OPERANT AND COGNITIVE THEORIES ABOUT ANXIETY

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Faulty perceptions and irrational immediate reactions to the perceptions

 Anxiety and fears may result from how we perceive and react to situations. It may help to separate the faulty perceptions, i.e. learned biases or distortions that take place in the process of perceiving the situation, from the irrational ideas, i.e. almost instant irrational reactions we have to that situation, such as "they shouldn't be doing that" or "I should be doing better than this" or "I can't do anything about this mess."

 The faulty perceptions occur when our erroneous expectations, fears, or wishes alter how we see other people and ourselves. We have a certain mental "set" before the event happens which causes us to see the situation in a certain way--we give it our own slant. Examples: a person desperately wants to have a good relationship with his/her lover, and fails to see the lover's loss of positive feelings and interest. A person wants to please others so much that he/she isn't even aware of his/her own needs. A person expects to be inadequate and so sees only his/her weaknesses and doesn't see his/her strengths or opportunities. A person has a pessimistic outlook, so every event is seen as the beginning of a catastrophe. A person has a severe self-critic, so every action he/she takes is seen as something to be ashamed of. Many of these faulty perceptions, called "maladaptive schemas" by Young (1989), arise from emotions or needs and obviously cause stress.

 The irrational ideas are often an instantaneous judgment that what is happening shouldn't be happening. Thus, Albert Ellis refers to "musturbation," i.e. believing that things must go the way I want them to, and if they don't, I have a right to get terribly upset. This demand for things--everyone love me, I be successful, don't blame or hurt me--is certainly going to produce stress, especially when the demands aren't met. These demands surely arise from a long history and a complex variety of emotions, thoughts, needs, fears, and hopes. These cognitive-emotional demands that life unfold differently produce, in turn, many new and disturbing emotions. This theory, which is the basis of Rational-Emotive therapy, will be described extensively in the next chapter and in methods #3 and #11 in chapter 14.

After perception, we appraise the situation and decide how well we can handle it

 As mentioned before, the same stressor, such as having to give a speech, is perceived and responded to very differently by different people. Jane would want to get out of doing it, be unable to think of anything worthwhile to say, and be certain that she would mess up and say stupid things. Another person with no more speaking experience might be thrilled, be eager to begin gathering material, be sure she has important things to say, and fantasizes doing well (in spite of some anxiety). The event has very different meaning to these two women; their expectations of themselves and others are entirely different.

Life is 10% what you make of it and 90% how you take it.

 Bandura (1986) as well as Richard S. Lazarus (1984) and his colleagues believe that stress and anxiety primarily arise when we believe we can't handle the approaching problem. Obviously, this involves an appraisal of the nature and seriousness of the threat in comparison to the kind and strength of coping mechanisms we think we are capable of using. We can be scared because the stressor (problem) is seen as overwhelming or because we believe we have no way to escape or solve the problem. The questions we ask ourselves are:

1. Is something important to me at stake? If yes, am I in trouble? These are complex judgments. But the answers can center on three areas: (a) seeing the harm as already done, "This is awful, I can't give a speech," or (b) foreseeing possible losses, "Yes, a threat of _____ severity is coming" or (c) seeing the situation as a challenge, "Giving the speech will be hard work and scary but it's a real opportunity, which I can handle."

All other factors being equal, a threatened person, like Jane, would probably do more poorly and be more stressed than a less threatened person. However, as we mentioned earlier and will see in the next paragraph, that isn't necessarily the case. It is possible that the more anxious person would work harder on the speech than a more confident person, and as a result of the thorough preparation do exceedingly well and feel fairly confident during the speech. In short, the perceived threats are reduced by seeing solutions (see next step).

2. "What can be done about this threat?" Coping refers to our attempts to manage external and internal demands or stress; it includes our thoughts, attitudes, skills and actions. This book is filled with coping skills. Our estimate of our own ability to cope is based on many factors, including previous experience in similar situations, exposure to self-help information and effective teachers, self-confidence and risk-taking in general, awareness of how well your personal coping skills compare to others', and faith in support from others (Holroyd & Lazarus, 1982). Self-efficacy is discussed later and extensively in method #9 in chapter 14.

Some of us are risk-takers and some are not. Siegelman (1983) writes about risk-taking in important areas of our lives, such as careers and relationships. Risk-taking is a psychological process involving decision-making, attitudes about change, self-concept, and fear of failure. She describes three kinds of risk-takers: (a) Anxious ones who make big decisions only with difficulty, after lots of time, effort, indecision and worry. (b) Balanced ones who make big decisions carefully, focusing on getting a good outcome and not preoccupied with failing or being perfect. They are flexible, giving more time to important decisions and handling situations differently. (c) Careless ones who make big decisions quickly and with unjustified optimism. They deny their anxiety and don't think much about the situation before or afterwards. If you take risks, which type fits you best? Obviously, too much fear inhibits us too much and too little fear doesn't inhibit us enough.

Decision-making is known to deteriorate under intense or prolonged stress; we become confused and irrational emotions may take over (Janis & Mann, 1977). See chapter 13 for ways to improve decision-making as a part of coping with stress.

How and what you think determines your stress level?

 Humans are constantly anticipating what is going to happen, sometimes accurately and often times incorrectly. We especially dwell on the good and bad possible consequences of our actions and choices. We can imagine how others will feel and act in the future. We can understand and misunderstand why others do and feel the things they do. All these cognitive abilities can serve us well or poorly; careful planning for the future can help us cope and reduce our stress; pessimistic predictions can make us miserable. For some reason, in our current culture, we seem very unaware of the many ways we could be viewing and interpreting a situation but aren't. Here is a classical example of cognitive processing:

 Suppose you are waiting for your boy/girlfriend who is half an hour late, which is unusual for him/her. You will think, "Why isn't he/she here?" And, you may answer the question from several viewpoints (called schemata by cognitive psychologists) or ways of understanding the situation, e.g. you can apply a rejection interpretation: "he/she isn't very concerned about or interested in me," or a threat interpretation: "I wonder if he/she has met some attractive person on the way here," or a catastrophe interpretation: "Oh, God, I hope he/she hasn't had an accident--I heard a siren a minute ago," or a shame interpretation: "I hope no one sees me waiting here, it's embarrassing to be stood up," etc. All these interpretations would be wrong if he/she simply got caught in traffic. Yet, each different interpretation leads to a different emotion. But, you don't have to force the data into any category (interpretation), you could refuse to draw a conclusion and just find something else to do until the boy/girlfriend shows up." But, most of us have our "favorite" expectations or schemas or ways of looking at things--it is part of our personality. By becoming aware of our tendencies to take certain viewpoints that may be wrong, we can start to change by testing the validity of our interpretations and opening our minds to more accurate ways of understanding our situations (see the later sections describing self-help methods).

 Let's consider the kind of cognitive schematas or structures of agoraphobics that lead to feeling afraid of having a panic attack (Hoffart, 1993). Such patients have certain beliefs: (1) once anxiety about becoming terrified starts, it doesn't stop and just gets more intense, (2) specific symptoms will lead to a disaster, e.g. rapidly beating heart means a heart attack is imminent, dizziness will result in your passing out, mental blocking indicates you are going crazy, and (3) the only way to avoid death or other serious disaster is to get out and keep out of those situations--to avoid getting scared and escape immediately. So, what are the consequences of this kind of thinking? They avoid situations that may bring on panic; they are very cautious in public situations (avoid excitement and stay close to exits); they try to control the symptoms (lean against wall when dizzy); they have an escape plan, carry tranquilizers, go with a friend only on nice days and when they are feeling good. In short, by so carefully avoiding the scary situations, the agoraphobic never questions or tests his/her beliefs about fears, so the phobias only grow, never shrink. So, to reduce fears, the fundamental bases or beliefs (1, 2 & 3 above) on which fears are built must be confronted, tested, and proven wrong. Expose yourself to the feared situation and find out you don't die, indeed the fear or panic decreases.

 In case you have difficulty believing that thoughts can have powerful impact on fears, consider this interesting but unusual example of how thoughts can radically influence our strong emotions. Scary sports, like parachuting, give psychologists a rare opportunity to repeatedly observe the relationship between thinking and fear. An interesting thing happens as we become more experienced parachutists. As one would expect, the beginning parachutist experiences increasing stress immediately before the time to jump. He/she is fairly relaxed the previous day and during the night. Early in the morning on the day of the jump, there may be some mild excitement. Even the ride to the airport is pretty calm. As he/she gathers the equipment and prepares to board the plane, the anxiety rises. As the plane takes off, his/her stress increases, until there is very high anxiety while waiting for the "ready" signal from the jumpmaster, approaching the door, looking out, and jumping. Few people do this the first time without feeling terror ...for a few minutes.

 Now, what happens with an experienced parachutist? Well, he/she is calmer than the beginner during the last few minutes before the jump. That's no surprise. But why is he/she more calm? Apparently because he/she is busy thinking about and planning or checking every detail of the jump: Is my equipment in order? Do I remember what to do? Where's the landing site? Where are the power lines? What's the wind direction and speed? Cognitive functions are dominant--taking care of business--and override the fear response. What happens with the beginner? He/she is thinking about: Will the jumpmaster see that I'm scared? What if the plane's tail hits me? I hope I don't freeze. I'm really scared. Oh, God, I don't want Ann/Joe to see me splattered on the ground. Again, our thoughts seem to determine our feelings.

 There is another interesting finding: the experienced parachutist is more anxious than the beginning parachutist on the previous day, during the night, early in the morning getting ready to go to the airport, and after the jump is completed. Why? We don't know why. Perhaps the total tension is about the same for experienced and beginning parachutists but seasoned jumpers concentrate on accomplishing the task (like professional performers on stage) and have to release the stress before and after the jump. Epstein (1982) points out the similarity to being alert and calm during a near accident but becoming shaky and scared afterwards.

 If certain thoughts can reduce stress, other thoughts should be able to increase stress. Some interesting research by Andrew Baum deals with persons who had been in Vietnam or near the nuclear accident at Three Mile Island (Adler, 1989). Persons who continued to suffer intense prolonged stress had many more intrusive disturbing thoughts about their experiences than persons with the same background who experienced less stress. The question is: does more intense physiological reactions of stress lead to more worried thoughts (seems likely) or do distressing, unpleasant thoughts raise our stress level (seems just as likely)? Another question is: do low stress people just avoid unpleasant memories and thoughts or have they handled the stress in some other way? One theory, suggested by Wegner (1989) and Pennebaker (1991), and supported by some fascinating studies, is that trying not to think about something stressful (i.e. denying, suppressing, or not disclosing) actually results in more uncontrollable negative thoughts about the situation. The deniers and non-talkers believe they are solving the problem when actually they may be making it worse. What is a better solution? Wegner and Pennebaker and almost all insight therapists would say these people need to think and talk about their stressful experiences and express fully their emotions. Cognitive researchers disagree, believing some people simply think about traumatic experiences differently than others and, thus, experience different levels of stress. Thus, cognitive therapists focus on changing the thoughts, not expressing the feelings. Research of this reduction-of-feelings vs. cathartic disclosure issue is badly needed.


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