Anxiety disorders constitute the most common psychiatric diagnosis, but our understanding of their underlying neurobiology is still limited. Moreover, unlike many psychiatric symptoms, anxiety has clear ‘adaptive’ analogues. Anxiety evoked when walking through a shadowy park at night, for instance, can prime defensive reactions and promote harm avoidance. One possibility therefore is that the pathological and adaptive states of anxiety share common underlying neurobiology. To this end, I will present studies in humans using a) a model of adaptive anxiety that has been back translated from animal models – threat of unpredictable shock – and b) studies in patients with anxiety disorders. I will first present neuroimaging data implicating coupling between the amygdala and the medial wall of the cingulate and prefrontal cortex in maintaining both adaptive and pathological anxiety. Next, I will present data suggesting that this coupling can be modulated by components of both pharmacological and psychological treatments for anxiety disorders. Finally I will present data from a parallel line of work linking anxiety to increased reliance on Pavlovian inhibitory control of behaviour.