“Anxiety is not the enemy—it is the messenger.” Dr. M
This phrase echoes deeply in therapeutic settings. Throughout my work, I’ve found that the children and clients I meet are not always struggling with anxiety in its purest sense. Instead, anxiety often shows up as a symptom—a signal—of something deeper. And when we fail to look beneath the surface, we risk managing symptoms rather than healing wounds.
Increasingly, clinicians, educators, and parents are recognising the benefits of a root cause approach to supporting those suffering from anxiety. Rather than focusing solely on symptom control—deep breathing, avoidance strategies, or distraction techniques—this model encourages us to explore why the anxiety is present in the first place.
Understanding Anxiety as a Response, Not a Disorder
In both adults and children, anxiety can be a physiological and emotional response to unmet needs, unresolved trauma, or chronic stress. The body’s stress system—particularly the amygdala and the hypothalamic-pituitary-adrenal (HPA) axis—becomes sensitised over time, especially in those who’ve experienced adverse events or persistent environmental stress (Van der Kolk, 2014; Siegel, 2020).
Children who grow up in unpredictable, critical, or chaotic environments often become wired for survival. Their nervous systems learn to scan for danger, even in safe spaces. As a result, they may struggle with separation anxiety, excessive worrying, panic responses, or even physical symptoms like stomachaches and headaches. Yet, their anxiety is not the problem—it’s the signal.
Root Cause vs. Surface-Level Support
Traditional behavioural strategies can sometimes fall short when working with anxious individuals. While helpful in moments of crisis, they may mask the underlying reasons the anxiety exists. A root cause approach aims to gently uncover the original source—be it attachment trauma, bullying, bereavement, sensory processing issues, or a past medical scare.
In reflective practice, I’ve seen time and again how children and adults flourish when they feel seen, heard, and safe enough to explore what lies beneath their anxious behaviours. A teenager with social anxiety may have been chronically shamed by a parent; a child with school refusal may have undiagnosed sensory sensitivities or a history of feeling unsafe in school settings. Each behaviour is a clue.
Identifying Triggers and Patterns
A key part of the root cause model involves mapping out triggers—those people, places, thoughts, or sensations that bring on a heightened state of anxiety. In young children, this might be transition times, separation from caregivers, or being in noisy environments. For adults, it could be criticism, perceived failure, or conflict.
Using trauma-informed tools such as trigger mapping or a body scan journal, we can help individuals notice patterns. “When do you feel this way?” “What was happening just before?” “What does it feel like in your body?” Over time, this builds insight—and with insight comes self-compassion.
Trauma, Memory, and the Nervous System
Emerging neuroscience supports the need to go deeper. The work of Bessel van der Kolk (2014) and Peter Levine (2010) illustrates how trauma is not just stored in our minds but in our bodies. This is especially relevant for children who may not have the verbal capacity to articulate what’s wrong. They may act out, withdraw, freeze, or complain of physical ailments.
A root cause approach honours this somatic reality. Instead of asking, “What’s wrong with you?” we ask, “What happened to you?” This small shift opens up a compassionate and curious space. Therapies such as EMDR, somatic experiencing, and child-led play therapy work precisely because they acknowledge trauma at the sensory and emotional levels—not just the cognitive.
Building safety before strategy
We cannot expect anxious children or clients to regulate their emotions until they feel safe. That safety must come not only from the environment but from the therapeutic relationship itself. Bruce Perry (2021) reminds us that connection comes before correction. A dysregulated child cannot learn, reflect, or problem-solve until they feel co-regulated by a calm, attuned adult.
This is where a root cause approach really shines. It’s slower, yes—but intentionally so. It builds a foundation of trust before exploring deeper wounds. It doesn’t pathologise behaviours but sees them as survival strategies. It invites individuals to tell their stories—not just manage their symptoms.
Benefits of Root Cause Work in Practice
From a psychologist’s lens, I have witnessed powerful transformations when clients are given permission to go deeper:
1. A 9-year-old boy with panic attacks at bedtime gradually disclosed memories of a house fire when he was 3.
2. A teenager with health anxiety traced her fears back to witnessing her mother’s medical emergency as a child.
3. An adult client with constant dread realised she had never felt emotionally safe in childhood and had internalised hypervigilance as her norm.
In each case, the anxiety made sense once the root was uncovered. And with that insight came relief—not just temporary calm, but genuine healing.
How Parents and Practitioners Can Support This Approach
For those working with or caring for anxious children, here are some ways to adopt a root cause lens:
1. Be Curious, Not Controlling: Ask open-ended questions.
2. Listen without trying to fix. Notice patterns and emotions behind behaviours.
3. Create Predictability and Choice: Help the child feel safe by establishing routines and allowing autonomy where possible.
4. Normalise Conversations About Feelings: Use tools like emotion charts, books, and storytelling to explore fears and worries.
5. Seek Professional Support When Needed: Trauma-informed therapists, especially those trained in body-based or attachment modalities, can offer deep and effective support.
6. Look Beyond the Label: See anxiety not as a flaw, but as a language—a way the body is trying to protect and speak.
A Deeper Kind of Healing
Anxiety may be loud, persistent, even overwhelming. But it is not senseless. When we shift our focus from controlling anxiety to understanding it, we open the door to lasting change. The root cause approach is not about blame—it’s about clarity, healing, and giving individuals the tools to feel safe in their own skin again.
Whether you’re a practitioner, a teacher, a parent, or simply someone walking alongside another, may we all learn to ask the deeper questions. May we stop silencing the signals, and start listening to what they’re trying to say.
References:
Perry, B. D., & Winfrey, O. (2021). What Happened to You?: Conversations on Trauma, Resilience, and Healing. Flatiron Books.
Van der Kolk, B. (2014). The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma. Penguin.
Levine, P. (2010). In an Unspoken Voice: How the Body Releases Trauma and Restores Goodness. North Atlantic Books.
Siegel, D. J. (2020). The Power of Showing Up. Ballantine Books.
Dr M’s thoughts 