Many of my clients clients who seek treatment for anxiety tell me that they just want to find peace and respite from the constant clamor of fears and doubts that race through their minds everyday. They want to know that everything is going to be ok, and they want some reassurance that their worst fears are not going to play out. Essentially, my clients want relief.
And who wouldn’t want that?
But when it comes to anxiety, no amount of reassurance is ever enough. Parents of children with anxiety may find themselves repeatedly providing reassurance over and over again, only to have their child return to them the next day (or the next hour) with the same fears and worries. Adults who suffer from anxiety may turn to their partners, family members, or friends, seeking reassurance about their concerns, only to find that their loved ones have become exhausted and weary from providing constant reassurance to their repetitive and seemingly endless cycle of worries.
As much as I understand the desire for relief from anxiety, my goal in treating someone with anxiety is NOT to help them discover an ‘anxiety-free’ life. I wish that I could create such a life for each of my clients (and for myself for that matter)! But the truth is that life is full of uncertainty and instability. We cannot create a sanctuary of peace and tranquility no matter how hard we try. Instead must learn to face life and to embrace all of the uncertainty that dwells within it, rather than continually seeking reassurance and safety. But how does one learn to embrace uncertainty when it feels so terrifying? How does one learn to tolerate the perpetual fears and doubts that follow us around each day?
The answer to this dilemma is not a simple one. But I would like to convey 5 simple truths that underly my cognitive behavioral treatment approach to anxiety.
1) Thoughts are just thoughts.
This simple truth can be very empowering. Research shows that most people (80-88%) experience disturbing and intrusive thoughts, images or ideas. Those without chronic anxiety are able to let go of the disturbing thoughts and move on with their day. Those who struggle with certain forms of anxiety, such as OCD, become highly focused on the thoughts and react strongly to them. They make efforts to either protect themselves or others, or they go to great lengths to avoid experiencing the thoughts themselves. In anxiety treatment, we learn that seeking safety from irrational fears will, in fact intensify the problem. We learn instead
to welcome the upsetting thoughts into our minds and allow the anxiety to wash over us.
Through a process called exposure therapy, we learn through direct experience, that thoughts come and thoughts go, but they are not reality and they do not define us. As we learn to face our thoughts, fears, worries and triggers on a regular basis, they become less distressing and we no longer feel the need to constantly elicit reassurance from those around us. We learn that thoughts are merely thoughts and they do not need to control our lives.
2) Anxiety is very unpleasant but it is not dangerous and it cannot harm us.
Anxiety can strike in many forms. Physiologically we may feel racing heart, shortness of breath, dizziness, sensations of choking, numbness or tingling, nausea and stomach upset. Psychologically we may experience feelings of unreality, feelings of losing one’s mind or going crazy. Emotionally we may be flooded with terror, fear, and helplessness. Mentally we may be wrought with horrifying thoughts and images. These experiences are very upsetting and most uncomfortable to say the very least. But they are not dangerous. Through exposure therapy, we learn to ride the wave of anxiety and we discover that at some point, even the strongest waves reach their peak and break. We learn that eventually anxiety passes, leaving us in tact, both mentally and physically. We learn that there is no need to try to control our experience of anxiety, that instead we ride the wave and we become strong and graceful surfers with practice.
3) Avoidance of situations, people, places, and things that trigger anxiety will keep us trapped.
Avoidance can give us a temporary sense of safety and control, but over time, avoidance only serves to strengthen our fear. And avoidance leaves us with a very small and limited life. For example, if I fear germs, I may begin to avoid public places and crowded spaces, but still go to school and friends homes. But pretty soon, I’ll go to a friends house and get a wave of anxiety about germs, and then friend’s homes become off limits too. Eventually a stomach bug hits at school and now school seems very unsafe too. Pretty soon I am stuck at home, isolated, with nothing to focus on but the fears swirling around in my own brain, more afraid than ever. Now the whole world feels dirty and I feel terrified to walk out my front door, so I spend countless hours at home, cleaning and washing to ensure that my home remains clean and safe. Avoidance has led to a worsening of symptoms and the only way out is finding the courage to face the fears.
4) Facing our fears head on is both terrifying and liberating.
Exposure therapy is not for the faint of heart. Sometimes it honestly feels like we are staring death itself in the eye when we confront our fears. But with the right support in place, we find courage within us that we never knew was there, and we find freedom in life that we never knew was possible. Through exposure therapy,
we discover that we are strong and brave and whole-hearted. We also discover a whole new world where we are free to live in the moment and take risks that are worth taking. We discover a life that feels worth living, and we leave behind the small narrow life that anxiety led us to.
5) By facing our fears head on, we develop confidence in our ability to cope, and we no longer need to run or hide.
Exposure therapy leaves us feeling like Olympic gold medalists in the sport of anxiety tolerance. We learn that anxiety comes and goes, and sometimes the waves rise up like a vicious tempest. But we trust in our ability to ride the wave and stay afloat in life. We no longer rely on our therapist or our loved ones to keep us feeling safe and intact. We now know how to navigate the stormy seas of anxiety.
If you or someone you love is suffering from anxiety, there is no amount of reassurance in this world that will bring relief. But you can absolutely find freedom from the vicious cycle of fear and dread if you are willing to take the first step.