Category Archives: Anxiety

Childhood Trauma Linked To Agoraphobia

The term agoraphobia derives from the Greek word ‘agora’ which translates as ‘open place’ or ‘market place’ so ‘agoraphobia’, in literal terms (as opposed to clinical terms) means fear of ‘open places’ or ‘fear of the market place.’

Agoraphobia is listed by DSM V (the Diagnostic and Statitical Manual of Mental Disorders, Fifth Edition – sometimes referred to as the ‘psychiatrist’s bible’) as an anxiety disorder and, in order to be diagnosed as suffering from it, an individual must experience a ‘marked fear’ of two or more of the five following situations :

  • using public transport
  • being in enclosed spaces such as shops
  • standing in a queue or being in a crowd
  • being outside of one’s home by oneself

As a result of this fear, the individual who is suffering from agoraphobia either avoids such situations or endures them whilst experiencing significant distress ; the distress or avoidance are caused by a fear that if something goes wrong escape would be difficult or help may not be forthcoming if panic symptoms or other incapacitating or embarrassing symptoms occur.



Research has found that certain types of childhood trauma increase an individual’s risk of developing agoraphobia such as the death of a parent or being sexually abused.


Research conducted by Arrindell et al. compared in-patient agoraphobics with ‘normal’ controls. All the participants were given questionnaires about how they were parented and it was found that :

These findings were given added weight because of the fact they replicated previous research findings involving agoraphobic out-patients (as opposed to in-patients that were used in the research described above).


Gittelman and Klein, in a paper reviewing research into whether or not there exists a link between agoraphobia and separation anxiety found that there is evidence of such a link in females but not in males ; they concluded from this that it is possible that agoraphobia has different causes in females than it does in males.

Furthermore, a review of research literature carried out by Gwinnett Center for Counseling and Family Therapy found that there was a link between adult agoraphobia and separation-anxiety issues as a child.


  • An imbalance of neurotransmitters in the brain leading to an exaggerated stress-respone.
  • Impaired spatial awareness.

To read about other anxiety disorders which may be linked to childhood trauma, click here.


Overcoming Agoraphobia

Stop Panic Attacks

David Hosier BSc Hons; MSc; PGDE(FAHE).

Childhood Trauma, Social Anxiety And The Spotlight Effect

I have written elsewhere on this website about how, if we experienced significant and protracted childhood trauma, we are at increased risk of developing social anxiety in adulthood. This is especially the case if we have been constantly criticized and denigrated during childhood by our parents / primary caretakers and we have internalized their rather less than flattering negative attitudes. Indeed, once such attitudes have been internalized our bad feelings about ourselves may become self-perpetuating and a kind of self-fulfilling prophecy and we may even develop intense feelings of self-hatred.


According to DSM-5 (Diagnostic And Statistical Manual OF Mental Disorders, 5th EDITION, also known, informally, as the psychiatrist’s bible), the symptoms of social anxiety include :

DSM-5 criteria for social anxiety disorder include:

  • fear and anxiety (which is intense and persistent) about specific social situations because of a belief that if one enters such a social situation others will judge one and one may be embarrassed and humiliated.
  • anxiety or distress that impairs daily functioning.
  • anxiety that is disproportionate to the situation.
  • avoidance of social situations that may trigger anxiety.
  • intense fear and anxiety within social situations that tests endurance.

The SPOTLIGHT EFFECT (Gilovich et al. 2000) refers to a psychological phenomenon whereby we are prone to believe that, in social situations, other people are paying us far more attention than they actually are.

Because of this, we are also liable to believe that we are being evaluated or judged far more than we actually are being (actually, mosr people are much too preoccupied with thinking about themselves and their own problems to be concerned about thinking about us).

The spotligh effect, then, is so-called because, especially if we are self-conscious, highly sensitive and lacking in self-confidence because of the way we have been treated in the past, in social situations we feel as if we are ‘in the spotlight’, whereas, as far as others are concerned, we are not (unless, of course, we happen to be a pop star in front of a massive crowd at Wembly Stadium which, to my profound regret, I never have been).


On the subject of pop stars, in the 1990s an experiment (Gilovich) to do with the spotlight effect was conducted involving a group of random students from which one was, again randomly, selected.

This student was then asked to wear a ‘T-shirt with Barry Manilow’s face on it. Why Barry Manilow? Because in the 1990s he was considered very uncool.

Newly bedecked in his ‘Barry Manilow’ apparel, he was then required to mix with others who did not know he had been instructed to wear the potentially embarrassing garment rather than to have garbed himself out in it of his own volition.

After he had done this, he was asked to estimate how many of those with whom he had mixed had noticed his potentially embarrassing, new, popstar-themed casual wear. He estimated 50%. The actual figure was 25%.


Because we have no choice but to ‘live in our own heads’ each day and interpret the world from our own idiosyncratic point of view, a compelling, but entirely wrong, impression is created within our minds that we are the ‘center of the universe.’


The feeling, then, that we are ‘in the spotlight’ in social aituations is merely an erroneous perception created by our own minds and it is useful for us to remember this next time we feel self-conscious in such situations.

And, anyway, we all secretly love Barry Manilow…don’t we??!!



David Hosier BSc Hons; MSc; PGDE(FAHE).

How Parents’ Anxiety Levels And Behaviors Affect Their Child’s Anxiety

A study involving 98 pairs of mothers and infants (the infants were aged from 12 months to 14 months) was carried out to investigate how the level of the mother’s stress affected the level of the infant’s stress (as measured by the reactivity of their respective nervous systems).


The mothers were separated from their infants before being assigned to one of two groups. The two groups were as follows :

GROUP ONE : The RELAXATION group in which the mothers were helped to relax to increase parasympathetic nervous system (PNS) reactivity (the PNS helps us to be calm and relaxed by, for example, reducing heart rate and blood pressure).

GROUP TWO : The SRESS group in which mothers were required to undertake a stress-inducing task to increase sympathetic nervous system (SNS) reactivity which induces in us the ‘fight or flight’ state by, for example, increasing heart rate and breathing rate.

Afterwards, the mothers from both of the above groups were reunited with their infants in one of two ways :

!) Half the mothers from each group had their infant returned to their laps. The researchers referred to this as the ‘TOUCH CONDITION.’


2) Half the mothers from each group had their infant returned to a high chair next to them. The researchers referred to this as the ‘NON-TOUCH CONDITION.’

Following this, acitivity in the infants’ SNS and PNS was measured and compared to their baseline levels.

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Infants returned to the STRESSED mothers showed significantly increased SNS activity compared to infants returned to RELAXED mothers and this effect was greater in the infants returned to their mother’s laps (THE ‘TOUCH’ CONDITION) than in the infants returned to a high chair next to their mother (THE ‘NON-TOUCH’ CONDITION).


Infants returned to the RELAXED mothers showed significantly increased ANS activity compared to infants returned to STRESSED mothers and this effect was greater in the infants returned to their mother’s laps (THE ‘TOUCH’ CONDITION) than in the infants returned to a high chair next to their mother (THE ‘NON-TOUCH’ CONDITION).


The researchers inferred from these findings that :

  • feelings of stress can be transmitted from mothers to their infants, particularly through touch.
  • feelings of calm and relaxation can be transmitted from mothers to their infants, particularly through touch.

These findings confirm what most mothers know instinctively.

How Parents Can Help Their Children Manage Their Anxiety ;

Research carried out at the University Of Lisbon (2017) conducted an interview based study that involved parents being asked to describe what strategies they employ to help their children reduce their feelings of anxiety.

The information collected from the study allowed the researchers to identify seven strategies that were UNHELPFUL (and that could potentially intensify the child’s feelings of anxiety) and, also, three strategies that were HELPFUL (and that were likely to ameliorate the child’s feelings of anxiety). I outline all ten of these strategies (the seven ‘unhelpful’ and the three ‘helpful’) below :


  • Reinforcing depenedence or avoidance.
  • Over-involvement (including being over-protective and being excessively controlling).
  • Negativity (e.g. blaming, criticizing or punishing the child)
  • Helplessness
  • Anxiety
  • Unrealistic Reassurance
  • Passivity (e.g. unresponsiveness to the child’s anxiety)


  • Helping the child to problem solve (e.g. developing plans to deal with the cause of anxiety or to cope with the anxiety
  • Encouraging the child to be brave
  • Providing the child with emotional support


Overcome General Anxiety for Kids | Self Hypnosis Downloads. CLICK HERE.

David Hosier BSc Hons; MSc; PGDE(FAHE).

Reducing Anxiety By Calming The Amygdala

We have seen from other articles published on this site that severe and protracted childhood trauma, resulting in the child being frequently subjected to extreme stress, can damage the development of the part of the brain known as the amygdala, which is intimately involved in generating feelings of fear and anxiety.

Indeed, in individuals who have experienced such serious childhood trauma that they have gone on to develop complex posttraumatic stress disorder (complex PTSD), the amygdala has been found to be overactive ; this can result in the affected person feeling constantly ‘on edge. hypervigilant, fearful, and, as it were, stuck on ‘red-alert’ / in a state of ‘fight or flight,’ with accompanying unpleasant bodily sensations such as a racing heart, rapid and shallow breathing (sometimes referred to as ‘hyperventilation), tense muscles, an unsettled stomach and nausea. Indeed, it is these very bodily symptoms that feed back to the brain leading to the perception of being afraid.


An overactive amygdala is not only associated with complex PTSD ; it has also been found to be associated with depressive and (as one, of course, would expect) anxiety disorders (e.g. Dannlowski et al., 2007).


Fortunately, another part of the brain, known as the prefrontal cortex (which is involved in planning complex cognitive behavior, rational, logical and abstract thought, speech, decision making, reappraisal of situations, active generative visualization and moderating social behavior) can be harnessed to inhibit the overactivity of the amygdala, thus calming it to allow symptoms of anxiety to dissipate and dissolve away.


If we suffer from PTSD or complex-PTSD we are prone to experience extreme fear and anxiety when it is not, objectively speaking, warranted. And, when we become fearful we can become locked into the fight / flight state, causing our body’s oxygen to be diverted to our muscles (particularly in out arms and legs) so that we may fight or flee more effectively. However, this reduces the amount of oxygen available to the prefrontal cortex which, in turn, means that we are limited in our ability to think rationally so that we are unable to reassure ourselves that the danger we perceive is not objectively justified, and, therefore, we are also unable to inhibit our amygdala’s overactivity.


In this fearful state, we need to control our breathing so that sufficient oxygen can reach the prefrontal cortex to allow it to function optimally ; we can achieve this by breathing in a relaxed and slow manner, and, when exhaling, breath out slowly from the stomach so that the diaphragm moves upwards to increase the pressure on the lungs and heart to expel air. This type of breathing beneficially affects the part of the brain stem known as the medulla which, in turn, sends signals along the vagus nerve, leading to increased activity of the parasympathetic nervous system and decreased activity of the sympathetic nervous system : in combination, this produces feelings of relaxation and ameliorates feelings of stress and anxiety.


To calm the amygdala further, we can also take advantage of the prefrontal cortex’s ability to visualization (see above) and undertake sessions of relaxing, guided imagery either with a therapist or using self-hypnosis.


Improve Visualization | Self Hypnosis Downloads

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David Hosier BSc Hons; MSc; PGDE(FAHE).

Traumatic Memory : Flashbacks, Fragments, Nightmares And Repression

Traumatic Memories

Remembering traumatic events is in some ways beneficial. For example, it allows us to review the experience and learn from it. Also, by replaying the event/s, its/their emotional charge is diminished.

However, sometimes the process breaks down and the memories remain powerful and frightening. Sometimes they seem to appear at random, and at other times they can be TRIGGERED by a particular event such as a film with a scene that shows a person suffering from a similar trauma to that suffered by the person watching it.

Traumatic memories can manifest themselves in any of the 3 ways listed below:


These are often intense, vivid and frightening. They can be difficult to control, especially at night.

Sometimes a flashback may be very detailed, but at other times it may be a more nebulous ‘sense’ of the trauma.

Sometimes the person experiencing the flashback feels that they are going mad or are about to completely lose control, but THIS IS NOT THE CASE.



These are more likely to occur when the mind is not occupied. They are more a recollection of the event rather than a reliving of it. When they do intrude, they can be painful. Often, the more we try to banish them from memory the more tenaciously they maintain their grip.


These can replay the traumatic events in a similar way to how they originally happened or occur as distorted REPRESENTATIONS of the event.


There used to be a concern that some memories of trauma may be false memories. However, the latest research suggests that memories of trauma tend to be quite accurate but may be distorted or embellished.

However, false memories CAN occasionally occur. This is most likely to happen when someone we trust, such as a therapist, keeps suggesting some trauma (eg sexual abuse) must have happened.

It is important to remember, though, that parents or carers will sometimes DENY or DOWNPLAY and MINIMIZE our traumatic experiences due to a sense of their own guilt. In other words, they may claim our traumatic memories are false when in fact they are not.


Very traumatic memories may sometimes be REPRESSED (buried in the unconscious with no conscious access to them). In other words, we may forget that a trauma has happened/ this is a defence mechanism. Sometimes the buried memories can be brought back into consciousness (eg through psychotherapy) so that the brain may be allowed to process and work through the memories allowing a recovery process to get underway.

Trauma, Memory And The Brain :

New memories are stored in the region of the brain known as the hippocampus. However, not all memories that enter the hippocampus are stored by the brain permanently.

Only some are transferred to the cerebral cortex for long-term storage; the rest fade away. The more important the memory, and, in particular, the more intense the emotions connected to the memory are, the more likely it is to be permanently stored. This process is called memory consolidation.

When an event occurs that is very threatening or damaging to us, the stress of this causes stress hormones ADRENALIN and CORTISOL to be released into the brain.

The effect of these stress hormones is to strengthen the memory of this threatening or damaging event.

The stress hormones released into the brain (in particular, the amygdala) also ensure the memory of the negative event becomes strongly associated with the emotions (such as fear and terror) that it originally evoked.


So, for example, if we are viciously attacked and maimed by a savage and demented Rottweiler, cortisol and adrenaline will be released into our brain to ensure that the memory is indelibly stored. These same stress hormones will also ensure that the emotions we felt at the time of the attack, such as fear and terror, also become strongly associated with the memory of our unfortunate encounter with the less than friendly canine miscreant.

This way of storing such memories evolved for the survival value it confers on our genes.

Also, when extremely traumatic events occur, the hippocampus can become so excessively flooded by stress hormones such as cortisol and adrenaline that it incurs damage.

This damage can then alter the way that the traumatic event is stored. Because of this, the memory may become:

– fragmented

– ‘foggy’ / ‘blurry’

– distorted

– inaccessible to conscious awareness

Furthermore, the memory of the extremely traumatic event may become highly invasive – especially when the person in possession of the memory is reminded of the traumatic event (even tangentially) – and constantly break through into consciousness wholly unbidden, re-triggering the release of excessive amounts of stress hormones into the brain ; this can lead to:

– flashbacks

– nightmares

obsessive rumination about the traumatic event


Our long-term memory can be divided into :

1. Declarative Memory (sometimes called explicit memory or narrative memory) – it is the part of our memory that we use for the conscious recall of facts or events.

Declarative memory depends upon language in order to organize, store and retrieve the information that it holds.

2. Non-Declarative Memory (sometimes called implicit memory, procedural memory or sensorimotor memory) – it is this part of our memory that allows us to automatically retrieve information connected to something we have learned without conscious deliberation.


For example, we can get on a bike and ride it without having to concentrate on exactly how we’re doing it or go over in our minds the steps involved in how we learned to do it; indeed, we need not even remember when or how when learned to do it (I certainly don’t) – nevertheless, the necessary ‘know-how’ has been unconsciously, permanently retained.

Non-declarative memory, unlike declarative memory, does not depend upon language for the organization, storage and retrieval of information. Because of this, non-declarative memories are frequently very hard indeed to describe in words (try explaining all the tiny body and muscle adjustments necessary to maintain balance whilst riding a bicycle – yet the memory of exactly how to do this has been faithfully, unconsciously stored, courtesy of your non-declarative memory!).


Due to their utterly overwhelming nature, we often can’t completely and linguistically, mentally process our traumatic experiences which prevent them from being stored in declarative memory; when this happens, the traumatic experiences are instead stored in our non-declarative memory.


The incompletely processed traumatic memories stored in non-declarative memory tend to be very fragmentary in nature. As we have seen, too, they are not stored in linguistic form but, instead, often in the form of :

– bodily sensations (e.g. muscular tension, increased heart rate, hyperventilation)

– images (e.g. these might come to us in nightmares or intrusively and unheralded during our waking hours as a result, often, of unconscious triggers – see below)

– emotions (e.g. extreme anger or fear)

Also, our unconscious, non-declarative memories may express themselves through chronic, seemingly inexplicable symptoms and behaviours.


Because the memory of our trauma has not been properly processed at the linguistic level we are likely to find ourselves unable to articulate our traumatic experiences in any coherent manner. (Click here to read my article on how we find it difficult to talk about our trauma).


Bodily sensations, images, emotions, symptoms and behaviours linked to our non-declarative memories of our original, childhood trauma may be triggered whenever anything even remotely reminds us of this trauma.

In this way, we may find ourselves re-enacting aspects of our original trauma in our everyday lives months, years or, even (in the absence of effective therapy), decades after the actual experience of our childhood trauma is over.






David Hosier BSc Hons; MSc; PGDE(FAHE).

Health Anxiety : Its Link To Childhood Trauma

health anxiety

We have already seen that, all else being equal, an individual who suffers significant childhood trauma is at greater risk than average of developing an anxiety disorder in adulthood. In this article, I will look specifically at health anxiety and what types of childhood experiences may put individuals at increased likelihood of developing it. With regard to this, the first question to answer, of course, is :

What Is Health Anxiety?

Health anxiety used to be referred to as hypochondria; however, this term is becoming increasingly obsolete due to its somewhat pejorative connotations. For a person to be diagnosed with health anxiety (and such a diagnosis, of course, can only be carried out by an appropriately qualified professional) s/he generally has to be preoccupied with thoughts centering around illness (i.e. a belief s/he is ill or an overwhelming conviction that s/he will imminently become ill) despite reliable, medical reassurances that this is not the case.

Furthermore, this preoccupation causes the individual significant distress and impairs normal, day-to-day functioning.

What Childhood Experiences Make It More Likely That An Individual Will Develop Health Anxiety?

First, individuals who suffered a serious illness as a child and were traumatized by the experience are at increased risk of developing health anxiety in adulthood.

Second, those who, in childhood, had a primary-carer who was excessively anxious about their health, or more generally overprotective, are at increased risk of developing health anxiety in adulthood.

Third, those who, in childhood, experienced a close family member (such as sibling, mother or father) being seriously ill are at increased risk of going on to develop health anxiety.

Fourth, people who, as children, had parents who excessively shielded them from the reality of health problems (e.g. parents who never talked about their own illnesses or the illnesses / deaths of other family members, including never allowing the child to attend funerals) are more likely to go on to develop health anxiety

Finally, growing up with parents who, to an excessive degree, feel the need to continually (and with excessive frequency) emphasize the vital and crucial importance in life of having one’s health.

Other Factors That Can Contribute To The Development Of Health Anxiety:

Childhood experience is not the only factor connected to the development of health anxiety in later life ; other factors that may contribute or be involved include :

1) Personality traits (characteristics) : e.g. a proneness to worry or intolerance of uncertainty

2) Chemicals in the brain (especially low serotonin activity)

3) Abnormal brain processes associated with low serotonin activity leading to excessive rumination (over-thinking)

health anxiety

Above : examples of the excessive ruminations that a person with health anxiety may have.

4) Genetic predisposition : it is possible some people may genetically inherit a tendency towards obsessive-like thinking.

Therapies :

Therapies available for the treatment of health anxiety include cognitive behavioral therapy (CBT) and trauma-focused therapy (CFT). However, sometimes (depending upon the individual’s particular constellation of psychological problems) other forms of psychotherapy may be more appropriate.

Also, because it is thought that serotonin-level abnormalities may sometimes be involved with health anxiety, antidepressants are sometimes prescribed for its treatment (under the guidance, of course, of an appropriately qualified professional).


Overcome Fear Of Illness 

David Hosier BSc Hons; MSc; PGDE(FAHE).

Does Trying To Relax Paradoxically Increase Your Anxiety?

Paradoxically, trying to relax can actually make some people feel more anxious and stressed, not less.

When I was extremely ill and in hospital (I was hospitalized on several occasions due to the seriousness of my condition), I was encouraged to attend certain therapeutic classes (which, because I was almost catatonic with severe clinical depression and anxiety, I most resolutely did not want to do –  amongst other myriad other symptoms, I had no motivation whatsoever, together with an unshakeable belief that there was no possibility at all of me getting even very slightly better (such thinking is almost universal amongst the seriously, clinically depressed).

However, I eventually agreed to attend a class in which the therapist tried to guide me (and the other patients who had attended) through a relaxation exercise. Just a minute or so into the exercises, I felt so overwhelmed by anxiety that I had to excuse myself and leave the room, seeking, instead, refuge in the smoking room where I chain-smoked innumerable cigarettes.

In fact, this such a paradoxical reaction to an attempt to relax is not especially rare – a small percentage of those with anxiety will react in a similar manner.

So, what is the cause of this paradoxical response? Several ideas have been proposed, and I briefly look at some of these below:


  • Trying to relax and ‘let go’ of stressful mental activity can induce in some individuals a feeling of loss of control. Related to this is the phenomenon whereby some people feel that, if they stop worrying about things, something terrible will happen and that their constant worrying is therefore somehow ‘protective’. Psychologists sometimes refer to such mistaken belief systems as ‘magical thinking’.
  • Fear of loss of identity – for some, being stressed (eg always busy, ‘driven’, ”keyed-up’ etc) forms part of their identity and they feel uncomfortable relinquishing this identity, fearing that if they do so others may see them as complacent, indolent etc rather than as the ‘dynamic’ individual they hope others perceive.
  • Brain wave activity – becoming relaxed correlates with a shift in brainwave activity from beta-waves to alpha-waves which may cause thinking to become cloudy, hazy and foggy; some individuals find this disconcerting.
  • Frustration – if we try to relax, and find we cannot immediately do so. this can lead to frustration which makes relaxation even more difficult; this can quickly develop into a vicious circle.

  • Fear – similarly to the above, we may fear we will not be able to relax (by thinking things like : ‘If I don’t relax soon, I’ll go completely and irreversibly insane’ – which was the kind of thing I used to think) thus putting too much pressure on ourselves. In this way, the fear that we will not be able to relax can rapidly become a self-fulfilling prophecy.
  • Depersonalization – relaxation techniques can lead to feelings of ‘depersonalization’ in some people. Depersonalization can manifest itself as feeling of being ‘detached from one’s body‘ or as being an ‘observer of oneself.’ Many find such a sensation unpleasant
  • Derealization –derealization’ can manifest itself as a feeling that ‘the world is not real’ and more like a nebulous, hazy, dreamworld. Again, many find this unpleasant. (‘Dearealiztion’ is a type of ‘dissociation.‘)
  • Distraction – for some individuals, certain types of stress (such as always ‘keeping busy’) can operate as a distraction from problems and worries the person finds hard to face (in extreme cases, this may result in workaholism‘). In this way, the stress/’keeping busy’ works as a psychological defense mechanism – the sudden dropping of this defense may lead to the person becoming vulnerable to being overwhelmed by floods of previously suppressed anxiety.

In response to the problem of the possible paradoxical effect a small minority of individuals may suffer as a result of trying to relax, some hypnotherapists have been trained in technique of inducing what is referred to as an ALERT TRANCE which some may find to be helpful.



Related Post :

Fighting Anxiety Can Worsen It’. Why Acceptance Works Better.’

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Childhood Trauma And Its Link To Depression And Anxiety by David Hosier MSc.

depression and anxiety

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David Hosier BSc Hons; MSc; PGDE(FAHE).