bird pic with textoffice (973) 835-2071
fax (973) 835-2083

Anxiety

Dear Friends,

          Anxiety is social claustrophobia.  Let me explain what I mean by this.  When I was a kid, the guys I hung out with in the neighborhood used to play a sadistic game called “Pile On.”  At any given moment anyone of us could call out the name of one of our friends and say for example, “Pile on Paul.”  Then, everyone would chase me around until they caught me and proceed to pile on me with the intention of smothering me.  The object of the game was to pile enough bodies on whose ever name we called out to make that person say “uncle.”  The other option was to start crying—which some kids did—but this was never a face saving option.  As a boy it was important to be tough and, hopefully, to be strong enough to either not get caught or to be able to throw the bodies off of you.  Usually though there were too many of us for that option to happen and, therefore, a more likely outcome was that whoever was at the bottom would either be reduced to tears or call out “uncle.”

          I remember being at the bottom of this pile more than once.  Because I would be out of breath by trying to not get caught, by the time they caught me and piled on me, my laughter would soon turn to panic because I couldn’t breathe.  Eventually I would have to capitulate and call out “uncle.”  Only then would my friends get off of me.  Of course, I must remind you that the same rules applied to everyone else.  I, along with the rest of my friends, had plenty of experiences of being on the top and the bottom.  In that sense the game was fair and it, ironically, bonded us together more strongly as friends.  It was a social way of toughening us up and a way to measure each other’s strength and resolve.

          But this game had another interesting dynamic to it.  It wasn’t until the full weight of all of the bodies was on me that I would find it hard to breathe.  The air would grow stale and the weight would make it so that whatever I could breathe would be in short supply.  It was nearly impossible to get a breath with the shear power of my diaphragm.  Specifically, the dynamic that I am talking about is the “pile on” made it so I was trapped.  Often, in this state, either I or another one of my friends would panic.  Sometimes this produced a surge of adrenalin and the person would freak out.  This made the person have a super-human amount of strength which he would use to get us off of him.  What made the game even more sadistic is that the more a person would squirm the more we would stay on top of him.  We would do this until we took it to that exact moment of not taking it too far and wind up hurting one of our friends.  When a person was let up from the bottom of this pile he would either be crying or he would be really mad.  With the rest of us laughing, the person would yell about how much of a jerk the rest of were, but eventually the tempers would calm down and we would go on playing the game we were playing before.  Of course, the cycle would continue.

          I tell you this story because when each of us took our turn being “trapped” at the bottom, we all would eventually experience being claustrophobic.  We were trapped by our own friends.  It was just like being caught in a small place like a closet and not being able to get out.  The more you realized you were trapped the more you would panic and the more that you would panic the worse you would make a situation over which you had no control.

          My point is that same thing can happen in relationships.  If we become trapped in a relationship, we experience the same closed-in feeling. This closed in feeling then produces the experience of claustrophobia.  Because it is happening in a relationship, it is therefore happening within a social interaction.  And because it is happening within a social interaction it is reasonable to refer to it as “Social Claustrophobia.”

          When I have clients who come in to see me complain about the symptoms of anxiety, sometimes in the form of panic attacks, agoraphobia, or generalized anxiety, I know that they have fallen prey to social claustrophobia.  I know before they do that they must be trapped in some important relationship in their lives.  As I explore with them the nature of their relationships, we eventually discover which person it is in their life in which they feel trapped.  This is often a spouse, but it doesn’t have to be.  It can be a child who is being smothered by a parent.  In these cases, the person with the anxiety doesn’t know that they feel trapped and the person doing the trapping doesn’t know they are doing the trapping.

          When I explain this to the person suffering from anxiety, it is usually received with great relief.  This is because, up to this point, the person hasn’t been able to explain why they feel so anxious.  They are usually embarrassed by the symptoms they are experiencing, and, up to this point they have usually been told that their symptoms are genetic and best treated by medication.  Please hear me that there is truth to this explanation.  Anxiety can be easily traced doing a family history.  Often there are individuals within the family tree that have a history of alcoholism.  This is because the person who is an alcoholic has found that alcohol relieves temporarily the pain of anxiety.  This person then uses alcohol to self-medicate the problem.  The problem with this is that alcohol is addictive.  As a result, the person ends up with 3 problems: the relationship in which they feel trapped, anxiety and its symptoms, and an addiction to alcohol. 

          A couple of other treatments are typically suggested to the client that are also helpful, but fail to answer the question, “why.”  One is behavioral modification in the form of systematic desensitization.  A prime example of this is the systematic desensitization of a client who is afraid to fly.  The client, in this treatment, would slowly and, in small but increasing doses, be introduced to flying on a plane.  They might be shown a film about people on airplanes, taken to an airport, talk with others who have overcome their fear of flying, engage in a group with others who have the similar problem, be encouraged to enter a plane that has no intention of taking off, eventually have the plane taxi down a runway, go on a short flight, and so on.  This is done with the intention of slowly introducing flight back into their lives so that they can discover there is nothing to be afraid of.  With the confidence gained by each small, but successful reintroduction to the world of flying, they gain a little more strength with each successful trial.

          Another common treatment is called cognitive-behavioral therapy.  This approach specifically challenges the irrational belief system that supports the anxiety.  By attacking wrong assumptions in a person’s belief system, the client can change their thinking and, therefore change their behavior.  A common example of this usually includes the idea by the client that because they have this anxiety toward flying (or anything else for that matter) that this must mean they are crazy.  A lot of people with anxiety think they are going crazy, and that something must be seriously wrong with them.  Because of this fear, they hide their painful symptoms and learn to avoid those situations where it will rear its ugly head.  This is why an agoraphobic will avoid going to a mall or driving on a freeway.  When they find out that they are not “nuts” or going “crazy,” they usually gain a sense of relief.  Cognitive-behavioral therapy is an important component in treating anxiety, but it still doesn’t answer the question, “why???

          It seems to me that most of the people in the field of psychology and the people-helping professions have stopped asking this question.  This is understandable and explainable with the onset of ever increasing sophisticated medications that are less addictive.  Another important factor has been the pressure by insurance companies to move toward brief therapy, and other short-term treatment modalities.  Insurance companies push therapists towards concrete and behaviorally defined treatment goals.  These two factors, along with the reality that most of our institutions of higher learning have abandoned answering the question why in favor of teaching cognitive and behavioral treatments, help to explain why no one bothers asking this important question any more.  This is disheartening to me.  It is also on of the reasons I write this article to you.

          In contrast, the explanation of social claustrophobia opens up the opportunity to treat the underlying cause of anxiety and not just its symptoms.  It also answers the question of why.  In others words, if a person becomes trapped in a relationship, just like my friends and I were during the game of “pile on,” the symptoms of anxiety make sense.  This is because anxiety is the natural reaction to entrapment.  Think of finding yourself trapped in a cage with a hungry lion.  The natural reaction would be fear and panic.  Interestingly, no one would call you crazy for having this reaction because your reaction would be normal.  You would quickly try to find a way out, look for a weapon with which to defend yourself, or give in by curling up into a fetal position.  This response is called “fight or flight” to the reaction of a threatening situation.  In contrast to the lion scenario, the problem and challenge of social claustrophobia is that it so subtle.  The threat is there, but no one can see it.  Therefore, the direct correlation between the relationship in which the person feels and is trapped, and the symptoms of anxiety, is lost.  Because the dynamics in this important social relationship are so subtle and seemingly unconnected to the symptoms themselves, almost everyone misses the correlation.  This is why most therapists resort to medication and cognitive-behavioral treatments.  The reason for this is that they fail to make this connection.  The reason I know about this connection between entrapment and anxiety is that I have suffered from anxiety and panic attacks.

          Let me share a personal story with you that should illustrate what I am trying to explain.  After I had graduated from seminary with an M.A. in Counseling Psychology, I took a job as an associate pastor.  My responsibilities included youth work, preaching once a month, and doing pastoral counseling, as well as a myriad of other things pastors do.  My relationship with the senior pastor started out very well, but soon deteriorated within the first year.  Without going into great detail, the souring of this relationship made it so that, for me, going to work everyday became a living hell. 

          During this time, my brother-in-law was getting married in Seattle, Washington.  My in-laws planned a two week vacation before the wedding that would take our family into British Columbia touring places like Banff, Jasper, Lake Victoria and Vancouver Island.  It was breathtaking to say the least and we all had a great time with the wedding culminating our two week stay.

          On the return flight home, I had a panic attack.  It was about three o’clock in the morning and my wife and son were sitting next to me sleeping.  My grandmother-in-law was sitting directly ahead of us, also sleeping.  We were about an hour out of Newark, New Jersey flying about 30 thousand feet above the ground.  The night was clear and slightly lit so that I could see the land and the lights below.  Suddenly, I had this irrational panic come over me.  In my mind, based on how I was feeling, I didn’t think I would be able to make it for another hour without freaking out.  I wanted to run up and down the aisle of the plane and yell, “Let me out, Let me out!!”  I knew this was a crazy and irrational thought because the plane can’t just come to a halt and let someone out at 30 thousand feet, but this is what I wanted desperately.  If you have never had a panic attack, this probably makes no sense to you, but, for me, at that moment I was in complete terror.  I didn’t want to wake my wife, and I certainly didn’t want to embarrass myself in front of my son and my grandmother-in-law.  I didn’t know completely what was happening to me, but as the panic subsided just a little, I began to use self-talk to help me through the next 15 minutes.  I reminded myself that nothing bad was going to happen to me.  I said to myself, “Just hang on...just hang on.”  15 minutes later, the plane began to make its decent and I felt an instant sense of relief.  I knew I was going to make it because soon I would not be trapped in the plane any longer.  It helped that the lights went on and everyone started to wake up.  I also got distracted by the process of descending and landing.

          This had never happened to me before on a plane.  I couldn’t explain it.  I didn’t want this to happen.  It came out of the blue. 

          When I got home, I began to put the pieces together.  I felt trapped in my job.  I hated my job, yet I couldn’t do anything about it, at least quickly.  I had a family to take care of and a mortgage to pay.  I couldn’t just go in the church office and quit.  After my vacation was over, the freedom of being on vacation and living that two week unreality was over too.  I had to go back to the hell I described earlier.  This entrapment made me panic an hour out of Newark because it was as if I was going back to be in the cage with a hungry lion.  Now it makes complete sense to me that I would panic at this particular moment.  When I understood this connection, I knew my days at the church were numbered and that I would have to put my energies into finding another job.  This I did, and eventually I went to work as a therapist.

          I now know the connection between social claustrophobia and panic attacks.  I have lived it.  Now I know that when I have anxiety that I need to repair a relationship that needs attention.  I have to stop ignoring the conflict.  I must open my mouth, become assertive rather than passive, stop my people-pleasing tendencies, and enter into what some people refer to as “the tunnel of chaos.”  I know I must stop being a follower, and, in contrast to this, take myself and what I am feeling more seriously.  I must risk the displeasure of a significant person in my life long enough to speak the truth.  I have to stop giving in to the lie that I don’t want to hurt someone else, and exchange it for the truth that I am hurting both myself and the other person by keeping my mouth shut. 

          Since confronting the senior pastor and finding another job, I have not had another panic attack on a plane.  I now fly with relative ease at least a couple of times a year.  It is not that I am completely free of anxiety, it’s just that now, as I said earlier, if I experience it in a significant way I know I am experiencing social claustrophobia, feeling trapped in an important relationship, and have to speak up.  It is relieving to know what is actually going on and to be able to explain it to myself.  It is helpful to have a frame of reference and terms with which to view something as subtle as the underlying causes of anxiety.  I hope this has been helpful to you. 

                                                                                        Paul