If you have anxiety and you’re thinking of coming to therapy for it, it’s worth thinking a bit about what anxiety really is. Because in psychotherapy, we typically think of anxiety as a symptom or effect, rather than a cause or the “problem in itself”.
You might have a diagnosis like GAD (Generalized Anxiety Disorder), a term which sounds on the surface like a diagnosis of something intrinsic to you. In a psychiatric setting, it may be treated as such, but in therapy, we instead think of it not as something discrete, genetic, “a chemical imbalance”.
Instead, it’s explored as something that’s a result of your life story, a side effect of your survival mechanism or way of coping in environments that were in some way adverse. The result of the kind of interactions you had early on, or later on. The way you were cared for, what school felt like for you, what happened in adolescence, or the challenge of becoming an adult.
All these experiences are part of your subjective history, which has a large part to play in shaping the character you have developed and the way you now deal with being in the world. Therapies that have a depth orientation and that involve some exploration of your past (psychodynamic therapy, broadly speaking) look with curiosity at why you’re like this. They try to find the strategy that you developed early on, consciously or not, to navigate your environment.
Because if you can understand why you’re anxious as an old habit, it puts you in a good position in the present to apply better here-and-now techniques. Or merely new awareness that allows you to contextualize your anxiety as being something that’s a product of an obsolete past, something that’s now out of date.
So that’s why we’d say something like Generalized Anxiety Disorder is not really a thing in itself, but a description (albeit sometimes a useful one) of an outcome; a symptom of something more profound. If you had headaches all the time, you’d probably be ultimately unsatisfied with a diagnosis of NDPH (New Daily Persistent Headache). You’d probably want to know why are you getting those headaches.
Similarly, anxiety is something treated in psychodynamic therapy as an outcome, a symptom of an older story. That deeper experience is what we focus on in therapy, as a key to undoing the way that anxiety shows up for you in the present.
Image credit: Brock Wegner
