Charting a Course for Better Managing Your Anxiety

Man walking at sunset Arriving at a Fork in the Road: The Start of Your Journey

Robert Frost wrote in his famous poem, The Road Not Taken, “Two roads diverged in a wood, and I—I took the one less traveled by, and that has made all the difference.” Making a decision to do something new and unknown is exactly the professional advice I give to people I see in my private practice who have been diagnosed with anxiety. Such individuals are regularly faced with what often seems like a “no win, feel bad” dilemma involving the need to make decisions to behave in one particular way or another, with little hope for a good outcome due to the enormous amount of doubt they feel when reviewing their choices. Someone who experiences panic may need to choose between driving to the store alone or asking a friend to accompany him or her, just in case a panic attack occurs in the car or while shopping. Individuals who experience a high degree of anxiety are typically “what if” thinkers who behave in a “just in case” manner. It’s not unusual for the people I see to ask questions such as: “I have sudden images of killing my 2-year-old grandson with a sharp object. Do you think I could be a psychopath?” Or, “I’m worried about giving my class presentation next week. What if I faint during my talk?”

What’s pretty clear about these questions is that those with chronic anxiety overestimate the occurrence of negative outcomes, overemphasize the severity of these outcomes, and underestimate their ability to effectively handle challenging outcomes. Such individuals also tend to believe that the troublesome thoughts and emotions they experience are true predictors of future disaster and thus should be assigned significant meaning for the purpose of discovering a mistake-free solution, directed at preventing horrible outcomes from occurring.

This need to discover the perfect solution is similar to Robert Frost’s reference to roads that fork in a wood. When needing to choose between the road that seems “more” or “less” traveled, a person may experience regret, remorse, second guessing, and a deep belief that something irrevocable will be lost no matter what decision is made, which often defaults to choosing the road typically traveled so often in the past. That is, a familiar road, which provides a short-lived sense of “certainty” yet results in feelings of exhaustion and the frequent need to engage in reassurance-seeking behaviors.

Certainty vs. Tolerance: Shifting toward a New Way of Thinking

So, what needs to happen for you to get off the road to certainty and onto a road that brings you closer to better managing your anxiety? My recommendation is to change routes and travel on a road called “tolerance” while also spending more time being curious about your “worry process” and less time questioning what your worrisome thoughts “really” mean.

Remember the person who asked me, “Do you think I could be a psychopath?” Had I responded by directly addressing the content of her worry (e.g., “I see no evidence from your history which would cause me to believe that you are a psychopath”), her follow-up questions may have been: “How can you be so sure? Have you ever worked with psychopaths in the past?” Directly addressing the content of her questions would only encourage her to continue traveling a familiar route, the road toward finding 100% certainty, and believing that in doing so, her anxiety would be eliminated.

Instead,my response was, “What makes that question about possibly being a psychopath so meaningful to you?” When a therapist helps someone with anxiety to shift his or her attention from the content that frightens, and instead to focus on being curious about the trigger that initially sparked his or her worry engine (and the factors that keep it running each day), hope grows—and with hope comes a willingness to take on more acceptable risks directed at acquiring a stronger tolerance level for handling situations involving a high degree of uncertainty. Since 100% certainty rarely exists in our lives, it makes more sense to travel a different road, one that is focused on increasing tolerance levels for uncertainty, as opposed to seeking a greater level of certainty itself.

I offer the following strategies for better managing anxiety.

  1. Stop focusing on the content of your “fear theme” and give more attention to the real trigger for your anxious feelings: All types of anxiety have a specific, fear-related theme. The theme is attempting to hook you into a cycle of anxiety. A person who experiences social anxiety is worried about negative evaluation from others when interacting in social situations. Someone with a diagnosis of panic is worried about suddenly experiencing rapid heart rate, dizziness, a feeling of suffocation, etc., when alone or with others. Information is power, so take the time to educate yourself about what really drives your anxiety. As unique as every person is who presents with anxiety, what they all have in common is an intolerance for situations involving doubt and uncertainty related to their primary “theme” and its associated, feared outcomes.
  2. Agree to learn skills that will help you become more tolerant and accepting of doubt and uncertainty: These skills have to do with learning to “think about how you think” (i.e., questioning yourself), such that you can reshape your thinking patterns to operate on a more reasonable basis. Once you learn to (a) lower your exaggerated predictions regarding your belief that something bad will happen, (b) recalibrate your estimates regarding catastrophic outcomes to a more likely probability, and (c) pump up your levels of self-efficacy, you’ll be halfway home.
  3. Actively seek out as many opportunities as possible that will trigger your strongest fears in order to strengthen new skills and weaken avoidance patterns: The rest of your journey is directed by your willingness to engage in opportunities that will help you practice acquiring a better tolerance level to the feeling of uncertainty, while also providing the evidence you need to truly believe in your new way of thinking. Creative behavioral exposures and response-prevention exercises are key components. Making this a lifestyle choice will bring you even closer to your destination. Warning: This part will not be enjoyable, but remember, just because it feels bad doesn’t mean it’s necessarily bad for you. Ask any athletic trainer about the necessity of mindful muscle burn—it’s a good thing! Make sure to add a healthy dose of acceptance and commitment therapy techniques as well.

So, next time you’re feeling highly anxious, remind yourself that it isn’t the content of your thoughts that is exclusively responsible for your anxiety, but instead the fact you are experiencing a state of uncertainty which, you’ll remember from previous successful journeys, is very different from real threat. Visualize yourself standing in a wooded area, at the intersection of two roads to travel: “certainty” and “tolerance.” Take a moment to remember that you have a new strategy which supports a stronger belief in your ability to take on anxiety and deal with it more effectively.

When you acknowledge and own this shift in thought patterns, you will find yourself in control of a journey heading in a direction that honors your values—and results in a stronger sense of satisfaction and happiness—en route to managing an emotion which has, for too long, been managing you.

© Copyright 2014 GoodTherapy.org. All rights reserved. Permission to publish granted by Barry C. Barmann, PhD, therapist in Incline Village, Nevada

The preceding article was solely written by the author named above. Any views and opinions expressed are not necessarily shared by GoodTherapy.org. Questions or concerns about the preceding article can be directed to the author or posted as a comment below.

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  • Catherine Boyer, MA, LCSW

    October 23rd, 2014 at 6:12 AM

    Helpful article! I love the switch in focus from reassuring the client to exploration and action plan.

    I’d also add that neurofeedback can be extremely helpful in reducing anxiety and panic. Many of my own therapy clients as well as neurofeedback referrals from other therapists do both talk therapy and neurofeedback. They can be very complementary. Therapist feedback is typically along the lines of, “he/she is really using the therapy now.”

  • Chrmen

    October 23rd, 2014 at 10:34 AM

    Its much easier to work with our experiences when we distinguish thoughts and feelings.
    Mindfulness practices(meditation)we notice more clearly the distinctions between thoughts and emotions by paying attention to our physical body and staying present (by breathing)which helps identify some of these emotions which in turn are uncertain feelings until we step back and tag them and turn them into thoughts. This a habit of a lifetime and takes time for change to happen but change does happen. To get rid of Anixities is impossible but learning to identify and developing a different type of relationship with it can help you deal with it by steping back and saying ohh thats a though or feeling such as anxiety and help you handle it better than fueling an uncertain feeling.

  • Jaci

    October 23rd, 2014 at 10:53 AM

    If you can just unlock the clues to those triggers, figure out what causes you the most anxiety and work your way backwards from theer, I think that you can successfully manage all of that. Whereas if you continue to have those anxiety producing feelings but never discover the cause, you are not going to ever be able to release much of that.

  • samuel

    October 24th, 2014 at 3:45 AM

    If you have never dealt with anxiety on thsi level then you don’t realize that it is so much more difficult to do all of these things than to just talk about it. It is very easy to say that you will start doing this and this to manage the symptoms but then when the real deal arises it is so easy to go back to all of your old ways of coping which for me is getting tense and anxious. I understand perfectly that I should know my triggers and be on the lookout for those but at the same time it can be challenging with just trying to live your life and not always feeling as if you have to be on the defense against something that you aren’t sure when or where it will strike.

  • Percy

    October 24th, 2014 at 10:59 AM

    I am not sure that I saw this mentioned and I know that all of the suggestions above are wonderful ideas but the use of medication can help to make all of tis a little easier too. Of course it is not the only answer and for it to work its best I do think that oyu have to explore other things, but I also know that sometimes it can help you focus and become more aware of those things that can cause you the most anxiety so it can help you make better decisions and work through those things more easily than perhaps you could without it.

  • Bryan

    October 25th, 2014 at 10:12 AM

    I knew that I did not want medicine to be my only hope against this so I started looking at other alternative methods for controlling and managing my anxiety I have come upon the perfect solution for me, whi is yoga and running. I have found a routine and believe me I am not great at either one but they help relieve some of the pressure that I feel in my veeryday life and that for me relieves a whole lot of my anxiety as well.

    Those two things have become a sanctuary for me, a little bit of an escape mechanism, not that I am hiding but it just feels good to let it go at times and forget about it all.

  • Lad

    October 26th, 2014 at 8:50 AM

    I would very much like to feel this shift in my own way of thinking, but as anyone knows who has generalized anxiety disorder, this change can feel overwhelming, unmanageable even at times. There is hope, I can feel myself getting there every day, but it is never an easy journey.

  • Kennie

    October 26th, 2014 at 6:10 PM

    I have to agree with Lad and Percy. The concept seems very logical but the reality is a different story. I am curious if many of the people who write the articles on this site have, themselves, experience chronic depression or anxiety. I have ready so many articles, books, studies, compendiums, etc… All sound so promising, and in my mind, I want to change my thought processes (loop). I have tried many techniques but ultimately regress right back to where I started. Sometimes, the more articles one reads, it seems to cause more anxiety and depression because it is rarely attainable. Are there studies that show long term results of behaviors changes?

  • Starla

    October 27th, 2014 at 1:38 PM

    You do have to make a conscious effort to change this course. Anxiety can be a terrible thing to have to deal with so you have to commit to taking a different approach. It might not work the very first time, but I think that if you will give it some time to work, you can successfully fend it off.

  • becki

    October 29th, 2014 at 1:29 PM

    Do you think that it is the anxiety itself which leads people who suffer with that to overestimate the negative and underestimate the good that they are given?

  • Jay

    November 4th, 2015 at 6:41 PM

    I like this. I struggle with anxiety and panic when things build up. I was able to conquer the uncontrollable panic responses by first talking to someone who encouraged me not to analyze too much but let my worries out through talking. She would tell me anxiety manifests in different ways and it’s ok. I would tell myself out loud that it’s just anxiety and I’m really OK kind of like down playing it and not avoiding it. Over time the root came out and it just got a lot better. It’s basically like this article but takes persistence to it. There were definitely days I was terrified battling it.

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