Most people are aware of what anxiety is like. Racing heart, sweating, tension in the muscles. But it can also be nausea, bladder urgency, jelly legs. At its worst it can sometimes be experienced as ringing in the ears, blurry or tunnel vision, delayed or racing thoughts, dissociation, and hearing voices.
I am glad you are here. There is misunderstanding about what anxiety is both amongst the public and mental health professionals. This means it’s hard to know how to really address it. In this section I will outline anxiety through the lens of psychoanalysis/attachment theory and particularly ISTDP (Intensive Short Term Dynamic Psychotherapy).
In many therapies (especially cognitive behavioural therapy or CBT), as well as folk psychology there is a belief that a thought can trigger anxiety. For example, thinking about an exam I have to take tomorrow makes me anxious.
However, neuroscience has cleared this up. We experience others and the world first in an unconscious way and we experience this with our emotions first. Conscious thought follows this process.
Fear is about objective danger
Fear is the physiological alarm state that we experience when we face an external risk such as a bus coming our way, a sound in the park at night.
Anxiety is about the emotions inside us
Anxiety, on the other hand, is what we feel when we there is a rise of an emotion inside us. Anger, sadness, and guilt in particular are emotions that can trigger anxiety so that rather than feeling angry or sad we become anxious. Anxiety can be a problem if we do not allow ourselves to fully and deeply experience our emotions. That’s where therapy can help.
Projection turns anxiety into fear
You may well have heard about projection. If we are unable to fully experience our feelings we may resort to projecting them.
This is very often the case with anger. Projecting this onto others then means we are afraid we will be the recipients of anger and will think we are being criticised, judged, rejected, or excluded.
Or take the example of sadness or attachment longing. We may become ‘compulsive caregivers’, looking after others, but neglecting ourselves.
Anxiety always occurs in relationships
When we experience anxiety it means that that we are feeling an emotions towards the other person, in the presence of another person, which makes us anxious. Rather than experiencing anger, for example, we experience anxiety. It is not necessary for the other person to be present, as “calling them up in our minds” can trigger the emotion and therefore the anxiety.
Why do emotions trigger anxiety?
The answer to this involves past experiences which shape how we relate to the world. Many of the experiences have occurred when we were very young before we had words. They are encoded, so to speak, in the body. Later trauma or discrimination/oppression can also shape our relatedness.
We essentially learn what emotions are OK to feel around our primary caregivers. If certain emotions are too distressing for them, they will begin to trigger anxiety in any situation where the risky emotion is likely to come up. Human beings also develop defences against the anxiety so often we don’t experience the anxiety either. This is commonly seen to those of us who appear unemotional or detached, for example.
How does therapy help
In therapy sessions, we pay careful attention to how you are feeling moment to moment. For example, your therapist may notice that in response to talking about a topic your body language changes. You appear tense and shift a lot. The therapist may say “I noticed we were talking about so and so and you started to become anxious. Can we look at what you feel inside towards so and so, so that you don’t get anxious instead?” Allowing oneself to experience emotions fully, in the presence of another person, reduces anxiety, provides information about what is important to you, and allows for deeper connection to that person.
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