lesson 3 Anxiety
Case Study … 1 案例研究… 1
Steve is a handsome man in his mid-40’s. As a child, he was always considered to be shy. He developed social anxiety as he grew into his teen years. He would often feel overwhelmed with dread whenever he was is a social gathering. Steve has always been afraid that he’d say or do something to embarrass himself in front of others.
Stephanie is a 29 year old divorced mother with two children. She was divorced a year ago after her husband decided to leave her for a co-worker. Soon after the divorce Stephanie started having a lot of headaches. She also began to experience headaches, was irritable, and found herself losing her temper at the children. Recently, she began to have shortness of breath, heart palpitations, and a tingling sensation in her hands.
Terms/Definitions … 2 术语/定义… 2
Anxiety is a continued state of fear. Feelings of dread, worry, and stress also arise in the individual. If a person is overwhelmed about work, family, or life event – even if there is nothing particularly stressful happening – this person may likely have an anxiety disorder.
Fear and anxiety are not necessarily the same. Fear is a response to a direct threat. For example, a person is walking down a dark sidewalk and someone threatens to rob him. That is a direct threat. Fear triggers an autonomic response in the brain to fight or flee from dangerous situation.
Anxiety is a response to a possible or perceived threat. The same individual walks down a dark sidewalk and feels uneasy about the potential reality that a stranger might harm him – that is anxiety. (NIMH, 2016)
Causes/Character … 3 原因/特征… 3
Anxiety can be caused by a number of factors:
Trauma – a current situation appears to be similar to a past pain or hurt
Modeled behavior – parents may have displayed anxious tendencies as they coped with stress
Physical health – blood sugar imbalance, over-working, lack of sleep.
Daily events – over-scheduled pace, repeated viewing certain TV shows or watching graphic news clips.
Symptoms of anxiety can include the following:
Nervous, restless or tense feelings
A sense of impending panic or doom
Increased heart rate (palpitations)
Breathing rapidly (hyperventilation)
Feeling weak or tired
Trouble concentrating on anything other than the current worry
Counseling Advice … 4 辅导建议… 4
Relationship fears are very common with people suffering from anxiety disorder. These may include: fear of rejection or abandonment, fear of not being understood, fear of being judged, fear of being alone, fear of loss, fear of change, fear of aging, fear of being overwhelmed, fear of being ignored, fear of lack of control, and fear of failure. (NIMH, 2016)
Explain how these fears could lead to anxiety.
Phobia vs. Fear: Phobias are a consistent, excessive, and irrational fear of specific things. A phobia will also interfere everyday activities.
Anxiety is generally based on an irrational belief that people establish about a particular thing, event, or activity. Since anxiety is often a learned behavior, it is important to help the person that their irrational fears are not necessarily going to come true. Encourage an anxious person to move their focus from internal feelings to external observations. (Corsini and Wedding, 2008)
Steps to Follow … 5 遵循步骤… 5
1)Be renewed in your mind. Philippians 4:8 and Ephesians 4:23 offer Scriptural guidance in this area. It is important to assist the client to learn to “re-think” what is true and real. Most fear, anxiety, and phobias are based on illogical thought-patterns. Help the client to focus on God’s promises in his Word regarding his providence, protection, and eternal salvation in Christ Jesus.
2)Gradually move ahead. This requires patience and trust. As a counselor, you need to remember that anxiety develops over a period of time. Changes and forward progression will also develop slowly over time. Consistent, patient encouragement is a vital attribute for a counselor in dealing with someone with anxiety disorder.
Light on the Path … 6 路上的光… 6
Read and React. Read the passage and answer the following questions:
Look at these phrases from Psalm 37:3-7. Notice a progression and pattern. Look at each phrase and the underlined word. What comfort does each of those phrases offer to an anxious heart? What pattern is provided that someone struggling with anxiety could apply to daily life?
3 Trust in the Lord; 依靠耶和华；
4 Take delight in the Lord, 以耶和华为乐，
5 Commit your way to the Lord; 当将你的事交托耶和华；
7 Be still before the Lord 你当默然依靠耶和华
and wait patiently for him; 耐性等候他；
Proverbs 3:5-6 – Trust in the Lord with all your heart and lean not on your own understanding;6 in all your ways submit to him, and he will make your paths straight.
箴言3:5-6—— 你 要 专 心 仰 赖 耶 和 华 ， 不 可 倚 靠 自 己 的 聪 明 ， 6在 你 一 切 所 行 的 事 上 都 要 认 定 他 ， 他 必 指 引 你 的 路 。
It’s been said that anxiety is a perceived, irrational, intense fear of unknown, everyday events. Explain how the Proverbs 3 reading offers insight as to how a believer might deal with anxiety.
Some Mindful Questions … 7 思考问题… 7
When do you find yourself afraid?
What causes you the most anxiety?
When do those feelings go away??
Do you find you are more anxious at different times?
How long have you felt this way?
How would your life be different if this anxiety went away?
Now, it’s Your Turn … 8 现在，实例练习…8
Choose one of the case studies provided. Apply the concepts we’ve learned in this lesson to the vignette:
Steve is a handsome man in his mid-40’s. As a child, he was always considered shy. He developed social anxiety as he grew into his teen years. He would often feel overwhelmed with dread whenever he was is a social gathering. Steve has always been afraid that he’d say or do something to embarrass himself in front of others.
Stephanie is a 29 year old divorced mother with two children. She was divorced a year ago after her husband decided to leave her for a co-worker. Soon after the divorce, Stephanie started having a lot of headaches. She also began to experience headaches, was irritable, and found herself losing her temper at the children frequently. Recently, she began to have shortness of breath, heart palpitations, and a tingling sensation in her hands.
1)What are the symptoms of anxiety that you suspect?
2)How would you help these individuals focus on external surroundings rather than internal feelings?
3)What steps would you suggest to help these people face their fears?
4)Why is patience so important when dealing with anxiety disorders?
5)What is the difference between phobia and fear?
Corsini, R.J., Wedding, D. (2008) Current Psychotherapies 8th ed. Belmont, CA Thomas Higher Education.
National Institute of Mental Health. (2016). NIMH Mental Health Information: Anxiety Disorder. Retrieved