As you no doubt know, bad things happen to good people from time to time. There’s no rhyme or reason for it and it’s not particularly fair, but such things do happen. Sometimes these events are quite awful such as serious traumas or illnesses. And when these things happen out of the blue, people often experience a huge wave of difficult feelings.

Emotions such as great upset, distress, anger, and despair are quite typical and frankly, normal at these times. It’s also pretty typical to find yourself railing about the unfairness of it all and the fact that you don’t deserve what’s happened. When these thoughts and feelings occur, generally the person will take on a new role in life—that of a patient or even a victim. And friends, healthcare providers, therapists, and family generally pick up the appropriate role of helpers.

Most people, who have more anxiety than they want, work hard to rid themselves of their anxiety. They try relaxation training, meditation, medication, and more, all in a desperate attempt to conquer uncomfortable, distressing feelings. And who can blame them? After all, isn’t that the goal of therapy—to rid yourself of anxiety, uncertainty, doubts, and discomfort once and for all?

Well, yes and no. Of course most therapists would love for you to be able to feel calm, relaxed, and peaceful all of the time. However, that goal isn’t possible for anybody. Life is full of unpredictable, often random, dangers, hassles, and perils. Therefore, if you have the goal of eliminating these things, you will almost certainly fail.

I’m pretty sure that I came out of the womb as a cognitive behavioral therapist. Well, maybe a behavioral therapist—I guess I wasn’t using language those first few months. But, I’ve always been acutely aware of how rewards, lack of rewards, and thinking all interact and influence feelings and behavior.

In my early training, I considered myself a radical behaviorist. I still do pretty much. I believe that the words we use and the thoughts we think can be considered verbal behavior. But, those beliefs are much more complex than what I wish to discuss today.

You read blogs all of the time exhorting you to get treatment for anxiety, OCD, and other emotional problems. But have you heeded that advice and gotten treatment? For many people, the answer is that they haven’t.

You might wonder why that would be the case. After all, if you have a problem, you should venture out and do something about it, right?

I’d like to suggest that if you’ve had significant problems with anxiety or OCD, yet avoided getting treatment for years, you’ve probably done so for some pretty good reasons. And it makes more sense to take a look at your reasons for not seeking treatment than to beat yourself up for not having done something about your problem. There are six major reasons or beliefs we’ve heard people give for avoiding treatment. See if any of these apply to you:

A couple of days ago, Laura wrote a blog on how anxiety can morph into panic. Many people experience episodes of mild to moderate panic here and there—a few of the common triggers for such episodes include looming deadlines, upcoming parties, and presentations to work groups. However, some people experience panic at a much more intense level, to the point that they actually develop a full blown Panic Disorder.

True panic attacks of this sort involve anxiety and fear of stunning intensity. The actual attacks usually peak within ten minutes and slowly fade, but it’s common for people to actually think they could die during one of these attacks. Common symptoms of these attacks include:

• Profuse sweating
• Rapid, irregular heartbeat
• Shortness of breath or sense of suffocation
• A sense of unreality or detachment
• Fear of impending death without any real basis
• Nausea
• Fear of losing control or “going insane”
• Trembling and shaking
• Chills and hot flashes
• Dizziness

When such attacks reoccur, the person worries about future attacks, has considerable concerns about the meaning of the attacks, or changes his or her behavior in order to avoid attacks, the odds are that a Panic Disorder is in play. Frequently, but not always, people with Panic Disorder also have Agoraphobia (fears of being in places that would be difficult or highly embarrassing to leave or escape from), but that’s a topic for another blog.

We all feel anxiety. Anxiety is normal and can be very useful. For example, last summer we were walking our dogs down by an irrigation ditch in Corrales and Chuck suddenly grabbed my arm and spun me around. The dogs followed—obediently. My first feeling was annoyance, but as I looked back at a snake slithering across the path, my physical response was quick.

I was alert and aware of the snake behind us. I distinctly heard a rattle as we moved quickly and silently away. I was not thinking, only acting.

When children are afraid of something, adults often reassure them. Many kids are afraid of the dark or of monsters under the bed. This fear usually starts sometime around preschool and is a great way to delay bedtime or to keep a loved one hovering around the bedside.

Many millions of parents, with good intentions, have said to their scared kids, “Don’t worry, there’s nothing to be afraid of.”

Most scared kids willingly accept their parents’ reassurance. They might get an extra hug or a night light or one more bed time story. Gradually, they outgrow their fears. But some kids don’t easily grow out of their fears. They may just be prone to anxiety or sometimes they get too much attention from their caring parents.

These kids’ fears may get them extended routines of reassurance such as long rigid rituals that must be performed each night before they sleep. And many exhausted parents give up and extend an invitation to their frightened children to sleep with them in their beds.

Social phobia is more than shyness. It involves intense worry about being with people you don’t know, or fear of unfamiliar situations. People with social phobia worry about being judged or evaluated for their actions. And they predict that those judgments will be harsh, negative, and humiliating. They understand that their concerns are greater than warranted, but find themselves overwhelmed with strong feelings of fear. These fears lead to avoidance of people or situations that make them uncomfortable—not to mention terrified.

Children and teens with social phobia don’t answer questions in school even when they know the right answer. They don’t want to seek attention and can seem distant, unfriendly, and sometimes even arrogant to others. As adults, they may avoid speaking up at work, making presentations, being socially interactive, and being assertive. It’s understandable that those with social phobia are often underachievers—at school, at work, and in relationships.

People with social phobia usually don’t seek treatment for their condition. That makes sense, because they tend to avoid attention of any kind and rarely ask for help. They don’t want to make a call to a mental health professional or seek a referral from their medical provider. Those with social phobia may lead restricted, lonely lives because of their condition.

No one really knows why there seems to be an incredible rise in the rates of people with autism. Conservative estimates point to a 300% increase. Some of the increase is likely due to better diagnosis. And we know that autism runs in families and appears to have a genetic component. Others point to environmental stressors such as increased exposure to pesticides and hormones. But there is little certainty in the scientific community about what is happening.

Children and people with mild autism sometimes appear to others as self-contained and aloof. Others may assume that those with autism are pretty calm, cool, and collected. However, they are likely very wrong.

Those with autism may suffer increased levels of anxiety and stress because of interpersonal isolation. They feel different from other people and worry that they may be disliked or misunderstood. This may lead the child or adult with autism to withdraw or avoid. This lack of contact with others can lead to more awkwardness and lack of opportunities to practice social interactions.

We all get upset from time to time. And sometimes, we let things roll off our backs. Other times, especially when we’re overtired, stressed, or vulnerable – it’s not so easy. Here are three examples.

Maybe you’re feeling a bit stressed and someone says, “Those are interesting shoes.”

Pretty benign comment right, but the shoes you are wearing are sort of weird and you’re feeling a bit off. So whether or not the comment was meant to be positive or neutral, suddenly you’re filled with feelings about your now ugly shoes. You might spend the rest of the day trying to hide your feet from others and you’re distracted with thoughts about what sorts of shoes would be “less interesting.”