What Are the Causes of Anxiety?
From Your Perspective, What are the Causes of Anxiety?
When we think of anxiety, we often think about symptoms. We group those symptoms into categories such as social anxiety, obsessive-compulsive disorder, performance anxiety, and so on.
When people come to therapy, they’re looking for relief from their symptoms. However, I’ve found that focusing exclusively on the symptoms of anxiety often makes it more difficult for people to find relief. This is because everyone’s experience of anxiety is different. Even two people with the same kinds of symptoms can have very different experiences of anxiety. The more someone can understand her particular experience of anxiety and its causes, the easier it is for her to begin to feel better.
Do You Have Any Examples?
I do. I have two patients who have social anxiety. Their experiences are completely different from each other. One patient was labeled the “bad” kid in his family. His parents were always finding ways to criticize and punish him. Their punishments included putting him in situations of physical danger. This patient’s social anxiety centers on fears that other people are going to criticize and hurt him.
My other patient had a completely different experience. She was the “good” kid in her family. Her older brother was the one who was always getting in trouble. This patient was a sensitive child who needed help navigating social relationships. Her parents were so preoccupied with her brother that they never noticed that their daughter was having trouble making friends. They just assumed that, because she was doing well in school, everything was fine.
This patient’s social anxiety centers around fears that she doesn’t matter to anyone. She doesn’t worry that people are going to hurt her. She’s afraid that people will ignore her and that she’ll be ridiculed if she tries to establish relationships with anyone.
As should be clear from these examples, people’s experiences of anxiety—what people fear will happen to them—are all tied up with what happened in their early relationships. The more people are able to understand how their early relationships created their particular form of anxiety, the more they can put it in perspective and begin to move past it.
When Working With Anxious Patients, What Are You Looking for in Particular?
I never assume that anyone’s experience is the same as anyone else’s. For example, on the surface, it can look like two people who suffer from performance anxiety have the same fears. More often than not, that’s not the case. One person I worked with had performance anxiety because everyone in the community where she grew up expected tremendous things from her. She was afraid of disappointing them. Another person grew up being told that he would never amount to anything and was afraid that audiences would reject him.
Even though both of these people had performance anxiety, their fears were completely different. In order to overcome their fears, they needed someone to understand their individual experiences, not assume that they fell into some general category called “performance anxiety”.
Once You Have Identified These Experiences, What Do You Do to Help People?
People who struggle with anxiety often berate themselves. They’re convinced that they’re being “irrational” and should just be able to talk themselves out of it.
I try to help people understand that there are actually good reasons for their anxiety and that those reasons are usually related to their experiences in their early relationships. When people see that their anxiety makes sense, it actually begins to diminish. When they see that their anxiety has less to do with what’s actually happening in the present than the ways in which their early experiences shape expectations about the future, they begin to experience genuine relief. This helps them better understand the causes of anxiety.
Click here to learn more about anxiety treatment with Dr. Jane Rubin.
Jane Rubin, Ph.D., is a clinical psychologist in Berkeley, California. She works with individuals in Berkeley, Oakland, the East Bay and the greater San Francisco Bay Area who are struggling with depression and anxiety. She also specializes in working with people who are trying to find meaning and direction in their lives.