When Anxiety Lives in the Body: A Somatic Perspective for High-Achieving Women
For many high-achieving women, anxiety doesn’t always begin as a thought.
It often begins as a sensation — quiet, persistent, easy to overlook.
A jaw that stays slightly clenched, even during rest.
Shoulders that never fully drop.
Breathing that remains shallow, as if the body is waiting for something to happen.
A low-grade sense of urgency that lingers beneath even ordinary moments — answering emails, driving, sitting in meetings, lying in bed.
From the outside, life may look stable. Productive. Even successful.
But internally, the body can feel as though it is moving at a different pace — faster, tighter, more alert.
Many people describe this as feeling “on” all the time.
Not panicked.
Not visibly overwhelmed.
Just unable to fully settle.
This kind of anxiety often lives beneath conscious awareness. It doesn’t always announce itself through racing thoughts or obvious worry. Instead, it shows up physiologically — through muscle bracing, constricted breath, restless sleep, or difficulty relaxing even in safe environments.
Because these sensations can feel familiar — sometimes present for years — they’re easy to normalize or dismiss as personality, work ethic, or ambition.
But over time, the body keeps the score of this sustained activation.
From a somatic therapy perspective, anxiety is not only a cognitive or emotional experience.
It is a nervous system state — one that lives in the body as much as, and sometimes more than, in the mind.
In my clinical work as a licensed psychologist in California, this pattern shows up often.
How High Achievement Masks Physiological Anxiety
And in many professional and high-performing environments, the very qualities that are rewarded externally can mirror states of internal activation.
Being prepared.
Staying mentally sharp.
Anticipating needs before they arise.
Double-checking details others might miss.
From the outside, these behaviors signal competence and reliability. They’re often reinforced through promotions, praise, and increased responsibility.
But inside the body, they can be fueled by something else entirely: vigilance.
Many of my clients describe running on what feels like activation energy — a kind of internal propulsion driven less by inspiration and more by the nervous system’s inability to fully power down.
This can look like:
Over-preparing for routine conversations or meetings
Rehearsing interactions mentally before they happen
Staying hyper-aware of others’ reactions
Difficulty relaxing after work is complete
A persistent sense that something important might be missed
Over time, productivity can begin to mask physiological anxiety.
The body stays mobilized, even when there is no immediate threat. Muscles remain slightly braced. Attention stays narrowed. The nervous system continues scanning, organizing, and preparing.
Importantly, external stability doesn’t automatically translate into internal regulation.
Someone can feel accomplished, secure, and capable — and still carry a body that is operating from chronic activation.
From a somatic perspective, functioning well is not the same as feeling settled.
The body can stay activated even when life looks stable.
Repetition like this teaches the nervous system that vigilance is the baseline.
The Vigilance Cycle: How Anxiety Gets Stored
From a somatic perspective, anxiety often follows a predictable physiological loop — one that develops gradually through repetition rather than appearing all at once.
It typically begins with some form of perceived threat.
This threat isn’t always dramatic or dangerous. It can be subtle — an email from a supervisor, tension in a meeting, a social interaction that feels uncertain, an unexpected change in plans.
Even anticipation alone can be enough.
When the nervous system detects potential threat, it mobilizes automatically.
Heart rate increases.
Breath becomes shallower.
Muscles brace in preparation.
Attention narrows toward what feels important or risky.
This is the body’s fight-or-flight response — an adaptive survival mechanism designed to help us respond quickly when needed.
In acute situations, this activation rises and then resolves once safety is restored.
But when activation happens frequently — especially in environments that require sustained performance, vigilance, or emotional monitoring — the body doesn’t always complete that settling cycle.
Instead, the activation can linger.
Muscles stay slightly contracted.
Breathing patterns remain constricted.
Sleep becomes less restorative.
The nervous system stays oriented toward anticipation rather than recovery.
Over time, this repeated loop begins to condition the body.
Trigger → Activation → Partial settling → Re-triggering
The nervous system learns through experience. The more often it rehearses vigilance, the more efficiently it can return to it.
Eventually, anxiety no longer requires a clear external trigger.
The body begins to maintain readiness as a baseline posture — organizing around protection rather than ease.
This is how anxiety becomes stored physiologically.
Not as a single event, but as a learned pattern of activation that lives in muscle memory, breath patterns, and autonomic nervous system conditioning.
From the outside, someone may appear calm, capable, and composed.
But internally, their nervous system may still be cycling through vigilance — preparing, scanning, and bracing, even in moments that are objectively safe.
Understanding this cycle is often the first step in shifting it.
Because when anxiety is recognized as a conditioned nervous system response — rather than simply a thinking problem — it opens the door to body-based approaches that work directly with the physiology of regulation.
Where Anxiety Lives in the Body
If anxiety is a nervous system state, it makes sense that it shows up physically.
Many people think of anxiety as something that lives in the mind — in thoughts, worries, or rumination. But physiologically, anxiety is a full-body experience. It involves muscles, breath, digestion, sleep, posture, and attention.
Over time, sustained activation doesn’t just feel emotional. It becomes structural.
Muscle System: Subtle Bracing
One of the most common places anxiety lives is in the muscular system.
The body prepares for threat through contraction. Shoulders lift slightly. The jaw tightens. The pelvic floor braces. The neck and upper back hold tension as if ready to respond quickly.
For some, this bracing is obvious — headaches, TMJ discomfort, chronic tightness.
For others, it is quieter. A constant low-level contraction that only becomes noticeable when they attempt to relax and realize how much effort “rest” requires.
Muscle bracing is not a flaw. It is a protective response.
But when it becomes continuous, the body rarely experiences true ease.
Breath Patterns: Constricted or Interrupted
Anxiety often alters breathing long before someone notices feeling anxious.
Common patterns include:
Shallow chest breathing
Subtle breath holding while concentrating
Exhales that are shorter than inhales
A feeling of never quite getting a full breath
Because the nervous system and breath are closely linked, constricted breathing reinforces activation. The body interprets limited airflow as urgency.
Over time, this can create a feedback loop: shallow breath sustains vigilance, and vigilance sustains shallow breath.
Many high-functioning women are surprised to discover how rarely their breath drops fully into the diaphragm during the day.
Digestive System: Holding and Hyperarousal
The digestive system is highly sensitive to nervous system activation.
When the body mobilizes for threat, digestion slows. Blood flow shifts toward muscles. Energy is directed toward action rather than restoration.
This can show up as:
Stomach tightness
Nausea during stress
Appetite changes
IBS-like symptoms
A feeling of “knots” in the abdomen
Even subtle, chronic activation can create ongoing digestive discomfort.
Because these symptoms are often normalized — especially in high-stress professional environments — they may not immediately be recognized as anxiety-related.
Sleep and Restoration: Wired but Tired
Perhaps one of the clearest signs that anxiety lives in the body is difficulty settling into restorative sleep.
Some people fall asleep easily but wake in the middle of the night with a surge of alertness.
Others struggle to power down at all, despite physical exhaustion.
The nervous system, oriented toward vigilance, has difficulty fully shifting into recovery mode.
This can lead to a paradoxical state: feeling deeply tired but internally wired.
And when sleep is disrupted, regulation becomes even more difficult the next day — reinforcing the activation cycle described earlier.
From a somatic perspective, anxiety is not simply a cluster of thoughts. It is a patterned physiological state that touches multiple systems at once.
Recognizing where anxiety lives in your own body is not about diagnosing yourself.
It is about noticing.
Because awareness of these physical patterns is often the first step toward shifting them.
Why Insight Alone Doesn’t Resolve It
For many high-achieving women, anxiety is not a lack of insight.
They understand their patterns.
They can name their stressors.
They may even recognize when their thoughts are exaggerated or unlikely.
And yet, their body remains activated.
This can be confusing — even frustrating.
If anxiety were purely cognitive, then reassurance, logic, or positive reframing would reliably settle it. But when anxiety is rooted in nervous system conditioning, understanding the story is only part of the process.
The body does not calm simply because it has been convinced.
It calms when it experiences safety.
From a physiological perspective, regulation is experiential. The nervous system shifts through repeated moments of lived settling — breath deepening, muscles softening, attention widening, heart rate stabilizing.
This is why someone can “know” they are safe in a meeting and still feel their jaw tighten.
Why they can logically understand that an email is neutral and still feel their stomach drop.
Why reassurance may provide temporary relief, but activation returns later.
Cognitive insight and nervous system regulation are related — but they are not identical.
One lives primarily in the prefrontal cortex, in language and meaning-making.
The other lives in autonomic patterns — in muscle tone, breath rhythms, and conditioned physiological responses.
The nervous system settles through experience, not explanation.
This does not mean insight is useless. Insight can reduce shame. It can increase choice. It can create space between trigger and reaction.
But when anxiety has become embodied — stored in posture, breath, and muscle memory — resolution requires working at the level where the pattern lives— often through structured anxiety treatment that supports both cognitive and physiological regulation..
Understanding the mechanism is empowering.
Experiencing regulation is transformative.
How Somatic Therapy Begins to Shift the Cycle
When anxiety lives in the body, healing must involve the body as well.
Somatic therapy does not begin by trying to eliminate anxiety or force calm. Instead, it starts by helping the nervous system experience moments of settling — often in small, gradual ways.
This may begin simply with noticing.
Noticing when the breath deepens slightly without effort.
Noticing when the shoulders drop a fraction of an inch.
Noticing when the body recognizes, even briefly, that it is safe enough to soften.
These moments can feel subtle, but physiologically they are significant. Each experience of settling sends new information to the nervous system: activation is not the only available state.
Rather than pushing for rapid emotional release or catharsis, somatic therapy builds capacity. It helps the body learn that it can move between activation and regulation without becoming stuck in vigilance.
This work often includes:
Tracking physical sensations in real time
Practicing grounding and orienting responses
Building awareness of activation before overwhelm
Developing resources that support nervous system safety
Working within a window of tolerance that prevents retraumatization
Over time, these experiences begin to interrupt the vigilance cycle described earlier.
Trigger → Activation → Regulation → Recovery
Instead of remaining mobilized, the nervous system learns how to complete the stress response and return to baseline more efficiently.
This is not about forcing the body to relax.
It is about teaching the body, through repeated lived experience, that settling is possible — and safe.
What Somatic Therapy Looks Like in Practice
Many people are surprised to discover that somatic therapy is slower than traditional talk therapy.
Sessions are not focused solely on analyzing thoughts or solving problems. Instead, they create space to notice how experiences live in the body — through breath, posture, sensation, and nervous system responses.
At times, we may pause mid-conversation to track what is happening physiologically.
You might notice your chest tightening while discussing a work situation.
You might observe your breath becoming shallow when talking about family stress.
You might feel your body settle when recalling a supportive relationship.
These real-time observations become entry points for change.
Rather than pushing past activation, we slow down enough to work with it directly.
Somatic therapy may include:
Grounding practices that bring awareness back to the present moment
Breathwork that supports regulation rather than performance
Orienting exercises that signal safety to the nervous system
Resourcing techniques that build internal steadiness
Mindfulness practices that strengthen body awareness
In my practice, this work is often integrated with brain–body approaches such as Brainspotting, which allows us to access and process activation held beneath conscious awareness.
Clients frequently describe this integrative approach as different from insight-only therapy.
They are not just understanding their anxiety.
They are feeling shifts in how their body holds it.
Over time, therapy becomes less about managing anxiety cognitively and more about developing a nervous system that can respond flexibly to stress — activating when needed and settling when the moment has passed.
A Different Relationship With Anxiety Is Possible
You don’t have to wait until anxiety becomes overwhelming to begin listening to your body.
Many high-achieving women seek somatic therapy not because they are falling apart, but because they are tired of holding themselves together through constant activation.
They are ready for a way of living that includes steadiness — not just productivity.
This work is not about becoming perfectly calm or endlessly regulated.
It is about building a different relationship with your nervous system.
One that allows for:
Recovery after stress instead of constant endurance
Awareness of limits before burnout
Access to rest without guilt
A sense of internal safety that is not dependent on performance
Over time, many clients notice that they are no longer living at the same physiological pace.
Their breath is fuller.
Their body softens more easily.
Their reactions feel less automatic.
Their capacity for presence expands.
Anxiety may still arise — it is part of being human.
But it no longer organizes the body’s baseline state.
If this way of understanding anxiety resonates, you can learn more about my approach to mind–body therapy on my Somatic Therapy page, explore anxiety-focused support through Anxiety Therapy, or read more about my work supporting high-achieving Black women.
You’re also welcome to request a free 15-minute consultation — a gentle space to ask questions and explore whether this work feels aligned for you.
Healing does not begin with forcing change.
It begins with learning how to listen to what your body has been holding — and discovering that it does not have to hold it alone.