恐慌症、恐惧症和焦虑症：如何应对？

This article contains some excerpts from the workbook “化恐惧为勇气“.

恐惧是婴儿最初也是最常见的经历之一。如果我们的情绪模式是在很小的时候形成的，那么它们就会更强烈、影响更大、更难解决。因此，许多人在应对和解决恐惧问题时遇到的困难，要比处理愤怒、悲伤和其他情绪时遇到的困难更大，而婴儿经历这些情绪的频率要比恐惧低或更晚。

Children can be temporarily frightened by their own unpleasant experiences, but if they feel supported by their parents, their fear will diminish and probably not become a permanent pattern. If parental support is missing, lasting patterns of fear are far more likely to be created. A child who perceives that parents react in calm, confident ways to unpleasant situations, will learn to trust that (s)he would be able to cope too. Children who receive their parents’ support, learn to feel confident when facing life challenges.

然而 如果孩子认为父母胆小怕事、缺乏安全感因此，他们可能会产生深刻而持久的恐惧和担忧模式。从这些孩子的角度来看，如果这些高大、强壮、聪明的人都害怕，那么他们所害怕的东西一定是非常可怕的。如果比孩子更强大、更有经验的父母都无法应对某种情况，孩子又怎么会觉得自己可以应对呢？一些特定的恐惧可以通过这种方式产生，比如对贫穷、疾病甚至蜘蛛的恐惧。此外，还可能产生一种模糊的、持续的、泛化的恐惧，我们称之为焦虑。

心理学家注意到，焦虑、缺乏安全感的母亲所生的孩子往往坐立不安，甚至在婴儿时期就经常哭闹。这很容易是学习焦虑模式的结果。如果焦虑症在生命早期就已形成，那么成年后的焦虑症患者可能就很难找到病因了。

恐慌症发作

 
恐慌症发作是一种非常令人紧张和崩溃的经历。在危及生命的情况下，恐慌是意料之中的；然而，本段的主题主要是明显不合理的恐慌发作，其背景可能不切实际或难以确定。

神经性惊恐发作可由轻微事件引发，甚至没有明显原因。它们可能会引起生理和情绪症状，如：头晕、恶心、过度换气、颤抖、恐怖感、瘫痪，甚至感觉自己快要死了。恐慌症发作一段时间后，会对未来的发作产生继发性恐惧，给患者带来额外的精神负担。

虽然科学无法轻易证明恐慌症发作的微妙心理原因，但忽视这些原因而只关注生理方面的问题并不明智。惊恐发作大多发生在情绪不稳定的情况下，例如公开演讲，这一事实表明，惊恐发作并不仅仅是随机的生理反应。下面的故事就是揭示恐慌症发作的无意识原因的一个很好的例子。

一位名叫坦尼娅（Tanya）的年轻女性经历了她的第一次恐慌症发作，当时和她一起旅行的一位朋友在一个陌生的城市暂时和她分开了。随后，她又经历了更多的恐慌发作，在她从小居住的房子被卖掉后，恐慌发作变得更加常见。在探索这些情况的关键方面时，我们发现 害怕失去控制以及害怕被遗弃的早期经历。幼儿感到被遗弃，但不知道这是暂时的，也不知道为什么会发生这种情况，就会产生一种恐慌感，这种恐慌感在未来甚至会被看似偶然的微小提醒所触发。

类似的过程也可能发生在公开演讲中。恐慌是由对极不愉快的事情的夸张、普遍的预期引起的。这表明黑白分明的认知是儿童的特点。许多人在孩提时代都经历过无助、屈辱和/或失控的时刻，而这个世界上的成年人似乎无所不能、无所不知。儿童会在这种经历的基础上建立永久的恐惧模式。

如何帮助自己

“First aid” in situations of panic attacks can be:

• 转移注意力，专注于环境中的一个小细节（如植物、石头）或自己的呼吸
• 专注于可以分散你对恐惧的注意力的活动，如与他人交谈、唱歌、注意自己的身体动作等。
• conscious thoughts: as our thoughts and expectations, not always conscious ones, direct our fears, it is important to put conscious efforts into redirecting them. Mentally repeat sentences such as “I am safe”, “Everything is all right.”, “This will pass quickly”, “I will be all right” and similar.

然而，这些方法只能带来暂时的缓解。要想永久性地解决问题，你需要从根源入手。要知道，你恐惧的原因可能是你生命最初时期发生的看似不重要的事件，而你可能无法有意识地记住这些事件。我建议你还要努力提高内心对话的质量。这些主题将是本书第二部分练习的重点。

选择一种放松方法并坚持练习，以便在危急情况下能迅速运用。照顾好自己的身体，避免使用酒精、咖啡因和烟草等精神活性物质。这些物质会让人在化学作用的诱导下得到暂时的缓解，但当药效过期时，你可能会感觉比以前更糟糕。此外，上瘾是绝对不可取的。

愿意面对生活和压力. You might need to prepare yourself up front – perhaps even a few days up front – by practicing encouraging yourself, being friendly to yourself, relaxing and imagining to behave in a way you want to. The more experience you create of successfully facing external challenges, the more you will feel that you can cope with future stressful situations.

恐惧症

恐惧症与惊恐发作不同，惊恐发作的诱因和持续时间通常无法预测，而恐惧症通常与对非常明确的物体或情境的恐惧有关，这些物体或情境在现实中并不危险。当面对恐惧症的对象时会产生恐惧感，一般在对象被移除后就会消散。否则，恐惧症的症状就会与惊恐发作相似：突如其来的强烈恐惧让我们感到无助、瘫痪和失控，即使我们理性地意识到这是不现实的。

关于恐惧症的成因有很多理论，但没有一种理论是完全正确的。根据每个人的具体情况，正确的理论可能不止一种：

1. 一些理论推测，恐惧症是 遗传 (that means, something that was a part of our distant ancestors’ genetic heritage, but was mostly bred out of humanity through evolution and now appears only very rarely). This can explain fear of snakes, heights, perhaps spiders and a few others, but not many other, sometimes bizarre phobias, such as fear of long words, fear of crossing a street, fear of a certain color and many other strange phobias.

 

2. 一些作者认为，恐惧症的对象可能是 符号 代表一个人潜意识中害怕或避免面对的情况或感觉。例如，蜘蛛可以象征一张网，它可以象征一种被困住、缠绕和禁锢的感觉。鸟类可能象征着自由；弗洛伊德曾将蛇（以及许多其他事物）与阴茎和性欲联系在一起。此外，还有许多其他的变体没有得到解释。

 

3. 也有可能发展成恐惧症 如果孩子看到父母表示恐慌害怕 of a similar object. Sometimes, if a child experienced parents becoming ill and/or dying, (s)he can develop agoraphobia – fear of open spaces, often fear of leaving one’s own home – as a consequence of fear of developing sudden symptoms of disease and losing control.

 

4. 有时，如狗恐惧症或社交恐惧症（害怕公开演讲、社交接触、脸红等类似症状），恐惧症的对象可能与以下症状相同或相似 最初引起恐惧的情况.最初的恐惧通常来自童年，因为童年的感知具有强烈的情绪和夸张的解释。

 

5. It’s worthwhile to explore the possibility that phobias are based on 童年恐怖经历但是（由于回避的防御机制）、 恐惧集中于环境中无关紧要的细节，而不是真正的原因.如果恐惧的真正原因在于与父母的关系，那么孩子们可能会发现，他们更容易把恐惧集中在恐怖场景中偶然出现的东西上，而不是对自己的父母产生恐惧。这可能无法解释所有类型的恐惧症（例如蛇恐惧症），但可以解释许多恐惧症。

 

探索恐惧症

The last theory above is very nicely portrayed in an example by Martyn Carruthers. One of his clients was diagnosed with agoraphobia. Careful exploration uncovered the real fear as fear of the sound of chewing! Following this fear into the client’s past, he remembered an experience when he was 5 years old and his father took him skiing. While taking an elevator ride, the boy became scared of the height. To “teach him out of it”, the arrogant father took the child by his ankles and held him hanging upside down through the elevator window. All the time, the father was loudly chewing gum. To avoid being afraid of his own father and the feeling he cannot be trusted, the boy unconsciously focused his fear at the sound of chewing.

Another interesting example comes from a man I will call David. He suffered from fear of heights which made his daily life and business activities difficult. When asked if he was afraid of falling or jumping, his answer was: “Of jumping.”

We proceeded exploring this feeling and uncovered deep dissatisfaction with his own personality. David felt he was not good enough – he was not fulfilling other people’s expectations, especially his mother’s, who expected him to inherit and continue the family business. The unpleasant self-image was also rooted in much earlier, childhood years.

第三个例子是一位从小受到过度保护的年轻女性。她的母亲不鼓励她做日常工作，并尽可能地代替女儿去做。女儿从未建立起自信，也不相信自己能够面对成人生活的挑战。她甚至不敢去超市购物。她被诊断为恐旷症，但我想说的是，这样的标签误导了她恐惧的真实本质。

As you can see from these examples, the causes of phobias are diverse and interesting. It is worthwhile to explore them with a qualified person. As the first aid, you can use the approaches described earlier under “Panic attacks: How you can help yourself”.

一种常见的实用方法叫做 脱敏脱敏疗法：缓慢而长期的学习，一开始通过温和的接触来面对恐惧症的对象，然后逐渐接受更强烈的挑战。不过，脱敏疗法并不能探究恐惧症的根本原因，因此最好与探究恐惧潜意识根源的方法相结合。

焦虑

焦虑是一种慢性、持续性的模糊恐惧。它比恐慌要轻微得多，但有些人在大部分时间里都会感到焦虑。焦虑通常不受特定对象或可识别原因的限制。我们可以将其描述为 模糊, generalized fear that something bad might happen, often without a specific idea of what or why. Sometimes anxiety might be focused to a certain type of situations, such as social contacts, yet it remains rather non-specific. It can last for years, sometimes intense, sometimes just “lurking” in the background of consciousness.

Anxiety can be logically associated to earliest experiences in life – since birth to approximately the third year of life (but not necessarily limited to that age). This is the age in which children’s perception of their environment is diffuse and foggy, instinctive and emotional, not focused and analytic.

幼儿并不清楚这是一个什么样的世界，也不知道该对这个世界抱有怎样的期望；他们往往会把自己经历过的一切概括化。如果他们认为自己所处的环境不安全，他们就会产生一种笼统的、模糊的概念，即 "不安全"。 抽象的、无所不在的威胁.这种感知到的危险可能更加可怕，因为它没有明确的定义。如果没有明确的预期，孩子们就可以自由地在头脑中创造最坏的可能情景。

对幼儿来说，这类可怕情况的例子有

• 经历 分居和遗弃 (例如，婴幼儿经常在夜间独自睡觉，他们的哭声得不到回应）；

 

• 情绪紧张或持续 父母之间的矛盾;

 

• 不一致、不可预测的父母或有以下情况的父母 洒狗血 to children’s unwanted behavior

 

• 奢望 父母的行为，或在任何情况下（例如，父母生病或残疾），子女感到他们必须以远远超出其目前年龄的成熟和经验行事。

 

• 与家庭以外的世界（陌生人、电视节目）发生不愉快的经历，尤其是 如果父母没有提供足够的情感支持

 

• 尤其重要： 恐惧或焦虑的家长.

Compared to panic attacks and phobia, anxiety is more likely to be “inherited” through several generations – children learn it through imitating parents. If a godlike, strong and wise parent (from a child’s perspective) cannot cope with the world, how could children expect to learn to do so?

虽然焦虑可能是我们遗传基因的一部分（我们有理由认为，恐惧、谨慎的个体更有可能注意到并避开危险，从而存活足够长的时间以繁衍后代），但环境在焦虑的形成过程中也发挥了重要作用，就像我们的许多其他遗传潜能一样。

面对焦虑

Here is an interesting example by a woman I will call Mary. She described her anxiety as fear of something that in her mind she perceived as huge, threatening black cloud which was radiating malice. We started exploring for more information, and eventually found out that the black cloud was a dissociated part of herself – she was actually 害怕自己不愉快的情绪 and “selfish” urges, which her rigid and uncompassionate early family taught her to condemn and suppress.

Suppressed emotions tend to feel stronger and stronger while striving to break into the consciousness. They might be biological instincts we were never taught how to deal with in constructive ways, or they might be emotions related to childish beliefs and needs, striving to make us pay attention to what those parts of us perceive as important. Many nightmares are caused by suppressed emotions that symbolically “chase” us.

如果这就是我们焦虑的原因，一旦我们关注并倾听这些情绪，一旦我们能以成熟的方式处理这些情绪，焦虑就会在令人惊讶的短时间内消失。理想情况下，我们应该努力消除童年时期的情绪印象，同时在同一时期练习新的、健康的方式来满足我们的情绪需求。

While some people fear that their own emotions might hurt others, more people fear that they would be overwhelmed by shame, fear or guilt in unpleasant social situations, or that they wouldn’t be able to stand up for themselves and act in assertive ways. This fear can fuel generalized anxiety related to social contacts and conflicts. If we avoid such challenges, or if we withdraw and allow other people to treat us without consideration, we learn to expect that we will allow it in the future, too. Thus 每一次新的逃避或退缩经历都会加重我们的焦虑.

如果这是你的问题，你就需要学习支持性的内心对话。你需要学会保持自我，在你可能忘记自己是谁的时候，记住你是谁（以及你多大了）。你还需要找出恐惧的根源，从而将这些恐惧从当前的生活环境中分离出来。最后，你需要温和地开始面对有威胁的情况，这样你才能建立自信，并在将来有能力应对它们。

Pay attention to all the advice in the paragraph “Panic attacks: How you can help yourself”. Long term stress can exhaust your body and influence your physical health, so pay particular attention to balanced nutrition and workout to keep your body in a good physical shape. Amino acid supplements such as tryptophan can support feel-good hormones, while l-theanine, lysine and arginine can lower cortisol (stress hormone) levels.

在应对各种恐惧时，最重要的目标与其说是消除恐惧，不如说是树立信心，相信自己能够应对生活中可能出现的任何情况。这意味着培养对自己的信任，无论发生什么，你都会支持自己，而不是回避自己的情绪。为了培养这种自信，有必要培养 与自己紧密联系.

“化恐惧为勇气” workbook

 
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