Anxiety and Stress

My experience of my working with clients in a GPs practice, also with Bupa and from my training has helped me with anxious clients.

Anxiety is a feeling of unease. The feeling of unease can range from mild to severe, and can include feelings of worry and fear. There are several different conditions that can cause severe anxiety. They include:

  • phobias: an extreme or irrational fear of an animal, object, place or situation
  • generalised anxiety disorder (GAD): a long-term condition that causes excessive anxiety and worry relating to a variety of situations
  • PTSD-post-traumatic stress disorder: a condition that has psychological and physical symptoms and is caused by very frightening or distressing
In short, three months of visiting James every week really helped me turn things round. James really gives you the space to talk and puts you at ease. He is an excellent listener, and his non-directive approach allows you to figure out the solutions for yourself and see things more clearly. He has helped me put my anxieties into context and seek potential causes from various critical points in my life - but his ultimate focus is on the here and now, and how to make things better for the future. He listens, gently probes and makes suggestions, and we developed tactics and strategies to help me change long-term patterns of negative behaviour.

My Clients Experience

  • Chest pains
  • Panic attacks
  • Hot flushes- sweating increases
  • Trembling or shaking
  • Nausea
  • Fear of going crazy

With panic attacks you can experience:

  • Very rapid breathing or feeling unable to breath
  • Very rapid heartbeat
  • Pains in chest
  • Hot or cold flushes
  • Feeling faint or dizzy
  • Sweating
  • Ringing in your ears
  • Tingling or numbness in your hands and feet
  • Feeling nauseous
  • Wanting to go to the toilet
  • Feelings of absolute terror
  • Feelings of unreality, called depersonalisation and derealisation

These can be caused by childhood experiences, agoraphobia and similar problems, personality traits (always anxious, over critical and disapproving of self and striving to conform to expectation of others), physical causes and depression. With panic attacks we would look at taking control, breathing, relaxation, assertiveness and visualisation.

Trauma. I have worked with clients who have experienced trauma at the Everyman Project, Bupa as a Critical Incident Manager and privately. A psychological trauma or critical incident typically refers to an event which a person is connected to, that is:

  • unexpected,
  • outside their usual range of human experience,
  • and that involves some form of loss, injury or threat of injury,
  • whether actual or perceived.

Types of incidents:

  • Road traffic accidents
  • Armed combat and its aftermath
  • Murder, including the trials
  • Terrorist incidents
  • Social Deprivation
  • Transcribing testimony & monitoring reports
  • Undercover reporting
  • Detention / being held hostage
  • Riots
  • Child abuse
  • Plane/ train/rail crashes
  • Natural disasters
  • Personal assault
  • Including a difficult editor or boss

What would be the person's reactions?

Physical reactions:

  • Insomnia
  • Fatigue
  • Hyperactivity
  • Tearful
  • Pains in the neck or back
  • Headaches
  • Heart palpitations or pains in the chest
  • Dizzy spells
  • Appetite changes
  • Flashbacks or "reliving" the event
  • Jumpiness: tendency to startle

Emotional reactions

  • Irritability
  • Anger
  • Sadness
  • Feelings of anxiety or helplessness
  • Feeling vulnerable
  • Feeling overwhelmed
  • Low motivation, listlessness
  • Survivor guilt

Effects on productivity

  • Inability to concentrate
  • Increased incidence of errors
  • Memory lapses
  • Increased absenteeism
  • Tendency to overwork / under work

For people who have experienced a trauma it is best if they:


  • Drink alcohol
  • Take unprescribed sleeping pills or medication
  • Isolate yourself
  • Get overtired
  • Miss meals
  • Bottle up emotions
  • Take holidays on your own


  • Talk about the incident
  • Talk about your feelings
  • Speak to a doctor
  • Try relaxation
  • Take exercise
  • Get back to the location of the incident
  • Go back to work

People seldom have all of them, but you may experience some of them. If you do, your coping is entirely normal.

Do not be surprised if you have different reactions at different times. Having reactions in this manner allows you to avoid an emotional overload. Some of these are normal reactions. If they persist, then you need to talk to somebody about them.

Do not be surprised if you find you are overly attentive to matters relating to safety. After a traumatic event it is common for people to become concerned or preoccupied with their safety or the safety of others. It is normal to want to feel that we can do something to prevent further awful things from occurring.