02/26/2026
One of the most common frustrations I hear from clinicians and highly educated clients is: “I understand my anxiety… so why is it still here?”
That question contains a hidden assumption: that understanding should lead to resolution. That if you can name your anxiety, trace its origins, and articulate its function, it should release its grip.
This is not the case.
Insight is cognitive. It lives in language, narrative, and meaning-making.
Anxiety, however, often operates at a completely different level — within the nervous system, in relational patterns, and in the space between what you know, and what you’ve experienced.
While insight is necessary, it is not enough to change what is rooted in the nervous system and/or been shaped by trauma.
So what comes next?
Sometimes what comes next is somatic work. Sometimes it’s relational. Sometimes it’s behavioral — doing the thing you’ve been understanding your way around. And sometimes, the most honest clinical move is helping someone learn to carry what persists rather than trying to eliminate it.
Trauma-informed approaches target a different level than talk alone, and can aid in acceptance rather than removal of our anxiety. One modality I practice, EMDR, works at a different level than talk therapy alone. It targets how experiences are stored and accessed, rather than simply how they are understood.
For many, this opens a path toward integration and acceptance of anxiety - rather than removal.
Acceptance is a legitimate pathway.
Anxiety, however, often operates at a completely different level — within the nervous system, in relational patterns, and in the space between what you know and what you’ve experienced. It has done its work, and something else is required.
I’m curious: what has shifted your thinking about the relationship
between insight and change?
