Two methods for treating anxiety

Pluralistic counselling involves using a wide variety of different methods to treat the spectrum of mental health conditions. Indeed, the ‘plural’ in pluralism implies that there is usually more than one way to approach a given problem, and furthermore, different approaches can be used together to benefit clients more.

In the spirit of pluralism, I offer two different ways of conceptualising anxiety and working with it. Please feel free to use either of them or both of them, as your needs require.

The intrasubjective model

This model basically contends that feelings of anxiety are an inner experience, as they belong to the person so afflicted. In many respects, this viewpoint accords with common sense.

Now the reason why it is called an intrasubjective model is that it proposes that when we feel negative feelings, including anxious feelings, we tend to distance ourselves from them, as we don’t want the discomfort or indeed the pain. So a pernicious inner conflict between parts is established. In essence, what we do is treat such feelings as ‘not me’ even though they are part of my inner world.

Anxiety, as I said, is no exception. Quite often, those that suffer more acutely from anxiety are ones that find it difficult to experience anxious feelings and so they try, in some way, to ‘flee’ from them. This attitude is premised upon the view that you ‘shouldn’t’ have anxious feelings, and that those feelings are not revelatory about anything in your world.

The intrasubjective model suggests otherwise, as it proposes that if you want to ease your distress, you should treat your anxiety as both yours (as much as it is uncomfortable to do so) and conveying a valuable (if not always accurate) message about what is happening in your inner and outer world. To adopt this attitude is to heal the schism between ‘me’ and ‘not me’, and to find practical ways of addressing your anxiety once you know more what it is about.

So, if you wish to try this approach, as counterintuitive as it might seem, try and approach your anxiety with a welcoming attitude and ask it to ‘speak’ to you. You might want to write out what your anxiety is ‘saying’ or you might want to voice it aloud when you have a private moment. Adopting a warm curiosity towards your anxiety and giving it expression, may allow you to discover more about how you’ve been feeling.

Externalising your anxiety

This approach is quite dissimilar to the one above. Where the intrasubjective model counsels taking ownership of one’s anxiety, the externalising approach, culled from narrative therapy, proposes that you treat it as an entity independent of yourself that nevertheless you ‘encounter’ in certain situations.

Such an outlook might seem positively bizarre. You might be wondering, ‘How could my anxiety be something external to myself?’ According to the externalising method, however, our feelings are not simply personal property, so to speak, but are social constructions (so, for example, that anxiety you might feel in an unfamiliar social setting could be class anxiety, which isn't simply something internal). The narrative approach assumes, then, that your anxiety is created by particular social situations with their concomitant beliefs, and that by externalising your anxiety you are able to get a better handle on when you ‘encounter’ your anxiety. Thus, knowledge of this kind can lead you to:-
One - transform how you conceive these situations.
Two - reinforce the parts of your life where you don’t feel anxious.

The first step of externalising is to objectify your anxiety, as if you were referring to an entity outside of yourself. So, you can call it ‘the anxiety’ (it’s often suggested in narrative therapy to capitalise the feeling) or some other name that captures the feeling (e.g. ‘the jitters’ or ‘the mean reds’).

After you have done this, you can ask questions of the anxiety, such as ‘Where do I often encounter you?’ ‘What kind of situations do you avoid?’ ‘What do you believe about me, about others and about the world?’ and ‘What would make you feel you don’t need to visit more often?’

Such questions can aid you in understanding the contextual component of your anxieties, which might be obscured when you treat them as part of your inner self.  

If you find these methods helpful and wish to deepen your work in this area, one way of doing this is to get in touch with a pluralistic counsellor, as they can provide you with a variety of methods to treat your anxiety (or other mental health condition).

Counselling Directory is not responsible for the articles published by members. The views expressed are those of the member who wrote the article.

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Written by Dr Alexander Fox-Choice Counselling at Harley Street

I am a counsellor with three private practices across the country (Harley street, London; Dundee; St. Andrews). I am trained to Masters level in pluralistic counselling, and I utilise a wide variety of different therapeutic approaches when working with clients. I also have a doctorate in English literature and my literary training informs my work.… Read more

Written by Dr Alexander Fox-Choice Counselling at Harley Street

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