Again, the short answer - it’s a mixed bag.
Treatment very much depends on your individual causal factors, how your anxiety symptoms are impacting you, and what you want to get out of therapy. Treatment also depends on your personality and what approach works best for your temperament and learning styles.
I’m not a step-by-step therapist. You bring your most pressing concerns to our sessions, and we take it from there. Whatever it is that matters most to you, that’s where we need to be. We wade into your inner world together and see what we find.
Depending on the needs of the individual client, I tend towards the following treatment avenues. As you read through these, are there some that you feel drawn to?
How Can We Treat Anxiety?
Supporting the Nervous System: Our poor, battered, exhausted nervous systems! If we go through enough stress, instability, or trauma in our lives, our nervous system can get hijacked. Our sympathetic nervous system (fight, flight) goes into a state of overdrive and gets stuck there. Even when we’re doing our best to relax, we feel like we’re always carrying stress and tension within us.
To help the sympathetic nervous system calm down, we work on supporting the parasympathetic nervous system, which is our nervous system’s counterbalance to fight, flight and freeze. When we are “in parasympathetic,” it is easier for us to feel peaceful, connected to others, and safe.
There are so many ways to support our parasympathetic nervous system and create a sense of safety in our bodies – we do this through breathing and relaxation techniques, building mindful acceptance, and by listening and responding to our own feelings and needs.
Building Self-Awareness and Self-Acceptance: If I had to isolate one thing that makes therapy helpful, I would say this: therapy gives us a space to share our thoughts and feelings in a non-judgemental environment, which leads to inner clarity and acceptance.
The most powerful thing we can do for our mental health is to know what we are thinking and feeling at any given time, and to be okay with whatever thoughts and feelings are arising within us. It’s that simple.
Sadly, though, we live in a culture that teaches us to be suspicious and dismissive of our feelings and needs. In many ways, anxiety grows from a constant internal battle where we say “I shouldn’t feel this way,” or “What’s wrong with me that I’m thinking this way?” But the fact is that we DO feel or think this way, and probably for good reasons.
In therapy, I focus on building the ability to see our thoughts, feelings, bodies, and needs with clear, compassionate awareness. We learn to allow our emotions to flow through us, to embrace where we’re at in life, and to honour the realities of our inner self, warts and all. When we are open to our inner experience, it’s easier to create a sane, realistic path ahead for ourselves.
Moving from Perfectionism and Low Self-Esteem to Self Compassion: Oh the horrific things we think about ourselves! If we were to write down all the cruel, unforgiving things we say to ourselves throughout the day, chances are we’d have an ugly list that our worst bully would never say (try it - you’ll be shocked). In this environment, anxiety thrives.
Once we build awareness about how hard we are on ourselves, the task is to explore where we learned to be this way. What critical voices from family, peers, and culture have we internalized? We learn how to gently lay those shaming voices aside. We get better at seeing our own strengths. We learn how to treat ourselves like a beloved friend who we deeply value, and to show up for ourselves with tender kindness.
Questioning Our Beliefs and Thinking Patterns: Do we have to believe everything we think? Many of us live with thought patterns that create anxiety within. Part of therapy is seeing these thought patterns, exposing their roots, and finding new ways to think about ourselves, others, and the world.
We can get caught up in extreme thinking. “I’m a failure”; “You can’t trust anyone”; “Nothing ever works out.” These are thought patterns that have been handed down to us by our caregivers, society, and negative life experiences. We can internalize these thoughts until they become habitual. When they show up, these extreme thoughts often come with intense emotions and destructive behaviors.
The good news is that our brains are plastic. We can rewire our thought patterns and shift how we think. We do this through first being aware that we’re thinking this way, then using strategies like questioning the logic of our thoughts, or by learning how to “think in the grey zone.” We learn how to “drop the storyline,” and let go of the rigid narratives that we carry about who we are. We also do this by addressing the traumas that are at the root of these beliefs.
Making Space for Our Feelings: We live in a culture that has very warped ideas about emotions. We are taught to see sadness, anger, grief, and fear as irrational enemies that we must control. We are embarrassed when we cry, we disown our anger, and we stuff down our grief. We are supposed to put on a smile and be happy, and if we’re not happy, we must be getting it wrong. All of this repression sets us up for anxious states.
It’s such a tragedy that we have been taught to mistrust and negate our emotions. They have so much to offer us. They flow naturally from our life experiences, and they long to be tended to by us. When we connect with our feelings, we can release anxiety and stress. In therapy, we learn how to slow down at the feeling level and give our emotions space to flow.
Understanding and Processing Trauma: Trauma often lies at the heart of our anxiety symptoms. Extremely challenging life experiences, chronic stress, a violent assault, emotional neglect – trauma has many faces. Some traumas are obvious to us, but others are harder to see. Traumatic experiences can lead us to believe that life isn’t safe, that we can’t trust others, and that we need to be on constant alert for danger. Trauma can have us believing that we deserve to be treated poorly, that we shouldn’t set boundaries, or that there’s something essentially wrong with us.
In therapy, we examine the role of trauma in our current struggles with anxiety. We put the puzzle pieces together as we look at how family and childhood experiences impact us today. We question and let go of trauma-based beliefs. We gently engage with emotional states that could not be expressed when traumas occurred. We let go of survival strategies that helped us in the past, but which no longer serve us. We see with compassion that we did what we needed to do to survive, and we honour our strength and resilience.
Identifying and Addressing Stressors: Anxiety tends to ramp up when we are going through stress. In therapy, we explore how stress impacts us. Does the stress have to do with our own perfectionism and high expectations? Is our stress rooted in trauma? Are there ways that we can care for ourselves daily that prevent stressors from overwhelming us?
Are there ways that our life could be simplified, re-evaluated, or changed that would help our nervous system to relax? It’s not uncommon to discover in therapy that our anxiety is related to stressors that our system can no longer abide, such as a toxic work environment, poor boundaries in a relationship, social isolation, or caregiver burnout - to name a few.
Anxiety can be a helpful alarm that cries out “Something in my life isn’t working! I need to make a change!” Once intolerable stressors are identified, we can explore how to bring about change.
Building a Healthy Lifestyle and Daily Self-Care Routines: We’ve all heard about the connection between exercise, diet, balanced living, and mental health. We all know that we’re supposed to do yoga, eat healthy, get a cardio routine going, get out in nature, cut down on Instagram, Netflix, alcohol … the list goes on. I don’t harp too much on lifestyle in our sessions because the chances are that you’re working on it. We try. We truly try.
When it comes to anxiety, there are basic tried and true practices that help us to manage and reduce our symptoms. These practices support our parasympathetic nervous system, and include breathing techniques, body relaxation practices, and mindfulness interventions. In therapy, I’ll encourage giving these a go to see what helps.
We can also explore what keeps us from forming healthy habits. Spoiler alert – it’s not because you’re lazy. How much do we use our addictive behaviors to manage anxiety? How does our sense of self-worth impact how much we invest in our self-care? What role does stress and exhaustion play in making healthy choices? How has trauma created behaviors that harm us? What happens when we put the “lifestyle to do” list aside and allow ourselves to do whatever it is we truly want to do with our precious free time?
What I find is that once my clients start to gain clarity about their inner worlds, lifestyle changes naturally occur. Self-care arises organically from a more aware, accepting, and compassionate stance.
Seeing the Bigger Cultural Picture: We live in a culture that is all too happy to blame us as individuals when we are struggling with our mental health. If we’re struggling, it’s because we personally got it wrong somehow. In therapy, we do spend a lot of time looking at the individual self – our individual traumas, our individual psyches, our individual solutions. This is the bread and butter of traditional Western psychology.
However, culture matters. A lot. In therapy, it can be helpful to look at how assumptions in our cultures have impacted us. What have we been told by our society about who we can be? How has poverty, racism, or sexism harmed us? How have the institutions in our lives compromised us? How can we live authentically in a world that punishes us when we don’t fit in? How do we make sense of pandemics, war, climate change, and the many disturbing uncertainties of our modern world? Seeing the bigger cultural picture can help us to let go of self-blame and to interact with our world more compassionately.
Meaning and Connection: What is the meaning of your life? How do you understand the purpose of your existence? Do you see yourself as ultimately isolated, vulnerable, and rudderless, or do you see yourself as connected to others, to nature, and to a greater whole? Anxiety often goes hand in hand with the belief that we are essentially alone, unsupported, and unequipped to deal with life’s challenges.
In therapy, we can explore a world view that sees suffering as the well-spring of our growth. Life is hard, yes, but we can learn from our hardships. Suffering can open our hearts and connect us to ourselves, our loved ones, and our community. We can open up to the possibility that we have inherent value - that all people have inherent value and dignity which is worthy of our protection.