Breaking Anxiety's Grip

"My heart beats so fast that it feels like it will explode out of my chest . . . A feeling of doom washes over me. Everything looks bleak and scary . . .My thoughts start to race . . . and my mind immediately turns to bingeing."

Everyone with eating disorders experiences feelings of anxiety like this. When clients come to me for help, I recommend that they heal themselves in four ways. First, I give them reassurance that they are definitely NOT alone with these feelings. Anxiety is the #1 reason Americans seek counseling. Second, I help them understand anxiety, how it develops, and how to feel more "in control" of it. Third, I teach them ways to help them stop the anxiety spiral. Then fourth, they learn how to comfort the "part" of themselves that becomes anxious.

Anxiety is excessive worry that is difficult to control. It causes: restlessness, being keyed up, feeling on edge, fatigue, difficulty concentrating, irritability, muscle tension, difficulty falling or staying asleep, or restless unsatisfying sleep. (If you think about it, most people in our high-pressure society feel anxious.)

Panic attacks are periods of intense fear or discomfort, with physical symptoms that develop abruptly and reach a peak within 10 minutes. These symptoms include: pounding heart, sweating, trembling, shortness of breath, feeling of choking, nausea, abdominal distress, dizziness, faintness, feelings of unreality or being detached from oneself, fear of losing control, going crazy, or dying, numbness, tingling, chills or hot flushes.

When you understand anxiety, it becomes less frightening and then can be dealt with in a calmer, more logical manner. Anxiety is an instinctual survival mechanism developed millions of years ago. When Ms Cavewoman saw a saber tooth tiger, her brain registered a "threat", and activated her "fight or flight response." Her body gave her a squirt of adrenaline to make her heart beat faster, lungs breathe more rapidly, thoughts come more quickly, and muscles tense up — all so that she could fight or flee.

This is all well and fine if I am about to be hit by a Northbound Lincoln Avenue bus. That automatic squirt of adrenaline burns off as I run for my life. But, most "threats" in today's society are abstract. Our brain cannot tell the difference between a real threat and one that is "imagined." So, when we think, "Oh no! What if I gain weight?" or "Oh my God! My boss won't like me if I speak up!" we get the same automatic squirt of adrenaline even though we would never start a fistfight or flee in terror. Striving for perfection also creates anxiety, because the person is never satisfied.

Worse yet, we notice our bodies' symptoms and think, "Oh no! I'm shaking! What if someone notices?" Our mind sees this as another threat, and before you know it, squirt! — another dose of adrenaline. This causes our bodies and minds to speed up even faster. When this is noticed and we think, "Oh my God! What's wrong with me?" — squirt! — more adrenaline. And so on, and so on.

To stop this out-of-control spiral, we need to recognize anxiety in our bodies. I often ask clients, "Where in your body do you feel anxiety? What does it feel like?" If your first anxiety symptom is a "lurch" in your stomach, then the next time it occurs you may recognize it and process it in a new way.

Deep breathing exercises, visualizations, and other techniques can halt the anxiety spiral. For example, visualize a calming color and then the color of your anxiety. Take a deep breath in through your nose, and imagine that you are "breathing in" your calm color. Breathe out through your mouth and "exhale" anxiety. As you breathe in your calm color, imagine yourself in a calm setting, such as a beach, a cabin or anywhere that feels safe. As you exhale your anxiety, imagine that it floats away from you like smoke or confetti in the wind.

Since anxiety tends to make us focus on the future, especially with "What if?" thoughts, a "mantra" (a calming phrase that is repeated over and over) can be very reassuring. A mantra such as, "Right now, this moment, I am not in danger" can bring us back to the present.

Sometimes just identifying that we are feeling anxiety and are having body symptoms, (but without the catastrophizing), can be calming. For example, "OK, I'm having body symptoms. So what? Nothing's going to happen." After doing all this for a while, you will feel in control of the anxiety by breaking the upward spiral of symptoms that had you in anxiety's grip.

However, it is not enough to just control the physical symptoms of anxiety. To finally stop the anxiety from reoccurring, you must address the underlying issues that started the anxiety originally, usually with the help of a counselor.

For each person, these underlying issues are unique. Yours may be based on family dynamics from years ago, or a trauma that never fully healed.

Whatever the cause, the process of resolving these issues is the same. Feel a bit of the anxiety. Then visualize this feeling as a "part" of you. If you imagine sitting next to this part, you may feel empathy and compassion for it. Ask it what it needs from you, what words it wants to hear more than anything else. Often the part wants validation, acceptance, and reassurance — phrases like: "Its okay to feel this way." "I am still good enough even though I'm scared." "It's going to be all right," or "I am not alone." Write these phrases down on a card and pull it out as needed.

When you feel more calm, then your adult self can take care of what caused you to become anxious in the first place. It sounds easy, but it does require work, courage, and persistence. The guidance of a counselor will help you finally resolve these underlying issues. Breaking the grip of anxiety will spiral you upwards—to happiness, health and success!

Amy Grabowski, MA, LCPC, is the founder and director of the Awakening Center's Eating Disorder treatment program in Chicago, Illinois. A version of this article appeared in The Awakening Center Newsletter. For more information: www.awakeningcenter.net.

Recovery May Mean Losing a "Friend"

Although eating disorders are serious, life-damaging and sometimes life-threatening illnesses, the individuals who are affected are often reluctant to get better. For many, their disordered thoughts and behaviors have become, familiar, reliable and safe companions — in some ways like a good friend.

Best friends and worse enemies

Many positive themes emerged when patients in an outpatient treatment program were asked to write letters to their disorder "as a friend." Besides liking being thin, some anorexics felt that they were more in control of their lives, although the opposite was actually more accurate. Some women even appreciated not having menstrual periods despite the obvious health issues. Bulimics saw fewer "pluses" although they did regard bingeing as a way of dealing with boredom in much the same way as one would call someone just to shoot the breeze. Several indicated that bulimia helped them to avoid or manage their emotions.

Anorexics often have a harder time embracing the recovery process than bulimics, partially because they see more positive aspects to their disorder. Lucy Serpell and Janet Treasure, the researchers who conducted this study at hospitals in London, indicated that, "If patients with eating disorders believe that some aspects of their disorder are beneficial or positive, their motivation to get well will be compromised."

These same patients were also asked to write letters to their illnesses as an "enemy." Health problems were a common concern, as were negative self-image — especially in bulimics, who listed more negatives — specifically ideas of shame, lack of confidence, and self-hate. They also disliked the wastefulness of their bingeing and purging, the secrecy, and the guilt. Bulimics were upset by obsessive thoughts about weight and shape, but anor-exics did not like having constant thoughts about food. In both cases, the list cons was greater than the pros.

Finding new friends

This information is useful to individuals in recovery for a few reasons. First, by acknowledging how they value their disordered eating, they can recognize why they might be ambivalent about giving it up. They can also see the "logic" behind their getting hooked in the first place. When someone sees that they have used an eating disorder as a "friend," they can better understand the importance of replacing it with worthwhile activities or uplifting people. By listing the disadvantages of their problems with food, they can counterattack the lure of remaining obsessed.

One activity that therapists often recommended is to write a "Dear John" letter to your eating disorder. Thank it for all of the good times, but explain to it why you must say "goodbye." Tell it how you want your life to be more complete and that it is getting in the way.

Caroline Adams Miller, who has written about her recovery from bulimia, took this a step further, "Although I spent many years trying to ignore it, hating it, then wishing it had never happened, I see today that my eating disorder is what was needed to change my life for the better." By successfully facing the underlying issues and quitting her bulimia, Caroline was empowered in a way that she may never have been otherwise, and that was its biggest plus for her.