In Praise of Anxiety - WSJ

28/07/2022, 12:48 In Praise of Anxiety - WSJ
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https://www.wsj.com/articles/in-praise-of-anxiety-11651849496
THE SATURDAY ESSAY
In Praise of Anxiety
Rather than suppress this misunderstood emotion, we need to understand its
essential evolutionary role in motivating us to action
By Tracy Dennis-Tiwary
May 6, 2022 11:04 am ET
Nobody likes to feel anxious. Anxiety is among the most pervasive and reviled of human
emotions. An entire industry has sprung up to aid us in eradicating it, from self-help books
and holistic remedies to pharmaceuticals and cutting-edge cognitive behavioral therapy.
Yet we are an ever more profoundly anxious society. Epidemiological studies show that
over 100 million people in the U.S. will suffer from an anxiety disorder in their lifetime.
Rates, especially among the young, have been rising for the past decade. Our efforts to
contain anxiety aren’t working.
As a clinical psychologist and neuroscience researcher, I have devoted the past 20 years to
understanding difficult emotions like anxiety, and I believe that we mental health
professionals have made a terrible mistake. We’ve convinced people that anxiety is a
dangerous affliction and that the solution is to eliminate it, as we do with other diseases.
But feeling anxious isn’t the problem. The problem is that we don’t understand how to
respond constructively to anxiety. That’s why it’s increasingly hard to know how to feel
good.
This “bad” feeling isn’t a malfunction or failure of mental health. It’s a triumph of human
evolution, a response that emerged along with one of our greatest attributes: the ability to
think about the uncertain future and prepare for it. Anxiety places us in the “future tense”
(pun intended)—a state in which we are motivated not only to survive but to thrive, by
being more persistent, hopeful and innovative.
It was the father of evolutionary theory, Charles Darwin, and his intellectual heirs, such as
psychologists Nico Frijda and Joseph Campos, who saw that unpleasant emotions like
anxiety confer a profound evolutionary advantage. Emotions provide key information
about our well-being and prepare us to act. Fear, for example, signals that you may be in
danger—from a predator, bully or speeding car—and readies your body and mind to fight or
take flight.
https://www.wsj.com/articles/in-praise-of-anxiety-11651849496 1/8
Treating anxiety like a disease prevents us from distinguishing

between ordinary anxiety and anxiety disorders, which occur
when our ways of coping with anxiety serve to amplify it.
Anxiety, by contrast, has nothing to do with present threats. Instead, it turns you into a
mental time traveler, drawing your attention to what lies ahead. Will you succeed or fail in
that interview for a job you desperately want? Anxiety prompts your mind and body into
action. Your worries impel you to prepare meticulously for the interview, while your heart
races and pumps blood to your brain so that you stay sharp and focused, primed to pursue
your goals.
In a pair of studies published in the journal Emotion by Jeffrey Birk, myself and colleagues
in 2011, we induced anxiety in young adults by asking them to vividly imagine being a
passenger in a car accident and helping injured people in its aftermath. Compared with a
second group who experienced a happy mood induction, the anxious group showed a
greater ability to focus and control their attention during a computerized assessment.
Over the past decade, research has also shown something that many scientists didn’t
expect: higher levels of dopamine, the “feel good” hormone, when we’re anxious. We have
long known that dopamine spikes when an experience is pleasurable and also in
anticipation of such rewards, activating brain areas that motivate and prepare us. The fact
that anxiety also boosts dopamine levels points to its role in making positive possibilities
into reality.
I reaped these benefits during one of the most difficult experiences of my life—when my
infant son was diagnosed with a heart condition requiring open-heart surgery. It was
anxiety that kept me going, even when I was running on empty. I worried and planned, read
everything I could find on his condition, imagined all the possible outcomes, found the best
doctors and persevered through every obstacle and sleepless night. Today, at 13 years old,
he runs on the school track team and lives like he never had a heart condition.
Anxiety isn’t just useful in emergency situations. It also spurs us to be more creative in
general. In a series of studies published in 2008 in the Journal of Personality and Social
Psychology, Carsten De Dreu and colleagues experimentally increased anxiety and other
emotions (such as sadness, happiness and anger) through autobiographical writing about a
past event. People induced to feel more anxious showed greater creative fluency during a
problem-solving task, including the quantity and originality of their ideas and their ability
to persist when obstacles arose. It takes effort and imagination to see future possibilities,
and anxiety keeps us focused on them.
Many of us feel overwhelmed by chronic anxiety and don’t see any benefit from it. We have
come to believe that the best way to cope is to treat anxiety like Covid-19 or cancer by
trying to eradicate it. But treating anxiety like a disease is a recipe for its spiraling out of
control; it prevents us from distinguishing between ordinary anxiety and anxiety
disorders, which occur when our ways of coping with anxiety serve to amplify it in ways
that are out of proportion to the situation and keep us from functioning in our professional
and personal lives. When we say anxiety is a public health crisis, what we really mean is
that the way we cope with anxiety is a public health crisis.
We need to develop a new mind-set about this misunderstood emotion. Reframing and
reclaiming anxiety as an advantage and a valued part of being human isn’t easy or just a
matter of willpower. It takes practice and time, and it doesn’t mean that anxiety becomes
enjoyable. Anxiety can’t do its job unless it makes us uncomfortable, forcing us to sit up and
pay attention. We don’t need to like anxiety—just to use it in the right way.
The first priority is to listen to yourself. Imagine you’ve been sitting with free-floating
anxiety for a couple of days. You’ve been trying to ignore it—just keep calm and carry on—
but it’s getting to you. So you decide to tune in to what your anxiety is telling you and go
through a mental checklist. What’s been bothering me? Is it that fight I had with my
husband? No, that got resolved. Is it that work deadline looming over me? No, that’s well
enough in hand. Is it my acid reflux, which has gotten worse, giving me stomach pains for
the past few days? Yes, that’s it.
Once you identify the source of your anxiety, you have useful information. And you now
know what action to take. When you schedule that appointment with the doctor, your
anxiety begins to lessen. You know you’re on the right track. When you see your doctor and
get a plan to deal with the problem, the anxiety wanes. If you were to find out that there
was something seriously wrong, anxiety would return, motivating you to take whatever
additional steps were necessary to deal with the illness.
As this suggests, it’s no solution simply to evade the causes of anxiety. Consider new
research on how parents help their children to deal with such problems. A parent’s natural
response is to try to accommodate a child’s intense anxiety. The family of a child worried
about flying in airplanes, for example, might limit vacations to drivable destinations. But
even though this may comfort the child in the moment, it prevents them from learning to
cope in the long run.
When we believe anxiety is a benefit rather than a burden, our

bodies follow suit and better prepare us to meet the challenges
ahead.
A new type of therapy called SPACE (Supportive Parenting for Anxious Childhood
Emotions), developed by Eli Lebowitz and colleagues at the Yale Child Study Center,
teaches parents a better option—working through anxiety rather than avoiding it. Instead
of allowing socially anxious children to stay home, for example, parents learn to gradually
expose them to challenging situations and provide support. In a 2020 study published in
the Journal of the American Academy of Child and Adolescent Psychiatry, Dr. Lebowitz and
colleagues reported that 87% of the clinically anxious children showed less severe anxiety
after their parents received the therapy.
This approach also applies to the problem of teen anxiety. By the time children in the U.S.
turn 18, tens of millions of them will have been diagnosed with an anxiety disorder,
according to the National Institute of Mental Health. The blame is often placed on social
media and the constant comparison with others that it encourages. But that’s too
simplistic: A study by Erin Vogel and colleagues, published in 2015 in the journal
Personality and Individual Differences, showed that it was only teens who were already
deeply invested in their social standing who had lower self-esteem and more anxiety after
viewing acquaintances’ positive social media profiles.
The key factor in the debilitating anxiety of teens is whether they are spending inordinate
amounts of time swiping and scrolling as a way to soothe and distract themselves. This
tendency to reject and suppress unwanted feelings and thoughts only serves, paradoxically,
to increase them in the long term. Teens and their parents need to see such avoidance for
what it is, try to identify the underlying cause and find a way to channel it into relief. When
they think of anxiety as an advantageous feeling that tells us what we care about, they can
be better motivated to pursue the future they want, whether it’s joining the school
newspaper, trying out for a team or saying hi to a new classmate.
It also helps to learn more about anxiety and how it works. In a pair of studies published in
2013 in the journal Clinical Psychological Science, Harvard researchers invited adults with
social anxiety disorder, who live in dread of negative social evaluation, to take part in an
experiment that was designed to feel distressing to them—giving a speech in front of a
panel of judges. Half of the participants were taught to anticipate and interpret their
responses—hearts racing, butterflies in their stomach, stumbling over words—as signs
that they were energized and preparing to face the challenge ahead. They were further
informed that anxiety evolved to help our ancestors survive and thrive by delivering blood
and oxygen to muscles, organs and the brain, so that they work at peak capacity.
Those participants who learned to reframe their anxiety as an advantage, compared with
those who didn’t, performed better under pressure, were more confident and showed
biological signs—steadier heart rates, lower blood pressure—of being focused and
engaged. The study showed that when we believe anxiety is a benefit rather than a burden,
our bodies follow suit and better prepare us to meet the challenges ahead.
A similar effect comes from being in the presence of others, which can cause anxiety in
some contexts but can also provide a pathway out. Research shows that receiving direct
social support is one of the best ways to manage all types of distress, including anxiety. A
2006 study from the University of Wisconsin, for example, brought participants into the
lab to take part in a high-anxiety situation: They entered a loud, claustrophobic MRI
machine to have their brain scanned and were told to expect electrical shocks in the course
of the procedure. One third of the group were allowed to hold the hand of a loved one, one
third held the hand of a stranger, and the last third were left alone.
Researchers found that holding a loved one’s hand in particular calmed areas of the brain
that are typically activated when people are highly anxious. Such social buffering should be
no surprise. We’ve known for years that anxiety increases levels of the hormone oxytocin,
which primes us to seek out more social support and connection. Humans evolved to rely
on “emotional outsourcing,” turning to others when a challenge arises. Managing anxiety
is no exception.
Finally, there are many ways to use anxiety to create a deeper sense of personal fulfillment.
Beginning in 1938, the Harvard Study of Adult Development, one of the longest-running
and most comprehensive longitudinal studies ever conducted, asked a fundamental
question: What leads to a healthy and happy life? Following over 1,300 people from all
walks of life over decades, the study has found that one of the best predictors—better than
social class, IQ and genetic factors—is having a sense of purpose.
A sense of purpose doesn’t mean some grand vision or a burning life mission. Purpose
refers to the values and priorities that make us who we are and give our life meaning.
Research by Geoffrey Cohen and colleagues at Stanford shows that when people take time
to express the purposes they hold dear and to contemplate why—whether it’s
relationships, skills or even humor—their mood lifts, concentration and learning improve,
relationships are more fulfilling, and physical health even gets a boost. A study published in
2014 in the Annual Review of Psychology by Dr. Cohen and colleagues showed that these
benefits can persist for months or even years.
That’s why it’s crucial to channel the benefits of anxiety, like persistence and hope, toward
purpose. The Canadian psychologist Patrick Gaudreau coined the term “excellencist” for
people who strive toward excellence and savor having a purpose. They experience higher
levels of anxiety than their less striving counterparts but don’t suffer the burdens of
perfectionism—the relentless pursuit of flawlessness that leads to high rates of burnout.
In a pair of studies published in 2022 in the British Journal of Psychology, Dr. Gaudreau,
Jean-Christophe Goulet-Pelletier and colleagues assessed divergent thinking, a key
indicator of creativity, in hundreds of young adults by asking them to do such things as
using common objects in novel ways. People who tended to pursue excellence over
perfection in these exercises made mistakes, but they came up with more—and more
original—answers. Thomas Edison wrote, “I have not failed. I have just found 10,000 ways
that won’t work.” He was an excellencist, a master of turning anxiety over his failures into
purpose.
Today we too often treat anxiety as a malfunction to repair, but anxiety doesn’t need fixing.
What needs fixing is our disease model of dealing with it, which is meant to increase
stability and destigmatize psychological struggle but is not succeeding and may even be
causing harm. Once we rescue anxiety from this mindset, we’ll be in a better position to
rescue ourselves.
—Dr. Dennis-Tiwary is professor of psychology and neuroscience and director of the

Emotion Regulation Lab at Hunter College. This essay is adapted from her new book,
“Future Tense: Why Anxiety Is Good for You (Even Though It Feels Bad),” published by
Harper Wave, a division of HarperCollins (which, like The Wall Street Journal, is owned by
News Corp).
Appeared in the May 7, 2022, print edition as 'In Praise of Anxiety Using Anxiety to Survive and Thrive'.

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28/07/2022, 12:48 In Praise of Anxiety - WSJ

THE SATURDAY ESSAY

Treating anxiety like a disease prevents us from distinguishing

When we believe anxiety is a benefit rather than a burden, our

—Dr. Dennis-Tiwary is professor of psychology and neuroscience and director of the

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