| Anxiety Treatment |
| Christian Jonathan Haverkampf |
Abstract—Anxiety is a highly treatable condition. However, it impairs the life of many. Treatment approaches, such as CBT may lead to quick improvements, which, however, may often not be sustainable. A more insight and communication-focused approach may lead to longer-lasting results. Communication-Focused Therapy® has been developed to that end.
Index Terms—anxiety, communication, depression, treatment, psychotherapy, psychiatry
I. INTRODUCTION
Anxiety is a very common condition, which affects many people. It can be very debilitating in everyday life. It can show up in many different forms. However, all these forms have certain things in common. Anxiety is usually a signal that some part of the patient’s life is not aligning with their needs, values, and aspirations, the ‘basic parameters’ (Haverkampf, 2018b). This alignment is assessed through internal and external communication. Anxiety is a signal that certain things do not fit together anymore.
Depression and anxiety are usually caused by how we interpret our internal and external interactions or non-interactions with the world. We need to construct working hypotheses to function in the world. However, problems arise when our interpretations and theories seem like facts. How we think and act today is thus linked to our interpretations of past communication events or missing communication, which has an influence on us today.
The quality and quantity of connectedness with others play a large role in whether anxiety and depression can develop and to which extent they can do so.
II. Connectedness with Others
Connectedness is something we build with other people. In the way we speak, and what we see and hear when we communicate with each other we receive and send meaningful messages. When our connection comes from a place within us that is authentic and open, the depth of our connectedness will be greater. Unfortunately, often connections are built on what we think and feel others would like us to do or be. This misalignment can lead to anxiety, depression, burnout, and other conditions. We may also misinterpret our own internal information and messages, and think we need or value something, which we in truth do not.
The level of connectedness plays a role. The more connected we have been, the less likely we are to misinterpret another person’s thoughts. Since we cannot mindread, connectedness is the next best thing. Connectedness endures how much meaningful information can be exchanged between one person and another. Information exchange can be verbal or non-verbal. Communication involves encoding and decoding, which depends on the information we already have about the world, our past and present experiences. If we have a distorted view of the world, ourselves, and our own actions, there will be a misalignment, which leads to greater anxiety.
Since the interpretations we made in the past are frequently stored more securely in our memory than the interactions themselves because of the potentially strong emotions associated with our interpretations, it would not reverse our interpretations unless we actively try to do so. However, the more we communicate with others and exchange meaningful information over time, the better we can accurately assess the world. It also helps us to encode and decode messages we exchange with others more effectively and accurately. Therefore, many therapies, and Communication-Focused Therapy® quite explicitly, aim at correcting communication processes and patterns.
Fear can play a large role in how we interpret our interactions with others. Fear may be linked to how we see others, which influences our interactions with them. But even beyond that, there can be a general fear of not feeling safe in the universe. The falling apart of families and wholesale distancing from religious practices, coupled with materialism and physicalism has disconnected us from those sources that can make us feel safe. We may look for it in business success or academic achievements, but they don’t provide the feeling of security, because that is not what they have been designed for. Deep connectedness with oneself and others can reverse this process, but several social forces act against it. The result is numbing loneliness.
Connecting with others requires that we can also connect with ourselves on a fundamental level. As pointed out, internal and external communication are mirror images of each other. (Haverkampf, 2010) This means identifying what we really need, value, and aspire to, three factors which I have dubbed the ‘three basic parameters’ previously (Haverkampf, 2017a, 2018b, 2018a). One may think one knows them, only to find out on a deeper inspection that what one truly needs or values is different. Other people and a misinterpretation of past events can distort what we think we need and value, making us less effective in getting our true needs met and leading to unhappiness, discontentment, and anxiety by affecting our communication with others. For example, if one feels one wants to be rich but on a deeper level longs for security and recognition, accumulating money does not lead to greater happiness if the feelings of insecurity and loneliness persist.
We may also read others incorrectly when we project our misinterpreted needs, values, and aspirations into them. This can also lead to more anxiety because it raises uncertainty when communicating with them. Once we understand these authentic basic needs, values and aspirations in ourselves and others, we can much more easily connect, and we are less surprised when they reject an offer to connect. Insight, understanding, openness, and connectedness go hand in hand. Anxiety is very often a problem of too little connectedness, which is due to communication difficulties. Hospitals, for example, are places where a lack of opportunities for connectedness can lead to even greater anxiety and worse health outcomes.
III. Connectedness with Oneself
Connectedness with ourselves is very important for our own mental health. It helps us to identify more clearly and accurately our needs, values, and aspirations, which helps against burnout, anxiety, and depression. The interaction between patient and therapist is important in this process because external communication affects the internal communication within the patient.
Once we can connect with ourselves, we feel safer and less alone, and thus less separated, which reduces anxiety and feelings of depression. For small children, connecting can be easier because they have not yet been socialized with all the communication rules adults need to contend with. There is less need to think about communicating. Particularly in patients with anxiety, there is a tendency to also overthink the process of communication itself. Since hurt also occurs through communication, there can be a tendency to protect oneself from communication with others and oneself. Very often communication has to be learned anew to a greater or lesser extent. In psychotherapy, we train the ability to think about thinking (metacognition) by communicating about communicating (metacommunication). Breaking down unhelpful thought and communication patterns help to make connectedness with oneself and others easier, which can reduce the level of anxiety one experiences.
Our internal connection is the channel through which communication with others becomes possible. Connecting with ourselves means allowing ourselves to be aware of our thoughts and feelings unhindered and with openness. What may stand in the way of internal transparency is that some of this information may be associated with fear or other feelings, which impedes the internal communication process. For example, we may have learned in life that some feelings are hurtful or cause negative consequences for us. If one had a parent with anger issues, a child could easily feel that the anger is directed at her own thoughts and feelings, causing the child to distance herself from her own thoughts and feelings. The result is a greater disconnectedness from oneself, which can then lead to anxiety or other ‘signals’ of misalignment. A wall of disconnectedness can also stem from expectations we think others have of us, the pressure we put on ourselves, and many other factors. The antidote to disconnectedness is an experience of greater connectedness, which can be learned in psychotherapy and practised through several techniques, including caring for others, mindfulness, and compassion.
Connectedness with oneself often requires the opposite of what seems to be needed. Stillness and calm can be helpful. The small, still voice within can get drowned out by hectic everyday life. In the life of many patients with burnout, listening to their own inner needs, values, and aspirations is difficult. The aim is merely to function and not to break down. Being on autopilot mentally and emotionally without being receptive to internal feedback can lead to anxiety and depression. The solution is not to shut off daily life, but to build more adaptive communication patterns, leading to better connectedness (Haverkampf, 2020).
Anxiety is also reduced when states of connectedness seem more meaningful. Very often people become more disconnected from themselves and the world because they lose the sense of the meaningfulness of being connected with themselves or others, which can occur in depression. Sometimes, rediscovering in a materialistic world a sense of spirituality can be helpful against anxiety. Important is the confidence a patient has in his or her own communication efficacy, the skilful use of communication patterns.
Internal connectedness does not necessarily mean consciously getting information. When we get lost in the moment, whether at work or while eating a meal at home, we are also connected with ourselves. It is rather when we are disconnected that it becomes apparent, such as through anxiety or symptoms of burnout. Activities where one gets lost in the present moment usually reduce anxiety, and symptoms of burnout, and can also help against certain forms of depression.
All organisms carry within them the footprints of past information, whether from inside themselves or from their environment. However, when one tries to read and interpret this information from the past, it is usually filtered through one’s present mood, emotions, and overall outlook in life. Memory is never as good as a current experience. So, a connectedness with oneself that can help against anxiety should be rooted in the present, while having valuable information from the past available. Centering in the present also helps to avoid an anxious living in the future or a depressed living in the past.
Connectedness with oneself is easier if it can be seen as a worthwhile task. Very often society puts an emphasis on the external, particularly in the West. Contemplation and reflection on our inner worlds may be valued but are seldom seen as a mark of success. However, connecting with oneself can make one more effective in the outside world. The lack of attention to their own needs, values, and aspirations can lead to misalignments between them and external interactions. The misalignments lead to less individual efficacy and fewer positive experiences in life. It is important to understand that many of the bad choices people make are not because there is something inherently wrong with them, but because they are conceived out of a vacuum of inside information. Many crimes can be traced back to some level of disconnectedness, such as a reduced capability of empathy. Anxiety, on the other hand, is in many people a signal that there is a misalignment.
Our communication with others helps our own internal connectedness. When we communicate with other human beings in a meaningful way, we learn about ourselves, and we can test out our communication patterns. Opening up to others individually or in groups improves our communication efficacy, which can lower many types of anxiety. Not all social experiences are positive though. We may also have traumatic experiences, such as rejection or mistreatment by others, which very often out of an attempt to protect ourselves from harm leads us even further away from others. However, this makes it even more difficult to see that behind their actions are their own unresolved issues, and we just happen to be in the wrong place at the wrong time.
IV. How Connectedness helps against Depression
A hallmark feature of depression is that patients ruminate about the past. One may look for something to hold onto or craves an explanation that could help one to feel better in the present. However, this often leads to a vicious cycle, when the view of the past is affected by the low mood and sees more of the things that did not work out. The longing for certainty makes it difficult to see how things may happen by chance and that we do not have control over everything. An inflated sense of responsibility leads to guilt and shame. A greater sense of connectedness with the world can reverse these feelings. It allows the patient to take a step back and look at the world as an interconnected web of cause and effect, where one individual plays only a small role. Acceptance and mindfulness can be helpful tools for connecting with the world and drawing conclusions from it. Both have shown some effectiveness with mood swings.
Connecting interpersonally is one of the main pillars of connecting with the world. Through others, we also connect with ourselves. Many therapeutic approaches have been developed around social activation, and there are group therapies where interactions with others can be practised. However, communication also needs to be meaningful, which enables it to bring about change within the participants and consequently in their communication patterns. Meaningfulness also has a positive effect on motivation and other cognitive functions. Our concentration and satisfaction increase when we see meaning in something. Thus, working with meaning can alleviate symptoms of anxiety and depression, while meaning in turn depends on connectedness and the quality of communication, internal and external.
V. How Connectedness helps against Anxiety
Connectedness integrates us better into the social fabric of the world, which promotes feelings of security and certainty and lowers fear and anxiety. Inner connectedness makes us feel more confident about ourselves, while external connectedness makes us more confident about our place in the world. This type of confidence in turn is a powerful antidote against anxiety. When we can align our external world with our needs, values and aspirations, when it is fully sufficient and satisfying to be ourselves, our anxiety, stress, and propensity for burnout decrease. People who are content with themselves feel less anxious. This does not mean giving up on achievement, just the opposite. It makes achievement even more satisfying and motivating because we can not only enjoy the achievement more but also the journey leading there. Achieving merely for the sake of achieving increases stress and anxiety. Connectedness with ourselves can protect us from this dangerous pitfall by giving the achievement and the journey leading there greater meaning. Anxiety means being caught in the future, while connectedness lets us also enjoy the present.
VI. Conclusion
Communication and connectedness place a significant role in the maintenance and healing of anxiety, depression and other mental health conditions. But they go even further because they can help us transcend mere functioning to feel great happiness, satisfaction, and contentment. Connectedness and more effective communication help patients identify their own basic parameters, the needs, values, and aspirations. This leads to a greater sense of security and stability.
Anxiety and depression come from and breed disconnectedness. Breaking this vicious cycle happens through connectedness, both internal and external. Communication-Focused Therapy® was conceived by the author around this concept. It may seem counterintuitive to fix something with what seems to be broken, namely communication, but this comes from the misconception that connectedness could ever be broken. It just becomes less visible and the object of fear and apprehension. Practically anything that brings greater connectedness, including questions (Haverkampf, 2017b, 2017c), can be helpful in increasing connectedness.
Conflicts of Interest
The author has developed Communication-Focused Therapy® but reports no other potential conflicts of interest.
References
Haverkampf, C. J. (2010). A Primer on Interpersonal Communication (3rd ed.). Psychiatry Psychotherapy Communication Publishing Ltd. https://jonathanhaverkampf.com/books/
Haverkampf, C. J. (2017a). Communication-Focused Therapy (CFT) for Anxiety and Panic Attacks. J Psychiatry Psychotherapy Communication, 6(4), 91–95.
Haverkampf, C. J. (2017b). Questions in Therapy. J Psychiatry Psychotherapy Communication, 6(1), 80–81.
Haverkampf, C. J. (2017c). Treatment-Resistant Borderline Personality Disorder. J Psychiatry Psychotherapy Communication, 6(3), 68–89.
Haverkampf, C. J. (2018a). Communication-Focused Therapy (CFT) for OCD (2).
Haverkampf, C. J. (2018b). The Basic Parameters (3rd ed.). Psychiatry Psychotherapy Communication Publishing Ltd.
Haverkampf, C. J. (2020). Connectedness. In C. J. Haverkampf (Ed.), Life Improvement Vol IV (pp. 41–60). https://jonathanhaverkampf.com/connectedness/
Jonathan Haverkampf, M.D. works in private practice for psychotherapy in Dublin, Ireland. The author can be reached by email at jonathanhaverkampf@ gmail.com. Copyright © 2022 Christian Jonathan Haverkampf. All rights reserved.
