Anxiety

Anxiety almost never arrives as a thought. It arrives first in the body: a clenched jaw, shallow breath, a closed stomach, sleep that breaks at four in the morning. The thought comes afterwards and looks for an explanation — work, the children, an appointment to make — and always finds a plausible one.

People who live with it long enough stop calling it anxiety. They call it their character. They say they are someone who worries, who checks, who plans ahead. And that is true: the alertness works, it protected them from something, often for years. The trouble starts when it will no longer switch off, even when there is nothing to be alert for.

What usually brings people here

• A worry that changes its object but never its intensity.
• A need to control, in advance, things that cannot be controlled.
• Quiet withdrawals: trips not taken, chances not followed up, invitations declined with an excuse.
• A tiredness that rest does not touch.

What we can do with it

The work does not try to silence anxiety, because silenced anxiety comes back louder. It tries to understand what the anxiety is talking about: which threat it is signalling, and why that signal stayed on after the situation that switched it on had ended. It is slow work and not at all spectacular, and for many people it is what finally changes things.