Can EMDR Therapy Help High-Functioning Anxiety?

You are successful. You have always done well in school, getting near-perfect grades, getting all the accolades you can get, graduating with honors. Then you went out, and got a great job, and you are regularly praised for how hard you work. You keep your house tidy. You eat healthy most of the time. You exercise regularly. You keep up with friends, making sure they know you want to spend time with them. You never ever miss an appointment, never leave anyone hanging. You are on top of everything.

From the outside, you look nearly perfect.

But on the inside, you feel like you’re drowning. You are constantly worrying, constantly overthinking. Always checking, always making a plan—Plan A, Plan B, Plan C—for when the worst case scenario happens. You are always people-pleasing, making sure not to be a burden on others. Always preparing for what could go wrong.

Yes, from the outside, you are successful and highly-functioning, but on the inside, you’re barely keeping your head above water as the anxiety wraps its relentless grip on you and tries to pull you under. And it is exhausting.

So even what is high-functioning anxiety?

It’s a non-clinical term to describe people who experience persistent internal distress while looking like they have it altogether on the outside. They manage to fulfill their responsibilities (e.g., going to work, doing chores, taking care of the kids, staying connected with friends, etc.) while simultaneously struggling with immense internal pressure.

What are some common signs of high-functioning anxiety?

·      Being an “overachiever” or perfectionist

·      Chronic overthinking

·      Organized

·      Always planning or preparing

·      Struggles to relax

·      People-pleasing

·      Terrified of making mistakes

·      Difficulty saying “no”

·      Constantly going through “what if” scenarios in their mind

·      Feeling guilty for resting or doing something for themselves

·      Difficulty staying in the present moment mentally

Why can anxiety be difficult to notice when you’re high-functioning?

Anxiety is often very debilitating, and can interfere with functioning for many people. However, productivity can actually serve as a coping mechanism for some people, and can help them in managing their anxiety. They may not appear to be anxious because their anxiety has become intertwined with the very things that make them successful. They work hard, meet deadlines, anticipate problems that they are then able to problem solve, they remember everyone else’s needs, keep the home organized, perform well at work. They rarely let things fall through the cracks. From the outside, these behaviors make them look like they are conscientious, ambitious, or responsible. And yes, those things are likely still true. However, internally, those behaviors are likely being driven by fear.

For example:

“I work really hard” can look like ambition to other people, but that person is likely being driven by a fear of failure or fear of disappointing/being rejected by others.

OR

“I need to do everything perfectly” can look like high standards, but may actually be driven by a belief that mistakes are not safe to make.

There is a notable distinction between functioning vs feeling regulated. Being able to function with anxiety certainly has its advantages, but it does not mean that your nervous system is calm or regulated. You may give a successful presentation, but experienced severe anxiety/panic before going on stage. You may meet the deadline every time, but you lay awake for most of the night worrying and second guessing yourself, thinking of every worst-case scenario. There is a difference between feeling enough low-level anxiety to complete the project, and completing the project because you are consumed by the anxiety and fear of failure.

So are you productive and organized and overly conscientious because you want to be? Or because anxiety won’t let you stop?

Where Does High-Functioning Anxiety Come From?

While some people may be more predisposed to anxiety, it often can develop from the following:

·      Past experiences of unpredictability

·      Childhood environments where mistakes had big consequences

·      Criticism or extremely high expectations of you

·      Experiences of rejection or embarrassment

·      Trauma or chronic stress

·      Learned beliefs like, “I have to be perfect to be safe,” or “If I don’t anticipate everything, something bad will happen.”

Anxiety doesn’t always come from one obvious traumatic event. It can build through a culmination of many lower-stress situations, over and over, strengthening the negative beliefs you have formed about yourself through these negative experiences.

Can EMDR Help With High-Functioning Anxiety?

Yes. EMDR can be an effective tool to help reduce high-functioning anxiety. EMDR won’t completely “erase” anxiety, but the goal is to identify and process the experiences that have contributed to the beliefs that may be maintaining the anxiety.

Possible targets that we may work through in EMDR that may be contributing to high-functioning anxiety:

·      Experiences of failure or criticism

·      Memories when you felt unsafe or out of control

·      Memories of shame or rejection

·      Early experiences in your life that shaped perfectionistic tendencies

·      Specific memories that still trigger intense emotional responses.

After you go through experiences such as these, it can impact the way that the brain and nervous system see certain situations. If you were consistently criticized as a child for making mistakes or your parents overreacted to those mistakes, you may panic now whenever you don’t get a perfect score on an exam or do perfectly on a work or home project. You were essentially trained that things needed to be done perfectly or there would be a serious consequence, such as a rejection or withdrawal of love, or your safety would be threatened.

In EMDR, as we work through those earlier memories of criticism or parental overreaction to a mistake, your perception of the memories and yourself will shift. Your belief may shift from “I need to be perfect or I won’t be safe” to something like “It’s okay to make mistakes sometimes because I am human.” This will happen naturally through reprocessing as your perception of the memory changes. As a result of looking at the world through this new lens, your brain and nervous system will not be detecting threats as often as it was when you were looking through the lens of “I need to be perfect or I won’t be safe,” and anxiety should naturally reduce.

EMDR Isn’t Just for Processing “Big T traumas”

Many people assume that EMDR is only helpful for “Big T traumas” or “obvious traumas” like going to war, being in a major car accident, a shooting, etc. Yes, it can be very effective in treating those memories causing PTSD, but it can also be effective in treating “Little t traumas” or lower level stressors/chronic stressors that don’t necessarily feeling like traumas, but have essentially trained the nervous system to be “on guard.”

In EMDR, we would try to find the root of anxiety, treating it from the past, present and future.

·      Past à Where did I learn this from?

·      Present à What situations trigger this response now?

·      Future à What am I afraid will happen if I stop overpreparing?

So What Would EMDR Look Like for Someone with High-Functioning Anxiety

We would start with assessment and identifying patterns and triggers. Then we would move into developing resources for stabilization and regulation skills that will ensure you can tolerate any distress that may come up when we’re reprocessing the memories. Then, once you feel you have a good handle on managing your distress when it comes up, we would identify memories, beliefs, or present-day triggers to work through in reprocessing. Once we both agree you’re ready, then we will reprocess the memories/triggers one-by-one, always moving at your pace. Through this process, you will develop more adaptive beliefs and responses to these memories/triggers, and your distress should reduce.

What EMDR Can and Can’t Do for Anxiety

EMDR may help reduce the emotional intensity associated with certain memories and triggers. It does not guarantee that you’ll never feel anxious again, as anxiety is supposed to be a protective emotion that keeps you alive. When there is an actual threat present, we want to feel anxious so that we can figure out how to survive the threat. We just don’t want excessive anxiety consuming you, where your brain and nervous system detect a threat where there is none. The goal of EMDR is to work through the memories that have contributed to a distorted assessment of threats and to have a more regulated nervous system that doesn’t kick into overdrive when it shouldn’t.

You Don’t Have to Look Like You’re Struggling from the Outside to Deserve Help

You don’t need to meet a certain threshold of functioning to get help for your anxiety. If you’re tired of struggling with overthinking, people-pleasing tendencies, fear of making mistakes, spiraling thoughts to the worst-case scenario, etc., you deserve to be able to go through life with some relief. Being “high-functioning” doesn’t mean it isn’t affecting your quality of life, it just means your struggles aren’t always obvious from the outside.

The goal of therapy isn’t to become less caring, or conscientious, or ambitious. These are good things that I highly encourage! We want to set the bar high in life, but we want it to be realistic, along with giving ourselves some grace when we make mistakes. The goal of therapy when dealing with high-functioning anxiety is to choose to be things like caring, conscientious, or ambitions because you want to be rather than fear driving you to be those things.

If you have any questions about high-functioning anxiety or using EMDR to treat it, I’d be happy to chat! Please feel free to reach out for a free, brief consultation.