Cathartic Response to Anxiety Overload

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How familiar are you with your body’s response to anxiety? Perhaps you already know the symptoms of how your body shows you that you’re feeling anxious. Symptoms like elevated heart rate, sweaty palms, flushed face, clammy skin, muscle tension, tension headaches, shallow breathing, uncontrolled worry, rumination, and more. Mild anxiety can serve as a motivator to ease our discomfort by spurring us into action. But what about when it becomes unbearable? An anxiety attack. An 8 our of 10 on the discomfort scale?  As humans, we can only sustain this level of discomfort for so long. Our bodies want to express or expel the discomfort to get back to our baseline of functioning, most easily accessed through cathartic release. Let’s take a look at some predictable choices the body has for cathartic release to return to baseline.

1.     Crying. Although clients may feel apologetic or uncomfortable with their own tears, it’s not uncommon for them to report feeling better or at least more neutral after a really good cry. This cathartic release is a common option their body chooses when feeling high levels of anxiety, with or without their consent. As therapists, we can support them in identifying safe spaces for crying if they feel uncomfortable with the expression or have a childhood chalked full of messages saying they shouldn’t cry. Therapeutically, crying can be a healthy outlet for anxiety.

2.     Screaming. Have you heard of scream therapy? Children have been encouraged to scream to regulate their little bodies. Adults may embrace this outlet on rollercoasters or a well-insulated car or soft pillow. As another expression of expelling strong emotions, it can be effective under the right conditions.

3.     Orgasm. Underrated yet effective! This is a more challenging cathartic release because of the blocks to libido and sexual arousal that can occur in states of high anxiety, especially in women. Yet the benefits of orgasm have been documented, including relaxation, more youthful appearance, and of course, stress relief!

4.     Comfort in Food. Have you noticed times where you are feeling stressed or anxious and crave comfort food? This is the body’s response to elevated cortisol levels, also known as stress hormones. When cortisol levels spike, we crave fatty or sugary foods. Seeking foods we enjoy can also be an emotional response to stress, such as seeking dopamine, the “feel good” hormone to feel happier or using food to fill the void of needs that remain unmet.

5.     Exercise/Movement. This is a cathartic release that is often found low on our coping list because of the assumption that we need to go to a gym to exercise. However, exercise is all about movement which increases oxygen intake and blood flow, both of which help us feel less anxious. Imagine being able to trick your brain from recognizing an elevated heart rate as an anxiety attack to an elevated heart rate due to movement or exercise? Not only does working our muscles give us some relief, the pleasant sensation of tired muscles or a loose, jelly-like feeling to our limbs after intentional exercise can be an enjoyable sensation after the discomfort of anxiety. Movement also serves to increase our breath, which can be a strategic response to anxiety which tends to make our breathing shallow and strained at our lungs instead of deep, restorative breaths at our belly.

Now that you’ve explored five possible cathartic release options to strong emotions including anxiety, which are you most likely to choose? Is there one outlet you’ve forgotten that deserves some experimentation to see how it works for you? As you can imagine, not all of these cathartic release tools are options depending on being in the community versus being at home. Yet in the therapy space, these outlets are seen as tools that can serve as homework to try, gathering data on what works best for your body in response to elevated anxiety you want to shift.

Adult Attachment: Creating Connections from Childhood

I panic when I don’t hear from them. I just want to be left alone. I want to reassure them that I’m here for them. These statements may capture several examples of responses from clients in your office engaging in work around their relationships. One powerful perspective on the functioning dynamics of intimate partner relationships is to look through the lens of attachment. In other words, by exploring childhood attachment and how it sets the foundation for interaction within relationships, we can experience an increased sense of awareness on how attachment translates to current relationships from needs being met or ignored in our early childhood experience.

Bonding Background

The study of attachment can first be linked to Mary Ainsworth and John Bowlby in the 1970s. Mary Ainsworth devised the Strange Situation, an experiment that placed babies in a lab with their attachment figure/parent and observed reaction in the baby as a stranger entered the room, as well as each baby’s ability to be soothed when the parent left the room and later returned. Based on Ainsworth’s research findings, we were able to identify three types of attachment: secure, anxious, and avoidant. Mary Main, another colleague, later identified a fourth type of attachment called disorganized to capture responses that were inconsistent and unpredictable when exploring a baby and their attachment figure.  

Attachment Attributes

Secure attachment in childhood looks like a distressed infant that is easily comforted when the attachment figure engages them, such as picking them up and soothing them with soft voice, physical touch, and proximity. In adulthood, the secure attachment individual is highly desired for their ability to reassure their partner and present as calm, grounded, and confident in the relationship. Anxious attachment in children can be portrayed as significantly distressed when the parent exits the room, with increased difficulty to receive soothing or reassurance when the parent returns. In adult relationships, the anxious attachment individual’s anxiety prevents them from feeling reassured in the relationship and can drive their behaviors to present as needy, anxious, and sometimes paranoid that the relationship will fail or that they aren’t “good enough” for the relationship to work.  Lastly, the avoidant attachment type in childhood will manifest in a baby as unaffected, cold, disconnected, and unconcerned with the parent leaving the room as well as an inclination to self-soothe, such as engaging in thumb sucking or playing with toys independently. The avoidant attached child has learned to rely only on themselves in not having the parent fully present, which can occur when parents are working long hours away from the child, are inconsistent in their reactions to soothe the child, or can occur in response to a parent’s mental illness such as depression preventing interaction and ability to attach in healthy ways.  In adults, avoidant attachment continues the theme of self-sufficiency and “not needing anyone” in a relationship, preventing them from connecting at a deeper level with others and can be portrayed as reluctance to commit to a serious relationship.

Linking to Literature

With John Bowlby’s Attachment Theory in mind, Amir Levine wrote an insightful book called Attached, that explores intimate partner attachment more deeply and offers examples of adult behaviors that can provide insight or identification of attachment styles. For client use, there are also helpful YouTube videos that can provide a brief overview of adult attachment such as the one found here. Another author, Stan Tatkin, took the idea of attachment a step further by providing symbolic representation of attachment that can also help one identify their attachment style.

Secure Attachment: An Anchor

Anxious Attachment: A Wave

Avoidant Attachment: An Island  

The imagery associated with attachment styles can help a client identify their reactions and resulting behaviors in intimate relationships, as well as assist them in identifying their partner’s attachment style and needs.

Creating Connection

In supporting your clients with exploring their attachment, you may find yourself pursuing additional training, such as Emotionally Focused Couples Therapy (EFT) that encourages vulnerable connection in couples and supports healing of attachment wounds. Or perhaps you link your attachment work to Gary Chapman’s The 5 Love Languages or communication and connection strategies from John Gottman’s training for couples’ work. Whatever means you choose to further dive into attachment needs, educating your clients on the possibility of positive shifts, such as moving to more secure attachment with their partners, can support movement towards healthier relationships. Levine and Tatkin emphasize that relationship attachment can shift and a person can present differently in each romantic relationship over their lifetime. With this in mind, exploring attachment can support your clients in discovering their own attachment styles as well as assist them in connecting and fostering healthy attachment in their intimate partner relationships.