Behind Anxiety Disorders

 

Behind Anxiety Disorders:
Phobias, Hypochondria, Panic Attack and OCD

Lic. Raúl E. Pérez

Translated by Maria Ester Garcia
Further translation and editing
by Jann Garitty

Introduction

This article outlines an approach for treatment of well-known disorders frequently treated by flower essence therapy. More and more, there are institutions that are specializing in the study of these disorders with different views as to how to treat them. We have seen the “discovery” of these clinical disorders by the general media though they have always been present in our society and are well known in psychopathology. These disorders belong in general to the group of Anxiety Disorders, according to the classification of the D.S.M. – IV (Diagnostic and Statistical Manual of Mental Disorders). Some of them have been updated and have had their names changed. For instance, the old “hypochondria,” is now Generalized Anxiety Disorder (GAD); its sufferer is excessively worried about health, money, family, or work. What is known as obsessive neurosis is now called: Obsessive Compulsive Disorder (OCD). Flower therapy is an excellent tool for the treatment of these and other anxiety disorders. However, very few patients and mental health professionals are aware of this possibility for treatment.

Still, even when utilizing flower therapy, we should be cautious and make an accurate diagnosis. I mention this because there are many patients who diagnose themselves as having “panic attacks,” perhaps influenced by confused information delivered through the mass media rather than by a correct professional diagnosis. Others have been diagnosed by a clinician, who then abruptly “labeled” them and prescribed psychiatric drug treatment, which they sometimes undergo for their lifetimes, even when the symptoms have disappeared. Patients argue that they take the medicine “just in case,” thereby producing a double addiction: physical and psychological.

We also see patients who suffer from true phobic episodes, hypochondria, OCD or panic attacks and have not received an accurate diagnosis, leading them to receive incorrect treatment or none at all.

Treating the core issue not the symptoms

There are many flower essences from the various systems developed worldwide that treat all degrees of fear and anxiety. But, I want to focus on another aspect of the personalities of these patients which has not been taken into account by flower practitioners in general, nor “specialists” who treat this problem with traditional therapies. This aspect is so important that we must analyze the treatment course for this type of patient.

Fear, panic or extreme anxiety are symptoms that, although deserving of consideration, sometimes become a smoke screen that covers up the core problem. This issue that I am referring to can explain why the patient, while being prescribed the right flower essences for fear and anxiety, does not always experience the desired outcome.

First, when I began my observations twelve years ago, I believed this phenomenon occurred only occasionally and so I could not generalize it to all cases. However, due to the systematic occurrence of this, I changed my mind and decided to tell my colleagues about it, and then also write this article for your consideration.

This phenomenon is easily observed. However, I have not heard practitioners who treat these disorders describe it when speaking of them. They limit their descriptions to symptoms and the feelings that patients experience.

When specialists speak about the underlying “causes” of these disorders, they generally underestimate the psychological aspect, and prefer to speak about “brain neurotransmitter failures…,” “neurobiological origin of disorders…” and even make mention of the genetic background. All of these factors may be the reason for behavioral changes. In the event of chemical alterations of brain functions, they may be “compensated” for with the appropriate drug. Generally, this treatment has to include a psychological component, either in a group or individually, but preferably a cognitive therapy.

Of course, we cannot dismiss the possibility of genetic and/or neurochemical disturbances in any human disorder. But, we have to realize that the body does not act on its own accord. In other words: the brain does not segregate specific neurotransmitters or stop the production of others by itself and for no reason. Chemical changes in the brain causing the disease may be found and understood upon learning in depth about the history of the patient. That is why the “clinical” approach is so essential as it is the interview with the patient that is a fundamental tool for all diagnostic procedure. Individuals, whether suffering or feeling happiness, generate chemical (hormonal) changes which impact the body. Further, if most of these disorders result in brain chemical imbalances, we should ask why so many patients use prescribed psychiatric drugs for years without getting better.

Working in clinical practice with these patients, I’ve discovered without exception, in addition to fear, anxiety, mental torment and/or external circumstances—all of which could have resulted in these symptoms—there are also deep feelings of possessiveness, isolation, loneliness and a need for affection. It is a true “emotional dependence.” According to Bach flower therapy (which is best known to us), this indicates ChicoryHeatherHolly problems. We can corroborate this by taking a detailed clinical history and paying attention to the patient’s words, because they will fully reveal the dominant emotional constellation.

Theoretical & Clinical Foundation

In consultations, we find that emotional neediness in all its various forms of expresson is present in these patients’ lives. Patients exhibit this in a variety of ways that lead us to this underlying, main issue. Most of these patient behaviorial symptoms are widely recognized by flower practitioners or clinical psychologists. Some examples are: the excuse of an illness or isolated symptoms to get attention and pity from others; blaming others to avoid responsibility for their own actions and also to manipulate them; the need to speak exclusively about their own “terrible problems” which are more important than anyone else’s, and so on.

We have seen these types of cases before; all flower essence practitioners routinely treat this type of patient. I’m grateful for other flower systems developed after Dr. Bach’s, that provide us with other essences to treat this affective disorder. It is a pathology that is truly overwhelming for the three flower essences originally directly linked to it from the Bach system—Chicory, Heather, and Holly—the essences of love. We could write a whole book solely devoted to these three essences alone.

Chicory

Holly

Heather

Having set forth the main focus of this writing, I will now now elaborate on it from different points of view, both theoretical and clinical.

Regarding the Bach system and Chicory, Ricardo Orozco states in his Manual for Advanced Practitioners (Manual para Terapeutas Avanzados):

“… This is an example (not the only one) to show how a flower of the system breaks out of its group scheme (Group 1 from Bach, “fear”), focusing on one thematic aspect. In this case, Chicory goes beyond the division of known/unknown fear (Mimulus-Aspen) and is indicated for this emotional fear.

Mimulus
Aspen

Chicory fear refers, in all cases, to the emotional loneliness, fear of loosing acquantainces and commited relationships, and in the end being alone…”.

Then, when he refers to the differential diagnosis between Chicory and Heather, he adds:

“...An important difference between these is the lack of control over outside emotional influences that substantiates the dramatic situation experienced by the Heather condition at its extreme. Chicory has some choice in how its patterns manifest, while Heather has lost all self–control and needs constant attention from any one.

“Fear of loneliness for Chicory becomes panic for Heather”

“....Chicory patients often suffer more than average from a number of illnesses. Disease plays an important role in the demand for attention. It may be useful in manipulating and blaming others. Regardless, it enhances self-compassion, an attitude always present in Chicory. Of course, all these coping mechanisms are used unconsciously and are motivatedby the fact that he or she is unable to ask for affection/emotional support in a more positive way.”

Then, Orozco says: “Heather is the champion of hypochondriac patients.” This is recognized by all as the tendency to exaggerate in Heather patients, who, as Mechthild Scheffer states, “make mountains out of molehills.”

María Luisa Pastorino, agrees with this statement when she says that Heather should be included in the treatment for hypochondria, whenever illness is used by the patient to obtain permanent companionship.

I have always found throughout my professional career, in almost fifteen years of work with flower essences, that the Chicory-Heather features in all of the hypochondriac patients I have had the chance to treat.

Hypochondria is the clinical condition that causes the patient to feel fearful of developing some serious, organic disease that may lead to death. It is one of the primary issues in the “cause” of most phobic symptoms, panic attacks and/or OCD. This happens even though most patients have undergone countless clinical tests—because only one test is not enough to convince them, since it may have been mistakenly carried out—which reliably and consistently show the absence of the feared diseases.

Why then, do these patients react negatively, in spite of not developing an illness, a fact that would be “good news” for anyone else? It seems they “need” this illness. Some patients even get annoyed and take offence because they are not “understood” (a typical Chicory-Heather feature). They argue that in spite of the negative results of the tests, “they may be developing something.”

Most of these patients know that their fear has no rational cause. However, when they are fearful they believe “the end is imminent” and their own death could come, although they have experienced the same feelings before and nothing did happen. Generally, these feelings of “imminent death” episodes last 30 or 40 seconds, but in other cases, they can last minutes. When I was a psychology student, I had a psychoanalysis teacher who said: “…There is no fear of death, actually it is a disguised fear of life…” Indeed, we can see in most of these clinical states an absolute lack of the most fundamental healthy life characteristics: maturity, independence, and responsibility (particularly in young people). These characteristics are deferred to important people in their lives who finally, “take over”: a partner, parents, close friends, and often times, a mother or maternal figure. The “true fear” experienced by these patients, is the very “fear of life,” of all the things it involves, with its challenges, risks and commitments, from which nobody is free.

We know that the main coping mechanism used by those with phobias is avoidance. By means of the personality’s defense mechanisms, these conflicts are projected onto other issues in order to hide their true fears that could be unbearable to deal with if they were permanently in their awareness. Therefore, by changing the issue, the conflicts can be avoided first in an “easier” way, although, as we can see in any phobia, the circle becomes narrower and the symptoms’ recurrence increases through the return of the repressed feelings.

A very important aspect in relation to these symptoms, is the “secondary benefit of the disease,” given by the “understanding, love and support” of loved ones who respond to this unconscious [need for] help. Therefore, the “emotional security” for these patients consists of this “protection” from their immediate environment, which then strengthens the need for affection and, at the same time, helps to “affirm” the emotional support they rely on. However, adult patients with these needs neither mature nor grow up emotionally, due to of the nature of this support. This happens because their demands are made from an immature, childish, place in their personality where they are stuck. Emotionally speaking, they are “children.”

They will continue to utilize these coping mechanisms and demand attention and affection. If there is no suitable treatment, they will get into a vicious cycle which they will never be able to stop, that may also be “strengthened” by the overprotection of some of the people who surround the patient. (Chicory features have many stages of development.) We can give a child “everything” and ask nothing of him in return. We should remember what Dr. Bach expressed when referring to this issue: fatherhood is a sacred task but temporary. If we observe the behavior of children with phobias, though in some ways “normal” according to their stage of life, we can see how a mother’s hug particularly, calms night fears, or the fear that comes in the middle of a nightmare. In other words, love is the great healer of fear , and we could say of all other suffering. When the child feels content, protected, and “nourished,” his fears fade away, he grows up feeling safe and confident and when he becomes an adult, he will be responsible for himself.

However, the time of needing protection and caring by others has hung on too long for this type of patient, who continues with their infantile demanding behaviors, yet, without satisfaction and without being responsible for the actions adult life requires. We well know that, despite all the needs they may suffer, Chicory-Heather personalities are “insatiable.” This means, they suffer dissatisfaction even when they receive the highly sought affection because of their disability of incorrectly “metabolizing” the feelings received from others.

Therefore, we can see that this type of patient has achieved an adulthood we could describe as “incomplete and immature,” carrying with them their emotional needs, which surely will appear again under certain circumstances. Thus, these patients will continue to utilize indirect ways or coping mechanisms to be assured that they maintain the emotional protection they desire. At the same time, this will also reinforce their regressive behaviors.

Fear, in its many expressions, is an extraordinary means to fulfill these types of needs, especially if other symptomatic manifestations have not worked. These strategies are understandable for the children I have cited as an example, since they are still developing their personalities—but, only up to a certain point.

There are many Chicory-Heather patients who have other physical or psychological symptoms which are enough for them to exert their control over, and make demands on others. But, this hope of “finding” an illness to achieve such purposes disappears in a hypochondriac patient due to the result of the diagnoses, so he has to resort to his fertile imagination and to his fears to “change the symptoms” or “create a new concern,” always based on his self-centered attitude. We can easily see how the hypochondriac patient improves in the company of his friends, family members or any person important to him. On the contrary, if he lives alone and if someone who has come to visit him must leave, “it just happens;” he begins to feel some type of disturbance or pain.

We can say that hypochondria is a special type of phobia, where fears are not revealed or expressed as in the case of simple phobias, but the “points of focus” are internal and linked to the body, even changing their position from one organ to another. Narcissism increases and is clearly evident in the excess of self-centered behavior when the patient speaks about his own problems. (Heather)

In some cases, the obsession with having an illness also includes primitive “magical thinking.” (Aspen-Crab Apple) We can see this clearly in patients who do not want to even hear the name of a particular disease (particularly cancer), for fear of contracting it. Even in cases of infectious and contagious diseases, magical fears are very intense.

Crab Apple

I remember a patient, who was very obsessive with the thought of getting AIDS and threw away a pair of new shoes because one of them had a red spot on it. He presumed it was a spot of blood and he thought, “I could contract the illness from it.” However, neither this behavior nor anything else he could do, would release him from his fears, because the magical thinking reinforced them.

There may be several fears that manifest: for example, fears not related specifically to health, even those such as a fear of being robbed or fear of any type of aggression. What I am referring to is the “fear of feeling fear” or “fear of the fear itself” that generally appears with another fear: “fear of becoming mentally unstable.” These varieties of fear could be overcome with Aspen, Saint John’s Wort, Grey Spider Flower, Dog Rose of the Wild Forces and Cherry Plum (to mention some examples).

St. John's Wort
Cherry Plum

Many people with simple phobias, who never experience the intensity of a panic attack, believe they have this type of condition. Sometimes, just the appearance of symptoms such as palpitations, tightness in the chest (distress), and so on, cause the sufferer to “infer” an imminent panic attack was about to happen or the symptoms themselves are confused with the “panic attack,” even though it is not actually occuring at the moment.

In clinical practice, the need for an “antiphobic counselor” is well known, since this presence “enables” the patient to face everyday life situations that alone he would never be willing to face. People with mild phobias usually “need” this type of accompaniment, which is an indirect “aid” and “support,” and which in many cases are a mere act of presence. However, this is preferable to the emptiness that “loneliness” means.

Referring particularly to phobias caused by situations inducing post-traumatic stress, such as an accident, different types of life-threatening violence, robbery, and so forth: we find that emotional demands may or may not appear later on, after the initial symptoms. This will depend on the patient’s prior personality structure before the incident that caused the post-traumatic stress.

These phobias or the consequences that the post-traumatic shock may produce can be treated easily with flower essences. This therapy will shorten the time of recovery, since the patient will not be “anchored” to his problems, because unlike the other cases already described, the symptom is not used as a secondary benefit.

It is very surprising that in most cases of intense phobias, panic attacks or OCD, there are no previous traumatic situations which could “explain” the occurrence and cause of the symptoms.

Clinical cases presented by Dr. Pérez illustrating his observations.

References

Bach, Edward, The Twelve Healers: And Other Remedies, Beekman Books, Inc. (June 1, 1996).

Orozco, Ricardo, Flores de Bach - Manual Para Terapeutas Avanzados, Indigo (February, 2000).

Scheffer, Mechthild, The Encyclopedia of Bach Flower Therapy, Healing Arts Press (2001).

About Dr. Raúl Pérez:

Raúl Enrique Pérez obtained his degree in Psychology at the “Universidad Argentina John F. Kennedy” in Buenos Aires, Argentina in 1977. During the last 17 years, he has specialized in holistic approaches to the treatment of disease using natural medicine resources, including flower essence therapy.

Raúl has participated in many national and international flower therapy congresses as a guest lecturer. He is often asked by many institutions to give lectures and courses about flower therapy and holistic approaches to health care. As a teacher, he has given lectures and courses about flower essence therapy in Buenos Aires, Spain, Uruguay, Brazil, Cuba and Chile.

He has written Bach Flower Remedies; Repertory of Symptoms and Clinical Observations, and “Australian Bush Flower Essences.” He lives in Buenos Aires, Argentina, where he maintains his therapeutic practice and works as a teacher and researcher in matters related to flower therapy, and transpersonal psychotherapy.

Write to Dr. Pérez.


 


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