The Unsolvable Problem of Anxiety
I feel anxiety is seen in the mental health field from a deficit model that blames the sufferer. It’s easy to think that our client suffering from anxiety needs to cope better, make cognitive shifts and practice new emotional responses, thus finding relief. When the client has trouble making these changes or the anxiety persists in spite of their best efforts, they can feel as if they are failing. A cycle can develop in which the client feels anxious about being anxious and/or feels guilty for not conquering their symptoms. Instead of helping our clients with anxiety, we have implicitly blamed them for the anxiety and their suffering.
It’s time to toss the deficit model when it comes to anxiety. One of the best things I like about being a marriage and family therapist is that right away, deficit thinking is discarded. We operate from a systemic view which says that anxiety naturally occurs in the context around the client because of the very human struggles and stressors we are subjected to. Thus the individual isn’t responsible for the anxiety. They ARE, however, responsible for responding, not reacting, to their struggles and stressors. Therapy becomes the process of exploring how the client can make ethical relational decisions. This is more difficult than it sounds. No wonder it’s more appealing to focus on superficial change than tackle the relationships that pelt us with anxiety.
Well, then, if it’s harder, what's the advantage of looking at anxiety systemically? Doing so opens up a concept known as split loyalty. But what does loyalty have to do with anxiety? A whole lot, according to a model of couples and family therapy called Contextual Therapy. Contextual Therapy sees anxiety as a signal that we are experiencing competing and sometimes contradictory demands for our time, attention, energy, and emotions. For example, if I am balancing caregiving for my elderly father while also raising a teenager, there will be times I have to make difficult decisions about which loved one takes priority. Balancing these loyalties creates anxiety because my human limits mean I cannot meet both responsibilities 100% the way that I want to. This does not feel good, and this feeling often gets called anxiety. I have done nothing to “make” this anxiety happen. It happens because I am simultaneously a daughter and a mother and trying to meet the responsibilities I have for each role.
From the perspective of split loyalties, it makes sense that we're anxious. No amount of coping skills will remove our competing loyalties and responsibilities. Breathing exercises and cognitive shifts have their helpful uses for anxiety management, but the reality is there’s a piece of anxiety about our loyalty conflicts that cannot be solved.
Wait–how is this split loyalty stuff helping us? By leading us to respond, not react, to anxiety.
First, acknowledge that this loyalty conflict exists and that you didn’t create it by yourself or perhaps, at all.
Next, take a look and weigh the needs you see, and don’t forget to consider your own needs! Use those breathing exercises and cognitive strategies to help you sort this out.
Then, acknowledge there's no easy way out. Again, use the helpful behavioral and cognitive tools you have learned, or find on the internet.
Think in I-statements. “I feel anxious when I’m caught between my dad and my kid” is more helpful than, “My kid and my dad are driving me nuts!”
Finally, be open and transparent as much as possible about these competing loyalties. Perhaps you say to your teenager, “Hey, I forgot I can’t give you a ride to work tomorrow because I have to take your grandfather to the doctor. Who do you know that might be able to give you a ride?” Or, perhaps you say to your dad, “Dad, I need to take Junior to work and it will make me late for giving you a ride. Can I send you a cab and meet you at the doctor’s office?”
If you are thinking, “My kid or my dad would freak out if I did that!” you might be right. The fact that you are taking (or not taking) a specific action to address your anxiety may itself create some anxiety for someone else in your relational world. That’s people being human, caught in their own anxieties and split loyalties. Once again, it comes down to the idea that you didn’t cause this anxiety (yours or theirs), but you have to respond to it, not react to it. The fact that you don’t always get this correct means that you are only human, and that too, is an unsolvable problem.
