By April Lehman, LPC
EMDRIA Consultant in Training
What is anxiety? These days it seems like the norm to hear people say they have “anxiety.” Especially over the past few years in the wake of Covid, political turmoil, and racial injustice, I think all therapists can agree we have seen an uptick in clients seeking therapy due to anxiety. And not just adults, kids are feeling the effects as well. But what is anxiety? Anxiety can be described as worry and fear regarding everyday situations. However, when these symptoms are persistent and begin to interrupt your daily functioning they can meet criteria for an anxiety disorder.
So, how do we manage anxiety and prevent it from interfering in our lives? There are some things we must understand first. It is normal to have some anxiety. Having some anxiety helps us stay out of harm's way and helps us prepare for important tasks. It’s completely normal to feel nervous about a first date or have anxiety about an upcoming speech, test, or big work project. However, if anxiety is something you experience on a more regular basis and you find it difficult to control or manage, it may be time to seek help.
The next thing that is important to understand is what’s happening in the brain. The amygdala is two almond-shaped structures in the Limbic System that can be referred to as the “smoke detector” of the brain. In the brain, the thalamus takes in sensory information from the outside world and combines this information into an understandable experience of “this is what is happening to me.” The information is then sent to the amygdala (unconscious brain) and the frontal lobes (conscious awareness). As the “smoke detector,” the amygdala detects threats. The frontal lobes can be seen as the “watchtower” - being able to see the situation, observe what is happening, predict outcomes, and make a conscious choice on how to proceed. The pathway from the thalamus to the amygdala is extremely fast; whereas, from the thalamus to the frontal lobes this information may take a few milliseconds longer for information to be transferred. Because the amygdala receives the information faster, it decides if a threat is present. If threat is detected, the amygdala signals the body to go into fight or flight mode, releasing powerful stress hormones, including cortisol and adrenaline. These hormones prepare us for fight or flight mode by increasing heart rate, blood pressure, and rate of breathing. The amygdala is usually able to adequately interpret threats. However, past trauma or adverse events can contribute to the amygdala misinterpreting if a situation is an actual threat (Van Der Kolk, M.D., 2014).
If you have experienced past trauma or early adverse events, your amygdala may be interpreting current situations as “danger” because they are linked to past trauma or adverse experiences resulting in anxiety. For example, having a humiliating experience in grade school could contribute to current anxiety in your adult life. These current symptoms may be fed by the unprocessed adverse experiences of the past (Shapiro, 2018).
So how do you manage anxiety? Well, as an Eye Movement Desensitization & Reprocessing (EMDR) Trained Clinician, my first thought would be to advise you to find an EMDR Trained Therapist and get into therapy. Yes, there are many self-care modalities to help with anxiety as well. However, to get to the root of the problem, I would suggest EMDR. Other techniques or exercises - such as mindfulness meditation, breathing exercises, proper nutrition, exercise, and yoga - would also be recommended to supplement this work. The point is not to treat the symptom, but get to the core by unlocking memories that may be unprocessed and feeding current anxiety. There are specific EMDR protocols to target anxiety. You and your therapist can come up with a comprehensive treatment plan to desensitize memories feeding anxiety and contributing to maladaptive thoughts about self in the present.
Knowledge is power. When you know what is taking place in the brain and body and how trauma and adverse experiences affect both, you are going to choose a treatment that offers to not only manage anxiety, but possibly resolve the core problem that is fueling these symptoms.
American Psychiatric Association. (2013) Diagnostic and Statistical Manuel of Mental Disorders (5th ed.) Arlington, VA, American Psychiatric Association.
Shapiro, F. (2018). Eye Movement Densensitization and Reprocessing (EMDR) Therapy: Basic Principles, Protocols, and Procedures (3rd ed.) New York, NY: The Guilford Press.
Van Der Kolk, M.D., B. (2014). The Body Keeps The Score: Brain, Mind, and Body in the Healing of Trauma. New York, NY: Penguin Group.
About the Author
April Lehman, LPC completed an EMDRIA Approved EMDR Basic Training in 2016. This training completely changed the way she conceptualizes treatment with clients and started her on the path to becoming a trauma therapist. She maintains a solo private practice in Kearneysville, WV as a therapist and EMDR Consultant in Training and is currently working toward becoming an EMDR Consultant for EMDRIA.