I work with and talk to so many people who experience anxiety. They say things like:

“I’m anxious.”

“I feel anxious,”

“I’m nervous.'‘

“I’m worried.”

The logical follow up question from any person would be “Why? What made you anxious?” Despite this being the most obvious response, it is the LEAST helpful one.

Hear me out. Let’s follow the conversation through:

Person A: I’m so anxious right now."

Person B: Oh no, why? What made you anxious?

A: I don’t know, I just am.

B: Right, but why? What just happened to make you feel that way?

A: I don’t know. Nothing.

B: Continues to probe with 14 different versions of the same question to keep getting the “I don’t know.”

Person A doesn’t feel supported, Person B feels frustrated that they could not be helpful and puzzled as to why the answer to a seemingly innocuous question is so hard.

Anxiety therapy near me Anya Surnitsky — Photo credit: Rodnae Productions/Pexels

Here’s why: Anxiety is an outcome of myriad triggers, internal and external. If anxiety is a product of a prior trauma, triggers are often implicit. This means they happen outside of conscious awareness. The way the light is shining through the window, the sound of the water running, fast movement in peripheral vision— these types of sensory cues are often fragmented in our bodies and easily triggered when something external lines up. It happens so fast that our conscious mind has no idea, we just experience the result of that trigger, which is anxiety, nervousness, etc.

People also experience social anxiety. Social anxiety can be a feature of ADHD, depression, or the autism spectrum. While it’s not rational, this can make people feel like they will be rejected by everyone at the function, no one will like them, everyone is staring at them, judging them, etc. Again, not rational. But all of these worries feel true and real.

The last and least likely scenario is that the anxiety is situational. People are smart. If there is a simple explanation of an anxiety trigger- like a loud annoying emergency test on the radio, the person will turn it off. We are wired to avoid pain. If there is a solution to resolve the anxiety trigger, it is likely that people will find it, and may not ever talk about feeling anxious in the first place.

Ok, so what is one to do? What is one to say? Doesn’t it seem rude not to ask why someone is feeling the way they are? On the surface, sure, I guess. But in practice, most people want to be seen and heard, not offered solutions.

Instead:

Be curious about the experience of anxiety, not the cause. This could sound like, “oh, I see. What is going on for you? Is your heart racing? Are you feeling scared? I know when I get anxious, I get really hot. Is that happening for you?” “Hmm, does this happen a lot, or is this a new experience?” You are getting to talk about the experience, versus the cause of it. Naming the feelings and talking about the sensations helps reduce the power the anxiety has.

Offer a range of choices “Ok, what would be the most helpful- do you want a hug, would you like me to just stand here with you and keep you company, do you want to vent, or would a distraction be helpful?

Distractions:

Movement: A walk, dance, go find a drink of water. Movement can help ease anxiety, as it often makes people freeze in the place where they are.
Talk about the last show you binge-watched, the last great meal you had, etc.
Play an easy game like the alphabet game— pick a category (fruits and vegetables), then take turns naming fruits and vegetables while going through the alphabet. Person A- apples; Person B- blueberries, Person A- carrots, and so forth.
Funny memes or tik-toks for easy laughs. Laughter is great medicine.

Orient towards safety and control

Anxiety makes us focus on the future and what’s out of one’s control. Helping Person A focus on what is within their control and tuning into safety in the environment can help calm the underlying threat.

It’s ok for the person with anxiety to not know the cause. It’s ok for you as the support person to not know how to resolve the anxiety or fix the problem for them. The act of attending to the person’s experience will help them feel seen and heard, and that action itself is more likely to be soothing than actively searching for solutions. Ironic that not talking about a solution can be part of a solution…

I sent the following message out to current and previous clients today. I wanted to make it pretty, with pictures, sparkles, bows, bells and whistles. But…. no time for that. Because of the trauma work I did BC (before Coronavirus), I am anticipating how NOW will impact LATER.

Are my thoughts exhaustive? No. Complete with ALL the resources? No. There are a ton of resources flooding your inbox, social news feed, and TV. I wanted to share my thoughts, experiences thus far with clients, and knowledge to help you, where you are now, quickly.

Email sent:

I am writing this to acknowledge, normalize, and inform you about how the current pandemic could be affecting you. I care about you and your stability, and how this pandemic may impact you and all of us going forward.

Knowing these things now may help buffer how the chronic exposure to this collective trauma is stored in your body and your memory.

First things first: This is a trauma. Collectively. It is affecting people differently and in myriad ways. We don’t need to get into the quicksand of whose hardships are worse, who doesn’t deserve to suffer because their “circumstances aren’t as bad,” etc. Please let's just leave comparative suffering at the door.

Because we are currently in a trauma, we do not know how we will react 6 months after the dust settles, when it could be termed PTSD. If you are experiencing panic, hypervigilance, sleep disruption, and symptoms you would have called PTSD, it’s more likely Acute Stress Disorder. This is the same thing, but it’s present and not past. In these times and circumstances, it is ok to seek medical intervention to help treat acute symptoms so that you can function as best you can.

Here are some trends I’ve been seeing from current clients that may be familiar and validating for you:

Feeling that you “should” be doing more than you are (i.e. being more productive)

Episodes of crying or being teary when that is not the “norm” for you
Trouble falling asleep or waking frequently during the night
Racing thoughts
Dread that makes you stay in your pajamas the whole day
A feeling of heaviness
Grief: Loss of normalcy, loss of future, loss of connection
Having good days and bad days
Feeling angry and irritable
Numbing
Trouble engaging in your regular activities, or normal “chores.”
Over-exercising or not being able to exercise
Fear: uncertainty, the unknown
Changed expectations: What are the new expectations, are there any, should we keep old ones, what expectations are fair, and on...

Why are we having these reactions? Remember that our body is primitively wired to respond to trauma with fight, flight, or freeze reactions. In a chronic trauma, we will initially have a surge of this, and then find a new elevated normal.

Fight: It’s hard to fight an invisible enemy ourselves. So we fight with our families, we displace anger onto the customer service rep on the phone, etc.

Flight: We cannot flee, we are trapped. We may flee in our minds by binge watching tv/movies, numbing with food, alcohol, or other things, sleeping, reading books.

Freeze: This seems to be the most common response that I’ve seen among the people I’ve spoken with. The freeze causes us to be unmotivated, not be “able to get things done,” increase feelings of apathy, feel depressed, etc.

Having these reactions is normal. You are human and you will experience human responses. It’s ok to numb. It’s ok to watch TV. When it gets to a self-destructive level, that’s another story.

The point is: we can give ourselves permission to be human, and acknowledge that we are affected. When the shoulds come to visit, ask them “who says?” And then if needed, give yourself permission to do whatever it is you need.

We have to name the feelings. Draw the feelings. Write about them. Talk to family and friends about them. Get mad and scream. Punch pillows. Dance. Do yard work. Do light exercise.

This pandemic threatens us by causing feelings of a lack of safety, power, and control. We don’t want those beliefs to set in for the long term.

In response:

Create as much security, predictability and normalcy as possible.
Control what you can control.
Let go of what you cannot.
Watching too much news will escalate feelings of powerlessness
Engage in self-care.
Box breathe, do bilateral movement. Bring your resting heart rate down.
Be kind to yourself and give yourself grace
Take naps

A bit of transparency, as I walk the walk, not just talk the talk:

I’ve struggled with the freeze response on some days. I’ve felt drained and exhausted. I’m working on processing my own feelings about this in creative ways with my family. I feel angry and frustrated. Powerless at times. Here are some of the things I did, or we did together to help us feel even just a little bit better:

Created a family journal/log/scrapbook

Wrote inspiring messages on neighborhood sidewalks in chalk for all the people going on walks (didn’t mean to rhyme)
Had honest discussions about grief, loss, sadness and anger
Supported each other with acute expressions of emotion
Gave permission to not do things that we felt we “should,” (i.e. laundry, some chores, cooking, etc.)
Box breathing
Guided meditations from You Tube or apps
Sent cards and letters to family and friends
Had group Zoom calls with family and friends
Naps!

I want to get this information out to you because I’ve been sitting on it for days, trying to figure out “the best way” to distribute the information. This mode is imperfect, not well-edited for grammar or organization. I am giving myself permission for it to be imperfect and ok as is, because I care more about your well-being, and I value contribution.

Wishing you health, safety, and peace,

Anya