Anxiety, identity and belonging: A nexus that needs exploring

There are multiple developmental triggers for anxiety, many of which are known, including cognitive distortions, trauma events and adverse childhood incidents. Yet, we still do not speak enough about the issue of identity and integration for those from diverse communities who were born outside of the United Kingdom and who settled here in the last 40 years.

Nearly a third of London’s population today were born outside of the United Kingdom, and many have had to settle into a new country that has been culturally, societally and religiously different from where they were born. One can say that settling in the UK has meant going through a ‘chalk and cheese’ set of experiences.

Furthermore, many of these individuals have had to learn English as a second language and live with the associated feelings of being ‘outsiders’ or ‘different’ as they settled into the country. Such experiences may have reinforced a sense of marginalisation and isolation, both of which impact a person’s sense of self, confidence and safety.

Settling into a country that feels, sounds and appears distinctly different from the countries of origin of people born generates a heightened state of ongoing stress within the bodies of these individuals. The ‘fight or flight’ response is highly activated on an ongoing basis and this is only natural since the individual is working their way through a new environment which could be hostile to them. But while a normal reaction, sustained exposure to stress hormones and the sensitisation and consistent activation of the limbic system is a precursor towards the development of anxiety states.

Therapists need to explore the kinds of language that were used to marginalise their clients, the tropes and power relations that were used and hoisted against them.

While the UK has made significant strides from the inward-looking and mostly mono-cultural country from when I first arrived in June 1983, racism and prejudice sadly still rear their ugly heads. They also amplify and heighten the fear and stress that people born overseas and settled in the United Kingdom feel. I, for example, remember the anger that I felt in the 80s and 90s when I was told that people could not spell my name and whether I came from India – racist slurs, shouts of ‘curry’ and monkey chants were things that I grew up with.

The anger stayed with me, it isolated me and held me in a straightjacket for many years, sensitising me to anxiety and fuelling cognitions that I must have had something wrong with me. This also meant that I could change quickly from fear to anger, a sign of emotional dysregulation that took me decades to work through. This was an early indicator of the anxiety yet to come.

In other words, integrating into another country places significant stress on individuals and if this is mixed in with the impacts of racism and prejudice, then fear or anger, a sense of societal dislocation and social isolation all create fertile conditions for anxiety to take root within.

Identity and belonging and their impacts on anxiety conditions are still areas that need therapists from diverse backgrounds to sensitively explore with their overseas-born clients who have anxiety. I would argue that it needs to be front and centre in any therapeutic work that is done, and we must work with our clients to find out more about where they were born and the cultures, faith groups and societies into which they were born. Therapists need to explore the kinds of language that were used to marginalise their clients, the tropes and power relations that were used and hoisted against them.

Finally, my own experience has shown me how identity and belonging are critical areas for healthy emotional development. In a country where politicians have made immigration, asylum and seeking refuge major political themes for the forthcoming election, identity, belonging and mental health may well become relevant topics once again.