Interview with Sara Laso: how anxiety influences us

Psychologist Sara Laso Lozano talks about her experience treating patients with anxiety.

Anxiety and stress are present in many of the psychological problems (pathological or not) that we suffer throughout life. Therefore, knowing their nature allows us to better manage this form of discomfort that occurs when stress accumulates too much and is counterproductive.

On this occasion we spoke to psychologist Sara Laso to explain the key aspects to understand stress and anxiety.

Interview with Sara Laso: the influence of stress and anxiety in our lives.

Sara Laso Lozano is a General Health Psychologist practicing in the city of Badalona. She is a specialist in Child and Adolescent Clinical Psychology and in General Health Psychology, and over several years attending to patients with all kinds of problems she has come to see the different forms that anxiety and stress take.

In what contexts is anxiety useful?

This is a very good question, especially considering that for most people, anxiety is a problem.

Anxiety is a response to a stimulus that is considered aversive, dangerous or unpleasant. It would act as if it were an alarm, an alarm that warns us that something is not going well and for what we must put solution.

We could say that although anxiety is considered a serious mental health problem, in my humble opinion, I think it is the best sign we can have to solve those internal conflicts that generate a deep discomfort. Therefore, I believe that anxiety can be useful in any context. Now, the problem lies in its management and how to understand it. The lack of control, the feeling of incapacity when we suffer it, the symptoms we feel and an altered mood, is when we could say that we really have a serious problem to solve.

As there is a point at which stress and anxiety become a problem? Do you think that in our culture of effort there is an attempt to normalize this pathological anxiety by passing it off as a necessary evil?

It is very true that society has normalized the concept of "anxiety", as if everyone suffered from it and even as if it were normal to suffer from it. There are people who consider that we are not exempt from it and we could even say that it is a disorder that doctors routinely diagnose on a daily basis.

Any discomfort that the person may suffer, goes through anxiety diagnoses and overmedication, considering that anxiolytics are the best solution and in many cases, it seems that the only one. We all know someone who takes anxiolytics. If we were to make a count of our closest environment that talks about anxiety as something normal, we would be alarmed.

What are the most frequent stress-related complaints that patients come to your office with in the first session?

The most frequent complaints are of a physical nature. They mention that they have general malaise, chest tightness, tachycardia, dizziness, headache, sweating, loss or increase of appetite, decreased sexual appetite, fatigue and in quite a few cases, Nausea and/or vomiting.

Now, in that first session it is important to find out how they feel emotionally and how it affects them in other areas and most of them feel feelings of hopelessness, demotivation, anguish, low mood, often accompanied by sleep and eating problems.

And what psychotherapeutic tools are most effective to stop experiencing this discomfort?

Personally I work a lot with different relaxation and breathing techniques. Specifically I put a lot of emphasis on diaphragmatic breathing, being one of the techniques par excellence in anxiety and/or stress disorders. It is a technique that seems simple when explained, but when it comes to practice it is where the difficulties come, because it can trigger symptoms of hyperventilation. For this reason it is important to train it in consultation and outside of it.

I do not want to forget that one of the techniques that I practice the most in my practice is Mindfulness. It is very suitable for anxiety and/or stress disorders. Well developed and with sufficient daily practice, the person experiences an improvement in a very short time. There are many studies on Mindfulness that support its effectiveness.

At a cognitive level, I like to work with cognitive techniques such as the ABC model of Albert Ellis that teaches us to visualize what thoughts we have, what we feel and how we act, cognitive restructuring and self-instructions. And finally, to include work around self-esteem, generally affected by feelings of lack of self-control and frustration derived.

What phases does the process of improvement of patients usually go through?

I am going to explain the different phases that the patient goes through until his complete improvement.

The first one is the understanding of anxiety. It is a very important phase and we could say that it is the basis of recovery. It is necessary to understand what anxiety is, why it occurs, to accept it and not to fight against it (the more we face it, the more we lose the battles), as well as to be aware of its responsibility.

Then there is the process of working through anxiety. It is important to learn to use the different relaxation and breathing techniques, as well as using cognitive techniques to stop those intrusive and anticipatory thoughts that anxiety generates. We tend to think beyond, we predict the future and we think we know it, so it is important to use cognitive techniques to manage thinking.

On the other hand, we can intervene by increasing self-esteem. The patient feels a substantial improvement, his self-control capacity improves and he feels that stress and/or anxiety does not dominate him. As a result, his self-esteem is improved.

Finally there is maintenance, the last phase of his improvement. A sufficiently long period of time elapses to decide that the patient is in the last phase of maintenance. Here is where the psychologist must help him to remember the various techniques, help him not to forget the etiology of his anxiety and that his thoughts about it continue to be adaptive.

And in relation to the role of the relatives of each patient... what can fathers, mothers, siblings and the like do to support a person who has anxiety and stress problems?

The most important thing is to begin to understand what is happening. We could say that here empathy and understanding are two essential factors to be able to help the patient.

I usually say that sometimes it is better to listen than not to give advice that can frustrate the patient. You should avoid "that's nothing", "come on, everything will be fine", "you'll get over it in two days", "don't think, you'll see how it works". Such statements or advice provoke frustration in the patient because he/she feels misunderstood.

And if you don't know what to say... embrace it and listen to it!"

Beyond the measures we can take individually to combat excessive stress, how do you think society should change so that this phenomenon is not so widespread?

As we have said before, the problem lies in the generalization and/or normalization of this phenomenon that leads to various psychopathologies, so we should start to emphasize it, to understand that stress is not normal and therefore, there is much that we must change. We would be talking about a social change and this is where we find the greatest difficulty in modifying this situation.

If we were able to change all this, if people were able to accept that suffering from chronic and pathological stress is not normal, they would accept, therefore, to modify their lifestyle, their maladaptive thoughts and the way of dealing with the various problems that life puts in our way.

So... What should we do? Think that education does not only help us to learn that 2+2 are 4. Education begins to support emotional intelligence, teach children Mindfulness techniques, relaxation and breathing techniques. This is the key.

If we develop emotional intelligence and how we should manage our emotions and our daily lives from the time we are born and are small, later generations would modify their way of living and this chronic and pathological stress would end up being a phenomenon of the past.