There's an image many people carry of anxiety: thoughts that won't stop, worries looping about something that may not have even happened. And yes, that's one face of anxiety. But there's another face that gets overlooked far too often, and that shows up constantly in my work with clients: the anxiety that lives in the body before the mind even knows it's there.
I'm talking about the jaw clenched on waking. The shoulders that creep up toward the ears by mid-afternoon on their own. The chest that feels like it's carrying weight. The stomach that turns before a meeting, or for no apparent reason at all. The heart that races when nothing you're doing justifies it, or the insomnia that arrives even after a calm day.
Those are signs of somatic anxiety. And they aren't imagined.
The body registers what the mind tries to manage
Gabor Maté puts it plainly: the body keeps score of everything the mind tries to handle, suppress, or ignore. Bessel van der Kolk built the title of one of the most important books of the last few decades around this idea: The Body Keeps the Score. It's not a metaphor. It's physiology.
When we live under constant pressure — work, relationships, money, existential weight — the nervous system enters a state of alert that doesn't always show up as "I feel anxious." Sometimes it shows up as chronic muscle tension, irregular digestion, difficulty taking a deep breath, or that fatigue that doesn't lift no matter how much you sleep. The body is processing something the mind hasn't yet been able to put into words.
There's a very concrete neuroscientific explanation for this. Stephen Porges, with his Polyvagal Theory, described a process he called neuroception: the nervous system's ability to scan the environment for safety or threat before we're consciously aware of it. Our nervous system reads the context — a voice, a look, a posture, a smell — and responds by activating states of alert or calm, with or without our conscious participation. The body reacts first. The mind interprets afterward.
When the nervous system spends a long time in chronic alert mode — something very common in people living with chronic stress — the body gets stuck in that defensive position. And then the physical signals don't arrive as clear messages of "I have anxiety," but as symptoms we mistake for muscular, digestive, or cardiac problems, or simply as "feeling bad."
Why talking about anxiety isn't always enough
For a long time, the dominant therapeutic model centered on thought: identify distorted thinking, question it, replace it with something more adaptive. That has real value, I won't deny it. But when anxiety has such a strong bodily expression, working only at the cognitive level is like trying to quiet a fire alarm by turning down the radio.
What I do in session — and what the field of body-based therapy proposes — is work directly with physical sensations. Instead of asking someone "what do you think about what's worrying you," sometimes the more useful question is "where do you feel that in your body right now" or "what happens to your chest when you get close to that topic."
That opens a different door. Because the body doesn't lie the way the mind does. It has fewer layers of rationalization.
Tools like Somatic Experiencing, developed by Peter Levine, work precisely with that language: sensations, impulses, the movement the body wants to make and that was interrupted at some point. Tapping / EFT is another tool that combines sensory stimulation of acupressure points with emotional processing, and has shown remarkable results in nervous system regulation when anxiety is at the root.
The goal isn't to eliminate anxiety. That would be like wanting to permanently eliminate physical pain: useful as an emergency painkiller, but dangerous as a life strategy. The goal is to learn to read anxiety as information. What is this tightness in my chest telling me? What does my nervous system need right now? Is there something my body knows that I haven't wanted to listen to yet?
Anxiety as a signal, not an enemy
One of the most important shifts that happens in therapy is moving away from relating to anxiety as something to defeat, suppress, or make disappear, and beginning to relate to it as a signal. A messenger. Sometimes annoying, sometimes intense, but with something to say.
When the body tenses the shoulders, it's saying something. When the stomach turns, it's saying something. When the heart races for no apparent reason, there is a reason — it's just operating below the conscious radar.
The therapeutic work that interests me is exactly that: going down to the level where the real information lives. Not to get stuck there, but so the nervous system can finally release what it's been carrying.
If you recognize yourself in what's described here — physical symptoms you can't quite place, an underlying tension that doesn't go away — it might be a good moment to explore this in a therapeutic space. In the first session we talk exactly about that: how the discomfort is reaching you, in the body and in the mind, and what paths we can take together.