Living with Anxiety: Taking the Long View

During my first meeting with a prospective client, I like to ask a few key questions:

How would we know if therapy was working for you?

What would be some signs that we could look for that would suggest that we were making progress toward your goals?

Responses to these kinds of questions vary; however, since I frequently treat clients presenting with concerns related to anxiety, responses often go something like this:

I would feel less anxious.  I wouldn’t be so controlled by my emotions.  I could make decisions based on what I wanted to do, instead of based on how much anxiety I think I would feel in any given situation.  I would feel more free.

What people don’t say: I wouldn’t feel anxious anymore.

My clients don’t ordinarily expect to be free from anxiety.  Perhaps that’s because we recognize that anxiety is an adaptive emotion that we actually need for survival.  After all, an adequate fear response in the face of imminent danger (think vehicle barreling toward you on the interstate) significantly increases our chance of survival.  However, due to biology, learning/conditioning, trauma, or a combination of these, many of us have developed a hyper-responsive alarm system; that is, a central nervous system that fires more often, for greater duration, and/or more intensely than what is needed for survival and optimal living.  

So what do we do about anxiety?

We are fortunate to have a number of really great options.  Some approaches focus on altering one’s physical response to anxiety.  We can learn to use paced breathing and progressive muscle relaxation to slow or counter the stress response.  A cognitive approach can help us learn to identify thoughts responsible for activating/enhancing anxiety and learn to challenge and restructure thoughts to be more accurate (and less emotionally “inflammatory”).  A behavioral approach might lead to increased engagement with pleasurable activities and experiences that provide a sense of accomplishment and mastery.  There is also a vast body of evidence that supports the use of interventions that expose us to our fears (e.g., elevators, arachnids, bridges) in objectively safe situations, in order to promote new learning (i.e., feelings of fear are not proof of danger; riding in an elevator is not objectively dangerous; I can ride in a elevator without bad things happening; I can cope with my anxiety in an elevator).  All of these approaches are valuable.  In particular, evidence-based psychotherapies, many of which contain a combination of two or more of the interventions listed above can help people feel better, faster, compared to psychotherapies that are not evidence-based.  

Taking the long view: Feeling better, faster

The “tag-line” for be. is “Feel Better, Faster.” I chose this years ago to emphasize the importance of using evidence-based psychotherapy – therapies shown to be effective through scientific research – to help people feel better as quickly as possible, because I fundamentally believe that people deserve to have access to effective treatments. [Side rant: When you see your physician, don’t you expect to be evaluated and treated with evidence-based, scientifically supported practices?  Don’t you want the same for your emotional health and wellness? End rant.]

In addition to emphasizing the importance of access to evidence-based psychotherapy, there is another reason that I chose “Feel Better, Faster.”  Here’s the thing: taking the long view – that is, learning to feel – or to feel better – learning to be with our thoughts and emotions in a safe and compassionate way results in greater psychological health and a richer lived experience.  Most of us were raised to value certain emotions over others (e.g., happiness: “great!”; anger: “nope!”); some were taught to fear their emotions (or learned to fear the “big” emotions of others); others were punished if they showed any emotion at all.  It’s no wonder that we have a complicated relationship with our feelings and have difficulty feeling them safely and with compassion.  What if the answer to feeling better isn’t so much about symptom reduction or feeling less anxiety?  What if, instead, it’s about learning to feel our anxiety (and perhaps other emotions, too) with less resistance; less struggle; less negative self-judgment; less fear?  What if you could be less anxious about your anxiety?  Can you imagine what that might be like?  What if you could have your anxiety AND live a life that was full, authentic, connected, and meaningful?  

Wait.  Shhhhhh.  Did you hear that?  Was that what I think it was?  Was that your mind telling you that you can’t possibly have that?  Thank your mind for that thought, and keep an eye on this spot.