Think You Have Anxiety? There May Be Something Else Going On

By Sarah Rodgers, LMFT, RDT, SEP

Many of the clients I work with come in describing some version of the same thing: they're anxious, they're hard on themselves, they feel something is off in their relationships. They've often tried therapy before. They're working on their communication, their reactions, their patterns. What they haven't usually considered is that their needs might actually be fine. That what feels like a personal failing might be a completely logical response to a relationship that taught them their needs were wrong.

Sometimes "anxiety" is exactly what it is. But sometimes, when we slow down and look at what that actually means in someone's day-to-day life, a more specific picture emerges: they spend a lot of energy monitoring other people's feelings. They're hard on themselves in ways they'd never be hard on a friend. They doubt themselves chronically, their reactions, their perceptions, their needs. They find it genuinely difficult to believe their needs are reasonable, or that their emotions aren't somehow excessive or wrong.

That's a particular kind of experience. And it often has a particular kind of origin.

When your needs feel like the problem

One of the things I notice most often with clients navigating this territory is that they don't usually come in saying "I think I was harmed by an important relationship." They come in saying "I'm anxious" or "I have trouble communicating" or "I don't know why I keep ending up in the same situations." They have a nagging feeling that they must be doing something wrong.

What often takes time to be open to is that their needs might actually be fine. That what feels like a personal failing, a character flaw, an anxiety disorder, might be a completely logical response to a relationship that taught them their needs were wrong, dramatic, or too much.

I'm talking about relationships with narcissistic parents, or partners, or both. And often both, because the patterns we learn early tend to show up again in who we choose later, and what relational treatment we accept.

Narcissistic relationships have a particular shape. There's usually one person whose feelings, needs, and perceptions are treated as the organizing principle of the relationship, and one person who learns, slowly and thoroughly, to organize around them instead. To anticipate. To manage. To minimize their own needs before anyone else can object to them. To take the blame when things go wrong, because in this relationship, that's how things go.

If you grew up in that dynamic, you didn't learn "my needs are sometimes inconvenient." You learned "my needs are the problem." And that's a very different thing to carry into adulthood.

The slow work of piecing it together

In my experience, it often takes some time for people to be open to this framing. And that makes complete sense, because accepting it requires a significant shift in how you understand your own story.

It means considering that a person you loved, or still love, was or is doing things that aren’t okay. Not just with you specifically, not because you are particularly difficult or worthless, but in general. That the way you were treated isn’t a reflection of your value. That the critical voice in your head isn't your own wisdom. That you aren't, in fact, the problem in the story you've been telling yourself.

That can be a lot to take in.

But there are moments to witness along the way that are genuinely moving. Like the moment someone gets angry on their own behalf, really angry, for maybe the first time. It's a sign that something is shifting: that they're starting to locate the problem outside themselves, where it actually belongs. That they're starting to trust their own perceptions a little more.

From there, something starts to open up. People become more willing to have needs, to risk wanting something, asserting something, taking up room in a relationship without immediately bracing for the consequences. They start to notice what it feels like to be treated well, and they find the contrast newly jarring. They start to take care of a part of themselves that never got proper care, and to grieve, sometimes, that it took this long.

It's a sticky process. It can feel two steps forward, one step back. But people start to feel better about themselves. More free. Less organized around everyone else's feelings and more in contact with their own. Less anxious, in the real sense, not because the anxiety was treated directly, but because the thing underneath it is finally being addressed.

What actually helps

Talk therapy is part of this, an important part. Feeling genuinely seen and understood, having your perceptions validated, building a narrative that makes sense of your experience: all of that matters, especially for people who've spent years having their reality questioned.

And also, because so much of this patterning lives in the body, in the nervous system's learned responses, in the felt sense of "my needs are wrong" that no amount of rational reassurance quite touches, I find that body-based and experiential approaches often reach places that conversation alone doesn't. Somatic work, parts work, experiential approaches like imagery or empty chair work: these can help people access and shift the felt experience, not just the understanding of it.

The goal isn't to arrive at some transformed, fearless version of yourself. It's more like: your needs stop feeling like such a liability. The critical voice loses some of its authority. You have more room to be yourself, to want things, to set limits, to exist in your relationships without perpetually managing everyone else's experience of you.

That's the work. It's not fast, and it's not linear. But it's some of the most meaningful work I do.

A note on terms

In this post I am referring to people whose behavior may be described as narcissistic or emotionally immature. I know, I know, everyone is “a narcissist” these days. It’s a word that is overused and can be weaponized. For the record, no, I do not think everyone is a narcissist and the answer to our problems is not always that someone else is a jerk. But I do see narcissistic behaviors often go unrecognized. There are covert forms of narcissism that can be very hard to spot! While not everyone who engages in narcissistic patterns is a diagnosable, pathological narcissist, the word narcissistic does describe particular ways of treating others and moving through the world. If you don’t like the term, maybe consider psychologist Lindsay Gibson’s work on Emotionally Immature people, which also speaks to problematic relational patterns and their impact while allowing you to find additional descriptors. Whatever the language, there are particular, identifiable patterns in relationships that do impact the individual on the receiving end, especially if the behaviors belong to a very close or important person in life.

If any of this resonates, or if you've been carrying a vague sense that something is off without quite being able to name it, I'd love to talk. I work with adults in East Nashville and virtually throughout Tennessee and Ohio. Schedule a consultation here.