At a glance
Anxiety often runs alongside a life that works, which is what makes it so hard to say out loud. You want the fear to stop, and you half trust it to be the thing keeping you safe. This article looks at what the watchfulness is doing, why it grows loudest when everything is calm, and what helps when the fear is already here.
Clinical insights from 22 years in psychotherapy
I’m Mark Colclough, MA, psychotherapist in Copenhagen. Qualified at the Psychosynthesis Education Trust and the University of East London. 22 years of full-time, face-to-face clinical practice.
- The coping becomes the cage. Clients arrive having arranged the week so well around the anxiety that they can no longer say what they are afraid of.
- It speaks in the quiet. Clients tell me the fear arrives in the still hours rather than in the thing they dreaded.
- The named worry is rarely the whole of it. When clients and I follow a worry past its first subject, something older is usually waiting behind it.
Clinical notes: My observations are anonymised and compounded from my session notes since 2004.
Why does the anxiety get louder when nothing is wrong?
Anxiety waits for the noise to stop. Through a working day you are occupied, and occupation acts as a kind of anaesthetic. The moment the demands fall away, late at night or on an empty afternoon, the feeling you have been outrunning arrives with nothing in front of it.
Many people read this as evidence that something is wrong with them, because the fear makes least sense exactly when life looks most manageable. What I usually find is that the calm has not caused the fear. It has only stopped hiding it. The alertness was running all along, paid for by effort, and when the effort stops the bill arrives. That is why rest can feel unsafe, and why you may fill an empty evening without ever quite deciding to.
Am I coping with anxiety, or arranging my life around it?
Much of what passes for coping is a quiet set of agreements with the fear. You take the earlier train so you are never rushed. You rehearse the conversation five times so you cannot be caught out. You say yes before you have checked whether you want to. Each of these works, and that is the difficulty. Relief arrives, the anxiety recedes for an hour, and the arrangement is confirmed as necessary.
- Rehearsal. Running an event in advance so that nothing can surprise you, which leaves you tired before it begins.
- Pre-emption. Agreeing, apologising or over-preparing to remove any chance of someone’s displeasure.
- Withdrawal. Declining the thing you wanted, then explaining the decision to yourself afterwards.
- Checking. Returning to the message, the lock or the figure for a certainty that lasts seconds.
Among 240 adults attending community health centres, those with anxiety reported both more avoidance of unwanted inner experience and less engagement in rewarding activity than people with no emotional distress.1 The study was cross-sectional and mostly women, so it cannot say which came first. It does fit what I see in the room: the more of a life that gets arranged around not feeling the fear, the smaller the part of that life which remains.
Why does my body start before I know I am frightened?
The body is quicker than the explanation. The chest tightens, the jaw sets, the stomach drops, and only afterwards does the mind go looking for a reason. Because the mind is good at its work, it finds one, and the reason it finds is usually the nearest available worry: the email, the appointment, the thing you said last week.
This matters for how you respond. Arguing with the subject rarely settles anything, because the subject was supplied after the fact. Noticing where the fear actually sits in you, and staying with that for a little longer than is comfortable, tends to do more than another round of reasoning. It is slower, and it asks something of you that reasoning does not, which is why most of us reach for the argument first.
What is the fear trying to protect?
Anxiety is nearly always loyal to something. When I ask what a worry is guarding, the answer is often a relationship, a standard, or a version of yourself that feels unsafe to put down. The watchfulness says: if I keep looking, I will not be caught out, and nobody will see me fail. That is not an unreasonable position. It is an old one, and it was useful once.
This is where the two wishes sit side by side. You want to stop keeping watch, and you do not entirely trust what happens if you do. Both are true at the same time, and neither is the false one. Treating the anxiety only as a fault to be removed misses the second wish, and the second wish is usually the reason the first one stalls. The question worth sitting with is not how to get rid of the fear, but what you would have to feel if it were not there.
What can I do when the anxiety is already here?
Start with the body, then with the arrangements, and leave the argument until last. Anxiety that is already running does not respond well to being reasoned with, and it responds badly to being told it is irrational.
- Name the sensation before the subject. Say where it sits and what it feels like, without deciding yet what it is about.
- Lengthen the out-breath. Longer out than in, for a minute or two, while you stay where you are rather than leaving the room.
- Loosen one arrangement. Take the smallest accommodation you make, leave it undone once, and watch what actually happens.
- Let the uncertainty stand. Finish the sentence “I do not know yet” instead of closing it with a prediction.
- Put back one thing you dropped. Something you used to do for its own sake, not for its calming effect.
These help within the hour. They do not reach the part of the anxiety that is old and loyal, and a difficult week is not evidence that nothing works. If the fear has narrowed what you are willing to do, if it takes most of your sleep, or if managing it has quietly become the main work of your day, that belongs in a room with another person in it rather than on a list. My psychotherapy practice in Copenhagen is where that work happens, and a first conversation can be about nothing more complicated than what you are actually afraid of.
Questions people ask
Do I need therapy if I am still managing everything?
Managing is not the same as being well, and it is the most common reason people wait far longer than they needed to. If holding it together takes most of what you have, that is a reason to come rather than a reason to postpone.
Will talking about the anxiety make it worse?
Talking about it often raises the feeling during a session, and that is usually the work rather than a sign of harm. The pace is yours, and you decide what gets opened and when.
What kind of therapy helps with anxiety?
I draw on psychosynthesis, analytical psychology and attachment thinking, which suits anxiety that has been part of you for a long time. A shorter and more structured approach can suit a recent and specific fear, and I will say so if that is what fits.
Can I come without knowing what I am anxious about?
Yes, and not knowing is one of the more workable places to begin. The not knowing is itself information, and it tends to loosen once the feeling is given more room than it usually gets.
Is therapy worth it if the anxiety comes and goes?
An anxiety that recedes for weeks and then returns is worth looking at, because the pattern of its return usually carries the meaning. What the quiet stretches have in common is often as telling as what the bad ones do.
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Sources
How this article was written: I choose the subject and the angle. An AI assistant researches and drafts. I read the draft, correct and improve it and stand behind every clinical statement. The professional and clinical judgement is mine.
