Listen to thisAs of now, we are a quarter century into the third millennia (in one, but not every, calendar). It’s a good time to take stock of where we are in our assumptions and theories of working with people. I use the phrase ‘working with people’ because what I aim to explore in this column is relevant to many professional disciplines, amongst them social work, child and youth care practice, early childhood education, psychology, psychiatry, nursing, and medicine. I want to start this coming quarter century by exploring anxiety, a concept that has become ubiquitous in just about every setting where any sort of performance is required. Young people in state care are anxious. Students in elementary and secondary schools are anxious. University and college students are anxious. Families are anxious. Communities are anxious. Several studies in Canada have found that over 50% of all students in secondary schools ‘suffer’ from anxiety in ways that impacts their performance. Anxiety, diagnosed or not, is the most common reason for seeking academic accommodations at Canadian colleges and universities.
Anxiety is manifesting differently from how it used to manifest. Today, many students are too anxious to speak in front of groups, too anxious to sit in class with others, too anxious to have their routines upended or interrupted, and too anxious to accomplish anything worth accomplishing. Young people in care are too anxious to prepare for leaving care. Some are too anxious to be released from custody settings. Many are too anxious to reconnect with their families. Some adults are too anxious to leave their homes lest they be impacted by crime or disease, or some accident. Others can’t go to work because they are too anxious about having to perform work tasks, including interacting with colleagues.
Anxiety is not something to be just dismissed as a fake mental health concern, nor can we respond with a simple ‘just get your act together’. For those experiencing anxiety, it is real and powerful, sometimes immobilizing. Because it is experienced in this way, for many people anxiety becomes a barrier to living life not only by its own manifestation, but also by the consequences of non-performance. Young people drop out of school or fall behind academically, severely limiting their educational journeys. Many people become unable to work, take leaves from work, and sometimes are unable to return. Relationships become strained as those with anxiety rarely meet the expectations of those without anxiety and vice versa. The impact becomes multi-dimensional – this means people are impacted by anxiety across many dimensions of life, culminating in further challenges to their sense of self, self-worth, mattering, and capacities. Many people impacted by anxiety feel looked-down upon, rejected for their non-performance, and questioned on the legitimacy of their challenge. Isolation often follows, sometimes with quite tragic endings.
This has always been the problem with mental health diversity. Those not feeling it can’t entirely relate. Still, professional helpers from across disciplines offer solutions to anxiety that range from medications to psychotherapeutic interventions, art therapy to anima-assisted therapy, and a wide range of other service modalities all designed to mitigate anxiety and generate the conditions for renewed performance. In every instance, anxiety is narrated as a problem in need of solution, or at least mitigation, because performance in society is understood as a function of conformity to performance indicators and methods. The norm is not merely performance and its related outputs, but also the aesthetic of performance, its culture, its artfulness, and its professional compliance. We are meant to demonstrate to others our satisfaction, our joy, our ambition to perform and achieve outcomes. Anxiety comes in the way of that. It disrupts expectations and it disorients the performance ethos. This is why we narrate anxiety as a problem in need of solution, and the fundamental goal of intervention is to separate a world of complacent conformity with performance expectations from a world that is disrupted by an inert sense that not all is well.
And yet it is increasingly difficult to argue that anxiety is misplaced, representing a deviation from the rational and realistic acceptance of social norms and the aesthetic of functional societies. Our professional impulse is to treat, to cure, or at the very least to open pathways for healing, as if anxiety were some kind of wound inadvertently procured during a spell of irrational and baseless paranoia. One might argue that precisely the opposite seems truer. Specifically, one might argue that anxiety is in fact a rational, entirely meaningful response to the world as it presents itself right now. A lack of anxiety, on the other hand, is representative of fatalism, a shrinking from responsibility, and frankly, a little sick. Not having anxiety at this particular stage of human history is akin to someone yelling ‘fire’ and we take a seat to see what happens next.
At the macro level, the world certainly provides for its share of reasons to be anxious. Decades ago, we were largely able to contain those reasons within a singular narrative of the Cold War and its accompanying anxiety about nuclear winter. Today, the world offers so much more than that: between climate change and the impending end of the planet, multiple wars threatening to expand, the end of democracy as we know it, the rise of ‘crazy’ into positions of political decision-making everywhere, and the inevitability of further pandemics, not to mention slightly more futuristic developments related to digital surveillance, robots powered by generative AI, and seemingly tolerated if not actively supported genocide of peoples deemed ‘less than human’, there is plenty of reasons to succumb to debilitating anxiety attacks. But even at the micro level, changes in societal structures and economic processes have become much more relevant even to otherwise privileged lives. Housing unaffordability, megacities that swallow its peoples, food insecurity and other visible changes are worrisome. Beyond that, however, perhaps most worrisome is the emergence of a parallel universe of social media, fake news, and a ‘house of cards’ approach to managing jobs, family, love, and obligation that make anxiety about the here and now as well as the future both reasonable and likely one of few defensive mechanisms we have left. The reality is that there is only one correct response to the question ‘do I matter’ - no, not really.
So, what does this mean for working with people who may identify feeling anxious, or who may experience exclusions and disadvantages as a result of having their performance impacted by an overwhelming anxiety? Should we be trying to solve their problem, cure their disease?
It seems disingenuous to suggest to people with anxiety that their anxiety is misplaced. ‘Don’t worry so much’, or ‘it will all work out’, or ‘don’t allow the world out there to define the world inside of you’ are almost certainly based on a false confidence that things will in fact be alright. Things will not be alright. At least not for most people, and as usual, the people for whom things will not be alright going forward are the very same people for whom things have not been alright for decades and centuries. What is different now is that the things that are not alright are no longer within anyone’s purview to fix. A social worker, a psychologist, a child and youth care practitioner can create moments where things may appear alright, but these moments are just as fake as the latest cure offered by TikTok.
This creates an interesting paradox. Advances in mental health sciences, evidence-based interventions, and innovations in pharmacology coexist with an increasing irrelevance of the entire project. Making people less anxious seems oddly misplaced at a moment in our existence where anxiety represents both a rational and a meaningful form of resistance to the abstraction of what it is to be human that we are asked to participate in. We could be asking questions like these:
How we construct anxiety is a function of how we experience the world around us. I suspect that one way in which many of us experience that world is simply through numbness – numb senses, numb minds, numb souls. Such numbness helps us accept unspeakable evil in the world and it helps us become comfortable with our obvious cowardness to speak against such evil. Such numbness also helps us accept that we just don’t deserve the certainties and assurances embedded in stable housing, food security, education, and freedom. Our criterion for recognizing our humanity is the biological cycle of waking, sleeping, consuming, and excreting. This has become the foundational structure of life, notably in the global North, where, it bares mentioning, anxiety is a far more pronounced phenomenon than in the global South. As professionals in human service fields, I wonder to what extent ‘helping’ people abide by this biological cycle corresponds to the aspirations we had when entering these professions. Excellent work in the mitigation of anxiety feels more like an execution of precisely those aspects of a person that make them human, including their vulnerability to becoming incapacitated in the context of performance.
What then are new directions in a world filled with anxiety? Where can we turn to find new ways of being with people as professionals entrusted with ‘helping’ others? Note the questions I am asking. I am not asking about solutions, because I am not sure there is a problem. I am also not asking for new ways to treat people with anxiety. I am asking about new directions (not solutions or answers), and I am asking about how we can be with people rather than do something to people.
One way we can be with people is as creative writers or documentarians. By this I mean that we can document their anxiety, what it means, how it manifests, and how it helps them exist. We can document how anxiety interreacts with the soulless void of those living the biological cycle, those who are numb. We can document the tension, the resistance, and the battle that exists in this context and that reminds us that as humans, we can fight. It is important to spend time documenting the experiences of those identified as having anxiety. If we are to develop new directions for being with people with anxiety, we will need new understandings about what it means to live with anxiety (and what it probably does not mean). In short, before we label and prescribe anything, we need to find new ways of seeing that transcend the problem-focused ways we see things in the context of diagnostics.
Another way we can be with people is as guides to the land, to nature, to inanimate objects, and as relational bridge to these objects. Instead of imposing capacity to connect to those who have given up (which is most of us), those who are conforming to the absurdities of our lives, and those who have succumbed to their numbness, we can serve as relational bridges to all that which still exists in balance with a much greater framework for existence that has sustained Indigenous and African communities for millennia. As professionals, we are unlikely to be satisfied with simply documenting the experiences of others. At some point, we will want to contribute something to make those experiences better. Our usual toolbox in this regard is limiting and likely has reinforcing elements of a problem-based and solution-focused way of responding. Drawing on trans-diagnostic and pre-diagnostic methods of being and ways of knowing can help those with anxiety but also professionals constrained by the limitations of standard interventions.
Finally, we can be differently with people by being differently with ourselves. A careful self-exploration of our professions and of ourselves as individual professionals and individuals can lead us toward identifying in what ways we are simply reproducing the very dynamic that gave rise to anxiety in the first place. In other words, we might ask ‘are we feeding the beast’, and ‘are we the beast that creates the impetus for anxiety in the first place’?
These new directions in being with people are not easy ones for professionals and professions that, notwithstanding their commitments to social justice and equity, nevertheless carry with them considerable commitment to their own ‘expert’ status. I suppose this is the great irony of the anxiety phenomenon. In treating anxiety, we rarely ask whose anxiety we are treating. One possibility is that we are treating our own anxiety about our professional relevance as this 21st century presents us with challenges that are unfamiliar and comprehensive in their impact.
So here is to 2025. Perhaps it will be a year in which honesty and some level of meaningful dialogue about what we aspire to as professionals in the helping professions might make a reappearance. Certainly, treating the very reasonable and well substantiated fears of others in a world that ought to make all of us very afraid seems misplaced as a starting point.
