Interview with Fontecha & Gayoso: managing anxiety problems

Anxiety disorders are part of the most frequent psychological problems, affecting all kinds of people. Alterations such as phobias, panic attacks, generalized anxiety or work stress form part of this category, and there are many situations that can lead to the development of disorders of this type. family.

Fortunately, psychology has been researching for several decades about the most useful therapeutic tools to deal with excess anxiety in its different forms. D.We will talk about this in this interview with Sonia Gayoso and Teresa Fontecha, psychologists with many years of experience dealing with cases of patients with anxiety-related problems.

• Related article: "Types of Anxiety Disorders and their characteristics"

Learning to manage anxiety: an interview with Fontecha & Gayoso Psychology Center

Fontecha & Gayoso Psychology Center is an entity directed by Teresa Fontecha and Sonia Gayoso and located in Santander. This team of psychologists has a professional career of more than 20 years, and is characterized by its wide variety of forms of intervention adapted to different psychological problems, and for offering sessions of between one and two hours of duration. In this interview they talk to us about anxiety problems and the ways in which they can be managed.

In your opinion, what are the sources of anxiety that may be causing the most problems during these weeks of the state of alarm?

In a very summarized way, we can propose 3 factors that can determine the appearance of anxiety in a situation such as the one caused by the coronavirus crisis: a situation of change, high uncertainty and a feeling of loss of control.

Any situation of change can be accompanied by a certain level of anxiety. naturally our nervous system prepares to face the unknown, something that is fully adaptive, that is, it alerts us and prepares us in advance for possible "surprises" and even threats.

In recent weeks we have all experienced strong changes both in our environment and in our activities. In a single weekend we went from a totally normal life to a completely exceptional one. Something that we had never experienced and for which we had no reference, which also entailed a high degree of uncertainty.

This situation is more than enough to explain an increase in activation in our nervous system. Somehow, our brain perceives "that something is wrong" and sets off a whole chemical display in our body that literally prepares for a "fight or flight" reaction that has helped us survive as a species throughout our history evolutionary.

Leaving aside the situation experienced by health personnel and other services considered essential during this crisis, for the immense majority of the population, this reaction that directs us to action (fight or flight) and that is completely adequate before the majority of threatening situations, it does not seem the most convenient when the enemy is invisible and the only possible action is to "stay at home", that is to say: the inaction.

In this way, we not only lose a sense of control over the situation we are facing, but also over the reaction of others. our own body, which is literally prepared for action and at the same time subjected to clear instructions from inaction.

This general description can be found in different particular situations, so that the type of changes experienced, the level of uncertainty and the feeling of control may vary depending on the personal, work, economic, social, family, health, etc. circumstances of each person before, during and after the period of lockdown.

Having good psychological resources to be able to identify the signs of anxiety and manage it correctly can make the difference between developing a long-term disorder or live this experience as a specific crisis and an opportunity to extract valuable lessons about the life we ​​want and about the goals we set ourselves throughout our lives existence.

It is also important to take into account two aspects. On the one hand, in the coming weeks situations of change will continue to occur: the time has come to recover some routines, but not all of them Before the crisis, it remains to be seen what the "new normal" that awaits us in the coming months will be like on a personal, social, economic, political etc

Secondly, it is convenient to take into account that anxiety responses can appear both at the acute moment of the crisis and in the following months.

And what are the population groups most vulnerable to these psychological changes?

We could distinguish three groups of people. First of all, those who have suffered the most dramatic changes and here, without a doubt, are the people who have lost a loved one in the exceptional conditions of isolation at we have been subjected to, and also those who have become ill and have feared for their own lives or that of someone close, with the consequent increase in the sensation of extreme vulnerability.

Secondly, those who have had direct contact with the suffering generated by the previous situations, that is, the health and social services personnel who have been on the front line of action against the virus and its consequences. Not only because of the contact with said suffering but also because of the extreme work overload to which they have been subjected and in many cases, the absence of means for their performance with the guarantees of safety and hygiene necessary.

These people have remained in a state of continuous alert in the face of the real risk of becoming infected and of infecting others, including their own families. These conditions increase the likelihood of developing symptoms of posttraumatic stress, which can manifest even months after the moment of crisis.

Thirdly, some people from the population as a whole who have experienced this situation in very different ways: from those who have felt in a a kind of unreality and denial of what was happening, even those who have experienced the possibility of contagion with deep fear, and especially, who have suffered a serious deterioration in their quality of life for economic reasons, interpersonal conflicts, social isolation, conditions of their own housing etc

Curiously, we have observed among our patients that those who had already experienced some anxiety problem in the past and have learned to detect and reduce it, have felt especially strong compared to other people in their around. This confirms the importance of three points:

Understanding what anxiety consists of, detecting the signs that indicate its presence, learning to manage it by reducing or neutralizing its negative effects.

What long-term consequences can an anxiety disorder produce?

Anxiety disorders can seriously interfere with people's well-being and therefore their health. Its long-term consequences could be divided into three areas.

Physical problems: disorders that interfere with digestive processes, muscular problems, insomnia, tachycardia, feeling short of breath, feeling tired, etc. A high level of anxiety sustained over time can cause a weakening of the immune system by which in addition to the general malaise, the body becomes more vulnerable to contracting infections of any guy.

Cognitive problems: presence of intrusive and recurring thoughts that can become obsessions, fears of different types such as feeling that "something bad" is going to happen, loss of ability to concentrate, memory disturbances, feeling of mental dullness, blockage, etc

Finally, motor-type problems: mainly avoidance or escape behaviors from situations that generate intense discomfort, for example, avoiding social situations with the consequent isolation that could even lead to the development of depressive symptoms, avoidance of open or closed places, trips... even the mere fact of leaving home. Many people find their only way of escape in the consumption of alcohol or other substances, generating addictive behaviors that further damage their health (physical, mental and social).

On other occasions, different types of checks and rituals can be developed as the only means to reduce anxiety before the possibility that something bad is going to happen, from compulsive handwashing to checking over and over again that everything is "in order".

An early approach to anxiety disorders can stop their development and save a lot of suffering in the medium and long term. When the first signs are detected, it is advisable to consult a professional as soon as possible.

At the Fontecha & Gayoso psychology center, part of your services are based on training programs in relaxation techniques. Is it usually easy to learn them in a short time and without previous experience?

Indeed, in our center we have been conducting courses on anxiety and specifically on relaxation techniques for more than 20 years. In recent years, we also offer the possibility of taking these courses individually, which allows us to fully adapt the program to the needs of each person.

This program usually consists of 4 sessions, each with a minimum duration of 1 hour, organized on a weekly basis to be able to practice at home between sessions. In this way we carry out a sequential training, in which the practice of the first exercises facilitates the learning of the following ones.

With good advice and monitoring it is relatively easy to learn these techniques and start putting them into operation from the first day, with which its benefits are evident from the first moment, improving remarkably with practice later.

In our center we take care of guiding each person step by step in learning the techniques, constantly adapting to their needs and difficulties.

Among all the relaxation techniques that are usually used in a psychotherapy center, which are the most useful, according to your point of view?

Mainly, breathing control techniques. It is a series of exercises that once trained can be practiced in any situation of daily life, which marks a before and after in the ability to manage anxiety.

By combining these exercises with other specific muscle relaxation exercises, both are enhanced by increasing significantly the feeling of control over one's own body, which is decisive for the management of the anxiety.

In addition, in recent years we have incorporated into our training program in relaxation techniques, the possibility of learning some basic Mindfulness exercises complementing the acquisition of effective tools for managing mindfulness problems anxiety.

In what situations and times of the day is it best to spend a few minutes doing these relaxation exercises?

The advantage of breathing exercises is precisely that they can be done at any time of the day. It is not necessary to look for a different place or position, they are simply incorporated as a routine that can be practiced in any situation and that immediately provides greater well-being. For this reason, we make sure that the people who carry out our program are able to practice these exercises from the first day of training.

As for muscle relaxation exercises, any time of the day is good, although this depends of the daily activities of each person and the availability of a time and a place for practice. On many occasions we indicate that this could be the time before dinner.

In this way, it is possible to reduce the level of general activation of the nervous system and rejoin the end-of-day routines with a greater sense of well-being and willingness to rest and reconcile work dream.

How long does it usually take from when you begin to apply these techniques until you notice results in your quality of life?

The truth is that the effect of breathing control and muscle relaxation exercises is immediate and once learned, They can be practiced at any time and in any situation, so their benefits are evident from the first days of the practice.

Our work is directed towards two objectives. First, learn to detect the bodily signals that indicate an increase in the level of activation of the system nervous when it occurs and have resources to stop its increase or neutralize its effects in a way immediate.

Second, progressively reduce the average level of general activation of the nervous system during the day, reducing the negative effects of long-term anxiety and the chances of suffering anxiety attacks at any given time punctual.

In both cases, practice is essential and in our training programs we make sure that each person can check the effect of the exercises from the first day of training. It is very gratifying to see how some people are surprised to achieve important states of relaxation from the practice of the first breathing exercise.