The Therapist - Anxiety

Dear Readers,


This month I will write about a common issue that brings people in to see me. People and their stories are always unique and it is my goal to assist in helping each person find the place within themselves from which life can be lived fully and enjoyably. One of the ways that I do that is to know the mechanisms of particular types of ‘dysfunctions’… depression and anxiety being the two most common. Here, I will focus on anxiety.


Anxiety is a particularly perplexing and uncomfortable condition, which is said to affect one in six Americans and 15 percent of people in England.


Anxiety is a mood disorder and includes panic attacks, phobias (of many kinds, social phobia being the most prevalent), general anxiety, obsessive/compulsive disorder, posttraumatic stress disorder, and other conditions related to medical or substance use. In simple terms, it is a fearful feeling that sets up an internal process which seems to perpetuate itself. Like dominoes which are lined up, a single ‘trigger’ can set off a chain reaction of thoughts that both increases a fearful urgency and leads to thoughts that are grandiose and far-fetched to the point of irrationality. This process can happen quickly, automatically and it is painfully disruptive to an ability to proceed and function with normal ‘here and now’ tasks. It produces a feeling of being ‘out of control’, often brings about feelings of guilt or shame, and questions about whether one is ‘crazy’.


Anxious people are often isolated because a fear of judgment, or a perceived stigma, prevents them from letting others know what is going on for them. All of it creates a snowball effect, starting small and feeding on the internal reality that it produces, all the time feeling worse.


Scott Stossel, an American journalist, provides a first-hand account of this in his new book, My Age of Anxiety. Check out the article he wrote in the Guardian at:


While the mechanisms are fairly easy to see and understand, it is not so easy to disrupt and change. Much like well-ingrained habits, we all tend to function from an internal ‘automatic’ response system. We learn it as children, before we have the developmental wherewithal to consider options. We cope with the challenges and nuances of life, opting for short-term solutions which inevitably run their course.


Anxiety is often the ‘information’ we need which tells us we need to reconsider the way that we have come to function. The problem is it creates its own fear of change. Many clients have said that while the feelings of anxiety are awful and undesirable, letting go of the familiar feels like stepping into the abyss. Often, when they feel better they mistrust the feeling of being OK. We tend to cling to what we know in order to feel like we are in control. It is a double bind. We are afraid to change and afraid if we don’t. It feels difficult to believe we can feel OK or even relaxed in a state where we are not in ‘complete’ control.


What we do know is that with the help of support and new awareness, we can overcome anxiety. We can break out of the hold it has and discover or rediscover what it is to feel an internal calm, without intrusive thoughts and worries. We can create an awareness that gives us options and choice as to how we respond and limit the effects of an automatic process that spins painfully out of control.


If this is relevant to you or someone you know, don’t simply accept it, get help and overcome it. — Douglas Holwerda


Do you have a question you would like Douglas’s help with? You can email him at This email address is being protected from spambots. You need JavaScript enabled to view it.. Personal details will not be printed 

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