Therapy for anxiety Therapy for anxiety
Related Articles
THE BEHAVIORAL DIMENSION FOR ANXIETY
Behavioral symptoms associated with anxiety may be classified into acute and chronic responses. In animals there is first the recognition of threat, perhaps associated with behavioral signs of fear, followed by four basic responses to threat: withdrawal, immobility, aggressive defense, and submission (Marks,
1987).
The behavioral signs of fear include a fearful facial expression, trembling, sweating, pale face, hyperventilating, increased muscle tension, and staring. The most overt and acute fear response—the fearful face characterized by raised and drawn-together eyebrows, a hard stare quality, and mouth comers drawn back— is universally recognized as fear.
Withdrawal, which may occur as flight, escape, or avoidance, is often associated with a fearful facial expression. Another response to threat is to become immobile. Immobility is classified as attentiveness, in which the animal remains inert while carefully observing its environment—a phenomenon suggested by the phrase “freeze in your tracks,” or as tonic immobility, in which a previously active animal exhibits prolonged freezing and decreased responsiveness.
An example of tonic immobility is the opossum “playing dead.” Attentive immobility is associated with the animal being able to identify better the nature of the threat. Predators are less likely to attack an animal exhibitingtonic immobility.
Aggressive defense is usually associated with displays of threat and has obvious survival value. Animals also may attempt to deflect an attack; for instance, a parent kill-deer may lead a predator away from a nest through conspicuous behavior, sometimes by simulating being wounded. Finally, animals
may be directly submissive.
Signs of submission seem to reduce aggression and to be understood even across species. For instance, diverting one’s eyes from an attacking animal may reduce the intensity of the attack.
Some of the acute behavioral symptoms of anxiety seen in humans may be related to these four basic responses to threat; they are further elaborated by the patient’s experience, cognition, physiology, pathophysiology, and coping responses.
For instance, during anxiety episodes some patients feel that their coordination is impaired, that they might faint and that they can’t move their feet.
All of these symptoms may represent immobility.
One curious yet often overlooked set of behaviors occurring during anxiety episodes, particularly those considered to be panic attacks, are subtle compulsive safety or avoidance rituals. For instance, a patient who had experienced panic attacks in high places would touch a stair tread a specific number of times at each floor when climbing stairs.
A businessman who reported panic attacks but denied any avoidance revealed upon further questioning that he never scheduled morning business meetings for fear of being overanxious at those times. A
manager at a machine shop would never close the door of a room behind him because of anxiety experienced in closed places.
Acute Behavioral Symptoms
Acute recognition of threat – Immobility.
Fearful facial expression – Inhibition of movement.
Sweating – Tonic immobility.
Trembling – Impaired coordination.
Pale or flushed face – Postural collapse.
Withdrawal – Hypervigilance.
Flight – Submission.
Avoidance – Averted gaze.
Aggressive Defense – Other.
Anger – Hyperventilating.
Irritability – Disoriented.
