One of Rachel Dubrow’s clients was anxious about a big presentation at work. It wasn’t because she was worried about speaking in front of her boss and colleagues. It wasn’t because she was worried about doing a good job.
She was afraid that she’d be judged for not having straight teeth. (Instead of discussing public speaking anxiety, she and Dubrow explored her self-image and the perceptions of others.)
Another client of Dubrow’s insisted on completing all his work before leaving the office, which meant that he stayed late. Every single day. He wanted his performance reviews to exceed expectations. This stemmed “from his childhood when his parents told him that in order to be happy, he needed to clean his room, put away his toys, do his laundry, and do the dishes just like they did before bed each night,” said Dubrow, LCSW, a psychotherapist who specializes in helping people who feel buried by anxiety, stress, relationship issues and depression.
Psychotherapist Lila Braida, LMFT, was seeing a client who was having anxiety about keeping her dog safe in the yard. Even though she knew her fear was unfounded, she didn’t feel any better.
After digging deeper, she and Braida identified the root of her anxiety: “She was preparing to pursue a second pregnancy after life-threatening health issues had come up during her first,” said Braida, who practices holistic counseling psychology in Napa, Calif. “She had not had any sense of control over that situation, and it became clear that staying hyper-vigilant over her dog’s health was a way for her to maintain at least a small area of safety and control in her household.”
With other clients, Braida also has witnessed how much of their social anxiety stems from their own sense of self. “Our ideas of ourselves as ‘overbearing,’ or ‘not good enough,’ can lead to an experience of social disconnect, where we aren’t comfortable being ourselves in relation to someone, unless we are compensating for our perceived shortcomings.”
Maybe we compensate by going out of our way to seem non-confrontational (because we fear that others will think we’re too much). Maybe we compensate by people pleasing or caring for others (because we think people won’t accept us if we don’t; a lesson we learned in our childhoods).
“That constant effort to be different from who we naturally are leads to stress and anxiety in social settings,” Braida said. “[A]nd it’s easy to see how someone could begin avoiding those settings over time when they associate them with feelings of stress.”
Braida also has seen clients experience tremendous anxiety over keeping their homes spotless or proving themselves at work—because they were in the midst of redefining their identity. Because they’ve become new parents or recently divorced or experienced some other major change in their lives, shaking up their status quo.
Our anxiety often has a root cause. Maybe you get anxious at work because you don’t trust yourself to succeed. Maybe you get anxious over final exams because you don’t think you’re capable. You don’t believe in yourself. Maybe you grew up in a home where independence was lauded and expected, so asking for help—at home or at work—terrifies you. So you try to do it all—even when you’re crumbling.
“Finding the root cause of anxiety is tricky because it can creep up on us,” Dubrow said. “We might start feeling exhausted, overwhelmed, unable to focus, or not able to fall asleep at night because we are thinking about so many things.” This leads us to focus on the physical symptoms and sensations of anxiety and to overlook the psychological ones. It can lead us to focus on techniques to reduce our anxiety—deep breathing, meditation, yoga—without really understanding what’s going on, without addressing the real issue.
To dig deeper, Dubrow suggested asking ourselves these questions: “How long has it been since I felt differently than I do now? What has changed in my life over the last three months, six months, or year? Are there other times in my life, past or present, where I felt the same way but the situation was different? If yes, what are they and is there a common thread?”
When she starts feeling anxious, Braida also pauses and turns inward. “…I compassionately check in with my emotional state.” She gently asks herself: Why am I so freaked out? What is this really about? And she listens for the answer—without judging herself.
Anxiety is complicated. There may be layers upon layers to unpack. There may be surprising causes—such as Dubrow’s client and her insecurity about her teeth; like Braida’s client and her hunger for control where it didn’t exist.
Seeing a therapist is always a good idea—and so is journaling about your anxiety. So is compassionately exploring what lies beneath the shakiness, sweaty palms, tight shoulders and butterfly-filled stomach. Because getting to the root can help us to genuinely diminish the anxiety—and better understand ourselves.