From anxiety to flow

Private Psychiatry is pleased to once again feature an article by Alex Monk, a psychotherapist based in London. Alex specialises in combining talking therapies with expressive arts such as drawing, sculpture, movement and music to treat mental health problems.

‘Out of what door do I go, where and to whom?’ From anxiety to flow.

Anxiety can manifest in many different ways and there are a wide range of reasons to feel anxious if we think about it. Yet anxiety is essentially a survival mechanism and it is experienced by everyone to some degree as we are biologically programmed to do so in order to survive. When it alerts us to danger anxiety therefore is perhaps a rational response to an irrational world. Moreover, anxiety is often about inner conflict, where opposing thoughts collide as we ruminate and try to find ‘solutions’ and ‘answers’ to ‘get rid’ of anxiety. Theodore Roethke captured this feeling of dread and helplessness in his poem ‘The Lost Son’:

‘Tell me:
Which is the way I take;
Out of what door do I go,
Where and to whom?’

Anxiety ranges from an optimal level where we feel alert yet are still in control (perhaps before a job interview or an important meeting) to an unpleasant nagging, through to engulfing panic attacks with overwhelming bodily responses as the sympathetic autonomic nervous system is activated. The resulting symptoms include increased heart rate and sweaty palms, with elevated production of the stress hormone, cortisol. When we are in the throes of acute anxiety, the right part of our brains floods the thinking, analytical left-brain with a stream of fragmented images and sensations, which render us in the kind of freeze state which Roethke so evocatively captures. This is why we want to get out of that ‘door’ as soon as possible.

However, it is perhaps the ‘to whom do I go’ in the stanza which is more relevant here, as it may allude both to the anxiety that separation from loved ones leads to, and to our inner wisdom that the best antidote to this is within the company of someone with whom we feel safe, learned in the days before we knew any words at all.  In this feeling of safety we release the hormone oxytocin, which is what soothes the distress.

When we are in a panic state, ‘time’, as David Bowie put it, ‘will crawl’, an agonizing state of stasis. However, when we are with those we love, or in a situation we enjoy or are immersed in, time seems to pass so much more quickly. This phenomenon of ‘time flying when we are having fun’ has been associated with the quickening release of the hormone dopamine. The psychologist Csikszentmihalyi called this experience ‘flow’, when we are ‘in the moment’ or we ‘forget ourselves.’

This ‘flow’ state can be activated in myriad ways spent alone, or with others. These include swimming, walking in nature, laughing with friends, in devotional or religious practice, or laying in a field watching the clouds pass in the sky.

The arts can also be a path to ‘flow’, for as we engage more with the world of the right brain and we are not thinking so much, it becomes less alien and scary to us. This includes creating art, getting lost in a painting at a gallery, making music or listening to some, dancing, or watching people dance. Don’t forget play too: by watching a child playing we can remember how lost in the moment we can be when we play and thinking takes a back seat.


Bowie, David. David Bowie Time Will Crawl. 1987. Audio Recording.

Csikszentmihalyi, M. (1990) Flow. New York: Harper and Row.

Panksepp, J. and Biven, L. (2012) The archaeology of mind. New York: W.W Norton.

Roethke, Theodore. The Lost Son. 1st ed. 2017. Print.


We use cookies, just to track visits to our website, we store no personal details. ACCEPT COOKIES What are cookies?