Anxiety is probably the most common reason people seek therapy in NYC and beyond. While it is commonly accepted that anxiety is an unavoidable aspect of the human condition, we also know that it can be a life-destroyer if its frequency and intensity are excessive, and if it is not handled effectively.

the age of anxiety

W.H. Auden’s "The Age of Anxiety" struck a chord in the consciousness of Western culture when it was published in the late 1940s. I think most of us would agree that its relevance has only continued to grow since then.

The feelings of dread, restlessness, irritability and psychic pain that one experiences during anxious periods can range from annoying/frustrating to unbearable/paralyzing, and thus it is no wonder at all that people are clamoring for instant relief. One result of this unfortunate reality is that prescriptions for Xanax, Klonopin, Atavan and other anti-anxiety medications have increased exponentially in recent years.

medication for anxiety—the pros and cons

Anti-anxiety medications are designed for short term symptom reduction and immediate relief from pain/discomfort, and they often work well in that limited regard. Anecdotally, clients often say that these medications ‘take the edge off’ which of course can be very valuable when you have certain deadlines and responsibilities to meet. Unfortunately, more and more people are developing an over-reliance on anti-anxiety medications in order to function normally, which is a big problem.

Why is it a problem? If it works, what’s the big deal?

Excessive dependence on anti-anxiety medication is a problem because it creates the illusion that cognitive/emotional growth is not necessary in adult life. As we know, when we humans find a ‘quick fix’ and start feeling better, we are apt to conclude that the problem is solved. If only it were that easy.

The truth is that while immediate symptom reduction feels good (and is very important in many situations), it too often crowds out and distracts you from the very important emotional ‘work’ that you need to do on your life so that anxiety is no longer such an obstacle to your personal sense of well being.

I often tell people in therapy that more reliance on pills equals less reliance on emotional regulation via healthy relationships with self and others.

alcohol/drugs & anxiety/depression

A number of people who seek therapy for anxiety (and/or panic attacks, depression, anger management issues, etc.) have been self-medicating with alcohol and/or drugs for years. What began as partying evolved over time into regular use in order to ‘feel normal’ or ‘get through the day.’ While the mood altering effects of alcohol and drugs 'help' with depression and anxiety in the moment, excessive use seriously exacerbates mood problems and relationship difficulties over time.

It is very common for people to think that their emotional and relational problems are unrelated to their habits of intoxication, no matter the drug of choice. In truth these things are deeply related. Fortunately, people experience enormous relief when they find out that simply decreasing instances of intoxication can have a significant impact on frequency and intensity of emotional pain.

anxiety as part of the human condition

Anxiety itself is not an ‘illness’ nor does it signal that you are doing something wrong. Anxiety is an unavoidable aspect of the human condition. That said, it is still important to ask:

Is my anxiety stopping me from living my life?

If so, therapy can help. And the way therapy helps with anxiety is to help you not only decrease and manage the anxiety, but also to understand and ‘use it’ effectively to build your life. Anxiety is a resource that we need to create with.

Such a constructivist approach to doing therapy with anxiety sufferers is important because when therapists or clients seek to ‘banish’ anxiety from the human experience, they are setting themselves up to fail in a big way.

anxiety: healthy or unhealthy?

Expecting to have zero anxiety in life is an unrealistic and self-defeating goal to be sure. In fact, we need to make a distinction between:

healthy anxiety – the anticipatory ‘butterflies’ (and other sensory symptoms) that accompany stepping outside your comfort zone as you endeavor to grow your life.

unhealthy anxiety – the free-floating restlessness and dread that seems to come out of nowhere and leads to overwhelm, escapism and self-defeating habits.

Obviously, healthy anxiety is forward moving and positive while unhealthy anxiety is paralyzing and destructive.

culture of anxiety

Very common complaints that I hear from people who seek therapy for anxiety take such forms as:

  • "I’m all over the place; I want to feel more relaxed and calm."
  • "I cannot focus, my mind is always racing; I’m too scattered."
  • "I can never stay in the present moment."
  • "It’s hard to be around people, I just feel too restless."

Such statements emanate from the fact that modern life is overwhelmingly busy and relentlessly competitive, in a context where the cultural norm is to minimize, ignore or numb your ‘negative emotions’ rather than talk about them openly and deal with them in healthy and collaborative ways.

Our cultural norm of pushing negative emotions aside with food, alcohol, drugs, gambling, work, pornography and other methods makes it more difficult for you to truly understand and master the subtleties and complexities of your own emotional life. Engaging in the above activities can be fun and exhilarating, but when the experience starts to get compulsive/obsessive, it becomes self-defeating on a variety of levels.

mindfulness for anxiety & panic attacks

Over the past 20 years, the concept of Mindfulness has become more and more integrated into mainstream thinking in the Western world, both inside and outside of therapy. Its origins are in Eastern/Buddhist philosophy. The concept of mindfulness refers to the habit/practice of pausing, slowing down and paying greater conscious attention to one’s own thoughts, feelings, sensations and surroundings.

What’s so special about that?

That’s the paradox of mindfulness: rather than being ‘special,’ it is actually very ordinary, while at the same time, it is transformative. With great simplicity, mindfulness helps you to be less easily drawn into the chaos and frenetic energy of modern life. It does this by waking you up to our own abilities to: (1) pause and step back; (2) re-direct your attention; (3) change your perspectives and adjust your attitudes; (4) re-connect to your own sensory experience (and to other people) in the here and now.

Slowing down, cultivating balance and trusting one’s instincts are all very difficult for people suffering with anxiety and panic attacks. And, they are precisely the capacities you need to develop over time (rather than over night) in order to ‘grow out of’ debilitating anxiety.

NYC therapy for anxiety

Facing fears and expressing authentic thoughts and feelings is also a very important aspect of recovery from anxiety and panic attacks. In other words, there is work to do within oneself to alleviate anxiety, but there is also work to do in one’s relationships and life activity. Anxiety is not just all in your head—it’s also in your life.

I address all of this and more in my therapeutic work in NYC with people suffering from anxiety and panic attacks, and it is very gratifying to witness the personal transformations that occur in the process.