Restoration Therapy: Trying to Define Anxiety

Anxiety in the Headlines
Anxiety is a hot topic these days. I am not saying that it has ever gone out of style, but it seems that anxiety has been increasing at record numbers in our culture and one can hardly look at the news without seeing article after article proclaiming the findings of some new study.

There was the big New York Time Magazine piece back in October of 2017 that garnered lots of national attention. In their article, “Why are More American Teenagers Than Ever Suffering from Sever Anxiety?” they discuss the rising rates of anxiety and adolescents and the struggle for many high school kids to navigate the transition into college. A few months earlier in June of 2017, The New York Times ran an article called Prozac Nation is Now the United States of Xanax, citing statistics that anxiety is now more prevalent than depression in our culture. And in December of 2017, The Wall Street Journal wrote an article called The Right Way for Parents to Help Anxious Children, where the look at the problem of many parents trying to shield their kids from anxiety, rather than helping equip them with the tools to navigate it. I even contributed a piece in early December of 2017 on this topic, Helping Adolescents Work Through the Rising Tide of Anxiety.

I could go on with article after article, but you get my point. Anxiety is a big deal, and more of a problem than ever before. In the New York Times Magazine article cited above they write the following:

“Anxiety is the most common mental-health disorder in the United States, affecting nearly one-third of both adolescents and adults, according to the National Institute of Mental Health. But unlike depression, with which it routinely occurs, anxiety is often seen as a less serious problem.” Statistic can vary from source to source, but according to the American Association of Depression and Anxiety, somewhere around 18% of the population (ages 18 and above), and 25% of the population (13-18 years old), suffer from anxiety.”

Trying to Define Anxiety

“Anxiety is the dizziness of freedom.”

This is how the great existential philosopher and theologian Soren Kierkegaard defined anxiety in his work The Concept of Anxiety. And it’s one of my favorite definitions of anxiety.

But what is anxiety really?

Trying to define anxiety can quickly become a tricky endeavor as it seems there are as many different definitions as there are people’s experiences. Most often when I am out speaking on the topic of anxiety I hear people define anxiety as stress, worry, panic, fear, restlessness, nervousness, apprehensive, jittery, a sense of uneasiness, and FOMO (otherwise known as the fear of missing out).

If you turn to the basic definition in the Merriam Webster dictionary you will read the following description of anxiety:

“1- a) Painful or apprehensive uneasiness of mind usually over an impending or anticipated ill; b) Fearful concern or interest; c) A cause of anxiety. 2- An abnormal or overwhelming sense of apprehension and fear often marked by physiological signs (sweating, tension, and increased pulse), by doubt concerning reality and the nature of the threat, and by self-doubt about one’s capacity to cope with it.”

It’s a pretty good definition of what anxiety is, and it covers both the physiological and psychological experiences of people when they have anxiety, but it still doesn’t quite get to the heart of the matter.

How would you define anxiety?

In a wonderful book about anxiety, Be Not Anxious: Pastoral Care for Disquieted Souls, Allan Hugh Cole Jr. writes about the congregational consultant Peter Steinke’s observation of anxiety. He writes the following about anxiety:

“Shares the same Latin root, angere, with the terms anger and anguish. Peter Steinke notes that angere, ‘is translated to choke or to give pain by pushing together,’ with its noun from angustus, meaning narrow.”

I love the insight of Steinke here because this feeling is what is often described to me by my clients that I work with in my private practice and other people that I come across in my work. And that is, people often describe both a physical feeling of not being able to breath very well, especially when the panic is gaining strength. In some cases people will describe what they thought was a heart attack coming on. So there is a physical feeling that literally feels like the airwaves in their throat are being pushed together and creating a choking sensation. And then there is this existential sense about anxiety where people feel like their life, or the options in their life are narrowing. When anxiety happens, people feel like their lives are physically and emotionally are pushing in on them.

My Own Journey With Anxiety
This description by Steinke is something that resonates with me personally. I share this story at length in my book The Anxious Christian: Can God Use Your Anxiety for Good?, but let me share a little bit of my personal narrative around anxiety with you. In April of 1986, when I was 11 years old, my mom died after a five-year battle with breast cancer. Two weeks after my mom passed away I went back to school in my 5th grade class and was unable to read out loud anymore. In fact, I describe this in my book as the day that I began to stutter. I could read and understand the words, but I literally could not produce a sound. And that is the way that it was for most of the next ten years. I did everything that I could do to avoid having to read out loud or be put in situations where I feel like I would be unable to communicate with others. I avoided making most phone calls, speaking situations, and definitely I was going to do everything I could do to avoid reading out loud in front of others.

Looking back on this time in my life I can clearly see that the stuttering was caused by the trauma of my mom’s death, but anxiety had already begun its work in me the five previous years leading up to her death, as I constantly worried about her dying and what life would be like for me if she were no longer to be a part of it. Like Steinke’s description I felt both a physical sensation of choking and my airways pushing together, especially when I tried to read out loud or speak to others on the phone. And I also felt something very existential…I felt that upon the death of my mom, my life had narrowed greatly, and that possibilities had closed up around me. This is anxiety at work in its multi-faceted ways, and that is what can make it so tricky to define.

For the next ten years I did everything that I could to try and avoid anxiety provoking situations, when finally in 1996 I was asked to give the sermon at the Easter morning sunrise service at my small Christian college. I had prayed for an opportunity to speak a few weeks earlier, feeling like the only way to work through my anxiety was to literally go through it. But this opportunity seemed to overwhelming and without much reflection I said no and thank you. As I hung up the phone I remember the prayer I had prayed weeks earlier about an opportunity to speak. So I called my friend back up in the chapel office of the school and said that I would speak. I would like to tell you that the next couple of months of sermon preparation were anxious free and that I got up on Easter morning 1996 and delivered an amazing sermon. But I didn’t. I did get up. I did deliver a sermon. And to my recollection I stuttered a lot of my way through it, but I survived. And it was that experience that sent me on a journey to really work through my anxiety. Over the next fourteen years between the ages of 21-35 I would start working with therapists on this topic, and all along the way my public speaking increased, while seven of those years were spent preaching each week as the college pastor at Bel Air Presbyterian Church.

Anxiety Is Not a Feeling, But a Response
My anxiety did not disappear, but I seemed to have a pretty good handle on it, and it was no longer impeding my life. But something was about to happen that helped me not only understand my anxiety at a deeper level, but really work through it in a transformative way. That something was when I started doing marriage intensives at The Hideaway Experience in Amarillo, TX, and that is significant because it put me into intimate contact with what I would later come to realize was Restoration Therapy, developed by Terry Hargrave. In December 2014 I officially started training with Terry Hargrave in his Restoration Therapy model, and it is in that training that I may have made the biggest discovery of my life in terms of anxiety, and it has helped me come alongside my clients in a much deeper way and help them transform their lives.

That discovery was that anxiety was not a feeling or an emotion, but was rather the response that I had to some deeper, underlying feeling. For most of my life I assumed anxiety was what I was feeling, and because of that assumption I spent most of my life chasing after the symptoms, trying to alleviate those, rather than work on the deeper issue. And I did a really good job of alleviating symptoms and working through them, especially when my vocations required me to get up and speak in front of others each week. But that didn’t get me any closer to what my anxiety was about.

As I began to do more work on my anxiety I soon discovered that underneath my anxiety was a feeling of inadequacy, of not being good enough, or not measuring up. There was also a deep sense of feeling abandoned after the death of my mom, and it those feelings that drove anxiety for most of my life. When I began to understand that, then I was able to work on those feelings, rather than just treat the symptom of anxiety.

It is this understanding of anxiety that has helped me the most and I think that is why I think that when we are talking about anxiety, that Allan Hugh Cole Jr. gets the closest to what I think anxiety is about. In the book Be Not Anxious: Pastoral Care for Disquieted Souls he writes the following:

“To put it another way, the type of anxiety that concerns us here, and the type I believe pastors tend to encounter, has less to do with circumstances or situations and more to do with personhood and relationship, though circumstances and situations surely may affect one’s anxiety.”

Though Allan Hugh Cole Jr is addressing pastors in this quote, I think that he gets to the heart of the matter in terms of what anxiety is. Anxiety is most often the response that one has when underlying feelings are triggered that effect one’s personhood and relationship. Another way to say it is that anxiety is most often triggered when we struggle with questions around identity and relationships we have with ourselves and others.

In the book Restoration Therapy: Guiding Understanding and Healing in Marriage and Family Therapy, Hargrave and Franz Pfitzer say something that I think reinforces what Allan Hugh Cole Jr is saying about personhood and relationships. They write the following:

“Human beings come equipped to do two basic things in the context of relationships: They make meaning about themselves and decide how to behave or at in relationships.”

If we are equipped to do these two basic things in the context of relationships, then it would make sense that anything that threatens it and triggers feelings in response to it, will cause one to respond with anxiety.

Working Through Your Anxiety
If you are someone who you or someone else would describe you as anxious, or struggling with anxiety, then I think there are some helpful next steps to take.

First, it’s important to identify what the underlying feelings of your anxiety are. Remember, if anxiety is a response, than try and locate what feelings are triggering it. There are several ways to do this. One, you could talk with a friend, pastoral counselor, or therapist and allow them to help you dive into identifying what these feelings are. Two, you could pull up some resources to help you identify what the underlying feelings might be. This is in fact something I do with my clients all the time since seeing words on a paper often has a great way of helping someone identify and discern what may be causing the anxiety. I recommend going through the Pain Cycle downloadable PDF that I blogged about on my site. Or you could purchase Think 2 Perform Feeling Word Vocabulary Chart and use that to help you identify underlying feelings. Identifying the underlying feelings will help give you or your therapist clarity on what you need to work on.

Second, it’s important to use some tools to help you manage and regulate your anxiety. Anxiety is the symptom, so now it’s time to work on the symptom. There are many tools one can use to help with anxiety, but I highly recommend using something like the meditation app Headspace as I believe the exercises you engage in really teach you how to regulate emotions and breathing in a way that helps lower anxiety. They even have an anxiety pack you can use specifically for anxiety. I also recommend that you do a personal assessment of your self-care. That is, how are you taking care of yourself physically, emotionally, mentally, and spiritually. I have found that when we are taking care of ourselves, we often do a better job of managing anxiety, giving us emotional space to also work through it.

Third, one of the most important things that I believe we can do with our anxiety is to reframe it as an opportunity for growth. That is, what is the anxiety I am experiencing saying about my life or how I am living it. Is it possible to see anxiety as a tool that can clue you into your own life and help you make changes that will help you grow?

I am going to dive in deeper in other blog posts about the ways that you can work through your anxiety, but for now I think it’s important to let you know that you are definitely not alone. As you could see from this article, anxiety is very prevalent in our culture and only growing. And if you are someone who identifies as having anxiety, then there are things you can start to do to help you transform it. So be encouraged and continue to explore what anxiety is for you and how you can work through it.

Rhett Smith is a Licensed Marriage and Family Therapist in private practice in Plano, TX. He specializes in helping people struggling with anxiety find new opportunities for growth, as well as spending a majority of his week with couples as they navigate relational issues. He is the author of The Anxious Christian: Can God Use Your Anxiety for Good? and What It Means to Be a Man: God’s Design for Us in a World Full of Extremes. Rhett lives in McKinney, TX with his wife Heather and their two children. You can discover more about Rhett’s work through his writing and podcast at www.rhettsmith.com

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