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By Chana Mark L.C.S.W.

In discussing the various manifestations of anxiety I will be making frequent references to the unconscious mind. My education and training in this field requires that I be knowledgeable about the workings of the unconscious mind, but it must be emphasized that there are many approaches to treating anxiety in addition to deep psychotherapy. It is beyond the scope of this article to discuss treatment approaches, but I do want the reader to keep in mind that there are other ways of understanding anxiety.

What Is Anxiety?

Fear and anxiety are two related phenomena, but are different from each other and they express themselves differently in the body. Fear is our reaction to an immediate threat, real or perceived. Our body may prepare for fight or flight. Anxiety is our anticipation of some future threat. We may become more vigilant, or more cautious and avoidant. What follows are some of the more common forms of anxiety.

Separation Anxiety

We first see separation anxiety in babies towards the second half of the first year. It is at this time that a baby has enough experience of mother to begin to realize that she is separate from and that she could go away. The baby does not have words to express this to himself, but like all of Hashem’s creatures he has an inborn instinct for survival. He knows that he would be helpless without her. He has not yet developed the capacity to realize that when she goes away, she also comes back. Older children learn this over time.

Unfortunately, there are some children who do not resolve their separation anxiety even when they get older.

What The Child Feels

Older children who feel anxiety when they are away from their home or their mother feel like babies. They feel “less than” the other children and ashamed, especially in front of their classmates or bunkmates. In camp, they may feel sad that they can’t have fun and be free like everyone else.

What the Parents Feel

All healthy parents want to see their offspring move on with life, have friends and do well in school. Obviously, these require the child to be out of the house much of the time. When doing what he has to do makes him feel anxious, parents feel great conflict. On one hand, they know it is not healthy to allow the child to stay home. On the other hand, it feels cruel to send them out, knowing that they will be suffering. This can cause friction between husband and wife too.

Father: Look, you can’t keep indulging her. She needs to tough it out. She’ll get used to it.

Mother: No, that won’t work. I tried that, and it just made the problem worse.


A phobia is an intense fear of an object or situation which is out of proportion to reality. Some examples:

Agoraphobia is the fear of open spaces. If a person finds himself in an open field he may feel panicky and lost. If she can’t find her car in a big parking lot, she may start to feel disoriented  and frightened. Some people suffering from agoraphobia cannot go to a large department store or a mall – it is too big and open.

Claustrophobia is the fear of enclosed spaces. There are people who will not use an elevator. When the doors close they feel trapped and anxious. Or, a child that becomes  panicky when he has to pull his shirt over his head. There are people that feel anxious when they have to wait in their car during a traffic jam. Knowing that they can’t move when they want to makes them feel trapped.

Phobias usually originate in childhood, and are often (but not always) the result of a  frightening psychological experience which was unconsciously represented by a “real-life” situation. The person with the phobia is “acting out” or “communicating” the pain of this psychological situation which was never resolved in childhood, so it pushes its way forward and expresses itself in the present in a disguised way.

How Do They Feel About It?

People with phobias may realize with one part of their minds that their fears are irrational. They are often sad when their phobia prevents them from performing normal or enjoyable activities. They feel restricted and sometimes, ashamed or “stupid”.

Obsessive-Compulsive Disorder (OCD)

OCD starts with intrusive and unwanted thoughts, images or urges. In some cases these are consciously experienced, in other cases, not. The individual feels compelled to relieve the anxiety caused by these obsessive thoughts by engaging in specific behaviors which are intended to “neutralize” the unwanted thoughts. These compulsive acts cannot realistically relieve the pressure of these thoughts or urges, no matter how excessively they are performed.

How Do They Feel About It?

OCD causes great suffering. For the person trapped in this anxiety and these behaviors, the feeling of “having to” perform them makes them feel that there is something very wrong with them. As they watch themselves do them over and over again, the excessiveness makes them feel trapped and miserable. People suffering from OCD are often acutely fearful that others perceive them as “not normal”.


There is help for all of these. The sooner the suffering person gets help, the more optimistic we can be that treatment will result in a positive outcome.

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