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To the family and friends of people with extreme anxiety...

Being a family member or friend of someone who experiences significant anxiety is often very challenging as there is often a relentlessness amount of irrational thinking that most probably impacts your life an awful lot.

It can be even harder when the individual with the anxiety is aware that their thinking is irrational, but struggle to change their behaviour regardless.

Have you ever lent back on a chair when the balance is lost and the chair begins to fall backwards? I have heard people explain how living with extreme anxiety is like living life in that split second. It is important for us to make these sorts of connections so that we can appreciate that it is not just a case of ‘not worrying’ because every ounce of their body is screaming fear at them.

Family and friends can often get drawn in to providing the individual will reassurance, tolerating hurtful comments, and repeatedly changing their behaviour to make the situation easier for the other person.

It makes sense that you might do this because it probably makes day to day life easier for you too. Easier for you because you avoid a battle of wills surrounding the behaviour, and easier for the other person as they have fewer situations to tolerate. Unfortunately, this only makes things better in the short term; in the long run it’s likely that resentment and frustration will begin to build as your life subsequently becomes narrowed as a consequence of these demands.

It’s also worth saying that some of the biggest therapeutic struggles come with clients whose family and friends have largely colluded and supported a range of safety behaviours. For example, the family member who takes all their clothes off in the porch and changes into fresh ‘house clothes’ before entering, or the partner who will stop whatever they are doing to immediately take their loved one to where they want to go in order to relieve their anxiety.

Bottom line is, boundaries need to be set! Boundaries that respect the difficulties and frustrations that you are both experiencing.

Boundaries are best set collaboratively so they are not used, or seen as a form of punishment. The best thing a family member or friend can do is encourage the individual to get professional help and support, but in the meantime it is important that people with anxiety try to tolerate some anxiety and this requires them to experience a manageable amount of anxiety on a regular basis. Without this, safety behaviours gather momentum and get bigger and broader.

What is tolerable for one person is not tolerable for the next and so between the two of you, you have to decide on where to start. A good place to begin is deciding what behaviours you both consider to be unacceptable, and agree how you should respond when this behaviour shows up.

Responding to your loved one could mean using phrases such as “I understand how you are feeling about this…” or “I recognise that this feels awful for you however…” before placing some boundaries on the request i.e. “it is not ok to talk to me like that and I am going to give you some space” or “we agreed that this wasn’t acceptable”.

Starting to build your loved one’s tolerance to some anxiety allows their mind to learn that it might have overestimated the risk and that perhaps if this was true for this situation, it could be true for some of the other situations it also sees as high risk.

I would love to hear your thoughts on this blog and would like you to share your experiences of setting or receiving boundaries.

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