GGZ2024 – Anxiety and Related Disorders (Lectures, Tasks, Practical & Skills)
Lectures
Lecture 1: Introduction & Lecture 01
What is anxiety?
Children also channel their fears, they do this due:
- Fantasy.
- Little blanket.
- Pacifier.
- Channeled in games.
- Soothed by caregiver.
“Take a moment to think back of a moment in your life in which you felt a sudden rush of
fear.”
Moments that you lost your parents in the crowd.
Giving a presentation for a bunch of people
How do you know that your anxious?
• Heartrate increases.
• Respiration increases.
• Sweating (cold hands)
• Tense muscle: trembling of hands, other parts.
• Tingling of hand and feet
• Hairs upright (goosebumps)
• Nauseous
• Anxious thoughts: thoughts like “I’m about to go fail, I might blackout.”
• Ruminate
• Worry
• Hide
• Get Away
The functionality of anxiety is to survive approach situations that increase survival and avoid
situations that decrease survival.
It also has a social function: it is signaling danger, and it also has a motivation of social adapt
behavior.
The conceptualization of anxiety:
1. Common sense: my conscious feeling is fear, so that is
why I react.
2. James & Lange: you see the stimulus; you have an
autonomic arousal and then you translate that as anxious.
3. Cannon & Bard: the stimulus is activating the subcortical
brain; this leads to a conscious feeling and the autonomic
arousal.
4. Schachter: I label my trembling as fear because I
appraise the situation as dangerous. The stimulus leads to
autonomic arousal, you appraise the situation and think it
must be fear.
,GGZ2024 – Anxiety and Related Disorders (Lectures, Tasks, Practical & Skills)
James & Lange: viscera are center of emotion. Senses > cortex > muscles, viscera > response
perceived as emotion > reaction.
Canon & Bard: Thalamus is key, bodily changes and emotional experience occur separately
and independently of one another.
Schachter & Singer: Two factor theory of emotion, A person uses the immediate
environment to search for emotional cues to label the arousal.
(mis)attribution of arousal (https://www.youtube.com/watch?v=P0aMEkGIcQE
Anxiety is a reaction to threat:
The freeze moment: prepare for fight-flight, it decreases
chance for detection.
Fight reaction: fight against the danger.
Flight: get away as soon as possible from the danger.
Biology of anxiety
The physiology of anxiety
Parasympatisch = down
Sympatisch = up
→ adrenalin and noradrenalin play a huge game in this.
1. Sympathetic
▪ Blood pressure increases
▪ Heartrate increases
▪ Respiration increases
▪ Sweating (cold hands)
▪ Increase of blood in muscles.
▪ Tingling of hand and feet
▪ Pupils enlarge → see more light
▪ Goosebumps
2. Parasympathetic
▪ Contraction of blatter and intestinals (urge to go to the toilet)
▪ Digestion stop: dry mounth and throat.
The cognitive reactions are:
- Hyperalert
- Narrowing of attention
,GGZ2024 – Anxiety and Related Disorders (Lectures, Tasks, Practical & Skills)
- Idea that time goes slower.
- Present or actual situation seems unreal.
- Perception that you watch yourself from a distance.
- Think you might faint.
The behavioral reactions are:
- Protect ourselves due safety behaviors.
- The urge to run & the urge to cry.
The differences between fear and anxiety
Heightened vigilance = your body is always on, cause of the fear of danger.
What is anxiety?
Anxiety is the feeling of fear or panic.
Most people feel anxious, panicky, or fearful about situations in life, such as money problems
or exams but often once the difficult situation is over, you feel better and calmer.
Sometimes the feeling of fear or anxiety continue after the difficult situation or sometimes
you may feel a stronger sense of fear than other people and this is when anxiety might become
a problem and can affect your daily life/functioning.
Several perspectives
1. Terror management Theory
“Humans are motivated to quell the potential of terror inherent in the human awareness of
vulnerability and mortality by investing in cultural belief systems. Since its inception, the
theory has generated empirical research intro not just the nature of self-esteem motivation
and prejudice, but also a host of other forms of human social behavior… depression and
psychopathology.”
➢ Self-esteem: consist of the perception that one is valuable member of a meaningful
universe.
➢ Anxiety: usually around three years of age children begin to learn about and become
concerned with the problem of death and anxieties regarding darkness and monsters
become more and more linked to real threats… that’s culminate with the realization
of the inevitability of death.
, GGZ2024 – Anxiety and Related Disorders (Lectures, Tasks, Practical & Skills)
So, a child becomes aware that the parents or caregivers are not omniscient and omnipotent
but fallible and moral.
Self-esteem thus functions as an anxiety buffer to maintain relative equanimity despite the
awareness of vulnerability and mortality.
Irvin Yalom
He says that: death agony has been a taboo even under psychotherapists. But people do
experience this fear, some dream about it, others try to suppress it which leads to
psychological symptoms.
We are mortal and will die, it is the deepest human wound.
Culture comes into play to provide a secure base in which the virtuous are rewarded
and the evil are punished.
https://www.amnesiagame.com/#main
https://entered.be/belevingen/i-can-hear-you/
2. Psycho-analytic view - Freud
Moving a bit more to the extreme side of the continuum
Freud recognized the importance of anxiety. He was one of the first writers to argue that
anxiety was a critical component of neurosis.
Anxiety is an aversive interstate that people seek to avoid or escape.
He says there are three major types of anxiety:
1. Reality anxiety
The most basic form, rooted in reality. Fear of a dog bite, fear arising from an impending
accident.
2. Neurotic anxiety
Arises from an unconscious fear that the libidinal impulses of the ID will take control at an in
opportune time. This type of anxiety is driven by a fear of punishment that will result from
expressing the ID’s desires without proper sublimation.
3. Moral anxiety
This type of anxiety results from fear of violating moral or societal codes, moral anxiety
appears as guilt or shame.
In Freud’s view, the human is driven towards tension reduction, to reduce feelings of anxiety.
Humans seek to reduce anxiety through defense mechanism → can be psychological healthy
or maladaptive, but tension reduction is the overall goal in both cases.
when some types of anxiety occur, the mind responds in two ways:
1. Problem solving efforts are increases.
2. Defense mechanisms are triggered. These are tactics which the Ego develops to help
deal with the ID and the Super Ego. (Super ego = your perfect one, ID = really driven
by your urges, your ego is in between.)
All the defense mechanisms share two common properties:
1. They can operate unconsciously.
2. They can distort, transform, or falsify realty in some way.
The changing of perceived reality allows for a lessening of anxiety, reducing the
physiological tension felt by an individual.
Lectures
Lecture 1: Introduction & Lecture 01
What is anxiety?
Children also channel their fears, they do this due:
- Fantasy.
- Little blanket.
- Pacifier.
- Channeled in games.
- Soothed by caregiver.
“Take a moment to think back of a moment in your life in which you felt a sudden rush of
fear.”
Moments that you lost your parents in the crowd.
Giving a presentation for a bunch of people
How do you know that your anxious?
• Heartrate increases.
• Respiration increases.
• Sweating (cold hands)
• Tense muscle: trembling of hands, other parts.
• Tingling of hand and feet
• Hairs upright (goosebumps)
• Nauseous
• Anxious thoughts: thoughts like “I’m about to go fail, I might blackout.”
• Ruminate
• Worry
• Hide
• Get Away
The functionality of anxiety is to survive approach situations that increase survival and avoid
situations that decrease survival.
It also has a social function: it is signaling danger, and it also has a motivation of social adapt
behavior.
The conceptualization of anxiety:
1. Common sense: my conscious feeling is fear, so that is
why I react.
2. James & Lange: you see the stimulus; you have an
autonomic arousal and then you translate that as anxious.
3. Cannon & Bard: the stimulus is activating the subcortical
brain; this leads to a conscious feeling and the autonomic
arousal.
4. Schachter: I label my trembling as fear because I
appraise the situation as dangerous. The stimulus leads to
autonomic arousal, you appraise the situation and think it
must be fear.
,GGZ2024 – Anxiety and Related Disorders (Lectures, Tasks, Practical & Skills)
James & Lange: viscera are center of emotion. Senses > cortex > muscles, viscera > response
perceived as emotion > reaction.
Canon & Bard: Thalamus is key, bodily changes and emotional experience occur separately
and independently of one another.
Schachter & Singer: Two factor theory of emotion, A person uses the immediate
environment to search for emotional cues to label the arousal.
(mis)attribution of arousal (https://www.youtube.com/watch?v=P0aMEkGIcQE
Anxiety is a reaction to threat:
The freeze moment: prepare for fight-flight, it decreases
chance for detection.
Fight reaction: fight against the danger.
Flight: get away as soon as possible from the danger.
Biology of anxiety
The physiology of anxiety
Parasympatisch = down
Sympatisch = up
→ adrenalin and noradrenalin play a huge game in this.
1. Sympathetic
▪ Blood pressure increases
▪ Heartrate increases
▪ Respiration increases
▪ Sweating (cold hands)
▪ Increase of blood in muscles.
▪ Tingling of hand and feet
▪ Pupils enlarge → see more light
▪ Goosebumps
2. Parasympathetic
▪ Contraction of blatter and intestinals (urge to go to the toilet)
▪ Digestion stop: dry mounth and throat.
The cognitive reactions are:
- Hyperalert
- Narrowing of attention
,GGZ2024 – Anxiety and Related Disorders (Lectures, Tasks, Practical & Skills)
- Idea that time goes slower.
- Present or actual situation seems unreal.
- Perception that you watch yourself from a distance.
- Think you might faint.
The behavioral reactions are:
- Protect ourselves due safety behaviors.
- The urge to run & the urge to cry.
The differences between fear and anxiety
Heightened vigilance = your body is always on, cause of the fear of danger.
What is anxiety?
Anxiety is the feeling of fear or panic.
Most people feel anxious, panicky, or fearful about situations in life, such as money problems
or exams but often once the difficult situation is over, you feel better and calmer.
Sometimes the feeling of fear or anxiety continue after the difficult situation or sometimes
you may feel a stronger sense of fear than other people and this is when anxiety might become
a problem and can affect your daily life/functioning.
Several perspectives
1. Terror management Theory
“Humans are motivated to quell the potential of terror inherent in the human awareness of
vulnerability and mortality by investing in cultural belief systems. Since its inception, the
theory has generated empirical research intro not just the nature of self-esteem motivation
and prejudice, but also a host of other forms of human social behavior… depression and
psychopathology.”
➢ Self-esteem: consist of the perception that one is valuable member of a meaningful
universe.
➢ Anxiety: usually around three years of age children begin to learn about and become
concerned with the problem of death and anxieties regarding darkness and monsters
become more and more linked to real threats… that’s culminate with the realization
of the inevitability of death.
, GGZ2024 – Anxiety and Related Disorders (Lectures, Tasks, Practical & Skills)
So, a child becomes aware that the parents or caregivers are not omniscient and omnipotent
but fallible and moral.
Self-esteem thus functions as an anxiety buffer to maintain relative equanimity despite the
awareness of vulnerability and mortality.
Irvin Yalom
He says that: death agony has been a taboo even under psychotherapists. But people do
experience this fear, some dream about it, others try to suppress it which leads to
psychological symptoms.
We are mortal and will die, it is the deepest human wound.
Culture comes into play to provide a secure base in which the virtuous are rewarded
and the evil are punished.
https://www.amnesiagame.com/#main
https://entered.be/belevingen/i-can-hear-you/
2. Psycho-analytic view - Freud
Moving a bit more to the extreme side of the continuum
Freud recognized the importance of anxiety. He was one of the first writers to argue that
anxiety was a critical component of neurosis.
Anxiety is an aversive interstate that people seek to avoid or escape.
He says there are three major types of anxiety:
1. Reality anxiety
The most basic form, rooted in reality. Fear of a dog bite, fear arising from an impending
accident.
2. Neurotic anxiety
Arises from an unconscious fear that the libidinal impulses of the ID will take control at an in
opportune time. This type of anxiety is driven by a fear of punishment that will result from
expressing the ID’s desires without proper sublimation.
3. Moral anxiety
This type of anxiety results from fear of violating moral or societal codes, moral anxiety
appears as guilt or shame.
In Freud’s view, the human is driven towards tension reduction, to reduce feelings of anxiety.
Humans seek to reduce anxiety through defense mechanism → can be psychological healthy
or maladaptive, but tension reduction is the overall goal in both cases.
when some types of anxiety occur, the mind responds in two ways:
1. Problem solving efforts are increases.
2. Defense mechanisms are triggered. These are tactics which the Ego develops to help
deal with the ID and the Super Ego. (Super ego = your perfect one, ID = really driven
by your urges, your ego is in between.)
All the defense mechanisms share two common properties:
1. They can operate unconsciously.
2. They can distort, transform, or falsify realty in some way.
The changing of perceived reality allows for a lessening of anxiety, reducing the
physiological tension felt by an individual.
