Anxiety and Relationships: Building Supportive Connections

Anxiety and Relationships: Building Supportive Connections

Striking at the very heart of building and maintaining a healthy ‘romantic’ relationship is the negative effect of anxiety on our ability to communicate, trust, and build meaningful interpersonal connections. This article aims to inspire partners of anxiety-sufferers with a brief summary of ‘tips’ to counteract the corrosive nature of anxiety, regardless of the type, root causes, severity, pattern and history of the condition as it is co-experienced on a day-to-day basis.

The Research

Firstly, neurobiological research has confirmed that the answer to the question that every anxiety sufferer in a relationship has asked themselves-

Is my anxiety affecting my relationship, or is my relationship affecting my anxiety?

-is an unequivocal ‘probably both’.

Advanced neuro-imaging and, lately, ‘omics’ research showing that there is substantial overlap between the brain regions, neurotransmitters, hormones and other neural, endocrine, and genetic mechanisms regulating ‘romance’ and those related to the manifestation of anxiety, reiterates this paradox.

For example, the amygdala, pre-frontal cortex, and anterior insula which are involved in anxiety processing, decision making, and interoception (self-awareness) respectively, are also involved in the processing of interpersonal information including social cues in romantic relationships.

Additionally, the amygdala and hippocampus regulate the emotional components of memory which further affects the interpersonal behaviour patterns often observed to be characteristic of particular relationship dynamics e.g. research has shown that both 1. individuals with anxiety disorders may have a heightened sensitivity to rejection, which can lead to increased feelings of anxiety in romantic relationships, and 2. individuals who experience romantic rejection may experience a similar level of distress to individuals with anxiety disorders.

If further reinforcement is needed, ponder the brain-imaging research finding that a painful physical injury ‘lights up’ the same ‘higher’ brain centres as an emotionally painful relationship breakup.

The good news, is that research also suggests that individuals who experience romantic love may experience a decrease in general level of anxiety. For example, individuals who reported higher levels of romantic love showed a decrease in cortisol, a stress hormone, in response to stress compared to those who reported lower levels of romantic love.

Communication in healthy relationships

Regarded as the apex predictor of healthy relationships generally, relationship quality modelling has identified these top 5 communication attributes, in descending order of importance:

  • Expressiveness- spontaneous affection and unconditional support.
  • Responsiveness- one’s availability to receive and ability to reflect back their partner’s expressions and reciprocally share their own emotions in providing comfort and protection.
  • Feedback- clarifying or confirming individual interpretations of, or intuitions around, dyadic (coupled) communications.
  • Attentiveness- consistent monitoring of another’s physical, mental, and emotional states as they relate to the other’s needs.
  • Meta-communicativeness- (communicating about communicating)- re-focussing or stop/pause/rewind actions eg behaviours to moderate/de-escalate communications which are exacerbating anxiety.

Tips for building and maintaining supportive relationships that can help manage anxiety

  • Be prepared: do some research into anxiety in general, and any diagnoses that might have been disclosed to you. Become aware of the thought-distorting effects of anxiety including jumping to conclusions quickly, magnifying/minimising, catastrophising, and black and white thinking (all or nothing, better than/less than).
  • Ease into a conversation to reduce anticipatory anxiety: choose the right time and place, and open gently with the type of conversation you wish to have and your hopes as to what can be achieved, whether that be simply ‘touching base’, asking for clarification or emotional/practical support, or delving into painful memories.
  • Be open & honest about your feelings in a non-judgemental but assertive style; “speak in the I” is one of the two ‘rules’ used by group Gestalt psychotherapists (the other is “only one I can speak at a time“). One effective assertive communication template is :

When you….(state the behaviour)…, I feel…(state the feeling/s)…, therefore….(set boundaries in a non-threatening way).

  • Listen actively: focus on feeling the emotion in yourself before thinking about the content.
  • Try to balance overall communication valence (positive/negative) by offering as many affirmations (praise, compliments) as you have participated in confrontations.
  • Be patient: effective communication is an iterative (step-wise, repeating) process that may require breaks (an anxiety sufferer will most likely have an already narrow window of tolerance).
  • Avoid taking on the role of expert, carer or therapist in ‘doing what’s best’ for your partner without consulting them. In particular don’t try to ‘fix’ them or explain why they ‘shouldn’t’ be afraid of something.
  • Use humour (as opposed to witty sarcasm) and playfulness where possible and appropriate.
  • Reiterate the positive aspects or strengths of the relationship as a counter-balance to confrontative conversations.
  • Be open to feedback, and aware of your own cognitive distortions (we all make them to some degree at times).
  • Practice self-care: a supportive role begins with self-support: eating and sleeping well, exercise, socialising with peers, and ‘me time’ are important considerations.

When to seek help

All relationships face difficulties, and most are resolved over time. However, when problems become a pattern, and seem unable to be solved, it is important to seek professional help from someone experienced in working with relationship issues.

Signs that anxiety is keeping a couple ‘stuck’ include:

  • Enmeshment/confluence: when a partner is anxious, they respond to their anxiety by collapsing or giving up easily. In effect they attempt to merge with or hide behind the other person in order to mitigate some of their anxiety. This can result in underlying tension, anger, and martyr behaviour.
  • Self esteem issues: when a partner feels anxious about a particular wish or desire and does not feel entitled to self-fulfilment, they may describe their anxiety as a joint problem. This makes it hard to know what part of the anxiety sits with the person who is raising an issue versus what part if any might belong to the other partner. A skewing or biasing of how couples assess risk vs benefit can inhibit relationship growth.
  • Stifled choices: when one partner tiptoes around the other’s anxiety, the resulting pattern of automatic submission for secondary gain (short-term conflict avoidance) causes a long-term reduction in choice availability and healthy risk-taking behaviour.
  • Passive-aggressive behaviour: when an anxious partner becomes increasingly passive and takes little responsibility for managing their anxiety, the other partner may compensate by over-functioning. This often starts as a loving gesture, but as it continues merely builds resentment. Both partners lose the ability to know when a legitimate threat exists and when anxiety can be endured, leading to relationship paralysis.

The psychologist’s role

Ideally, both partners agree to seek assistance, however psychologists are equipped to provide individual counselling around relationship-related issues if one partner is reluctant or unwilling to participate at first.

A registered and experienced psychologist is able to form a clinical picture of anxiety, incorporating an assessment of many factors including attachment type (eg insecure, anxious), history of trauma and other adverse life experiences, genetic or behavioural traits, co-morbidities including substance/behaviour disorders, chronic pain, physical or intellectual disabilities/disorders, and ‘organic’ behavioural disorders.

Based on their assessments, a psychologist may utilise a variety of treatment approaches including cognitive behavioural couple therapy (CBCT), short-term dynamic psychotherapy, schema therapy, emotion-focused couple therapy (EFCT), and eye movement desensitisation and reprocessing (couple protocol) therapy (EMDR).

For those seeking ‘proprietary’ therapeutic approaches (eg Gottman Relationship Therapy), information regarding a psychologist’s training/accreditation should be sought prior to commencing therapy.

If you think you may benefit from couples counselling, please contact us for more information.


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