If you deal with overwhelming anxiety, you know it can affect your entire being. Your mind may be filled with fear and visions of future disasters. Your body will tense as your fight, flight, or freeze system kicks in. And you may feel spiritually depleted as the internal battle saps your energy.
Anxiety is a many-headed beast, and so any single technique for managing it probably won’t be enough. It takes a more comprehensive approach that addresses the many facets of our anxious experience. Over the past few decades, countless research studies have confirmed what common sense and ancient wisdom told us long ago: That our well-being depends on the simple practices of minding thoughts, facing fears, and being present.
1. Question the Story
Anxiety is always making predictions, and we often mistake them for reality. Anxiety says, for example, “You’re going to fail,” and we take that statement as a fact. But anxious predictions aren’t facts any more than weather forecasts are weather.
If you start to pay closer attention to what your mind is up to, you’ll discover that it’s a reliable source of fake news. It has a strong Things-Won’t-Work-Out-for-You bias that comes through in every headline:
- You’re going to be late.
- Everyone will be disappointed.
- You have a disease.
- Your loved ones are in danger.
- This will turn out badly.
When we recognize anxious thoughts as stories, we can start to question whether they’re fact or fiction. Is your anxious prediction the only possible outcome? Or are there alternative endings that anxiety has not imagined?
Start Here: What Are the Odds? When you notice you’re worried about something bad happening today, think about how likely that outcome really is. Has it happened many times in the past? Is it the most likely outcome? Are there other things that could happen instead? Most of the time, the things we worry about never end up happening, so the anxiety we experience causes us unnecessary suffering. Redirect your energy instead toward the things around you that are in your control.
2. Face Your Fears
Anxiety compels us to avoid the things we’re afraid of, and yet avoidance only leads to more fear. The more we avoid, the more we reinforce the story that the thing we’re afraid of is actually dangerous. For example, if we avoid certain social interactions because we’re afraid they’ll be awkward, we’ll strengthen our fear of those situations.
Avoidance is also addictive and leads to more avoidance. Each time we avoid something that makes us anxious, we feel a sense of relief, which the brain interprets as a reward. That reward makes it even more likely that we’ll avoid again in the future. In the process, our world shrinks and we miss out on positive experiences (which is why anxiety often leads to depression). You may also start to see yourself as inadequate to face life's challenges.
Nothing conquers anxiety so powerfully as facing what you’re afraid of. When you stop avoiding, you give your brain a chance to learn something new. Most likely you'll discover that your feared disasters don’t come true. What you find instead are manageable problems that you can handle.
Start Here: Stare Down Your Fear. Look for ways you’ve let fear hold you back—at work, in your relationships, or in your free time. Face one of your fears today, choosing something that is somewhat challenging yet manageable. Reach out to someone close to you for support if necessary. Imagine what your life would look like if you pushed through one fear every day.
3. Be Present
Anxiety is based on fantasies about an imagined future. For this reason, focusing on the present can be a powerful antidote to anxiety. When we’re fully in the present moment, anxiety doesn’t exist. How could it? Anxiety requires uncertainty about an unknown outcome, which can only be about the future.
I’ve been reminded countless times how future-oriented fear can hijack our minds. For example, I was walking home from the train after work one evening when suddenly I imagined one of my kids becoming deathly ill. I felt the weight of the scene I pictured, almost as if it were already happening.
And then thankfully something brought me to my senses, and I realized it was complete fantasy. My reality was that I was walking home on a beautiful sunny evening, the birds were singing, and as far as I knew, my kids were healthy (which a few minutes later I learned was true). The grip of sadness and anxiety loosened as I stepped into what was actually happening.
This is not to say that problems never exist in the present. Indeed, life might be seen as a series of problems we must face. And we can handle each of our problems as it arises, in real time, using our experience and abilities.
The patients I’ve treated often confirm the difference between anxiety and real problems. Even when the thing they fear happens, it’s not what anxiety told them it would be; the anticipation was generally worse than the actual experience. For example, someone who was terribly afraid of seasonal illnesses actually did get sick, and found that it was unpleasant but was something she could deal with.
A crucial part of being present is embracing the unknown. When we let go of our anxious preoccupation with the future, we accept that uncertainty is baked into life. We can’t know the end from the beginning, and efforts to do so only degrade our experience.
Being truly present also means opening to our reality rather than resisting it. For example, if our train is running late and we might miss the start of an important meeting, we may tell ourselves our train can’t be late. But it very well can! Rather than fighting internally against our circumstances, we can acknowledge that they are the way they are. That kind of acceptance puts us in a stronger place to choose how we respond.
Start Here: Embrace Uncertainty. It’s uncomfortable not knowing in advance how our lives will go: Will I stay healthy? Will I succeed? Will people love me? Or on a smaller scale, Will I find a parking space? Will I be late? Yet trying to know in advance how things will go often leads to worry and anxiety. Treat today as an opportunity to be open to—even embrace—the fundamental uncertainty built into our existence.
Integrating These Practices
These approaches have been tested most often in the context of cognitive, behavioral, and mindfulness-based therapies. Cognitive therapy gave us cognitive restructuring, a systematic way to identify and challenge the stories we tell ourselves. Behavioral therapy gave us exposure, a structured program for facing our fears. And mindfulness-based therapies offer formal practices in coming more fully into our experience, moment by moment.
Importantly, there are not stand-alone approaches. While they were developed somewhat independently, they’re actually inseparable, and work best when woven together into a powerful three-strand cord—what I call Mindfulness-Centered CBT (“Think Act Be” to keep it simple).
Thoughts affect our actions, like when we think someone won’t like us and so we avoid them. Actions influence thoughts, too, so facing a certain fear can change the way we think about it. And the quality of presence we bring to our experience will greatly influence our thoughts and actions.
As you use these practices in your own life, look for opportunities to integrate them:
- Allow greater awareness and presence to help you recognize the mind’s stories.
- Mindfully open to uncertainty as you face your fears.
- Question your anxious thoughts to help you conquer avoidance.
The practices in this post are adapted from The CBT Deck.
And remember, you don't have to face your fears alone; to find a therapist near you, visit the Psychology Today Therapy Directory.
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Carpenter, J. K., Andrews, L. A., Witcraft, S. M., Powers, M. B., Smits, J. A., & Hofmann, S. G. (2018). Cognitive behavioral therapy for anxiety and related disorders: A meta‐analysis of randomized placebo‐controlled trials. Depression and Anxiety, 35, 502-514.
Gillihan, S. J. (2019). The CBT deck. Eau Claire, WI: PESI Publishing.