An individual's sensitivity to his own negative sensations is the primary focus of the 2008 book, “Overcoming the Fear of Fear: How to Reduce Anxiety Sensitivity”. The authors, Margo C Watt Ph.D. and Sherry H. Stewart Ph.D., are licensed clinical psychologists and on university faculties in Nova Scotia. They draw on their substantial academic publications, as well as the research of their peers, for their book.
The authors define Anxiety Sensitivity as an individual's responsiveness to the physical sensations of being in a stressful situation. The subtle distinction between the sensation of fear or anxiety, and how an individual responds to that sensation, may contribute to the reader's understanding of the complex reactions to stress. A person's Anxiety Sensitivity may be high or low.
High Anxiety Sensitivity (AS)
The authors cite their own work and the work of Bernstein when they estimate that between 10 and 20 percent of the population have high AS. By studying pairs of identical and fraternal twins, researchers at the University of California San Diego found that about 50 percent of the variability in AS can be explained as a genetic trait.
PTSD, Panic Disorder, Depression, and Alcohol or Substance Abuse
Besides Panic and Anxiety Disorders, the authors state that high Anxiety Sensitivity appears to be related to Posttraumatic Stress Disorder, Clinical Depression, and the abuse of alcohol and other substances. Although it is sometimes difficult to know whether AS precipitated or was the result of the disorder, AS has been shown to be a predisposing factor for panic attacks in several studies.
Cadets at the Air Force Academy were given a questionnaire for Anxiety Sensitivity as they started basic training. The cadets with high Anxiety Sensitivity were much more likely to experience panic attacks during their training. In another study, pregnant women who scored high on the AS questionnaire reported more intense labor pain than women with low AS scores.
Criteria for Panic Disorder and Major Depression
The book lists the American Psychiatric Association's criteria (DMS-IV) for Panic Disorder and Major Depression. For each diagnosis, the patient must exhibit a number of symptoms from a short list over an extended period. A few panic attacks or a short period of depression would not qualify as a psychiatric disorder.
Coping with Anxiety
Some of the methods individuals use to try to cope with anxiety are avoidance, distraction, alcohol, prescription medications, and illegal drugs. Watt and Stewart tell us these methods do not work. The book offers only one method to reduce the symptoms associated with anxiety, which is “to expose ourselves to the feared sensations.” The book was highly informative by providing the common “clinical methods” to evoke fear-like sensations, which they call Interoceptive Exposure Techniques. The goal of interoceptive exposure is to reduce the feared sensations with repeated presentation of the stimulus.
Cognitive-Behavioral Therapy and Lifestyle Change
The book covers Cognitive-Behavioral Therapy (CBT) and lifestyle changes in separate chapters. In this reviewer's opinion, the book is a little ambiguous in its use of anxiety and anxiety related phrases. At times anxiety means the worry we generate by thinking negatively about future events. For this type of anxiety, the authors suggest Cognitive-Behavioral Therapy. However, as reviewed in the previous section, the authors feel that the anxiety symptoms that flow from stressful sensations can only be reduced through habituation, the repeated exposure to the stressful stimuli.
The suggestions made in the lifestyle chapter are of a general nature and would improve all aspects of an individual's health, including cardiovascular health and memory.
The final chapter is a moderate-length case vignette that brings together all the principles advanced throughout the book. This final case study is sufficiently long to make the advice “real”.
Recommendation
Watt and Stewart introduce Anxiety Sensitivity in a very digestible volume. In spite of the easy-going style, a host of well-documented information is packed into the work. In this reviewer's opinion, “Fear of Fear” is not a self-help book; rather, it illustrates the type of treatments that are available from professionals trained to handle AS. The book offers insight into human emotion, cognition, and behaviors, helping the reader understand himself as well as those around him.
Sources:
- “Overcoming the Fear of Fear: How to Reduce Anxiety Sensitivity”; Margo C Watt Ph.D. and Sherry H. Stewart Ph.D; ISBN-13: 978-1-57224-558-7, New Harbinger Publications Inc, Oakland CA, 2008.
- "Diagnostic and Statistical Manual of Mental Disorders DSM-IV-TR"; 4th Edition; American Psychiatric Association; 2000.
- Bernstein A, Zvolensky MJ, Kotov R, Arrindell WA, Taylor S, Sandin B, Cox BJ, Stewart SH, Bouvard M, Cardenas SJ, Eifert GH, Schmidt NB. "Taxonicity of anxiety sensitivity: a multi-national analysis". J Anxiety Disord. 20(1):1-22, 2006.
- Schmidt NB, Lerew DR, Jackson RJ. "The role of anxiety sensitivity in the pathogenesis of panic: prospective evaluation of spontaneous panic attacks during acute stress". J Abnorm Psychol. Aug;106(3):355-64,1997
Richard Walloch - Don't believe me because of my education or professional experience. Believe me because of the evidence and arguments I advance.
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