We need to talk about anxiety
The title of this article may be misleading. Yes, in order to deal with anxiety, we need to talk it through, that is obviously a valuable approach. In addition, anxiety has become such a commonplace issue for so many that we must urgently address it, that is also true. Nevertheless, when I say we need to talk about anxiety, I am referring to the word itself and our use of it.
Via the media, HR departments and social conversation, the terms 'anxiety' and 'social anxiety' are becoming increasingly commonplace in everyday conversation as they are being raised in the public's consciousness. Without question, the rise in awareness of anxiety as a mental health condition and the increasing openness we have towards talking about it is a hugely beneficial development in our culture. Having more open dialogue around anxiety can only be a good thing in regard to the nation’s well-being. However, ironically, there is a risk that we may begin to limit our exploration and openness towards anxiety via the way we apprehend and use the term.
Of course, the nature of language is symbolic, it points at something that has been established with an agreed meaning. With its use though, there can be an effect upon the potency of a word because its meaning is constantly being negotiated and re-established. A word like ‘anxiety,’ that refers to an experience, but an experience that may have a myriad of manifestations, can start to be reduced to simply that, a word. A word that abstracts and limits the very concept it denotes. Clearly, we cannot blame the word itself, it is how we utilise it that matters. So, how is that happening to 'anxiety'?
Putting aside the physiological and neurological perspectives, what is the underlying context of anxiety that I am talking about? Anxiety (and stress) is essentially a 'grown up' word for being scared. Now, you may think 'no, I get anxiety from driving in busy traffic' or 'I get anxiety anticipating a social situation’, I am not ‘scared’ of them though. That can be true, but the object of our fear is not necessarily what will initially trigger our fear (a.k.a. our anxiety), it is what lies beneath the triggers, which are themselves relatively harmless.
Taking the two scenarios mentioned above as examples. Experiencing anxiety whilst driving, we are not afraid of the steering wheel we have in front of us, even though simply being sat there may be enough for us to feel anxiety. We are not afraid of the road signs or the traffic lights. We can, however, be afraid of what that situation precedes or represents to us. For example: the potential of a collision, breaking down and not being able to cope in some form; situations such as the aggression or injury of another driver involved; overall the sense of threat or vulnerability we would experience during one of those occurrences.
In the case of a social situation, perhaps we are afraid of saying something that others will consider foolish and the experience itself of being viewed as foolish. Perhaps maybe we are afraid of feeling judged on how we look, that we will be perceived as unacceptable in some form. In addition, we can develop a fear of the symptoms of anxiety itself: that we will start sweating or blushing profusely and everyone will see us and think something negative about us as a result; that we may lose control completely and have a panic attack. There are many and varied possibilities that our minds may emphasise.
With generalised anxiety we can suffer a sense of dread, being on edge, fearing the future. We may experience existential dread regarding fears and thoughts of death. A heightened sense of death can be much broader than simply our own mortality – others mortality can still cast its shadow, there is the ‘death’ of transitions, ending of relationships, ending of identities etc. The objects of these fears are essentially inherent to our human condition so individual, existential exploration (possibly via therapy) is required.
Having a fixation upon death to the level that it freezes us, overwhelms us, to a point that we retract, stop looking after ourselves and stop living is something that needs attending to. However, being aware of death is a consequence of having a rational, conceptual mind and, for many, it can give a helpful, motivating context and perspective on their life. Keeping in mind that our time is limited can help us appreciate everything around us and increase our compassion for others – giving a sense of camaraderie, we’re all in the same mortal boat, so to speak.
If our anxiety has emerged from a traumatic experience, we may be afraid of re-experiencing those events or re-experiencing the sense of self that we felt at that time, a loss of control, as if we are in a descent into chaos. We can begin to feel the familiar physical sensations, thoughts and feelings. We may be able to acknowledge, intellectually, that we are not 'back there,' where it all happened, but the 'flavour' of the experience is the same.
Ultimately, with anxiety we fear being immersed in an experience where our vulnerability is fully exposed to ourselves and to others, on full display to the world. We may feel that there is almost an aspect of us that we regard as fundamentally not ok, even unacceptable - our fragility, our vulnerability.
So, what exactly is the problem with our use of the word ‘anxiety’? The problem with any term, potentially, is that it can fence off further investigation into what it represents, it can become abstract – we only attend to its surface and forget its true content and context. Equally, if others do not understand that it is the inner experience of anxiety and the fear at its core that is the issue then it is more likely it will be perceived as trivial, as nothing to worry about really. Anxiety not taken seriously is fertile ground for negating cliches to emerge – ‘they do not know what real worry is; what have they got to be anxious about? It’s only a few people; they are just milking it; we all have to go through that etc etc'
If the concept of anxiety becomes abstracted, we can start to attend to the outer aspects of anxiety rather than the causes of the anxiety. For example, we avoid driving or we avoid social events or interaction with strangers, maybe we have had medication prescribed to mitigate some of the acute symptoms of our anxiety.
After these measures have been taken, we may consider the issue dealt with, we have done what we can. However, none of those strategies are attending to the specific causes of our anxiety, the core fears that our anxiety is emanating from. Consequently, we may be dismissing the potential to be genuinely free from anxiety.
With a qualified counsellor, they could explore with us and help us understand why or how we are experiencing anxiety so, for those of us undergoing counselling, it is not such a concern. It is also important to acknowledge that there are some severe cases of anxiety that may require an approach that does focus more upon removing exposure to anxiety triggers, temporarily or permanently, and where the use of medication is appropriate.
Ultimately, the point I am highlighting is that we need to ensure that we do not, through our everyday use of the word ‘anxiety,’ forget that we are talking about being afraid, often of specific occurrences and experiences. We are not being ‘dramatic, silly or attention seeking.’
If we say we feel anxiety in certain circumstances then we are talking about human suffering, genuine fear with rational reasons (one of which may be neurological so not evident to an onlooker or even after questioning) behind it, whether we can identify them or not. I wholeheartedly agree with a very wise man who once said to me 'if we had full understanding of any situation, there is only one fitting response - compassion.'