Helpful Anxiety, Harmful Anxiety, and the Bell Curve of Anxiety

Quite understandably, we avoid feelings of anxiety.  We can even get anxious about getting anxious.  But right levels of anxiety are essential in facing challenging tasks. There is a bell curve to anxiety.  Optimum levels of anxiety, at the top of the bell curve, motivate, focus and energize us.  They leave us primed, revved, and ready to act on demanding tasks. 

 On the other hand, high levels of anxiety, on the right-hand tail of the curve, are overwhelming and debilitating to our focus.  Heart racing and pulse pounding, along with possible difficulty breathing and an intensely shaky feeling that threatens embarrassing and/or dangerous loss of control, we are panicking and may feel like we’re going to die.  Because the symptoms of high anxiety are alarming and mimic serious medical problems, people suffering from high anxiety often go to the ER; and, in fact, with severe anxiety, you need to have the symptoms checked out by a medical doctor. It’s not until you’ve ruled out underlying medical problems that you can be sure it’s an anxiety problem. 

But, on the left-hand tail of the curve, too little anxiety is also a problem.  With too little anxiety, we’re lackadaisical. We lack a sense of urgency.  The under-anxious person is often accused of being lazy or irresponsible.  Nothing matters.  Appearing unmotivated, he can’t mobilize the energy to stay on-task and get projects done.

 People who suffer from high anxiety suffer markedly.  But so do under-anxious people.  In fact, under-anxious people are often people who secretly suffer high anxiety.  It may look like this.

 Some people go from low anxiety to panic very quickly.  They never experience the helpful levels of anxiety.  Rather, any hint of anxiety escalates into unbearable and incapacitating anxiety.   Their experience of anxiety is all-or-nothing.  If they feel anxious, it's automatically a huge, overpowering anxiety. 

 So anxiety becomes the enemy.  At the first signs of anxiety, under-anxious people flip into a false self-soothing to get rid of the anxiety.  Of course, self-soothing can be very useful in managing anxiety.  But under-anxious people make unrealistic self-statements that deny the real difficulty of tasks they face in order to soothe away all anxiety… Daunted by the massive memorizing required by a test, a grad student tells himself, “Life’s too short to be always studying!  I’ll go play ball with the guys and deal with Econ later.” Or, not liking the anxiety she feels facing a demanding project which she’ll have to present before a large group, an engineer tells herself, “I’ve got this.  I’ll finish it next week.”  Or suffering immense anxiety about performance evaluation, a young man avoids practicing for his driver’s test, with the discomfort it triggers, saying, “How hard can it be?!  Millions of people pass it!”

Thus dreading the panic that quickly and inevitably follows that first sign of anxiety, under-anxious people trade in the benefits of “good” anxiety for a desperately sought, artificial calm.  They become absorbed in dealing with their anxiety rather than dealing with the task that’s triggering the anxiety.  They procrastinate.  Then, finally facing the task when it’s too late, they feel a realistic panic which unfortunately reinforces the whole idea that challenging tasks cause panic and are to be avoided.

 What to do to break this cycle?! Once underlying medical causes to the anxiety have been ruled out, a two-prong approach to therapy can be pivotal in mastering the anxiety.  First, it's crucial to learn increased awareness of your body, its sensations, and what the first rumbles of anxiety feel like as well as how to sustain those smaller doses of anxiety without having them automatically surge into overwhelming anxiety.  This type of body awareness is the special domain of somatic experiencing therapists who know how to teach you to listen to your body, recognize and be at home with different levels of anxiety, and learn techniques for soothing your anxiety so that you can nurture and sustain optimum levels of anxiety.

The second prong involves enhancing self-esteem through a depth psychotherapy that invites exploring past experiences that have left you feeling “one-down” or not good enough. Such feelings of low self-esteem can leave us easily overwhelmed, anxious, and depressed.  Convinced we’re not good enough, we’re easily daunted and don’t feel “up to” new tasks. Because these feelings of inadequacy are deeply rooted (in the limbic center of our brain, our so-called “emotional brain”), we can’t just talk ourselves out of them.  We may not even think about these memories.  Nevertheless, these memories can haunt us compellingly through feelings of anxiety, depression, and low self-esteem.  Depth psychotherapy gently invites us to remember these buried memories so that they can be finally faced and put to rest. Addressing painful memories and past trauma can allow a more robust sense of self to emerge so that we are no longer so anxious and intimidated before life and its tasks.

  • © July, 2015 Maribeth Ekey

(This article is based on  recent decades of research and thinking  on anxiety as well as on the neuroscience of memory, especially Daniel Siegel's helpful, hopeful writings and research. Further, in his nonfiction book, David and Goliath, Malcolm Gladwell provides intriguing applications of the bell curve or inverted U-curve to human behavior.)




Productive Therapy artfully blends two essential ingredients: empathy and confrontation.

A client once complained about me to a friend, “My therapist is hard on me; she confronts me…” to which the friend wisely replied, “She sounds like a good therapist!”  He knew that his friend needed confronting in order to grow.

              Confrontation, easily supplanted by a steady diet of empathy, is often overlooked in therapy.  Client and therapist alike may enjoy deep understanding and gratifying “aha’s” but readily avoid the more anxiety-eliciting confrontation. 

              Empathy is wonderful, healing…  absolutely necessary to growth in therapy.  For clients to dive into searing memories of shameful betrayal, overwhelming loss or terrifying assault that they’ve carefully (and sensibly) avoided all their lives, they must trust that a therapist understands them and is for them.  They must trust that they will get kindness and support, not harsh judgment.  It is legitimately difficult to trust another person with the most vulnerable moments of our lives.  Empathy and understanding are bedrock to building the trust that invites openness about our suffering.

              But confrontation is also vital to growth.  As a thoughtful mentor once put it, if all we do with our clients is empathize, then we are simply stuck in a rut with them.  We just keep saying, in essence, “poor baby,” but never help them out of the rut.   Getting out of the rut requires the added jolt of confrontation.  In confronting, we dare to introduce a perspective that counters the client’s perspective—insight they hadn’t considered, maybe didn’t want to consider, that may be a little jarring or hard to swallow.

              Such confrontation causes discomfort and anxiety.  That’s why it’s counter intuitive in therapy:  we think of therapists as soothing anxiety, not inviting it!  But right levels of anxiety can actually be quite helpful (see upcoming  blog).  They can jostle complacency and lend impetus and energy to the work of therapy. 

              Consider…  A man comes in to a session upset about mistreatment by his boss.  Wincing, I empathize with the real hurt caused by the boss’s mean-spirited words.  I linger in the hurt with the client, unpacking other memories of similar hurt, sincerely with him in protesting the pain and unfairness he’s experienced.  There’s been a lot.

 Pivot point… Do we stay stuck in the rut?  Or is there some bigger perspective I can offer that, while risking offending him, can invite him out of the rut.  Gingerly, I say, “You know, you played a role in your boss’s harshness.”   Yes, he’s offended…   but we have history together; he trusts me enough to be curious to hear more.  And we begin looking at a pattern in this man’s choices—an unconscious pattern of extreme passivity that triggers irritation and sometimes downright harshness in friends and colleagues, subtly protecting him from a closeness that terrifies him. 

But confrontation--this uncomfortable insight—is embedded in empathy.  This man is not passive because he is a jerk or lazy or manipulative.  He’s passive because precious energy and initiative were beat out of him as a child.  A desperate choice, huge withdrawal from life was the only protection he knew.  But there’s a problem in this choice:  the passivity which protected him so well as a child is costing him dearly and unnecessarily as an adult. 

And so goes the blend of empathy and confrontation that invites healing.  Deep empathy—a non-judging and comforting understanding that tells us we are not alone in our suffering--permeates good therapy; but discerning confrontation must be boldly and gently added to the mix.  Confrontation invites a shift in perspective that leads to real change—not just “feeling better”—but substantive growth which sustains well-being.  

 Lots of empathy… a well-placed confrontation… lots of empathy...    is the essential blend that works not only for therapy but also for friendship, marriage, and raising kids. 

©  6/30/15 

*Any resemblance to actual people is coincidence and our shared humanity.