Efficacy of EMDR Treatment in Generalized Anxiety Disorder after a Long-Standing Pharmacological Treatment - A Case Report.

Anxiety is generally defined as a response of the human body to danger or threat. It usually occurs when, on the one hand, a person does not expect that in the future everything will be alright, and on the other hand, does not feel ready for such a future. It can be more precisely defined as a feeling of apprehension, which occurs as a response to a threat that a person considers vital for his/her existence. Anxiety is an unpleasant emotion of fear and apprehension. The main difference between fear and anxiety is that, with fear, there is a real threat in the present. Whereas with anxiety, this threat is anticipated in the future. The purpose of anxiety is explained with the evolution theory (Bujas 2014, Crnkovi 2017). During human evolution, anxiety has served to enable the protection of the system, namely to motivate the adaptive functions inducing the flight-or-flight response in potentially dangerous situations. (Beck et al. 1985, Hawton et al. 2008). Anxiety is an inevitable part of life in the modern world. There are many situations in our everyday life in which it is appropriate to react with a certain level of anxiety. Anxiety becomes a problem when it occurs at times when there is no real danger or when it continues long after the stressful situation had passed. When the acceleration of processes in the body is delayed at the time when no action is needed, a person will notice only the bad sides of anxiety, unpleasant aspects of body changes. After that, anxiety starts affecting a person’s everyday life and it is necessary to learn how to control it. In a later stage of his thinking about anxiety, Freud linked the appearance of anxiety itself to "traumatic situations" in which anxiety develops automatically because the psyche is overwhelmed by an excessive influx of stimuli that it can no longer control and can be relieved of "dangerous situations" in which a person learns to anticipate danger before it becomes traumatic. In anticipation of a dangerous situation, signal anxiety arises, which serves to mobilize forces under the guidance of the Ego, to make the person more prepared to face the traumatic situation or to avoid it. Given that the function of the Ego is to control incoming stimuli or to relieve them effectively, it is to be expected that traumatic situations will occur more frequently in early childhood, when the ego is still relatively weak and underdeveloped (Rudan 2017). Anxiety affects the entire being because it is simultaneously a physiological, behavioral, and psychological reaction. On a physiological level, it can include bodily reactions such as palpitations, muscle tension, nausea, mouth dryness, or sweating. On a behavioral level, anxiety can decrease a person’s ability to act, to express himself/herself, or to deal with everyday situations. Psychologically speaking, anxiety is a subjective state of apprehension and anguish. By itself, anxiety is not an abnormal reaction but a normal manifestation of human nature which is a part of a hereditary repertoire (Born 2012). However, being in a prolonged state of anxiety is a self-devastating tendency in humans. People have a choice to leave the state of anxiety when they realize it is dysfunctional, that is, when it hinders solving problems (Ellis & Harper 1996). Although not abnormal, the state of anxiety does not contribute to efficient problem solving, on the contrary, it interrupts it. Generalized anxiety disorder is characterized by chronic anxiety that lasts for at least six months. Dealing with generalized anxiety disorder is followed by a worry whose intensity and frequency are always excessive compared with the probability that the events a person is afraid of will ever occur. Generalized anxiety disorder, according to the view that Beck and Emery suggest (according to Born 2012), is manifested with ‘basic fears’ which are more general in nature than specific phobias. Examples of basic fears are: fear of loss of control, fear of not being able to overcome difficulties, fear of rejection or abandonment, fear of death, or illness.