Anxiety For me, anxiety feels like what I lovingly call the "Willy Wonka shit tunnel." There's a frightening scene in the original Willy Wonka film that starts out as a sweet boat ride through a magical land of supersized candy and turns into an escalating scene of fear and loss of control. As the boat enters a dark tunnel, the mood turns. The boat starts going faster and faster while terrible images flash on the walls, including a close-up of a millipede crawling over someone's face, a chicken getting its head cut off, and a lizard eating a bug. None of it makes narrative sense; it's just scary and confusing. All of this is happening while the passengers--children and their parents--are freaking out and Willy Wonka, played by the incredible, wild-eyed Gene Wilde, is maniacally reciting this poem at an increasingly frenetic rate: There's no earthly way of knowing Which direction we are going. There's no knowing where we're rowing Or which way the river's flowing. Is it raining? Is it snowing? Is a hurricane a-blowing? Not a speck of light is showing So the danger must be growing. Are the fires of hell a-glowing? Is the grisly reaper mowing? Yes! The danger must be growing For the rowers keep on rowing. Any they're certainly not showing Any signs that they are slowing! That's what anxiety feels like to me. Escalating loss of control, worst-case-scenario thinking and imagery, and total uncertainty. Let. Me. Off. The. Boat. As the team and I reviewed the research, what I learned abut language and how some of these experiences work together felt like a life jacket for me--something that would keep me afloat if I had to jump off that boat before it headed into the shit tunnel. I hope it does for you too. "You are afraid of surrender because you don't want to lose control, but you never had control; all you had was anxiety." The American Psychological Association defines anxiety as "an emotion characterized by feelings of tension, worried thoughts and physical changes like increased blood pressure." Anxiety can be both a state and a trait. To better understand this, let's get clear on what these terms mean. The best explanation I've come across is from The Oxford Review Encyclopedia of Terms. Here's how they explain it: *A trait is considered to be something that is part of an individual's personality and therefore a long-term characteristic of an individual that shows through their behavior, actions, and feelings. It is seen as being a characteristic, feature, or quality of an individual. For example, someone who says "I am a confident person" or "I am just an anxious person" is stating that these attributes are part of who they are. *A state, on the other hand, is a temporary condition that they are experiencing for a short period of time. After the state has passed, they will return to another condition. For example, someone who says "I am feeling quite confident about this interview" or "I feel nervous about doing this" is describing states. I loved their closing sentence, which may be the understatement of the decade: "However, working out what is really a trait and what is a state can be often difficult and is the content of much scientific argument at times." So, when we say that anxiety can be both a state and a trait, it means that some of us feel anxious mainly in response to certain situations, while some of us can be naturally more predisposed to anxiety than others. Generalized anxiety disorder is different from both trait and state anxiety. According to John Hopkins Medicine, "generalized anxiety disorder is a condition of excessive worry about everyday issues and situations." It lasts longer than six months, and "in addition to feeling worried, you may also feel restlessness, fatigue, trouble concentrating, irritability, increased muscle tension, and trouble sleeping." Approximately one-third of U.S. adults will be affected by an anxiety disorder in their lifetime; however, it is estimated that fewer than half of the people with diagnosable anxiety disorders seek any type of professional treatment. It's very difficult to work through an anxiety disorder without professional help. I'd describe myself as having frequent state anxiety with trait rising, and I know that therapy has been essential for me in terms of recognizing and understanding my reactions and developing techniques for working through my feelings of anxiety. I've also had to give up caffeine, commit to eight to nine hours of a sleep a night, and exercise almost every day. An intolerance for uncertainty is an important contributing factor to all types of anxiety. Those of us who are generally uncomfortable with uncertainty are more likely to experience anxiety in specific situations as well as to have trait anxiety and anxiety disorders. Our anxiety often leads to one of two coping mechanisms: worry or avoidance. Unfortunately, neither of these coping strategies is very effective. Worrying and anxiety go together, but worry is not an emotion; it's the thinking part of anxiety. Worry is described as a chain of negative thoughts about bad things that might happen in the future. What really got me about the worry research is that those of us with a tendency to worry believe it is helpful for coping (it is not), believe it is uncontrollable (which means we don't try to stop worrying), and try to suppress worry thoughts (which actually strengthens and reinforces worry). I'm not suggesting that we worry about worry, but it's helpful to recognize that worrying is not a helpful coping mechanism, that we absolutely can learn how to control it, and that rather than suppressing worry, we need to dig into and address the emotion driving the thinking. Avoidance, the second coping strategy for anxiety, is not showing up and often spending a lot of energy zigzagging around and away from that thing that already feels like it's consuming us. And avoidance isn't benign. It can hurt us, hurt other people, and lead to increased and mounting anxiety. In her book The Dance of Fear, Dr. Harriet Lerner writes, "It is not fear that stops you from doing the brave and true thing in your daily life. Rather, the problem is avoidance. You want to feel comfortable, so you avoid doing or saying the thing that will evoke fear and other difficult emotions. Avoidance will make you feel less vulnerable in the short run, but it will never make you less afraid." The entire premise of this book is that language has the power to define our experiences, and there's no better example of this than anxiety and excitement. Anxiety and excitement feel the same, but how we interpret and label them can determine how we experience them. Even though excitement is described as an energized state of enthusiasm leading up to or during an enjoyable activity, it doesn't always feel great. We can get the same "coming out of our skin" feeling that we experience when we're feeling anxious. Similar sensations are labeled "anxiety" when we perceive them negatively and "excitement" when we perceive them positively. One important strategy when we're in these feelings is to take a deep breath and try to determine whether we're feeling anxiety or excitement. Researchers found that labeling the emotion as excitement seems to hinge on interpreting the bodily sensations as positive. The labels are important because they help us know what to do next. Dread occurs frequently in response to high-probability negative events; its magnitude increases as the dreaded event draws nearer. Because dread makes an anticipated negative event even worse, we often prefer to get unpleasant things over with quickly, even if doing them sooner means that they will be unpleasant (e.g., a more painful procedure now is preferred to a less painful procedure later). I felt so called out when I read this. I can convince myself that an experience is going to be disastrous and work myself into a dread-frenzy. It's terrible, because even if it goes well, I'm so dread-exhausted that I can't enjoy it. For anxiety and dread, the threat is in the future. For fear, the threat is now--in the present. Fear is a negative, short-lasting, high-alert emotion in response to a perceived threat, and, like anxiety, it can be measured as a state or trait. Some people have a higher propensity to experience fear than others. Fear arises when we need to respond quickly to physical or psychological danger that is present and imminent. Because fear is a rapid-fire emotion, the physiological reaction can sometimes occur before we even realize that we are afraid. The typical responses are fight, flight, and freeze. In the research, you can find many lists of what elicits fear in us. The items range from rodents and snakes, to the inability to see our surroundings, to observing our children in peril. However, no matter how much the lists vary, one item is on every list I've seen: the fear of social rejection. We can never forget that we experience social pain and physical pain in the same part of our brains, and the potential exposure to either type drives fear. To close this section, I want to go back to my friend and mentor Dr. Harriet Lerner. She writes, "Throughout evolutionary history, anxiety and fear have helped every species to be wary and to survive. Fear can signal us to act, or, alternatively, to resist the impulse to act. It can help us to make wise, self-protective choices in and out of relationships where we might otherwise sail mindlessly along, ignoring signs of trouble." Like all of the experiences in this book, both our anxiety and our fear need to be understood and respected, perhaps even befriended. We need to pull up a chair and sit with them, understand why they're showing up and ask ourselves what there is to learn. Dismissing fear and anxiety as not useful to our quest for connection is as dangerous as choosing to live in constant fear and anxiety.