Toxic relationships and anxiety

I see many clients in my practice who feel that they are lacking. They feel lost, directionless, and often present with anxiety and/or depression.


Clients talk of low self-esteem and low confidence, often feeling shy, and group situations leave them feeling exposed and vulnerable. The judgement that they fear and imagine from others, renders them unable to make informed decisions, and survival comes in the form of keeping a low profile, avoiding certain events and filtering their own true thoughts; all to appear acceptable and to sustain these connections. Clients will assume that they are defective, broken, or inept in some way, desperately seeking a radical change in their own biological make-up. 

“I am and always have been an anxious person” is often the rhetoric that I hear. Believing that they are at fault and always have been. 

A need to connect

Human beings are social creatures. Our very survival is dependent on that connection with another. Unlike some reptiles and fish species, that if abandoned are still able to adapt and survive; human babies cannot fend for themselves. We are born with a cry that enables us to get noticed and our needs met.

From birth, we therefore begin to learn the importance of connection. Carl Rogers: a founder of humanistic psychology, believed that to feel secure and to live authentically, within our environment we need these connections to foster at least three core conditions; unconditional positive regard, empathy, and congruence. 

Rogers said that with these key ingredients, a secure foundation has a better chance of developing within the individual. A secure self-concept allows the individual to experience and explore life with curiosity, validation, encouragement, and support. These core conditions provide the foundation for self-acceptance, forgiveness, learning and growth. 

When listed like this, you can be forgiven for thinking how easy it is to be able to offer another such an honest, open, and understanding environment. Alas, though, this is often not the case for many. In my experience as a mental health practitioner, it has been the absence of these very ingredients that have led clients to seek professional help. An absence of the core conditions of the human psyche can lead to feelings of insecurity, low self-worth, self-hatred, and anxiety. 

An absence of the core conditions

Relationships can be formed in many ways. We can connect with others as family members, intimate partners, peers, colleagues and friends. From each one of these relationships, we seek acceptance, validation, and reassurance that we are OK in this world and this in turn helps us to foster a healthy sense of self. An unhealthy or distorted sense of self can occur if we surround ourselves with people who cannot offer the relationship the core conditions and this is explored in the examples below: 

1. Unconditional positive regard (UPR)

Unconditional positive regard (UPR) is the ability to accept an individual with no conditions attached to what they say or do. There is no judgement, advice or opinion added to someone’s thoughts, feelings, or emotions. This encourages individuals to reveal their true selves and to feel wholly supported and accepted within themselves despite any mistakes or failings that they believe they have made. 

The absence of UPR can manifest in the form of critical judgement. This when used as a frequent form of communication can be harmful and it can be learned. The individual here, that is unable to show UPR in the way that they relate with others, would intend to go beyond constructive criticism.

They’d attempt to demean, belittle, and cause emotional distress. It is destructive and doesn’t offer any form of solution. Critical judgement can come in many forms. It can be delivered as a personal attack where someone is trying to insult a specific personality trait or personal attribute; “you’re incessantly cheerful, it’s exhausting” or “it’s because you’re too shy that you didn’t get selected”. 

It can also be used to try to undermine skills and abilities such as “You couldn’t possibly succeed at that job as you are useless with spreadsheets” or “You’re not fit enough to join the police force, I wouldn’t bother applying if I were you.”

It can include body shaming. “Perhaps you should lose weight, that dress looks ridiculous” or “Your skin is looking bad at the moment, you should give up drinking.”

These comments lack an understanding of where that individual might be, emotionally at that present time. There is little empathy or any form of support or encouragement. They may include derogatory language that can be emotionally damaging and harmful to an individual’s well-being. 

If a connection, is unable to provide UPR, in that moment or over time, we might feel judged, humiliated, undermined, and worthless. It can be hard not to feel at fault or to question our own self-worth. It can be hard to realise that this is harmful if you’ve been subjected to repetitive critical judgement since childhood. 

These feelings can further imbed a negative sense of self which impacts confidence and self-esteem and an ability to manage and sustain healthy relationships going forward. 

2. Empathy

Empathy is the ability to attune yourself to someone else. To be able to listen and sit with someone else in their experience. A truly empathic person, can actively listen, be open-minded and be willing to accept and appreciate diverse perspectives and experiences. They do not jump in with their own experiences or advice. They do not assume that they know how you feel and there are no ‘you should do this or feel this way’ statements implied.

Instead, a level of curiosity will be present in helping you to gain more insight, they’ll be asking you open questions to find out more about you. It is wanting to show an interest in your experience and not to compare it to their own. 

For example, someone lacking empathy might say, “Well as it wasn’t your fault, you shouldn’t feel sad about it and let's try to move on.’ Although this statement may feel supportive it can also be dismissing of the sadness that the individual does feel about the event in question. It can shut the individual down and imply that their feelings are wrong or need to be forgotten. 

When an individual lacks empathy, it can be hard for them to be able to hear, understand and accept what you say or feel. They might appear distant or detached from you and this can further fuel our anxieties and cause us to question our self-concept. Without any form of emotional intimacy, we can find ourselves filtering our conversation and it can be difficult to generate true depth or meaning to that relationship. 

A lack of empathy can make it hard to resolve conflict. You might find that you always have to remain submissive and agree to that person’s ideals, decisions and perceptions. 

3. Congruence

Congruence is the ability to be honest and transparent with another. When being congruent, that person clearly feels secure in their thoughts and feelings and doesn’t feel a need to hide parts of themself. Even if they are met with confusion or judgement, by remaining congruent, they can remain true to themself and their own values. 

“I know you might not agree with my decision here, however, it feels right for me at the moment in time.” 

Being congruent comes from a place of trust. If you understand yourself and know what your values are, it is easier to stay aligned with these values by making decisions or choices that feel real, genuine and authentic to who you are as an individual. It means that you won’t be doing and feeling things that you think you should just to please another. By actively choosing yourself, you can show integrity and consistency in who you are. Feeling less confused contributes to healthier relationships, confidence and self-esteem. 

What constitutes a healthy relationship?

A relationship appears healthy if the communication between those involved fosters growth and development and will always consider the individuals' feelings within the delivery. It will feel supportive, respectful and consider the strength of the relationship in question and encourage a constructive dialogue between both parties. 

A relationship often feels emotionally healthy if/when you feel the following when in their company:

  • accepted and understood 
  • encouraged and supported
  • listened to and respected

What can you do if you’re in an unhealthy relationship? 

The first step can be to try to reflect on the relationship and work out what it is that feels difficult. If you spend time with someone and you’re leaving that interaction feeling low, dismissed, ignored, sad and bad about yourself then this can be the first sign that maybe some or all the core conditions discussed above are missing. 

Becoming aware that a relationship might be unhealthy can bring a whole host of difficult feelings. Disappointment, sadness, fear and a sense of loss can all emanate for example. It can be helpful to start discussing these emotions with a trusted friend or therapist. 

Therapy can help you to gain a clear sense of self. We can look at your core values and how you are meeting those values in the decisions that you make. Therapy can help you to develop confidence and self-esteem and with these attributes, you can begin to see what connections serve you and you'll be able to put in healthy boundaries where necessary.

Although difficult, you can end or distance yourself from difficult relationships, no matter who these people are. If they bring about discontent with your mental well-being, you can value yourself and give yourself the permission to end them, with the support of a therapist. Enhanced self-awareness allows you to make changes that can benefit you and improve your life. 

The views expressed in this article are those of the author. All articles published on Counselling Directory are reviewed by our editorial team.

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Sidcup DA14 & London SE9
Written by Alexandra Weir, Therapeutic Counsellor, Psychotherapist Dip. Couns, MBACP
Sidcup DA14 & London SE9

My name is Alex Weir and I am an accredited Integrative Therapist that works in private practice with adults both online and in person. I work in Southeast London and I have experience working with issues such as anxiety, depression, relationship difficulties, trauma and bereavement.

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