Therapy

Anxiety and Anger- The Three Circles View.

In my therapy room I meet many clients who find they have become dominated by anxious feelings, they worry and catastrophise. Frequently they will describe attending to a worry only to find their brain is searching out a new focus for their anxiety; a new problem to pop into the worry slot in their minds. They intuitively feel they need to fight their anxiety, to battle against it in order to overcome it.

Another group of clients I frequently meet are those who are driven. They are often professionally or financially successful and yet they feel something is missing. They may turn to drink or drugs for relaxation. Sometimes they notice their drive seems to be morphing and changing over time into worry and anxiety, or perhaps they frequently feel anger rising over inconsequential domestic events. These clients often feel they need to do battle with their anxiety or anger – to face up to it and push it away once and for all. This desire to fight back against our feelings of Anger or Anxiety, to stand up to them and beat them is a very common response.

Anger and Anxiety are part of our threat response system. They are working hard to look for problems or danger and trigger us to respond. This is designed to keep us safe. Evolutionarily this is advantageous as threat to life is clearly something to be avoided. If we live in a war zone then being, vigilant and acting quickly can keep us alive. The problem comes when we try to fight these feelings to beat them down and overcome them. This rarely works because we are just responding to a threat response with another threat response. We are maintaining ourselves in the unwanted heightened state – frequently becoming more anxious and frustrated at our inability to move on from these feelings.

So, the question becomes how to support clients to see the need for a different response. To help clients move away from their own intuitive response. How can they help themselves to move to a position of calm and safety?

If a client can sense calm and safety, then their body will follow; the brain will reduce the flow of cortisol and increase levels of oxytocin. Cortisol – a stress hormone- not only prepares the body for fight or flight but also reduces our ability to think calmly and logically. Oxytocin increases our feelings of safety and connectedness allowing us to feel relaxed and make informed choices. Once the world is viewed through this more relaxed lens feelings of anxiety are reduced and clients report feeling safe and content.

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Fig 1 The Three Circles Model - Paul Gilbert (The Compassionate Mind – A new Approach to Life’s Challenges 2009)

To stimulate and support this conversation with clients I like to use the 3 circles model (Fig 1.) from Paul Gilbert (The Compassionate Mind – A new Approach to Life’s Challenges 2009). This model shows three interlinked emotional systems. As I facilitate a conversation around this model clients begin to identify and discuss their own patterns. Very often they report moving between the Incentive or Drive System (blue) and the Threat System (red). When we discuss if they spend time in the Soothing System (green) they reflect that they do not. Perhaps they don’t value it as it doesn’t “Achieve” anything. Clients begin to think about the effects of never feeling soothed or relaxed, perhaps not connecting with their friends and family. It becomes clear that the Drive and Threat Systems maintain feelings of anxiety and worry.

I also explain that it is from this soothing space that we can offer ourselves compassion and understanding. It is from this stand point that we can reasonably assess our achievements and feel satisfaction. It is from this space that we can begin to hold tenderness for the behaviours that perhaps we find shameful. In short it is from this space that we heal. Clients usually feel that this holds truth for them; they then become motivated to help themselves spend time in this soothing caring space.

The process then becomes client led as they explore their own next steps. Perhaps reconnecting with their old football or rugby team will support their feelings of connectedness. Other clients are more family focused and decide that cooking with their children may provide a root to their green zone. This exploration is a client’s own journey but key to its conceptualisation is Paul Gilbert’s 3 Circles model.

When supporting clients who have suffered Adverse Childhood Experiences (ACEs) and / or traumatic events moving towards this space of compassion and safety can be the beginning of a journey of healing. The ability to find compassion for one’s self can be very supportive in helping reduce feelings of shame. This can be a key step in a client’s journey towards reducing the effect of triggers and developing their ability to stabilise and regulate.

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