No-Pills Anxiety Buster, Part 23

By Dr. David H. Rosmarin

Associations between interpersonal relationships and anxiety have yet to be fully explored by psychological science. Perhaps the individualistic ethos of Western culture has precluded a thorough analysis of this subject matter. Nevertheless, the extant literature on attachment suggests robust links between familial relationship quality and symptoms of anxiety over time (e.g., Fenna et al., 2012, Journal of Abnormal Child Psychology), and recent literature has tied attachment anxiety to increased cortisol secretion, suggestive of greater stress (Jaremka et al., Psychological Science). For these and other reasons, recent variants of cognitive-behavioral therapy, such as DBT, include modules to help patients to better manage their interpersonal relationships.

It is therefore not altogether surprising that, according to the Connections Paradigm (the theory that underlies the Connections Program), enhancing our relationships is a key strategy to reducing anxiety, stress, and depression. Here is an introduction to what the paradigm has to say about this matter.

In a nutshell, interpersonal connection can be summed up in one word: Giving! Those who dwell in the world of interpersonal connection, they (1) identify the needs of other people, (2) consider those needs, and, ultimately (3) exert an effort to meet them. In other words, interpersonal connection involves correctly assessing other people’s experiences, gauging what they need, and responding appropriately.

It is important to note, however, that giving does not mean that one should never receive. It further doesn’t mean that all gifts constitute “connection”! According to the Connections Paradigm, there are four ways in which we provide or receive:

– Providing in order to give (e.g., giving flowers to provide hope)

– Receiving in order to give (e.g., accepting ugly flowers graciously)

– Receiving in order to take (e.g., stealing)

– Providing in order to take (e.g., doing favors for others without accepting anything in return, in order that people will be indebted)

This being the case, interpersonal connection is defined as giving such that one is providing or receiving, in order to give to others. The focus is always on the other! If someone lacks something and we provide it, or if they need to provide something and we receive it, we enter the world of interpersonal connection. By contrast, interpersonal disconnection occurs when we act selfishly–without considering the needs of others.

What does this mean in practice? Needless to say, there are myriad ways to give to others and therefore many facets of interpersonal connection. The starting point, however, is noticing others’ needs. Simply observing the (many) needs of others is a step towards connection.

Try the following exercise each day for a week: When in the company of another person, take 30 seconds to observe him or her and ask yourself the following questions: What is this person’s need right now? What do they want, but currently not have? What might be on their mind? What could I do for them right now that could make life easier and better, even in a small way? v

David H. Rosmarin, Ph.D., is an instructor in the Department of Psychiatry at Harvard Medical School and Director of the Center for Anxiety in Manhattan, a clinical-research facility with a focus on the Jewish community. He can be reached at


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