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Complementary Healthcare Information Service - UK

What is Anxiety?

Article written by Geraldine Marsh

As I write this article, I experience the beginnings of anxiety. My palms start to sweat, my stomach feels unsettled, and my heart pounds. Will it be well written? Or a complete disaster. Do I have to do this? Perhaps it is best if I do nothing ergo, risk nothing.

Familiar feeling?

Who hasnt experienced anxiety mild, chronic or acute. No matter what the external cause of the anxiety. - a driving test, an interview a family Christmas it can feel like it inhabits us. If someone were to ask where is your anxiety? You might answer its in me and its here now. We feel it in the present moment. Despite the cause lying outside of us and somewhere in the future.

Is it, therefore real?

Anxiety faces us like some kind of riddle it lives in the present yet circles the unknown future. It is Unseen yet is tangibly in existence for those who suffer such chronic debilitating anxiety that it limits their lives and abilities. D W Winnicott introduced the idea that within us we have a kind of "Potential space". He believed this space was created as we develop as babies, that our awareness extends away from our carer to take in the world. In an ideal world this space feels like an inviting and safe interpersonal field in which one can be spontaneously playful while at the same time feeling connected to others. An imaginative space between you and what it is you perceive as your reality. Winnicott believed that if you received good enough parenting, then generally we would perceive our space as a friendly place, and with the encouragement of this freedom within the parenting relationship, easier to negotiate this space and move from dependence to exploration of our world, towards independence. However, anxiety was induced if this space did not feel safe. That our relationship with our care giver was not secure or holding enough to enable us to reach out and explore. Or alternatively, our care giver held onto our dependence, depriving us of the opportunity of exploring that space. Hence the delay in experiencing the idea of space away from our care giver is filled with insecurity.

Another way to describe anxiety would be to say therefore, that anxiety lives in that creative space which is actually outside of our Selves. Creatively we are all capable of dreaming up monsters and demons or angels and helpers. With anxiety we have merely populated our creative space with the worst possible outcomes. Yet as much as Winnicotts ideas are helpful in regard to anxiety, often one does not have the time with a client to work creatively in a psychodynamic fashion, and if a client has limited time, CBT is seen as an effective tool to deal with anxiety. The client would be asked a series of questions and fill in forms to help them form an idea of the types of thoughts and conscious thinking processes that occur in any given anxiety-provoking event.

All well and good, but sometimes, with the limitations of time short therapy and CBT, one can end up feeling all that has been achieved with a client, is merely enter into negotiations about what the realistic size of their monsters are. However they are still monsters albeit smaller ones by the end of the counselling.

There is a popular metaphor used by psychodynamic counsellors when asked to comment on CBT techniques. It suggests that when one uses CBT techniques with a client the client will weed their garden pulling up the problems. However, if the client does not go deeper to the roots of their emotional issues once the CBT stops the weeds (problems) will come back. I would like to suggest that psychodynamic thinking on anxiety also does not cover the issue adequately either. For we may pull a weed out by a root but what are we left with then? An empty garden. Then what? How do we populate our garden with things of beauty. What alchemy could possibly change our imagined demons to angels? Is it necessary for us to plant within our client a different personal philosophy? That the world can be a safe, harmonious and beautiful place? Is that not directive? We share our reality who is to say picturing the world in this way is any more accurate, than filling the world with fear.

What if, then, as a counsellor, we employed with our anxious client, the skills of a Life Coach. We would be suggesting approaches along the lines of feel the fear and do it anyway. Encouraging them to look for expansion into that perceived hostile world. Yet anxiety is fear and fear induces contraction not expansion expansion would be the last thing an anxious client would consider. But ironically, it is this contraction of the space that an anxious client inhabits, that traps them and defines them. As much as they try to make their world feel safe, it does not feel safe. There is the known unhappiness of the present or the unknown fear of any change in the future.

Sometimes clients will say oh we didnt do much, we just seemed to talk. Yet what can feel insignificant about this process to a client to the counsellor is the clients significant vital and dynamic push and pull of safety versus change. The conversation may explore the clients unhappy current situation, but one that is known to the client (therefore safe, albeit unhappy). The conversation then may yoyo the other way exploring the unknown, and anxiety-provoking, future possibilities. As a counsellor does one stay within the comfort zone of a client and their desire for safety, or come out, pushing and championing the clients desire for change. Push too hard and you fear jeopardising your therapeutic relationship with your client, urging them to leap into that anxiety inducing idea of a future. Are you counselling or advising? Its their change, not yours.

Therefore, reverting once more back to the solid ground of psychodynamic thinking, what one is left to do is point out to the client what unconscious processes you can see at work, that are keeping them locked in their familiar unhappiness. Yet thanks to the variety of modalities and tools at the disposal of the modern counsellor, a counsellor can now pull simply on what seems to work for the client when it comes to anxiety. Whether that means using CBT, Mindfulness exercises, psychodynamic processes, or, yes, even life coaching.

About the author:

Geraldine Marsh, PG Dip, MBACP is a counsellor at Gatehouse Complementary Health. She has particular interest in and experience with clients experiencing issues with anxiety, depression and bereavement.

Website: http://www.gatehousecomplementaryhealth.com

copyright © Geraldine Marsh

 

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