Empathy, Trust, and Respect: Supporting People Who Experience Anxiety

About the Author

Greg Austin is the founder of Inclusive Fitness, which provides one-on-one and small group strength and conditioning training to neurodivergent people and their families in a custom-designed center, day-program sites, and online to promote strength, confidence, and independence.

I’m not an expert on anxiety. I don’t personally experience persistent anxiety. Like every human being, I feel anxious from time to time, sometimes intensely. But that’s not comparable to what many people experience on a regular or even ongoing basis.

So, why am I writing about anxiety? Well, I do live with someone who experiences anxiety a lot of the time. My teenage son is autistic, has ADHD, and is often very anxious. I also have the opportunity to work and engage with many autistic and other neurodivergent athletes at Inclusive Fitness, the business I helped found to offer consistent, high-quality strength and conditioning training for neurodivergent people and their families. Many of our athletes experience anxiety, in some cases very intensely and persistently. In fact, anxiety for autistic people is often significantly heightened relative to neurotypical people. (This article provides an overview of the connection between autism and anxiety and references recent research.)

Like my son, our athletes have helped me grow in many ways, including understanding – albeit abstractly – their lived experiences, perceptions, ideas and ways of navigating the world and living a full life with anxiety. I have learned as a father and as a professional working with neurodivergent individuals that having a thorough understanding of anxiety is imperative to effective engagement.

Understanding Anxiety

A lot of research has been done to try to uncover the roots of anxiety, and many models have been proposed to help people think about anxiety in a broader, more integrated context. A relatively recent article posits four underlying factors for anxiety among autistic people, which I am reframing as areas of focus rather than deficits:

1. How one processes and responds to external stimuli
2. How one identifies, describes and manages internal emotional states
3. How flexible one is in thinking about the world around them
4. How one tolerates and manages uncertainty
   

I think the points they are making have validity and value. These four factors almost certainly play a critical role in determining the type, intensity and duration of anxiety that any person experiences. However, I would add a fifth point, which is one’s self-perception of their role in the world and within relationships with others.

Considering these points are crucial, and in our work we have used them to develop ten factors, which I believe makes a big difference in supporting neurodivergent people who experience anxiety. Whether in a fitness setting, an educational environment, a domestic living situation, a recreational opportunity, or any other situation, these factors can provide a thoughtful and practical framework for supporting any person where anxiety is an issue.

Relationship-Building

1. Context: Why are we entering into and working to sustain and grow the relationship? What are the drivers that are moving us together? What are our respective goals, are they aligned, and do we have a mutually agreed-to plan to achieve them?
   
2. Empathy: What steps can we take to try to understand the person and where they come from? How do they perceive themselves and their place in the world? What is important to them? And how can we use this information to shape our mindset and approach to creating a more productive experience and outcome for them?
   
3. Respect: What can we proactively do to ensure we see the whole person and not just “the diagnosis” or “the challenge,” presume competence in their desire and ability to excel, and stay focused on their needs and goals versus pursuing our own agendas?
   
4. Roles: What can we do to establish clear and mutually respectful roles with each other, that consider each person’s self-perceptions? How do we build trust over time, so that ideally we become partners in achieving success together?
   

These first four factors are, I think, the very foundation of any fruitful, enjoyable and lasting relationship. At its most basic level, this is about building and sustaining deep trust. Getting this right sets the stage for the remaining six factors that follow:

Reducing Anxiety

5. Anticipation: How do we communicate in advance what to expect, help someone create their own set of personal expectations, and reduce uncertainty?
   
6. Alignment: How can we best ensure that what is experienced in reality is consistent with what is anticipated, so that there is as little uncertainty as possible?
   
7. Environment: How can we create a space and experience that reduces distractions, provides a sense of calm, conveys respect, and creates the conditions for mutual engagement and learning?
   
8. Communication: What supports, tools and approaches to sharing information and expressing needs, preferences and ideas can we put in place to give everyone the opportunity to be heard?
   
9. Control: In what ways can we provide options and choice – to the extent that someone wants, can tolerate or needs them – so they have a high degree of ownership over what they do and experience when working with us?
   
10. Follow-through: What processes can we put in place to communicate progress, challenges, ideas and changes so that we are regularly reminded of context and remain aligned over time?
    

The research into the effectiveness of exercise and other forms of physical activity in helping reduce and manage anxiety is both vast and compelling. Exercise helps us all feel more relaxed, “comfortable in our skin,” and generally less anxious. But before someone can benefit from the anxiety-reducing benefits of exercise, it’s crucial that they be able to engage in exercise in the first place by addressing the most pressing anxiety-producing issues they may face.

Many of our athletes have never exercised before. They often don’t know what to expect, and that by itself can produce a lot of anxiety. We go through these ten categories of questions before we ever start working with an athlete as well as throughout our time together to lower barriers by seeing the whole person, striving to understand how they see themselves and their relationship with others – including us – building a relationship of trust based on their needs, taking steps to reduce ambiguity, and establishing confidence in the experience and results. When we do that, then we can raise the bar – by challenging our athletes to challenge themselves and achieve great things together.

This takes time, but we’ve seen it work over and over. While the process may be slow, the outcomes are long-lasting and the journey is incredibly rewarding.