September 2002
Clarifying Anxiety, Fear, and WorryFeatured Writer: Gregg Dana, M.A. Licensed Clinical Professional Counselor

One element of a healthy emotional life is the ability to identify and label our feelings. If we know what we are feeling and what those emotions mean, we can do better at responding to them in a balanced, appropriate way. In my personal and clinical experience, it is especially useful to understand the difference between the feelings of fear and anxiety and the way they are generated by worrying.

I understand fear to be a relatively uncomplicated feeling. We feel fear when we are threatened, when we expect to be hurt. Fear is an unpleasant, highly energized emotion that helps us defend ourselves against the threat. Our bodies react with general arousal, increased energy and tension in our large muscles, heightened mental vigilance, and all of our many responses to adrenaline, the fight-or-flight hormone, being released into our bloodstream.

A useful example of a situation in which I would feel fear is my car stalling while crossing railroad tracks. I see a train approaching, and I am filled with fear. My sudden burst of energy helps me jump out of the car and make sure my passengers are safe. I run down the tracks with unusual speed to warn the engineers. When the incident is over, I feel physically and emotionally exhausted because of the intensity of my fear reaction.

Anxiety is a feeling very similar to fear but without a clear threat. We become anxious when we are convinced that something may hurt us, but without anything specific for us to fight or flee. In an anxious state we feel the bodily arousal of an adrenaline response, but there is no stimulus except our thoughts about danger or our mental images of being hurt in some way. Anxiety is very unpleasant, even debilitating, and we cannot escape it by taking a specific action to relieve the feeling. Because there is no direct stimulus and no obvious way to stop anxiety, our anxiety can grow as we become anxious about the possibility that we will feel anxious.

My car again stalls on the tracks. I look around and don't see a train coming. There is no imminent threat to my safety, but I cannot sit comfortably in the car because I am anxious. My mind is filled with images of a train smashing into my car, so I keep looking up and down the tracks, immobilized by not knowing the direction from which the train might come. I can't figure out what I can do to prevent the accident. I am miserably anxious, shaky and agitated, but it is not clear what I can do to relieve my distress.

In the hold of anxiety, with my mind focused on mental images of a train wreck, I may not perceive the situation accurately. It's as if I have closed my eyes because I can't bear to see a train actually coming. Perhaps the tracks are rusted, indicating there has been no train there for a long time. Because I am convinced a car stalled on tracks is in danger, I may ignore or dismiss evidence to the contrary. I will remain sitting in my car, my knuckles white on the steering wheel, going nowhere.

Eventually I will probably end my anxiety by doing one of three things: (1) I may get so tired of feeling bad that I take impulsive action, wanting to do anything, even something I know isn't a good idea, to escape the anxiety. (2) Some other concern may become urgent enough to demand my attention away from my imaginations of the train wreck. (3) I may self-soothe enough to metabolize my adrenaline so that I can think again and come to a good decision about my situation. Whether I was ever in real danger or not, I will be exhausted from this anxious experience.

Worrying is a mental activity that normally occurs when we are safe and otherwise unoccupied. We may be lying in bed after the alarm goes off, sitting comfortably on the sofa, or doing something that doesn't require our full attention. We worry by creating mental images and thoughts about possible events that are threatening or unpleasant. As we imagine troubling scenarios, our bodies respond with a low-level adrenaline arousal, so we feel tense. Fearful worrying focuses our attention on a particular threatening situation, so our worrying can be a useful time of planning our response. Anxious worrying is a useless process of fretting repetitively about vague, unspecific concerns in which there is nothing we can do to fight or flee.

Now I am going through my morning routines before I drive to work and a news story about a car-train accident reminds me of all the train tracks I cross on my commute. I start to worry, imagining that my car might stall and cause an accident. If my worrying is fearful, as I drive to work I will approach railroad crossings with increased attention to my driving, the condition of my car, and the traffic around me. I will have plans about my reaction if something does go wrong. Responding with appropriate fear to the threat described in the news story and worrying about similarly threatening situations may be a productive way of avoiding specific harm. My competence at driving may actually be enhanced by my fear and worrying.

If my worrying is anxious, covering all the dangers of commuting, I get in my car without specific concerns to notice and avoid. My fingers grip the wheel, my legs feel tense, and I scan the road, but I actually see less because I can't bear to look at all the threats coming from every direction. My anxiety makes it more likely that I will have an accident, and I arrive at work feeling already fatigued from the stress I caused myself by filling my mind with anxious worrying.

Our minds and bodies respond to threats, whether real and imminent or only vague and possible, in the same way, so the feelings and physical reactions of fear and anxiety are similar. When we worry, imagining and thinking about potential harm, our worrying can be fearfully productive or anxiously counter-productive, determined by the clarity of our thoughts about the situation we are imagining. The goal of a healthy emotional life is not to experience fear and anxiety less-fully or to stop worrying, but to understand these experiences and manage them so they serve us well.

Featured Writer
Gregg Dana, M.Div., M.A., applies his training and experience in family systems theory and brief, strategic, family therapy with people who have identified specific concerns or issues and are eager to discover new ways to understand and solve their problems—especially couples experiencing marital difficulties or families with challenging teenagers.

He is also a leader of the Marrying Well Seminars which are designed to help couples prepare for marriage. They include presentations of informative material interspersed with opportunities for each couple to talk together and apply the concepts and tools to their own relationship.

For more information on the next Marrying Well Seminar, call 847.518.1800.

Growing is an occasional publication of The Counseling Center of Lutheran General Hospital. If you would like to receive future issues of Growing, just call the main office with your name & address. Permission to reprint the main article is granted, with proper credit given to the author.

Main Office: 1610 Luther Lane ~ Park Ridge, IL 60068-1243 ~ For Information, call: 847.518.1800

Other Locations: Arlington Hgts., Deerfield and Libertyville.