An introduction to working with anxiety | Kelly Hearn

Psychotherapist Kelly Hearn offers an introduction to working with anxiety and how to manage a reactive nervous system. Kelly offers practical insights into ways in which you can learn to ground during uncertain times. She explains how yoga, breathwork and meditation can offer support.

Working with anxiety

As a psychotherapist, I work with clients on managing their anxiety.  As someone with a highly reactive nervous system, I’ve also had decades of practice managing my own and so have a deep personal connection to this work. While anxiety feels pretty pervasive at the moment, the good news is there is a lot we can do to actively support ourselves in anxious times.  This is what I’m referring to when I talk about working with anxiety.

I was thrilled to be asked to contribute to the Movement for Modern Life course because it offers practices I know to be effective, and highly complementary to psychotherapy.  Increasingly, GPs and therapists are making ‘social prescriptions’ of yoga, meditation and breathwork as the research points to the benefits of these in treating anxiety.  In addition to this brief blog, I will be contributing to the MFML course a number of short psycho-education audio recordings with exercises. I will also facilitate a live workshop ‘Getting Grounded in Uncertain Times’ in early November. 

Defining Anxiety

Let’s start with defining what we’re talking about.  Anxiety is a psychological, physiological and behavioural state of uneasiness or uncertainty. It usually arises when we are either overestimating threats or underestimating our ability to deal with them.  Anxiety is related to stress and fear in that all three overlap and share some of the same symptoms.  Yet there is an important difference in that both stress and fear are caused by something external and specific, a stressor, or a particular threat that frightens us.  Anxiety tends to be generalised worry or dread; it can feel pervasive, even existential.  Or a nervous energy that has us playing a never-ending game of whack-a-mole as worries appear only to be replaced with new ones.  

Anxiety exists on a spectrum.  While most of us experience it some of the time, it tips into what can be classified as a disorder when the anxiety starts to interfere with basic functioning over a prolonged period.  Generalised Anxiety Disorder (GAD) is the most common affecting up to 5% of the population, but others include Panic Disorder, Phobias, Social Anxiety Disorder, post-traumatic stress disorder (PTSD) and Obsessive Compulsive Disorder (OCD). The American Psychiatric Association estimates that 30% of adults will experience symptoms of an anxiety disorder at some point in their lives.  

Read more about yoga for stress and anxiety in this complete guide

The Age of Anxiety?

We are nearly two years into a global pandemic, the future progression of which is still uncertain.  Covid only added to a building list of collective worries:  Climate change, racial injustice, political divisiveness, economic inequality, terrorism…. all of which have had their effect on our mental health.

It may feel like we are living in ‘The Age of Anxiety,’ although this was actually the title of a 1947 Pulitzer Prize-winning poem by WH Auden. Thousands of years prior, Greek and Latin physicians and philosophers had already identified anxiety as a medical reality.  Ancient Epicurean and Stoic philosophers’ work included practices that sound remarkably similar to modern cognitive behavioural psychology.  All of this is to say that anxiety isn’t new.  It isn’t an aberration.   And it isn’t going away.  However, anxiety isn’t the problem (she says controversially). It is our relationship to anxiety that needs to change.   

Changing Our Relationship with Anxiety

As a culture, we have a tendency to fear anxiety, or to pathologize it.  To think it is a character flaw to overcome, or eradicate.  Us anxious ones judge ourselves for being too weak, sensitive, or lacking resilience.   So now we’re anxious, and also feeling bad about it.   Two times the fun.  But what if we could see anxiety for what it is: something built into our nervous systems, a part of being human.   As counter-intuitive as it sounds, anxiety can also co-exist with some pretty positive traits and even be a catalyst for personal growth if we’re open to it.   So rather than fighting anxiety, can we get curious about how we might relate to it differently?  Engage openly in ways that bring a bit more ease to our lives, and maybe even some pretty important insights? 

In order to do so, we also need to acknowledge the ways we try to avoid anxiety.   The more anxious we are, the more we want to distract ourselves from this reality.  The automatic reach for a drink, a muffin, Netflix, news or social media-scrolling, yet another work email…something, anything, that will rescue us from any emerging anxious thought, often before we’re even conscious of it.  Or the very common ‘manic defence,’ a frenzy of activity separating us from unwelcome feelings. 

Unfortunately, the avoidance of painful emotions doesn’t get rid of them.  They are merely reduced to a buzz of anxious energy; a low hum we ignore by staying distracted or in motion; a source of intrusions in our sleep; a driver of inexplicable physical ailments; a building tension that can erupt unexpectedly. When we ‘manage’ the symptoms this way, we miss the fact that they can be an excellent source of information; that their appearance is a sign for us to ‘take note, there are some needs that require attention here.’  

Read more in Yoga for Stress and Anxiety: A Complete Guide

Confronting the Habit of Worry

So we’re open to looking at our anxiety, noticing and sidestepping avoidance tactics.  What next?  Many of us try to outsmart anxiety with analysing and strategizing.  We believe we are being proactive, trying to think and plan our way out of danger, and so de-risking the situation.  While the desire to exert some control is understandable, our attempts are often futile as we try to know the unknowable.  Even worse, we can develop a dangerous habit of compulsive worry, needlessly taxing our already overburdened nervous systems.  In the words of the Persian poet Hafiz:  ‘Now that all your worry has proved such an unlucrative business, why not find a better job?

Skillful ways of working with anxiety

This article is the first of a two part series. In the second article is offering constructive ways to work with anxiety.

Kelly Hearn, Psychotherapist and Co-Founder of Examined Life, trained at the Centre for Counselling & Psychotherapy Education (CCPE) in London and is a registered member of the BACP and UKCP. She has wide experience working within the NHS, private practice and at The School of Life. Kelly co-founded Examined Life, a collective of psychotherapists, in 2020. She is also an avid ‘sanity walker’ and yogi; activities which help her balance when her mind is over-active.