Interview with Catalina Briñez: this is psychological therapy in cases of GAD

Generalized Anxiety Disorder (GAD) is a psychological disorder that affects many people with very different lifestyles; It is an anxiety disorder that is difficult for those who suffer from it to understand, since it is not linked to a specific source of fear or fear, but rather to various life experiences in general.

Fortunately, decades of research in mental health have allowed psychologists specialized in psychotherapy to have been able to understand the functioning and dynamics on which the GAD is based, as well as effective forms of intervention to give it solution. Therefore, on this occasion We have interviewed one of these experts in emotional well-being, the psychologist Catalina Briñez, who will talk to us about generalized anxiety.

• Related article: "Generalized Anxiety Disorder: symptoms, causes and treatment"

Catalina Briñez: the GAD, seen from the perspective of a psychologist

catalina briñez She is a General Health Psychologist and founder and Director of Brilo Psicólogos, a therapy center located in Benalmádena that also offers online services by video call. In this interview she tells us about the characteristics of Generalized Anxiety Disorder and its treatment, based on her years of professional experience helping patients.

What are the main signs that a person is not experiencing simple anxiety, but is developing or has developed Generalized Anxiety Disorder?

To answer the question, we must first clarify that anxiety is an adaptive mechanism that human beings have to face situations that They involve a high emotional demand because they arise from something that we interpret as a risk and we need to have our senses sharpened to be more effective; for this there is a change in neuronal and visceral biochemistry, which allows us to react quickly according to demand.

However, when anxiety begins to be recurring, constant and causes significant discomfort, we no longer speak of "simple anxiety" as you have formulated. your question, we are talking about a condition that includes very uncomfortable physiological symptoms (muscular tension, tachycardia, tiredness, headache, difficulty breathing, to sleep), thoughts that cause you great fear, emotions related to defenselessness and avoidance behaviors which isolate us from the the rest.

These circumstances are a recurring reason for consultation and are usually related to some particular aspect or trigger that is expressed mainly as phobias or panic disorder.

In Generalized Anxiety Disorder (GAD), the discomfort is not due to a stimulus or specific life experience, but to many aspects of life that even include all the vital areas of a person: concern for the family, for health, for the neighborhood, for work, for the economy of the country, for global warming, for wars, for the poverty... generating a very high intensity and frequency of discomfort that does not allow for moments of relaxation, since the mind always has a concern to deal with. As you can see, it is something that causes a lot of suffering and should be addressed.

The 8 recurring signs that I observe in people who consult and may present GAD are the following: Intense worry for more than 6 months without a specific event that caused it. produces, stress, fatigue, irritability, problems concentrating, sleep disturbances, restlessness upon awakening, physiological symptoms (pains in the body, muscular tension etc.).

Is it relatively easy to recognize these cases when people come to consult? What are the reasons for which they complain and refer discomfort in their day to day?

It is not difficult to recognize GAD cases, since they present specific characteristics that can be quickly identified; What is true is that they often present as comorbidities or at the same time as other types of problems. For example, depressive states, traumatic experiences, family conflicts, lack of motivation, insecurity... to mention a few, for which a good differential diagnosis must be made so as not to confuse a GAD with the sequelae of another underlying disorder.

The people who consult usually arrive encouraged by a member of their family or a friend, who are generally the ones who detect that something is not going well. Their main complaint is a constant worry that oppresses their chests, that they are never calm and they don't quite know why, although when they begin to speak they report a number of fears. They also comment that this situation affects their interpersonal relationships and work life, they often feel misunderstood.

As a psychologist, have you detected any common pattern in the characteristics of people who usually develop GAD? Is there a specific profile that is more likely to suffer from this psychological alteration?

They tend to be people with a high level of inhibition (what we commonly call shy people or withdrawn), tend to avoid harm, and therefore do not usually take risks or try things new. They tend to be very aware of their bodily sensations (tachycardia, tension, pain...), people dependents in need of protection and protection, as well as difficulty in adapting to the changes.

A person who presents a predisposition or biological vulnerability to the alertness, which is reflected in high levels of anxiety as a trait, which we measure using tests psychological. Such people often have a more apprehensive interpretation of life since childhood.

What goals do you usually set for these patients once you both recognize that their problem fits with the clinical picture of GAD?

On the one hand, achieving emotional self-regulation. Many times we believe that the problem is feeling fear, but the difficulty is not the feeling itself, but the intensity or degree of discomfort that it generates. When we learn to regulate the intensity of emotions, we can experience a negative emotion without causing me significant discomfort and therefore be more decisive.

On the other, analyze our internal dialogue: detect thoughts that cause us discomfort and propose thinking alternatives that can explain the same concerns but that are more functional.

It is also necessary to learn to deactivate the body's physiological reactions to fear. Negative thoughts are usually produced from a signal of discomfort in the body, and this in turn is given by the biochemistry of our body in relation to stress. Breathing exercises or muscle tension and relaxation, as well as guided relaxations, are usually very helpful.

In addition, you have to face feared situations. Avoidance is often a component of our behavior that maintains our apprehensive interpretation of the world. If, for example, my fear, among many others, is going to a shopping center for fear of getting dizzy or nauseated, even if I have to buy something that I need, if I go several times and I don't feel bad, or I can manage the anxiety, I am giving information of effectiveness to my internal dialogue. This step is usually taken after having developed the previous points.

Finally, it is essential to strengthen emotional ties. Positive and quality interactions with others help us get out of ourselves, which helps take weight off our own feelings of apprehension; generous and empathetic attitudes, as well as feeling support and affection favor emotional intelligence.

And how does psychotherapy usually develop, based on the way you work?

For me the most important thing is to know the person beyond their diagnosis, because according to their individual characteristics, strengths and context, an effective therapeutic strategy is proposed.

Thus, the first step is the evaluation where the person is known, their needs, and the factors that generate the discomfort are analyzed. Later in the intervention, techniques that have proven effective to achieve the proposed objectives are applied, but these are adjusted to the times and individual characteristics. Once the objectives are achieved, there are some follow-up sessions.

Within the sessions, people often find relief by feeling that they can express all their thoughts without fear of judgment; It is a deep interaction where empathy is fundamental since it allows you to propose solutions that really fit the client, which is usually very rewarding.

Assuming that psychotherapy is always a personalized process, what advice do you usually give to people with Generalized Anxiety Disorder so that they apply them in their day to day and between the sessions in which they meet with you?

The activities that are carried out at a general level in daily life are essential for the consolidation of the techniques used during psychological sessions; As you have said, there are various strategies that can only be used according to individual characteristics but also at specific moments of therapy and in specific circumstances.

However, at a general level there are several guidelines that can help reduce anxiety, and they are as follows.

First of all, do physical exercise: whatever you prefer, practice Pilates, yoga, dance, take walks especially in contact with nature or the sea.

Second, take care of food. By eating properly, our energy and physical well-being will increase, therefore the physiological symptoms of anxiety and our attention to them will be reduced.

You also have to socialize: sharing with positive, affectionate people, doing different activities with them decreases the negative or catastrophic charge of thoughts.

In the same way, it is important to practice a hobby. Doing something we really like generates positive affect and on the other hand helps us focus on the present. It can be reading, painting, learning an instrument, cooking a dish that we enjoy... there are various ways to focus our mind on relaxing content.

Finally, take time to breathe. Something as simple as taking breaths to make sure that oxygen reaches the abdomen (diaphragmatic breathing) helps reduce cortisol levels (a hormone that has a great impact on the stress).