Dr Peter Klug Mood Disorders Trauma-related Disorders Forensic Psychiatry Occupational Psychiatry

Dr Peter KlugDr Peter KlugMood DisordersMood Disorders

Trauma-related DisordersTrauma-related Disorders

Forensic PsychiatryForensic Psychiatry

Occupational PsychiatryOccupational Psychiatry

ANXIETYANXIETYAND HOW TO MANAGE AND HOW TO MANAGE

ITIT

ANXIETY AND ANXIETY AND FREUDFREUD

IN EVERYDAY LIFEIN EVERYDAY LIFE

ObjectivesObjectives

Relate Freud’s structure of the mind to Relate Freud’s structure of the mind to yourselvesyourselves

Use Freudian theory to understand the Use Freudian theory to understand the nature of anxietynature of anxiety

Understand excessive anxiety and its Understand excessive anxiety and its typestypes

Understand the management of Understand the management of anxiety and aggressionanxiety and aggression

How to use these strategies for How to use these strategies for yourselfyourself

Three Great Insults to Three Great Insults to MankindMankind

Copernicus : The sun, not the earth, Copernicus : The sun, not the earth, is the centre of the solar systemis the centre of the solar system

Darwin : We evolved from animalsDarwin : We evolved from animals Freud : We don’t know what we’re Freud : We don’t know what we’re

thinkingthinking

EGO

ID

SUPEREGO

Conscious

Preconscious

Unconscious

When you got up When you got up this morning this morning what did you what did you

consciously not consciously not have to think have to think

about?about?What is the same What is the same about you every about you every

day?day?

EgoEgo

OrganizedOrganized Mediates between the person and Mediates between the person and

realityreality TasksTasks

Perception - including self perception Perception - including self perception and self awarenessand self awareness

Adaptation to realityAdaptation to reality Uses anxiety to ensure safetyUses anxiety to ensure safety Action, memory, expression/emotion,Action, memory, expression/emotion,

SuperegoSuperego

The last function of the psyche to The last function of the psyche to developdevelop

The representative of the society within The representative of the society within the psychethe psyche

Conscience or moralityConscience or morality Ideal aspirations [ ego-ideal ]Ideal aspirations [ ego-ideal ] Mainly unconsciousMainly unconscious Develops from the ego by identifying Develops from the ego by identifying

with parentswith parents

SuperegoSuperego

Approves or disapproves of the ego’s Approves or disapproves of the ego’s actionsactions

Critical self-observationCritical self-observation Self-punishmentSelf-punishment Demands repentance or reversing a Demands repentance or reversing a

wrongwrong Provides self-love or self-esteem for Provides self-love or self-esteem for

having done righthaving done right

EGO

ID

SUPEREGO

Conscious

Preconscious

Unconscious

IdId

Completely unconsciousCompletely unconscious Develops from the primitive Develops from the primitive

unformed psycheunformed psyche Precedes the ego and the superegoPrecedes the ego and the superego Represents our instinctual drivesRepresents our instinctual drives

Hunger/ThirstHunger/Thirst AggressionAggression SexSex

Dreams: The Royal Road Dreams: The Royal Road to the Unconsciousto the Unconscious

A psychic phenomenon that occurs A psychic phenomenon that occurs during sleep in which thoughts, during sleep in which thoughts, images, emotions etc. present images, emotions etc. present themselves to the dreamer, usually themselves to the dreamer, usually with a definite sense of realitywith a definite sense of reality

They fulfill a vital purposeThey fulfill a vital purpose They foster solution in fantasy of They foster solution in fantasy of

needs and conflicts too dangerous for needs and conflicts too dangerous for solution in realitysolution in reality

DreamsDreams

They work through destructive and They work through destructive and traumatic experiences that defy the traumatic experiences that defy the coping capacities of the waking statecoping capacities of the waking state

It is one of the ways in which It is one of the ways in which impulses from the unconscious reach impulses from the unconscious reach the level of consciousnessthe level of consciousness

It is a universal psychic function It is a universal psychic function which is typical of the human mindwhich is typical of the human mind

Anxiety and GuiltAnxiety and Guilt

SUPEREGO

EGO

ID

Anxiety and GuiltAnxiety and Guilt

SUPEREGO

ego

ID

Anxiety and GuiltAnxiety and Guilt

SUPEREGO

ID

Anxiety and Excessive Anxiety and Excessive AnxietyAnxiety

Anxiety is normal and necessary to Anxiety is normal and necessary to function on a daily basisfunction on a daily basis

Anxiety does not cause distress or Anxiety does not cause distress or dysfunctiondysfunction

Excessive anxiety is associated with Excessive anxiety is associated with symptomssymptoms

Symptoms can be gathered into Symptoms can be gathered into syndromessyndromes

Fear vs AnxietyFear vs Anxiety

Fear is the Fear is the response to an response to an immediate threatimmediate threat

Anxiety is the Anxiety is the response to an response to an anticipated threatanticipated threat

Primitive FearsPrimitive Fears

Personal InjuryPersonal Injury AbandonmentAbandonment

The Physical Impossibility of Death in the Mind of Someone Living

What are some of What are some of the symptoms of the symptoms of fear and anxiety?fear and anxiety?

Symptoms of Fear and Symptoms of Fear and AnxietyAnxiety

Somatic = BodilySomatic = Bodily Psychic = Mental or Psychic = Mental or

PsychologicalPsychological

Symptoms of Fear and Symptoms of Fear and AnxietyAnxiety

SomaticSomatic Headaches, neck aches, back aches Headaches, neck aches, back aches TremorTremor Breathing changesBreathing changes SweatingSweating Nausea and vomitingNausea and vomiting Diarrhoea and urinary frequencyDiarrhoea and urinary frequency Ringing in the earsRinging in the ears Blurred visionBlurred vision

Symptoms of Fear and Symptoms of Fear and AnxietyAnxiety

PsychicPsychicFlightFlightDreadDreadApprehensionApprehensionFreezingFreezingConfusion and IndecisivenessConfusion and IndecisivenessSense of unrealitySense of unrealityObsessionalityObsessionalityAvoidanceAvoidance

What kinds of What kinds of anxieties do I anxieties do I currently deal currently deal

with?with?-At home?-At home?

-At work?-At work?

What kinds of What kinds of strategies do I strategies do I use to manage use to manage

these anxieties?these anxieties?

Strategies for Managing Strategies for Managing AnxietyAnxiety

Becoming aware of being anxiousBecoming aware of being anxious Identifying symptomsIdentifying symptoms Identifying stressesIdentifying stresses Addressing stressesAddressing stresses Relaxation techniquesRelaxation techniques DistractionDistraction ExerciseExercise

Managing AnxietyManaging Anxiety Managing recreational timeManaging recreational time

Planning aheadPlanning aheadHolidaysHolidaysSchool holidaysSchool holidaysWeekendsWeekendsLong weekendsLong weekendsEveningsEveningsLunch breaksLunch breaksDon’t take work away with youDon’t take work away with you

Strategies for Managing Strategies for Managing AnxietyAnxiety

Active hobbies/interestsActive hobbies/interests CraftsCrafts ArtsArts GardenGarden ShedShed

Avoid screens at every opportunityAvoid screens at every opportunity Read books unrelated to workRead books unrelated to work Cultivate friends from other walks of lifeCultivate friends from other walks of life Spend time outdoorsSpend time outdoors Spend less time managing moneySpend less time managing money

Strategies for Managing Strategies for Managing AnxietyAnxiety

Sexual activity planningSexual activity planning More frequent sexMore frequent sex Spend longer having sexSpend longer having sex

Strategies for Managing Strategies for Managing AnxietyAnxiety

Slow Food MovementSlow Food Movement Slow Life vs Cult of SpeedSlow Life vs Cult of Speed The World Institute of SlownessThe World Institute of Slowness CittaslowCittaslow

Strategies for Managing Strategies for Managing AnxietyAnxiety

Drugs and AlcoholDrugs and Alcohol Alcohol - gramsAlcohol - grams Caffeine - coffee, Coke, Diet Coke, energy Caffeine - coffee, Coke, Diet Coke, energy

drinksdrinks NicotineNicotine Prescribed drugs: Stilnox, Xanax, Valium, Prescribed drugs: Stilnox, Xanax, Valium,

Temaze, Mogadon, etc, etc, etc….Temaze, Mogadon, etc, etc, etc…. Smack, speed, dope, ekkies, acid, special K, Smack, speed, dope, ekkies, acid, special K,

ice, etc, etc, etc…..ice, etc, etc, etc…..

Sleep HygieneSleep Hygiene

What you can and cannot do What you can and cannot do in bedin bed

Identifying and Identifying and challenging challenging unhelpful unhelpful thinkingthinking

A cognitive approachA cognitive approach

BIOBIO PSYCHOPSYCHO SOCIALSOCIAL

THE LATE GEORGE ENGEL

ANX EXCESSANX

1. ACUTE2. CHRONIC3.3. TRAUMATICTRAUMATIC

• Generalized

• Panic

• Pan/Ag

• OCD

• Phobias

• PTSD

SYMPTOMANXIETY

BIO

PSYCHO

SOCIAL

DEPRESSION

BIO

SOME TYPES OF SOME TYPES OF THERAPYTHERAPY

EducationEducation Supportive psychotherapySupportive psychotherapy Psychodynamic psychotherapyPsychodynamic psychotherapy Inter-personal therapy - IPTInter-personal therapy - IPT Cognitive behaviour therapy - CBTCognitive behaviour therapy - CBT Relaxation techniquesRelaxation techniques Group therapyGroup therapy

MORE TYPES OF MORE TYPES OF THERAPYTHERAPY

Narrative therapyNarrative therapy Gestalt therapyGestalt therapy Art therapyArt therapy Music therapyMusic therapy PsychodramaPsychodrama Encounter groupsEncounter groups Humour therapyHumour therapy Play therapyPlay therapy Dream interpretationDream interpretation