Supporting a Client with Anxiety Through Polyvagal Theory and a Humanistic Approach

Introduction

Supporting a client experiencing anxiety requires more than simply helping them reduce anxious thoughts. Anxiety can affect the way a person experiences their body, relationships, environment, and sense of self. Two approaches that can offer a compassionate framework for understanding and supporting anxiety are polyvagal theory and the humanistic approach. While these approaches come from different theoretical traditions, they can complement one another by combining an understanding of nervous-system responses, using psychoeducation to convey it, with an emphasis on empathy, acceptance, autonomy, and the therapeutic relationship.

Polyvagal theory proposes that the autonomic nervous system continually evaluates cues of safety and threat and influences physiological and behavioural responses. A humanistic approach, influenced by thinkers such as Carl Rogers, emphasises the importance of empathy, congruence, unconditional positive regard, and the client's capacity for growth. Together, these perspectives can help the practitioner understand anxiety not as something that needs to be immediately eliminated, but as an experience that can be approached with curiosity, compassion, and respect.

I have worked with many clients using this combination to reduce symptoms of anxiety and start returning to feeling freer and less restricted again, through therapy in my Keighley office in BD20, online and through outdoor therapy in Bingley and Silsden.

Understanding Anxiety Through Polyvagal Theory

From a polyvagal perspective, anxiety can be understood partly in terms of autonomic nervous-system activation. When a person perceives threat, whether that threat is external or internally experienced, their nervous system may move into a state associated with mobilisation. This can involve increased heart rate, muscle tension, rapid breathing, heightened alertness, and a strong urge to act or escape.

For a client experiencing anxiety, these physical sensations can themselves become frightening. For example, a racing heart may be interpreted as evidence that something is seriously wrong, which can increase fear and further intensify physiological arousal. Helping clients develop an understanding of this cycle may allow them to view their bodily responses with less fear and shame.

Polyvagal theory also places considerable emphasis on cues of safety and social connection. In therapy, the practitioner's tone of voice, facial expression, pace, posture, and general manner can therefore contribute to the client's experience of safety. A calm and accepting therapeutic environment may help a client feel sufficiently secure to explore difficult emotions and experiences.

It is important, however, to present polyvagal theory carefully. Some of its specific biological claims remain debated within the scientific literature, so it is best used as a therapeutic framework or lens rather than as an established explanation for every aspect of anxiety.

The Humanistic Approach

The humanistic approach offers a complementary perspective by focusing on the client's subjective experience. Rather than positioning the therapist as an expert who diagnoses and fixes the client's anxiety, the humanistic practitioner seeks to understand the client's world from their perspective.

Carl Rogers identified three core conditions that are particularly relevant: empathy, congruence, and unconditional positive regard. Empathy involves attempting to understand the client's feelings and experiences without imposing the therapist's interpretation. Congruence refers to the therapist being genuine and authentic within the therapeutic relationship. Unconditional positive regard involves accepting the client as a person without judging or rejecting them because of their difficulties.

These principles can be particularly valuable when working with anxiety. Clients may already judge themselves harshly, believing that they "should" be able to control their fear or that their anxiety makes them weak. A humanistic therapist can provide an alternative experience in which anxiety is acknowledged without the client being defined by it.

For example, rather than saying, "You need to stop thinking about this," a therapist might respond, "It sounds as though your mind is working very hard to keep you safe, even though that is becoming exhausting." Such a response validates the client's experience while creating space for curiosity and self-understanding.

Creating a Sense of Safety in Therapy

The therapeutic relationship can be central to integrating these approaches. From a humanistic perspective, the relationship provides acceptance.

I offer therapy for anxiety, panic, stress, fear, overwhelm, including when these are heightened by medical issues including menopause and perimenopause, or by neurodiversity including ADHD and autism. Therapy in Keighley, Bingley and Silsden.