What is general anxiety.
General anxiety is simply explained by stating that a person may feel anxious is a number of different settings. For example, it can be said when one experiences general anxiety regardless of where that person is,he or she are likely to feel anxious. In other more specific presentations where anxiety is present only in specific areas of life for example, where one has fear of heights.
How does general anxiety affect our lives?
When one has a fear of meeting another person, going to a specific place, or having to perform a particular duty, the tendency to avoid that situation becomes powerful. So every time the anxious person is faced with making the decision to do or not do, is a huge issue in their lives. Every time they decide to avoid doing whatever it is that scares them their anxiety becomes more and more entrenched. This behaviour of avoidance is re-inforced every time they avoid the feared object. When we continue to avoid these situations we fail to learn anything about how this anxiety is affecting our lives and how we might deal with it.
Acceptance and Commitment Therapy approach is used when working with this category of client. After the first session assessment, avoidant behaviours and their consequences are discussed. It is important at this stage in therapy that the client's narrative is validated. Learning to live in the present moment is worked through. This process is strengthened by using mindfulness exercises. The purpose of learning to live in the present moment is to break the cycle of anxiety. Anxiety is always about the future and what disaster or tragedy may be waiting to strike us. The next stage is acceptance of thoughts, feelings and body sensations. Because we are human and alive we will always have these internal experiences, so acknowledgement of this fact is an important step in this process. Defusion of thoughts, memories and images are worked on thorough a series of 'letting go' exercises. Defusion simply means 'creating distance' between ourselves and our thoughts, memories and images. Making room for painful feelings starts with some exercise of acceptance of emotions as part and parcel of the human person. We then learn to do some breathing exercises, moving to awareness exercises. The objective here is to treat the feeling of anxiety as being a normal and natural experience. Feelings are like the lights on the dash board of our car,the reason they light up is to tell us that something is not right under the bonnet.
Life values are an integral part of the model of ACT. Life values are described in the ACT literature as like setting your compass to go west, then following that path as best you can for the rest of your life. In session the client's values are identified. Thoughts, feelings, memories, images, body sensations and behaviours that come between the client and her or his values are identified. The question is then asked, 'is this thought, feeling or behaviour taking you towards or away from your values'. The answer to this question provides raft of information, which can be worked through in the session.
Between session work
Between session work is part and parcel of ACT. At the end of each session a list of home work exercises are agreed between the client and the therapist, this is always checked at subsequent sessions. The reason for between session work is that any change we attempt in life is a process which takes time. In therapy it is no different, so we start the change process when we first present for therapy and we then continue this process for the duration of the sessions and indeed for the rest of our lives.
How long will therapy last?
The course of therapy for the presentation of general anxiety is usually 4 to 5 sessions, which is needed to cover the course adequately, follow up sessions (1-2) at four to six weekly intervals are always advised. This practice is highly recommended and indeed is evidenced based.