Anxiety, Get Thee Behind Me.

One of the most common experiences that leads people to seek therapy is anxiety. Which makes sense. Anxiety is an uncomfortable feeling you’re having, maybe along with worries you can’t shake, so why not look for help from someone whose job it is to understand anxiety and to know what to do about it?

I treat a lot of different presentations of anxiety, and one of the first conversations I have with a client on this topic will be:

What’s the goal of our work on anxiety?

This might sound like an unnecessary question. Isn’t the obvious answer, to get rid of the anxiety?

Addressing that question, and clarifying the goals of anxiety work in therapy, suggests a first question:

What is anxiety for? Why does it exists in the human experience?

Anxiety isn’t a mistake or a dysfunction; it serves a purpose. Anxiety is there, built in to our system, to warn of us impending danger, and to feel uncomfortable enough to make us take some action to make the danger go away before the feeling of anxiety withdraws. And when I say “danger,” this could be physical danger or emotional danger. Sometimes the perceived threat is about a concrete event happening; sometimes it’s about a relational situation that feels frightening to experience. That second type can sometimes take a little reflections to sniff out.

Now: since anxiety is a built-in survival mechanism, we wouldn’t be trying to make it so that you never feel anxiety again. That’s too high a bar, and also it would rob you of a crucial survival tool. Let me suggest more feasible and healthy goals for anxiety work:

Let’s make it so that when you feel anxiety:

  1. You can identify the reason you’re feeling anxious; and
  2. The amount of anxiety you feel is proportional to what’s actually going on.

If you can get to that point, then you don’t have to add the worry that when you feel anxious it means that there’s something wrong with you. Because a lot of the time, it doesn’t.

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