Anxiety Is More Complex Than We Might Think |
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Chronic anxiety is a key symptom of complex trauma.
In therapy, over-simplification can lead to disappointment.
Recovery may require attention to many areas of life and a variety of approaches and may take time.
The therapist’s regulation of their own anxiety is key to the work.
Anxiety can be a necessary response to potential threats, but also a serious chronic condition that negatively affects our functioning and well-being. In either case, we feel wary and on edge, scared or irritable, with overactive thoughts. We are tense and easily startled into more powerful fear responses.
The key factor is whether our fear-system, our biological responses to threat, can ‘switch off’ once the threat has passed. If we hear a strange creak alone in bed at night, we might tense up, hold our breath and listen carefully; our heart beating faster. If we hear it again and recognise the hot water pipe noises, we can relax and quickly fall back to sleep.
However, if anxiety is a habitual state, we might still guess that it was the hot water pipes, but we can’t relax—we keep imagining an intruder breaking in—staying awake for hours in a state of fear.
What is anxiety? The biological response is at the core, what I call fear-alert, our instinctive reaction to danger sensed at a distance.[1] Our hearing, eyesight, and sense of smell become more acute to evaluate the threat, and our startle response is readied, and the nerve signal regulating our heart rate is withdrawn. The ‘brake’ that holds our fear........