Common Themes In Anxious Fears (Ep 291)

Common Themes In Anxious Fears

Among people that struggle with chronic or disordered forms of anxiety, there are a wide range of individual primary fears or concerns. When you ask a large enough number of our friends what they are afraid of, you’re going to get a pretty wide range of answers primarily because everyone experiences fear, worry, concern, and anxiety is a slightly different way. In this little non-scientific experiment, we find that anxious people – your peers – expressed a wide range of primary anxious fears. I can’t list every one of the individual responses or we would be here for hours, but here is a sample of primary anxious fears that folks expressed.

• Death
• Going crazy
• Passing out
• Psychosis
• Having a heart attack
• Going insane
• Becoming depressed
• Fainting
• Never getting better
• Being embarrassed
• Vomiting
• Losing control
• Hurting their kids
• Schizophrenia
• Choking
• Not being able to cope
• Not being able to handle
• Fear about the future
• Feeling like a failure
• That the feelings will never stop
• Serious illness
• Medical emergency
• Being hospitalized
• Suffocation
• Dizziness
• Blood pressure
• Feeling unreal
• Detaching from oneself
• Dry mouth
• Having symptoms forever
• Needing to get to a bathroom

I could go on and one listing every response. There were quite a few of them.  But the software that I used to run this little experiment groups answers together and creates a word cloud where the most common answers are displayed in large type in the center of the cloud and less common or single answers are in smaller type near the edges.  The biggest words right at the middle of the cloud were:

• Death
• Crazy
• Passing Out
• Heart Attack
• Dying
• Loss of control
• Psychosis
• Suicide
• Cancer
• Going Insane
• Breathing
• Embarrassment

So what do this word cloud and all these fear words and phrases tell us? What can we learn from this? What I really want to point out today is how so many varied and individual responses, when taken together, show us common threads and themes that run through our community.

Immediate Medical/Physical Threat

You might be afraid of a heart attack or suffocation or you may interpret anxiety symptoms and fear as indicating an actual immediate physical or medical threat. Pick a physical sensation or urgent medical emergency that you fear when anxious or triggered.  It almost doesn’t matter what that specific emergency is, it falls under the category of immediate medical danger.  Anxiety creates physical sensations in our bodies. Among people struggling with chronic anxiety or anxiety disorders, these sensations can be interpreted as indicating immediate medical threat or emergency. Welcome to common theme number one!

Immediate Mental, Emotional, or Psychological Threat

Common theme number two is similar, but focuses on immediate psychological or mental emergency or disaster. This is seen in responses that point at a fear of psychosis, insanity, losing control, or becoming stuck in a highly anxious or dissociated state forever. There are lots of words and phrases that speak to this common thread so it might look like there are so many different anxious fears. But for those that live in dread of being mentally broken by extreme anxiety or panic wowever way it’s described this is – according to our little unscientific word cloud – the second most common thread or theme found in anxious or anxiety driven fears. The physical sensations and tidal wave of thoughts and mental/emotional internal experiences are often interpreted by anxious people as indicating an immediate threat to one’s mental, cognitive, or emotional well being.  Here we have common theme number two.

Not Being Able To Cop With Or Handle The Anxious State

Common thread number three is its own thing, but it’s also related to the first two themes we pointed out. In this common theme, the central concept is the fear of not being able to cope with the experience of anxiety and being overwhelmed by it. This might be interpreted physically, mentally, emotionally, or socially but in the end this thread is all about physical sensations, thoughts, and emotions being “too much” to handle, dangerous, or capable of creating uncontrollable disastrous outcomes.

• Anxious people that fear that they will embarrass themselves are expressing the fear of not being able to handle that embarrassed feeling.
• Our friends that fear that they will never get better or will return to previous anxiety related struggles are saying that they fear being unable to adequately cope with how they feel and what they experience when triggered.
• People that fear physical or mental incapacitation are expressing the belief that their bodies and brains will be overwhelmed by anxiety and fear and will break in some way leading to a horrible outcome like death or a permanent psychotic state.
• If you fear bathroom related accidents or vomiting, you will want insist that these are practical, justifiable fears that fall outside the scope of the usual approach to anxious fears, but you are really expressing a strong belief that those experiences are absolutely intolerable and represent un-handleable disasters from which there can be no recovery or rebound.

Specific Outcome Obsessions

Our last common thread that I want to point out from our word cloud will be familiar to anyone dealing with OCD or health anxiety, or even GAD. I tend to argue that there is very little difference between GAD, health anxiety and OCD from an operational standpoint (even though these are different diagnoses) because this common theme in anxious fear is based on becoming fixated on or obsessed with specific outcomes or problems. Often these outcomes are not immediate like they are in the first two common themes.  They may be framed as future constructs, things that might happen later at a specific time or at some undefined point in the future. 

We see these in our word cloud when our friends expressed fear about engaging in acts of harm or self-harm, being unsure about their true sexual orientation, having an undiagnosed serious medical issue, or developing a serious medical issue in the future. The specific nature of the problem leads to mental or behavioral rituals or compulsions designed to alleviate the discomfort associated with fearing that outcome. Continued researching, asking for reassurance, re-thinking and re-analyzing things (rumination) are common examples of this.

What Can We Do With This Information?

As always, we want to look at how we can use this information?  How does it help us?  How might you apply this in your own recovery efforts? There are two primary takeaways that I can identify here.

The first is the age old “you are not alone” thing.  This is true. People who are new to all this often see themselves as uniquely broken or dealing with sensations, thoughts, or beliefs that nobody else has. They feel truly alone in this struggle and might draw the false conclusion that they are beyond hope or that nobody else on the planet shares their experience. Even people who have been at this for a while can begin to think that the length of their struggle is unique and that nobody else could possibly be having the same issues for this long.  In these situations, knowing that you are not alone in your experience can be encouraging, motivating and reassuring. Sometimes this kind of thing can provide a measure of hope and optimism that would be otherwise hard to access.

The second takeaway is more practical.  If you see your anxious fears through a specific lens and have been working hard to address the specific content that frightens you, how might this change?  You may be spending your days trying to determine “how to overcome shortness of breath” or “how to detect or prevent cancer”.  You may be laser focused on your particular OCD theme and working overtime to prove that you will not harm someone or that you really do love your partner or are not a horrible person.

If you could step away from the specifics and recognize the larger theme at play, what might happen?  In the process of overcoming chronic and disordered anxiety, we look for recovery progress that is more durable and long lasting because lessons learned in one context (fear of a heart attack for example) are applicable across multiple contexts (like fear of never getting better or fear of not sleeping). If we lose sight of the bigger picture and remain narrowly focused on the specific content of our worry and fear, we run the risk of trying to improve our lives be learning how to deal with individual obstacles that then seem to continually morph and change over time.

If you see recovery as the act of becoming certain about your status as a good person or your future relationship with anxiety and fear, you may wind up frustrated and confused when “solving” those fears only leaves you with others that have popped up in their place.

Stop for a minute or two.  Zoom out. Notice that you are not the only one having these experiences, and at least consider the possibility that progress might be found in stepping away from the specifics of your fear and instead working on your relationship with fear and uncertainty themselves. 

When someone asks me for tips on air hunger I am often heard to say that it’s not about air hunger, it’s about learning to get better at being worried and afraid.  This is why I say such ridiculous sounding things every day.

Our little word cloud experiment is a good illustration of this concept in action.

Links Of Interest

• All Your Fears Are One Fear – Episode 111
• My Panic Attacks Explained Workshop
• My Agoraphobia Explained Workshop
• My Panic and Agoraphobia Recovery Guidebook
• Follow me on Instagram
• My YouTube Channel
• Disordered – With Josh Fletcher

Disclaimer: The Anxious Truth is not therapy or a replacement for therapy. Listening to The Anxious Truth does not create a therapeutic relationship between you and the host or guests of the podcast. Information here is provided for psychoeducational purposes. As always, when you have questions about your own well-being, please consult your mental health and/or medical care providers. If you are having a mental health crisis, always reach out immediately for in-person help.