Understanding anxiety. Part III: The role of psychotherapy, art, and dance.

If you are a little bit confused after reading the two previous articles on Understanding Anxiety, you are in the right frame of mind. If you are “a lot confused” after reading the last two articles, that is also quite a typical reaction. Anxiety is not simple because human minds are not simple.

Psychotherapy and anxiety.

Working with a psychologist on a psychotherapy process can be one way of figuring out answers to these complex questions. One of the ways that psychotherapy works is by enhancing the person’s self-awareness. We all have blind spots when it comes to our own thoughts, feelings, and motivations. Engaging in a psychotherapy process with a qualified clinician can be a bit like a mirror. If you stand very close to the mirror, you only see a small part of yourself through it. Through the process of therapy, it is like taking a bit of a step back from the mirror – you are still able to see what you saw before, but you see much more of yourself in the reflection. This may mean that you learn new things about yourself – things that you like and don’t like. This can mean confronting uncomfortable or inconvenient truths or feelings. While this can be difficult, it can also be very valuable. After all, if your car is acting up, but you refuse to open the hood and look at what’s underneath, you probably won’t be able to address the problem. Similarly, it is very hard to figure out how to cope with an emotional pain if we refuse to look inside our own mind.

So how can psychotherapy help with anxiety? One way the therapeutic process can help is figuring out what the anxiety feelings mean – is this potentially an anxious response to a stressful situation? Is it existential angst that’s arisen because there is a mismatch between what you need and what you do? Or is it unhelpful, disordered anxiety that is magnifying danger and underestimating you as a person? Perhaps there is a mix. It is useful to figure out what is going on because different types of anxiety need different responses from the person. Often people notice mental discomfort or anxiety, but are not aware of what the anxiety is about. Through the process of psychotherapy, this can become clear.

If the anxiety is about an impending problem that can be solved, then getting support from others, reminding yourself of your strengths, accessing resources, and actively solving the problem would often be enough for the anxiety to be calmed. For example, if a person thinks that they are not prepared for a work presentation they have to give and feel anxious, taking the time to research and prepare the presentation, run it by a friend or co-worker, and practicing answering common questions could be enough for the anxiety to be resolved. If the problem is avoided, however, the anxiety feeling will grow. For example, if there is a problem at work and you have been meaning to talk to your manager about it, but felt nervous and have not done so, putting the conversation off will lead to anxiety about it increasing.

Sometimes by talking through and unravelling thoughts and feelings in psychotherapy, we might learn that the uncomfortable anxious or dread feeling is coming from the “Department of Existential Anxiety.” What then? Existential psychotherapists like Irwin Yalom would say that sharing our common human fears with one another – fear of dying, fear of insignificance – can help us find common ground, feel stronger together, and tolerate existential anxiousness when it comes up. If we are stuck alone with our basic human fears, they are heavier and more burdensome. Sharing them with a person who is supportive and understanding can create a sense of belonging and common ground. That person might be a psychologist, but they could also be a friend, family member, or intimate partner. Let’s go back to our hypothetical example of “Jack,” a lawyer who has begun to doubt if his career path is something that he truly wants and enjoys.  If there is a close friend that Jack trusts and can talk to, the two of them can have a conversation about Jack’s doubts, worries, and feelings of malaise and anxiousness. Perhaps his friend encourages him to explore other options, to take a brave step into the scary unknown – figuring out what career Jack would truly find meaningful, regardless of what other people want him to be or do. The friend’s support could help Jack take this risk and explore things that he is truly drawn to, not just jobs that he thinks he can do or should do. These conversations, whether they occur in psychotherapy or in another trusting relationship, can help people find meaning despite life being uncertain and stressful.

Now what if the person tries to understand their anxiety and figures out, through psychotherapy or otherwise, that they are dealing with anxious feelings that are disordered? Let’s take another hypothetical example. We’ll call the person in this example “Natalie.” Imagine that Natalie is a student. She has some functional, situational anxiety and worries – about managing her tight finances, exams, finding a job that can support her studies without overwhelming her. But she also notices very strong anxiety whenever she meets new people. So much so that even though she wants to make new friends, she refuses to go to any parties and events when invited. She does not venture out of the comfort zone of several acquaintances that she has, but also feels lonely without any close friends. She becomes overwhelmed with anxiety when introduced to new people. Let’s imagine that Natalie works with a psychotherapist and discovers that when she meets new people, she expects that they will find her boring and reject her. If she takes a deeper look at this expectation, she might find something else  –  the belief that she is not likeable, not worthwhile as a person. Sometimes beliefs like that are heavy burdens that we carry around without noticing them – perhaps they have simply been there for a very long time, so they feel familiar, or perhaps they are buried underneath the distractions of daily life. In psychotherapy, one way to work with Natalie and to help her with the social anxiety would be by working on helping Natalie see herself in a new way. This might mean challenging the self-critical beliefs she holds or exploring the origin of these beliefs. It might mean helping Natalie to notice and appreciate her positive qualities and encouraging her to take small steps towards connecting with others.

Self-awareness, of course, is something that can be cultivated outside of the psychotherapy environment as well. Some people find the practice of mindfulness and meditation, for example, as a way to “pop the hood” of their mind and take a careful look inside.

The role of creativity: art & dance.

What else can help with anxiety besides psychotherapy and self-awareness? We are going to delve into a completely different world for a moment here: the world of creativity and expression, the world of art. Visual art is a part of this article. How does it affect you? How does it change how you relate to the ideas you are reading? To anxiety? To your self-understanding? If we take visual art as an example – cartoons, painting, photography, etc. – one thing that this type of art does is create a representation of complex human experience that is instantly relatable. Many people see Armin’s depiction of “Functional Anxiety” in the Part I of this blog series and instantly say, “that’s me!!!”

One of the most difficult parts of understanding emotions is that language is limited in how well it can understand emotion. Emotions can manifest physically (e.g., ‘hollow stomach’ feeling, sweaty palms when you are anxious), but we can never hold an emotion in the palm of the hand. Visual art allows us to make this abstract word ‘anxiety’ something real, to look at it, be curious about it. Words like ‘anxiety’ and ‘sadness’ can be difficult to grasp – we can see different sides of sadness, but “what” it is remains elusive. Compare it to saying something like “apple” or “car” where you immediately have an image pop up of a concrete, real thing that you can touch or hold in your hand. Visual art, poetry, sculpture, music, and other art forms can help us see the sides of anxiety that are hidden. They can also help to find common ground with other people by expressing and showing that we all experience anxiety, that it is part of our humanity.

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Dance is an art form that uses the body to create art. For me, contemporary dance is especially interesting because it explores complex human issues and dares to look at real feelings. Contemporary dance varies greatly in terms of its purpose and form, but the common ground that ties it together is exploring the reality of our very human, very emotional experiences.

The photographs you see here, for example, are from new work , “Thyself,” choreographed by Dyana Sonik-Henderson for Broken Rhythms dance company. Thyself explores themes of anxiety, identity, relationships, and self-sabotage. Dyana writes, “ThySelf explores who we are in public, in private. Dancers explore the fractured self that comes together to create coherent identities that transform and dissolve moment to moment. Rather than thinking that thoughts and identity are stagnant ThySelf views them as ever evolving layers that crack and separate to create individual moments that make up our day to day reality.” As you read on – what do you see in the images? What looks confusing or scary? What strikes a note or feels relatable?

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Dance can help us remember that anxiety is not just about the thoughts or feelings – anxiety is also about the body. Anxiety affects how the body feels (e.g., tense muscles, shortness of breath) and what you do with your body – literally, the actions you take. When we become stuck in anxiety, we can also forget that we have bodies that can take us out of the mental ‘stuckness,’ where we were literally sitting, frozen and inactive.

 

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Whether you are taking a dance class or dancing to your favorite song in your bedroom, being in the dance experience can remind you of the very basic joy of moving your body to a rhythm. Dancing and being mindful of the experience – especially when it’s shared with others in a supportive environment – reminds us that there is such a thing as existential joy, the feeling of happiness and excitement of being alive.

 

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Allowing yourself to dance freely with no judgments or expectations (that last part is easier said than done) can be an outlet for anxiety and stress, a way to express feelings without words, a way to literally move through the feelings, acknowledge them, and allow them to come and go, but not get stuck in them. Anyone who can move their body can dance, even if that means tapping your foot to the beat of that great song on your radio. The challenging part is giving yourself permission to do it without judging how your body looks or feels.

On the other hand, if you are watching a dance performance that deals with topics of anxiety, relationships, and human conflicts, perhaps you see yourself in it. Perhaps you experience a sense of connection and common ground with others – and voila, even without talking about it your worries, you already feel less lonely as you realize you are not alone in worrying. Dance can show us, in a literal way, how we feel – even if we are not aware of our own feelings. This echoes my earlier sentiments about self-awareness and how important it is to mental health.

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Dancers and artists are human, too, of course. They are not exempt from anxiety. When they struggle with worry and angst, they need support, just like any other person. That does not, however, diminish the capacity for art and dance to be creative outlets of expression and connection that help us to cope.

As human beings, we have enormous potential for resilience, self-knowledge, and creativity. Self-awareness and resilience go hand in hand. There is not going to be one method, whether it’s dance or psychotherapy, that is a ‘silver bullet’ for anxiety. Some anxieties should not be eliminated because they can be helpful, such as the functional anxiety we discussed. Some anxieties may need to be tempered if they become too intense and interfere too much with quality of life. Try different things. Talk with a psychologist. Try a dance class. Give painting a shot. Notice what works for different feelings and situations. Cultivate awareness of when anxiety is related to a simple problem that needs to be solved and when anxiety may be related to something more complex that needs to be explored in a therapeutic setting. Anxiety is uncomfortable, but it is not an enemy. It is a signal that something needs your attention, something hurts and needs to be soothed, healed, or resolved.

-Alina Sotskova

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