Anxiety and fear, like pain, are wired into our nervous system. Also like pain, they are signals that something requires our attention. Anxiety and fear are signals of impending threat. The body reacts virtually instantly to defend itself in the face of a threat. The threat might be a physical challenge, such as an attack by an assailant. Or it might be a psychological threat, such as taking an important examination, giving a speech in public, or having a suspicious spot on a medical X-ray.
Anxiety and fear are good things when looked at from an evolutionary or adaptive standpoint. They are the body’s early warning system that a threat is present to which we need to respond. When we experience fear or anxiety, the body’s sympathetic nervous system kicks into gear, pushing out adrenaline and other stress hormones into the bloodstream that increase our state of arousal and general preparedness to handle an impending threat..
But when anxiety becomes an unwelcome constant companion or when we become fearful of objects or situations we encounter in daily life that pose no objective threat, then anxiety becomes problematic, impairing our daily functioning and general well-being. If we are anxious much of the time, we may find it difficult to concentrate at work, to relax at home, or even to fall asleep at night. Fears can prevent us from fully living our lives, especially when they rise to the level of a phobia. One young woman I treated, a recent law school graduate, suffered from acrophobia (fear of heights). She had turned down a job offer from a prestigious New York law firm because the firm’s offices were on the 47th floor of a building with floor to ceiling windows. Throughout her job interview, she sat panting in a state of near terror, simply because she had inadvertently looked out the window. She told me she had declined a job offer from the firm, opting instead for a much less desirable job at a small firm whose offices were situated above a storefront.
The curious thing about phobias is that they usually involve the ordinary events in life, not the extraordinary. People with phobias become fearful of the routine, ordinary experiences which most people take for granted, such as riding on an elevator, driving on a highway or an elevated roadway, having lunch with co-workers, or even something as prosaic as signing your own name in front of others. Phobias become maladaptive or even disabling when they interfere with daily functioning. A person with severe agoraphobia (fear of venturing out in public), for example, can become literally housebound.
A key step in managing fear and anxiety is practicing something we can do without any conscious effort—breathing deeply. But many of us have forgotten how to breathe deeply or never learned to breathe deeply in the first place. Gaining control over our breathing helps tone down our body’s alarm response and quells anxiety. Here’s a diaphragmatic breathing exercise you can learn in about a minute’s time:
1. Sit comfortably in a chair, placing your dominant hand on your stomach.
2. Place your other hand over your upper chest.
3. Breathe deeply, inhaling through the nose and exhaling through the mouth, taking in a sackful of air that pushes out your dominant hand with each in-breath. Try to keep your other hand still while breathing in and out. In this way, you regulate your breathing through your diaphragm and not your chest or throat muscles.
4. Match breaths so that each in-breath and out-breath are approximately equal in length.
5. Once you get the knack of it, you can remove your nondominant hand from your chest, letting it lie comfortably on your side.
6. To deepen your state of relaxation, pick a calming word you can repeat silently to yourself on each out-breath, such as the words "one" or "relax." Simply repeat this word silently to yourself each time you exhale. Stretch out the sound of the word as you repeat it. Breathe deeply in and out, repeating your calming word on each out-breath.
Some people find it easier to breathe diaphragmatically while lying on their backs. You may lay comfortably on your back, while placing your dominant hand lightly on your stomach. Breathe deeply enough that you gently lift your hand with each in-breath and let it fall with each out-breath. Practice repeating your calming word on each out-breath.
When you become comfortable using deep breathing relaxation, you may find that simply repeating the word "relax" to yourself at times you’re feeling tense or anxious may be sufficient to bring back your relaxation response. If not, find a quiet place to practice the technique for a few minutes to restore feelings of calmness.
Diaphragmatic breathing is an important behavioral coping skill you can use whenever your body’s anxiety reaction is revved up. In the next blog, we’ll focus on cognitive coping skills you can use as well—that is, what you can think or say to yourself to manage anxiety.
© 2016 Jeffrey S. Nevid