Interview with Fontecha & Gayoso: managing anxiety problems

Psychologists Teresa Fontecha and Sonia Gayoso talk to us about the management of excess anxiety.

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

Fortunately, psychology has already been researching for several decades about the most useful therapeutic tools to cope with excessive anxiety in its different forms. DThis interview with Sonia Gayoso and Teresa Fontecha, psychologists with many years of experience in the field of psychology.psychologists with many years of experience dealing with patients with anxiety-related problems.

Learning to manage anxiety: interview with Fontecha & Gayoso Centro de Psicología

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 trajectory of more than 20 years, and is characterized by its wide variety of forms of intervention adapted to different psychological problems, and by 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 alarm weeks?

In a very summarized way, 3 factors 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. Our nervous system naturally prepares itself to face the unknown, something that is totally adaptive, i.e. it puts us on alert and prepares us in advance for possible "surprises" and even threats.

In the last few 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 we had never experienced before and for which we had no reference, which also entailed a high degree of uncertainty.

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

Leaving aside the situation experienced by healthcare personnel and other services considered essential during this crisis, for the vast majority of the population, this reaction that directs us to action (fight or flight) and which is completely appropriate in most threatening situations, does not seem the most appropriate when the enemy is invisible and the only possible action is to "stay at home", i.e.: inaction.

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

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 living this experience as a one-time crisis and an opportunity to learn valuable lessons about the life we want and the goals we set for ourselves throughout our lives.

It is also important to bear in mind 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, nor as before the crisis, it remains to be seen what the "new normality" that awaits us during the coming months will be like at a personal, social, economic, political, etc. level.

Secondly, it is convenient to keep in mind that anxiety responses can appear both in the acute moment of the crisis and in the following months.

And which population groups are most vulnerable to these psychological alterations?

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

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

These people have remained in a state of continuous alertness to the real risk of becoming infected and infecting others, including their own families. These conditions increase the probability of developing symptoms of post-traumatic stress, which can manifest themselves even months after the moment of crisis.

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

Curiously, we have observed among our patients, that those who had already experienced some anxiety problem in the past and had learned to detect and reduce it, have felt especially strong in comparison with other people in their environment. 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 are the long-term consequences of an anxiety disorder?

Anxiety disorders can seriously interfere with people's well-being and consequently with their health. Their long-term consequences can 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 so that in addition to the general malaise, the body becomes more vulnerable to infections of any kind.

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

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

At other times, different types of checks and rituals may develop as the only means of reducing distress at the possibility that something bad is going to happen, from compulsive hand washing to checking over and over again that everything is "in order".

An early approach to anxiety disorders can halt 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?

Yes, in our center we have been giving courses on anxiety and specifically on relaxation techniques for more than 20 years. In recent years, we also offer the possibility of individualized courses, which allows us to adapt the program completely 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 follow-up it is relatively easy to learn these techniques and start to implement them from the first day, so that its benefits are evident from the first moment, improving significantly with subsequent practice.

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. These are 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, significantly increasing the feeling of control over one's own body, which is crucial for anxiety management.

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

In what situations and moments of the day is it more advisable to dedicate a few minutes to perform these relaxation exercises?

The advantage of breathing exercises is precisely that they can be done at any time of the day. There is no need to look for a different place or position, they are simply incorporated as a routine that can be practiced in any situation and that brings greater well-being immediately. Therefore, we make sure that the people who take 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 on the daily activities of each person and the availability of a time and place for practice. In 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 return to the routines at the end of the day with a greater sense of well-being and readiness to rest and sleep.

How long does it usually take from the time you start applying these techniques until you notice results in the 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 practice.

Our work is directed towards two objectives. Firstly, learning to detect bodily signals that indicate an increase in the level of nervous system activation when it occurs and having resources to stop its increase or neutralize its effects immediately.

Secondly, to progressively reduce the average level of general activation of the nervous system during the day, reducing the negative effects of anxiety in the long term and the probability of suffering anxiety crises at specific moments.

In both cases, practice is essential and in our training programs we make sure that each person can see 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 already from the practice of the first breathing exercise.