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Section 21
Anxiety Response

Question 21 | Answer Booklet | Table of Contents

(See Appendix at the end of this Manual for reproducible Client Worksheet #4)

Here is a sample of diagrams that can be used with clients to help educate them regarding the Components of their Anxiety Disorder. These can be reproduced for a homework hand-out, sketched on a note pad, flip chart, or chalkboard in your session.

Relation of Appraisal to Components of Your Fear

Appraisal: Degree of danger <--> Anxiety
Appraisal: Degree of danger -->Behavioral mobilization

The Vicious Cycle, Incorporating Unpleasant Emotional Feedback (Anxiety),
Unpleasant Performance Feedback, and Unpleasant Feedback

Cognitive Appraisal: 1. Danger 2. Inadequate performing skills <--> Anxiety -->
Cognitive Appraisal: 1. Danger 2. Inadequate performing skills <--> Flaws in performance -->S
Cognitive Appraisal: 1. Danger 2. Inadequate performing skills <--> Negative audience reaction

Primal Responses to Threat

What happens as you perceive danger? Depending upon the nature and the context of the threat, you may show a variety of responses. These patterns appear to be "programmed" and are largely automatic. Therefore, they can be called "primal." They are more innate than the learned or acquired responses that involve more skill and are under voluntary control. Some of your common behavior patterns may be:

1. Fight: If you feel trapped, fight takes the form of protective actions: warding off a blow, attempting to deter further attack by using threatening display or defensive fighting.

2. Flight: Generally the method chosen when you are about to be attacked; this is initiated largely by anxiety.

3. Freeze: Occurs prior to an actual attack. This provides time to appraise the situation before deciding on the type of strategy. The freeze response also prepares you to absorb the impact of an attack. This response tends to occur automatically in the presence of danger and is manifested by general inhibition or stopping of voluntary actions. This voluntary action may include movement or speech as well as your thoughts. It also occurs to prevent hazardous actions, such as walking off a steep embankment.

4. Faint: This may be a response when you feel helpless, overwhelmed, or exposed to mutilation or blood, and associated with a "collapse reaction."

5. Retraction: Drawing back from a dangerous situation.

6. Duck, Dodge, Jump: Evading missiles or falling objects.

7. Clutching, Clinging: Grasping to maintain balance, prevent falling, drowning, and so on.

8. Reflexes: Eyeblink, gagging, coughing.

9. Calling for Help: A spontaneous distress call.

Homework: Your Therapist can help you keep a record of your productive uses of the above Primal Responses.

Personal Reflection Exercise #4

The preceding section contained Diagrams and Primal Response information for your anxiety- disordered clients. Write three case study examples regarding how you might use the content of this section of the Manual in your practice.

Update
Psychological interventions for generalized
anxiety disorder: Effects and predictors
in a naturalistic outpatient setting

Krzikalla, C., Morina, N., Andor, T., Nohr, L., & Buhlmann, U. (2023). Psychological interventions for generalized anxiety disorder: Effects and predictors in a naturalistic outpatient setting. PloS one, 18(3), e0282902. https://doi.org/10.1371/journal.pone.0282902

Peer-Reviewed Journal Article References:
Allan, N. P., Judah, M. R., Albanese, B. J., Macatee, R. J., Sutton, C. A., Bachman, M. D., Bernat, E. M., & Schmidt, N. B. (2019). Gender differences in the relation between the late positive potential in response to anxiety sensitivity images and self-reported anxiety sensitivity. Emotion, 19(1), 70–83.

Banks, D. M., Scott, B. G., & Weems, C. F. (2018). Anxiety, hostile attributions, and differences in heart rate response to ambiguous situational vignettes in adolescents. Emotion, 18(2), 248–259.

Goodwin, B. J., Constantino, M. J., Westra, H. A., Button, M. L., & Antony, M. M. (2019). Patient motivational language in the prediction of symptom change, clinically significant response, and time to response in psychotherapy for generalized anxiety disorder. Psychotherapy, 56(4), 537–548.

QUESTION 21: Primal responses are not voluntary and appear to be what? To select and enter your answer go to Answer Booklet.