Anxiety – The ‘Bad’ Guy?

Anxiety gets tough and mixed press: A ‘bad’ emotion, a ‘negative’ label, only a stone’s throw from a mental health diagnosis and the stigma that comes with it.  Or has it become a fashionable excuse, a ‘snow flake’ statement, an over-used phrase so diluted as to have lost meaning at all?  Well, it’s non of these things really, it’s just an emotion, information about how we’re reacting to our environment or to our own thoughts.  It generates it’s own restless energy and might manifest physically as sweaty palms, a racing heart, shallow rapid breathing, a knot in your stomach, a lump in your throat.  

It’s an emotion that makes us want to move away from things, away from the cause, most of us would rather not linger with it for too long.  Like all information our brain receives, it serves a purpose.  How we use, behave and respond to that information will shape our lives and those around us.  I’m extremely aware of my own anxiety levels and actively try to determine the causes, not so much the acute stuff which is more obvious but the chronic background anxiety and uneasiness.  I find that the main sources are often conflict, fear and procrastination. That for me, most of these will centre around work.  Anxiety isn’t something that I can vanquish from my life, it’s necessary but managing it in a healthy way is always a work in progress for me.

As such the following excerpt from “The Art Of Happiness” by His Holiness The Dalai Lama & Howard C Cutler spoke to me about dealing with anxiety, especially with respect to work.  The context is a conversation about how the Dalai Lama manages anxiety around giving public teachings, he concluded that:

‘Sincere motivation acts as an antidote to reduce fear and anxiety.’

The author goes on to write: 

‘Well, sometimes the anxiety involves more than just appearing foolish in front of others.  It’s more of a fear of failure, a feeling of being incompetent…’  I reflected for a moment, considering how much personal information to reveal.

The Dalai Lama listened intently, silently nodding as I spoke. I’m not sure what it was.  Maybe it was his attitude of sympathetic understanding, but before I knew it, I had shifted from discussing broad general issues to soliciting his advice about dealing with my own fears and anxieties.

‘I don’t know… sometimes with my patients for instance… some are very difficult to treat- cases in which it isn’t a matter of making a clear cut diagnosis like depression or some other illness that is easily remedied.  There are some patients with severe personality disorders, for instance, who don’t respond to medication and have failed to make much progress in psychotherapy despite my best efforts.  Sometimes I just don’t know what to do with these people, how to help them.  I can’t seem to get a grasp on what’s going on with them.  And it makes me feel immobilised, sort of helpless,’ I complained.  ‘It makes me feel incompetent, and that really creates a certain kind of fear, of anxiety.’

He listened solemnly, then asked in a kindly voice, ’Would you say that you’re able to help 70% of your patients?’

‘At least that,’ I replied.

Patting my hand gently, he said, ‘Then I think that there’s no problem here.  If you were able to help only 30% of your patients; then I might suggest that you consider another profession.  But I think you’re doing fine.  In my case also people come to me for help.  Many are looking for miracles, for miraculous cures and so on, and of course I can’t help everybody.  But I think the main thing is motivation.  To have a sincere motivation to help.  Then you just do the best you can, and don’t have to worry about it.’

I feel I could go on and type out the whole chapter word for word but I’ll just skip forward to The Dalai Lama’s summary of this concept.

‘With a sincere motivation, one of compassion, even if I made a mistake or failed, there is no cause for regret.  For my part I did my best.’

This excerpt spoke to me not only because the application of this teaching to a clinical, all be it psychotherapy, scenario but the acceptance that failure is an option and 70% success is success.  The sincere motivation side of this is complicated, I truely believe that we all entered our profession with the sincere motivation to help others but that external influences continually pressure us into conflict.  The conflict of health care vs business, the pressure of measurable productivity vs patient satisfaction and unmeasured treatment outcomes, the looming threat of complaints and consequences, undermining confidence to up skill into more complex treatment scenarios.

So, I leave you with this thought: are you helping 70% of your patients? If so you’re probably doing fine.  If you are only helping 30% they maybe take a closer look at what’s going on.  What are your motivations when planning treatment for patients? Is this a source of chronic anxiety? Can you align those motivations more with your personal values and find sincerity within them?

If you are experiencing regular anxiety, look towards it not away from it and see what your body is trying to tell you about your world around you and within. The action you take on this information will shape your perception and experience of anxiety, which doesn’t have to be ‘bad’.