Here I present my first notes on anxiety. Hannah Arendt would call this a pre-understanding: making explicit my initial prejudices and ideas so they may serve as a map for further exploration.
I feel compelled to write because, in my daily experience, anxiety appears everywhere. Not only in myself, but also in what I hear from patients at ON Care, from friends, and from family. It is a persistent emotional suffering that, at certain moments, seizes us and throws us off balance.
In many conversations, what emerges is not only the confession of “living anxious” or “being stressed,” but the deeper unease of not knowing what to do: how to manage it, whether there are tools for it, or whether suffering from it means being incapable or emotionally immature. I do not have a definitive answer; if I did, my life would be free of anxiety—and it is not. But it is far lighter than it was ten years ago, and that contrast motivates me to inquire into what anxiety really is and what we can do with it.
My aim is modest: to sketch, first, what I myself mean when I say “I am anxious”; then, to contrast it with what I hear from those around me; and finally, to bring it into dialogue with two different traditions, psychoanalytic and cognitive-behavioral. These notes are nothing more than a first map—imperfect and partial, yet enough to begin exploring this unease that runs through so many lives.
What is Anxiety?
I say that anxiety is, first of all, an emotion. That is, when I find myself saying “I feel anxious,” I am saying that I am experiencing an emotion. But what does this mean?
Imagine a washing machine. The same machine may be in a dark laundry room or out in the middle of the street under the sun. The place changes, but the machine remains the same. Now imagine it turned on: it is not the same when it is filling with water as when it is spinning. Its chassis vibrates differently, the valves open or close, the parts work under different tension. It is the same machine, but in different modes of being; not just changes of place.
Emotions are something similar. When we are sad, joyful, or furious, everything in us shifts mode: what we think, what we desire, how we move, even how our body responds. An emotion is not a fragment of us; it is the way our whole being finds itself in that moment.
That is why, when I say that anxiety is an emotion, what I mean is that anxiety is a mode of being. A mode that colors our thoughts, our actions, and our physiology. Just like the washing machine in its different cycles, we too find ourselves in different modes: joyful, sad, proud, ashamed… or anxious. The question, then, is: what distinguishes this mode of being—anxiety—from the others?
When I say I feel anxious, what I am naming is a state of diffuse restlessness. A restlessness that pushes me to move without clear direction and from which, at the same time, it is very hard to refrain. It is like having an urgency without knowing where it comes from. And so, almost unconsciously, I rush to find an object that might give it meaning: opening Instagram or Twitter, reading the news nonstop, smoking a cigarette, eating without real hunger, tidying up anything, sending an unnecessary email, or even exercising compulsively. For me, anxiety is the fundamental state of dispersion: restless, yet without knowing toward what.
I also understand it as linked to procrastination. Procrastination is not an emotion, but the action of evading a task one has committed to. I have something pending, but the restlessness drags me into doing anything except that task. Not all procrastination comes from anxiety, but in my case the two have often been deeply connected. And yet, I cannot say that anxiety came from procrastination either, because when I forced myself to work despite it, I discovered that I was not truly paying attention to what I was doing. I did it just to do it, while the diffuse restlessness kept me from really concentrating.
This diffusion or indeterminacy is what distinguishes it from other emotions. Fear, for example, is also restlessness, but with an object: a dog that barks at me, a phone call I dread to answer, a trip that scares me. Faced with that object, I prepare to flee or to fight. And then my entire world shows itself as ordered: the door as an escape route, the stone I had ignored as a weapon of defense. Everything arranges itself around the object that triggers the fear. Anxiety, in contrast, makes the world appear disordered.
Frustration, on the other hand, is the restlessness that arises from an obstacle: I want to open a door and it won’t open; I want to improve my life and I fail. In both cases, the unease is anchored in something concrete.
Anxiety, by contrast, is not. It is a restlessness without a defined object, one that scatters and empties me.
This definition seems to match what a woman once told me. She explained that a certain family situation left her in a state of permanent restlessness. That unease drove her to eat sweets and snacks again and again, as if trying to soothe something she could not name. In her case, the situation might have been a concrete object, but when I asked her, she said it wasn’t exactly fear: it unsettled her, it worried her, but there was nothing she could really do to resolve it, and she was not calm either—what she herself called a “zen acceptance.” She was caught in a tension without direction, which by the end of the day left her tired, drained, and with the feeling that she had had no control over herself or her environment.
A man, on the other hand, described his anxiety differently. For him, it appeared when he imagined being overwhelmed in the future: “I get anxious when I think about all the things that could go wrong.” One episode struck me: once, he lay awake thinking that the following week he would be at an airport with two small children and eight suitcases. He pictured himself carrying everything, trying to manage them, losing control. He could not sleep in anticipation of that situation. He could not be at ease or find direction, and although he admitted that his reaction was somewhat exaggerated and useless—since what could he do a week in advance?—the restlessness gave him no peace.
A mother, in turn, described her son as anxious because “he couldn’t stay still,” unable to concentrate on anything. For her it was exhausting: nothing held his attention for long; he drifted from one thing to another superficially. At school he was also reprimanded because he seemed unable to control himself. I remember commenting: “is it like a diffuse and indeterminate energy?” “Exactly!” she answered.
Here lies the paradox: we use the same word—anxiety—for different experiences. A diffuse restlessness discharged in compulsive acts, a catastrophic anticipation of a concrete event, a scattered energy without focus. Are these really the same? Or are we naming different emotions with a single word? To find some orientation, I will draw on two traditions—different in spirit but both concerned with anxiety—that may shed light on these experiences.
Anxiety according to cognitive-behavioral psychology
Clinical classifications—such as the DSM-5—place under the category of anxiety disorders diagnoses like generalized anxiety disorder, social anxiety, panic attacks, agoraphobia, or specific phobias. What they all share is the presence of excessive fear and anxiety, suffered with such intensity that they produce functional impairment in a person’s life. By the name, it seems we are talking about the same emotion we all know—everyday anxiety—but lived in an extreme degree: not just as discomfort, but as an obstacle to working, caring for children, or sustaining daily relationships. In the conversations I’ve had with patients, friends, or family, most do describe anxiety, yes, but not in a way that incapacitates them entirely: they live with persistent unease, though they keep going with their daily lives.
If we understand anxiety in this way, then my friend’s story would be an episode of intense anxiety, and only the emotion experienced with that intensity could properly be called anxiety. The child’s account and my own might need another name. My friend’s case, stuck in her family situation, becomes more confusing: there is a concrete trigger, yes, but no clear direction of action—no object toward which to move or from which to flee, so she eats. So the question arises: is this anxiety, or some other form of distress that we have ended up calling by the same word?
Cognitive-behavioral psychology interprets anxiety in a way consistent with the DSM-5 and, in large part, is the discipline that provides it with its conceptual framework (medicine is another of its sources). For this approach, anxiety is a normal adaptive response to a perceived danger: it prepares us to face a challenge or protect ourselves from a threat. In this sense, anxiety and fear go hand in hand and could even be taken as synonyms. A social phobia, for example, is an extremely intense fear of a concrete social situation. What makes this emotion problematic is when it becomes exaggerated: as in the story of the suitcases, where the anticipation of a reasonable difficulty was lived in a disproportionate way.
Now, if anxiety is an adaptive response, then it is good to feel it, because it prepares us to face challenges. In fact, to live constantly with some anxiety means to live constantly with challenges and threats, and that is life: one cannot remain alive without feeling challenged. It has to be accepted—we must step out of the comfort zone. However, when the fear we feel overwhelms us, something is not working well. But what?
If the fear is disproportionate, perhaps it is because the perception and the cognitive scheme that governs it are mistaken. In cognitive-behavioral terms, what happened to my friend was a cognitive distortion, and what must be done with someone suffering from intense anxiety is to help them identify that distortion and correct it. The procedure consists in detecting what triggers the unfounded fear, reasoning through it with the person, and—above all—exposing them gradually and in a safe environment to the object that provokes their anxiety. First, by talking about what might happen at the airport with eight suitcases, then simulating the situation, confronting those dangers in the simulation, and finally accompanying them to the airport itself. This is called exposure therapy.
This leaves us with a problem: the other situations we call anxiety, those marked by diffusion as their main trait, don’t quite fit this definition. So what are they? Are they anguish instead? It is confusing. The psychoanalytic tradition would call these cases anguish—or even use anxiety and anguish as synonyms—treating them as equivalent phenomena. And since they do resemble fear (restlessness can feel like urgency in daily life, or like terror in a panic attack), it would also say that the case of the suitcases is anguish. From that perspective, cognitive-behavioral psychology would be seeing only the tip of the iceberg: the concrete object of the phobia would be nothing more than the result of a defense against a deeper anxiety.
Anguish: the psychoanalytic and psychodynamic view
Unlike cognitive-behavioral psychology, the psychoanalytic tradition—and more broadly the psychodynamic one—does not reduce anxiety to a cognitive distortion in response to an external object. It speaks instead of anguish, and understands it as an experience of diffuse restlessness, without a defined object, that overwhelms the subject.
In the iceberg metaphor that closed the previous section, the visible tip is the concrete fear: “what will happen at the airport with two children and eight suitcases?” But from the psychoanalytic perspective, the psychic energy sustaining that unease does not come from there. What is shown is only a displacement: the true source remains hidden, unnamable. It would be real fear if, once the situation were faced, it disappeared. But anguish persists because it has no clear object: its objects are defensive substitutes, evasions that resolve nothing. That is why, even though my friend knew his “anxiety” was irrational, he still could not sleep—a whole week before the trip.
Panic attacks show this starkly. Clinically, they are still classified in the DSM-5 as an anxiety disorder, but phenomenologically they are something else: a fear that erupts suddenly, without direction, lived as total loss of control. That is why those who suffer them remain afraid of their return: they do not know where it came from or how to prevent it.
Obsessive-compulsive disorder (OCD) also illustrates this well. The DSM-5 removed it from the group of anxiety disorders because it privileged the presence of obsessive thoughts and compulsions as defining traits. But anyone who has seen a true case of OCD recognizes the anxiety that pervades it. When the obsessive is prevented from carrying out a ritual, what invades them is diffuse restlessness: the sense that something catastrophic will happen—catching an illness, everything descending into chaos. First comes the terrifying indeterminacy; the compulsion appears later as an attempt to give it determination. The same happens with phobias: it is preferable to be afraid of airplanes than to confront an indeterminate nothingness.
The psychoanalytic tradition understands these phenomena as mechanisms of displacement and defense. What appears as fear of flying, of dirty hands, or of an unlocked door is, in reality, a way of protecting oneself against a deeper fear: fragmentation, abandonment, madness. This is why exposing someone abruptly to their phobic object can be counterproductive: it may destroy the defense without yet giving words to what was hidden. In this framework, therapy is a slow process, layer by layer, where little by little the unnamable is named. Only then is it possible to face it.
Seen from here, the stories I have gathered—the friend kept awake by the suitcases, the restless child, the woman who takes refuge in sweets, and my own—are indeed experiences of anxiety in the deeper sense: restlessness about something uncertain, unlimited, impossible to determine. That is why we live it as loss of control—and why many mistakenly think the cause is their obsession with control. And it is also why we seek to impose order with rituals, ruminations, or distractions. Anguish eases only when it can be named, when someone listens and gives it the shape of a story.
I have lived it in my own flesh. As I learned to name my trauma—that which by definition resists being named or spoken—to acknowledge my fear and the pain that came with it, anxiety began to lose its grip. Before, without the resources to name it, any trivial image that evoked it would drag me immediately into avoidance. Only when I was able to put words into the midst of the disorder did anxiety begin to transform, giving way to another emotional tone—different, yet more bearable.
From this perspective, I cannot help but suspect that my friend’s child who “cannot stay still” is, deep down, hurting; that the woman who turns to sweets cannot fully grasp what unsettles her. Trauma is a fracture that radically evades. When it cannot be named, it generates defenses that become symptoms: compulsions, ruminations, distraction, addictions. It is even plausible to hypothesize that certain conditions—like attention deficit disorder—can be understood, at least in part, as defenses against that fracture: ways of avoiding the unnamable, of escaping the pain that cannot be put into words.
An anxious age
Anxiety and its displacements are not only clinical phenomena. They also operate in everyday life. Every time we, unable to stand three minutes of waiting in solitude, reach for our phones and open Instagram, we do the same as the compulsive hand-washer: we avoid staying with what emerges from within us, with that indeterminate ground that frightens us.
Our contemporary condition contributes to this. The constant bombardment of superficial information deprives us of the resources to know ourselves in depth. The field of the unnamable expands, and with it, anxiety. The cultural response has been more control: schedules, productivity apps, predictive algorithms, artificial intelligence that organizes life. But the more we try to control everything, the more we feel something slipping away.
How, then, to deal with anxiety? Here I propose two possible paths. One is that of cognitive-behavioral psychology: to face fear little by little, until discovering that what we imagined was not so threatening. The other is that of the psychoanalytic and psychodynamic traditions: to pause before our restlessness and seek what it conceals. This means naming what happens to us, not in a merely descriptive sense—“I’m afraid of flying”—but in a more radical sense: looking under the rug, honestly, at the torrent of our inner world. Naming here means daring to follow the thread of an image, letting it lead us somewhere else, as in dreams. It means attending to the subtle shifts in our modes of being, even to what seems insignificant, until what was hidden begins to take shape in words.
Put differently, cognitive-behavioral psychology invites us to know outwardly: to identify fear and face it little by little, until we discover it was less threatening than imagined. Psychoanalysis and psychodynamic thought, on the other hand, point inward: pausing before our unease, seeking what it conceals, putting it into words.
And these are not the only ones. Neuroscience focuses on physiology and prescribes drugs that regulate neurotransmitters. Mindfulness proposes training attention to remain in the present. On the cultural plane, some have even spoken of the “retirement of God”: the loss of a transcendent horizon that once gave meaning and calm. Each approach illuminates something, but none exhausts the experience.
These pages do not offer a final answer. They are only a pre-understanding, the first steps in an inquiry that, for me, will be long and arduous. An initial attempt to articulate what anxiety-anguish reveals about ourselves and about our time.
