A Guide to Anxiety Theory

A Guide to Anxiety Theory

Anxiety is a normal and natural process. Actors often refer to the fact that being nervous before going on stage improves their performance, and certainly it is the case that a reasonable level of anxiety before a test, for example, is likely to result in better preparation and therefore a better result.

So what causes anxiety, in whatever form, to reach a level that is disruptive and longer a benefit?

Here are some theories. I present these as possibilities and have no strong beliefs around their ”truth”. Some people believe that one or other theory is THE answer, but I prefer to be open to possibilities. I feel it is also likely that for most cases there are a mixture of causes operating on different levels.

Preparedness theory

One theory of the aetiology of anxiety disorders, particularly specific phobia is that they are an inevitable part of our biology, hard-wired into our brain through the process of evolution, a vestige of the times when seeing a tiger in the wild told the ancient man to run, and run fast.

The theory suggests that we are prepared to be afraid of things that are a danger. This can be demonstrated in an experiment where a shadow in the shape of a hawk is passed over the cage of a chick which has been isolated since hatching. The chick panics. However, it does not panic if the shape passes over backwards: ie it “knows” which way a hawk flies!

Humans, therefore, have a whole range of things that may cause fear, and we learn one way or another at what level that fear is appropriate. For example, we may have an in-bred fear of dogs due to the danger of wild dogs centuries ago, but someone raised with dogs in a secure family home is likely to push that fear down to a low level, whereas someone who has a bad experience with a dog may push the fear up the scale.

Conditioning theory

Perhaps the most prevalent theory in anxiety research is the theory of conditioning. That is that a person “learns” that something is to be feared through experience. This experience may be a one-off experience of may be something that is repeated. Experiments have shown that phobias can be instilled in this way. Either the experience is in itself unpleasant or frightening or it is associated with something else that is unpleasant or frightening.

For example, if a child is repeatedly locked in a cupboard for being naughty, they are likely to be scared and may generalise this experience into a fear of small spaces. Another person may be fine with small spaces until being stuck in a lift just once. Someone else might take an experience of being unable to get out of a theatre when they needed the loo and generalise this to a fear of being trapped.

Conditioning theory also fits for some cases of social phobia in that the person learns from their experience that certain situations lead to embarrassment or rejection or some other sort of difficulty.

The Match-mismatch theory

This theory is based on the idea of the subject having an inaccurate expectation of the fear that a situation may provoke. This can work both ways in that an underprediction tends to be followed by an increase in predicted fear. Also fearful people tend to over predict.

Avoidance behaviours and anticipatory fear are influenced by mismatches.

Psychoanalytical theory

In some forms of psychoanalysis, there is a belief that anxiety states are the result of repressed emotion, usually from childhood. The emotion, which is often thought to be a result of something sexual, is too strong for the child to cope with, thus it is repressed. The mind however, makes a symbolic representation of whatever caused the emotion and causes a symptom or symptoms as a result.

The theory states that this original emotion must be found or symptom substitution will occur. In writing this course we searched the psychological literature for evidence of this. The only studies we found which reported symptom substitution were in cases of severe eating disorders and tourettes syndrome. Most studies found symptom substitution did not occur. Also one paper found that by giving full consideration to the concept of secondary gain, symptom substitution was avoided.

One study refers to symptom substitution following “sudden removal of symptoms with hypnosis”. As will be shown later, I do not advocate any such  sudden removal of symptoms.

There is an important difference between this theory and the others. This is the relevance of the symbolic connection. That is that the source of the anxiety may not seem to have any connection to the state produced. For example, a person with a phobia of spiders may not even have been anywhere near a spider when the original event occurred, but later the subconscious mind linked the two together.

Learnt behaviour theory

This theory is similar to the conditioning theory, but with a difference. That is that here, the subject has learnt from someone else’s experience that an anxiety state is to be expected.

For example, a boy’s mother is phobic of snakes. She screams every time one appears on TV. The boy learns that snakes are to be feared and copies the phobia.

This can also apply in other anxiety states. For example if it is the way of the family to avoid social contact then this behaviour can be internalised as “the” way to be.

Short term causes

The above theories all predominantly focus on the causes of long term anxiety states. However, there can be other factors which trigger anxiety disorders in a more acute way:

·       loss

·       change

·       drugs

·       medical conditions including hypoglycemia, hyperthyroidism, mitral valve prolapse and cardiac problems.