What Is Underneath the Anxiety
One of the most difficult things about anxiety is trying to define its roots. In an earlier post I wrote about the challenge of trying to define it, but in this post I want to explore more in depth what the underlying roots are that trigger anxiety. You may remember that in that earlier post I talked about how anxiety is not a feeling or an emotion, but rather anxiety is our response to feelings.

Anxiety is Something That We Do
One way that I talk about anxiety is that anxiety is something I do, it’s something that I become. Literally, I do anxiety. I become anxiety. In the Restoration Therapy model, anxiety, to become anxious is placed under the section of Violations of Love in the Pain Cycle, and is referred to as a coping strategy when one flees in shame. Terry Hargrave and Franz Pfitzer write in their book, Restoration Therapy: Understanding and Guiding Healing in Marriage and Family Therapy:

“When however, there is a lack of love or safety, the limbic system is activated, and there is stimulation of emotional pain that begs reaction to cope by using either the power to fight for oneself or anxiety to flee and get away from the threat.”

Simply said, some type of emotional pain is triggered inside us, and one of the ways that we cope is that we become anxious.

This insight is extremely critical to the understanding and treatment of anxiety, and is unfortunately something I didn’t really understand clearly until the last six or seven years, and even more clearly in the last several. When I wrote my book The Anxious Christian in 2012 I had a pretty good understanding that my anxiety was about feelings of abandonment, not being good enough, and that primarily my anxiety was wrapped up in the death of my mom. But in my understanding of anxiety at that time, anxiety was just another feeling, rather than some behavior that I moved into. Again, this insight is critical because it keeps one from simply chasing the symptoms of anxiety, rather than dealing with the root issue. Let me give you a clear example of this in the illustration below.

If a client comes in to see me complaining of anxiety it is tempting to just explore their anxiety with them and to give them some tools to work on the anxiety. Now this may be helpful, but I may end up forever just helping them deal with the symptom, rather than helping them identify the root feelings that may be responsible for triggering the behavior. There is a huge distinction here, because one leads you down a path of just applying band aids to a situation, and the other helps you go in and address and heal the wound.

So for years I was treating my anxiety by just treating it as a symptom, and I would apply one band aid after another, but never really addressing the core issue. It is when I started working with The Hideaway Experience and Terry Hargrave and the Restoration Therapy model that I began to see that there were some underlying feelings in my life that needed to be healed so that I could properly deal with the anxiety.

Identifying Your Pain Cycle in Regards to Anxiety
In the previous post I shared with you Allan Hugh Cole Jr’s insight that anxiety was primarily a struggle with one’s personhood and relationships, so let’s use that as a starting point to help you identify your underlying roots of your anxiety. And then let’s also combine that with the Restoration Therapy model which constructs a Pain Cycle around violations of love and trust. Love is primarily about our identity, and trust is primarily about our safety. I think that these two concepts fit nicely, because personhood is all about our identity and relationships is all about trust.

So then, we can say that when you become anxious, what is most likely being triggered for you at a deep level, are feelings that attack your sense of identity or how you relate to other people. Knowing this is critical, but how do you start to really zero in on the particulars?

There are several ways that I help someone begin to identify, name, and understand the underlying feelings to their anxiety. One, is that in my conversation with them I listen closely to what they are saying about their situation, and I reflect back to them what I believe are some of the feelings they identify or struggle with. This is a powerful way to identify underlying feelings, but it requires someone opening up, and another person listening intently. Two, I love to hand a client a piece of paper in session that has a bunch of feeling words listed on it. I have created a list of feeling words that I culled from the Restoration Therapy book and The Five Days to a New Marriage book, and I find the list to be a very powerful guide for people looking to identify their anxiety. Often I will give it to clients to take home and sit with and explore for a week or two. Most clients are able to look at the list and begin to clearly define some of the feelings they feel…perhaps for the first time…and then they are able to trace it to their anxiety as a behavior.

Being able to know what you feel, and then being able to communicate it is so powerful for most people. It not only helps them understand themselves better, but it helps them communicate how they feel to other people. And when they do this, people they are in relationship also have a better understanding and more empathy for them. And this dynamic changes relationships. Let me give you an example from my own life that helps you understand how anxiety plays out for me from both a violation of love and personhood perspective, as well as from a violation of trust and relationship perspective.

What I have begun to understand about myself is that whenever I start feeling unwanted, not good enough, alone, abandoned, I tend to cope by moving into anxiety. I can trace a lot of these feelings back to my family of origin and going through the five year period with my mom battling breast cancer. There were many times that I felt like I was alone, and ultimately I felt like she abandoned me in her death, even though it wasn’t something she did on purpose. In my anxiety from her death I often tried to find validation and affirmation from others and to the degree somebody wanted me and was there for me I was non-anxious, but when they weren’t, I became anxious. Also, I know that when it came to my relationship with God I tried in every possible way to negotiate with God to not allow my mom to die, so it ultimately felt like I wasn’t good enough when she did die. All of these violations fall under the violation of love in the Restoration Therapy model, and they are ultimately struggles around my identity.

I also know that when I am becoming anxious I am often feeling out of control, unsafe, life feels unpredictable, and I feel like I can’t measure up. These feelings lead me to becoming anxious, and I know that I can trace these feelings as well to the period of time when my mom was battling breast cancer and ultimately died from it. A good example that makes this more concrete is that my father was encouraged by my mom’s oncologist on several occasions to let my brother and I know that my mom was not doing well and that she had a short time to live. But then my mom would get better and life would go on. This unpredictability in my life created a lot of anxiety and it often made me insecure in relationships.

I see these two aspects of anxiety often play out in my life on a daily basis. It’s especially powerful in my work where I tend to feel quite often that I am not good enough and I become anxious. And I often feel insecure in my relationships with others because I’m not measuring up, and then I become anxious.

As I begin to do more work around anxiety, especially as it relates to the Restoration Therapy model, I believe that anxiety makes an appearance as a coping behavior both under violations of love and trust, and in all the ensuing actions of blame, shame, control and escape. Though anxiety is most often placed under violations of love and in the shame category, I think there is plenty of evidence, and I have lots of examples in my work, and in my personal life, where anxiety can manifest itself in many different ways and areas.

Focusing on the Root Feelings of Anxiety to Promote Change
It’s one thing to identify the underlying feelings that trigger our anxiety, and it’s a whole other issue to try and heal those underlying feelings. In fact, I would say that most clients I work with, with some guidance, have a fairly easy time identifying their root feelings and then connecting it to their anxiety. In other words, most people I work with have a pretty easy time constructing their Pain Cycle. But when we start talking about how to heal those root feelings driving the anxiety, it can be a huge challenge.

One of the ways that I like to frame this challenge for clients, especially those that I work with from a Christian or faith background, is around the idea of taking off the “old self” and putting on the “new self”. If you aren’t familiar with that language, let me share it here with you briefly. In the bible, in the book of Ephesians, Chapter 4:20-24, the apostle Paul writes the following words:

20 That, however, is not the way of life you learned 21 when you heard about Christ and were taught in him in accordance with the truth that is in Jesus. 22 You were taught, with regard to your former way of life, to put off your old self, which is being corrupted by its deceitful desires; 23 to be made new in the attitude of your minds; 24 and to put on the new self, created to be like God in true righteousness and holiness.

Essentially, in identifying the underlying roots of our anxiety, we are constructing the Pain Cycle, which is the pattern that most of us have operated from for probably the majority of our lives. The Pain Cycle is what I developed in my early childhood around my mother’s battle and death with breast cancer, and which I continued to reinforce in later years. So one of the ways I want clients to think about their anxiety and the way that it works in their lives, is that it is something they have probably been doing most of their lives…it is part of their “old self.” And in order for them to not automatically operate from their Pain Cycle and let those underlying feelings lead them into anxiety, they have to not only identify their “old self” at work, but they have to begun to go about identifying and operating out of their “new self”. It’s a process of daily identifying and taking off the old, and putting on the new.

I tend to believe that most people already have a “new self” at work, or what is referred to as the Peace Cycle in the Restoration Therapy model (and in which I will delve into deeper in a future post). But when we are unaware of our Pain Cycle, we tend to let it control the show, rather than choosing to operate out of the Peace Cycle.

If someone is anxious for example, and we have identified that the feeling of “not good enough” is the most prevalent underlying feeling that drives their anxiety, then we want to begin work on healing that feeling. There are several ways to do this, but here are some of the most common that I have explored in counseling with others. One ways is that I want to help them identify truths about themselves, often coming from three different sources: a) truth from God…that is, how does God see them? Does God see them as not good enough, or do they feel they are good enough in God’s eyes? This can be a challenge for people struggling spiritually (which I will get into in a later post); b) truth from others…that is, what have they heard communicated to them from others over the years? What messages have been communicated in terms of being “good enough.” Again, this type of truth can be powerful because it comes from an outside source, but it can be challenging because we don’t want to help someone base their truth about themselves on an external source that is not consistent; c) truth from themselves…that is, what do they believe deep down inside about themselves? Do they believe they are good enough?

Working through these truths is an important component in helping a person transform their underlying feelings that trigger their anxiety.

Another way to help someone in counseling deal with the root feelings that trigger their anxiety is to simply set up some experiments they can practice that put them into contact with their anxiety in such a way that they learn not only to be okay with anxiety, but they learn to navigate it. For example, in the case of me being a stutterer, one of the things that I intentionally did in my life, and even to a greater degree with some therapist’s help, I practiced working through my anxiety by putting myself in situations that triggered my anxiety, and then practicing working through it. I was in the habit of saying yes to every speaking engagement that was offered to me which triggered the feeling of “not good enough”, “not measuring up”, etc, and led me into anxiety. But as I recognized that feeling, I would then go about practicing telling myself that I was “good enough” and literally working through my anxious situations. When I succeeded I started to believe more in myself, and when I felt like things didn’t go great, well I figured out other things to work on.

Chase the Underlying Feeling, Not the Symptom
So if you are someone who is struggling with anxiety, or you are working with someone who does, do yourself a huge favor…don’t chase the anxiety because you are only pursuing the symptom. Instead, help that person dive deep into, and explore what underlying feelings may be triggering the anxiety. Are they questions about their identity and personhood, or are they questions about their safety and relationships? Perhaps the anxiety hits on all those areas. But as you help them identify the underlying feelings, and you keep anxiety as a response (identifying the Pain Cycle)…as something they do, you will draw some clear distinctions in terms of helping the healing process. This distinction will give you clarity on the feelings that you must work towards treating, and the actions that will help them work towards being non-anxious (the Peace Cycle). If you can do this, you will be able to help most anyone you work with who has anxiety problems.

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 rhettsmith.com