THE HIDDEN FACES OF ANXIETY - PART 1 - understanding the cause of anxiety to better deal with it!

A lot has been written about anxiety by now. In my experience this word is sometimes missused and can cover a range of states/feelings many times unclear.

My intention with this article is to contribute to a better understanding of anxiety and to underline the complexity of this feeling/state/reaction - and by that, to invite to a better scrutiny/thoroughness in looking for help for anxiety. My hope is that, it will also give inspiration for more suitable ways to relate to and navigate anxiety.

This article is inspired from my own experience working with clients in my private practice and from collaborating with shelters for both victims of human trafficking and women victims of abuse in their close relationships. Furthermore I use the knowledge that I acquired during the years of reading literature on the topic. (I will put some references at the end).

I will write about how I have come to understand anxiety and what I have seen as helpfull to the various clients I have worked with.

It is not meant as a scientific article.

In the process of writing I have discovered that it becomes a longer article than I intended. In part because of the complexity of the subject and in part because I want to describe as much of the complexity as possible. So it became a 3 part article with the following content:

PART 1 covers:

• Introduction

• Signs of anxiety

• Some points that I challenge about anxiety

• How I approach it

• What is anxiety and what might be behind anxiety - it's functionality

• Anxiety from an existential perspective

PART 2 covers:

• Anxiety as a sign of stres

• Anxiety as result of a traumatic experience

Go directly to Part 2 by clicking here.

Part 3 covers:

• Anxiety as cover for old wounds - childhood relational trauma - the connection to attachment and the connection to shame.

• A few words about our environment and it's relationship to anxiety

Go directly to Part 3 by clicking here.

INTRODUCTION - SOME CLARIFYING POINTS:

A nuancing is needed here - anxiety can be regarded from two perspectives:

• the healthy one, part of our life, of our existence - some examples - change brings both enthusiasm and anxiety with it (a new job), the unknown is another thing that can bring anxiousness (a new city, group of people), pushing our limits when learning something new, etc.

• the unhealthy one that needs help to be dealt with - that prevents us to live and keeps us in a survival mode - the one that can be constantly present - like a background music that never goes away, and it's so present that it becomes part of who we are (or we think so). The one that can paralyze us and our actions.

This article is about the second one - the anxiety that can disrupt our functionality and our relationships.

SIGNS THAT ONE POTENTIALLY HAS ANXIETY

Body reactions:

• pressure in the chest/in the gut,

  
  

• inner and/or outer restlessness

  
  

• shortness of breath

  
  

• irregular heartbeat

  
  

• cold and/or sweaty extremities

Mental signs:

• overthinking situations, discussions, actions

  
  

• thought spiraling that leads to difficulty to sleep (fell asleep and sleep)

Behavioral signs:

• need of control and signs of obsessive compulsive behavior (OCD)

  
  

• procrastination

  
  

•  difficulty to wait (f eg for an answer)

• difficulty to contain the unknown

Emotional signs:

• a sense of dread or imminent danger

  
  

• feeling easily emotionally overwhelmed

  
  

There are people that don't feel the anxiety and don't regard themself as anxious, but they still are - f eg people don't connect over thinking or procrastination with anxiety.

The list is not exhaustive ... and these signs can be all present or only some of them.

SOME POINTS THAT I CHALLENGE - THAT I CONSIDER "MYTHS" OR NARRATIVES ABOUT THE UNHEALTHY ANXIETY

• "having anxiety/being constantly anxious is normal" - although a lot of people live this way (and I experience that there is a tendency to normalize it, at least on social media). I think it is possible to live. a life that is not guided/controlled by anxiety.

  This narrative leads to the next:

  
  

• "you have to learn to live with it, you have no choice" - this comes from the perspective that anxiety is the disease - I disagree - you can heal and live an anxiety free life - but you have to understand what is behind anxiety

  
  

• "medication cures the anxiety" - at best, it keeps it at bay - and by doing that, it gives a feeling of being cured on the short run - but it's not addressing the reasons of anxiety. Medication can help stabilize someone whos life is heavily disrupted by anxiety - and who in the meanwhile works on the cause of the anxiety. So medication can be a temporary means that helps to start the real work with healing anxiety and not the cure itself.

  
  

• "you can train yourself out of anxiety" - yes, on the short run (you can have some metacognitive and behavioral "tools" that help and you can experience results) BUT no, on the long run - if the underlying reasons are not dealt with, there is a big chance that anxiety will come back).

HOW I APPROACH ANXIETY:

1. I regard anxiety as a symptom that wants to tell me something.

2. I regard anxiety as my friend and not my enemy.

   
   

3. I don't focus on fixing anxiety - meaning I don't give tools for managing/controlling anxiety although it can be satisfying to do that. WHY? I think fixing helps like a plaster for the short term because it does not resolve the cause - it can south for a while - but it will most probably come back …. 

   
   

   We can talk in therapy about some strategis that can help manage anxiety while we work on the main reasons.

   
   

4. I am looking for the cause - WHY? In my experience, when the reason or reasons of anxiety will be addressed, anxiety's function is done and is not needed anymore. That is why it will be less and less in time until it's gone.

5. I look at anxiety from a trauma perspective, using a trauma lens.

6. I look at anxiety from an existential point of view.

WHAT IS THE CAUSE OF ANXIETY - TO DEAL WITH ANXIETY WE NEED TO UNDERSTAND IT'S FUNCTION

What is anxiety:

• A mental state - constant worry - negative expectation

• A physical state - tension, restlessness and unease

• A emotion - unrest, alarm, dreadfulness

The list is not complete and it can be all of them or some of them.

What might be behind anxiety:

In my experience, for the most, anxiety is a cover for the following three conditions/possibilities:

• stress

• relational trauma and/or childhood trauma - abuse, neglect, attachment.

• a traumatic event - f eg sexual abuse or traffic incident, unexpected loss of a loved one....

I will address each of them separately.

I do not say that these are the only conditions - these are the conditions that I met in my work with clients.

Anxiety's function:

I am convinced that anxiety has a function - most likely it's a lid that keeps

deeper feelings/emotions at bay. In that sense, anxiety functions as a protective mechanism.

The better we understand anxiety's function, the better we can deal with it.

Here is an extract from Lars Sørensens book (the translation is mine):

"A lot suggests that anxiety is not an independent emotion but a reaction that relates to other emotions. Anxiety appears when the emotions are too painful and unbearable. Usually the person does not perceive that connection. On the contrary, it is part of the hidden nature of the anxiety - that the anxiety attack is being perceived as coming unannounced and without connection to something. It is as if the intention of the "feeling the anxiety" is to give the person “the anxiety” to occupy its attention and be worried about, because what has happened is too painful for the mind to take care of."

What is anxiety protecting us from? It depends on the emotion that the anxiety covers. If underneath anxiety is anger, anxiety protects us from feeling the anger because we are afraid to be overwhelmed by the destructive dangerous fury if we allow ourselves to feel it.

In case of sadness/grief underneath - anxiety is triggered because we are afraid that, if we feel the sadness, it will never end and we will drown in sadness and become insane.

ANXIETY FROM AN EXISTENTIAL POINT OF VIEW

I chose to write about the existential perspective because it helps to have a broader understanding of the complex topic of anxiety. For this chapter I use as inspiration Schibbye's book "Relationships". Sometimes I quote her and sometimes I write my interpretation of how I understand Schibbye integrated with my own experience from working with clients.

Schibbye talks about the outer world and the inner world - the external that influences us (norms, rules, society, education…) and our inner core that we are born with (that

exists before the external).

A way that our inner core (our inner world, our sens of self) shows up is in the form of helplessness, emptiness and most of all anxiety.

The external contributes to our feeling of safety. BUT, if our feeling of inner safety is determined only from the external (a job, a relationship, money, else), the moment that we loose the external safety (f eg because of change) then anxiety arises. Because the risk is -  If we are not a thing with an externally - controlled identity, we risk to be “nothing” or no thing. This is anxiety provoking.

So, in an existential crises, when anxiety comes, there are two possible scenarios:

• clinging even more to the external and gaining more control of that or,

• freedom through getting to know our own sense of self (inner core).

In my opinion, what determines whether the anxiety will lead to the one or the other scenario is, how aware we are of our anxiety and if we make the active choice to be curious and work on ourselves.

That means that - anxiety can represent a possibility for liberating ones self and self realization.

And, anxiety can also be extreme and therefore paralyzing.

The focus on the outer world can keep the individual disconnected from the inner core - protected from ones self.

A safe feeling of ones self value can not be entirely dependent on the external world but has to be anchored in the inner core.

As therapist my job is to help become aware and challenge the influence of the external world. In that way the person comes closer and discovers the dipper inner world.

Another way to consider the existential perspective is the conflict between integrity and collaboration that Jesper Juul talks about in his book "Your competent child". Throughout our entire life we have to constantly navigate choosing between taking care of our integrity (needs, boundaries, wishes, mm) and to collaborate with the people around us, with the environment we are in.

The way I see the connection to anxiety - when the conflict is unbalanced in the sense that we over collaborate, then anxiety can knock on the door. The function of anxiety will be to cover up for the underneath emotions that arise because of the over collaboration (pain, sadness, anger, helplessness, etc). In that sense, we will focus on managing the anxiety and continue to over collaborate, instead of confronting ourselves with the situation, because that would feel too dangerous, unsafe, uncomfortable.

Navigating this conflict in our adult life depends on the quality of the relationship that we have had with our caregivers and the safety/unsafety of the environment we grew up.

Click here to continue to PART 2 of the article that covers:

• Anxiety as a sign of stres

• Anxiety as result of a traumatic experience

The literature that I use for inspiration is written in Danish - the translation is mine both of the text and the titles.

Literature references:

1. Lars Sørensen "Shame - innate and learned/acquired. When shame leads to soul murder" (The original title: "Skam - medfødt og tillært. Når skam fører til sjælemord".) Hans Rietzels Forlag 2013

2. Anne-Lise Løvlie Schibbye "Relationships - a dialectical perspective on existential and psychodynamic psychotherapy" (The original title: "Relationer - et dialektisk perspektiv på eksistentiel og psykodynamisk psykoterapi") Akademisk Forlag 2010

3. Jesper Juul "Your competent child - toward a new paradigm in parenting and education" Balboa Press 2011