|
The only way we can help the individuals suffering from anxiety to take him to a good psychiatrist and start their psychotherapy. As Micheal Balint a psychoanalyst who pioneered the use of psychotherapeutic methods in medicine wrote, ‘the doctor is a drug: the question is in what dose and with frequency it should be prescribed’. The two drugs frequently used for the treatment of anxiety are tranquillizers and ‘doctor’. Both can be effective in short term but can in the long term produce the complication of dependence and may even exacerbate the symptoms of anxiety.
Now coming to the psychotherapy:
First comes the exploratory psychotherapy. Normal individuals who become anxious are usually relieved of their fears by reassurance and the ability to reassure is that’s an important part of a doctor’s skill. Reassurance in neurotic individuals is often ineffective however as it deals only with the surface fear and not with the underlying conflict. A man who develops repeated attacks of pain in which he is convicted that he is about to die of an heart attack can be reassured that he ECG is normal and that he is a fit man and be discharged. Yet a few days later, he may develop another attack and present again to the doctor. The underlying fear and root causes of his anxiety of which he may be unaware or unconscious should be exposed. Only when this fear is exposed and when he has learned to accept the dependent part of himself, will has anxiety cease.
This kind of exploration is helpful in the relationship with a doctor or therapist and so move from a position of anxiety to one of secure attachment, he will be relieved of the symptoms. Thus in exploratory psychotherapy the doctor aims to be understanding but is non-directive. Then comes the behavioral therapy, in which the doctor aims to change the person evaluation of most cases of anxiety. In some cases, it may not to be followed by long-term psychotherapy. If the person can learn to resolve his inner conflicts through his feared stimulus often in the reassuring presence of the therapist. An important feature of behavioral treatment for anxiety is relaxation training. Here the person learns to control anxiety through muscular relaxation and deep breathing, sometimes with the aid of tape recorded instruction.
Physiological measures like galvanic skin response and pulse rate may provide objective evidence of anxiety reduction. When self administered, this is known as auto-genic training. In cognitive therapy, the person’s underlying assumptions and view of the world are challenged and he is asked to consider and ponder rationally about the causes of his anxiety. Their tendencies to catastrophise that is fear dichotomise that is divide the world into black and white, good and bad are pointed out and alternative strategies suggested. And last but not the least is psychotropic drugs. When anxiety is a manifestation of depressive illness, the treatment of depression with anti-depressants also relieves anxiety. Short term use of minor tranquillizers such as benzodiazepines is occasionally justified for the relief of stress-related anxiety. Long-term use of tranquillizers should be avoided. An anxious person associates the feared stimulus with unpleasant feelings. The therapy aims to desensitize the person by gradual exposure to the blockers relieve the peripheral symptoms of anxiety and may also be occasionally useful. |