anxiety - Coppin State University

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anxiety - Coppin State University

ANXIETY

COGNITIVE

FUSION

& WILLINGNESS

Gary Powell,

Head of German, Trinity School,

Croydon, CR9 7AT, UK

garyjamespowell@hotmail.com

Gary Powell, Trinity School Staff Twilight Talks Session,

6 February 2006


Mind = danger alarm

♦ Our minds have

evolved as an early

warning system to

alert us to problems

and dangers.

♦ This was useful

when we were trying

to avoid being eaten

by predators.

Illustration conceptualised by Joseph Ciarrochi and David Mercer, University of Wollongong, NSW, Australia,

with

artwork by David Mercer. Not to be used in commercial publications without written permission from Joseph


New predators …

♦ The dangers we are exposed to in

modern life are a bit different, though

…. and negative thoughts from our

minds can sometimes be triggered very

easily.


Social anxiety

♦ ....such as when we

are expected to talk

to a large group of

people.

♦ Some people are

very phobic of

public speaking.

♦ But will we be eaten

by our audience if

they don’t like our

presentation?

Illustration conceptualised by Joseph Ciarrochi and David Mercer, University of Wollongong, NSW, Australia,

with

artwork by David Mercer. Not to be used in commercial publications without written permission from Joseph


Subjective perception 1

♦ Perception involves a

subjective response

and maybe an

interpretation.

♦ We bring a lot of

psychological baggage

with us when we

perceive things.

♦ We might see a threat

as this man does …

Illustration conceptualised by Joseph Ciarrochi and David Mercer, University of Wollongong, NSW, Australia,

with

artwork by David Mercer. Not to be used in commercial publications without written permission from Joseph


Subjective perception 2

♦ ...whereas an

observer watching

you might see this

.....

Illustration conceptualised by Joseph Ciarrochi and David Mercer, University of Wollongong, NSW, Australia,

with

artwork by David Mercer. Not to be used in commercial publications without written permission from Joseph


The mind as ‘word machine

…’

♦ Our minds generate ‘negative chatter’ all the

time.

♦ Minds = hypersensitive danger warning

systems.

♦ Many of the messages (thoughts) are

inaccurate, or even absurd.

♦ But negative and inaccurate thoughts often

tell us they are true, and that we really are in

danger.

♦ They ‘feel’ true as well.

♦ We tend to give them a high credibility rating.


Negative thoughts lead to

painful feelings

♦ Automatic negative thoughts give rise to

painful feelings.

♦ Human beings are tremendously vulnerable

to suffering, and one of the most remarkable

facts about the human condition is how

difficult it is to be happy.

♦ Relational Frame Theory suggests that the

reason for the prevalence of human

psychological suffering is the fact that we

have developed language.


SPIDER


WORDS (=THOUGHTS)

EVOKE FEELINGS

♦ If you are afraid of spiders, the very

word ‘spider’ may well evoke associated

thoughts and feelings……,

♦ To a greater or lesser degree, as

though a real spider were present…


Careful talk during meals …

♦ This is why talking about someone

vomiting isn’t a good idea when people

are eating ….

♦ There is no real vomit present – but the

mere word ‘vomit’ can have the same or

similar stimulus functions as real vomit.

♦ Not good for the appetite …


Transfer of stimulus functions

♦ Relational Frame Theory refers to the

way that the stimulus functions of a

thing or event tend to get transferred to

the word used to describe it.

♦ If you are afraid of spiders, the fear,

anxiety, urge to run away and physical

effects of seeing a spider, can be

evoked by the mere word ‘spider.’


The problem …

♦ Language has, of course, produced amazing

outcomes for humanity, and is absolutely

invaluable for the success we have achieved

as a species in many areas.

♦ However, it is also responsible for a great

deal of human psychological suffering as a

result of the transfer of stimulus functions

from referents to the language used to

describe the referents.


Words as causes of pain ...

♦ Hearing someone just talking about their

relationship break-up, or about a recent

bereavement, can be very painful for

someone who has just experienced

something similar.

♦ All that person is exposed to is WORDS,

however – but the words evoke automatic

thoughts and feelings, as though a REAL

bereavement/relationship break-up were

HERE and NOW.


Bringing the future and the

past into the present ….

♦ There is a whole wealth of anxiety

hidden away in our personal histories,

and a wealth of potential anxiety that

could be experienced in our personal

futures.

♦ In the present, thoughts can occur that

remind us of anxiety experienced in our

past. We can also anticipate anxiety

that might occur in the future.


Bringing the future and the

past into the present ….

♦ If we take these thoughts literally, rather

then observing them AS thoughts …

♦ And if we are not WILLING to

experience anxiety, or whatever

emotion we are anxious about

experiencing …

♦ Then we will certainly experience

ANXIETY.


THE PREVALENCE OF HUMAN

SUFFERING

♦ It is remarkable how prevalent, intense

and persistent human suffering is.

♦ At any one time, it is thought that 30%

of the population is suffering from what

would be diagnosed as a major

psychological disorder. Many more are

suffering an intense degree of

unhappiness that would not be

diagnosed as psychological illness.


THE PREVALENCE OF HUMAN

SUFFERING

♦ Given the prevalence of human

suffering, there is a case for saying it is

normal, and that those who do not

experience much psychological

suffering in their lives are the ones

diverging from standard human

experience...


An example of the anxiety

trap: The Past …

♦ Say I gave a talk on ‘anxiety’ last year that

didn’t go down well. People jeered,

complained and walked out. Some people

stayed behind and threw rotten eggs and

fruit. Posters were put up around town

vilifying me for the presentation.

♦ As a result, I felt embarrassment, shame,

feelings of failure and inadequacy, anxiety ...


An example of the anxiety

trap: The Future

♦ Let’s say that I have also been invited to

give a talk on ‘anxiety’ next month

somewhere else by different people

who didn’t know how badly the last one

went down.

♦ What do you think would be going on in

my mind?


An example of the anxiety

trap: The Future and the Past

constructed as a verbal

present.

♦ Both of these thoughts, about the past

and the future, will be experienced

verbally, as thoughts, in the PRESENT.

♦ Even though the anticipated negative

future may never happen, the thoughts

about it cause elements of its stimulus

functions to be experienced HERE and

NOW, not THERE and THEN.


An example of the anxiety

trap: The Future and the Past

constructed as a verbal

present.

♦ There will be two lots of thoughts going

on:

♦ Memories of the past: ‘The talk on

anxiety was a disaster last time, and a

very painful experience.’

♦ Anticipation of the future: ‘The talk on

anxiety may (will) be a disaster again.

The same thing may (will) happen.’


An example of the anxiety

trap: The Future and the Past

constructed as a verbal

present.

♦ I might worry intensely for a month, experiencing anxiety and

dread, imagining all kinds of outcomes.

♦ When I give the talk, it might go well, or it might go badly.

♦ Imagine it goes badly, and I experience negative consequences

yet again. Do you think that the emotional discomfort

experienced at the time of the talk will be as painful as the

month of worry leading up to it?

♦ Can the pain caused by the mind verbally constructing a

negative future in the present, be greater than the negative

experience if/when it actually occurs?


VERBAL RULES &

PROGRAMMING

♦ Without language, we could not evoke a

negative past, or anticipate a negative future,

in this way.

♦ But the way our minds encourage us to deal

with pain makes things worse.

♦ People tend to live by an unwritten rule that

suffering is bad, and the absence of suffering

is good …

♦ … and that if something is bad, you should try

to get rid of it by acting on it directly.


VERBAL RULES &

PROGRAMMING

♦ Although this rule can work well with things in

the external world, it does not seem to be a

successful technique when applied to painful

thoughts and feelings.

♦ Painful thoughts and feelings do not tend to

disappear by trying to avoid or mask them.

There might be some temporary relief from

distraction, alcohol, etc….but the feelings and

thoughts tend to return.

♦ The rule: ‘I must avoid my painful feelings,’

does not work.


The crescendo of anxiety:

An example

♦ Let’s imagine that someone has a fear of high

buildings, but wants to accompany her family

up the Empire State Building.

♦ She is not willing to experience anxiety; or, if

she does, she is not willing to experience a

high level of it.

♦ She starts off thinking ‘I hope I don’t have an

anxiety attack. I am going to try not to think

about the possibility of having an anxiety

attack.


The crescendo of anxiety:

An example

♦ As discussed earlier, the very phrase ‘I could

have an anxiety attack,’ whether spoken or

thought, is a stimulus function for the feeling

of anxiety and associated thoughts.

♦ The thoughts, ‘I must not experience X,’ and ‘I

must not think of X,’ actually contain the very

words that are going to provoke feelings

associated with X. So a degree of anxiety is

produced by the that thought …


RULE: I

must avoid

anxiety!

I must

get rid of

this

anxiety!

I know: I

will

struggle

against it!

anxiety


It’s not going. It’s getting

worse. This is terrible. Must

struggle harder.

This is what happens if

experience brings you anxious

thoughts and feelings, and you

struggle to get rid of them. You

end up with the original anxiety

(pain), plus new anxiety caused

by the failed attempt to get rid

of it (suffering).

anxiety


It’s getting even worse. This

is a disaster. What if it gets

worse still? Must keep

struggling …

Instead of getting

smaller, your

anxiety gets bigger.

So you keep on

struggling. This is

also unsuccessful

and you get

increasingly anxious

about your anxiety

getting worse and

feeling your

attempts to stop it

are unsuccessful.

anxiety


Just what I feared! It is getting

worse! It is going to kill me! I

must keep struggling …

anxiety

So the struggle goes on and on, and the anxiety gets

bigger and bigger.


PANIC!

anxiety


CHECKING

♦ She might, however, be doing fine in the lift to

the top of the building. She has not had any

thoughts about the experience so far at all. A

good day.

♦ So she thinks: ‘This is going pretty well. I

haven’t had an anxiety attack.’

♦ If she is unwilling to experience anxiety, she

will keep checking to ensure it is not there.

This is then likely to be the very thing that

sets it off.


I must not get anxious!

Imagine you got wired up to a special polygraph machine

that measures anxiety. You are told that, if you get too

anxious, you will be shot. What will happen?

Illustration taken from http://www.acceptanceandcommitmenttherapy.com/resources/VisualAids.html


Try putting your fingers into both ends of the

Chinese finger trap. What happens? How can you

best get your fingers out? Can you see any parallel

with your psychological experience?

Illustration taken from http://www.acceptanceandcommitmenttherapy.com/resources/VisualAids.html


Emotional discomfort is something that is to a large degree outside of our control as human

beings. Life will bring all of us painful feelings and thoughts from time to time. However, we can

control our willingness. Being willing to experience does not mean wanting to experience painful

emotions, however. It just means that you are open to fully experiencing your emotions, good

and bad, without trying to suppress them, push them away or get rid of them. You can set the

willingness dial high, or low. If you set willingness low, then when emotional discomfort comes

along, it may get to be high. If you set willingness high, then your emotional discomfort will be

less likely to stay high or increase. Scientific studies have demonstrated that painful emotions

tend to stay around longer when an individual tries to get rid of them directly. A willingness to

experience painful emotions will also prevent the pain escalating, which happens when an

individual is unwilling to experience the pain, struggles to get rid of it, and adds frustration,

depression, anxiety and maybe other negative emotions to the experience.

Illustration taken from http://www.acceptanceandcommitmenttherapy.com/resources/VisualAids.html


YOU

I will fail

if I speak in

public

I must not

fail

at public

speaking

anxiety

Avoidance of

public speaking

Let’s have a look at what is

going on when you have a

negative thought - let’s say

about public speaking - and

the thought leads to anxiety,

and the anxiety leads to

avoidant behaviour.


Cognitive fusion

♦ COGNITIVE FUSION is a major cause of

psychological pain. Most human beings seem

to be held up by this.

♦ It happens when people take thoughts

literally, for the things they represent, and is

caused by the bidirectional stimulus functions

of language.

♦ A thought ‘I am going to fail at this’ is just a

thought, even though it presents itself to us

as reality, and true.


Cognitive fusion

♦ Distress can be compounded by the

evaluation ‘failing at this would be

terrible,’ which is also a thought, to be

regarded as such.

♦ Not only do such thoughts fuse with the

objects of the thoughts, but we fuse with

the thoughts as well. We think that the

thoughts are an intrinsic part of our

identity and being.


YOU

Negative

thought

COGNITIVE

FUSION

Avoidant

action

Pain


We are not

our thoughts

We are not

our feelings

We are not

our actions

There are meditation exercises to practise defusion from

thoughts, where thoughts become increasingly seen as

what they are, and not what they say they are: i.e. Just

thoughts. You can develop the ability to observe thoughts

as thoughts.


OBSERVER

SELF

COGNITIVE

DEFUSION

Negative

thought, viewed

AS a thought

Painful feeling,

viewed AS a feeling


Programming

♦ Apart from unwillingness to experience pain

and cognitive fusion caused by the nature of

language, the third major cause of our anxiety

is PROGRAMMING.

♦ According to RFT, we find ourselves acting

according to a number of unhelpful verbal

rules, many of which have been instilled by

society, parents, peers, school, etc.


Identifying programming

♦ It is not always easy to identify unhelpful

programming that is governing our lives.

♦ We might have been told by our

parents, for example, that unless you

get a top grade in an exam, you are a

failure. Some of our pupils might have

been told that very thing by their

parents. The implication is also that

being a failure is terrible.


Identifying programming

♦ There is always at least a theoretical chance

that the things we most fear could happen.

We cannot completely control the universe to

eliminate risk.

♦ If you fuse with the thought ‘A grade ‘B’ is a

fail,’ and are not willing to experience failure

(because you have fused with your

programming) …

♦ Then the thought ‘I could fail’ will produce

anxiety. If you are not willing to experience

anxiety, then you will experience anxiety.


Summary

♦ Avoiding anxiety by struggling against it

directly is the problem, not the solution.

♦ Being willing to experience anxiety, and its

associated thoughts – which means actively

taking them all in - will keep anxiety at its

natural level, instead of provoking an

escalating spiral of suffering.

♦ Defusing from difficult thoughts and observing

them as thoughts, and not as the ‘truth’ or

‘reality’ they say they are, will avoid the

escalation of suffering.


Further reading/research







‘Get out of your mind and into your life: the new Acceptance and Commitment

Therapy,’ Steven Hayes, New Harbinger publications, 2005.

‘Acceptance and Commitment Therapy: An Experiential Approach to Behavior

Change , Steven Hayes, Kirk Strosahl, Kelly Wilson, Guilford Press, 2004.

‘Relational Frame Theory: A Post-Skinnerian Account of Human Language and

Cognition, Steven Hayes, Dermot Barnes-Holmes, Bryan Roche, Kluwer

Academic/Plenum Publishers, 2001.

‘Acceptance and Commitment Therapy for Anxiety Disorders: A Practitioner's

Treatment Guide to Using Mindfulness, Acceptance, and Value-Based Behavior

Change Strategies,’ John P Forsyth, Georg H. Eifert, New Harbinger

Publications, 2005.

http://www.contextualpsychology.org/en (main Acceptance and Commitment

Therapy/ Relational Frame Theory website)

http://health.groups.yahoo.com/group/ACT_for_the_Public/join Acceptance and

Commitment Therapy Listserv/ discussion group for the public.

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