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Treatment of Anxiety, Gambling, and Phobias

by Jurriaan Plesman BA (Psych), Post Grad Dip Clin Nutr

 

Anxiety defined

Anxiety Seeking behaviour

Adrenal Exhaustion

Free-floating anxiety

We will try to show how best we can treat ourselves of the debilitating afflictions of anxiety and phobias. If problems arise the assistance of a psychologist or counsellor should be sought.

Anxiety and phobias have this in common that they are driven by the fear response. Unexplainable fear reactions may be due to illnesses – such as hypoglycemia – that have the effect of over-producing stress hormones. This has been discussed extensively in this web site. If the root cause of anxiety is physiological, then this needs to be treated before considering “psychological” aspects. Here we will discuss mood disorders from a more psychological viewpoint.

 

We can learn to be fearful of any object if it is accompanied with a negative experience, like an electric shock, or heat. This is how children learn to avoid stoves, heaters, hot irons, boiling water and other dangerous things. Fear is essential to our survival, when we think about the dangers of driving a car and making sure the brakes work properly. Such fears cause us to think of methods to overcome the threat. A soldier’s survival in war may depend on how cautious he is. Many war heroes were in fact very cautious people.

 

Anxiety is closely related to this fear response. It can become associated with any neutral stimulus, if it is paired with a traumatic stimulus like the sensation of pain. However, by the same token this kind of problem solving may also lead to obsessive-compulsive reactions if the object or situation comes to haunt a person by senseless repetition of thoughts or acts in his attempt to reduce anxiety or guilt. Examples are kleptomania or the compulsion to steal something for which the kleptomaniac has no use. The compulsive washing of hands for fear of becoming infected by germs is another example. This may be classed as “making sure” behaviours, such as compulsion to check whether one has closed the doors, water taps or windows, compulsion that everything is in its proper place. In all these acts there appears to be some attempt to reduce some internally generated metabolic or ‘psychological’ anxiety, unrelated to environmental events. This is further explained in:Obsessive Compulsive Disorder (OCD) and Nutrition

 

When the object of fear becomes less specific and a person cannot identify the cause of the fear response, then we speak of a free-floating anxiety. It is free-floating, because it tends to occur from one situation to another, not generated by external happenings but from within.
Anxiety attacks are usually due to an overactive autonomic nervous system which produces such physical symptoms as a rapidly beating heart, gastric disturbances, bowel disturbances, visual difficulties, cold hands and feet, tense muscles, particularly in the back and neck. These happen also to be symptoms of reactive hypoglycemia, and this should be considered the first candidate in the treatment of free-floating anxiety. Anxiety attacks are said to be caused by the rapid descending blood glucose concentrations typical of hypoglycemia (What is hypoglycemiaBeating anxiety and panic attacks). For how the Autonomic Nervous System is activated by the neurotransmitters, adrenaline and acetylcholine, see Anxiety and the Autonomic Nervous System.
Over time, tense feelings exhaust the immune system and the person complains of fatigue and failing memory. Such symptoms may also lead to chronic fatigue syndrome. See Chronic Fatigue.
Anxiety attacks may also follow allergic reactions to food items or environmental toxins and sensitivities. Often specific sensitivities tend to spread out over time to a wider range of substances in the environment as the immune system weakens further. Allergic reactions generalize to more and more substances. If you want to find your allergies please read:
Anxiety may also emerge from stressful social conditions, our workplace environment, problems in the home, worries about the future or stressful relations with loved ones, constant worries about children.
When blood sugar levels crash from high to low – mainly in response to stresses and to refined carbohydrates (sugars) or allergic reactions – the body produces adrenaline to convert stored sugar (glycogen in muscle tissues and liver) back into glucose. This prepares the body for action. But adrenaline is also a fight/flight hormone. Thus it is important to stabilize the blood sugar levels by having frequent or three hourly snacks (depending on how fast your reaction to sugar intake is). One way of providing a slow but regular release of glucose is by taking glycerine. Glycerine is a sweet tasting substance, obtainable from your chemist, that bypasses the pancreas and it is converted to biological energy in the liver, thus providing a source of normal physical and mental activity.
This should be considered a temporary measure until blood sugar levels settle down. The herb fenugreek is also a glucose stabilizer as are many other herbs. Perhaps a herbalist can help you out there.
The aim in the treatment of hypoglycemia is to to avoid these wild fluctuations of blood sugar levels by a natural diet, very similar to the diabetic diet. (See The Hypoglycemic Diet)

 

Continued exposure to these stresses may lead to adrenal exhaustion when the adrenals fail to synthesize the necessary stress hormones at the right amount and time. This could also be a sign of Chronic Fatigue.
The immediate nutritional treatment for adrenal exhaustion would be the adoption of the hypoglycemic diet and supplementing the body with the various coenzymes, vitamins and minerals such as vitamins B1, B2, B6, B12, folic acid, pantothenic acid (B5), C, zinc, magnesium and potassium – all involved with stress reactions. Hypoglycemia aggravates adrenal exhaustion, because erratic blood sugar levels drain stress hormones. See Rich Sources of Nutrients.
In addition to the hypoglycemic diet there are many antistress herbals which may be beneficial such as Withania somnifera (Indian ginseng, Winter cherry), also Korean and Siberian Ginseng, Damiana, Gotu Kola 2500mg pd, Wood Betony, Skullcap, Vervain and Zizyphus.
A herbalist or naturopath should be able to help you to choose the proper remedies.
The underlying causes of stress – nutritional, environmental, psychological, social – need to be isolated in the first place. If it is not possible to have regular holidays from stress – in both the physical or spiritual sense – then we may need to look at our relationships with significant others, rearranging responsibilities in the household or the work place, and re-examining one’s priorities and goals in life. These may all be sources of stress. To deal with these problems we need the various social and problem solving skills learned in the psychotherapy section in this web site. Familiarity with the psychotherapy course in this web site should therefore enable people to pinpoint most of the sources of their internal or social conflicts and how to deal with them. People with a high regard for the self, with a clear outlook on life, and an ability to assert themselves in an non-aggressive manner and able to resolve conflicts seldom experience anxiety attacks. Unachievable goals such as displayed in “perfectionism” is a major source of stress and anxiety. It is not only restricted to self-criticism, but often directed at others, causing social disharmony. Behaviour patterns prompted by avoidance of anxiety are sometimes classified as Avoidance Personality Disorders (APD). Leisure activities such as playing golf, fishing, sailing, bush-walking and bowling are instances when people find relaxation. These activities allows the body to synthesize beneficial neurotransmitters (such as serotonin, dopamine) in the absence of stress and stress hormones.

Other remedies may be regular periods of relaxation each day as explained below when we consider Relaxation Therapy.

Thus the treatment of free floating anxiety begins with the adoption of the hypoglycemic diet together with the antistress nutrients and herbs mentioned above, the elimination of allergies and other stresses in one’s diet, health or environment.
This should then be followed by an attack on some psychological sources of stress, such as inner conflicts and doubts about oneself, stemming from a negative self-image which has ramification in one’s network of important relationships. Many of these stresses, leading to anxiety, can easily be resolved by some minor alterations in the way we react to people and situations, simply by studying the PSYCHOTHERAPY course in this web site.

Anxiety seeking behaviours – Gambling

Thus far we have considered behaviour patterns that aims at avoiding anxiety. There are behaviours that appear to seek the opposite, namely activities that are rewarded by an adrenaline rush. Just like a person who is addicted to coffee, which temporarily triggers a bursts of energy, so there are people who seek the thrills of risks and competition to mobilize an anxiety response as a reward. Possible mechanisms are that the adrenaline rush elevates blood glucose levels, which in turn raises insulin levels, which then facilitates the absorption of amino acids including tryptophan which leads to the reward of serotonin. Whatever the internal metabolic mechanism involved, no doubt the hypoglycemic condition may be implicated. Many risk seeking sports reward people with the needed excitement, such as parachute jumping, boxing, mountain climbing, car and motorbike racing. These activities may be within the normal range, but some activities may become pathological and very self-destructive as when a person becomes addicted to compulsive gambling. A gambler competes with luck, which by definition is a rare event. Compulsive gamblers report the enjoyment of their adrenaline upsurge as the major element of addiction. It provides them with a needed high, usually followed by a bout of depression, sense of hopelessness and guilt. These roller-coasters conform with the symptoms of hypoglycemia. In some individuals the desperation of paying off debts may lead to the selling of their homes, and in extreme cases have prompted them to commit armed robbery, or bank robbery. Unlike businessmen who seek to reduce risks at all costs, gamblers enjoy exposure to risks and the adrenaline rush they create. Gamblers could also be seen to live a sheltered life, when needs for excitement are stifled. Gambling may also be interpreted as absence of any goal-directed behaviour prompted by one’s values system. See “Values Clarification
The gambling pigeon
Psychologists – called behaviourists – have another theory that clearly explains the power of compulsion in behaviour. This is based on studies that show that a certain behaviours can be reinforced by reward or non-reward. The latter leads to extinction of that behaviour. This can be illustrated by Skinner’s experiments with pigeons in 1968. They in fact can be taught a gambling addiction, by a series of what is called a schedule of reinforcement.
Let us suppose a pigeon pecks at a red button, and is then immediately rewarded with food (a seed). Every time it hits that button it is rewarded with food. We can increase the rate of pecking by presenting food after say every ten hits of the button. This is called an intermittent reinforcement schedule. Note that the pigeon can maintain a rate of pecking of about 4,000 responses per hour for as long as 15 hours. Studies have shown that by reducing the number of rewards we increase the rate and number of pecks by the pigeon.
If we vary the intermittent reinforcement schedule, that is we reward the pigeon at an average of say fifteen hits, then we can increase even more the intensity and number of hits by the pigeon. Strangely enough it means that we can make an organism respond more by reinforcing him less!! A gambler has learned to respond in the absence of previous reinforcements!! He has learned to continue to bet when his previous bets has been rewarded only a fraction of the time. Thus he has learned to be loser, a psychologically proven fact on which casinos and gambling organisations depend. It is interesting to speculate, whether the negative self-image is the consequence or the original cause of the gambler’s disease.
Like an alcoholic, a compulsive gambler usually hits his rock-bottom – the red line beyond which he won’t go – before he is ready to seek help in psychotherapy. The location of this red line, depends on his values system. “Where are his priorities?” His struggle with control over his behaviour – and over the demon of luck – is a major prop in his self-image.

As in alcoholism, there usually is an ‘alcoholic wife’, to whose controlling character he is strangely attracted. The gambler often satisfies the wife’s need to control, and often both need to undergo therapy. But it is also this wife and children, who usually are the source of motivation to undertake this psychotherapy, because they often become major victims of his addiction. Again treatment should start with the adoption of the hypoglycemic diet, followed by a course of psychotherapy with a chief emphasis on the self-image and “values clarification”.

 

Phobias
Unlike free floating anxiety attacks, a phobia is a fear response to an identifiable object in the environment but in the absence of any real danger. They are called phobic reactions. Common phobias are agoraphobia, fear of open spaces, claustrophobia fear of confined spaces.
Some other strange-sounding phobias are mysophobia fear of dirt, monophobia fear of being alone, arachnophobia fear of spiders, homilophobia fear of sermons, onomatophobia fear of names, melissophobia fear of bees, katelophobia stage fright, benolephobia fear of sharp objects and hydrophobiafear of water to name just a few.

Other technical names of phobias:Technophobia – Fear of technology Sciophobia – Fear of shadows Decidophobia – Fear of making decisions Nyctophobia – Fear of night Electrophobia – Fear of electricity Topophobia – Fear of performing (Stage Fright) Tropophobia – Fear of moving or making changes Triskaidekaphobia – Fear of the number 13 Gephyrophobia – Fear of crossing bridges Ophidiophobia – Fear of snakes Gatophobia – Fear of cats Hydrophobia – Fear of water Batrachophobia – Fear of reptiles Pyrophobia – Fear of fire Astrapophobia – Fear of lightning Spermophobia – Fear of germs Pnigerophobia – Fear of smothering Cynophobia – Fear of dogs Aerophobia – Fear of flying Ochlophobia – Fear of crowds Blennophobia – Fear of slime Katagelophobia – Fear of ridicule Spheksophobia – Fear of wasps Thalassophobia – Fear of the ocean Kakorraphiaphobia – Fear of failure, Gynophobia – Fear of women Agoraphobia – Fear of open spaces Claustrophobia – Fear of enclosed spaces Eremophobia – Fear of being alone Acrophobia – Fear of heights Musophobia – Fear of mice Apiphobia – Fear of bees Gamophobia – Fear of marriage Scholionophobia – Fear of school Odynephobia – Fear of pain Keraunophobia – Fear of thunder Amathophobia – Fear of dust. See: More Names of Phobias

Phobias are sometimes difficult to treat, because the person is often persuaded to believe that it is a sign of weakness in one’s personality. Thus he forces himself to confront this ‘weakness’ thereby unwittingly reinforcing the phobia.
Any object or situation can become the subject of a phobia. Most of these may have been acquired from a frightening childhood experiences, but some developed in adulthood. Sometimes the object of fear has been generalized, as in a case when a person has developed an unreasonable fear of all furry animals or furry things after an attack by a dog in early childhood. Or the fear response is generated as a result of word associations. Fear of white things may have become associated with the snow white collar of a minister of religion instilling purity and high standards of morality in one’s childhood ridden with feelings of guilt.
Another possible and perhaps more plausible explanation for a phobic reaction is that an object may have been paired with the fear response during a free-floating anxiety attack.

 

A phobia can also be seen and as a distortion of reality under the influence of excess stress hormones as a result of a inner metabolic disorder. See also: Delusions.  Free-floating anxiety attacks phobias are closely related to hypoglycemia and hence the first step in the treatment is the adoption of the hypoglycemic diet.

 

Agorophobia
To explain the psychological treatment of phobias, we will discuss the treatment of agoraphobia as an example as to how most other phobias can be treated.
Agoraphobia should be seen as a separate, or perhaps an additional condition to hypoglycemia. I had a client who had severe hypoglycemia, crashing half an hour after ingesting refined carbohydrates (in her case milk shakes) AND agoraphobia or fear of open spaces. On many occasions she had tried and forced herself to leave the house, which may have aggravated her condition.
It is important never to force yourself to leave the house if you are anxious, because this could reinforce the fear response. You should only leave the house if you are totally relaxed.

 

Let us look at how a phobia can be treated.
Imagine a child frightened of water. This is hydrophobia. Psychologists use “Systematic Desensitization”, that is getting the child to relax by letting it play near or far away from the water. By gradually getting the child to play nearer the water (by gradually placing toys near the water for instance) it remains relaxed near the water. Very soon the child will play IN THE WATER, and you may now have to educate the child on some of the dangers of water. Technically speaking, what we have achieved is to pair a relaxation response with the object of the original fear response. This process takes place over a period of time depending on the severity of the phobia. The principle is to introduce the fear object gradually whilst in a state of relaxation.
This technique can be extended to “Imaginal Systematic Desensitization” where a person’s mental image of the fear object is gradually introduced whilst in a state of relaxation. Here again we pair the fear object with the response of relaxation.
Thus in the treatment of agoraphobia, we must first learn how to relax in the house! This can be learned by mastering relaxation therapy at first as follows:
Sit and relax in an easy comfortable chair, close your eyes, and feel how heavy your body is, starting with your feet, gradually working up to your legs, your body, your arms, chest and head. Imagine that you are laden with lead and that you are sinking deep into the easy chair. Feel the pressure of your body against the cushions in the chair. Soon you should feel so relaxed that you cannot be bothered to get up and then enjoy the whole experience!!
Do this a couple of times until you can relax in a shorter period of time each time you sit down to relax.
Following a series of these exercises you should be able to relaxed in a fairly short period of time. These daily exercises alone should help you in free-floating anxiety attacks. The success of non-directive counselling is based on the fact that a person can relate traumatic experiences in an atmosphere of acceptance, understanding and relaxation in the presence of a counsellor, thus pairing anxiety arousing images with the relaxation response!
In phobias we are going to use your ability to relax by introducing images in your mind, whilst you are relaxed, on similar principles.
Thus the next step is TO IMAGINE that you walk around the house.

 

In a session of Imaginal Systematic Desensitization by a psychologist, you will be asked to lift your index finger, whenever you feel the first sign of anxiety. This is usually felt in the pit of your stomach or a tension in another part of the body. Each individual has a unique locus of such tension. You will be asked to recognize this sign as a first warning of anxiety.
In your imagination, walk around in the house, go to the kitchen, to the corridor, to the bedroom, to the laundry, to the front door. Oops you feel a tension in your stomach when you imagine going to the front door. Walking to the front door could easily arouse the fear response and then you should lift the index finger indicating to the psychologist that the image of the door arouses fear. You may do this as well, although there is no real psychologist in the room. You are your own psychologist now! When you lift your index finger, the psychologist would immediately lead you away from the front door and guide you to a safer place in your home. Thus don’t go to places in your imagination that the first warning signs tell you may be dangerous.
This indicates that you get anxious, and immediately in your imagination return to the lounge room, the place of safety. Thus whenever you feel the first signs of anxiety you immediately return to the place of safety. Get to know this bodily warning sign, this is the first sign of the uncontrolled fear response! Never allow your autonomic nervous system to trigger an anxiety reaction because of your imagination! Gradually you will discover that you can leave the house and walk around in your garden in your imagination.

 

As an aside, some people may find it difficult to reach this state of relaxation, because they have been “trying” to relax. “Trying” implies “making an effort” which is the opposite of being relaxed. Trying to do anything at all, implies that you will fail to do whatever you are trying to do. Just relax!
Your exercises in relaxation should be pleasurable.
You will soon discover that you can remain relaxed by walking to the front gate in your imagination , or perhaps to the street in front of your house.
Now still imagining, make a trip into town, on the railways, bus stops and in shopping centres. The aim is to be able to walk into the street or anywhere you fancy in your imagination all the time sitting in the chair!!!! Remember to return home immediately into your chair whenever you feel the warning sign of anxiety in your stomach.
Repeat the relaxation exercises and imaginal trips at home over several days, even weeks if necessary, until you feel you have control over your autonomic nervous system. Here it should be said that individuals differ in their learning curves: some people are fast learners, others somewhat slower, but you all will get there in the end.
You are now ready to experiment in vivo, in real life, by walking to the door, into your garden, into street, always ready to return home when you start to feel anxious. My bet is that you won’t feel anxious and that in fact you will experience a sense of relief and exhilaration.

 

When you have gained total control over your ability to relax and walk anywhere in your imagination, you will soon find that you can get out of the chair and walk out of the house. But remember, if you feel tension (in your stomach) immediately return to the safety of your home and start all over again. Learning to respond in the correct way at the level of the autonomic nervous system requires repeated exercises, just as we learn to play the piano. Furthermore, we need to keep an eye on other causes of anxiety reactions when we are not on the correct diet!
If at this stage you still encounter difficulties, it would be wise to get help from a professional counsellor who is familiar wit Imaginal Systematic Desensitization.
I have been able to help car phobic people to drive a car. These are clients who have learned and know how to drive a car, may even have a licence, but have developed an abnormal fear of driving. This could have been exaggerated, by forcing themselves to drive a car under condition of extreme anxiety. They have been able to overcome these fears by imaginable desensitization by imagined trips whilst in a relaxed state. They visualized walking around a car in the middle of an empty paddock, getting to sit inside the car, then driving the car in the paddock – no fences or other objects – then introducing lonely country roads, then gradually introducing houses on the side of the road. When the client experienced the warning sign, there was always a side track leading back to an large empty paddock. Gradually more houses were introduced, then a dog or cat on the road, then a cyclist, then an other car in the distance, but fortunately he disappeared into a side road. You will have to have a vivid imagination, changing the scene immediately when the index finger goes up. Soon the client is driving a car in a busy city street, reversing his car for parking purposes….all in his imagination. Having done this several times the client is now ready to experiment in real life.

 

Other scenes can be created for people with stage fright, a very common phobic reaction. We can start off standing at the back of a hall full of people, or a hall with only one person. The possibilities are infinite. Then in one’s imagination we move the client progressively to the front, until he stands viewing a sea of faces staring at him. Imagining what people would think of you at this stage may point to a negative self-image – a useful tool of the “paranoid situation” as discussed in “Improving one’s Self-Image”. Apart from that, it is still important to prepare your speech and practise this at home in a safe surrounding, before embarking on your speaking engagement to a large crowd in a real life hall.
This is an outline of the program to give you an idea how people overcome their phobias. It is like the hydrophobic child playing with his toys which are gradually placed near the edge of the water. There are other methods such as ‘implosion’, where a client is exposed to a fear object without an escape route. Many counsellors – among them myself – are reluctant to use this method on ethical grounds.

 

In summary: Both anxiety attacks and phobias are marked by an exaggerated fear response that derive from internal factors most probably related to a hypoglycemic reaction or a response to allergies. These need to be attended to first by adopting the hypoglycemic diet and a program designed to avoid allergies.
If these attacks have taken place over a long period of time the possibility of adrenal exhaustion should be considered, which need to be treated with the hypoglycemic diet and special vitamins and minerals, plus antistress herbals as mentioned (i.e.,Withania somnifera).
In free-floating anxiety attacks the person needs to have a careful look at some of the sources of stress in his/her social life, apart from internal factors. These may be related to the environment in the home or work place, relationships with significant others such as family members, partners, children, or to ambitions in one’s career. These are usually centred around a poor self-esteem, and lack of social skills in handling people.
The most common source of anxiety is “perfectionism” or the striving for unattainable standards of performance by the self and others.
Most of these sources of stress can be traced to a negative self-image – the core of our personality – and can be corrected by studying the PSYCHOTHERAPY course in this web site.
In “anxiety-seeking” behaviour a person is believed to be driven by an inner metabolic need for adrenaline, the energizing hormone, that can provide a high, just as a person addicted to caffeine derives ‘pleasure’ from the drug. Many ‘risky’ sports satisfy these needs. But addiction to adrenaline may be severely self-destructive in the case of compulsive gambling. The treatment for this has common features with the treatment of alcoholism.
Phobias are treated, 1) by learning how to relax (relaxation therapy), 2) and by gradually introducing the objects of fear in imagination, whilst in a state of relaxation.
Thus adopting the hypoglycemic diet and doing the daily mental exercises over a period of time will help you overcome the debilitating affliction of anxiety and phobias.
If these do not help, please consult a clinical psychologist and/or a nutritional doctor.
See also:

2 Responses

  1. mary johnson says:

    Thankyou so much for all your articles! They are so helpful to me.
    I’m wondering how I can determine the correct dosage of B vitamins,etc.
    Any advice?? Thank you !

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