When my Anxiety Speaks to Me, What Does it Sound Like?

Abstract

Anxiety disorders are some of the most commonly diagnosed mental health difficulties in the world. However, no study has examined the phenomenological qualities of anxious thoughts. Literature on mental health difficulties that are frequently comorbid with anxiety disorders have found that people often experience an alien internal voice with which they engage in an internal dialogue. We were interested in whether anxiety disorders also present with an internal dialogue. If so, then it may be important to address the relationship between the two speakers in the anxious dialogue, particularly if the dominant speaker produces the anxiogenic thoughts. This thesis presents two chapters discussing how anxious thoughts may be part of an internal dialogue. The first chapter provides an extensive rationale for why anxiety disorders might present with an internal dialogue based on literature on the internal dialogue in psychosis and eating disorders. The second chapter reports on a study examining whether dispositional anxiety presents with an internal dialogue. In this study, 33 undergraduate students high and low in dispositional anxiety participated in a semi-structured interview about the nature of their anxious thoughts. Verbatim transcriptions were coded for form and content. The resultant findings were inconclusive about whether dispositional anxiety was characterized by an internal dialogue. However, we found that participants across levels of dispositional anxiety frequently experienced their anxious thoughts as dominant, cold, and critical, and that their anxious thoughts were often accompanied by other thoughts that were less dominant, warmer, and less critical. Both the anxious and other thoughts were often internal representations of family members. These characteristics parallel the phenomenological qualities of the internal voices in psychosis and eating disorders, which may suggest that similar phenomena are occurring.