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on 16 June 2012
No one goes through life without experiencing anxiety from time to time.This concise book however is about the severe forms of anxiety that would be considered a clinical problem and represent the commonest type of emotional disorder afflicting millions.This is another pithy illuminating review from the Freeman brothers' team who produced a previous account on Paranoia that I thoroughly enjoyed.They have a knack of explaining complex psychological and neurobiological concepts with great clarity and fluency.The text provides a comprehensive look at all aspects of the condition,the theoretical explanations of the disorder, the interplay of genes and life experiences which influence susceptibility,a clinical description of the six main anxiety disorders and finally the treatment options on offer.

I particularly enjoyed their account of the cognitive aspects of the disorder.Emotions arise from the way we appraise or interpret events. Anxiety sufferers possess unhelpful schematic beliefs about themselves, overestimating the potential threats of future events and underestimating their ability to cope with them.They tend to use instinctive emotional reasoning.Fear is a product of interpretation as thoughts and feelings are closely related.It seems that " Cognitive psychology" is becoming the dominant paradigm in this field.The neurobiological explanations of anxiety in terms of imbalance of certain parts of the limbic system or the imbalance of the neurochemicals are undoubtedly important but their elucidation have not borne out any great therapeutic results.The practical applications derived from understanding the mistaken beliefs of the sufferer have led to formulate"Cognitive behavioural Therapy" that has been much more effective than treatment with drugs like SSRIs or Benzodiazepines.Unfortunately despite its success very few sufferers receive it because of considerable shortage of trained professionals in the field.

I was fascinated to learn that OCD(obsessive-compulsive disorder) is the only anxiety disorder which can be occasionally helped by means of Neurosurgery( cingulotomy)if intractable, as its neurological malfunction circuit is different from the other types.It was also interesting to find out that of all the phobias, blood phobia is the only one that result in a drop of blood pressure and possible fainting.Other phobias if anything put up the heart rate and blood pressure.

The text despite its conciseness is full of remarkable insights into this common emotional disorder.I would have liked a bit more information about stress and how it exacerbates the emotional reactions ,nevertheless this has been a thoroughly enjoyable and instructive read.
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on 31 May 2012
The `very short introductions' series from Oxford University Press is large in number much as the books are small in size. This is number 318. The books are diminutive but elegant to behold - their portability surely an asset. And they are not in fact very short - concise would be a better way to describe them.

This edition on anxiety is marked by its balance - it really does emphasise how very much anxiety is a normal part of daily life, but can gain momentum to become problematical. The balance is also evident in the recognition that science does not hold all the answers. The latest view on its potential genetic basis, for example, tends to steer towards a poly-genetic cause, but even then, the environment is seen as at least a partial factor in anxiety problems.

The book starts by covering a history of anxiety understandings, along with related theories. It builds slowly and comfortably, almost as if to calm any anxiety the reader might be experiencing. The reading experience is very engaging and entertaining as well as informative.

Before individual chapters on 6 types of anxiety, a splendid chapter relates the real-world experience of Michael Palin, the comedy and traveller, and Graham Taylor, the football manager. It is very enlightening to hear how very successful people also experience anxiety, even if not the all-consuming form that plagues many of us. But it would, I feel, have been better to hear from a sufferer in place of one of these celebrities - to hear how anxiety affected their life and how they overcame the affliction.

The main types of anxiety covered are phobias, social-phobia, panic disorder, generalised anxiety disorder, obsessive-compulsive disorder and post-traumatic-stress disorder. (But later, on discussion of treatments proffered to sufferers, `mixed anxiety and depressive episode' replaces social phobia. The only mention of this form of anxiety in the book).

The key problems with anxiety becoming engrained and spiralling out of control are well covered, many foretold by the nature of childhood. (But little mention is made of the enormous effect of the environment during pregnancy, and nurturing in the first 12 months of life, where a neurotic nature can be formed).

The practical nature of the book is evident in the recommendations to distract the anxious mind from the physical effects of anxiety and thereby focus on engaging in the world. (The Palin narrative was especially informative on this matter). And of course to recommend CBT (Cognitive Behaviour Therapy) as first choice ahead of medication is spot on.

There are some in-depth discussions of measured brain activity in those who suffer from anxiety, but with obsessive-compulsive disorder, they fail to describe the nature of the frontal lobes to calm the amygdala - a weak feedback loop - that ensures repeated behaviours that are a hallmark of this condition. Explaining to sufferers that its not them but their brain structure to blame can help them relax the emotional grip of the amygdala.

It is easy to highly recommend this book. Do not be fooled by the size - this book is packed with useful information. They even find room for references for each chapter and a set of anxiety questionnaires (although it omits one for panic disorders).
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on 20 September 2012
Anxiety is prevalent in the adult population and many have problems severe enough to be considered as a clinical disorder. Accessible to the general readers, this book demystifies anxiety, major disorders of anxiety and their treatment.

Anxiety is an emotion which develops in human within first six months after birth. Its purpose is to alert us to potential threat and thus to react appropriately. Both genes and environment play a role in anxiety.

Major anxiety disorders are phobias (persistent and excessive fear), panic disorder, generalized anxiety disorder (excessive and uncontrollable worry), obsessive-compulsive disorder (regular and distressing impulses) and post-traumatic stress disorder. They are found to be more common in women than men. Cognitive behavior therapy (psychological therapy) is the preferred treatment of choice for anxiety disorders than by medication. Such treatments focus on changing the way people think about their sensations, panics and ability to cope with them.

I reckon that the common sense information of anxiety presented in the book is indispensable for all layman!
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on 22 February 2016
This book outlines some of the most common anxieties in the modern world. Its summaries of these conditions are adequate, but then the analysis of possible treatments is dealt with too briefly.
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on 3 May 2015
Fantastic reference to Anxiety. Clear outlines of the social and psychological factors. Get it if anxiety is a problem for you or you need an insight into the problems afflicting a loved one.
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on 27 May 2016
A great introduction into the philosophic as well as the biological anxiety: this covers many overtly anxiety based disorders such as OCD, phobias, and social phobias.
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on 18 December 2012
This little book gives a good overview of anxiety it's causes and treatment through various therapies.
There could be more detail but then it would have to be bigger!
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on 3 January 2014
This is a good introduction to some aspects of a subject concerning human being, namely "anxiety" (including fear, pp 11-12). Various approaches to the subject are concisely presented and main treatments are cursorily pointed out.
However this book ignores a number of cardinal issues, which should have been taken up even in a "brief introduction," such as: (1) Religious beliefs regarding adversity and traumas as God-ordained, and ideologies regarding suffering as a sign of heroism and of devotion to an important mission, which ameliorate anxiety and often prevent it; (2) societies getting used to anxiety-generating events, such as wars and terror, which are accepted as part of "normal" individual and national history.
Worse, the most extreme cases of anxiety-producing environments, such as concentration and killing camps and prolonged combat are not discussed. Studying the history of survivors of Nazi killing camps who later led a fulfilling live in supportive cultural and material environments leads to quite different understandings, well treated in professional literature amazingly ignored in this book.
This leads to post-traumatic stress disorders (pp. 102-110). Treating it has become quite an industry, a telling fact not mentioned in the book. But it is far from clear when it helps or rather reinforced post-traumatic symptoms by explicitly recognizing them as needed treatment instead of leaving them to natural healing processes -- with treatment in some respects creating the disease. This issue, as well recognized in some countries, should have been presented. And the overall sociology of anxiety disorders, which in part regards them as a socially constructed disease, in completely ignored.
In line with a rather narrow psychological approach also neglected are social psychological and cultural aspects, such as differentiation between societies more or less exposed to many traumatic events, which seem to produce quite some immunization of large parts of the population to anxiety disorders. And the book mainly deals with Anglo-American approaches, ignoring rather different ones in Western Europe, which are influenced by a history of war, occupation and mass-killing not experienced by the USA since the Civil War.
Luckily the human species has shown capacities to withstand much stress, such as the Black Pest in Europe, without long-term disabling psychological effects and without the benefits of post-trauma treatments. A more historical and comparative approach would have served to put the subject into broader perspectives, as needed for in-depth understanding.
This is all the more necessary because "anxiety" is likely to become much more acute and widespread in the foreseeable future because of likely large scale global traumatization, such as socio-economic crises, misuse of human enhancement, mass calamities caused by synthesized viruses, climate catastrophes, and so on.
Despite its narrow scope, I do recommend this short publication as a good though limited introduction to a subject that concerns all of us which can be read easily in two to three hours.
Professor Yehezkel Dror
The Hebrew University of Jerusalem
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