Charting a Course for Better Managing Your Anxiety

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 Barmann, PhD, Anxiety Topic Expert Contributor

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