In Gestalt psychotherapy, anxiety can be understood through the concept of arousal and the way the organism regulates or interferes with contact with the external environment. In every living organism, needs continuously arise. Our body and nervous system become mobilized and enter a state of increased arousal, preparing us for contact with the environment and for action. This arousal is a healthy and essential process for survival, directly connected to our self-regulation and our ability to respond creatively to what is happening in the present (Perls, Hefferline & Goodman, 1951).
However, when this mobilization cannot proceed toward expression, contact, or completion, arousal remains in motion and is not discharged in a full cycle of completion. In such cases, it is experienced as anxiety, internal tension, or diffuse worry. From this perspective, anxiety can be seen as the result of an imbalance between an organism’s needs and desires and the actions required to satisfy them.
Often, in the absence of physical or relational action, the tension shifts to the cognitive level. Persistent thoughts and overanalysis of scenarios occur without the accompanying necessary action. One could say that the more action is restricted, the stronger the overthinking process becomes. Thought functions as a form of imaginary discharge and compensation, which, however, does not lead to real satisfaction or fulfillment of the need, since it does not happen in reality.
For Rollo May (1950), anxiety arises when something essential to a person’s existence is threatened and the individual cannot mobilize creatively in response to this threat. Irvin Yalom (1980) also describes anxiety as an integral part of the human condition, linked to fundamental existential issues such as freedom, responsibility, isolation, and meaning. When we distance ourselves from our authentic experience and real needs, anxiety intensifies and often manifests as diffuse worry or physical tension.
Modern neurobiology similarly describes anxiety as prolonged activation of the autonomic nervous system (the system responsible for alertness and mobilization of the organism) without adequate regulation and return to a calm state. When the organism remains on high alert for a prolonged period, physical and psychological symptoms of anxiety appear, such as tension, worry, difficulty concentrating, and sleep or eating disturbances.
When basic needs such as rest, safety, setting boundaries, or emotional closeness are continually ignored, the mobilization of energy associated with them does not disappear. Instead, it becomes blocked and transforms into physical or mental tension, often manifested as anxiety. Anxiety, therefore, can be seen not as a sign that “something is wrong,” but as an indication that something essential within us requires attention.
The more we learn to pause, observe our bodies, and ask ourselves, “What do I need right now?” the more contact with our needs is restored, and internal tension is reduced. Through this process, anxiety ceases to be an enemy to be fought and becomes a marker for reconnection with ourselves and our authentic existence.
Breathing is one of the first bodily functions affected under stress or anxiety. During intense anxiety, it often becomes rapid, shallow, irregular, or even interrupted unconsciously. These changes are not random but part of the body’s physiological response to perceived threat. When we focus our attention on the breath and allow it to slow down, especially through slower diaphragmatic breaths, we send an immediate safety signal to the nervous system. Thus, breathing becomes not just a relaxation technique, but a way to reconnect with the body and the present moment.
Within psychotherapy, the transition toward emotional regulation, supported by the therapeutic relationship, is often noticeable through a simple bodily sign: the breath spontaneously begins to deepen and becomes slower. Without conscious effort, the body feels sufficient safety to shift from arousal toward regulation. This change does not emerge from rational understanding but from the lived experience of safety created within the therapeutic relationship.
Stanford neurobiology professor Andrew Huberman recommends the fastest way to relax the body: How to quickly lower stress
References:
Perls, F., Hefferline, R., & Goodman, P. (1951). Gestalt Therapy: Excitement and Growth in the Human Personality.
May, R. (1950). The Meaning of Anxiety.
Yalom, I. (1980). Existential Psychotherapy.
Porges, S. (2011). The Polyvagal Theory.
Van der Kolk, B. (2014). The Body Keeps the Score.
