COPYRIGHT CITY SANCTUARY THERAPY

No part of this website, including the blog content may be copied, duplicated or reproduced in any manner without the author’s permission.

Any information, materials, and opinions on this blog do not constitute therapy or professional advice. If you need professional help, please contact a qualified mental health practitioner.

Is there such a thing as ‘healthy’ anxiety – a certain amount, or in response to certain factors?

We have a repertoire of feelings- sadness, joy, shame etc- anxiety is one of them. Anxiety is normal; it prepares the mind, and body to deal with danger. Anxiety was our ancestors’ evolutionary tool, which enabled them to stay safe from dangerous predators and survive. Like our ancestors, we are biologically primed to detect danger, and threats, and seek safety. When there is perceived or real danger, there is a natural interaction between our thoughts/cognitions, feelings, physiology, and behaviours, all in preparation for safety. Physiologically, our bodies rapidly produce adrenaline, and cortisol, as well as trigger other physiological changes such as sweaty palms, muscle tension, heart racing, all in response for danger. Simultaneously, the mind gets ready to deal with the danger by catastrophising & considering the worst-case scenarios. All these changes are perfectly normal, and for safety-preparing us to deal with danger. If anxiety is situational, proportionate to the situation, and not overwhelming, it can propel us through difficult situations in life. Anxiety also helps us stay alert, safe, problem solve and execute tasks in a robust and timely manner. For example, if you have an exam coming, anxiety can have a positive impact in motivating you to fiercely prepare for the exam. The physiological changes, and catastrophic thoughts of failing may enhance your enthusiasm to study harder. During the exam, anxiety may increase your focus, and the hypervigilance may enhance your ability pay attention to detail.

How can you tell the difference between ‘normal’ anxiety that’s to be expected, and an anxiety disorder?

The easiest way to conceptualise what is normal anxiety, and what is disordered anxiety is placing anxiety levels on a scale of 0-10. 0-5 is normal and healthy anxiety which can be easily managed, and thrusts us through life, while 6-10 becomes disordered anxiety where the body’s danger alarm system becomes faulty, and cause impairment in functioning. Anxiety only becomes problematic when the normal physiological and behavioural responses to danger are either exaggerated, remain present for longer periods of time, when the responses are persistent (chronic), and when they intensify leaving the subject feeling utterly overwhelmed. Anxiety triggers unpleasant and at times distressing physiological sensations that we want to quicky relieve. In normal anxiety these feelings, and physiological responses naturally pass, or they can be easily managed. Problem anxiety happens when the danger is overestimated, the subjects underestimate their ability to cope and unable to manage the physiological responses and need to take dramatic actions (behaviours) to alleviate these fears. This means that a situation that may be perceived dangerous by someone with anxiety, may not be viewed as dangerous, by someone who doesn’t have anxiety. The mind’s interpretation of events of what is seen as a threat or dangerous, and the ability to cope with what is considered dangerous or threatening determines whether one has an anxiety disorder or not.

Is it helpful to label anxiety in this way?

Apart from generalised anxiety, anxiety can manifest in various forms such as health anxiety/hypochondriasis, obsessive compulsive disorders (OCD), agoraphobia, panic disorder, specific phobias, social anxiety, hypochondriasis, or Post Traumatic Stress Disorder (PTSD). It is helpful to label anxiety because if left untreated, anxiety can worsen over time, leading to functional impairment. This negatively impacts one’s quality of life, and mental health overall. The physiological changes caused by anxiety can cause other secondary health issues such as insomnia, and depression- anxiety is known to co-exist with depression for this reason. Psychosocially, anxiety can have an impact on relationships- for example people with generalised anxiety, social anxiety, OCD, agoraphobia, PTSD may find it difficult to leave their homes, or socialise leading to isolation. This negatively impacts on their self-esteem as well as social inclusion, and lead to poor mental health. It is vital that people have the awareness of what anxiety is and seek treatment in a timely manner.

If you suspect that your anxiety might be a bigger issue, what can you do?

If you suspect you have anxiety, seek help from your GP or a registered/accredited psychotherapist. GPs may consider anti-anxiety medication depending on the nature and severity of the symptoms, and they would also consider therapy adjunct to medication. At times GPs prescribe therapy alone. Cognitive Behavioural Therapy (CBT) is the best form of treatment for anxiety disorders. CBT can be delivered by a qualified therapist; some GP surgeries and other health services deliver CBT online or in groups. CBT helps the subject evaluate the danger- identify and challenge the beliefs they hold about perceived dangerous situations, help them let go of safety behaviours, and learn to self sooth in order to manage the physiological arousal which is most distressing for anxiety sufferers. For example people who have panic attacks can experience nausea, dizziness, increased heart rate, sweaty palms and a feeling of being out of control. The hyperventilation is what exacerbates these symptoms as shallow breathing means the body gets deprived of oxygen and it carries more carbon dioxide. Slow and controlled breathing would help to regulate the body and bring it back to its natural homeostatic state. Psychoeducation is helpful as it enables the subject to learn what anxiety is and understand their body’s arousal system which makes the sensations less disturbing and unsettling. Self-help techniques to manage the body’s arousal and emotionally regulate-breathing exercises, self-talk statements which helps normalise anxiety, take away the danger, and learn from the past experiences are helpful. Mindfulness is also helpful as it allows us to develop objectivity and view our thoughts as a product of our mind not a reality. One can try to use these techniques independently to resolve anxiety symptoms.

Revising parenting in the digital age

By Dr Joyline Gozho

Published 1st September 2025

Parenting can be a challenging experience, which many people approach differently. Some parents adopt a relaxed and permissive approach, others choose to be more authoritarian, while others simply go with the flow. All these parenting styles have their pros and cons, as children are unique and cannot be squeezed into a universal box.

Parenting has changed over the generations due to the emergence of digital technology and social media. The Gen Z (late 1990s- 2010s) and Generation Alpha (born 2010 onwards) were born in a technology culture where their lives are heavily influenced by technology. These paradigm shifts have also changed how we approach parenting and raise children. Creativity and unstructured play, which existed in the pre-digital era, has almost been taken over by digital games on electronic gadgets. Instead of following intuition, some parents rely on online information and social media as a source of information on parenting- for example, weaning, sleep training, potty training, and dealing with tantrums.

Is there such a thing as good or bad parenting?

The challenges of parenting can create complex feelings in some parents, such as guilt, shame, frustration, envy, self-blame, resentment and regret. For example, parents of a child who has challenging behaviour may experience shame, guilt and self-blame. The reality is that no one has the blueprint for parenting the right way. What is vital is that parents adapt to the child’s unique needs, not just environmentally and economically, but emotionally as well.

Psychoanalysis places huge significance on the impact of our childhood experiences in shaping us as adults – personality, sense of self, emotional and psychological health, and relationships with others as adults. In appreciation of parenting challenges, psychoanalyst Donald Winnicott (1953) coined the concept of the “good enough mother”, highlighting what makes wholesome parenting.

Winnicott asserts that a “good enough mother” is one who can meet her child’s needs, adapt to the child’s uniqueness, offer impingements at the right time, allowing the child to develop a sense of self and become aware of the existence of others. Most importantly, the child must tolerate frustration, waiting, and disillusionment. Winnicott considers this to be what enables the child to become independent, resilient, develop gratitude, and develop the ability to tolerate life’s hardships as an adult. The digital age, where information is readily available, leads to children never learning to tolerate frustration and waiting. Instead of exploring for themselves, the internet and social media give them instant gratification and on-demand information.

Importance of natural play and creativity in psychological development

The availability of electronic gadgets, virtual games, and the existence of an alternative virtual world have changed the way children play and socialise. Winnicott (1951; 1971) views play and creativity as essential ingredients in healthy development, which enable the child to reality test and develop a sense of self – true self vs false self. Winnicott views play as the process of discovering the self through the creative experience – learning about oneself and the world through creativity and imagination. Winnicott conceptualised the “transitional space” as a space for play where the child can develop the sense of the inner and outer worlds, as well as distinguish reality from fantasy. Natural and unstructured play enables the child to problem solve, develop critical thinking skills, reflexive thinking, and develop the ability to think multidimensionally. When children are given electronic gadgets with programmed games instead of natural, unstructured and explorative play, their ability to develop these skills may be hampered.

Importance of play in social skills and confidence building

Children learn about themselves and the world through interacting with others. They develop many social competencies through real-life interactions, which can never be replaced by digital or virtual interactions. They also learn complex language skills, vocabulary, develop confidence and self-esteem, learn negotiation skills and self-advocacy, learn about boundaries, social etiquette and other non-verbal communication skills they can only experience through interacting with others in real time. The digital world is also harmful, as some young adults’ sense of self is heavily influenced by influencers on social media – Instagram, Facebook, and TikTok. Eating disorders are on the rise, as are depression and anxiety. This is contributed by the strive to maintain unrealistic beauty standards and lifestyles emulated on social media. This also led to poor self-esteem and low self-worth.

Importance of play in cognitive development

The availability of information on the internet and social media means children no longer use their cognitive faculties as they get readily curated information digitally. Natural play enables exploration, curiosity, problem solving, facilitates memory development, executive function skills, creativity and reasoning. Digital games can be addictive, and excessive use of digital devices can lead to poor concentration, a lowering of attention span, impulsivity, aggression and violent tendencies. Many studies, including Giedd (2012) and Nivins et al (2024), evidence the thinning of the cerebral cortex due to the level of stress digital technology exerts on the brain. We learn through repetition and exploration; new information is encoded in our neuropathways. The addictive nature of digital games can impede the neurological development of the developing brain (Giedd, 2012; Lissak, 2018).

Boundaries and emotional intelligence

The readily available information online and social media also means children never learn to tolerate frustration and resultant complex feelings, which is significant in our personality formation. The instant gratification means children do not learn boundaries as they get whatever they want whenever they want. Freud’s (1923) tripartite model delineated the id, ego and superego – he referred to id needs as instinctually driven by the pleasure principle, which seeks instant gratification, while ego develops through the awareness that “l do not always get what l want”. The availability of information online leaves children with impoverished egos as they never learn to negotiate their needs and deal with absence. This also stops them from developing boundaries and accountability.

Sensory overload and emotional regulation

Nivins et al (2024) and many other researchers have investigated the impact of technology on the developing brain. The sharp increase in the diagnosis of ADHD, autism and other behavioural problems poses a question of whether there are contributory environmental factors. The human body is not primed to cope with the level of stimulation we have in our modern-day world. Our ancestors thrived in jungles where there was neither stimulation nor pollution. The level of stimulation from electronic gadgets has a huge impact on the nervous system, thrusting it into survival mode. When we are constantly in survival mode, the body never learns to regulate itself, and it naturally releases cortisol, the stress hormone, to deal with stress. Children are born naturally curious and ready to explore. Many parents give children gadgets to stop them from seeking attention from them. While this may work in the short term, it may impact their emotional development in the long term. Children learn to regulate themselves initially through co-regulation with their parents; if parents respond to the child’s distress by giving them gadgets, they never learn to regulate themselves.

Parenting tips:

Limit the amount of time children spend on electronic gadgets.
Prioritise real-world interactions – play dates, park walks and the outdoors.
Promote no gadget natural, creative play.
Do not respond to the child’s distress by giving them gadgets; sit with them and try to understand what they are feeling and experiencing – help them name their feelings.
Teach your children about their nervous system – arousal – and teach some simple breathing exercises and grounding exercises.
Avoid buying electronic toys and gadgets as rewards and gifts, as you are simply teaching your children to value them more than they are worth.

References

Giedd, J.N. (2012) The digital revolution and the adolescent brain evolution. Journal of adolescent health, Vol 51 ( 101-105)
Freud, S.(1923) The ego and the id. Standard Edition, 19: 1-66
Lissak, G. (2018) Adverse physiological and psychological effects of screen time on children and adolescence: Literature review and case study. Journal of Environmental Research Vol 164: 149-157
Nivins, S., Sauce, B., Liebherr, M., Judd., Klingberg, T. (2024). Long term impact of digital media on brain development iof digital National Library of medicine,
Winnicott, D.W. (1953). Transitional objects and transitional phenomena: A study of the first not me possessions. International Journal of Psychoanalysis, 24: 89-97
Winnicott, D.W. (1971) Playing and Reality: Tavistock press