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Presented by Sue Milne, Registered Psychologist
Presented by Sue Milne
Registered Psychologis
Disarming Anxiety
WHAT’S AHEAD…..
• What is anxiety
• Difference between useful anxiety and anxiety
disorders
• How can CBT help
• Taste test of CBT strategies
• Connections between biblical and
psychological wisdom
• Biblical wisdom about anxiety
• Anxiety and relationship with God
FEAR AND ANXIETY (ARTWORK BY KATSUSHIKA HOKUSAI)
“THE SCREAM” (EDVARD MUNCH 1883)
“WOMAN IN AN
INTERIOR”
WILHELM
HAMMERSHOI
(1864-1916)
ANXIETY IS USEFUL WHEN….
• It helps us to survive
• It’s proportional to the threat
posed
• It triggers responses that are
consistent with the demands
of the situation
USEFUL FIGHT, FLIGHT, FREEZE NS WELL
• True threat detected
• Speedy protective
response
• Kept safe
USEFUL SHORT TERM RESPONSES TO
TRUE DANGER
• Focus on the threat
• Increase alertness
• Increase muscle tension and blood flow to the heart
• Prepare the body for fight, flight or freeze
ANXIETY - SENSITIVITY TO THREAT
(NOT USEFUL)
Overestimates the degree of threat
Overestimates the significance of threat
Anxious brain asks…...What if…........?
Is it possible….?
Rational brain asks…...How dangerous is that really?
How likely is it that this bad thing will actually
happen?
All things considered, probable is that?
EFFECT OF
ALERTNESS/ANXIETY/AROUSAL
ON PERFORMANCE Designed for
change…..
Very calm Aroused Panic
Anxiety Level
Performance
Very poor
Average
Very good
Anxiety
facilitates
Anxiety
debilitates
PROBLEMS ASSOCIATED WITH ANXIETY
CHANGED THINKING
• Focus on possibility of “threat”
• likelihood and significance overestimated
• ”What if….”
• Loss of broad perspective
• Difficulty concentrating and remembering
• Jammed/going blank
• Other thinking distortions
PROBLEMS ASSOCIATED WITH ANXIETY
CHANGED BODILY RESPONSES and BEHAVIOUR
• Increased heart rate
• Increased muscle tension
• Increased breathing rate
• Blood flow away from the digestive system
• Sweating
• Urge to escape
• Avoidance
• Sleep disruption
PROBLEMS ASSOCIATED WITH ANXITY
CHANGED EMOTIONS
Overwhelm
Keyed up
Detached
Irritable
Heightened emotional sensitivity
Loss of self-confidence
WHY DO PEOPLE SUFFER ANXIETY?
INCIDENCE
(ABS 2007- MOOD ANXIETY AND SUBSTANCE USE
DISORDERS)
• 11.17 PROPORTION OF PEOPLE AGED 16-85 WITH A MENTAL DISORDER(a) 2007
•
15
INCIDENCE OF MENTAL HEALTH
CONDITIONS (AUSTRALIA)
• 9% Mood disorders
• 11% Anxiety disorders
• 13% Personality Disorder
• 6.5% Alcohol use disorder
• 2.2% Substance use disorder other than alcohol
• 0.4% Psychotic illness
• A high level of co-morbidity exists
16
DISORDER NAME
Panic Disorder 2% Worry that panic will result in physical or mental collapse
Agoraphobia 1.7% Fear of situations where in the event of a panic, it may be
difficult to leave or access help
Social Phobia 2.8% Fear of evaluation/scrutiny; fear of being
shamed/rejected
Generalized Anxiety
Disorder
4.1% Persistent worry that disaster will occur (across various
domains of life)
Obsessive Compulsive
Disorder
.8% Worry that fears of self-caused harm to self or loved
ones will come true
Specific Phobia 8% Fear of personal harm occurring if exposed to a situation
or thing
Posttraumatic Stress 1.7% Fear of the intrusive memories of past harm or threats of
ANXIETY DISORDERS
COGNITIVE BEHAVIOUR THERAPY
A SKILLS-BASED PSYCHOLOGICAL THERAPY
Behaviour/Actions
Thinking/ Beliefs
Feelings/Emotions
APPRAISAL AND SELECTIVE ATTENTION
Event
Anxiety
Appraisal
Selective
attention
(Perception
of threat)
ANXIETY CYCLE
Fear provoking thoughts, images or situations
Perception of threat
Fight Flight
Freeze
Response
Worry about
ABDOMINAL BREATHING
Breathe in:
Belly pops forward as the
diaphragm drops down
Breathe out:
Belly tucks in as the diaphragm
rises
DEALING WITH CATASTROPHIC THOUGHTS
WORST
SCENARIO
BEST
SCENARIO
MOST LIKELY
SCENARIO
FROM AVOIDANCE TO APPROACH
• Planned
• Graded
• Repeated
Guided by “habituation”
MINDFUL OBSERVATION (ACT)
• Intentional focused awareness
of the present
• Observation without
judgement
• Focus on physical senses (or
thought/emotions/surroundin
gs)
FRIENDS AND FAMILY
• RECOGNISE IMPACT- STATE WHAT YOU NOTICED
• APPROPRIATE SUPPORT- ASK, DON’T TELL
• WORK WITH THEIR PLAN
• SUPPORT THEIR EFFORTS
• GO AT THEIR PACE
• OFFER PRACTICAL OPTIMISM
THE FLIP SIDE OF ANXIETY MANAGEMENT-
STRENGTHEN WELLBEING!
(POSITIVE PSYCHOLOGY)
Positive emotions
Engagement
Relationship
Meaning
Achievement
Flourishing
Sound evidence that resilience skills support mental health
WORLDVIEWS
Psychological Theory
Humanism
Positivism
Existentialism
Christian WV
Relational God
Designed planet
Humans precious & fatally flawed
Grace not Graduation
Blessed to be a blessing
Evidence historical > scientific
COMMON RECOMMENDATIONS
Give thanks to God “in all
circumstances”
Practice gratitude in order to promote
positive emotion
and well-being
COMMON RECOMMENDATIONS
Mind your thinking
Distorted thinking
patterns trigger anxious
emotions and actions.
Thinking habits can be
changed in order to
reduce anxiety
Think about
“whatever is noble,
right, pure,
lovely, admirable,
excellent, praiseworthy’
COMMON RECOMMENDATIONS
Love one another
Bear one another’s
burdens but let each person carry their
own load
Can only grow to maturity in community
Social support and social connection help us to
buffer stress, broaden perspective and reduce
perceived threat
Interpersonal boundaries help us to be
appropriately responsible
COMMON RECOMMENDATIONS
Find a purpose for living that is
greater than self
As God’s dearly loved children, our
primary purpose is to love Him and
love others
ANXIETY AND BIBLICAL WISDOM
Worry - daily needs
- the future
Matthew
5:25-34
Matthew
6:34
Don’t worry
Recognize God’s care for creation
Pray and ask
Focus on a life that pleases God
One day at a time
Peace during anxiety Philippians
4:4-7
Praising God for his goodness
Giving thanks to him
Ask Him to help
Savor what’s good Philippians
4:8-9
Thinking about good things and putting
them into practice brings God’s peace
Our anxious hearts can falsely
“condemn us”
1 John 3:18 Test our own accusing thoughts; measuring
them against our actions. Be reassured that
God is greater than
Cast your anxiety on him, for He cares for you
1Peter 5:7
GOD’S PEACE THROUGH CHRIST
Significance Security
Dearly Loved Children (1John3:1)
Made in God’s image (Genesis 1:27)
Assurance of his acceptance when
we receive the gift of eternal life
through Christ (1 John 5:13)
A Purpose-filled life “Blessed to be
a blessing” (Genesis 12:3)
Promised God’s presence always
(Matt 28:20); Grace strengthens us,
empty ritual does not (Heb 13:9)
Valued- no performance pressure
or image management needed (2
Cor 4:7)
No matter how great the anxiety, we
can’t be separated from God’s love
(Romans 8:39)
FINALLY
• There is hope
• Psychological strategies can help
• A fresh start with God can help
• Taking small steps of change can
lead to big changes
• Get a cheer team and begin!
“There is no fear in love, but perfect love
drives out fear”
1 John 4:18

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Disarming Anxeity

  • 1. Presented by Sue Milne, Registered Psychologist Presented by Sue Milne Registered Psychologis Disarming Anxiety
  • 2. WHAT’S AHEAD….. • What is anxiety • Difference between useful anxiety and anxiety disorders • How can CBT help • Taste test of CBT strategies • Connections between biblical and psychological wisdom • Biblical wisdom about anxiety • Anxiety and relationship with God
  • 3. FEAR AND ANXIETY (ARTWORK BY KATSUSHIKA HOKUSAI)
  • 6. ANXIETY IS USEFUL WHEN…. • It helps us to survive • It’s proportional to the threat posed • It triggers responses that are consistent with the demands of the situation
  • 7. USEFUL FIGHT, FLIGHT, FREEZE NS WELL • True threat detected • Speedy protective response • Kept safe
  • 8. USEFUL SHORT TERM RESPONSES TO TRUE DANGER • Focus on the threat • Increase alertness • Increase muscle tension and blood flow to the heart • Prepare the body for fight, flight or freeze
  • 9. ANXIETY - SENSITIVITY TO THREAT (NOT USEFUL) Overestimates the degree of threat Overestimates the significance of threat Anxious brain asks…...What if…........? Is it possible….? Rational brain asks…...How dangerous is that really? How likely is it that this bad thing will actually happen? All things considered, probable is that?
  • 10. EFFECT OF ALERTNESS/ANXIETY/AROUSAL ON PERFORMANCE Designed for change….. Very calm Aroused Panic Anxiety Level Performance Very poor Average Very good Anxiety facilitates Anxiety debilitates
  • 11. PROBLEMS ASSOCIATED WITH ANXIETY CHANGED THINKING • Focus on possibility of “threat” • likelihood and significance overestimated • ”What if….” • Loss of broad perspective • Difficulty concentrating and remembering • Jammed/going blank • Other thinking distortions
  • 12. PROBLEMS ASSOCIATED WITH ANXIETY CHANGED BODILY RESPONSES and BEHAVIOUR • Increased heart rate • Increased muscle tension • Increased breathing rate • Blood flow away from the digestive system • Sweating • Urge to escape • Avoidance • Sleep disruption
  • 13. PROBLEMS ASSOCIATED WITH ANXITY CHANGED EMOTIONS Overwhelm Keyed up Detached Irritable Heightened emotional sensitivity Loss of self-confidence
  • 14. WHY DO PEOPLE SUFFER ANXIETY?
  • 15. INCIDENCE (ABS 2007- MOOD ANXIETY AND SUBSTANCE USE DISORDERS) • 11.17 PROPORTION OF PEOPLE AGED 16-85 WITH A MENTAL DISORDER(a) 2007 • 15
  • 16. INCIDENCE OF MENTAL HEALTH CONDITIONS (AUSTRALIA) • 9% Mood disorders • 11% Anxiety disorders • 13% Personality Disorder • 6.5% Alcohol use disorder • 2.2% Substance use disorder other than alcohol • 0.4% Psychotic illness • A high level of co-morbidity exists 16
  • 17. DISORDER NAME Panic Disorder 2% Worry that panic will result in physical or mental collapse Agoraphobia 1.7% Fear of situations where in the event of a panic, it may be difficult to leave or access help Social Phobia 2.8% Fear of evaluation/scrutiny; fear of being shamed/rejected Generalized Anxiety Disorder 4.1% Persistent worry that disaster will occur (across various domains of life) Obsessive Compulsive Disorder .8% Worry that fears of self-caused harm to self or loved ones will come true Specific Phobia 8% Fear of personal harm occurring if exposed to a situation or thing Posttraumatic Stress 1.7% Fear of the intrusive memories of past harm or threats of ANXIETY DISORDERS
  • 18. COGNITIVE BEHAVIOUR THERAPY A SKILLS-BASED PSYCHOLOGICAL THERAPY Behaviour/Actions Thinking/ Beliefs Feelings/Emotions
  • 19. APPRAISAL AND SELECTIVE ATTENTION Event Anxiety Appraisal Selective attention (Perception of threat)
  • 20. ANXIETY CYCLE Fear provoking thoughts, images or situations Perception of threat Fight Flight Freeze Response Worry about
  • 21. ABDOMINAL BREATHING Breathe in: Belly pops forward as the diaphragm drops down Breathe out: Belly tucks in as the diaphragm rises
  • 22. DEALING WITH CATASTROPHIC THOUGHTS WORST SCENARIO BEST SCENARIO MOST LIKELY SCENARIO
  • 23. FROM AVOIDANCE TO APPROACH • Planned • Graded • Repeated Guided by “habituation”
  • 24. MINDFUL OBSERVATION (ACT) • Intentional focused awareness of the present • Observation without judgement • Focus on physical senses (or thought/emotions/surroundin gs)
  • 25. FRIENDS AND FAMILY • RECOGNISE IMPACT- STATE WHAT YOU NOTICED • APPROPRIATE SUPPORT- ASK, DON’T TELL • WORK WITH THEIR PLAN • SUPPORT THEIR EFFORTS • GO AT THEIR PACE • OFFER PRACTICAL OPTIMISM
  • 26. THE FLIP SIDE OF ANXIETY MANAGEMENT- STRENGTHEN WELLBEING! (POSITIVE PSYCHOLOGY) Positive emotions Engagement Relationship Meaning Achievement Flourishing Sound evidence that resilience skills support mental health
  • 27. WORLDVIEWS Psychological Theory Humanism Positivism Existentialism Christian WV Relational God Designed planet Humans precious & fatally flawed Grace not Graduation Blessed to be a blessing Evidence historical > scientific
  • 28. COMMON RECOMMENDATIONS Give thanks to God “in all circumstances” Practice gratitude in order to promote positive emotion and well-being
  • 29. COMMON RECOMMENDATIONS Mind your thinking Distorted thinking patterns trigger anxious emotions and actions. Thinking habits can be changed in order to reduce anxiety Think about “whatever is noble, right, pure, lovely, admirable, excellent, praiseworthy’
  • 30. COMMON RECOMMENDATIONS Love one another Bear one another’s burdens but let each person carry their own load Can only grow to maturity in community Social support and social connection help us to buffer stress, broaden perspective and reduce perceived threat Interpersonal boundaries help us to be appropriately responsible
  • 31. COMMON RECOMMENDATIONS Find a purpose for living that is greater than self As God’s dearly loved children, our primary purpose is to love Him and love others
  • 32. ANXIETY AND BIBLICAL WISDOM Worry - daily needs - the future Matthew 5:25-34 Matthew 6:34 Don’t worry Recognize God’s care for creation Pray and ask Focus on a life that pleases God One day at a time Peace during anxiety Philippians 4:4-7 Praising God for his goodness Giving thanks to him Ask Him to help Savor what’s good Philippians 4:8-9 Thinking about good things and putting them into practice brings God’s peace Our anxious hearts can falsely “condemn us” 1 John 3:18 Test our own accusing thoughts; measuring them against our actions. Be reassured that God is greater than
  • 33. Cast your anxiety on him, for He cares for you 1Peter 5:7
  • 34. GOD’S PEACE THROUGH CHRIST Significance Security Dearly Loved Children (1John3:1) Made in God’s image (Genesis 1:27) Assurance of his acceptance when we receive the gift of eternal life through Christ (1 John 5:13) A Purpose-filled life “Blessed to be a blessing” (Genesis 12:3) Promised God’s presence always (Matt 28:20); Grace strengthens us, empty ritual does not (Heb 13:9) Valued- no performance pressure or image management needed (2 Cor 4:7) No matter how great the anxiety, we can’t be separated from God’s love (Romans 8:39)
  • 35. FINALLY • There is hope • Psychological strategies can help • A fresh start with God can help • Taking small steps of change can lead to big changes • Get a cheer team and begin!
  • 36. “There is no fear in love, but perfect love drives out fear” 1 John 4:18

Editor's Notes

  1. Fear-specific immediate event; anxiety and excitement both arousal states; Anxiety- Vague, non-specific, distant Anxiety move sand changes; Katsushika Hokusai 1760-1849
  2. The artists wife, Ida.
  3. Metaphor
  4. (c) IOH 2003,
  5. Genetics a strong genetic vulnerability, but not solely deterministic Early experience- assumptions about harm and responsibility In agoraphobia and social phobia alcohol problems follow from self-medication Problematic alcohol consumption associated with triggering of panic and GAD
  6. In the past 12 months 6.5% of Australian adults met criteria for an ICD-10 alcohol-use disorder and 2.2% had another ICD-10 drug-use disorder. Men were at higher risk than women of developing alcohol- and drug-use disorders and the prevalence of both disorders decreased with increasing age. There were high rates of co morbidity between alcohol- and other drug-use disorders and mental disorders and low rates of treatment seeking..2% The prevalence of 12-month DSM-IV independent mood and anxiety disorders in the US population were 9.21% (95% confidence interval [CI], 8.78%-9.64%) and 11.08% (95% CI, 10.43%-11.73%), respectively. The rate of substance use disorders was 9.35% (95% CI, 8.86%-9.84%).
  7. % are estimated lifetime prevalence in Western countries;
  8. Positivism states that positive knowledge is based on natural phenomena-information derived from sensory experience, interpreted through reason and logic, forms the exclusive source of all authoritative knowledge. Humanism emphasizes the value and agency of human beings, individually and collectively, and generally elevates critical thinking and evidence (rationalism, empiricism) over religious truth claims Existentialism Proposes that each individual—not society or religion—is solely responsible for giving meaning to life and living it passionately and sincerely, or "authentically."[13][14]
  9. James 1:15; Philippians 4:8 –whatever is…think about