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Anxiety is not only a serious problem but it is complex with many
facets--just look in this chapter at all the different forms it takes.
Furthermore, besides having to cope with a fear itself, the sufferer
often has a stressful reaction because he/she had the fear. This is
called a "second-order feeling." Just as there is a panic reaction to
being told "you have cancer" or "you have heart disease," there is
usually a strong negative reaction to having an intense fear or panic
reaction or physical problems that interfere with work or cause
disabling depression. The second-order feelings might be regrets,
dread, self-criticism and/or hopelessness, something like "What is
wrong with me? What did I do wrong? Why can't I stop this feeling?
There must be something wrong with me, I don't like me. I seem so
helpless and worthless." That is, a second-order of stressful problems
(self-doubts and self-criticism) develops that could overwhelm or
sabotage the mending of the original problem (the performance
anxiety).
For example, consider a singer or speaker who experiences some
anxiety while performing (clearly a treatable or maybe even a tolerable
problem). But, if this person begins to self-blame, awfulize, and worry
endlessly that the stage fright might get worse or ruin the next
performance, these second-order stage fright worries can soon
become more of a problem than the mild-to-moderate anxiety feelings
while performing. Some therapists would put aside the second-order
concerns for a while and go straight to reducing the stress reaction
while performing. (If the performance anxiety is reduced to an
acceptable level, then the worry and self-criticism about failing on
stage will fade away.) On the other hand, other therapists would
assume that the negative expectations and self-talk needs to be
reduced first by (a) taking a Rational-Emotional approach to test the
validity and rationality of the awfulizing about stage fright and/or (b)
by encouraging the client to see that some stress during a
performance is not only normal but can even be used to advantage as
motivation to practice more. Once the self-concept is more positive,
(imagining performing while very relaxed) or reduced by actual
exposure, practicing singing or speaking over and over many times.
When an unreasonable fear becomes serious enough to interfere
with our work or social lives, it is called a phobia or a panic reaction
(see next section). About 13% of us have had a phobia. There are
three types of phobias: simple phobias (fear of death, cancer, insanity,
the devil, the dark, enclosed places, heights, flying, storms, bugs,
germs, spiders, mice, snakes, dogs, shallow water, etc.), social
phobias (fears of public speaking, meeting people, having to introduce
people, being judged, getting embarrassed, becoming confused,
forgetting what you wanted to say, and the fear of being afraid), and
panic disorders (unpredictable attacks of terror, sweating, weakness,
pounding heart, dizziness, and a belief that he/she will lose control, go
crazy, or die). Many therapists believe that panic attacks that truly
terrify us are physiologically and chemically different from our ordinary
fears and anxiety. Panic disorders and agoraphobia, which is the most
