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The Vicious Cycle
Generalizations, catastrophizing, and dichotomous thinking all act to generate a primal response. Shortness of breath is an example of a primal response. If you recall, a primal response is one that is applied to automatic, unconscious, involutional activation or inhibition of a behavior pattern. A freeze reaction and mental blocking are examples of primal responses. These primal responses sometimes create a vicious cycle. Think of a client you have that exhibits primal responses as a response to anxiety.

Symptoms that Pose a Threat
The spiraling, or vicious cycle in anxiety disorders, can be seen as you observe how a particular symptom may, in itself, pose a threat. This threat occurs either by impairing performance or by indicating to a suggestible person that it is a sign of a serious disorder. These secondary effects make your client feel even more vulnerable. As the sense of danger increases, more primal responses are activated, and these, in turn, may present further handicaps and threats. Unfavorable feedback from others has a similar negative effect.

Here's an example of how this cycle, from impaired performance signs of a serious disorder, creates a vicious cycle.

I treated a client, Joe, who had to give regular team presentations at work. Joe perceived a serious flaw in his performance. He based this "perception" on negative responses from the team, such as yawning, restlessness, etc. Also, he felt he had a lack of organization, poor inflection, and rambled. Next, he had fears such as, "I may not be able to hold their attention--They may look down on me because of my lapses--I may not be able to keep going." These ideas increased his sense of vulnerability and stir up anxiety and other defensive mechanisms.

How Joe's Anxiety Led to Further Dysfunction
The anxiety itself led to further dysfunction.
First, the unpleasant emotional experience served to distract him from the task at hand just as would a sudden, sharp pain.
Secondly, he interpreted his anxiety as a sign that he is not functioning well, that he does not have control over himself -- that is, the intensity of his anxiety rather than any accurate assessment of his actual performance is taken as evidence of his dysfunction. He is in the grip of notions such as, "This is a sign that I'm not making it."

As Joe's attention is diverted to his anxiety, there may, indeed, be an increase in his outward show of "nervousness" as well as increased difficulty in performance. He became increasingly "weak and powerless," he sensed his greatest danger and his vulnerability to disapproval from the audience. He began to believe that he could not depend on his functional capacities to see him through this crisis.

However, if Joe received positive signals from the audience, he believes that he is performing well, he is less likely to feel threatened. He thinks, for instance, "At least I'm getting across somewhat to the team," and "They seem receptive so I guess they are not going to attack me." Any interference with his voluntary control over his thinking and speech, over his posture and over subjective sensations such as nervousness, will decrease his self-confidence.

"I'm not in control of my body."
However, symptoms such as swaying, a quivering voice, faint feelings, loss of fluency, rigid posture, all mean to him, "I'm not in control of my body." The sense of one's control slipping often means that "anything can happen," and voluntary control is especially devastating to people who place a high premium on having control because of their need for autonomy.

The negative evaluation of self, of their performance, and of the audience's response increased the anxiety, which further interferes with performance and reinforces the notion of being deficient.

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