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Books

Making Anxiety an Ally
with Psychotherapist and Author
Natalie Kohlhaas

By Hillary Hart

Over the last few years, we have seen an increase in reports of anxiety in the media with different solutions and remedies to help combat the feelings of anxiety.

I had the opportunity to talk with psychotherapist Natalie Kohlhaas on her perspectives of anxiety and how we can view it as a friend and guide, if we will allow it.

Through her work in helping other people navigate anxiety and her own life-changing experience, Natalie has come to view anxiety as an invitation to pause and change course.

By pausing and differentiating between fear and anxiety, she believes you can achieve your dreams, feel a sense of peace and safety, and experience the wonders of life.

Hello Anxiety, My Old Friend by Natalie Kohlhaas

Congratulations on writing your first book, “Hello Anxiety, My Old Friend.” What inspired you to write this book?

I've had so many clients who have told me over and over again, "I've never heard anyone talk about anxiety the way you do. When you describe anxiety, it makes so much sense to me.”

And they would say, “You should write a book." I finally listened to all of my clients.

As the title suggests, you consider anxiety to be an asset and friend. How did you come to that thought process?

I've encountered what I consider 8 different miracles. All of these miracles have affected my personal understanding of what anxiety is, and when I combine those with the professional research that is available on anxiety, I've been able to understand that anxiety is not the same thing as fear.

Most people lump it all together, and because of that, we run away from our anxiety. We want to push our anxiety into a closet and keep it there and hope that we can go on with our lives.

Through the different things that I have encountered, I have recognized that anxiety is actually not the same thing as fear, but it is trying to help us to try to reach for new adventures, open up to vulnerability and growth, and wanting us to experience a wonderful, miraculous life.

How do you differentiate the main differences between anxiety and fear?

What happens is most people lump them together. I work with people to untangle that and often I walk them through a little visualization.

Imagine you are being ushered into a room with a big table, and that table has a whole bunch of people surrounding it. They ask you, "Can you go get up and stand up in the middle of the table?"

Of course, you're kind of taken aback by that, and you're like, "Uh, excuse me?" You get up there and stand on the table and the doors open up and the manager walks in.

He has a piece of paper in his hand, and he throws the piece of paper onto the table and it says, “You’re not good enough to succeed."

Now, immediately all the people that are around the table start digging in because they have every piece of information about your thoughts, your experiences, and your feelings. They dig in, and they start stating and pulling out all these things, like "I remember when she had a hard time with that!," "Oh my gosh, you felt overwhelmed when this was happening," and "Oh, she really could have done better with that!"

In the midst of all this, the doors open up, and in walks your very best friend, and they see you standing on the table with all of these people saying terrible things to you. They go over to you and ask, "What are you doing on the table?! Get off the table!"

Of course, there are so many voices going off, you can't hear your one friend's voice. So they reach across the table, and they're grabbing your feet and trying to pull you off the table.

In the meantime, all the people around the table have now moved on to the future, and they're saying, "Well, you know, if you did that in the past, all of these things are going to happen in the future. It's certainly going to happen and it's probably going to be even worse.”

Now your friend can't take this any longer. She gets up on the table, she's shaking your shoulders and sees that you're turning glassy-eyed, you're becoming overwhelmed, and so she finally just pulls you off the table, throws you out of the room, and closes the door.

This is what we know as a panic attack. The person who placed the topic on the table is fear. Your very best friend who came into rescue you was anxiety.

Would you say then, that a benefit of anxiety is that it allows you to pause and change course, if you'll allow it?

Yes, exactly. Fear and anxiety actually walk together, but anxiety is working as a gatekeeper.

What happens is that when fear starts telling you something that is incorrect or goes against your values, or for some reason, it's not actually allowing you to experience the opportunities in front of you, your anxiety is trying to get you to pause, take a step back and really look at that information or decide that, "This is not pulling me in the right direction. I actually need to change direction."

The main purpose for fear is to keep us safe. It wants to keep us safe physically and it wants to keep us safe emotionally. It doesn't want us to get hurt.

Whether that's being hurt by a saber-toothed tiger, or by being hurt by somebody being horrible and bullying us, that's its sole direction.

What happens is anxiety is watching over that, and when fear is telling us there's a saber-toothed tiger in the room, and there really isn't a tiger in the room, or there's a possibility we could actually gain something and not get hurt, the anxiety is there telling us not to listen to fear, that it's pulling us off course.

What would you consider the most common sources of anxiety that you have seen in your work as a psychotherapist?

People are feeling like they'll be alone or unliked. They often feel thoughts of I’m not good enough, I don't deserve something, something about me is broken, maybe I'm stupid, maybe there is something that's wrong with me.

These are common pieces we see over and over and that people are grappling with. Often, fear is playing with these topics and trying to provide evidence and support it.

Of course, the acronym for fear is False Evidence Appearing Real. And so, it's looking for evidence, but often that evidence is being misrepresented and is incorrect.

Invariably, it's pulling somebody away from what they truly know they need or want, which is where our values come from.

Natalie Kohlhaas

When someone is noticing that anxiety creep in, do you have a process you can recommend that they can use to change course?

The first thing I often do, which is a tried and true method, is have someone work through breathing exercises. Invariably, I always hear the same thing from people, "Ah, I've done that. It doesn't work."

Then I have them show me how they do their breathing exercises. Breathwork is often something that is very different from what the person is doing.

So, we walk them through how to actually do the breathwork so that it is activating the parasympathetic nervous system (PNS), which allows your body to go into rest and digest, whereas the sympathetic nervous system puts them into flight, fight, and freeze. So really, that is the pause that we have them engage.

When they can go into that pause, we can have them work on different grounding techniques so that they can get present.

Notice in my example that fear was having you go into all the things in the past, and it was telling you that somehow or other, it had a crystal ball about everything that's going to happen in the future, but it's not actually having you be in the present.

In the present, we can actually gather information that shows us there is no tiger in the room, or in this very moment.

We're not in a situation where we're being physically or emotionally hurt, so the present is where we want people to get to, so we have them do the pause, then the grounding techniques to get into the present, and from there we have them recognize what is the topic that fear is having you play with, and how do I unravel that topic?

What is your go to breathing exercise?

I have my clients go through a story with a saber-toothed tiger and what's going on with their body. I'll take you to the end of that story.

You've just been chased by a saber-toothed tiger and you have made your way back to the cave, and you've rolled the rock in front of the door and you take some huge breaths and think, “We actually got back to safety! We're finally here!”

That is the kind of breathing that activates the PNS. Very big, deep belly breaths. When we take it, we can feel our lungs pressing into our spine as they fully expand. Then we hold it, then we release it. And then we take in another really deep breath and feel it again.

When we work with individuals on how to do this breathing, I typically have them lay down. It's easier for you to feel your spine being pressed and each time we press against our spine; we're actually engaging the vagal nerve.

We want to press on it and release. Typically, we do 3-3-3. We do three deep breaths, then breathe normally for a moment, and then three deep breaths again, breathe normally, and then three more deep breaths again.

It's best to practice it before you're in a situation of anxiety. You can do this anywhere--you could be sitting at work at the table, take your deep breaths, and then breathe normally. You want to do enough to put enough pressure on the nerve to send the message up to your brain to let you know that you're safe.

Have you noticed an increase in anxiety in people since the pandemic?

Yes, very much so. One of the things that is so concerning is that the pandemic for many reasons increased fear. Now there is not only fear of illness, but fear of stability, fear of what will happen with my job; there's fear of how will I get together with my friends?

There was so much shifting in what we consider familiar. What happens is, with familiar, even if familiar isn't necessarily a great thing, we know it, so we feel comfortable with things that are familiar.

When we shift into a place where things are unfamiliar, even if the unfamiliar may for some reason be better, it is not going to be comfortable. And of course, that's going to start triggering all kinds of doubt.

I always tell people, doubt actually is only going to grow one thing, and that's fear. And as that starts growing, our anxiety is going to have to go into overload because anxiety is wanting to recognize when there is something we actually need to be afraid of, and when we are just creating a possibility that may not actually happen.

What's the big takeaway you want your readers to have from the book?

I really want them to know, at the end of the day, anxiety is never going to give up on you. It is a very big and very loud friend and kind of obnoxious, but it will always walk with you all day long.

It will listen to you and it always wants you to understand that it has your back. And it wants you to reach for your truth and to reach for all the wonder that is out there in the world.

I want people to know they can actually use this inner strength that they have. We've numbed it down and tried to not hear it or feel it because we have labeled anxiety as something horrible.

We all know we can have our feelings and all feelings are ok, but somehow we don't include anxiety in this.

Was there anything that really surprised you about the process of writing, or that you learned while working on this?

Everyone always said you should write this book, and when I sat down to write it, I thought, “Am I really going to have much to say?” I spit out over 300 pages in less than three weeks. It just came pouring out from some place. It was astounding to me just how much was in there that was looking for an opportunity to help a lot of people.

This is where I am, particularly with the pandemic. I see people individually, I work with groups, but we really are hitting a crisis in many ways of mental health.

It almost feels like a mental health mini pandemic. And I want this to be able to provide opportunity for many people in many places and walks of life to recognize they can use this and harness their anxiety.

This is my hope, that moving forward, this offers a little gleam and recognition and provides them with skills of how to move forward and to really reach for all the possibilities that could be there for them.

I read that you were a breast cancer survivor and were pronounced dead for nine minutes. The fear of death seems to be a huge one for so many people. How did you manage your anxiety and fear around that time?

I came out of that situation feeling like I still have purpose on earth and I need to get out there. I have gone through breast cancer, chemotherapy and radiation, a lumpectomy and then reconstruction which caused my blood clot, and then finally the pulmonary embolism that filled my lungs, stopped my heart.

I was technically dead for almost 10 minutes. And yet here I am, still today. So again, I want people to recognize that fear can tell us all kinds of things that are not necessarily true.

The doctors were saying they didn't know if I'd be able to walk around, feed myself, know my family, and yet here I am. I'm walking, I'm talking, I'm sitting with people. I'm going to work and conducting my life. And all of that, was probably more of what fear was dictating, and not that it wasn't a possibility, but it wasn't my possibility. And I listened to my anxiety and realized that was not my possibility.

What's next for you? Do you have any other projects in the works right now?

We're working on creating an online course for individuals that we can walk through these processes. Maybe they're not able to work with a therapist. I want this to be available for a lot of people.

I'm working on creating a workbook that goes with the book that gives step by step processes. I give a lot of that in my book, but I know for some people, having something to hold onto and go back and review is so helpful.

Particularly for us anxiety people, we want to process, we want our steps, we want to plan, we want to know how we're going to go through this. It gives us comfort. I want to be able to provide that for individuals.

We’re hoping the online course will be available when the book releases.

“Hello Anxiety, My Old Friend” is out now and available at Amazon, Barnes and Noble, Walmart, Target, and as an e-book. An audio book is also in the works.

You can learn more about Natalie and her work at www.HelloAnxiety.net.



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