The Four Components of Anxiety

anxietyCognitive behvioural therapy (CBT), sometimes called cogntive therapy, is a type of thereapy that focuses on how various factors within us and our environment interact with each other to to produce and maintain many issues that people struggle with such as anxiety and depression.

In CBT/cognitive therapy, we recgonize that, in addition to your environment, there are generally four components that act together to create and maintain anxiety: the physiological, the cognitive, the behavioural, and the emotional. These are described below.


The physiological component of anxiety involves physical symptoms and sensations such as:

  • Increased heart rate; shortness of breath; tightness in chest
  • Dizziness; weakness or tingling in your legs; feeling like you’re going to faint
  • Muscle tension; tension in the face and head; headaches
  • Lump in the throat
  • Nausea or other discomfort in the stomach
  • Feeling hot; sweating; sweaty palms; blushing


The cognitive component of anxiety involves thoughts and worries that often take the form of “What if …?” questions. These “What ifs” can be related to the anxiety-provoking situation:

  • What if I fail?
  • What if I embarrass myself?
  • What if something bad happens to me or my partner/spouse/child?
  • What if I don’t fit in and nobody like me?
  • What if I have a panic attack?

The “What ifs” can also be related to the the physiological symptoms you’re experiencing:

  • What if I have a heart attack?
  • What if I pass out?
  • What if I need medical attention?
  • What if I don’t fit in and nobody like me?


upward spiralThe behavioural component of anxiety can involve reduced performance due to the anxiety. If you’re focused on your worries or physiological symptoms, you might find yourself distracted, and so concerned with what’s going on in your mind and your body that you feel removed from the outside world. As a result, things that would be simple if it weren’t for your anxiety—such as a work-related task, or socializing—become much more difficult to perform.

Another behavioural feature of anxiety is avoidance. Avoiding what you’re anxious about usually makes the anxiety subside in the short-term. If you’re anxious about socializing, or flying, or public speaking, or leaving the house, then by avoiding those situations leads you can avoid feeling anxious for the time being. However, avoidance winds up severely restricting what you can do and negatively affecting your day-to-day life. And when you do try to—or are forced to—face one of those situations, the anxiety returns stronger than ever.


The emotional component of anxiety consists of emotions typically associated with anxiety such as fear, dread, panic. Anxiety can also lead to other emotions such as frustration, anger, disappointment, sadness and depression.

The interaction between these elements is explained in more detail in the video below. To learn how to manage anxiety better, please check out my free Self-Help Course for Anxiety.

One of the reasons that overcoming anxiety can be so difficult is that anxiety generates vicious cycles involving these four components. Once you get stuck in these vicious cycles, they can be hard to break. Cognitive behavioural therapy (CBT) and cogntive therapy are one of the most effective ways to get you unstuck. In the next couple of posts, we’ll look at the vicious cycle of anxiety, and how we can break this cycle.

Guelph Therapist Greg Dorter

I’m a Guelph therapist specializing in counselling and therapy for depression, anxiety and low self-esteem. For more information about how I can help you overcome anxiety, or to make an appointment for cognitive therapy/cognitive behaviour therapy (CBT) for anxiety, please call me at 226-500-4086 or email

3 thoughts on “The Four Components of Anxiety

  1. I am a functional trainer and my job involves public speaking, direct customer communication and delivering training to senior personnel in the organization. Although I feel confident of my skills and ability to communicate clearly, I’m always under a lot of stress and am anxious about my performance in front of a group of people; whether the faces are familiar or new to me. I believe that sometimes when I am able to take control of my emotions and my behavior, the cognitive and psychological factors make me anxious and stressed. I’ll constantly have to work upon in dealing with all these factors simultaneously.

  2. Fantastic blog you have here but I was wondering if you knsw of any
    fforums that cover the same toppics talked about in thios article?
    I’d really like to be a pawrt of online community where I can get responses from other knowledgeable individuals that share the
    sawme interest. If you have any recommendations, please let me know.