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7. What are life’s normal, expected phases of anxiety?

Normal, adaptive anxiety is a feature inherent to human development. As we progress from one stage to the next, we have to experience anxiety to get from point A to point B. Austrian neurologist Sigmund Freud used the birth of the infant as a model for explaining what might happen in understanding anxiety.

He saw us - like the baby leaving the womb - as leaving one comfortable place to enter a new place, though less comfortable initially despite its also affording greater freedom. With each developmental phase, new anxieties appear; we have to prepare for the next step towards autonomy. Children learn to walk and to separate from their parents. In American culture, we often leave home to go to school or to college. Or, as we become sexually active, choose a long-term mate, entertain the complexities of parenthood, navigate the vicissitudes of normal aging, or cope with medical illness or death, we relive the built-in human experience of anxiety about what might happen in the next phase. Moving to the next phase provides the desired liberation from the constraints of the prior phase or a feared loss of those freedoms in the case of end-of-life stages.

These anxious phases are all within the normal range. In any given life, one phase’s progress may resonate with a particular person’s experience from a prior phase. For example, a child who suffers from early parental divorce or parental loss from illness may have a harder time leaving home and being independent due to painful memories or fears. A child might feel responsible for the caretaking of the remaining parent or feel that her leaving home might kill that parent, whom she also loves and needs.

These fears could resonate with actual feelings stirred in association to the divorce, when people who are significant to the child’s world did leave and did cause pain.

Rick’s comments:

Freud’s definitely onto something-I was doing just fine in the womb. Since then, things have gotten shakier. I’m aware that I have avoided potentially enjoyable, worthwhile, and important activities because of anxiety-either because of fear of failure or just plain fear. This is where anxiety has not served a useful function. Instead of helping me to avoid danger, it whispers that life is dangerous so avoid, avoid, avoid . . . On the more positive side, when I don’t let anxiety and OCD prevent me from doing something new and exciting, I have a real feeling of accomplishment.

What questions can I ask myself about my anxiety to understand it better?

A. Is this symptom new in onset or more longstanding (i.e., what is my history with this particular symptom?)

B. Is this symptom present more in my mind (e.g., worry) or in my body (e.g., nausea)?

C. How high is the temperature on the anxiety thermometer?

D. When I have had these symptoms before, what has helped me?

E. What kind of treatment does my doctor think would help me the most (short-term versus long-term, dynamic versus behavioral, medication versus not, psychiatrist versus psychologist or social worker, symptom focus versus personality focus)?

F. How much does substance abuse complicate my condition and/or improvement?

G. What makes my symptoms get better or worse during this episode?

H. Who else in my family has any symptom like this and what has helped them get better, or what has made them worse?

I. What does this particular symptom mean to me?

J. How much of my anxiety comes from feeling alone or unable to cope by myself, and how much of it comes from feeling that what I feel will be unacceptable to others (i.e., they would leave me if they knew what I was really feeling)?

Terms:

Psychiatry/psychiatrist - the study, diagnosis, treatment, and prevention of mental illness and behavioral disorders.

Psychiatrists - are medical doctors (MDs) who study and practice psychiatry.

Psychology/psychologist - the study of behavior and the processes underlying behavior.

Psychologists - are those who specialize in the study of psychology and have acquired their PhDs.

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