Experiencing the same problems repeatedly? Why it happens and what you can do about it.

MAINTENANCE PROCESS

 

A maintenance process is a psychological process that perpetuates a problem. It is a vicious circle that begins with the initial thought, behaviour, or even a physiological response that creates a result which continues the problem. For example, an anxious client may feel their heart racing and blood pressure rising. They may infer that they're having a heart attack, when in fact it is a panic attack. They then panic, because they think they're seriously ill.

We engage in different types of maintenance processes which cause problems to continue for us.

 

SHORT-TERM REWARDS

 

Humans have evolved over time to be more motivated by short-term rather than long-term consequences. Negative behaviours are often the result of positive short-term rewards, even though the long-term consequences may be negative. Addictive behaviours are relevant here. A classic example is smoking. You know it's dreadful for your health and is associated closely with heart disease, heart attack, stroke, vascular disease, lung disease and pneumonia, but you make a choice to continue. You might tell yourself that smoking relaxes you and the anxiety you feel has to be controlled by nicotine. But you also know the anxiety is perpetuated by the withdrawal of nicotine. The same idea applies to over-eating, substance and alcohol abuse.

 

Here, you can ask yourself, what do I gain from continuing with this behaviour? What is important to me in the long-term? Is this behaviour taking me closer to my goals in life?

 

SAFETY BEHAVIOURS

 

Safety behaviours are carried out because you fear a disaster is going to happen. As a result, you do something to avoid that disaster, through directly avoiding it, escaping from it or subtly avoiding it. For example, if you fear social settings, you might avoid going to parties. This reduces the anxiety you feel about facing people and sends you the message that this is a good strategy to manage the anxiety. In reality, you never face that fear and never get to find out what unhelpful beliefs are holding you back.

Of course, there are times where you would engage in safety behaviour to avoid injury. For example, you may choose not to take your car onto the motorway, because the tread looks too thin and instead decide to take it to the garage. In this case you're reducing your anxiety and avoiding the risk of injury. In the case of the social anxiety above, you're trying to prevent a feared catastrophe. There is no risk to life, but you fear facing people. In the latter case, you could consider challenging your anxious thought with something more helpful. For example, you could ask yourself, "what's the worst that could happen in this social setting?".

 

PERFORMANCE ANXIETY

 

This is a social anxiety where you worry about how you are going to perform in front of other people. It could be to do with delivering a speech, sexual performance or eating in front of others, for example. The worry creates anxiety which leads to decreased performance. In the case of eating in a restaurant, this nervousness may create clumsiness and cause you to spill food or drink, again reinforcing the idea that you shouldn't eat in front of others.

Again, if you avoid a situation because you're worried about your performance, you are reinforcing the idea that there is something to fear and the fear just gets bigger! Each of the above examples has its own potential solution, but it all comes back to challenging your thoughts. Perhaps you could think about what there is to gain by working through your fear? Or what do you gain by worrying about your performance?

 

REDUCTION OF ACTIVITY

 

Someone who is experiencing depression may hold negative beliefs about being active. If you're in this situation, you may tell yourself, “I'm not going to meet my friends, because I don't want them to see me depressed”. Your activity levels reduce and as a consequence, there is less social contact (or less activities that used to give you pleasure). You feel depressed as a result and so the cycle continues. Again, you can challenge this thought. "What is the worst that can happen if I meet my friends today?" "What is the best thing that could happen if I meet them?" Challenging your thinking pattern causes you to reassess how you see the world and reminds you of the opportunities available to you.

 

CATASTROPHIC INTERPRETATION

 

This brings me back to the example of the panic attack. A cognitive or physiological event is signalling a disaster to you. In this case, both the misinterpretation of the symptoms (increase heart rate, rapid breathing, high blood pressure and sweating) and the anxiety they cause, lead to these symptoms being perpetuated. Therefore, your mind runs away!

What could you tell yourself at this point? If you are having a panic attack, it is difficult to think rationally (I speak from experience here!), therefore preparation could help. If you know you're prone to panic attacks, you could think through what options you have when they hit. How can you make yourself safe? Who can you contact for help? What are the symptoms of a heart attack, so you can identify if this panic attack is the same or different to your usual ones?

Of course, let's be clear, if you're having recurring pain in your arm or chest pain or any other symptoms of a heart attack, of course, you need to dial emergency services immediately.

 

SCANNING (HYPERVIGILANCE)

 

Scanning/hypervigilance is when you develop a high level of awareness or vigilance. You become obsessed with perceived threats, you overestimate the level of danger in situations, your heart rate and blood pressure increase and you become edgy. Hypervigilance is common where people experience post traumatic stress disorder (PTSD), generalised anxiety disorder (GAD) or schizophrenia.

It's common for hypervigilant people to worry about health and become anxious about symptoms of a disease. In looking for symptoms, you notice exactly what you're looking for and perpetuate the illness, real or imagined. These symptoms might be normal, but they are enough to confirm your worst fears. Hypervigilance creates a perpetual state of fear in you and doesn't protect you from danger. It causes you to be accident prone and to make mistakes. It also distracts you from the positive things that are happening in your life.

 

For example, if you have a head injury, you may experience concussion symptoms. This can make you feel anxious. As a result of the anxiety, you may start to Googling to check for concussion symptoms. You notice that loss of speech and forgetfulness are common. Now every time you pause mid-sentence, you may panic that you've forgotten your words. You may interpret the situation in a negative way and this continues the idea that you are unwell, which is not necessarily true. Relaxation techniques such as meditation can be helpful for these situations, as can challenging your thoughts about the perceived threat.

 

SELF-FULFILLING PROPHECIES

 

In this situation, you think something is going to happen and therefore you make it happen, reinforcing your opinion. Let's say you have been invited to a social event and have decided that the only reason you've been asked is because your best friend is going and the host felt they had to invite you too. You decide you're not really wanted and ignore the invitation. The next time the host organises a social occasion, you don't get invited. This reinforces your idea that they didn't want you there in the first place, when in fact, maybe they decided not to invite you because you didn't respond last time. You've created the situation by your actions.

 

The way to manage this is to think about ongoing themes in your life. Do you tend to keep getting into relationships but they never last? Do you go from one job to another but never feel appreciated in any of them? Self-fulfilling prophecies run deep and often stem from how we were treated in our family growing up and the lessons we've learned about that. If you repeatedly find yourself in negative situations, ask yourself, "what are my expectations here?", "are they realistic?", "what would a friend say to me about this situation?". You may spot some negative thinking patterns, which can be challenged with cognitive behavioural therapy (CBT).

 

PERFECTIONISM

 

If you're striving to be perfect and always meet your own high standards, you'll never be able to maintain that in the long-term. Life gets in the way and eventually your ill health caused by perfectionism will also get in the way! It's a common pattern maintained by people with low self-esteem and failing to consistently meet these high standards reinforces that low self-esteem.

Instead, ask yourself what you gain by setting yourself such high standards? Is there another way to meet this need instead of striving for perfection?

 

SUMMARY

 

You'll notice a common thread in all the situations above. They involve someone feeling anxious, fearful or panicky about a situation. Thankfully, they also can all be overcome by changing your thinking patterns. Cognitive behavioural therapy (CBT) is ideal as a solution to perpetual problems. If you'd like guided through CBT to help you with an issue that's troubling you, please get in touch to book an appointment.