While walking towards the London Underground to catch a train to work Pamela Ashcroft was run over by a car. She sustained a traumatic brain injury and has to undergo a number of complex surgeries.
As she recovered she developed anxiety. Below in her own words she shares how she eventually overcame it and offers some top tips which might help other people going through a similar experience.
"I started to get panic attacks while I was at the rehabilitation unit in hospital and I was learning to walk with a stick. I was afraid that I was going to fall or that someone was going to push me over.
"In part, my feeling of vulnerability was because my tibia bone had been broken in a car accident but despite my feeling vulnerable, the doctor had confirmed that the bone had healed enough and I was able to walk on it.
"Soon after I was discharged from hospital, I went out to the local shop about 15 minutes away from my house. I went out on my own to challenge myself and I felt the trip had gone well. A few days later, I took another trip to the shops but this time the roads and the street on the way down there were much busier because it was rush hour and a local school had just finished for the day.
"As I walked on the busy road, I had started to feel vulnerable and by the time I left the shop people who had sensed my feeling vulnerable, had began to ask me if I was ok. At first I told them I was fine but on the way out of the shop I had to cross a road and at that moment, I realised that I was too scared to proceed. An unknown lady kindly offered to walk me back home. From there onward my panic attacks were beginning to dominate my life and I could not leave my house on my own.
"I was afraid that my anxiety would generalise. Fortunately I was able to see a Neuropsychologist at Neurolink in Harley Street and he applied ACT (Acceptance and commitment therapy) with me.
"We named my anxiety the “Anxiety Monster”. My Neuropsychologist encouraged me to understand the nature of the Anxiety Monster eg, on which part of the body I would sense it and to describe it’s texture.
"While I was out on a walk on my own, I noticed that the Anxiety Monster’s presence was more apparent as I approached traffic and that the feeling was coming from my tummy. It would give me sudden commands like “Turn around and go home”.
"My Neuropsychologist encouraged me to turn the Anxiety Monster into a funny character who would give me commands in a voice like Donald Duck’s.
"I envisioned the Anxiety Monster looking like a character from Sesame Street and it became funny receiving commands from it.
"Through ACT I discovered that my anxiety was linked to trauma in my childhood and I started to feel compassion for the Anxiety Monster.
"ACT encourages you to accept your feelings of anxiety, to allow them to be there. However, despite of those feelings, you tell the Anxiety Monster “I know you’re telling me not to keep walking, but I’m going to carry on walking anyway” and then follow through.
"My Neuropsychologist encouraged me to do daily challenges that had a graded approach. I learned that with anxiety you can’t approach it with one foot in, one foot out, you need to dive into it.
"I pushed myself and approached challenges with determination such as using escalators in a department store initially with my Neuropsychologist and then meeting him on the floor below.
"As homework, I would challenge myself to walk to the local park alone which I managed to do at gradual distances along the way until one day I got to the park. I had been practising using the underground with my Neuropsychologist and on one occasion, I travelled one stop ahead of him and got off at the next stop so I would meet him on the platform.
"On my last session, I caught the underground to the session on my own. Now I travel by underground alone to meet friends and I have joined the gym and use the treadmill so I can get back into running.
"You can’t fix anxiety. It’s a human emotion and we wouldn’t be able to survive without it. However there are ways to calm you down and manage anxiety. I want to share these top tips that helped me manage anxiety.
Accept your feelings of anxiety. When doing an activity that usually creates anxiety for you, tell your anxiety that you know it’s there but that you’re going to do what you intend to do anyway. Eventually the anxiety will subside. You can compare talking to the anxiety to a parent talking to a toddler having a tantrum. The parent explains that they’re going to do a certain thing and that is that. Eventually the toddler gets tired and takes a nap.
We are not our thoughts and our feelings. The feeling of anxiety is not you. This becomes clear when you learn to observe your thoughts. Do this exercise. Every time you identify a thought or feeling in your mind, tell yourself “I’m having a thought that...” “I’m having a feeling that...”. Set aside twenty minutes every day to train your mind to do this to. Perhaps look at a candle flame as you do the exercise so that your mind doesn’t wander.
What short term goal do you want to achieve through managing your anxiety? This could be using the underground on your own or joining the gym or meeting friends. It is important to have something to work towards.
At first, set smaller goals towards your main goal for instance to walk a few houses away from your house or to cross the road. As I increased in confidence I took bigger steps such as I went to the underground platform with a friend, caught the train alone and got off at the next stop. Then my friend met me at the next stop. I built this up to eventually catching the underground in my own.
If your inner voice tells you that you can’t do something, ask yourself “If I buy into this idea will this help me towards achieving my goal?”
My goal was to use the underground on my own and I realised that one of my main challenges in doing that was using escalators. So I practiced using escalators in a department store first with a friend and then on my own.
Make sure you are doing an activity every day to work towards your goal. Develop a daily calendar of events according to what you feel you can manage but at the same time push yourself and then stick to the calendar.
Once you achieve your goal practice it regularly so that it becomes natural. You can set yourself new goals to keep challenging yourself.