Understanding Anxiety and What to Do About It

Think about situations you avoid as a result of your anxiety. Are there any that are holding you back from achieving your goals?

In my last blog, I wrote about the power of emotions and how all feelings — good, bad or neutral — should be honored, not suppressed. Hopefully by now you are taking the time to get to know yourselves from the inside out, and recognizing how leaning into your emotions can improve your relationship with yourself and others.

Today let’s talk about anxiety.

Signs You May Have Anxiety

Anxiety is generally not a welcomed emotion because of the uncomfortable physical and emotional sensations which accompany it. These include:

  • Feelings of tension, worried thoughts and physical changes like increased blood pressure.
  • Recurring, intrusive thoughts or concerns.
  • Avoiding certain situations out of worry.
  • Physical symptoms such as sweating, trembling, dizziness or a rapid heartbeat. Source: APA

The Difference Between Anxiety and an Anxiety Disorder

It’s important to distinguish between normal anxiety and anxiety disorders.

Normal everyday anxiety is part of life which we can’t and shouldn’t ignore. In fact, normal anxiety can actually be helpful in many cases. For example, if you have a deadline, a manageable level of anxiety may motivate you to complete the project. You might have that nudging voice saying, “You’d better get moving on that project or else you won’t meet your deadline and your boss will get mad at you!” Without this voice, you might procrastinate, not meet your deadline and possibly get into trouble.

Anxiety is also a protective mechanism, warning us of a potentially perilous situation, and may help us flee should we encounter danger.

Anxiety disorders are distinguished from everyday anxiety in that the physical and emotional consequences are more intense, and may interfere with a person’s normal functioning. Excessive anxiety may sometimes lead to full-blown panic attacks. Therefore, it’s important to treat anxiety and panic disorders with therapy, and sometimes medication; if the symptoms become excessive, they can result in significant medical and emotional complications.

How to Manage Anxiety

Many of my clients express intense hatred towards their anxiety. Some even say they feel weak because they have recurring anxiety. We are a culture that delegitimizes and demonizes painful emotions, so many of us do anything and everything to avoid feeling. The fear of physical and emotional symptoms causes us to avoid activities that create discomfort. What happens next? The more one avoids feeling anxious, the worse the anxiety gets.

People tend to isolate, numb out, and evade activities that create anxiety as a way to suppress this intense emotion. How does this work out in the long run? They miss out on fulfilling and potentially prosperous opportunities. Furthermore, the more they trick themselves into thinking that they beat their anxiety, the worse they feel about themselves.

For example, I work with many college students who are required to do presentations. On several occasions, some of my clients have asked me for a note excusing them from presenting because of their anxiety disorders. My response each time is “NO!” Initially they may feel a sense of relief knowing that they have dodged presenting. However, in the long run they will miss out, and their fear of presenting will get progressively worse. The only way to address their anxiety is to face it head on. By gradually exposing themselves to feared situations, they can habituate to them, and their anxiety will decrease. This is what exposure therapy is all about.

Treating Anxiety with Exposure Therapy

In my practice, I incorporate exposure therapy which is a type of behavioral therapy designed to help people manage problematic fears. It works by using various techniques to gradually expose a person to situations which create anxiety. The goal is to create a safe environment in which a person can reduce anxiety, decrease avoidance of dreaded situations, and improve their quality of life.

Throughout my years as a therapist, I have found that we can talk about an issue over and over, but without addressing it head on through exposure, the client won’t improve as quickly, or at all.

How does exposure therapy actually work in a therapy session? Here is a brief description of what we do.

Step 1: Describe Your Anxiety

First, we start by talking about how the person experiences anxiety in their body and mind. I ask them to notice physical sensations they experience, as well as any thoughts which come up. Many of my clients beat themselves up with thoughts such as, “I am so weak to have this anxiety,” “I shouldn’t feel so anxious” or “Why can’t I get rid of my anxiety? I should be able to manage this situation without being anxious.” All of these self-deprecating thoughts have a negative effect on self-esteem, and get in the way of feeling happier. They can also eventually lead to depression.

Step 2: Integrate Mindfulness

In addition, I ask my clients to practice mindfulness by staying with the physical sensations they experience, and not judging themselves for these sensations or thoughts. I ask them to be compassionate towards themselves, the same way they would be to a friend who is suffering from similar symptoms.

Step 3: Rank Triggering Situations

After practicing mindfulness, we come up with a hierarchy of anxiety-inducing situations, e.g., public speaking, social situations, flying, etc. I ask my clients to rank each situation based on the level of distress they feel in that situation (on a scale of 0-10).

Step 4: Build a Plan for Tackling Anxiety

Next, we start by tackling the situation which causes the lowest level of distress, moving up along the hierarchy towards more anxiety-inducing situations. We do this by designing exposures which create anxiety. Exposures may include going to a networking event, going to a coffee shop, making eye contact and conversation with the barista, or for some, eating specific foods which my clients deem “feared foods.”

Step 5: Take on Anxiety

Finally, some exposures are conducted in session, whereas others are done between sessions for homework.

Successfully Managing Your Anxiety

To summarize, the more a person practices exposing themselves to feared situations, the more they habituate to these situations, and the less anxious they feel over time. Working with a therapist who has expertise in exposure therapy can be very useful as the therapist can guide one through each of the exposures in a supportive manner.

I challenge you to try exposing yourself to a situation you historically avoid. Try doing the exposure regularly until your anxiety diminishes to a very manageable level. Yes, it will definitely be hard at first, but my bet is that you will feel happier and more confident in the long run.

I hope that you all have enjoyed this blog. As always, I welcome any comments, questions or concerns you have about tackling your anxiety.


Karen Chinca - LICSW | Cognitive Behavioral Therapy and Wellness - Brookline MAAbout Karen Chinca: Karen Chinca is a Licensed Independent Clinical Social Worker (LICSW) located in Brookline, Massachusetts. She has over ten years of experience in Cognitive Behavioral Therapy (CBT). She specializing in treating individuals and families who are dealing with academic, personal, and professional stress.