Even though a person might recognize that the muscular pain and difficulties in breathing were simply a response to stress, if the bodily reactions are extreme the experience can be uncomfortable and frightening enough to give rise to a fear of the symptoms of anxiety: a fear of fear. Anticipation of this discomfort, the fear of finding oneself in pain and having difficulty breathing, can then produce the stress that triggers the problem.
Bodily reactions to stress and anxiety attacks can perpetuate problems in other ways. The physical symptoms of shaking, sweating, nausea and faltering voice can indeed impair a person’s performance, particularly in public or social settings. An awareness of this can easily undermine the confidence of an anxious person, increase worries about performance and worsen the physical symptoms.
Consider the person who is afraid of spilling tea as he carries a cup across a room, or the anxious child who has to recite a poem to his class and is scared that he might falter. In each case the fear of making mistakes could bring about what the individual most fears: trembling to the point of spilling the tea, and becoming inarticulate.
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