This blog post on anxiety brings together the experiences of Michelle Vickers, UK psychotherapist and coach, alongside my experience of working with anxiety in a trauma-informed way.
From a trauma-informed perspective, it’s important to remember that anxiety is not “just in the mind” or something to get rid of. It is often a protective response shaped by experience, learning, and sometimes earlier life events that may or may not be fully remembered. It makes sense that the nervous system learns to stay alert when it needs to protect us.
Anxiety disorders are highly prevalent and appear to be increasing, which is often linked to a combination of modern life pressures, greater awareness, and improved access to diagnosis and support.
In the UK, it has been estimated that millions of people experience anxiety symptoms at any one time, with studies suggesting that around one in six to one in three people may be affected depending on how anxiety is measured and defined.
In Spain, large-scale surveys have similarly shown that a significant proportion of the population report having experienced anxiety symptoms at some point in their lives, with a notable number receiving a formal diagnosis of an anxiety-related condition.
These figures likely underestimate the true prevalence, as many people do not seek professional help due to shame, normalisation of symptoms, or lack of access to services. Overall, the data highlights that anxiety is not an isolated or rare experience, but something that is increasingly common and widely shared across different ages and social contexts.
Understanding anxiety
Anxiety can be understood as a learned response to perceived threat, which can become a habitual cycle of thoughts, feelings, physical sensations and behaviours.
At a basic level, anxiety is protective. It helps us respond to danger. However, it becomes problematic when this system is activated in situations that are not actually unsafe — for example, meeting a friend for coffee, going to work, or leaving the house.
From a trauma-informed lens, the key question is not “what is wrong with me?”, but rather:
“What has my nervous system learned it needs to do to keep me safe?”
The anxiety cycle
Anxiety is often maintained through a repeating cycle:
- Thoughts (often “what if…” thinking)
- Feelings (fear, panic, dread)
- Body sensations (racing heart, dizziness, tension, nausea)
- Behaviours (avoidance, reassurance seeking, withdrawal)
These parts interact and reinforce one another. For example, a thought such as “something bad might happen” can create fear in the body, which leads to avoidance, which then reinforces the belief that the situation was dangerous.
From a trauma-informed perspective, this is not “faulty thinking”, but a nervous system doing its best to protect us based on past learning.
Symptoms of anxiety
Anxiety can show up in many ways:
- Physically: palpitations, breathlessness, dizziness, fatigue, digestive discomfort
- Cognitively: rumination, worry, difficulty concentrating, intrusive thoughts
- Emotionally: fear, panic, irritability, overwhelm
- Behaviourally: avoidance, isolation, compulsive checking, substance use
It is also very common for people to experience shame around these symptoms, especially when they are not visible to others. A trauma-informed approach always works to reduce shame and increase understanding.
Anxiety disorders
Anxiety can present in different forms, including:
- Generalised Anxiety Disorder
- Panic Disorder
- Obsessive Compulsive Disorder (OCD)
- Social Anxiety Disorder
- Post-Traumatic Stress Disorder (PTSD)
- Phobias
- Body dysmorphia
- Agoraphobia
These are not separate “types of people”, but different ways the nervous system can organise itself around fear and protection.
The role of life experience and trauma
Anxiety can develop through a combination of factors, including:
- Early attachment experiences
- Childhood emotional environment
- Trauma (single events or ongoing experiences)
- Stressful life transitions (bereavement, illness, loss, change)
- Cumulative “smaller” stressors over time
Sometimes anxiety is linked to clearly identifiable events. At other times, it can feel as though it has no clear beginning — which can itself feel confusing or frightening.
A trauma-informed approach holds both possibilities as valid: the nervous system responds to what has felt overwhelming, whether or not it is consciously remembered.
The brain and the threat response
When we perceive threat, the brain activates a rapid survival response:
- The amygdala scans for danger
- The hypothalamus activates the stress response system
- The body prepares for fight, flight or freeze
This process happens extremely quickly, often before conscious thought. That is why anxiety can feel overwhelming or “out of proportion” — it is a survival system that has become highly sensitised.
A note on rumination
Rumination (repetitive thinking without resolution) is very common in anxiety. While the brain is trying to solve a perceived problem, it can actually keep the cycle active.
A trauma-informed approach does not try to force thoughts away, but instead supports a different relationship with them — helping clients recognise thoughts as mental events, not facts or predictions.
The Fear Monster (Michelle Vickers)
One helpful metaphor introduced by Michelle Vickers is the “Fear Monster”.
This is a way of understanding how anxiety can feel like it has a life of its own.
In this model, the Fear Monster grows when:
- we avoid feared situations
- we feed it with attention and rumination
- we respond to it automatically with protective behaviours
It becomes stronger through fear and avoidance, and it shrinks when we begin to respond differently.
The key idea is not to “fight” the Fear Monster, but to begin to:
- notice it
- understand it
- and slowly change our relationship with it
In trauma-informed work, this is never about forcing exposure or pushing someone beyond their window of tolerance. It is about building safety, awareness, and choice over time.
As Michelle Vickers describes, anxiety can feel like it feeds off itself and takes up a great deal of mental space. The Fear Monster helps make this visible in a way that is easier to work with gently in therapy.
Measures to prevent and manage anxiety
Alongside therapy, there are supportive ways to reduce anxiety and strengthen emotional regulation. These are not quick fixes, but gentle practices that can help the nervous system feel more balanced over time.
- Maintain a balanced lifestyle
Prioritise sleep, regular meals, hydration, and moderate exercise. - Build supportive connections
Stay connected with trusted people, hobbies, and shared activities. - Engage in enjoyable activities
Make space for things that bring pleasure, creativity, or meaning (e.g. walking, music, art, nature). - Learn relaxation and grounding techniques
Breathing exercises, mindfulness, yoga, or gentle movement can help regulate the nervous system. - Develop awareness of triggers and symptoms
Noticing early signs of anxiety can help create more choice in response. - Work with emotional awareness
Learning to identify and name emotions can reduce overwhelm and increase understanding. - Seek support from others
Friends, family, or supportive communities can help reduce isolation. - Reality-check anxious predictions
When anxiety escalates, gently consider: What is most likely, not just what feels possible? - Differentiate between control and uncertainty
Focus on what is within your influence, rather than trying to control everything. - Seek professional support when needed
A GP, counsellor, or psychotherapist can provide guidance, understanding, and structured support.
How therapy can help
An integrative humanistic and trauma-informed approach to anxiety focuses on:
- building safety in the therapeutic relationship
- understanding patterns without judgement
- supporting emotional regulation
- reconnecting mind and body
- developing awareness of triggers and responses
- gently increasing choice and flexibility
Approaches such as Person-Centred Therapy, CBT-informed strategies, mindfulness, and body-based awareness can all be helpful when adapted to the individual.
There is no single “correct” way to work with anxiety. What matters most is that the approach fits the person, their history, and their current capacity.
Final thoughts
Anxiety is not a personal failure. It is often a sign of a nervous system that has learned to stay alert in order to protect you.
The aim of therapy is not to erase experience, but to support you in developing more choice, more flexibility, and a kinder relationship with your own internal world.
Sources:
- Vickers, M. (Counselling CPD training on Anxiety – UK psychotherapist and coach)
Statistics referenced (UK and Spain mental health prevalence data – various public health sources including NHS and national surveys, 2013–2023 data ranges)