something that unites us all. We all feel anxiety, and this unifies us. When we feel anxiety, we should feel inherently connected to others. The next principle is that avoidance or distraction never works. When a person avoids, it solves the problem for that day, but overall anxiety increases. Instead, the key principle is to lean into anxiety. Morrow and DuPont Spencer demonstrate by having Atomic Warhead candy with the client. Interestingly, they do every intervention along with the client to foster empathy. I love that and it is really effective. The point of anxiety is that it is like the Atomic Warhead candy. It is grating, but if a person leans into it, it dissipates over time. The last principle is to change a person’s relationship with anxiety. They demonstrate this principle with a finger trap. Morrow tells a great story about a CEO at a training who, in violation of being told to wait for the demonstration’s beginning, puts both of his pointer fingers into a finger trap. The result is what one would expect. The pointer fingers go into the trap, and they do not come out. No longer feeling in control, the CEO struggles against the finger trap. The team begins to notice and laugh. A cringeworthy moment, as the kids say these days! Taking pity on the business leader, Morrow intervened and recommended that the CEO push his fingers inward and twist. The result? The fingers come right out. This reveals what is perhaps the deepest truth about anxiety. When we struggle against it, it gets worse. When we relax and allow it to pass through our system, it stays for a while and then moves along. The irony of anxiety is people spend hours or days in mental gymnastics wrestling with it when the solution is to do nothing, which is far easier.
As I have mentioned, diagnosis is the beginning of dealing with anxiety. So, I will present the interventions in light of each distinct diagnosis.
Phobias and Social Anxiety
The main event of healing phobias and social anxiety is Exposure and Response Prevention (ERP). This intervention involves using graded exposure. Graded exposure involves exposing oneself to lower levels of distress and succeeding prior to exposing oneself to higher levels of distress. A person “graduates” from lower level challenges to the higher level ones, until all trigger events are greeted with a non-trigger response. The first step is to identify triggers. Then, people need to develop a Subjective Units of Distress Scale (SUDS Scale). This involves listing trigger events. Then, the trigger events need to be ranked from least stressful to most stressful. Assign each trigger event a number from 1 to 10, with 1 being totally calm and 10 being in a panic attack. Then, try exposure once per day or once every few days. When in an exposure situation, focus first and foremost on muscular relaxation. Where muscles are relaxed, the brain cannot stay in a fight or flight response. Another important methodology that is effective during exposures is Cognitive Behavioral Therapy. Identify the negative thought(s). Diminish its importance and allow it to sit. Focus on positive thoughts. One last helpful tool is to offer oneself a reward for completing exposures. This is using an external motivator to help a person become internally motivated.
OCD
Obsessive Compulsive Disorder (OCD) involves intrusive obsessive thoughts that cause people to perform compulsive acts. For example, a person might have a thought that a benign action was sinful and then might be driven to pray in compulsive, unhealthy ways. In the extreme, intrusive thoughts can keep people from receiving the Eucharist or going to Confession. Exposure and Response Prevention also is helpful for many types of OCD. Build a list of experiences from lowest intensity to highest and start leaning into the anxiety. Again, use muscular relaxation and, in the case of OCD, Cognitive Behavioral Therapy plays a particularly important role. Identify the negative thought. Then, diminish its importance. The thought likely will have fear attached to it as an emotion. Even though the thought seems real and feels real, it is not real. A process called fusion is occurring. The negative thought is fused to the conscious mind like a piece of metal that has been welded to a structure. The answer is defusion—to detach from the negative thought and to focus on positive thoughts and activities. An analogy that I often use is the Wizard of Oz. The Wizard of Oz makes himself look like a giant, green monster. However, the man behind the curtain actually is a weak coward. The same is true of OCD thoughts. They make themselves seem powerful, but they are, in fact, weak. Diminish their importance, let them sit, and live in the moment. This is how a person who struggles with OCD becomes fully alive.
Panic Disorder
Panic Disorder is characterized by sudden unexpected episodes of intense anxiety and fear, accompanied by various physical and cognitive symptoms. These symptoms include rapid heartbeat, sweating, trembling or shaking, shortness of breath, chest pain, dizziness, nausea, numbness, and tingling in the hands or feet. While Panic Disorder can be caused by stressful life events, like traumas, it often is caused by genetic predisposition, neurochemical imbalances, and other medical conditions. Thus, Panic Disorder can be triggered in the same way that people would expect seizures to be triggered. Things like bright lights or environmental factors can trigger panic attacks. Given the frequency of medical conditions being involved, it often is essential for a person with Panic Disorder to consult a doctor prior to consulting a therapist. Once medical conditions are identified that cause the panic attacks (and the incidents are substantiated as panic attacks and nothing else), or if medical causes are ruled out, then someone is able to work with a therapist.
Panic attacks may not be eliminated fully. However, it is possible to limit their frequency and to manage them well. One of the most powerful tools against panic attacks is awareness. This begins with the awareness that a person will feel like she or he is dying, but it is just a panic attack. A good practice, if a person is confident that she or he is experiencing a panic attack, is to stay calm and proceed in normal activity. Other elements that often are helpful include sniffing lavender, sitting or lying down, grounding by focusing on one’s surroundings, relaxing muscles, and engaging in deep breathing.
Generalized Anxiety Disorder
Cognitive Behavioral Therapy is one of the most powerful tools against Generalized Anxiety Disorder (GAD). People who struggle with GAD tend to experience excessive worry, feeling on edge, tension, difficulty relaxing, irritability, restlessness, and feeling overwhelmed. Cognitive Behavioral Therapy helps people by increasing thought awareness, often called mindfulness. It helps to keep a journal of thoughts that a person is having. What is inaccurate about these thoughts? What are the better thoughts to have? One of the most important tools is postponing. If anxiety is creating a sense of urgency to perform an action, it is a good idea to say to oneself, “I will take that action in three days if it still seems like a good idea then.” Spoiler alert…it rarely does! Solution Focused Therapy also can help people to identify better solutions to problems. Once a plan is formed for an anxiety provoking event, it is good to remind oneself, “I have plan and I cannot be certain beyond that. I will trust God.” The final thing that a person can do is to use Acceptance and Commitment Therapy to visualize making space in one’s body and in one’s mind for anxiety. Let the anxiety sit. After a visit, it will go on its way.
Medical Anxiety
Medical Anxiety often pertains to Illness Anxiety Disorder, previously known as hypochondria. This involves excessive and persistent worry about having or developing a serious illness. This can result in cognitive symptoms, physical symptoms, and behavioral symptoms that disrupt a person’s life. One of the unique aspects to Illness Anxiety Disorder is that many of the people who struggle with it have been through repeated trauma. Therefore, in addition to many of the methodologies used to treat anxiety, it also can be helpful to use trauma interventions. For example, Internal Family Systems can be used to identify the wounds of the Wounded Exile, one of the key parts of the self. The Wounded Exile likely feels fundamentally broken and disconnected from others. These two phenomena often give rise to Illness Anxiety Disorder later in life. The Guardian/Manager is the part of the self that keeps the self safe. In the case of Illness Anxiety Disorder, the Guardian/Manager may have developed symptoms of illness as a way of getting needs met. The Wounded Exile can unburden in a visualization like visualizing negative emotions being given to Jesus and being redeemed. The Guardian/Manager can develop a better strategy for meeting needs, like asserting needs and asking for support in healthy ways. The Guardian/Manager can also develop better skills for identifying positive people to be around and gravitating toward them. Many people who struggle with Illness Anxiety Disorder struggle to identify positive people and to seek relationships with them.
However, trauma healing is just the beginning of the journey. Medical Anxiety and Illness Anxiety Disorder can have symptoms that need to be managed over time. Cognitive Behavioral Therapy can help with identifying thoughts that provoke anxiety and that can fuel compulsions to research medical issues. It is important to identify these thoughts and to refocus on positive thoughts and activities. Someone with medical anxiety should never research potential medical issues on the internet. Researching potential medical issues on the internet often drives a person to the towering heights of medical anxiety. Mindfulness-Based Cognitive Therapy can help with Illness Anxiety Disorder. The reason is that it promotes journaling and tracking. Also, it helps a person to connect past events, traumas, and life patterns with the anxiety. This allows a comprehensive approach to healing. Finally, Acceptance and Commitment Therapy helps people to make space for medical anxiety and for them to keep moving forward in situations.
Wellness
Wellness gets its own section when it comes to anxiety. Practicing great wellness does amazing things when it comes to overcoming anxiety! This begins with diet. Of course, if a person has unique dietary needs, that person should consult a nutritionist or dietitian.
In general, the following really help with gut health and in turn predispose a person to overcoming anxiety.
1 spoon of fish oil daily
1 spoon of olive oil daily
Daily Multivitamin
Yogurt, kombucha, kefir, or probiotic supplement daily
At least 4 to 6 portions of fruits and vegetables daily
These supplements promote a healthy gut that generates serotonin. It is likely that the serotonin then goes to the brain and helps to reduce anxiety. Eating a healthy, balanced diet, and keeping portion sizes at health levels also helps with anxiety.
In terms of exercise, regular exercise also helps with anxiety a lot! It releases endorphins, stimulates GABA production (GABA is a neurotransmitter that helps to calm the brain), generates serotonin in the brain, improves sleep, reduces muscle tension, activates the brain, builds resilience, improves concentration, and boosts self-esteem. Integrative exercising is extra helpful, because it aids connectivity in the brain. Examples of integrative exercises are SoulCore and pilates.
In terms of sleep, it helps to reorganize brain connections and restores the prefrontal cortex, which helps with emotional regulation. Also, it lowers cortisol levels, improves cognitive function, and emotional resilience. Sleep helps to ward off sleep deprivation, which drastically increases anxiety. Good sleep tips include to aim for about 8 hours of sleep per night, to be early to bed and early to rise, and to practice good sleep hygiene, which involves staying away from screens and exercise in the evening, using a weighted blanket, and having good lighting for sleep.
Of course, as Catholics, prayer is the most important wellness category of all! If we can trust God and surrender to Him, then we can find peace amidst the storm of anxiety. Turning to Mary gives us the graces that we need to be successful, because she is full of grace! If an apple a day keeps the doctor away, a Rosary a day keeps the anxiety (and the devil) away.
Medication
Medication can be helpful in the case of anxiety. Increasingly, I try to approach almost every issue that I work on with clients as a spectrum disorder. That is to say, some people are on the low end of the spectrum, some are on the middle end of the spectrum, and some are on the high end of the spectrum. Medication can be helpful at times, especially when a client is in the mid or high range on the spectrum of anxiety. Additionally, specific circumstances and the cause of anxiety should be considered. If anxiety is genetically inherited, that can increase the likelihood that medication will be helpful. Most importantly, it is important that medication is considered on a case by case basis, and diagnosis and prescription should occur with a psychiatrist.
The most common medicines for anxiety disorders are Selective Serotonin Reuptake Inhibitors (SSRIs) and Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs). When it comes to anxiety issues, I tend to favor SNRIs a little, because norepinephrine often plays a role. As always, though, I defer to diagnosing psychiatrists. In terms of what to expect with medications, it is important to note that it usually takes about 4 to 6 weeks for the positive effects of medicine to show. Also, it is important to keep an eye out for bad side effects. They often show soon to the start of taking the medication. If there are bad side effects, discontinue use immediately and return to the psychiatrist. If there are not bad side effects, it often is a good course of action to start at a very low dose and do a follow up with the psychiatrist after 6 weeks to readjust. Another thing to consider is what withdrawal symptoms are like if a person is planning on getting off the medication. Some SSRIs and SNRIs do have bad withdrawal symptoms.
In terms of what I have experienced with SSRIs and SNRIs, I would say that some people have found them helpful. Some people have told me that they have saved their life, or given them a new lease on it. Some people have told me that nothing happened when they took the medications, even over time. Finally, some people have had really bad side effects and do not plan to return to medication usage. I consider myself to be medication agnostic. I think it is a valid option. If it helps, then great! If it does not, there are many other options to explore. One thing that I am adamant about is that medication alone will not solve an anxiety problem. A person also needs effective tools to manage anxiety.
Conclusion
Why does God allow us to experience anxiety? I welcome people to explore their own answer and to take it to prayer. The following are some of my answers. One answer is that having an anxious mind is not all bad. An anxious mind helps a person stay alert, solve problems, and be more empathetic. Anxiety leads to resilience and motivation to learn new skills. Another explanation about why God allows anxiety is that it is a cross that brings about intimacy with Christ and others. Remember that anxiety connects us to the rest of humanity in a common struggle and that the suffering from it brings about intimacy with Jesus. God is able to work through us in special ways because of our struggle. Also, overcoming anxiety requires courage. Anne Lamott says that “courage is anxiety that has said its prayers.” Amen to that! Courage is not courage without anxiety. When we overcome anxiety, it is a prayer that glorifies God that is more transcendent than any prayer that we offer in words. May we all pray in our lives in this glorious and transcendent way.
Resources:
The Anxiety Resource Center has educational information on anxiety:
https://www.anxietyresourcecenter.org/resources/educate/
Is anxiety preventing you from flourishing in your life and/or relationships? Reach out to the Catholic Healing Institute and Tom Weishaar for therapy from a Certified Clinical Anxiety Treatment Professional (CCATP)
www.catholichealinginstitute.com
Tom Weishaar, MA LPCC CCTP-II CCATP is the President and CEO of the Catholic Healing Institute. He lives in Steubenville, OH with his wife and three children.
