What is "anxiety"? It's not a simple sum, that's for sure!

This definition ignores the physical impact of anxiety. Anxiety is rooted in patterns of thought, that much is true, but it is also a physiological response to what we experience as dangerous stimuli. Think of panic attacks - the physiology has taken over rational thought. And when we're not at the panic-attack stage but still in deep anxiety, body tense, heart beating uncomfortably, to what extent can we simply think our way out of it? Is it really as simple as re-estimating the challenges we face, and our resources to tackle it? For myself and most of my clients, the answer is 'no'. Let's face it, we've all been trying to do that anyway.

So what is 'the work' that needs to be done?

Anxiety stems from various beliefs and experiences that are 'true' to us. We all operate from a world-view, created from our these beliefs and our experiences. And our world-view, beliefs and experiences are all inter-related and impact each other. For example, you're running late for work. You may think 'that's OK, I'm rarely late and I'm performing well in my role, I'll just call them and let them know'. Your experience is that you're competent, your world-view holds that it's OK to be late once in a while, you believe people will respond well to a phone-call. Alternatively, you may also think 'what is wrong with me that I can't manage my time better? They're going to think I'm slack'. Here, you are responding from a different world-view and set of beliefs and experiences.

I know for myself and my clients, in the second scenario our bodies can start to tense up and our thoughts can start to spiral. We may head into negative thinking styles, such as catastrophising ("I'm going to get a bad performance review'), or blaming ourselves ('I should have realised the traffic would be bad'). Those are just two examples of negative thinking styles, which are part of Cognitive Behavioural Therapy for Anxiety. But in my experience, working on thinking styles alone does not get to the root of anxiety.

Because underneath those thinking styles there are core beliefs about ourselves, created in childhood e.g. 'I am stupid', or 'I need to work harder than other people'. When triggered, we may also experience negative feelings that come from childhood that aren't warranted in the current situation, and resort to childhood coping mechanisms, whether that be arguing, people-pleasing, or trying to be perfect etc. A part of therapy is noticing our triggers, and differentiating between our responses as an adult and those of the child within us. Noticing is a powerful part of therapy - when you notice your own triggers and how you are naturally inclined to respond, and where that response comes from, you have a choice and the power to respond differently.

In Bessel van der Kolk's book 'The Body keeps the Score' he talks about the effect of trauma on the brain's chemistry and the body's physiology. Traumatic experiences rewire the brain to cause people to be hypervigilant to threats, and can keep us in a state of hyperarousal long after the perceived threat is gone. Anxiety works similarly, we can be responding right now, in the present, to past threats or perceived future threats. Understanding what, in the current situation, has us feeling threatened can help us to differentiate between perceived threats and genuine threats. Moving forward with this knowledge allows us to gradually and gently, over time, rewire the brain to respond differently to fake threats.

These are just some of the ways we tackle anxiety in therapy. So I would not define anxiety as simply the result of overestimating the challenges and underestimating our current resources to handle the challenges, because it ignores the many layers of anxiety beyond rational thought, including the physiological aspect. Instead I would argue that there are many wonderful resources for reducing anxiety, and it takes a process of discovery to find out which ones work best for you. And that is the 'work' of therapy.