I listen to a lot of personal narratives. Of course I do. What's consistently amazing to me is when someone tells me how they cannot remember a time when they weren't extremely "afraid" or "high strung" or "anxious" inside themselves. "I'm in flight or flight all the time! That's my life story!" "I can't stand it that I work so hard to appear normal at my job, only to go home and freak out over every little thing!" Or..... "I get this from my mother. I watched her crap herself constantly because she had to have everything "perfect" for my dad by the time he came home each night. And when he did come home, none of us knew if he would be "good" that night or not because he was so unpredictable anyway!"
For some clients, the earliest root(s) of their personal struggle with anxiety began with the proverbial unwanted mix of genetics. Mental health issues and disorders are in large part inheritable, though the debate still rages on as to the exact root cause(s). Doesn't matter if you were born into the best or the worst family system; genetics count for a whole heck of a lot! And what about genetics vs. epigenetics? Speaking of which, epigenetic patterns are equally powerful factors which impact a person's way of interacting with the world around him/her/them. Epigenetics are the patterns of thinking, feeling, and behaving that run through family systems throughout the generations. Epigenetic trends are often discovered through paying attention to "family stories"...but also by the creation of family genograms. More on that later on in this post.
So let's look at some very early examples of how anxiety can come to roost in a person's life. Consider the example of being a born "screamer" as a newborn baby. Did you ever think about this? Some infants seem to adjust quite nicely with the ebb and flow of life around them---while others squirm, scream, and squall their way through their first year of existence. What were you told about the kind of baby you were during your own first year of life? For those babies born who are "highly sensitive", everything from digestion to lighting, sound, texture, smell, and taste can cause significant and chronic distress. And we wonder why babies end up learning "basic mistrust" after their first year of life? You and I would too if so much of what we experienced felt more "bad" than "good" during Year One! This is how genetics and genetic predispositions can create anxiety without any help from anybody from the moment of one's own birth!
Then there are the epigenetic- driven patterns and influences. So if our newborn "screamer" baby is born into a family that also yells and screams its way through issues and problems---how will that work to soothe and calm the highly sensitive infant? Newsflash: it will not! Highly sensitive or not, past patterns of functional AND dysfunctional behaviors DO have an impact on how we "respond" to life and people as soon as we make our debut onto the world's stage! Now imagine how any infant's life would be impacted if baby's primary caregiver was alternately neglectful (of the baby's basic needs), and/or abusive? Even babies can develop the same "thousand yard stare" common to war veterans suffering from PTSD! Why we don't connect these dots relative to our own familial experiences is mind boggling to me. So many of us really DO prefer to live and function in denial than face this kind of historical information to help ourselves heal, change for the better, and grow as a person (maturity-wise) over time!
When you top off familial historic contributions with traumatic birth-related experience(s) of which there are many (including being born prematurely, addicted, and/or with congenital and/or cognitive impairments!)---anxiety can definitely "show up" in a person's life from literally "Day One" of existence. I don't know why we ignore these things when we are about to have children, or are raising children, or are "done" raising them. Children are not pets. They are not objects. It takes a whole lot of maturity and personal sacrifice to raise children ESPECIALLY when they make clear how being here isn't easy for them physically, mentally, emotionally, and/or socially speaking!
In psychotherapy, we often create genograms for clients who claim "I don't know how I got to be this way..." Unlike family trees which focus on superficial data, genograms focus on our own family's historical epigenetic patterns going back generations. It's profound to see a client connect the dots of family history with one's own life "now". "I never thought about how successful my family was on both sides until just now!" "Yikes we sure had a lot of gamblers in my family!" "Wow! No wonder I've been anxious my whole life! Look at my mother's side of the family!" "Well no WONDER I'm that way; so many of the women on my dad's side were this way too!"
Some clients resist the genogram exploration option as part of cognitive behavioral therapy. The reasons are varied, but when I hear "I don't remember much about my childhood", I will very often suggest interviews with the parents, siblings, and/or other first degree relatives. Many times the best sources of data to help my clients understand their chronic and intense anxiety are the people who lived with him/her/them early on!
When a person's anxiety is linked to their own issue around poor self-image, saying to me things like "I already know my family was A, B, C, or D; do I really have to do a genogram and see it all in written down?" Yeah, you do. Why? Because what you can't see, you can't acknowledge and then work to correct in your own life and time. After all, chronic and intense anxiety is NOT a wanted state of being unless it is only temporary and has to do with eustress. In case we forgot, eustress is that stress (or anxiety!) that is what every human being would experience before achieving something positive and/or "big" so to speak. Eustress is what stimulates, energizes, and motivates us to go out there and "do" our very best work and/or to make the positive changes we want in our own lives. Eustress is what we feel before we get that gold medal at the Olympics, receive our 30 day sobriety coin, take our last final exam before graduation, speak publicly in front of 200 people, etc. Distress, on the other hand, is what causes ongoing personal suffering just because we are "here"...and because we have become comfortably familiar with it as state of existence we have no idea how to better and more effectively manage.
For people with chronic and intense anxiety, life feels like one never-ending "fight flight or freeze" scenario being played out repeatedly with various people, including those we believe we are "closest" to. And if we aren't "that" way trying to get through our days, we can feel alternately depressed to the point of inertia. "I don't even get out of bed some mornings and for sure have gone out without having taken a shower or brushed my teeth.."
This is one hell of a way to live!
Seriously, people who are addicted to certain choices and behaviors that basically numb them to the realities of present day life DO struggle, each and every one of them, with chronic and intense anxiety. Beyond the cause(s) mentioned at the beginning of this blog post, there is another primary cause associated with distress-based anxiety. Can you guess what it is? As Sigmund Freud put it in the late 1800s, "this man suffers from his....memories." After all, aren't we ALL living in the psychiatric unit of the universe right now? Trauma is universal! Watch tonight's evening news if you doubt me in this regard! We have all experienced it whether directly or indirectly. If we don't believe that, we are truly kidding ourselves. Trauma is a right of passage, just as would be attending our first day of school. Yet for SO many of us, our trauma history represents a life-long death sentence we believe we are stuck with for as long as we live.
As Dr. Michael Yapko, an Australian psychologist has stated in his online (youtube) presentation about trauma, anxiety, and depression....how is it that some people experience horrific and multiple trauma(s) and completely fall apart in all ways imaginable---while others demonstrate tremendous resilience and genuinely learn to move past it? Dr. Yapko's early work decades ago was within an inpatient psychiatric unit where he heard countless trauma narratives from his patients. I also trained in an inpatient psychiatric unit; I do recall those trauma survivors that left our unit and did continue their own work of healing, positive change, and personal growth once discharged. I also remember the survivors who chose a much different path. Choosing to be and remain "stuck" in our past or present traumatic experiences definitely impacts our own ability to more effectively manage our anxious lives over time. As many war veterans have articulated, "if I get better, then I am a traitor to my friends who didn't make it out alive like I did." Wow, but this is a common way of thinking!
Dr. Bessel Van der Kolk, author of "The Body Keeps the Score" is probably the most time-honored clinician in existence for his work on trauma by explaining the effects trauma has on the mind, body, and spirit. I recently downloaded his book to play in my car; it is an amazing reference in explaining how "trauma" was historically identified and then treated within our country to the present day. For example, did you know that PTSD (Posttraumatic Stress Disorder) was not even identified as such by the American psychiatric community until 1980? That was because until that time, "Shell Shock" was limited to describing war veterans with the symptoms of PTSD. As Dr. Van der Kolk further states, female survivors of childhood incest were believed to represent one in 1,000,000 women in this country. At that time, there were 100 million women in the U.S. Since Van der Kolk had seen 47 female survivors with chronic anxiety and depression who were also sexually abused by a family member as children, he wondered how nearly half of all SA survivors in this country found their way to his office! We had so much to learn and acknowledge about the impact of trauma on ALL of us back then! And "back then" wasn't that long ago for our present generations still here on planet earth might I remind!
As I will often remind clients, "Watching graphic horror movies will NOT help better manage your chronic anxiety, okay?!" We can be so clueless when we chase those dragons without realizing. I recently heard of a ten year old female who is addicted to horror films. Listen parents, the horror films of "today" are NOT the same as the horror films pre-1960 okay? Frankenstein, Dracula, and the Wolfman HAVE been replaced with entities that are the stuff of true nightmares that do NOT abate themselves easily---if ever! And then you wonder why your kid(s) can't sleep, have become even "more" anxious, and are exhibiting other disturbing behaviors you can't easily explain? Come on!
Chronic and intense anxiety is truly the ball and chain nobody wants to be shackled to for months, years, or decades. And yet...it remains the #1 mental health issue in our world today. That's never changed. Maybe if we change how we "do" our own lives for real...and for sure...we will find that it IS possible to lesson and reduce the place anxiety has held in our lives for far too long.
Next post, the treatments that are proving to help those who suffer with chronic and intense anxiety...