January 27, 2003
Working with Feelings - Fear & Anxiety
Feelings flow in a continuum that includes the variations of happiness, anger, shame, sadness, and fear.
Fear is the body's most desperate alarm mechanism and is therefore usually the most difficult emotion to deal with. When the brain identifies something as dangerous, it immediately starts a cascade of hormonal messengers that start up the flight-or-fight response. When we feel fear, the body is convinced that something is desperately wrong, and it wants to escape as quickly as possible. If flight or fight is obstructed, the next reaction is to freeze into a shock state. With shock, the system escapes in another way - by mental dissociation. The attention of the mind simply goes elsewhere. Taken to an extreme, dissociation can lead to psychosis.
Fear includes many variations of quality and degree, including anxiety, agitation, panic, obsession, compulsion, phobias, and paranoia. All types of fear exist as an anticipation of danger in the form of hurtful criticism, humiliation, abandonment, abuse, or attack. Since people troubled with fear expect the worst, it is very hard for them to trust or relax.
The first step that brings many people to therapy is the recognition that the fear they feel is exaggerated. This is an important realization, because it indicates an assessment that present-day reality, for the most part, is not as dangerous as they feel it is. This can lead them to consider that this fear emanates from past unresolved events.
Although people with fear issues may realize intellectually that they are overreacting, their bodies do not. Their bodies are cautious and doubtful of everything and everyone, including the therapist. A certain amount of caution is wise, but in the extreme it can get in the way of developing the trust necessary to open up and heal.
Therefore, when fear predominates, the creation of safety is the most crucial issue. The first step in addressing this is to give the client as much decision-making power and control as possible. As a therapist, I make suggestions, but make it clear that he or she is under no obligation to take them. I also do not immediately focus on deep feeling work, since that may frighten or overwhelm the client. I attempt to make the experience as stress-free and supportive as possible. With time and repetition, the client may feel safe. It is usually only then that fearful feelings will come forward for expression.
In the early days of primal, it was believed that defenses to feeling expression would never drop unless they were dismantled directly by the therapist. It was this invasive, "defense-busting" approach that made primal therapy so controversial.
That approach has proven to be a major miscalculation. We now realize that an organism will not let down its defenses if it still perceives a threat. If a therapist is aggressive with a client, the client may acquiesce to the authority figure, but a part of them will feel violated and go into shock or hiding. Full healing expression will not occur. Too many people with serious fear issues have been abused this way by those in authority, from doctors to therapists. Safety is key.
Pacing is also crucial. Pushing and rushing will only increase the anxiety. Everyone wants to get better quickly, but we have to realize that long-term problems take a while to resolve. In the case of fear, the only quick fixes are cognitive/behavioral modifications, which do not address the causes of the fear. Fear requires a gentle, slow, "toe in the water" approach. Each fearful feeling needs to be engaged and expressed in small, manageable amounts. The body has to get to know that it doesn't die every time it faces fear. After a while, it starts to sense that the world is not always so dangerous.
Since visceral fear causes a flurry of fearful thoughts, these thoughts can trigger more fear, and pull the situation into a terrifying spiral. Catching fearful or self-destructive thought patterns before they take over is the forté of cognitive psychotherapy. I find that meditation, however, is much more effective for this purpose. The right type of meditation will help to label thoughts for what they are - thoughts forms, rather than realities. It's simple, but effective if practiced regularly.
In primal integration, we engage the awful feelings instead of pushing them away. Pushing them away only lets them get stronger and more destructive. By facing and feeling old unresolved feelings, we not only release the charge from our systems, but we get to experience these anticipated fears and discover that we can survive them. Often they are not as bad as we thought. In this way, modern primal is similar to behavioral therapy. In behavioral therapy, the therapist gets you to face your fears gradually, but not express them, so that you will be "desensitized" to them. In primal, we let you face the fears gradually and express the fear. This way you no longer have to be afraid because you have experienced it - and you become more sensitive in a balanced way, not less. We can't fully enjoy life if we are numb and defended.
Another essential element in resolving fear is healing and strengthening all the aspects of regular life - including friendships, career, exercise, creativity, rest, and diet. Therapy sessions alone will not be enough. The stronger and more supported a person feels, the safer they will feel, and the more fear they will be able to release.
Traumas of fear are often traumas of inaction. Awful things happened to us that we weren't able to escape from or fight off. We were also forced to "swallow" our fear and hold it in. In order to heal from these types of wounds, we need to express and release the fear in an active way. When fear is initially felt in session, we often physically curl up in a protective posture. To fully be released, however, we need to let our bodies be more active - by crying deeply, shaking, writhing, kicking, making running motions, yelling, or screaming. It's not that we "act" this way, but that we let the feeling "do what it wants." Support is necessary for all feeling expression, and especially when it comes to fear. We need to feel safe and fully accepted in our fear. Then we can feel it, express it, integrate it - and move on.
No one wants to feel fear. With safety, support, and time, we can get to the other side.