Am teaching on anxiety, panic, and OCD tonight. Definition of anxiety: Responding to ambiguous stimuli (life situations) by reading them in the worst possible light. The Scriptures teach us that fear and worry are not good things. Time and time again God tells his people not to be afraid. We see that God wants us to see life through a different set of eyes, much as Elisha wanted his servant to see the army of angels instead of their enemies (2 Kings 6). But given the numerous encouragements to not give in to fear, we must admit it is a common struggle for every human being. Some struggle more than others.
What is going on with those whose lives are filled with worry and fear? Are they less spiritual? More sinful? It is easy to say, “buck up” to folks who are anxious–and entirely unhelpful to most. Logical challenges may help some in the moment, but usually don’t get to the root of the matter. Jesus encourages fearful people by pointing them to seeing life from 40,000 feet. He doesn’t deny risk and suffering but encourages folks to keep their eyes on him. And with Peter, he reaches out to grab ahold of him even when he does start looking at the waves.
But what of the physiology of anxiety? What do we know and how does the christian counselor make use of the data. First, what do we know?
1. Fear responses are quickly learned and seemingly etched into the amygdala. One bad experience of food poisoning from a turkey sandwich at Applebees means my stomach tenses a little when I see deli turkey. Imagine what happens if you suffer repeated assaults or worse! The earlier the person is exposed to deep fears, the more likely they suffer from hyperarousal and startle responses.
2. Neurotransmitters are involved which means you act first and think later. There’s little conscious cognitive processes involved until after the fact. We need medical advances to deal with neurotransmitters instead of our current anti-anxiety meds that just shut everything down (e.g., xanax). A fear inducing stimuli leads to immediate neurotransmitter changes that then divert blood from organs to muscles, tension builds, shallower, less effective breathing begins, Carbon Dioxide builds in the blood stream which in turns creates pain, numbness, and a sense of danger. And so the cycle continues. During and after, we make attributions and so enhance the connections of the feared stimuli and our flight response. The higher the perception of pain, the greater fear/flight response.
3. OCD, in particular, has some probable links to early exposure to viruses such as Strep and Flu.
4. PTSD patients have higher right brain activity (than do non-PTSD individuals) when exposed to anxiety provoking stimuli.
That’s just a few things we think we know about the physiology of fear. Now, what do we do with it from a spiritual standpoint?
1. Worship. Worship/meditation on other things takes our full attention away from the fear stimulus. It forms habits and relationships as we repeat what we want to believe until we actually own it and believe it on its own merits.
2. Fight. We do challenge our thinking as soon as we can. Yes, the fight/flight chemicals are coursing through our veins but we challenge just the same so we can break some of the connections and the ways we reinforce our fears. One other way we fight may seem a bit odd. We admit there are real things that are scary and overwhelming out there. We do not try to deny the reality of suffering (past or future) but admit it over and over. It is scary to die. I was assaulted in that alley. I am in pain and more may be coming. But, God is with me and it is good to call on him and ask him tough questions about his protection of me.
3. Work. Building habits where I do not allow myself to run from the feared situations (where appropriate!). Moving myself closer to some of the feared scenarios in a slow and consistent manner. No, this is not flooding (where you are dumped in the pit of snakes because you have a phobia of snakes…). Allow the work to take the time to reorient the deep recesses of the brain. Don’t expect or look for immediate change!
Well, this post is too long. I’ll try to write more on anxiety this week since most of us suffer from it at some point in our lives. Myself included.
Musings on Faith and Psychology 
I’ve been reading your blog for awhile now and just read through your posts on anxiety and PTSD. I have struggled with this for many years. I went to counseling years ago, but it seemed to make everything worse. (Really!) Life has gone on. I’m a happy, productive person…mostly. For awhile, I drank too much to deal with the anxiety. I’m not drinking anymore, and now I’m having a heck of a time dealing with the anxiety at night. i don’t want to open up a can of worms and make things worse with counseling…I just want a good night’s sleep, honestly.
I try to pray…to meditate on scripture…but the physiological response of fear in my body makes it impossible to relax. Here’s the typical scenario: I’ve got the kids tucked into bed, picked up toys, set up the coffee pot, and checked the locks on the doors. My husband is travelling for work, so I’m alone. I crawl into bed and try to relax, think happy thoughts, pray. Suddenly, I remember that I forgot to shut the garage door when I picked the kids up at school earlier in the afternoon. Maybe someone snuck into the house and is hiding in the basement? Now I’m in a full-blown panic. My heart is racing and I’m drenched with sweat. I try to relax, to tell myself that everything is fine, but I’m officially freaked out. I get up, check the house, change into clean pajamas, but by this time, I’m wide awake and it takes me another hour or two to relax. I’ve sworn up and down to my husband that I won’t drink anymore (it’s not safe with three little kids to take care of). A few times a week, I take pain pills just to relax (leftover from a recent surgery), but that’s not a good solution.
This is long, but I really like your down-to-earth approach to things. What should I do? I’m emberassed to bring this up with anyone at my church, and the whole thing just feels so overwhleming to me, like I’m just going to be stuck in this awful place forever.
W, I’m sorry to hear of your struggle. I recognize that sometimes counseling can make matters worse, either because the counselor isn’t doing a great job or because (and this is especially true with PTSD) counseling requires you to go back and immerse yourself in painful memories and whatnot. Most of us tell our clients that things may get worse at first. It would make sense because most of us live in some form of temporary denial to get through the day. Counseling removes that a bit.
But, I would suggest that while the physiological response kicks in each time, it kicks in because of cognitions and an underlying heightened state of vigilance against expected, probable danger. Now, I must say also that many people feel that when things are out of the ordinary (i.e., a spouse is not home). I do not sleep as well and find myself more alert to noises in the house when Kim isn’t there. Does it happen for you even when he is home? Is he away frequently?
The most successful treatments in psychology are for panic attacks. It sounds like that is your problem, along with obsessive, intrusive thinking (btw, does that happen during the day as well?). In the moment, they are overwhelming and given the repetition, they feel impossible to change. I would suggest that the best way of changing them is by a slow approximation of the fearful events. Imagining the situation and working on physical relaxation. You learn relaxation best when everything is fine. Later you can start to apply it when things are more likely going to cause the anxiety. You begin to practice the so whats. So what if the garage door is open. As you begin to get good at relaxation training during the day, you begin to approximate the evening situation. When your husband is home, have him sleep on the couch or the guest room and you in your bed to practice relaxation and mental push backs on the fears with your scriptural meditations.
This is probably hard to do on your own so I would suggest looking for a cognitive therapist, someone who really knows how to treat panic disorder. I’d prefer a secular expert over a novice Christian. Medicating with pain meds is probably not a great idea. If you need to medicate, and you might, I’d suggest considering an SSRI antidepressant. Short-acting medications like Xanax will surely stop the panic attack, but then have other issues (e.g., rebound effects possible, abuse if not careful). Also, be sure to eliminate caffeine in the pm.
Here’s a prayer for you: Heavenly Father, would you enable W. to find some trusting friends or experts to share her struggle with. Fear is overwhelming her. In her fear, please speak to her and give her great comfort as a shepherd speaks tenderly to his sheep. You know we are an anxious lot and so you promise to be with us in the midst of our dark nights. Provide a way of escape from these fears, Lord. Amen.
Phil,
Thank you for your thoughtful response. In answer to your questions, my husband is away frequently during the work-week. (Maybe M – Th or T- F, it varies week-to-week.) And, no, I don’t struggle with anxiety when he’s home. And very rarely during the day.
Your advice makes sense. I’ll give it some thought. I can’t tell you how wary I am of seeing a counselor again. Maybe I’ll just go to my regular doctor and get a prescription for…something? Xanax?
I took some kind of beta blocker when I was in counseling last time, over twelve years ago. The theory was that on the medication, I’d be able to explore the trauma and somehow recover from it. (I was assaulted on my college campus; ironically, after leaving a prayer meeting to pray for the serial rapist targeting our campus.) That experience does not define me. I’m a productive Mom, a writer, a Sunday School teacher.
Is denial really such a bad thing? It gets a bad rap, but, honestly, if I gave myself fully to negative memories and emotions, I would not be able to function.
I will consider your advice carefully. Thank you, again.
Made an earlier reply to your last response but it seems to have disappeared…so trying to reconstruct…
W, Thank you for your honest reflections here. I think a lot of folk can relate to your struggle. I can’t make recommendations re: medication. Short acting meds give immediate benefit (could be abusable though), but don’t teach the key cognitive pushbacks and relaxation/distraction behaviors needed to defeat panic. Longer acting drugs (SSRIs) may help you too but not in the crisis. I’d pick up the Panic and Anxiety workbook from Borders, it might give you some help too.
I am fully in agreement with you that giving oneself over fully to negative memories and emotions is not only not helpful but dangerous. It is not what counseling is all about. And if you have a counselor who wants to always immerse in these experiences, then something is wrong.
Lord’s blessings as you continue to fight fear’s lies.
Phil
Thank you, Phil.
Now I’m wondering if I just had a crummy counselor last time. She definitely wanted to immerse in the ugly details…a lot. She also went on about her own past…a lot. It was hard to take at $120 bucks an hour! In the end, I stopped going (against her wishes) and spent an hour a week getting a manicure and pedicure. Started feeling much better about myself. Hey! Maybe that’s the answer! I’ll just get my nails done every now and then…
Seriously, though, I do appreciate the time it took to repsond to these semi-anonymous comments. And I will consider what you’ve said carefully.
Your welcome. and Yes, you probably had a crummy counselor if she talked about herself.
Sorry to dig up this old thread. It seems to be the way this issue goes in my life, though. Life goes on for awhile, and then all this junk rears it’s head again.
I’m revisiting the idea of finding a new counselor, and I’m wondering if you have any good advice on how to go about it?
I look in the phone book and online, and I just don’t know where to start. I don’t want to get in another crummy counseling situation. I’m leery of the whole process.
But I think I need some help.
I recently experienced a great amount of fear and anxiety…I did a lot of praying and reading up on it. God’s word says He did not give us a spirit of fear but of power, love and a sound mind. I had to repeat that over and over throughout the day and night. I realized that the fear I was experiencing was not of God and it was spiritual. Do not be ashamed to tell someone at church. What you need is prayer and I would suggest Theophostics instead of counseling. There are usually people in the church that are trained in that ministry and they, with the help of the Holy Spirit can help you find the root of the lie that is causing you to fear. As soon as I began to experience fear, I had some wonderful ladies at church intercede and warfare on my behalf….within two hours, I experience such peace. I still have to conquer thoughts that might lead me back to believing I should be afraid. The Lord has had me face certain things I thought I couldn’t do and I have found I can do it and I don’t have to fear those things. I am praying for your complete deliverance of fear and anxiety. God bless!