Margaret Howard Blog
Cross-posted on the Huffington Post here.
It's so easy to make someone's anxiety worse. But so, so possible to make it better, and not just in the short term, either. Every time you truly support someone who's having anxiety to feel safe you're helping them feel better in the long term, too.
First I'm going to show you the steps. Then I'm going to explain some things. Then I'm going to elaborate on the steps.
Explaining Some Things
A couple of important concepts to grasp right off the bat:
Anxiety is a body state. It is not a frame a mind. It is not a thought. It is not a choice. Anxiety is governed by the Autonomic Nervous System (ANS) which is outside of conscious control. This is the involuntary system, the same one that keeps your heart beating, governs the body processes you don't have to think about to keep them going. Just like all pain is outside of conscious control, anxiety is pain in the body. It's a weird pain, yes. But there's a whole concrete system of nerves and organs and brain stuff (the brain is a concrete thing, like a heart or liver, not a collection of ethereal thoughts and ideas, and parts of it extend into the body through nerves) that is the physical state we call "anxiety" (See here, here, and here).
So, suggesting to someone that they should will their anxiety away is tantamount to telling them to will their sprained ankle or heart attack or appendicitis away: "Come on, let's go! You're choosing to feel pain! Just stop it!" You wouldn't do that, right? So don't do it when someone is suffering the pain of anxiety (or depression, either, but we're talking about anxiety right now), either (for more detail on the science behind this see this excellent report for lay people by research psychiatrist Stephen Porges, here).
Anxiety is involuntary. It arises because the Autonomic Nervous System (ANS) has been exposed to something that's thrown it into a state of activation. This may or may not be something that your loved one even notices with their cognitive/conscious brain. The job of the ANS is to respond to things before the brain has time to figure out what to do, because that's just too slow for survival. The ANS evolved to keep us safe. It's an emergency response system. The brain is too slow to be counted on. By the time the brain figures out which way to run, you're tiger food.
When someone has suffered an overwhelming experience but for one reason or another wasn't able to run or fight off the threat, then the system can get "stuck," so when a similar threat or something that contains an element of the threat pops up in the environment, the system turns the automatic, ANS threat response back on. This is all kind of complicated neurobiology stuff and I'm trying to keep this short, so just see any of the links I've provided in this article if you'd like more detail.
The ANS is seeking safety. That's it in a nutshell. In order for the anxiety state to ease, a sense of safety must be achieved. Particularly if the original trauma(s) happened inside a relationship or human interaction (some example: emotional abuse, physical abuse, rape, infidelity, traumatic birth, traumatic death) it's very important that the relational response to the anxiety state be one that seeks to help the person suffering to feel safe.
This cannot be stressed too much: It does not matter what's "logical." It doesn't matter what's "rational." You are not dealing with the cerebral or prefrontal cortex (the "executive function" part of the brain) here. You're dealing with the involuntary nervous system. So it's that you must seek to soothe.
As Stephen Porges, the eminent researcher in neuropychiology and trauma says in "NEUROCEPTION: A Subconscious System for Detecting Threats and Safety":
"Independent of conscious awareness, the nervous system evaluates risk in the environment and regulates the expression of adaptive behavior to match the neuroception of an environment that is safe, dangerous, or life threatening. . . A neuroception of safety is necessary before social engagement behaviors can occur. These behaviors are accompanied by the benefits of the physiological states associated with social support (http://stephenporges.com/images/neuroception.pdf).
Remember, the trigger to the nervous system activation that is causing your person's anxiety may have been something they didn't even consciously see, feel, or hear, so asking them why this is happening may not be helpful. Just help them feel safe, and later on they may figure it out.
Elaboration on the Steps
Provide safety, emotional and physical. Whatever that means to them.
What does your person need right now to feel safe? To be held? Or to not be touched at all? This can be so variable, from person to person and even from one time to another with the same person. This is because, again, the ANS is not the cerebral cortex. There are variables neither of you may even notice. So just try to figure out with your brain and intuition what would help your person to feel safe right now, and do that.
Don't judge! (Even if you think the anxiety is "about" you.)
Under no circumstances should you tell your person reasons why they should not be feeling what they're feeling. Again, you need to conceive of this as a physical pain, which it is, and use the same standards you would for empathy with that.
Don't get all logical about why your person "shouldn't" be having their pain!
This is kind of an extension of #1. Logic is not going to help. The Autonomic Nervous System does not speak that language. Yours doesn't either, and it's pretty likely one day you'll also have an ANS response that needs this kind of help, so get your karma in line now and communicate with the your person's Autonomic Nervous System gently and lovingly, with no judgement or "shoulds."
Communicate respect for what your person is experiencing in the moment:
These are all good phrases. They're not the only good phrases, but hopefully you get the idea. They are not judgemental. They show you're listening and you care, and that the most helpful thing. Also, check that your body language agrees with your words: Turn toward your person. Stop doing other things. Look them in the eye, if they're comfortable with that, and if not, still avoid looking at a screen or book or whatever. Just be there, and be present. But if they want to be alone, then definitely respect that.
Communicate gently, but not condescendingly. This includes body language.
One last note. If you find that you are having feelings of anxiety in your own body, or racing or negative thoughts, then it may be that some prior experience of your own (whether you remember it or not) is affecting your ability to be present and create safety for your person, and if that's the case then you may need to seek some expert practice for yourself. And that's good! None of us are supposed to be in this alone. We did not evolve as solitary creatures roaming the plains and forests. We evolved in communities, in groups, in couples, so that's how we're hardwired, to work together. Responding to one another with kindness and empathy has real, physiological benefits, and every time you respond to your anxious person well, gently, and nonjudgmentally you're helping them rewire their brain and nervous system for less anxiety. It just takes time, love, and patience. And here you are reading this, so clearly you care. And caring is half of what's needed. The other half? Just learned skills. And now you've got some.