Anxiety – What Is It?
The term anxiety is used conversationally to mean everything from stress to worry to fear. It’s commonly used, in part, because it is a normal aspect of human experience. In fact, anxiety can be both adaptive and helpful. It can motivate us when we need to prepare for an exam or important work obligations, such as a presentation or deadline.
Anxiety is often thought of as a thought or a feeling, but anxiety can also be somatic. Somatic is another word for body. At the NC Center for Resiliency we specialize in treating all types of anxiety but are especially well versed in supporting Clients to understand and regulate anxiety that shows up as physical symptoms such as heart racing, excessive sweating, shortness of breath, and tingling or other sensations. Somatic anxiety is an essential part of our autonomic nervous system, which regulates bodily functions that include our fight-flight survival responses. In other words, somatic anxiety helps our body physically activate to quickly respond in situations where we may need to flee and defend ourselves. To read more about somatic anxiety and how it’s treated at the NC Center for Resiliency, scroll down to the section entitled Somatic Approaches to Anxiety.
While most people do not enjoy anxiety, somatic or otherwise, the anxiety most experience is manageable and quite different than an anxiety disorder. An anxiety disorder is generally understood to be a combination of excessive, overwhelming fear and chronic, anticipation of future threat (APA, 2013). Individuals living with anxiety disorders often cannot control their worry or the physical symptoms that accompany them. Frequently, one’s social, work, and personal life is negatively impacted by the disorder and can lead them to seek help from a medical or mental health professional.
The National Institute for Mental Health cites research indicating that 31.1% of adults experience an anxiety disorder at some point in their life (NIMH, 2007). If you are experiencing anxiety and you feel it’s out of your control, excessive, and unhelpful, please know you aren’t alone. Anxiety disorders are not only common, but are also quite treatable.
What Causes Anxiety?
There is no single cause for anxiety. It is often multidetermined. For example, one person may have anxiety due to an untreated medical condition whereas another may experience anxiety resulting from use of a substance, such as caffeine or alcohol. Frequently, people experience anxiety due to past trauma or life events that were unsettling and overwhelming. Other times, the source of one’s anxiety can include all the above!
When you are seeking anxiety treatment, you want to be sure your provider is helping you look at all aspects of your life currently – not just the medical aspects or solely the psychological sources of distress. A comprehensive treatment plan will consider all aspects of your life and health, not solely symptoms and symptom management.
It can feel like a huge task to seek out psychotherapy in general, let alone a comprehensive treatment plan. This difficulty may be especially true if you struggle with an anxiety disorder. You may already be worrying about a lot! Reaching out for support is your main goal when starting you journey towards having control over normal anxiety and healing from anxiety stemming from past trauma. No matter what the source of your anxiety, please know that it is not your fault or a personal failing that you are feeling this way. In fact, your use of this article is a sign of resilience and a clear step towards helping yourself or someone you care about.
Types of Anxiety Disorders and their Treatment
There are different types of anxiety disorders, including generalized anxiety disorder, panic disorder, and a variety of phobias. The treatment for each disorder varies depending on how the treating professional understands the source of the anxiety. Behavioral, Cognitive, and Psychodynamic treatments are among the most commonly used psychotherapy approaches utilized in this area and are explained briefly below. At the NC Center for Resiliency, we integrate somatically oriented interventions when using any of the following approaches for anxiety treatment.
Below you will find a brief description of these commonly used approaches to anxiety treatment. For more information about how the NC Center for Resiliency integrates these approaches and uses somatic modalities, please scroll down to the section summary.
A common treatment for anxiety disorders is behaviorally based and focused on relaxation techniques to support Clients with gradual exposure to feared stimuli, such as phobias or panic symptoms. This approach is often coupled with cognitive approaches that understand anxiety as stemming from erroneous thinking patterns. A cognitively based treatment typically focuses on helping Clients to identify the behaviors that follow their unhelpful thoughts. By learning how their thinking is leading to more worry and fear, Clients begin to change their thoughts, which can help them to shift behaviors that make anxiety worse. Common cognitive behavioral treatments include Cognitive Behavioral Therapy, Dialectical Behavioral Therapy, and Acceptance and Commitment Therapy.
A Psychodynamic treatment approach to anxiety typically views anxiety as a secondary emotion and as a coping strategy rather than errored thinking. In general, psychodynamic therapists support their Clients to develop an awareness into the ways their anxiety prevents them from connecting to past experiences and relationships due to the painful and sometimes overwhelming feelings, such as grief or anger, connected to them. In other words, anxiety is understood to convey important meaning about one’s story and experience. Clients are supported to develop a greater sense of resiliency to both relate to their feelings without fear and use anxiety as an adaptive fight-flight response in situations that merit them, rather than in situations that may be harbingers of past, difficult feelings.
Somatic Approaches to Anxiety
At the NC Center for Resiliency we emphasize a focus on the body or “soma” and regulation of its nervous system as a means to address anxiety and related disorders. This approach is sometimes referred to as “bottom-up” rather than “top-down,” because it relies heavily on the role of sensations in the body rather than thoughts or feelings. While thoughts and feelings are viewed as important, they are not typically the primary focus of treatment. Instead, a somatic therapist supports Clients to learn the language of the body to help them better engage the body’s innate ability to rebound from stress and overwhelming experience. While many somatic approaches, such as Somatic Experiencing, Sensorimotor Psychotherapy, or Eye Movement Desensitization and Reprocessing were originally created to heal the effects of traumatic experience, they can also be used to address anxiety. As mentioned above, these approaches are very effective when anxiety is related to past trauma, but can also be impactful for anxiety unrelated to trauma. After all, sensations associated with typical anxiety is physiologically similar to hyperarousal or activation that manifests in traumatic stress disorders. In both types of anxiety, the body is activating a defensive response to protect itself through fight or flight, and in situations in which there is no escape, we tend to freeze.
When you see a somatic practitioner, you can often expect to be supported in orienting. Orientation is a somatic term for bringing one’s attention to the present moment through all of our senses (sight, smell, sound, etc) without fear. This task is not small for individuals with anxiety! The somatic approach has a wide range of techniques to support Clients to experience the present moment without fear in a slow manner, so that it is not overwhelming. Overtime, Clients develop a sense of control and mastery over their moment by moment experience, making anxiety much more manageable. Once a Client is able to orient to the environment, they are supported to resource somatically by tracking sensation inside and gaining a greater awareness of what both positive and difficult experiences feel like for them.
Somatic approaches are highly attuned to the diversity of experience in the body and the importance of helping Clients learn what is safe and regulating for their body, rather than looking for an “objective” or “ideal” form of regulation. Individual resources can be external, like a calming plant, animal, or trusted friend. Resources can also be internal like a felt sense of calm or joy in the body.
Once a Client has the ability to resource and track sensation in the body, they are guided through somatic gradual exposure to difficult sensations, which supports greater resilience to anxiety related bodily responses, such as heart racing, excessive sweating, muscle tension, etc. A somatic therapist may support the Client to then self-regulate through the use of imagery, physical movements and gestures, or to connect feelings and meaning related to various sensations. As the Client moves through this process of exposure, anxiety becomes less threatening. It can now be experienced as a source of information from the body rather than a source of threat. Many Clients report finding this type of self exploration and mastery of bodily experience to be quite empowering as they are now able to choose the best course of action in any given situation based on their desires and needs, rather than fear of sensation.
There are many causes and types of anxiety disorders. Remember, the somatic approach is one of the innovative methods of treatment.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA.
Mayo Clinic. (2019). Anxiety Disorder.
National Institute for Mental Health. (2007). Any Anxiety Disorder.