When Anxiety Lives in the Body: A Therapeutic Coaching Guide to Feeling Safer From the Inside Out
Over the past few newsletters, we’ve been exploring the different ways anxiety can show up in our lives.
We’ve looked at situational anxiety, where particular circumstances, environments or experiences can trigger our internal alarm system, and relational anxiety, which can emerge in our connections with others through fears around rejection, conflict, abandonment, approval or feeling emotionally unsafe.
This time, we’re turning our attention to another important expression of anxiety: physical anxiety.
Because anxiety does not always begin with a thought we can identify.
Sometimes, the body speaks first.
Your chest feels tight. Your heart races. Your stomach twists. Your jaw clenches. Your breathing becomes shallow. Your muscles tense, or you feel a restless surge of energy without immediately knowing why.
And then the mind notices.
Why do I feel like this? Is something wrong? What if this gets worse?
Suddenly, you are not only experiencing anxiety. You are becoming anxious about the sensations of anxiety themselves.
A therapeutic coaching approach invites us to respond differently.
Instead of asking:
“How do I make this feeling disappear?”
We begin with:
“What is my body trying to tell me, and what might help me feel a little safer right now?”
That shift can change the way we relate to physical anxiety.
Your Body Is Not the Enemy
Physical anxiety is often the nervous system doing what it was designed to do: protect you.
When the brain detects possible danger, uncertainty, conflict or vulnerability, the body can mobilise quickly. Your heart rate may increase, muscles tighten, breathing change and attention become more focused on anything that might represent a threat.
The challenge is that the nervous system does not only respond to obvious physical danger.
It can also respond to emotional pressure, uncertainty, difficult conversations, feeling judged, exhaustion, overstimulation, memories or simply carrying too much for too long.
Sometimes the trigger is subtle.
Your body may simply be saying:
“Something does not feel safe enough right now.”
The aim is not to fight your nervous system.
It is to help it recognise when the danger it is anticipating is not the same as what is happening in the present moment.
When the Body Itself Influences Anxiety
Physical anxiety can also be influenced by what is happening inside the body.
Hormonal changes, poor sleep, illness, caffeine, exhaustion, medication changes and thyroid problems can all affect how activated we feel. Anxiety may also become more noticeable at certain points in the menstrual cycle, during pregnancy or after birth, and through perimenopause or menopause.
The aim is not to analyse every sensation or assume there must be a medical explanation.
Instead, stay curious.
Ask:
“Is there anything happening physically that might be making my nervous system more sensitive right now?”
And if symptoms are new, persistent, severe or significantly different from what you normally experience, it is sensible to speak with an appropriate healthcare professional.
The Physical Anxiety Loop
One reason physical anxiety can become so intense is that the sensations themselves can create a feedback loop.
Imagine your heart starts beating faster.
You notice it.
Why is my heart racing?
Your attention sharpens.
Your body interprets that increased alarm as further evidence that something may be wrong.
The heart beats faster.
Now the mind thinks:
Something really is wrong.
The cycle continues:
Sensation → interpretation → fear → stronger sensation → stronger interpretation.
Breaking that loop does not always mean getting rid of the first sensation.
Often, it means changing what happens next.
Instead of:
My heart is racing. Something terrible is happening.
Try:
My heart is racing. My nervous system is activated. This is uncomfortable, but I can stay with myself while it settles.
You are not pretending the sensation feels pleasant.
You are simply trying not to add another layer of threat to it.
When Physical Anxiety Shows Up: Notice, Name, Regulate, Respond
Rather than reaching for lots of different techniques, it can help to have one simple framework you can remember.
1. Notice
Start by observing what is happening without immediately trying to change it.
What is happening in my body right now?
Perhaps there is:
• tightness in the chest
• butterflies or nausea
• tension in the shoulders
• a clenched jaw
• restlessness
• heat
• shakiness
• a racing heart
Try to notice the sensation rather than immediately judging it.
2. Name
Give yourself a simple explanation for what is happening.
Try:
“My nervous system is activated. This feels uncomfortable, but I don’t need to treat it as an emergency.”
Naming the experience can help create a little distance between the sensation and the story your mind may be building around it.
3. Regulate
Give your body one simple signal of safety.
You do not need to do everything.
You might:
feel your feet on the floor,
let your exhale become a little slower,
look around the room and notice what is actually around you,
stretch,
take a short walk,
drink some water,
or step outside.
Choose the action that feels most supportive in that moment.
The aim is not to force yourself to become perfectly calm.
It is simply to help your nervous system move a little closer towards safety.
4. Respond
Finally ask:
“What would help me feel 5% safer right now?”
Not completely calm.
Not fixed.
Just a little more supported.
Perhaps you need:
rest,
food,
movement,
reassurance,
less stimulation,
a boundary,
some space,
connection with another person,
or permission to pause.
This question moves you away from “How do I stop this?” and towards “How do I support myself through this?”
That is an important therapeutic shift.
Aim for 5% Safer, Not Perfectly Calm
We can accidentally make anxiety harder by demanding that it disappear.
Am I calm yet?
Why can I still feel it?
Why isn’t this working?
Now we are monitoring ourselves constantly, which can keep the nervous system alert.
Instead, lower the bar.
Ask:
“What could make this moment feel 5% safer?”
A glass of water.
A quieter room.
A few minutes outside.
Eating something.
Putting your phone down.
Changing position.
Speaking kindly to yourself.
Postponing something that does not need to happen immediately.
Five percent may sound small, but regulation often happens through small, repeated experiences of safety.
You do not need to move instantly from anxiety to peace.
Sometimes progress is simply moving from overwhelmed to slightly less overwhelmed.
Listen for the Message Beneath the Sensation
Once the intensity has reduced a little, you can become curious about what might be underneath it.
Ask:
“What might my nervous system be anticipating?”
Perhaps rejection.
Conflict.
Failure.
Being judged.
Losing control.
Disappointing someone.
Or perhaps the answer is simply:
“Too much.”
Too much responsibility.
Too little rest.
Too many decisions.
Too much uncertainty.
Too much emotional labour.
Physical anxiety is not always evidence that something bad is about to happen.
Sometimes it is a sign that your internal capacity has been stretched.
So instead of asking:
How do I become better at tolerating even more?
Try asking:
“What needs to become lighter?”
Learn Your Early Warning Signs
Physical anxiety is often easier to respond to when you recognise it early.
Your first sign may not be a racing heart.
It might be that you start rushing.
Your jaw tightens.
Your breathing becomes shallow.
Your shoulders rise.
You stop feeling hungry.
You scroll compulsively.
You become irritable.
You mentally rehearse conversations.
You struggle to sit still.
Try asking at the end of the day:
“What did my body do today when I felt under pressure?”
Over time, patterns become easier to recognise.
And when you recognise the pattern earlier, you have more choice about how you respond.
Your Body Needs Experiences, Not Just Explanations
You can understand anxiety intellectually and still feel it physically.
Knowing why you are anxious does not automatically switch the nervous system off.
The body learns through experience.
Every time anxiety rises and you stay present rather than panicking about the sensation, you create a new experience.
Every time you rest before reaching exhaustion, you create a new experience.
Every time you set a boundary rather than overriding yourself, you create a new experience.
Every time you feel discomfort and discover that it passes, you create a new experience.
This is how trust begins to develop.
Your body gradually learns:
“I can feel discomfort and still be safe.”
“I can experience uncertainty without abandoning myself.”
“I can have anxiety without anxiety making every decision for me.”
A Simple Practice for This Week
When you notice physical anxiety, remember four words:
Notice. Name. Regulate. Respond.
Notice: What is happening in my body?
Name: My nervous system is activated; I do not have to treat this sensation as danger.
Regulate: What is one thing I can do to help my body settle?
Respond: What would help me feel 5% safer right now?
You do not have to perform the process perfectly.
The practice is simply about developing a different relationship with your body.
One based less on fear and more on curiosity, support and self-trust.
A Final Thought
Physical anxiety can feel incredibly convincing because the sensations are real.
But a real sensation does not always mean there is immediate danger.
Sometimes your nervous system needs rest.
Sometimes it needs nourishment.
Sometimes movement.
Sometimes reassurance.
Sometimes a boundary.
Sometimes medical support.
And sometimes it simply needs time.
The goal is not to become someone who never feels anxious.
The goal is to become increasingly able to notice anxiety without immediately becoming frightened by it.
Perhaps the most useful question is not:
“How do I stop feeling this?”
But:
“How can I support myself while this feeling moves through me?”
That is where regulation begins.
As we continue exploring the different faces of anxiety, it is worth remembering that they often overlap. Situational, relational and physical anxiety can influence one another, and recognising how anxiety tends to show up for you can create more choice in how you respond.
In our next newsletter, we’ll be looking at emotional anxiety — what happens when feelings themselves begin to feel overwhelming, difficult to tolerate or unsafe, and how we can develop a healthier relationship with our emotional world.
Important: Physical symptoms associated with anxiety can overlap with symptoms of medical conditions. New, severe, persistent or unexplained symptoms—particularly chest pain, fainting, severe breathing difficulty or other concerning changes—should be assessed by an appropriate healthcare professional. Therapeutic coaching can support emotional awareness, coping and behavioural change, but it is not a substitute for medical or mental-health treatment when this is needed.
When Anxiety Lives in the Body
