There is nothing more painful and frustrating than when you are in a state of constant anxiety. These intense feelings exaggerate your present-day troubles and make it hard for you to function at your best.

If you are one of those people, whose anxiety becomes so frequent and forceful that it begins to take over your life—you may benefit from psychodynamic therapy that incorporates a neurobiological focus.

38 Year Old Man Seeking Treatment for Anxiety

Take, for example, Adam, a 38-year-old advertising executive who in spite of glowing work reviews said in our first consultation:

“Yesterday, my boss said she couldn’t be happier with my performance  –but I only see my flaws. I constantly second guess my decisions. I’m barely sleeping at night; I can’t stop my mind from racing. I know my feelings are irrational, but they feel so real.”

Family of Origin

In examining Adam’s family-of-origin issues, we traced some of his debilitating anxiety to his formative years. His mother, although very affectionate, berated him when he failed to live up to her high standards. His father, a shy and withdrawn man, failed to protect his son in the face of his wife’s attacks.

Over time, Adam, in an attempt to please his mother, became stuck in a perfectionistic cycle where each new task became another opportunity for self-criticism, disappointment, and perceived failure. He had internalized his mother’s overly critical and demanding views and had trouble finding a separate and more reasonable voice of his own to judge his performance.

One of the major goals of Adam’s treatment was to develop a new relationship with his anxiety.

Learning about the psychological and biological underpinnings of anxiety can help you to identify how your mind and nervous system get triggered and what you can do to help yourself when you feel overwhelmed.

In Adam’s case, we identified patterns of emotional experiences, established in childhood, that recreated unhealthy dynamics in his present-day relationships. This helped him gain more control of his reactions by naming the problem and giving himself more time to think through and develop other points of view. This enabled him to develop a soothing internal self to care for the childhood part of him that felt unable to cope with anxious feeling states.

To soften his harsh inner critic, we developed an “intuitive, wise self” for Adam to consult with. This more compassionate part of him would try to calm the anxious part with nurturing and wise interpretations.

Biological Underpinnings

People with overwhelming anxiety may suffer from an overly sensitive amygdala.

According to the National Institute of Mental Health (NIMH):

“Several parts of the brain are key actors in the production of fear and anxiety . . . the amygdala and the hippocampus play significant roles in most anxiety disorders . . . It can alert the rest of the brain that a threat is present and trigger a fear or anxiety response. ”

Under normal conditions, the amygdala acts as a warning system to protect you from potential dangers or threats.

Some researchers suggest that people who suffer from anxiety disorders have difficulty reducing their amygdala arousal. When there is little or no danger, their nervous system overreacts—triggering a cascade of stress hormones that produce increased heart and breathing rates, shaking and trembling, sweating, which is often accompanied by negative preoccupations and distressing thoughts.

Self-Soothing Techniques

In order for Adam to gain some immediate relief for his anxiety, I introduced two self-soothing techniques or grounding practices he could use between sessions to help him to lower his amygdala arousal.

I taught him a simple deep breathing technique that promotes relaxation by slowing the heart rate and calming the nervous system: a timed breath where the exhale is longer than the inhale (inhale to 4, hold briefly, and exhale to the count of 7).

Another exercise to achieve neuropsychological balance when anxious is to place your hand on your heart and take slow deep and gentle breaths while bringing up a memory of a time when you felt safe, loved, and cherished. This process releases the safety and trust hormone called oxytocin. The resulting calming sensation allows you to take some time to figure out what to do when you’re feeling overwhelmed.

Treatment Outcome

Through our work together, Adam learned about the underlying biological and emotional causes of his anxiety. He learned to develop new strategies to manage both his highly sensitive nervous system and his overactive mind. He eventually saw the constant negative chatter that had plagued him since childhood as a relic of his childhood relationship with his mother that he didn’t have to engage with.


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