While not everyone has an anxiety disorder, we all experience anxiety. Anxiety is both life-saving and debilitating. Anxiety helps us finish those projects with deadlines and helps to keep us alert when we are driving. Anxiety helps children behave in school and helps us achieve our goals. Anxiety is hard wired in humans. The National Institute of Mental Health reports that around 40 million people over the age of 18 will be affected by an anxiety disorder in a given year. That is about 18% of the population in America. Anxiety is one of the most common psychiatric disorders in children.

Many of my patients ask me, where does anxiety come from? Anxiety has its roots in the oldest part of the brain, the archipallium or primitive (reptilian) brain. It is the fight or flight response that helped our ancestors survive predators and other dangers in the environment. It is possible that some individuals are more sensitive to the environment; in other words, they were more tuned in to its sights, sounds, smells, temperature, etc. than others. These individuals were probably the first to sense danger and to warn others of the need to flee. It was an adaptive trait that became a part of our day to day life. We need anxiety to help us get things accomplished; however, with too much anxiety, we stop performing.

Yerkes-Dodson Human Peformance Curve


Cognitive behavioral therapy teaches us that our thoughts are in relationship to our feelings. If we can change the way we think about things, we can change our reactions or feelings. When people come to me with anxiety, they are usually on the burnout side of the curve (6-10). Using Relaxation training and cognitive behavioral therapy, I help them learn to keep anxiety within the peak performance range (5-6).

Relaxation training is one of my favorite skills to teach individuals. Systematic muscle relaxation, deep breathing, and guided imagery are relaxation methods that help individuals achieve optimal performance. Systematic muscle relaxation involves tensing and releasing muscles in the body, from the toes to the face. Deep breathing is deep, meaning from the diaphram, and regular, evenly in and out. Guided imagery is similar to a story that guides us to a calm place in the body. Optimal performance is the result of mastering these skills.

Additional treatments are available for treating anxiety. New evidence based practices for anxiety include mindfulness, EMDR (eye movement desensitization and reprocessing) and ERP (exposure response prevention). EMDR and ERP are individualized treatments. Mindfulness can be taught either in a group or individually. Both will be discussed in a future informational release. An introduction to mindfulness training is offered in our Optimal Performance, Relaxation and Stress Reduction Group.