Generalized anxiety is the condition of elevated levels of anxiety without a specific trigger.  Generalized anxiety can seem to exist for long periods of time in many different situations without a specific trigger.

Despite the fact that there does not seem to be a specific trigger, there is a trigger (or multiple) that is causing the elevated levels of anxiety.

Try to identify a trigger or situation that intensifies the anxiety.  Practice the tools both mental & physical, and keep them on you as much as possible throughout the day.

PTSD is a manifestation of anxiety disorders.  Due to a traumatic experience, your ‘self defense’ system (anxiety) has been taught there is danger, and now your system is trying to keep you safe and prevent you from experiencing that again. 

Anxiety is our natural defense system which asses danger and works to keep us safe.  Anxiety is ‘fear’.  Fear is a tool that is used by our natural self defense system to control our behavior.  Any form of fear related response falls under “anxiety”.

It becomes a disorder when the response is out of proportion to the risk of danger.  It becomes an irrational response to an irrational perceived threat of danger.  PTSD is a fear related response to a memory of fear.  There is no danger right now, the response is based on a memory of a previous traumatic experience. 

OCD is often associated with “checking”.  There is typically a process of repetitive checking to be certain to prevent a dangerous situation from happening.  Even washing hands, checking locks, driving around the block; are all various types of checking.

OCD sufferers may also be very aware of numbers.  Often acting on only specific times of day for certain tasks, all in an effort to correspond with specific numbers. 

All manifestations of checking and behavior driven by OCD is in an effort to control the outcome of a situation.  The checking is to reassure the person that something bad has not happened, but the checking has to continue in order to prevent it from happening.

Any type of speaking done in public can raise anxiety levels in most people.  People are typically very judgmental of themselves, and we project our own criticism onto ourselves through our audience’s perspective.  Ultimately, we fear our own judgements more than that of others.

 The sad thing about most people is that they do not necessarily care about others.  What I mean is that they do not spend their energy in worrying about how someone conducts a speech of sorts.  The other thing to remember is that all people make mistakes.  Everyone forgets a word, mispronounces a word, loses a spot when reading and can even lose track of a thought from time to time.  And all these “mistakes” are absolutely acceptable behavior when someone is speaking out loud.  It is ourselves that expects perfection and zero tolerance in normal behavior.

Social anxiety is rooted in the idea of being accepted, and more importantly controlling the experience in which we want to be accepted.

We often worry about our behavior so that we do not embarrass ourselves.  What we say, how we act, all aspects of our behavior are manipulated in a sense to prevent an embarrassing situation.

When we attempt to live up to unrealistic expectations, this manifestation of anxiety can reach all aspects of our life.  Accepting that we are not perfect, and more importantly that we do not have to be perfect, is what will ultimately begin the recovery process for people suffering with social anxiety.  However, it is a process and should be approached in small, manageable steps. 

Specific Phobias

Fear of heights are very common.  Most people are a minimum cautious when in high places.  For those with a phobia it goes beyond the typical caution into an irrational belief that a fall is imminent.  This fear may develop from a previous traumatic event, or from a persons individual insecurity of being able to maintain balance in certain situations. 

Practice Suggestions:

Practicing heights can usually be started at malls, parking garages or even a building with multi levels.  When beginning practice do not run to edge of railing and look over – this will certainly cause higher levels in most people, even without a disorder.  The way to approach the railing is at arms length – looking straight out across – do not look down.  Practice tools (mental & physical) until levels begin to come down.  Slowly get closer to the railing – always looking out and across – never down.  Even practice with your back to the railing and stand closer. 

Fear of flying in an airplane or helicopter.  Often times this begins from an event when a person wants to get off the aircraft and is unable.  This is often associated with claustrophobia (fear of small spaces) since airplanes tend to be tighter spaces.  It has been said that more than 50% of people with aerophobia also have some other manifestation of anxiety disorders.

Practice Suggestions:

Often practicing on public transportation (buses, trains) has been useful in helping to desensitize to being on an aircraft.  Flying with someone can help.  Be proactive in using tools prior to getting to the airport.

The definition of agoraphobia continues to change as new understanding arises.  The best definition I believe is “fear of being outside of our comfort zone”.  Each individual will create what their specific comfort zone is.  The person suffering from agoraphobia will often experience depression, and possibly panic disorder.

Practice Suggestions:

Depending on how sensitive a person is will determine where to begin.  For a housebound agoraphobic, literally taking one step outside is where to begin.  Wherever your particular starting point is, slowly & gradually continue going slightly beyond that starting point.  Using tools as much as possible during the practice.

Some research may suggest that a fear of spiders may be an instinctive response.  However, when the fear is out of proportion to the threat of danger, then this is a disorder.  However, on the other hand spiders have often been associated with fear in general; through entertainment (movies, television, etc.), even books.  Therefore, we may have developed a sensitivity to spiders through many various outlets.

Practice Suggestions:

When beginning to work on fear of spiders, I often recommend using photos to begin.  Followed by videos on the computer.  Once you are desensitized to images of the spider, you can purchase a toy/plastic spider and practice having this stay on your hands.  One step further, you can visit a local pet shop or nature center to begin working with live spiders.  You can speak to the store personnel or the director at the nature center and work on a plan to possibly get closer to the spider.  And maybe even let one crawl on you.

Storms in general can raise anxiety levels somewhat in most people.  However, for thunder & lightening specifically the occurrence of higher levels go up drastically.  Some experts believe that this phobia is so common that it may be the third most popular phobia that people suffer with. 

Practice Suggestions:

One of the most difficult fears to expose yourself to.  I recommend practicing the tools often when there is no weather event at all.  When a weather event begins, regardless how small it may be, treat it like a major event using your tools and managing your thoughts. 

Often affects people when approaching smaller spaces that they will be confined in for some time.  To name a few; airplanes, elevators, public transportation, MRI’s, and many others.  The fear seems to arise from both the inability to escape if they need to, as well as the feeling of suffocation. 

Practice suggestions:

Finding the right space to practice in will depend on how sensitized you are.  Some areas that seem to work well are closets, the back seat of a small vehicle, even a tanning bed.  Note that the tanning bed does not have to be turned on; a fee would have to be paid for use of the bed, but explain to the attendant that you are practicing tight spaces and they typically work out a cheaper rate.  The idea is to expose yourself to tight spaces in small, manageable steps.

Fear of dogs is likely the third most popular fear of animals.  The fear may arise by a bad experience with a dog; whether getting bit personally or even witnessing someone else getting bit.  The other common factor for developing this type of fear is simply by the reinforcement that dogs may bite. 

Practice Suggestions:

If you know someone with a friendly dog that you feel comfortable with I would suggest start here.  Otherwise possibly a local pet shop that sells puppies.  Or even the local shelter.  Explaining that you need a smaller, friendly dog to begin working with will help in creating a better experience.  As your comfort level grows, you can move onto larger dogs that may appear to be more threatening.

Fear of dentists often stem from expectations of the experience.  Many people have reported that nothing bad has happened personally from a dental encounter.  Rather people fear the expectations that they believe will happen to them while in the dentist chair. 

Practice Suggestions:

Often times if you speak to your dentist ahead of time and explain your fear, the dentist will set aside time to have you come into the office and just sit in the chair.  Many times this “introduction” to the chair without the pressure of an appointment can help tremendously.  Practice mental tools and even keep a “touch” tool in your hand, during both the introduction visit and during the actual appointment.

Fear of insects includes a response to all types of insects or bugs.  Often times this fear begins as a child when there is a life experience that teaches that bugs can be scary or dangerous.  The fear is often reinforced by entertainment (movies, television, etc.).

Practice Suggestions:

When beginning to work on fear of insects, I often recommend using photos to begin.  Followed by videos on the computer.  Once you are desensitized to images of various insects, you can purchase a toy/plastic spider and practice having this stay on your hands.  One step further, you can visit a local pet shop or nature center to begin working with live insects (crickets, mealworms, etc.).  You can speak to the store personnel or the director at the nature center and work on a plan to possibly get closer to the insects.  And maybe even let one crawl on you.

Fear of bridges may include vehicle or walking spans.  Fear of bridges may vary greatly depending on individual sensitivities to certain environments.  This fear may also be linked with agoraphobia or acrophobia (heights).

Practice Suggestions:

Many times walking on overpasses may be a good way to begin working on bridges.  Followed by small bridges that are able to be driven with lower levels of anxiety.  Practicing the roads leading to the bridges often help in desensitizing the experience.  You can ask someone to help in the process.  A helper can first drive the car, then sit in passenger seat (and talk), then sit and do not speak, followed by sitting in the back seat.  You can also have someone on the phone to speak to if that helps the experience to begin.

Fear of public speaking is mainly rooted in the concern of being judged by others.  Often this fear begins in children when people are mainly more concerned about making mistakes and/or being judged.  In many cases public speaking may also be accompanied by social phobias as well.  Some estimates state that upwards of 75% of all people experience some level of fear of public speaking.

Practice Suggestions:

The most import thing a person can do to help the experience is to be well prepared.  Know the material you will be speaking, and practice it often.  You can speak to a mirror.  You can record yourself and play it back.  The idea is to become so familiar with the wording and practicing it that you will have less fear.  And remember that everyone makes mistakes.  I know that we judge ourselves harsher than we judge others, and this is true for everyone.  No one will judge you more than they judge themselves.  But even if you make a mistake its ok, its common for people to lose their place, mispronounce a word and even have to start over.  Be gentle with yourself and do not hold yourself to such high expectations. 

Fear of blood often arises from an earlier traumatic experience.  The sight of blood is often associated with a medical issue and even possibly death.  Therefore, it is the idea that just the sight of some blood, even small amounts, indicates that there is a major problem. 

Practice Suggestions:

I would recommend finding videos on the internet of small amounts of blood.  Watching a finger get pricked, and then working up to blood being drawn.  Remember, small, manageable steps – do not rush this but slowly & gradually build up to watching these videos.  Eventually I would speak to your doctor and have an appointment set up for him to work with you on this fear.  Once you are desensitized to the videos, you can have your doctor introduce you to the process of giving blood, even if a finger prick to begin.  Even leaving red paper – or white paper with red ink on it – around so you will see it often will help to desensitize you to the color red. 

Fear of illness can manifest itself in many ways.  Often the condition begins when a person feels a sensation that is unexplainable at the moment.  This may lead up to the conclusion that the sensation is a sign of an illness.  The fear can also manifest as the worry of catching an illness. 

Practice Suggestions:

The more you check and look for confirmation that you are not sick, the more your anxiety will intensify.  The best thing to do is to practice on not checking or not validating the state of your health.  Once you are determined to be in good health by your medical care provider, and you are certain that this is a phobia you are dealing with, then it becomes a matter of managing your thoughts.  Learning to change your focus away from your fear and onto the tools.  Learning that you will be ok if you do not pay attention to specific sensations or feelings.

Fear of death typically arises from experiencing some situation as a child surrounding the death of someone else.  The fear may include things associated with death (coffins, tombstones, etc.).  Many people state that the fearful thoughts center around the unknown, as well as how final death is.

Practice Suggestions:

If more than one phobia exists I would begin working on the other phobia first.  Necrophobia is a difficult one to begin with.  Practice comes back to managing your thoughts and learning to look away from your fear.  But it is very difficult to desensitize you to your trigger, so this is why working on another phobia (if possible) is a good way to begin.

Fear if the dark is often centered around perceived unseen dangers.  The fear may begin from a personal traumatic experience.  Or it may begin from hearing of experiences that other people have had.  The dark is portrayed by the entertainment industry (movies, television, etc.) as being danger, and this reinforces possible earlier concerns.

Practice Suggestions:

To begin I would suggest using a room that you can make completely dark.  I would suggest shutting the lights for a short period at a time in a controlled experience.  While the lights are out, use tools both mental & physical.  And pay attention to the time.  Each practice period try to extend the time slightly, building up to the point that you can remain for hours at a time.  Once a level of comfort is established in one room, begin working in other areas.

The fear of choking is typically centered around the idea of eating solid foods will cause illness or death.  Even if illness or death are not the main concerns, some type of embarrassing behavior is enough to avoid eating solid foods.  Often times this fear begins from a personal experience, or witnessing an experience of another person. 

Practice Suggestions:

To begin practicing you can introduce small amounts of solid foods, while working on mental tools.  Practice does not require large amounts of foods.  A small quantity of something that raises your levels slightly to begin with is plenty.  Work the mental tools and eat the food that you are able to.  As the smaller quantity of food becomes easier, you can add slightly more.  Eventually increasing quantity and size.  Before moving onto more difficult foods.

Fear of needles may involve actually receiving an injection of some sort, or even seeing the needle.  This fear may be related to other type of phobias involving sickness, doctors or blood.  Often there is no specific traumatic experience that begins the fear, but rather the persons own expectations as to what it involves.

Practice Suggestions:

To begin you can use videos on the internet, plastic toy needles and even plastic syringes sold in most pharmacies.  The idea at first is to become desensitized in seeing the needles and in holding the needles.  As you become more and more comfortable with being with the needles, you can discuss with your doctor or pharmacist to see what options there are for blood donations in a very controlled environment to hep you further your practice.


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