Importance of fear

While reading my ACT (Acceptance and Commitment Therapy) book- just finished week 2- I read something that had me a little bemused. In short it said that anxiety and fear may not be the enemy but actually a requirement. This was then illustrated in a story about the Emperor Moth. Basically that it needed to get out of its cocoon on its own in order to survive and some person thinking they were doing good helped it along which killed the thing.

To quote from page 74:

"All we are asking is that you open up to the possibility that your anxious thoughts, images and feelings may serve an important purpose in your life. You may not see this purpose from where you are right now. In fact, it is next to impossible to see any importance behind anxiety and fear when you're focused on getting yourself out of your anxiety cocoon."

I can't buy into that. I cannot see any purpose to having these things that are ruining and restricting my life and if there is a purpose then I don't want it. No thanks, keep it please. If there is a purpose to feeling suffocated and shaking all over when all you want to do is sit down and play with your kids or relax watching TV then I fail to see what that is.

Last night I was watching the Jonathan Ross show, on BT Vision Replay, and was listening to Stephen Fry talk about the Kakapo. The parallels were interesting. New Zealand has a few Kakapo left. Way back when there were no predators so these birds evolved with no fear but adversely into fat, flightless birds- some would say lazy. This made them easy prey but not a problem as there were no predators. Then predators were introduced, by man unsurprisingly, and they were all but wiped out as they had no fear and were easy pickings. Now here I can see why fear is a much needed ally.

But I still cannot buy into the theory in general. That is rational fear. Its the irrational that annoys me. That explains why we have the fight or flight mechanism built in. That does not explain why I cannot just sit on a sofa without fearing I am going to become incapacitated due to this mechanism. As I said I don't want it- thanks.

A little thought

We have five senses and they all give us constant sensations which pass in thoughts to our brain. Here the functionality is the same as it always was. But in a state of anxiety or nervous exhaustion something has changed. The difference between now and before is that we fear some of those thoughts. And this usually leads us to a conclusion. If only we could stop these thoughts then we would not get anxious and panic. For most, including myself not long ago, this is the conundrum we face. Just how do we stop those horrid thoughts?

For three months in 2006 that was my question to the visiting CPN. She brought me presents. I had a new relaxation CD, a new visualisation CD and questionnaires by the bucket load. Nothing of use. Every time she came I would say: How do I stop these bad thoughts? She had no answer. This infuriated me. I had only one question and required only one answer but never got it. She was supposed to have all the answers and could not even provide one. Now I know the answer to the question and that is that there is no way to stop the thoughts. If only someone could have told me that then it would have saved over a year of ripping my brain to shreds in search of an answer. More than that if someone had only just told me why I could not stop the thoughts and that I was wrong in my theory then it would at least have put my mind at rest.

If we look at the process again in the first paragraph we see the answer to that question is clear. So clear that it was always staring me straight in the face and I never saw it because I was already convinced otherwise. The process of thought has never changed. Our senses still work the same though maybe a little more heightened but the thoughts to our brain are still the same. The difference is that we now fear them and there is the real question: why do we fear them? Well actually that is not the question. It really doesn't matter why we fear them. I could spend another couple of paragraphs explaining that but it doesn't really matter. What is important to know is that it is not the thoughts themselves that are the problem but our reaction to the thought.

An example of before and now may illustrate the difference. We are walking along and notice that we are a little out of breath. Previously we may take an intake of breath to compensate or we may just note it but keep walking on. We may even stop for a moment to let it right itself and go on. Regardless of what we did before it is not enough to trouble us. We receive the thought, look at it, realise it is not a problem and continue. The thought comes, is viewed and the is let go with no emotional attachment to it so never returns.

Now it is different. We are walking along and suddenly notice we are a little out of breath. The same thought is sent from our senses. Now though we look at it and add fear to it. What the hell is wrong? What is wrong with my breathing? I'm going to stop breathing! Am I going to suffocate? Right away fear is attached and if we try to ignore it then the thought keeps coming back because it has an emotional attachment. Not only that but trying not to think of it brings it to mind every time prolonging it and giving it more importance. We have not dealt with it and the more we try to ignore the more the emotional attachment intensifies. As we realise we cannot rid ourself of this thought and cannot face it either anxiety grows and sooner rather than later the flight or fight mechanism kicks in with the release of adrenalin. We must escape to the safe place and though we may get relief there that thought has still not been dealt with. It will be waiting for us bigger and badder the next time the next time we are in the same situation. And because of that a simple association is enough to link to the thought and then relive the experience again.

So it is simple to see where the problem lies. It is also simple to see the solution: we just have to change the way we react to our thoughts. The application though is not so easy. Its the reason why I know how to recover but can't seem to put it into practice. Although the theory is simple in that we must unlearn the way we have programmed ourselves to react it is not as straight forward as that. The longer you have reacted that way the more the reaction is set in stone and very hard to change- it almost bypasses concious thinking. But to change you have to keep trying to react differently. It is finding the way to react differently and go against what has become your natural reaction which is the biggest challenge of all.

If you read any self help materialon anxiety then at the root is this theory that this is key to recovery. It is just dressed up differently with their own slant on things though in the case of Claire Weekes I would say that is not the case as she was a pioneer in the field. But for the others there is no real difference from what she wrote 40 years ago to what they are writing now and charging for at a higher cost. There are alot of people out there taking advantage of people's desperate state.

What does concern me though is that the people we look to in a time of need like GPs and mental health workers do not seem to know this. I have found through bitter experience that they are very ill informed and I have yet to find one of any help at all who knows what they are talking about. So it is good that there is material out there to help us because however much it costs that is the only place we will find true understanding. The trouble is though that we may have to put up with years of ignorance relying on people we thought new the answers before we find out our trust has been misplaced.

Anyway that is just a little thought of mine to sit in among the other little thoughts we are being bombarded with each second of every day. I hope though it is a positive one.

The hospital

Lately I've been having this recurring scene in my head which I put down as something else to do with anxiety. Nothing scary but just something that appears to be from childhood. The strange this is that it is new and I cannot for the life of me remember having it before. But because of this I was unsure whether it was a dream I was remembering or an actual childhood memory.

The thing is I was sure it was in Glasgow. That is where I was born and that is where I stayed until I was about 4 years old before we moved away. The recollection is very clear. I am lying in a single bed on a ward which is on the ground floor and I must be 3 or 4 years old- that's how I feel for some reason, maybe younger. The ward had about 10 or 12 beds in an open plan arrangement. Behind me is a wall but ahead of me are windows looking out onto some greenery.

It is unusual that the lighting is dim. It must be late and I think that is how I can see outside so clearly. But it is not darkness outside but more like the onset and everything is that dull grey blue, twilight. At the foot of my bed are my gran and my mum who are waving me goodbye and I feel so sad inside because I don't want to be alone. I've never been left alone before. So I am 3-4 years old. I am sure my brother, who is 5 years younger, is not yet born and I'm old enough to sit up in bed and communicate with them

The most bizarre thing to pop in to my head and its been recurring. Still though I did not give too much thought to it until the weekend when two things happened. The first of these was a little bit of genealogical research. As part of my records I like to collect photographs. This is probably because I don't have many family photographs. I've never seen what my maternal grandfather looked like nor my mum's older sister. Both are dead now but no one has any photographs and there are some family I have met but do not have photographs of. So what I tend to do is collect photographs of places. At the weekend I was on a site which is great for old photographs in Glasgow and I was searching for Poorhouse photographs as I have a few ancestors who died in Poorhouses. To my surprise among the search results was a name I knew- Stobhill Hospital. The reason being because I was born there and my grandparents worked there. Its not a Poorhouse but once was Barnhill Poorhouse. So I clicked on the photograph and I could not believe that I recognised it. It was the place from my recent recollection. I can see roughly where I would have been.

I knew one thing. It could not have been from my birth as there is no way I would remember that and it didn't feel like I was a baby. But as far as I was aware I had never been in hospital for anything so it was a little bit of a mystery and one I would follow up when I next talked to my mum- we haven't talked in a few weeks.

On Sunday my mum phoned to see how we all are and you would think after this little episode I would be chomping at the bit to ask about this but in truth I had forgotten and my mind was elsewhere. It was only when we were talking about the kids and how they were doing that the memory returned to me. I have a niece who is very ill and her brother was also ill as a baby too. My wife is convinced that it was because her sister never breast fed and my mum said that it wasn't true because she never breast fed and we were never ill. And that was it. That was the moment I remembered and asked about my recurring memory.

She paused for a bit and then it seemed like the penny dropped. Yes I was in hospital ans I was about 4 at the time. She had only just gotten out of hospital with an appendix problem and my gran was looking after me. My gran had then phoned her to say I was very ill and had to be taken to hospital so the two of them got the bus there and I was kept in overnight. When I described the scene she said that was about right and how she remembered it. It was on the ground  floor in an open ward and it was after visiting time because I had just been submitted so that's why the lights were dim.

I then asked what was wrong with me and she said she can't really remember. It was something to do with an ear infection that then led to problems with my stomach. Why she has never told me this I don't know. About 6 years ago I had to go to hospital with an ear problem and now my hearing is not good in my right ear due to a perforation in the ear drum. Why didn't she tell me about this before? I am sure there is some link and maybe a bit of warning would have got me there sooner as I put up with it for months before my wife forced me to go. She also forced me to register at the doctors as I had never done it before.

Anyway that was my little bit of strangeness and I just wonder if I am going to get any more memories coming back now. I hope so as I have learnt something new that I never knew about before. And that is the problem with my parents. Unless you know what to ask then you don't get offered any information and even when you do it is usually some ambiguous answer.

Agoraphobia?

I hate labels but when it comes to reference you need them however ambiguous they may be. For example I have an agoraphobia diary but am I agoraphobic? That is debatable but I use the term because I can think of no other.

Reading the books by Dr Claire Weekes I identified fully. What alarmed me though was that by definition I have over the years basically suffered from a nervous breakdown. That term is something that scares me- well it did previously until I knew what it actually was. The idea of "a breakdown" was one of total loss of control lying on the floor or in a ball crying and screaming before being hauled off to the funny farm. In my mind, and I am sure in the mind of others, it is the complete breakdown of the self and loss of control. In reality it is no more than an exhaustion of the nervous system from overuse. This is though what has happened to me. It is not something I would ever tell anyone though nor even truly admit to myself because of the connotations it involves. Stupid really but I find something pathetic in my state and try to shy away from all things that make me appear weak. Just another label I could do without in my life.

Without doubt labels are powerful and labels can have a powerful hold over you which is why I try to avoid them. When we have conditions then the first thing we want to do is pigeon hole them. We want to know our problem and we want to categorise it so if for any other reason we know what we are dealing with and how maybe to tackle it. What we tend to forget though is that labels are usually very general. In the case of agoraphobia as an example the experiences may vary. Someone may actually be afraid of certain places and some not. More than that though is the severity. Two people may feel a connection because they both have labelled themselves agoraphobics and are sharing the same experience. One though may lead a very normal life and cannot travel out of the country while the other may spend every day in their room unable to leave it. Frequency also plays its part. Someone may still consider themselves agoraphobic because they experience panic every so often while another experiences it almost on a constant basis.

I could easily label myself and have done but I am trying this year to move away from these terms. It could easily be said by however loosely a definition that I am a sufferer of monophobia, social anxiety, agoraphobia, general anxiety, chronic fatigue and panic attacks. That is quite a list and all have been added one after the other. If I was to term myself in this way then I would say it all started with general anxiety which made me chronically fatigued which in turn led to panic attacks and because of these I became agoraphobic through fear of having them outside. I then started to develop social anxiety for fear of having these attacks in front of people but also because of being stuck indoors I was getting little interaction with people. And then came monophobia because being at home with my family was my only safety and when they all went, my wife especially, then I suffered from monophobia.

The reality is quite different. I have one condition and that is a nervous disorder which is to say nervous exhaustion which has led to me fearing the nervousness itself and so the cycle goes. And in this state I have started to find new labels for myself but in actual fact they are false. If I was not nervously disordered then I would not have any of the other labels to give myself. In brief I will explain that for a couple of these labels. Monophobia- the fear of being alone. Am I afraid when alone? No is the answer. I am highly agitated only when my family are so far away that I cannot reach them. If they are away for the day I am fine but if they go abroad for example or somewhere far away for a week then I get anxious. Why this is I am not sure but I think it is to do with the fear of something happening to me and no one around to help and my family, I mean my wife, is the only one who can because of what could loosely be termed social anxiety. In this I mean I have trouble around people and especially large groups. This is not entirely true either. In reality I have problems when people visit my home to see me. When the health visitor comes to see my wife I am completely at ease and the same goes for her friends- as long as it is not for a long time. So it is not a complete fear of people or their perception of me just as I do not really have a fear of being alone.

I'd like to explain all this in terms of agoraphobia. This is a label I gladly picked up and stuck on the front of my shirt. I seemed to fit the definition well so stuck with it. I was, and to some extent still am, stuck in a safe zone. I can only walk so far due before I panic and have to return home. To most that would seem like agoraphobia. But it is not really so I will explain.

Last week I posted my walk to the library. This is the edge of my safe zone. This is as far as I can go. What I will now do is try as honestly as I can from memory to explain my feelings there. At the same time I would also like to compare these to how an agoraphobic would feel- or how I guess they would feel.

Agoraphobia is fear of the market place literally. Standing here I would expect an agoraphobic to have a fear of what lies ahead of them and they would be afraid to venture there. Is it a fear of the place itself? If this was a flat open land instead would that fear still exist? What I would expect is that the agoraphobic in this place where the photo was taken would be perfectly fine if a little pensive. If they were told it was OK to turn around and walk back all would be fine. If they had to venture forward though they would find anxiety building until it led to a panic attack. But standing here they would be fine. Now is that me?

The answer is no. This is where the nervous disorder is key. I am constantly tired and never feel refreshed. I am on edge always and never able to relax. My nerves, my body physically, have become so exhausted over these years that I get no relief. My muscles feel weak and just generally I always feel fragile. I am chronically fatigued. So when I go out the door I am not feeling my best and the more I walk the weaker I get and the more laboured my breathing becomes. I walk on and my home, my safe zone, gets further away. Anxiety builds slowly but if I can loosen up and try not to worry about my breathing I can continue on without ever thinking it will lead to panic.

Outside the Library I am not the same as the agoraphobic. I am not fine but instead very weak and out of puff. I am not standing physically sound with fear of going to that place beyond. I feel shattered and instead am worried whether I can make it home. That is the difference. My worry here is whether I have the energy to walk back home and my fear is that the further I go the harder it will be to get home. When I look forward I have no fear of what is in front of me. Were I to go forward I would not find a building anxiety because of where I was going but instead because of where I was going from. It is not mental, it is physical. Were I here refreshed and in good shape then I could walk on fine without any panic. I have no fear of what is in front but instead only of whether I can make it back home in one piece the further away I walk. And that is the same in all directions I walk from my home.

The fatigue creates anxiety and the anxiety creates fatigue. Its difficult to know what is worse. But there is one difference. If I had the fatigue without the anxiety I still couldn't go much further. If I had the anxiety without the fatigue I could. But as one lends to the other I suppose its a bit of both, but not just agoraphobia as most would perceive it.