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When will this be over? When will it be safe to see my parents? My children? When can I travel again? How can I know for sure that I am safe in a restaurant? That my loved ones are safe? That my mask is good enough? Could the mutations undermine the vaccines? What else will happen that we can’t even predict? I want to know those answers for sure!
We often tell our patients that “surrendering the struggle” is one of the most helpful ways to deal with the discomfort of uncertainty. And very often we get the response, “Whoa!? Oh No! Are you telling me that I just have to surrender to having to constantly find ways to reassure myself? That I will never be free of checking? That I can’t do anything about it? That I just have to accept that I’m going to suffer from the anxiety and worry forever?”
And we answer, “Of course not!”
Therapeutic Surrender is a way to train your brain to work against the elements that are keeping you trapped in constant worry and rumination. It is an attitude that allows you to counter the distortions of anxious thinking, to starve your worry of the energy generated by paradoxical effort, and to extinguish the effects of negative reinforcement. It is a way to stop the process of compulsive reassurance-seeking and ruminating around things we cannot know or solve.
Therapeutic Surrender is an effective way to contact your own good common sense. The end result will be a lessening of your suffering as your brain and body learn to be more comfortable with not knowing for sure.
The attitude of therapeutic surrender is not a technique for controlling or reducing anxiety itself. Efforts to control, eliminate, avoid or suppress anxiety tend to backfire, as we have discussed in previous posts, and as you probably already have found out by trying various “anxiety management techniques."
Nor is Therapeutic Surrender just giving into your anxiety. It is not surrendering to the need for reassurance, and it certainly isn’t taking seriously your internal anxious dialogue. It is also not a technique for banishing doubts.
It is learning how to practice an essential attitude shift. It is not hopelessness or giving up: it is ending the miserable struggle. It involves understanding that we simply cannot know the answers to all our pandemic questions, that all we have are best guesses and uncertainties, and that we can manage while not knowing for sure.
Therapeutic Surrender is most effective not when used to reduce anxiety, but rather as a way to be while you experience it. The relief comes by changing your relationship with doubt and uncertainty, not by making you feel more sure. In these times---with so many uncertainties---it is normal to be aware of things to have doubts about.
Therapeutic Surrender requires that you make a distinction between what you reject and what you allow. It means rejecting the option to end your discomfort with another dose of reassurance or some form of avoidance based on feelings instead of facts. But it also means surrendering to the feelings of anxiety, distress, guilt, and frustration that come about when you forego reassurance and avoidance.
It entails actively allowing the feelings and thoughts while rejecting and refusing to do what the feelings and thoughts are telling you to do to get rid of them. It means acknowledging that the anxious bullies in your mind are there, but not letting those bullies rule your actions.
And not continuing to believe---or even hope---that doubts about how this pandemic will unfold for you---or for the world---can be allayed with just one more fact or expert or analysis. It can be distilled to a short mnemonic: DEAF. Distinguish distress from real danger right now. Embrace uncertainty. Avoid avoidance. Float and let time pass.
When Therapeutic Surrender is well learned and has become your automatic response to an anxious urge to seek unproductive reassurance, here is what happens: The urges no longer matter. They can’t derail you. They come and go. They happen less often. They fade away.
This means that Therapeutic Surrender is not something that will immediately give you relief. In fact, you will probably experience additional discomfort for a while. Successful Therapeutic Surrender means denying yourself the short-lived comfort that comes from “just one more check, one more spray of disinfectant, or that extra handwashing,” or, “I will feel better if I just do this ...”
In the moment, some kinds of unproductive reassurance are so easy and automatic that they are really hard to resist. It just takes a moment to send a text, only a glance to try to judge someone else’s mood, a split second to reread what you have just read, or another dab of sanitizer when a doubt pops up. Choosing instead to focus on the nature of your discomfort without judgment, learning to wait and let time pass, and staying with your feelings of uncertainty are not easy tasks.
But this is an attitude anyone can learn with practice. It is also an opportunity for you to focus on long-term goals and values instead of short-term relief. While you are doing nothing whatever about your doubts or worries, you can pursue whatever is next to do, whether it is petting your dog, making lunch, having a conversation on Zoom, getting out of bed, or seeking employment.
There is room for both Therapeutic Surrender and a manageable life with less struggle. Even in these uncertain times.
