Dear Therapist,

I’m in my early twenties and a year ago was given a wake-up call by my doctor who diagnosed me as pre-diabetic. She was frank that if I didn’t make some lifestyle changes sooner rather than later, I’d be looking at Type 2 diabetes in the near future. After discussing my cholesterol, blood pressure and weight with her, I was sufficiently motivated to tackle the emotional eating that has been a feature for me since childhood.  

The good news is I worked with a therapist to get my eating under control, including addressing the earlier issues that led me to self-soothe with food. Combined with a new gym routine, my weight and other health indicators have improved markedly. However, I have been left with frequent anxiety in the absence of my comfort blanket of carbs and sweets. My therapist assures me this is perfectly understandable but it doesn’t make living with the anxiety any easier. My mum suggested I speak with my doctor about anxiety medication but I wonder if this might be another crutch for managing something I should be able to do on my own? I’d love your thoughts. 

Signed,

Healthy but Anxious

Dear Healthy but Anxious,

You should feel very proud of yourself for overcoming a longstanding behaviour that was detrimental to your health. You’ve already done a lot of hard work addressing the symptom (emotional eating) and now you are left with the underlying root cause (anxiety). We all have strategies to escape feelings of discomfort. Yours was food. Others are: alcohol or other substances, scrolling or binge watching, compulsive shopping or gaming, workaholism or ‘busyness,’ rumination (getting lost in blame, resentment or other dramas) to name a few. What I’m going to say to you applies to all of us, as we’re all prone to such avoidance tactics to a greater or lesser extent.  

Anxiety is an unavoidable aspect of the human experience. It has roots in our evolutionary biology as a survival mechanism to detect and respond to danger. Our ancient brains, built for survival, now face a world of constant triggers—and in turning so often to distractions, we’ve somewhat forgotten how to process the raw energy of disturbing emotions. You have taken away your primary avoidance strategy. The next step is having the willingness and discipline to reembody sensations that feel threatening but, on exploration, are merely uncomfortable.  

I invite you to observe what you are experiencing at the sensation level in the body when you feel anxious. To get curious and ask ‘What am I feeling right now that I don’t want to feel?’ Again, keeping the exploration to physical sensations (tightness in the chest or stomach, shallow breathing, jitteriness etc.) without interpretation. Often, our clever minds try to be helpful and make sense of what we’re experiencing in these moments. But this mental activity when already anxious tends to inflame rather than calm. We can get very seduced by our stories – another way of distracting ourselves from feeling! – and these can also keep us stuck in the past rather than fully participating in the present. So we’re not trying to understand anything when caught in an anxious episode, just riding the waves of what can be intense physical sensations. Asking: ‘Are these sensations really a threat I can’t endure, or can I be with them?’ It might be exceedingly uncomfortable, but if we can observe, time and time again, that they are disturbing but not harmful, we are able to navigate these periods with more ease and confidence.  

There is an analogy here with your gym visits – I’m guessing these were difficult in the beginning.  Getting on a bike those first times, or starting a weights routine. You stayed with the discomfort to get the result of better health. You have also learned not to succumb to powerful urges to numb your feelings with food. Be proud of how much you have already accomplished. You are well practiced and ready for the next step. 

Yours,

Kelly Hearn