Anxiety and Stress

Most people who come to see me about anxiety have already tried to talk themselves out of it, and found that it doesn't work. Anxiety is not a failure of reasoning, and it doesn't yield to being told that it is irrational.

What does help is understanding what it actually is, what it is standing on, and how to have a different relationship with it — one that isn't a fight you lose every time.

Fear, anxiety and stress are not the same thing

These three get used interchangeably, and knowing which one you are in is often the first step to working with it well.

Fear is present tense. It is a defensive response to something observable — the swerve away from an oncoming car, the flinch at a loud noise. It has a clear object, it is largely reflexive, and it passes once the threat has.

Anxiety is future-oriented. It is the mind rehearsing something that hasn't happened, often without a clear shape: a looming “what if” rather than a specific “what”. Because its object is imagined rather than present, anxiety can carry on long after any real threat has gone, if one ever existed at all.

Stress sits between them. It is what we feel when the demands placed on us seem to exceed our ability to meet them. Seem is the operative word: two people can face an identical deadline and experience entirely different levels of stress, depending on how capable they believe themselves to be.

Naming which of the three you are in, in a given moment, already starts to loosen its grip.

The four things anxiety stands on

Anxiety tends to stand on four legs, and separating them matters, because each one calls for a different response.

• Consequences, rooted in the past. These call for processing, and often for self-forgiveness.
• Lack of control, rooted in the present. This calls for identifying what is actually within your control right now — usually less than you fear, and more than you think.
• Uncertainty, rooted in the future. This calls for tolerance rather than resolution. Some things genuinely cannot be settled in advance.
• A perception of threat, which at its worst feels omnipresent. This calls for grounding: bringing attention back to what is verifiably true in this moment.

Working out which leg is carrying the most weight is often the most useful hour of the work.

Anxiety usually carries a message

Anxiety is uncomfortable, but it is not meaningless. Understood rather than fought, it very often turns out to be pointing at something: something that needs to shift, something that needs to be started, or something that needs to stop. Read that way it stops being only an affliction and becomes usable — a prompt that can get a needed change under way.

I know this one from the inside. After my accident, and the complications that followed it, I went through a long stretch in which anxiety caused me a great deal of distress — for exactly as long as I did not understand what it was telling me. What eventually changed was not that the anxiety went quiet. It was that I heard it, and let it move me to address a very difficult stage of my life instead of bracing against it. The relief came from the addressing.

So a good deal of this work is not about switching the signal off. It is about working out what is being signalled, and what you want to do about it.

When anxiety stops being useful

Some anxiety is simply part of being alive — a normal response to uncertainty, or to stakes that matter. It is worth paying closer attention when:

• The distress is debilitating, and, left long enough, starts tipping into depression
• Avoidance and procrastination take over, keeping you from anything resembling ease
• It interferes with the ordinary things that make up a day
• You can no longer do tasks you would normally manage without thinking

If you recognise yourself in more than one of those, it is worth naming directly rather than working around it.

Your body is doing the right thing at the wrong time

The racing heart and the heightened alertness that once kept a nervous system safe can fire in situations that no longer call for them. That does not make your body dangerous or broken. It makes it outdated, which is a very different problem, and a far more workable one.

Anxiety also speaks with the voice of an inner critic — a mind that has built up its own set of lies that feel like facts. Two patterns are worth catching:

• Awfulising — treating a difficult outcome as catastrophic rather than merely difficult.
• “Must” thinking — the rigid belief that things must go a certain way, or be unbearable if they don't.

Both come from Albert Ellis's Rational Emotive Behaviour Therapy, which is one of the approaches I draw on. Naming a pattern as a pattern is usually the point at which it stops passing for fact.

Two things you can actually do

Become a curious observer rather than a participant. Ask, simply: in this moment, right now, am I safe? Most of the time the honest answer is yes, and the anxiety is about a moment that isn't here.

Snapshot analysis. Pause and ask: as things stand today, is this actually true? Anxiety is usually a story about the future, assembled out of fragments of the past. A snapshot of today, taken on its own, is nearly always less alarming than the story.

A few things worth having on hand for when it is loudest:

• A thought is not a threat. Scary thoughts cannot hurt me.
• The presence of a thought is not evidence that it is true.
• Just because I'm scared doesn't mean I can't do it. Scared and capable are not opposites.
• Anxiety, uncomfortable as it is, is temporary and in itself harmless.

What actually changes the pace

Recovery from anxiety isn't linear, and it isn't governed by willpower. Five things tend to shape how quickly it shifts:

• How often you get the chance to practise
• Whether you genuinely intend to change, rather than wishing to
• Whether you are willing to face intensity rather than keep avoiding it
• Whether you are willing to revisit past experiences rather than go around them
• How consistently you keep up a mindfulness practice

None of these require perfection. They require repetition.

Mindfulness, and why I use it

Mindfulness runs through everything I do rather than sitting in a box of its own, and for anxiety in particular it has a substantial evidence base behind it — especially when combined with structured approaches such as cognitive behavioural work or schema therapy, and especially when practised consistently rather than occasionally. The clinical foundation for much of this is Jon Kabat-Zinn's work on Mindfulness-Based Stress Reduction.

You don't need to overhaul your life for it. Ten minutes a day has been shown to improve the capacity to stay calmer under stress. The dose matters less than the consistency.

Three pictures that do more work than an explanation:

• The kite — held with a grip firm enough to keep hold, and loose enough to let it move. A kind of loving, playful firmness.
• The flight attendant — put your own oxygen mask on first. Self-care isn't selfish; it is what makes caring for anyone else possible.
• The weather forecast — a cold front is passing through. It is real, it is uncomfortable, and, like weather, it moves on.

You are larger than your anxiety

In the grip of it, people commonly lose trust in their own ability and resourcefulness, because attention narrows onto the parts of themselves that feel like they are failing. But you carry a long history of experience and struggle that can be put to use rather than discarded — and finding meaning in past difficulty is often what loosens the hold of guilt, shame and self-doubt.

You are not defined by your angst. You are a considerably larger and more whole person than any anxious season suggests.

When more support is needed

Counselling is not always enough on its own. Where a psychiatric assessment, medication or more intensive treatment would help, I will say so and help you find the right person, and we can continue working alongside them.

Where this often overlaps

Anxiety rarely travels alone. It sits close to self-worth and self-esteem, it is often what is underneath a withdrawn young person's behaviour (help for youth at risk), it is commonly what people are medicating in addiction, and left long enough it tips towards depression and loneliness.

Practical details

Sessions are fifty minutes, in person at my practice in Stellenbosch or online by Zoom, in English or Afrikaans. Fees and other practical questions are answered on the FAQ page.

Getting in touch

Send me a message by email, WhatsApp or the contact form. You don't have to be in crisis to justify it.

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