12 Chapters
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Chapter Twelve - Summary

Fear, Rhona M. Karnac Books ePub

In the current economic climate where government is consistently looking for mechanisms by which they can reduce public spending, it is not surprising that we as British citizens should feel the effects of this reduction by the lessening of resources in the NHS. It is politically and morally correct for us all to give due credence to mental health issues, and to stop the deficit comparison that has for so long been active to undermine mental health in comparison to matters of physical health. I am sure, as practising mental health practitioners, you are in full accord with me. It seems to me, therefore, that there ought to be a moral imperative to increase the funding of mental health services, as they have always (since the inception of the NHS in 1948) been underfunded in comparison to matters of physical well-being. While there is plenty of political rhetoric concerning the need for all of us to talk about mental health, and not to allow it to remain a “hidden topic” that is spoken of in whispering undertones, there is unfortunately not a commensurate increase in funding or availability of help for those who suffer from mental health problems.

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Chapter One - The Symptoms of Anxiety and Fear

Fear, Rhona M. Karnac Books ePub

Anxiety and fear

It is absolutely true that anxiety and fear, in reasonable amounts, are a normal part of everyone's life. It is usual, and expectable, that when we are faced with sitting an examination, or attending a job interview, or asking the boss for a pay rise, or finding our way across London for the first time, the majority of us will suffer some level of anxiety. Similarly, if we are faced with being in our home while an earthquake or a tornado is in progress, or we have just been involved in a serious car accident, then it is to be expected that we will experience feelings of fear.

However, I have placed the words “some level of anxiety” in italics in the above paragraph because this highlights the central point. In the case of your clients, do the feelings of anxiety or fear wash over them during the event, but pass when the situation is over? Are there logical reasons to explain why they are suffering from anxiety? Do the symptoms so commonly associated with anxiety (which I will describe in detail shortly) pass quite quickly, and enable them to return to feeling normal within a reasonable period of time? So—the point I am making is that feelings of anxiety and fearfulness are normal, if they are experienced in response to a definite, logical stimulus, and are not experienced in an out-of-control manner, or for an extended period.

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Chapter Four - The Labels: Anxiety States and Phobias

Fear, Rhona M. Karnac Books ePub

Panic attacks

When anxiety is experienced in a heightened form—when worry and repeated months or years of fear have taken their toll—the individual may suffer what is known as a panic attack.

Any of you, as therapists or clients, who have suffered such an experience, will not be able to forget how you felt during these periods of time. It may well be that you felt—as I did at first—that I was about to die. I felt that I would not, and could not, survive if I continued to feel like this. There is an inexplicable tendency to want to run away—though “where” precisely, one is not sure, except perhaps to the safety of home. The emphasis is upon escape from the awfulness that is being experienced in the moment. It is very difficult—or well-nigh impossible—to think clearly or reason things out during a panic attack. Thoughts race from one image to another; cognitive processes do not function. This mental confusion does not help the person to achieve their desperate wish to escape. In time, the sufferer may begin to have the awareness that this is what it means to experience “a panic attack”.

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Chapter Two - The Fight or Flight Cycle

Fear, Rhona M. Karnac Books ePub

The link between fear and anxiety

There is a simple reason why we as individuals suffer the myriad of symptoms when we are anxious, and why these symptoms seem to multiply and grow more pronounced over time.

When we feel fear, our bodies are programmed, since primeval times, to release two hormones, adrenaline and noradrenaline. Our brains, in response to a fearful situation, send a biochemical message to our pituitary gland to release a hormone that in turn triggers the adrenal gland to release the hormones that I have just mentioned.

Now, your clients may well be wondering why as human beings we are flooded with what seem to be inconvenient and unnecessary hormones that are in reality causing such havoc in their lives at present. In fact, these two hormones have a very important function. We need to think back to Stone Age Man. When he was faced by a fearful situation—say the approach of a bear that was intending to eat him to slake his hunger, or he came upon an ambush of rival tribesmen—he needed to take action very quickly in order to save his own life. There were two options open to him at this point: fight or flight. He could either prepare himself in an instant to fight “the enemy” (be it a bear or rival tribesmen) or alternatively, he needed the energy to run away as fast as his legs could carry him.

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Chapter Eight - Case Study: Using Systematic Desensitisation to Recover from Agoraphobia

Fear, Rhona M. Karnac Books ePub

Introduction

In this chapter I present the first of two extended case studies. This story focuses upon the story of a woman who, in her middle years, started to suffer from severe agoraphobia. This led her to seek me out as a therapist, having learned that I had helped a number of clients suffering from panic and phobia. Together we embarked upon a systematic desensitisation programme. The case study tells of how she set about learning the art of relaxation, and then developed a hierarchy. She proceeded to visualise the tasks, each in their turn, and to carry them out in the external world with my help and encouragement. I will say a little about the psychodynamic history of her life, which perhaps led her to suffer from agoraphobia so badly.

Psychodynamic history

Carole had been brought up by parents in the North East of England. Her parents had worked together in the family business (a retail establishment), and had left her—as elder sister—in charge of her younger sibling. By the age of ten, she had become adept at preparing and cooking the evening meal. She would return from school, let herself and her sister into the house, and first of all clear up the remains of breakfast and put dirty laundry in the washing machine. She would then prepare the evening meal—often a casserole, or chops and vegetables—and start to cook it in time for her parents' return from their shop at seven o'clock. It would also be her responsibility to entertain her younger sister, who was five years younger than her.

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