What Is Anxiety, and Why Am I Feeling It?

We’ve all experienced anxiety - elevated heart rate, tightness of breath, racing thoughts, a sense of both urgency and being unable to settle down, maybe other symptoms - and it’s one of the most common things we see in therapy today. It’s very uncomfortable! But what exactly is it, and why is it something that we experience sometimes?

You can think of anxiety as a kind of free-floating fear, fear without a specific object. What is happening behind the scenes is that the sympathetic branch of the autonomic nervous system has been activated, which puts us into the widely-known state of fight or flight. So it may come with irritability (fight response) or a sense that you have to get away from whatever situation you’re currently in (flight response), as well as an increased tendency to perceive threats (there are actual physiological changes in the eyes, ears, and processing centers of the brain that tune us more into threat). 

This state of anxiety is obviously quite adaptive for mammals living in the wild, where there is a constant threat of predators. In that setting anxiety represents a sense that something is off, even if you can’t quite pinpoint what it is. For us humans, our nervous systems get trained early in our lives to respond to our environments in a process known as neuroception, which trips us automatically into a sympathetic response when there is a sense of threat. Neuroception develops from a combination of innate genetic tendencies and early life experiences, and understanding the specifics of your neuroception are a staple of therapy.

Since most of us aren’t usually being hunted by tigers these days, those threats tend to come primarily from other people and from social institutions. When we’re in a stressful situation where it feels like our livelihood or well-being are potentially threatened by other people, our neuroception kicks in and throws us into a state of sympathetic anxiety. This might mean you’re facing a big work deadline, stuck in Austin traffic, talking about something uncomfortable in therapy, or even just sense a possibility of judgment.

Our rational minds can often see that these things aren’t the threat our nervous systems are perceiving them as, but our bodies still react as though they are. Hence anxiety. 

Therapy for this consists of understanding at a deeper level the things that trigger your neuroceptive system to shift into the state of anxiety, techniques for settling yourself once you recognize that you’re in that state, and then using that understanding and those techniques to shift your neuroception in such a way that you are no longer triggered in the same way by the same things. It is totally possible to change this over time. If you’re ready for that journey, in Austin or Texas, and want some help with it then reach out today!

Why Do You Keep Asking What I’m Feeling In My Body?

One refrain you will hear from somatically-informed therapists over and over again is the question “What are you feeling in your body?” This question is both highly informative for the therapist and often highly confusing for clients. So let’s dig a little into why we ask it.

There is this widespread misconception in European-descended cultures that mind and body are separate things, an idea that goes back almost 500 years to the French philosopher Rene Descartes. I deconstruct this idea in this post, but as a quick summary we now know that mind and body are two aspects of the same thing. We might say that mind is the experience of being a body in the world, not something totally separate and unrelated.

Emotions, in particular, are complex experiences that are the result of the intersection of bodily-based sensations and brain-based rules of emotion and cognition, received fully or in part from the cultural attitudes we grow up around. Take anger, for example – an emotion that involves a sense of danger due to the perception of an infraction on our boundaries. Most of us have plenty of access to the cognitive rationalizations of why this or that thing has made us angry. But anger also inevitably comes with activation in the body – typically some tightness in the chest and/or shoulders, sometimes a buzzing or tingling in the arms or legs, and more, though the specifics may vary.

These somatic markers (“somatic” means “of the body” and somatic therapies are therapies that address what is happening in the body as well as in the mind) aren’t just peripheral to the experience of anger. Rather, anger is the experience of the brain’s attitudes meeting this information coming up from the body. And as long as the body remains in this activated state, you will continue either to experience anger or to dissociate the emotion altogether, which means it’s still present in your body but your brain is no longer registering it. 

The emotion doesn’t really go away until you return your body - and in particular your nervous system - to a calm state. Your cognitive story follows the bodily state. So all the thinking you do about it is much ado about nothing – if you don’t deal with the bodily experience in an integrated way then the emotion will just continue to come out sideways. That might look like snapping at your partner or kids, or it might look like a persistent self-attack or low mood that you just can’t seem to make sense of.

Addressing only the thinking part of the equation can, in fact, make things worse, as our thoughts become new perceptions, which in turn entrench the emotional state. I’m sure you’ve noticed this – you get worked up about some issue and there’s a rant going in your thoughts, and the more you internally rant about it the angrier you get. To get out of the loop you have to interrupt the feedback loop between thought and emotion by placing your focus as purely as possible on the actual sensation.

So, as somatically-informed therapists, we are always trying to tie what you are experiencing in the moment back to what is happening in your body, because that is where the loop can most easily be interrupted. Working with these affects and moods at a bodily-level offers a tremendous amount of leverage for taking charge of runaway emotional states, including loops of anxiety and depression.

Stepping In It

Has this ever happened to you? You’re talking to people and suddenly you realize that you just said something bone-headed, or forgot a key piece of information, or inadvertently referenced a tender spot for someone? You might feel flooded with emotion, especially shame and self-criticism. Your focus narrows, your breathing gets shallow, and it becomes very difficult to think clearly. In fact, the only thing you can really think about is how badly you just screwed up.

This response is totally normal. We’ve ALL stepped in it this way. And it’s okay! We’re geared to spot social danger, and what you’re experiencing is your body’s response to finding itself in a situation where you could have done something that was dangerous to your belonging to a group. 

Again, totally normal, but it does leave your mind-body system in a state where it needs some specific types of tending in order to get back to its regular functioning. So here’s a step-by-step process that you can try on and see if it works for you.

1. Breathe. Take a couple of deep breaths, and really let yourself feel them as your diaphragm rises with the in-breath, is full at the top of the breath, and then falls with the out-breath. Alternatively you can just pay attention to the flow of air over your upper lip as you breathe in and out. Tracking this sensation sends a signal that things are safe and that your body can start to relax. Often this is enough to settle people down and allow them to return to normal functioning.

2. Remind yourself that it’s okay, you just made a mistake, but it’s unlikely you do anything truly dangerous. You’re safe, and whatever happened, it’s just needing some repair. That will look different in different situations, but it’s doable.

3. Get yourself some space. If you’re still around the people you found yourself embarrassed in front of, and the first two steps aren’t calming you down, then it can be helpful to get a little space for a few minutes. Excuse yourself and go to the bathroom, or walk outside for a few minutes. Engaging the senses here can be really helpful - there are many ways to do this. Here are a few, but feel free to come up with your own:

   • Run cold water over your hands and really feel the sensation, or drink a glass of cold water and feel it flowing down your esophagus and into your belly.

   • Gently stroke your own skin. The inside of the forearm can be a good spot that is highly sensitive, or sometimes it’s helpful to gently touch your face and neck. Again, really let yourself feel the sensation.

   • Look around wherever you are and name to yourself things you see, then things you hear, then things you smell, then things whose touch you can feel (air currents, clothes, etc.), then things you taste.

4. Go for a walk. If none of this works, then getting away from the situation and going for a walk can help your body discharge some of the self-protective energy it is feeling.

Try these out and let me know how they work for you!

Who SHOULDN’T use psychedelics?

There’s so much hype out there right now around psychedelics that it’s easy to think they’re a cure-all for everybody. But as I have tried to make clear in the disclaimers of my series on psychedelic integration, these substances can also have real downsides, and it always is important to consult with your physician before embarking on this kind of journey to minimize the possibility of negative interaction effects with other medications or underlying health conditions.

In this post I want to lay out some of the common contraindications - though, again, this post does not substitute for a consultation with your medical doctor. It is also important to note that the research on this aspect of psychedelics is still in its infancy, and rapidly evolving, so the information presented here may be out of date by the time you are considering using these substances - another reason to please consult with a physician before taking a trip.

If you are on any serotonin-enhancing medications, then you need to be very careful with psychedelics, as the combination can produce a toxic and potentially fatal level of serotonin in your brain, a condition known as Serotonin Syndrome. This includes the MAOI and very common SSRI (Prozac, Zoloft, Paxil, Celexa, Lexapro, and others) classes of antidepressants, lithium, and antipsychotics. If you are using any other medications, then, again, it is very important to consult with your physician.

Psychologically, if you or your family have a history of psychosis or bipolar 1 disorder, then psychedelics are probably not a great fit. This includes schizophrenia, schizoaffective personality, or any other disorder with psychotic symptoms. Also, if you have ever had a psychotic episode following a previous psychedelic experience, then that is likely a contraindication.

In addition, if you have a history of severe trauma and haven’t yet developed tools to help you stay regulated while exploring the memories of your traumatic experiences, then it is a good idea to stay away from psychedelics until you have developed those skills and can make sure you are in a space where there is the strong support you might need to stay safe. These substances often drop people right back into those experiences - which can be a really helpful thing, but only if you are prepared to ride those rapids. If you need help developing these skills then reach out to a trauma-informed therapist who can help you.

Physically, anybody with high blood pressure or other heart conditions are not good candidates, as many psychedelics can raise your heart rate. This is also true of people who are pregnant, or have glaucoma.

And once again, if you have any questions about whether these substances are suitable for you, then please consult with your physician. We want you to stay safe through these experiences!

Human Suffering and Cultural Ideas, Part 2 - Humans Aren't Animals

This series of posts is looking at the way that received and persistent ideas can contribute to psychological suffering. And one of the most persistent and problematic ideas out there is that we humans are somehow different from animals. I mean, most of us know from high school biology that humans are technically animals, but we still tend to think of ourselves as somehow uniquely distinct from other animals.

And of course we are distinct, in the same kind of way that all species are distinct from one another.

So why is this idea so problematic? Two reasons. The first is that, at this point, it has been the enabling idea behind an enormous amount of ecological destruction. It’s not talked about as much as climate change, but we are in the midst of a mass-extinction event, the likes of which have only been seen a handful of times in the history of the planet, and that has been driven by this crazy notion that we are somehow distinct from the natural world. This affects all of us in some terrible ways that will continue over the course of all of our lifetimes.

Second, and perhaps most relevant in psychotherapy, is that this idea leads us to forget and neglect our own animal bodies. We tend to think of the “I” as primarily our conscious, thinking minds, and then treat our animal bodies as secondary, background actors in dramas led by our mental chatter.

But we’ve got it backwards. As Iain McGilchrist argues in his brilliant The Master and His Emissary, the reality is that our conscious, thinking minds are very thin layers on top of our far vaster neurological and physiological bodily apparatuses, which we largely share with all mammals. Our conscious mind is meant to be a tool of this more vast self; in our modern age, however, we have flipped the script and now the tool runs the show at the expense of our animal being.

Evolution rarely undoes. Instead it stacks function on top of function, and our rational human minds are no different. They have evolved on top of our mammalian selves, and are meant to work in conjunction with those animal bodies, rather than running the show. 

Indeed, the vast majority of human functioning (usually) happens completely outside of our conscious awareness. We walk without thinking about it, our hearts beat and our lungs breath and our kidneys and livers do their thing. Even our speech and demeanor require a fair amount of focus in order to do things differently from our usual patterns.

Our mammalian bodies also automatically react to situations the same way the bodies of other mammalian species do. We startle at sudden noises, we feel fear and joy and pleasure and pain and hurt, all in our animal body. And, likewise, our mammalian bodies have an innate wisdom about how to move through emotional difficulties, a wisdom that any journey that actually heals must tap into. 

Which is where thinking of ourselves as something different from animals really becomes an impediment. The conscious mind is all about maintaining control - over our environments, our circumstances, and our bodies - and when it runs the show control is the name of the game. 

But if we’re going to tap into our animal bodies’ innate emotional repair capabilities then our conscious minds have to let go, and allow the body to run the show for a bit. And when we grow up with the constant emphasis being on control, then that letting go can feel extremely scary. (This is actually part of why psychedelics can be such a powerful force, something we’ll address in a future post.)

Which is also one place where therapy can be powerful - knowing there is a supportive other there who can help make sure you’re safe, even if you feel out of control, can make relaxing into the body’s innate healing power, in a titrated way, easier. So reach out if you’re needing help with this!