Why We Develop Anxiety with MS and What We Can Do About It, Part II of II

In Part I of my two-part series Why We Develop Anxiety with MS and What We Can Do about It, I described the stressful events we experience starting from the onset of disease that can plant the seed of anxiety as our lives grow more complicated and unpredictable.

The unpredictable nature of RRMS and the good/bad days we have that happen without warning can act as glue that cements the gas pedal to the floor of our terrified feelings, making it impossible to ease up the pedal on our racing thoughts. While there are plenty of valid reasons to worry when we have a relapse—such as wondering whether our disabilities will resolve completely or partially--there is a difference between responding to stress and responding to anxiety.

John Tsilimparis, MFT, an existentialist therapist, explains the difference between stress and anxiety as follows:

Worrying about confrontation

Keeping our MS a secret at work, for example, can also keep us in a state of constant fear (anxiety) that we’ll be found out and fired. A stressful event at work can trigger that fear. Let’s say you arrived at the office late that morning because you hit heavy traffic. When your boss walked past you in the hallway, she seemed to give you the cold shoulder. You worry that tardiness was the cause of her dismissiveness, and that she will judge you as unreliable and therefore unfit for your job. In reality, that might not be what she’s thinking at all. But you are convinced she’ll eventually call you into the office and scold you for your lateness, then fire you. You coast through the day with a roaring sound in your ears from your racing heartbeat, pretending that you aren’t dying inside worrying about that confrontation. Your inner voice might say something like:

See? I’ll never be able to hide my MS. I always do something to ruin things and make my life worse. I don’t deserve to keep a job, I’m too much of a lazy wuss. I have to be more disciplined and always be on time without making stupid mistakes so people will like me. Now I’ve really gone and done it. I’ll never work again.

Rebuilding your identity

Tsilimparis goes on to explain that anxiety as a chronic disorder erodes our core values, creates low self-esteem, and ultimately, a loss of identity. But we can rediscover those values and rebuild identity by discarding the false narratives that keep us in constant fear and telling ourselves some new ones that are more in line with reality. Here is a narrative choice that I could try on myself the next time I arrive late to anything:

I was late this time but that doesn’t mean I’m a bad person. It happens sometimes. And if somebody does confront me about it, it isn’t the end of the world. I’m not going to get fired/rejected/dropped as a patient. It’s going to be all right.

Choosing new behaviors

In his book Retrain Your Anxious Brain: Practical and Effective Tools to Conquer Anxiety, Tsilimparis incorporates existentialist thought by describing our individual sense of identity as a continuous discovery of life’s meaning through personal experience. As a practitioner of cognitive behavioral therapy, his approach to reprogramming our fearful thoughts is to alter the fixed thoughts that can cause anxiety. Vital to reprogramming our narratives is what he calls challenging the idea of consensus reality, which is what we are convinced is the reality of others to which we must conform, and which has nothing to do with what we really think or believe or feel. When we are free of such bonds, we can find our unique identity and consciously create our own reality. Simply put, if we think new thoughts, we can feel new feelings and choose new behaviors.

Tsilimparis writes that our goal is extreme acceptance.—He describes that as a universal coping skill, an ongoing process to stay flexible and tolerant of whatever the world throws at us.

Extreme acceptance is ultimately tied up with that of our own imperfections. “We are all exquisitely flawed,” he writes. And that is what makes us all unique.

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