Anxiety Symptoms?

The Clinical Symptomatology of Anxiety Neurosis. This list is compiled from – Freud,S. (1925-26). In Vol.10, Inhibitions, Symptoms and Anxiety. P.94-97.

The first person account, the ‘I’, mentioned at times in the list is Freud’s voice.

 The clinical picture of anxiety neurosis comprises the following symptoms:

 

  1. General irritability. Common nervous symptom. “Increased irritability always points to anaccumulation of excitation or an inability to tolerate such an accumulation-that is, to an absolute or a relative accumulation of excitation. One manifestation of this increased irritability seems to me to deserve special mention; I refer to auditory hyperaesthesia , to an oversensitiveness to noise-a symptom which is undoubtedly to be explained by the innate intimate relationship between auditory impressions and fright. Auditory hyperaesthesia frequently turns out to be a cause of sleeplessness, of which more than one form belongs to anxiety neurosis”.
  2. Anxious

“Anxious expectation, of course, shades off imperceptibly into normal anxiety, comprising all that is ordinarily spoken of as anxiousness–or a tendency to take a pessimistic view of things; but at every opportunity it goes beyond a plausible anxiousness of this kind , and it is frequently recognized by thepatient himself as a kind of compulsion. For one form of anxious expectation -that relating to the subject’s own health-we may reserve the old term  hypochondria.

A further expression of anxious expectation is to be found in the inclination to moral anxiety, to scrupulousness and pedantry.

Anxiousness-which, though mostly latent as regards consciousness, is constantly lurking in the background-has other means of finding expression besides this. It can suddenly break through into consciousness without being aroused by a train of ideas, and thus provoke an anxiety attack. finally, the feeling of anxiety may have linked to it a disturbance of one or more of the

 

bodily functions-such as respiration, heart action, vasomotor innervation or glandular activity. the feelingof anxiety often recedes into the background or is referred to quite unrecognizably as ‘being unwell’ ‘feeling uncomfortable’ and so on.

  • Anxiety attacks accompanied by disturbances of the heart action, such as palpitation, either with transitory arrhythmia or with tachycardia o longer duration which may end in serious weakness of the heart and which is not always easily differentiated from organic heart affection; and, again, pseudo­ angina pectoris-diagnostically a delicate subject!
  • Anxiety attacks accompanied by disturbances of respiration , several forms of nervous dyspnoea, attacks resembling asthma, and the like. I would emphasize that even these attacks are not alwaysaccompanied by recognizable anxiety.
  • Attacks of sweating, often at
  • Attacks of tremor and shivering which are only too easily confused with hysterical
  • Attacks of ravenous hunger, often accompanied by
  • Diarrhoea coming on in
  • Attacks of locomotor vertigo.
  • Attacks of what are known as congestions, including practically everything that has been termed vasomotor
  • Attacks of (But these seldom occur without anxiety or a similar feeling ofdiscomfort.)
  1. Waking up at night in a fright (the pavor nocturnus of adults), which is usually combined with anxiety, dyspnoea , sweating and so on, is very often nothing else than a variant of the anxiety But thepavor can also emerge in a pure form, without any dream or recurring hallucination.
  2. Vertigo’ occupies a prominent place in the group of symptoms of anxiety neurosis. In its mildest form it is best described as ‘giddiness’; in its severer

 

manifestations, as ‘attacks of vertigo'(with or without anxiety), it must be classed among the gravest symptoms of the neurosis.

Furthermore, I am not sure whether it is not also right to recognize alongside of this a vertigo a stomacho laeso [of gastric origin].

  1. On the basis of chronic anxiousness (anxious expectation) on the one hand, and a tendency to anxiety attacks accompanied by vertigo on the other, two groups of typical phobias develop, the first relating to general physiological dangers, the second relating to locomotion. To the first group belong fear of snakes,thunderstorms, darkness, vermin, and so on, as well as the typical moral over-scrupulousness and forms ofdoubting mania . Here the available anxiety is simply employed to reinforce aversions which are instinctively implanted in everyone.

The other group includes agoraphobia with all its accessory forms, the whole of them characterized by their relation to locomotion.

  1. The digestive activities undergo only a few disturbances in anxiety neurosis; but these are characteristic Sensations such as an inclination to vomit and nausea are not rare, and the symptom of ravenous hunger may, by itself or in conjunction

with other symptoms (such as congestions), give rise to a rudimentary anxiety attack. As a chronic change, analogous to anxious expectation, we find an inclination to diarrhoea, and this has been the occasion of the strangest diagnostic errors.

The behaviour of the gastro-intestinal tract in anxiety neurosis presents a sharp contrast to the influenceof neurasthenia on those functions. Mixed cases often show the familiar ‘alternation between diarrhoea and constipation’. Analogous to this diarrhoea is the need to urinate that occurs in anxiety neurosis.

  1. The paraesthesias which may accompany attacks of vertigo or anxiety are interesting because they, like the sensations of the hysterical aura, become associated in a definite sequence; although I find that these

associations, in contrast to the hysterical ones, are atypical and changing. A further similarity to hysteria is provided by the fact that in anxiety neurosis a kind of conversion takes place on to bodily sensations, which may easily be overlooked-for instance, on to rheumatic muscles. A whole number of what are known as rheumatic individuals-who, moreover, can be shown to be rheumatic- are in reality suffering from anxiety neurosis.Along with this increase of sensitivity to pain, I have also observed in a number of cases of anxiety neurosis a tendency to hallucinations; and these could not be interpreted as hysterical.

  1. Several of the symptoms I have mentioned, which accompany or take the place of an anxiety attack, also appear in a chronic form. In that case they are still less easy to recognize, since the anxious sensationwhich goes with them is less clear than in an anxiety attack. This is especially true of diarrhoea, vertigo and paraesthesias (an abnormal sensation, typically tingling or pricking (‘pins and needles’), caused chiefly by pressure on or damage to peripheral nerves. Just as an attack of vertigo can be replaced by a fainting fit, so chronic vertigo can be replaced by a constant feeling of great feebleness, lassitude and so”

 

Anxiety -Symposium -BCAT

Thank you to all at BCAT for a wonderful morning!  Pleased about how it went-the facilitation by Nick Hall and the people I met.  

Saturday, March 20th 2021 –  Zoom

https://www.bcat-team.org.uk/training#SYMPOSIA

Anxiety Symposia with Smita Rajput Kamble

Anxiety affects daily life. Development and growth is that rare human achievement when we can overcome anxiety and it’s debilitating affects. This symposium will get to grips with understanding anxiety via a psychodynamic lens.

WHEN: Saturday 20th March, 2021 – 10am to 1 pm (with breaks).

WHERE: Online  COST: £60.

Payment:

You can pay by direct bank transfer to Coop Bank, sort code 089299, account no. 65682890, putting your own name as a reference and email us to say you have done this, or send a cheque payable to Bedford Counselling Centre to Bedford Counselling and Training, 71 Gwyn Street, Bedfordshire MK40 1HH.

Why do this workshop?
We experience anxiety and fear every day of our lives-whether it is about work, our health and safety and/or our relationships with others. Anxiety and generalised anxiety disorder almost always tops the chart of most browsed mental health subjects. This symposium will give you an in depth understanding of anxiety and its roots in guilt, hate and fear of castration. In the therapeutic space of group and individual work you will be able to understand how you as a practitioner help people manage their anxiety and begin to heal.

Aims

  1. To understand what is anxiety –its function in normal and abnormal conditions. The effect of fear and anxiety on possibilities of growth and development.
  2. The psychodynamic lens: pre-oedipal and oedipal anxiety. Klein and Freud on anxiety.
  3. To discuss how and why we help clients become less anxious and more contained.

Process for symposium

There will be a speaker presentation on the history of and psychodynamic theories about anxiety as well as examples of its presentation in the consulting room. The presentation will be followed by participant discussion. The speaker will then

facilitate pair and group work so that participants can apply theory to their own clinical practice examples.

Target Audience

This symposium is suitable for qualified and training psychodynamic psychotherapists, counsellors and mental health practitioners. The primary theoretical focus will be psychodynamic, but practitioners of other modalities are welcome to attend as long as they have made themselves familiar with some of the pre-course reading.

Smita Rajput Kamble 

Smita is a psychoanalytic psychotherapist in private practice. She is a training supervisor at Bedford Counselling

Foundation. In the past, she was one of the faculty at WPF Therapy, London Bridge where she taught the Advanced Clinical and Theoretical Issues seminar to Year 3 and 4 psychodynamic psychotherapy trainees. She also conducts CPD activities within the psychodynamic community in London.

*Please note that this symposium may either be held at the University of Bedfordshire in Bedford or on Zoom, depending on the state of Covid 19 restrictions by March.


CONTACT US TODAY TO BOOK A PLACE:
TEL: 01234 219905 – EMAIL: enquiries@bcat-team.org.uk
Please email us if you are interested in receiving up to date information about our CPD programme, courses and conference and we will add you to our mailing list.

Meditative Method

Like a water lily, grounded, looking upwards

Meditative methods are as numerous as there are beliefs and approaches in this world. Most of them will expect that you can still yourself and concentrate on something to calm yourself. If this works for you-concentrating perhaps on a ray of light, or white light or a point on your forehead etc, start this way. Starting any way possible is a good step forward. Meditation has too many known benefits. Hypertension and many other diseases are known to become less problematic-blood pressure and heart rate fall considerably with meditation. Once you have learned to marshall/collect your thoughts, then try the method below:

The best method is to let thoughts pass by, without judging them. You are only an observer. You do not have to act on them. You can say to yourself ‘this is my thought’ but you don’t react. These thoughts might be alarming, disgusting, upsetting…triggering action…it does not matter. They must pass by like an assembly line – where you watch them but don’t exercise restraint or do anything to change them. After some time, gaps will occur. Like the glimpse of sky between clouds. A time will pass and there is no thought. These gaps are restful, the result of lack of judgment and manic pursuing of thoughts. It is the free space in which you will feel liberated, timeless. Savour the gaps. Enjoy them. They will pass and other thoughts will come – things to do, jobs to get back to.

Let thoughts come in now. It is alright now to go back. You have meditated, even if it is for a minute. You will not have to force yourself to make meditation a part of your routine anymore. Your body will like to go to that place again. You can do it anytime, anywhere. It will be an enjoyable restful activity.

At times, you may fall asleep. Some views suggest that it is not meditation of you fall asleep. I say that anything that helps you to go into a deep sleep is a good thing. Clearly, your mind and body needed it !

What is Trauma and How We Try to Master It


In one of his earliest essays, Beyond the Pleasure Principle (1920), Sigmund Freud discusses the case of a boy, one and a half years old, who develops a game to deal with the trauma that he suffers for the first time when his mother, who he is very attached to, goes away for a prolonged visit and then returns.

He throws the ball over the bed and it goes out of sight. He makes a sound to show his surprise and wonder. After it is found and brought to him, he does an ‘ooo…’ in a delighted way.

Freud is promoting the theory that there is an economic motive involved-the need to restore ‘pleasure’ by which Freud means ‘equilibrium’ in the psychical system which has endured a sudden shock of not seeing his mother for an unpredictable time.

Sigmund Freud

This is how the game helps him to master the trauma of seperation and loss. Says Freud: “..At the outset, he (the boy) was in a passive situation-he was overpowered by the experience; but by repeating it, unpleasurable though it was, as a game, he took on the active part.” 

This observation -deduction has paved the way for the development of the idea of trauma. Not many credit Freud anymore. With new approaches, the original thinker is ‘deleted’. Do read his works. Elegant writer.

From this game, he also deduced that an object thrown away by this child is his/her way of mastering his anger, owning it. If you can imagine that the object/toy stands for mother or father or anyone who he/she is attached to and leaves unexpectedly, causing uncertainty and pain, a child can at least take it out on the object/toy and throw it away or break it. This little boy had heard that his father had to ‘go away to the front’ as it was war time. He would throw the object away and say, ‘go to the fwont!’ In this way, he was able to master, at least in his mind, a situation he had no control over-his father going to war, his mother leaving him for a visit.

Relationships ?

When couples fall in love, sex and passion is not far away. It is present and overwhelming. The test for real wellbeing benefits of couple life-and there are many proven benefits of a long term relationship- is when they can voice differences which, however unpalatable to the other, demonstrate how you can be robust, flexible, containing of the other. The easier thing for some is to close down when it gets unpleasant. At times, most human beings simply don’t like to hang around when things get bad. Others get stuck in and go for the long haul. This ability to weather the storms and stay together, smile and find mutual things to do creates a great foundation for good relationships.

It is when we open our thoughts and minds to others and see them as human beings that we really becoming richer as human beings. One has to work 24/7 to keep expanding and not contract -against the impulse to shrink when things get rough. To go against the instinct to keep the circle around us from shrinking.

People gain more depth and personality when they allow themselves to create more space for the other person to be and the other person returns the gesture. Judgment ought to give way to expansion in understanding the other and accommodating what feels odd at first. The growth of civilisation depends on this give and take.

However, when that generously given space is used in a parasitic way- i.e. the other invades and takes over rather than shares in a mutual understanding, the relationship loses the balance which makes the relationship healthy. The  scale becomes lopsided, the see saw weighs more heavily on one side-the person who takes advantage of their partner’s goodness and kindness, does it far too long and there is an end to it. The sweetest of people come apart under this kind of stress.

Enduring couples allow arguments and quarrels and the love and passion that comes in its aftermath, when anger ebbs away. If this anger remains and ferments in a toxic way, perhaps because this is the way the persons involved have seen their parents behave, then the relationship will spiral downwards. Time must be made for increasing wisdom, understanding and kindness for the relationship to go on and encompass children and elders in its folds.

Why is Meditation Difficult ?

Meditation is a part of the concept of mindfulness. Being present and moving from reaction to reflection. 

People have trouble meditating because we are so programmed to structure our thinking through various routines, it is difficult to try something unstructured which feels empty. 

For e.g, if your day is filled with activities it makes you feel you have achieved something – jobs are ticked and done. In this case, meditation becomes another activity to be ticked. What it ought to be is a timelessness-a space where you don’t realise how much time has passed and that you actually did tick a box !

Our minds are hardworking spaces- constantly taking in and processing stimuli from the environment. Meditation is the only way you can rest it, besides sleep of course. Even in sleep, the mind processes difficult emotions which can result in dreams. These dreams when interpreted, can create a way of living which is very satisfying.

Meditation is an unstructured space. An unstructured space is prone to get cluttered up – a bit like the garden shed. Unwanted thoughts, judgments, musings…..these create anxiety and the person finds meditating difficult. If you find yourself forcing a calmness, it is counterproductive. You ought not to be forcing a calm.

Is your Therapist Mindful?

According to the Wiki, ‘Mindfulness plays a central role in the teaching of Buddhist meditation …described as a calm awareness of one’s body functions, feelings, content of consciousness, or consciousness itself, it is the seventh element of the Noble Eightfold Path, the practice of which supports analysis resulting in the development of wisdom. The Satipatthana Sutta (Sanskrit) is one of the foremost early texts dealing with mindfulness. A key innovative teaching of the Buddha was that meditative stabilisation must be combined with liberating discernment.

Mindfulness practice, inherited from the Buddhist tradition, is increasingly being employed in Western psychology to alleviate a variety of mental and physical conditions, including obsessive-compulsive disorder and anxiety and in the prevention of relapse in depression and drug addiction.’

How does a therapist incorporate mindfulness?

‘Congruence’ and ‘countertransference’ are concepts that come close to a natural and organic incorporation of mindfulness. Through an inner knowledge of himself/herself and how one is feeling with the client in the present moment, a therapist is able to help the client process difficult feelings in the room.

How does a person incorporate mindfulness in everyday life?

A quiet spot in a busy day is enough to become aware of one’s feelings, who/what triggered them and letting go of their clinging negative properties, like allowing a ship to let go off the harbour. Mindfulness is the important punctuation needed to move from reaction to reflection. Reactions are lively, reflections are calming.

However, sometimes a deeper exploration cannot be embarked on when there is a crisis and life becomes a set of reactions. At such times, an effort at reflecting may stop a spiral of destructive reactions.

Migration, Displacement, Stress

Increasingly, people find themselves having to migrate to other areas of the UK or from one country to another, in order to find jobs that are suitable for them. This migration has a history and goes back to the beginning of the human race and the wandering, nomad that some of us might identify within ourselves has long term ancestors.

Milton Keynes can feel ‘modern’ to the newcomer

Moving to a new city may be an exciting venture. Milton Keynes, for example, attracts quite a migrant population, not just from other countries but from different parts of the country. It has a good success rate in employment and seems on the surface to be a buzzing city with lots to offer to someone who is new here.

The underlying issues that accompany a migration is the loss of a secure base (if there was one before). However big the reward for such movements, the human cost is high. Separation and loss cause the human to regress to some of his/her earliest experiences of loss and the response to such losses.

Our infancy is like this pic. Someone familiar is ‘holding’ us

If you observe a baby who is still at the very earliest stages of life, the eyes constantly find its mother/caregiver because that is how he/she finds an emotional and psychic anchor in the aftermath of the loss of the womb life.

If you observe yourself in a new place, you may find yourself searching in a similar way for familiar things – a McDonalds’ sign, familiar landmarks, a nice smile from someone to make you feel welcome etc. I have often heard talk in the local gym of how friendly everyone is here and how they would not want to be in that other place where no one smiles at the other. 

These are the things which bring relief to the soul that searches for a home where it can feel safe. With the relative feelings of safety come the need to perform and make one’s mark on the environment. The healthy normal human will make a seemingly unfamiliar, even hostile environment into a place they begin to feel at home in.

An ethnic word can bring relief to the homesick

Some people may never make a new place their home because all the goodness is left behind in the place they left to come here.
This is called splitting and projecting goofy shopdness into an idealised place.
Such splitting can occur with people as well. You may often hear stories of how good the previous boyfriend/girlfriend/mother/father/brother/sister/teacher etc was and how no one can ever take their place now.

Such a splitting harms the experience of the present and the potential to live and enjoy something new in the present.

Counselling/therapy can help to work through the idealised lost experience of someone or something and open up the capacity to live life more deeply and fully.

But the bottomline sometimes is that no two things are the same and we, as living organisms, require some amount of sameness and familiarity in order to feel secure and grow. Letting go of things one cannot have anymore and ushering in the new is an art that may enrich one’s experience of life’s constantly changing parameters.

What is Psychotherapy ?

Psychotherapy is a process. If you can believe that all living organisms require a cocoon in order to transform into something else, then therapy can be that cocoon. You sit week to week with a psychotherapist who knows what the process is and listens attentively. You pay for it so the process is marked as something that needs to have some achievable results.

Jung wrote extensively of the process of individuation and rebirth. He urged getting rid of moralising and seeing every action as part of a process.  Moralising tends to keep one in a simple, one dimensional compass-it reduces creative ways of thinking about problems.

For e.g, if your spouse cheated on you, you would go into some reactive mode – leave or make charges, file for divorce etc.

On the other hand, you could ask ‘why now?’ which may lead to a better understanding of how someone may have reacted :

  1. for eg, was it the onset of midlife (starting from mid 20s) or
  2. The coming of age of children, the uncomfortable feelings they arouse and the displacement of such feelings onto an outsider.
  3. It could lead to an understanding of how the person’s parents behaved at a similar time-
  4. in a family that lives together, more often than not, we pick up behaviour that is embedded deeply rather than the ‘we must not do this and that’ which we constantly repeat to ourselves.

If my son for eg breaks a plate, the doorbell is ringing and I find out I have lost my wallet I am more likely to behave like my parents than all the taught behaviour of how I must react because the crisis disbands studied ways of thinking. It takes us back to our primitive roots.

Psychotherapy that can bring about change, that punctuation in your attitudes and behaviour if you allow it to.

Fathers and their function ..

Traditionally, the father went out into the world and brought back the sustenance from the outside world that the family require-food, shelter, warmth. In ancient times, still visible in more primitive places, he deals with the threats from the external world and interrupts the mother-child duo with, ‘I too belong with you’. this would the classical view, as proposed by psychodynamic literature from the past.

From the beginning of time, mother has played this part too. Fathers have gone to battle and mothers have gone into the wild for foraging and guarding the home and vice versa, mothers have left it to the fathers to do the mothering. This shows us that the gender of a person does not necessarily align with maternal and paternal, masculine and feminine, from the beginning of civilisation.

In psychodynamic thinking, fathers are symbolically associated with rules and regulations – the boundaries that keep a child safe not only from the external world but the internal one. This may take away from empathy and the more maternal aspect of nurturing so that the role of a father-whether a woman or man does it- may be seen as hard, someone who comes in the way of freedom to do as we please.

Mothers clearly do this job many times. More often than not, one finds the mother laying down the law for her child-on playgrounds, social life and in school. This type of rule making for the child gives him/her the inner strength to make something of himself/herself.

Society creates an umbrella for the parent and child. Schools, doctors, shops, environments of toddlers’ groups, support groups etc. make up the circle around the mother/father/child/family. These circles provide the environment within which we find a nest to settle into and feel safe.

The circles that bind us and keep us safe.