Do you suffer from Anxiety?

The Anxiety Maintaining cycle – Part 1

By James Wilson: Toulouse Therapy

My name is James Wilson and welcome to my new blog for Brawd Health.

I am a qualified and accredited cognitive behavioural therapist with over 10 years experience. I currently have a private practice in France working with the English speaking community.

Each month I will write about an aspect of mental health, shinning a light on how our mind works and offer advice on improving the relationship we have with our emotions.

If you have any questions or areas you would like me to consider please let me know (email

In this, my first blogpost, I will consider one of the key tools I initially use with clients to help them understand how situations evolve, leading to unwanted emotions or unhelpful behaviour. It is called a “maintaining cycle”.

Below is an example of a maintaining cycle focusing on someone struggling with social anxiety, as this is the most common anxiety disorder. In this example the trigger for the anxiety is someone, lets call him “Pete”, thinking about meeting a new group of people in a pub that evening.

(note: if you’re reading this on a phone, turn it sideways for a better view of the image below)



As Pete considers this prospect his cognitions (cognitions are defined as thoughts, images and memories) include “No one will talk to me”, “I will say something stupid” or “If someone asks me a question then I won’t know what to say”.

For Pete this is also accompanied by an image of him being tongue-tied with people pointing and laughing at his muteness. It is this feared outcome that leads to the emotion of anxiety. This happens as emotions are a byproduct of our cognitions, whether conscious or unconscious.

As this horror movie plays out in his mind Pete’s breathing changes and he starts to sweat. Pete’s behaviour is to ruminate on his cognitions (this means playing the negative scenario over in his mind like a record going around on a record player). He considers avoiding going to the pub, but his friend is picking him up soon so he feels forced to go.


When Pete and his friend arrive at the pub (after an unusually quiet car journey) he stands slightly away from the group and says very little throughout the evening, offering only short responses and not asking any questions.

Although he survives the encounter Pete spends the following day carrying out a “post-mortem” on his evening and concludes that, although not catastrophic, the group had definitely taken against him and he doesn’t want to return.

Although his withdrawn behaviour helped Pete control some of his short-term anxiety the consequences for him potentially include missing another opportunity to meet a new group of friends and another opportunity to learn how to mange his social anxiety.

His mood is also reduced and his self-esteem takes another knock.


Next time I will consider some ways in which Pete can help himself…