What does it take to cure my anxiety? NOT ROCKET SCIENCE.
It’s not finding the best medicine or doctor. It’s not fixing the thoughts. It’s not how much energy you spend on understanding your problem. It’s not the house, the job, the money or the relationship you hope will fix your troubles. It's not the prayers you'll make and the temples you'll worship.
It's the behavior that directly targets your anxiety that will cure your anxiety
Bitter sweet news, right?
“Hooray!! It’s something I can control myself. I don’t need anything else. I don’t need anyone else.”
“This sucks. Behavior is the part I struggle with. That’s what I cannot do. You tell me to do what I cannot do, in order to do what’s needed to be done? What’s wrong with you? Don't you know it’s not possible for me?”
We get that. If facing your fears was that easy, you wouldn’t have anxiety, would you?
Of course things get in the way when it comes down to facing the fears. Such as, "I try but I fail, the fear consumes me" Or "What is the right thing to do?" Or "My mind doesn’t buy into anything else."
There is no doubt for a second that real and legitimate things get in your way of doing the right thing.
But all that means is that you need help with execution. It doesn't mean that anxiety is incurable.
Behavior is the only way to break the anxiety loop.
Why "only"? Because unless you behave un-anxiously, all the insight, medication or wisdom of a lifetime cannot save you. "At least I am brilliantly insightful about how my fear of water came about" will not cure you. Taking a shower will.
We have to deliberately create the exact kinds of experiences that our brains need in order to recover and change. And creation cannot happen without the doing. Not the thinking about the doing. But the doing.
And why do we want our brains to change? If you are cured of anxiety, it does not mean that you now have special powers to tackle a malfunctioning, misbehaving brain. It means that you literally have a new brain . It means that you have changed the circuitry of your brain from anxious to wise. You now have a brain that's been trained to automatically respond wisely, allowing you to experience emotions but without anxiety. Neuroscience (1) shows us that this is possible despite your age or your history (with anxiety).
You need behavior for this. If you understand but don't behave as if you understand, it's not going to work. Insight is important, but action is where the rubber meets the road. You need to be able to "show yourself" that you get it. (Really, it's about showing your amygdala).
You need to show yourself that despite your twenty-year old OCD thought that tells you how your house will burn down if you don't check the stove 16 times, you don't check the stove 16 times.
Then, when your heart is pounding with more fear and more uncertainty (because this time you did something different), you need to show yourself that you are successfully riding the storm. Not by going back to the stove. This time, you're going running.
While you're running, you need to be able to show yourself that "look, I'm running this time. I'm not camping by the stove". If this means you have to do this every 5 seconds, so be it.
When that's over, you need to show yourself that your anxiety symptoms weren't powerful enough to stop your running and in fact are now less intense.
Then when the thought desperately tries a new power tactic "This was a fluke. The past you is the real one", you NOW have the authority to say: "Screw you. This time, I have ACTUAL, PERSONAL proof that not listening to you turns out to be okay. Maybe even better. I burned 500 calories and my pants fit better."
Thought: "What about your crazy past? That will never change. You will always be someone who spent 20 years as a miserably anxious, obsessive person. How sad is that?"
You: "Yeah, but so what? I'm not buying into another bullshit layer that'll keep me stuck "
Thought: "What if it all comes back?"
You: "I'll go running again."
Essentially, you have proved that the only "fluke" are these thoughts. You're not buying into them anymore.
And this kind of proof, created from your own courageous behavior, is what does the job. Therapy can bring you to the point of understanding fear, but you have to "do" fear to conquer it.
You're done buying into the mind's bullshit that holds you back from a life worth living. SO WHAT if you've listened to the bullshit your whole life? This time you're moving on anyway.
Once behavior is performed by you, you have to interpret it correctly. Focus on what you achieved, and whether it was in the direction of your goals and values. Even if your goal right now is to just make it past the next 5 minutes.
In anxiety, we have become habituated to extreme levels of suspicion and critical analysis. Even when we achieve good results, we are suspicious.
"What if I stayed calm only because I talked to my therapist before? Only because I took a medicine? Only because it was a fluke? Oh-my-gosh, what if it was the wrong thing to do? What if this, or nothing I ever do, will be enough?"
Stop yourself from doing this. This again is anxiety talking.
If you performed an un-anxious behavior, admit and accept that YOU DID IT, BECAUSE OF YOU. There were no other variables that made this happen, but you.
Interpret your experiences in a way that stops the obsessive critical analysis. Of the situation. Of yourself. If you tried your best, you have to learn to get comfortable with that. If it still wasn't "perfect" by your definition, the task ahead is not to change the moment, but to change your definition.
Scientifically, it happens like this:
Behavior creates COUNTER-memory (positive memory) of yourself and of your own coping skills with handling whatever comes your way. Whether your own internal thoughts. Or your stressful external circumstances.
With just one behavior, you re-train your amygdala (brain) through two routes. And in the end, it's all about soothing your amygdala.
The amygdala does not understand language. The amygdala understands memory. You cannot "tell" your amygdala to not create fear. The amygdala will do that only if it sees the object as safe. One way it sees it as safe is if it remembers it as safe. If the amygdala only remembers you as freaking out when confronting this object, it will always interpret it as a threat. That's why you have to change your memory. And you have to do it by behaving un-anxiously. Fall short of that and your amygdala won't buy it.
Memory of your new, un-anxious behavior is then hardwired into you. You will not forget it. All memories influence your amygdala, even positive ones. Next time, you confront the same triggers, your amygdala will remember that "The last time, he behaved un-anxiously as if there was no threat (despite 30 years of behaving anxiously). I don't have to raise an alarm anymore".
This is called de-sensitizing your amygdala.
With performing behavior, you challenge all previous distorted thinking and assumptions, without trying to change, alter or manipulate your thoughts. Previously, you underestimated your own coping skills. Fusion with negative thoughts made you create the distorted belief that you have to first deal with the subject-matter of your thoughts before you can feel safe. NOW, you witness that despite the thoughts, you tried something new and better. You learn the essential lesson of holding one's thoughts lightly and not taking them as 100% true. And guess what? You survived. And are probably giddy from your courage.
One Behavior. Two Behavior. Three Behavior. The upward spiral begins
Each successful behavioral episode builds on the previous one. In time, un-anxious behavior starts becoming instinctive, and you re-wire your brain to respond un-anxiously. You build up enough positive memories of yourself to draw upon every time you face an anxious situation. You are able to remember from your memory bank that despite a lifetime of anxious reactions, the same you has also performed un-anxious reactions - which have worked out better for you. Your amygdala starts backing off (desensitizes) as it learns that despite the alarms it habitually used to raise, the "new you" behaves as if there is no threat. Your amygdala starts getting trained to react only to appropriate threats. This in turn has a positive effect on your day-to-day biology. Since your amygdala is not triggered, you don't deal with anxiety symptoms, are less hyper vigilant and more calm. When you are able to stay more calm, you will notice that your thinking styles (perspectives and worldviews) are calm, collected and wise. This further influences your behavior. You gain confidence in making un-anxious choices and have more faith in your own coping skills. You become more interested in role modelling/mirroring the right kind of people. Pretty soon, your default conditioning changes from worry to resilience. Your new, un-anxious energy and vibe starts attracting the right kind of people into your life. You live closer to your true nature and temperament. You start making choices in relationships, work and hobbies more aligned to your core values.
It's an upward spiral at the end of which lies a life enriched with emotions, but free of anxiety.
And it all starts with behavior.
Why do you fail?
What hijacks your behavior when you are gifted with so much insight? Do you even know what is the right behavior for you? How can you be sure? How much worry is "too much worry"? How much is "too little"? Isn't it subjective or does all good behavior have to look the same for all of us? Who decides this? Doesn't your feeling dread and fear mean something? If you fear losing your most precious things such as your life, your sanity, your health, your reputation or your loved ones, what's wrong with that? Doesn't it simply show how much you care?
Do you have these answers? Are they good for you? Are you clear on them? Even so, have you accepted them more than just intellectually?
If not, therein lies a clue on why behavior seems beyond your control.
To do the right behavior, you need two things.
One, you need to know what is the right behavior for you.
Two, you need to know what gets in the way (No, it's not a chemical imbalance).
There are two kinds of anxiety sufferers:
1. Those who cannot see that their responses create their suffering. They TRULY believe that they think and behave with logic and good sense. For them, anything else is just plain stupid.
2. Those who can see that their styles are distorted but they are overpowered by them. They don't know what else to do and how to do it.
In anxiety, when your mind and body are controlled by symptoms produced by the amygdala, rationality is "hijacked". But you don't know that. Because your rational mind is still telling you something. It is giving solutions to your problem. Also, the call of the hour is to take action. Any action. The moment does not pause itself and wait for you to "figure it out". So you do whatever you think is rational at the time.
So, you rationally believe the only behavioral options available to you are the ones you finally choose.
"What's wrong with them?", you ask. "What's wrong with caring enough to protect myself from danger and pain?"
Nothing really. Except that if it gets in the way of living up to your own values and goals, then it's a problem. Not for me. But for you.
When you start imposing rigid, inflexible rules and limits that have to met in order for you to experience life, soon the edges of life start closing in on you.
Eventually, what remains is a very narrow range within which life is behaving itself properly and you are feeling safe. Except that, that is no longer life that we want to experience.
So in the process, you don't win over life by playing it safe. You lose. And eventually, THAT realization is the most painful.
Anxiety is never a problem with negative thoughts happening in the head. Gosh, there is and will never be a limit to the kinds of gibberish a human mind can produce. Any human mind; not just one with anxiety.
Anxiety is problem with entirely fusing with thoughts, without wiggle room, and then guiding behavior from that place of fusion.
What are the behaviors you choose to do in the end? Do they protect you from anxiety or actually cause your anxiety? And if you know all this, then what gets in your way?
Here we have won half the battle. At least we know and admit we have anxiety; that our styles are distorted, and they create more trouble than help solve anything.
But knowing about something doesn't necessarily change it, even if it's a necessary first step.
When it comes down to it, we are still paralyzed with fear. What's up with that? Why isn't my brilliant insight and honest admission enough?
Problem 1: Trying to "fix" your thinking
Problem 2: Not knowing what else to do
Problem 3: The amygdala
So we are told that our thinking styles are distorted. When we finally get around to seeing that, what is the next step that seems rational? Fix your thinking. And behavior will follow.
This seems intuitive. The problem seems to be my thoughts. If I can bring myself to not think in a certain way, I will be fine. If I can stop thinking "I am failure" or "Anxiety has ruined my life" or "I will never get cured", then I will be okay.
You get the same message from your therapist, spiritual leaders and self-development books like "The Secret."
"You are your thoughts".
"I think, therefore I am". "
So much attention is given to thoughts.
Which is great approach for those who are anyway conditioned towards positive thinking and high self esteem.
But it is very bad advice for those who come to the table with automatic and conditioned negative thinking styles. And low self-esteem because of those styles.
Why? Because there is too much pressure on them to "change your thinking."
When we try to force ourselves to manipulate thoughts, we are met with instant failure. Thought control (or for that matter, memory and emotional control) does not work. Even the research (2) shows us that.
The more you try, the more the opposite happens. The more entangling and forceful they become. The more frequent they become. The longer they stick around. The more they loop around in the head.
In short, when you try to control thoughts, they get a little bit more life and a little bit more power.
And so despite your newfound promise to cure yourself, what do you find? Your old thoughts don't really care. You leave the therapist's office and they're back. You finish reading a positive self-development book and within minutes, they're back. You meditate for 3 hours and in 3:01, they're back.
And this shocks you. And then you give up.
"I tried, but failed. Maybe I'm just a negative person. Maybe I'm not meant to be happy."
No. You tried the wrong thing. You tried something there was no need for. You tried something that was destined to fail. "Control your thoughts" is an oxymoron.
Shouldn't we know this? After all, we have anxiety. Isn't the whole issue with anxiety one of paying too much attention to thoughts? By now, shouldn't we know that the battle against thoughts is a loosing one?
The confusion happens because this time we are trying to "think positive and get cured". We expect our brains to be grateful and ecstatic, and automatically produce only "good thoughts".
Nothing wrong with wanting to be positive.
But to demand old thoughts to first go away before anything else can be done? That's asking for trouble.
That's why I detest the rubber band therapy which asks you to snap the band on your wrist every time you have a negative thought. Are you serious? You want me to punish myself for something I did not create? How much power do you want to give this thought? And why can't I allow the thought to hang around if it wants to? Why is everyone so afraid of thoughts when the only thing to be afraid of is fusing with thoughts?
Thoughts are not in anyone's control. And if that frustrates you, your problem is not with thoughts, but with control.
The best news is that you don't even need to control thoughts for an anxiety cure. You do not need to worry about the content of your anxious thoughts, their history and their reality once you have identified them as useful or useless for you and your future course.
But then what will guide your behavior? You still need some thoughts, philosophies, ideas and plans to tell you what to do. What are those?
Those are your so-called "positive" thoughts.
How are they decidedly "positive"? Because they're aligned with the values & goals you want your life to follow.
"But wait, if my negative thoughts don't go, how can I have positive thoughts?"
You can. Together with the negative.
The way to cure anxiety is to develop "positive" thinking alongside any negative thinking. It means you allow the negative thoughts to freely roam around and say whatever they want. "You are a failure" should be given the permission to hang around as much as it wants and as long as it wants. And then despite its presence, you introduce another thought. A thought which is conscious and intentional. A thought that is rooted in your truth. Don't make it artificially sweet if that's not your style.
"Yeah, this 'I'm a failure' is a thought I've rehearsed for a while. This time, instead of fighting it, I'll allow it to stay. But I'm changing my career anyway."
This works. And there you go. There's the behavior you wanted.
By the way, the tools you just used were Mindfulness and Acceptance and Commitment Therapy.
More often than not, the right behavior is easy to identify. It usually means taking action in line with your goals and values despite what the anxious thoughts tell you. Many anxiety sufferers have triggers that are easy to identify (even by them) as ones that they must get over if they want any shot at a good life.
Get on that airplane so you can see your ailing mother.
Ignore the stove so you can attend college.
Leave your room so you can go buy groceries.
But sometimes it is not so clear what the un-anxious thing to do is.
If your marriage makes you miserable, should you leave your spouse and children or stay? If you leave, can you live with the guilt? Will you really be happier? If you stay, can you live with the guilt? Will you really be happier?
If your job makes you miserable, should you quit now or stay? If you quit now, who will pay the bills? Can you live with the stress of not knowing what's next? If you stay, will this mean you copped out or made a wise decision?
Should you beat up your schoolyard bully if you weigh 105 lbs? 305 lbs? Does your answer change if he swears at your baby sister?
These are issues with VERY HIGH stakes. Their answers are not easy.
An indisputably wise behavior for one person could very well be an indisputably un-wise behavior for another.
And so the right thing to do is circumstantial. It depends. It varies. It is not so black-and-white. No one else can prescribe it for you. In fact, chances are you are in a mess probably because you bought into someone else's definition of the right behavior.
If your mind is foggy and scattered, seek help with clearing the fog.
But even then, in these grey-area matters, the person does not struggle so much with not knowing what to do and what not to do. Usually he knows exactly what he wants to do, based on his current reality. "No, I am not leaving my job." "Yes, I am asking for divorce" "No, I am not punching my bully."
He struggles more with how to comfortably accept his decision for himself and by himself, and the repercussions thereafter.
Anxiety comes from being terrified of facing the possibility of making a mistake. And even then, if you're truly honest, you secretly know that if a mistake were to happen, most likely you will not see it as a mistake but as a learning experience. So whose voice are you really scared of? You think it's your own that will tell you in the future "Mark, you're a god forsaken stupid fool to have taken that leap". And you're right, IT IS your voice. But how the heck did you learn to be so self-critical and negative? And how the heck did you get to thinking that "it all" has to be perfectly flawless all the time?
The work here is to fix these areas. Of self-judgment, anger and perfectionism. It is not about finding a black-and-white answer. When it comes to living and relating, there are usually none.
It's learning not just how to sit comfortably with the shades of grey, but also the uncertainty and ambiguity that immediately arises when "black" and "white" is removed from the picture. Sitting with ambiguity trains you to stop worrying about questions that indeed cannot be answered in the moment. Whether your divorce makes you better off or worse can only be seen in the future. Even if all day today, you asked 10 family members and 6 friends. And then all night, dove into your own mental predictions.
It means being okay with not leaving a corporate job which pays the bills to launch a tech start-up; the way 90% of B-school friends did. But not just that. It also means sitting comfortably with not knowing for sure whether or not it's a good move.
Make your therapy sessions more about getting trained on getting comfortable with your own choices. Invariably, this path will lead you to explore areas new to you. Such as acceptance and forgiveness. The antithesis of anxiety.
There's another reason why people don't know what is the right thing to do. It's because all of their identity comes from their distortions. Remove the distortions and you strip away all of who they are. "If I am not allowed to be catastrophic and angry, then who am I? I will wither away into nothing."
So you think. Or it could mean you start again from a clean slate and create another kind of you.
Being asked to become a child again? This can be excruciating terrifying or insanely liberating. You choose. Plus you don't have to do it out loud anyway. As long as you can weather the uncertainty and unpredictability.
The amygdala is responsible for the biology of anxiety.
Of course you know this - the biology can be one heck of a problem. Sometimes, it is all of the problem. Heart racing through the roof, chest tight, breadth restricted? Especially when you know there is nothing to fear? Are you kidding me? This in itself can cause anxiety. In fact, it does. Panic Disorder is all about fearing anxiety symptoms. Aka, fearing the amygdala.
Hopefully you know by now that you - "the you, you" - is not causing this. You are not to blame for "feeling" fear. Your amygdala is doing this.
If you haven't educated yourself about the amygdala, I suggest you do that first before reading on.
So is your amygdala out to get you? Are you cursed? Powerless?
Your amygdala is NOT out to get you. On the contrary, it thinks it needs to protect you. But it's no guru, wise therapist or a genius computer that can really solve your problems. All it knows to do is to prepare your body to face threats, problems, dangers, issues. That's it job. That's all it knows. That's all it's trained for.
Of course the symptoms suck. But you must learn how to solve this problem in ways that don't create 10 more. If you get stuck in blame and depression because your amygdala is overdoing itself, you are adding another useless layer of "troubles to deal with" for the amygdala.
How do we deal with the amygdala (anxiety symptoms) without going down?
Whenever I look around for information about the amygdala, I find the words "threat" and "danger". I don't like these. I prefer the word "conflict".
Because it's usually subtle subconscious "conflicts" that are enough to activate the amygdala. The amygdala is not falsely misinterpreting objects as "threats" and "dangers". But instead, the amygdala is correctly picking up our mental conflicts, even if consciously we are clueless about what it is that's really bothering us.
Conflict arises when your desire and actual don't match. Your desire could be irrational. Or your understanding of the actual could be warped. Whatever. The amygdala will find it and the amygdala reacts to it.
When you close the gap between desire and actual, your amygdala grabs the congruence and backs off. "Phew! This dude has no conflict. I can chill."
A backed-off amygdala is what makes you feel good again. Your heart rate's back to normal. Your palms aren't sweating. You can breathe again. You're not dizzy and uncoordinated. You can focus and concentrate.
It's the opposite of the state of anxiety and thus, it's very, very desirable.
Lesson learnt? Close that god-forsaken gap.
And so, most of us since infancy have been trained to close the gap. But usually, the only way we know is by bringing actual closer to desire. We work our butts off to achieve what we desire. Good grades. Good jobs. Good relationships. Good income. That's great. Nothing wrong with having aspirations.
BUT...In anxiety, we are usually facing conflicts that either cannot be bridged or that require desire to align with actual, and not vice versa.
What's going on here?
First, there's an obvious conflict between what you desire and what you want. Result? Amygdala triggered.
But what makes it worse for your amygdala is facing the reality that this gap CANNOT be bridged. At least not by the way you usually resolve things "Just figure it out and make it happen!"
Now, you are trapped. Either your desire simply cannot be met (your past cannot change). Or nothing you do can guarantee your desire will be met (as human, you are not equipped to know the future).
The only way to resolve this conflict is by bringing your desire closer to actual.
One clean, quick, swift action will do it.
What if I choose to accept my reality? What if I know I don't necessarily like my situation, but I accept it anyway? In the head, this sounds like "I hate this, but whatever."
What happens with Acceptance is that you stop the mindless fighting and anger. When you fully accept that which you cannot change, there is no conflict. You may not like it, but what if you accept that too?
Without the conflict the amygdala backs off and counter intuitively the symptoms ease.
Provided you are not doing this as a manipulative trick. If you "accept" while all the way you have one eye on the prize, your amygdala won't buy it.
True acceptance looks a lot life grieving. You are sad. You are tired. You give up the fight. And you have no freakin' idea what lies ahead. All you know is that for your own sake, you give up the fight.
Why should I accept?
Don't if it doesn't make sense to you. But if you find that most of your life is going unlived because of your refusal to experience your present-moment unbridgeable, unsolvable, unanswerable and unchangeable conflicts, it's a good time to start exploring doing something different.
How to accept?
Just accept. No games. No mind tricks. No manipulation. Don't suppress thoughts, memories, sensations and symptoms. Allow your present moment to be exactly what it is. One with a triggered amygdala. One with conflicts you don't necessarily like. One with opposing emotions, feelings and sensations.
And then, remind yourself that you've not "given up". But instead you now make a commitment to lead a life true to your values despite youR past, present and future. And you'll do this by identifying behaviors that'll make that life possible.
It may take some time and training for your amygdala to really "get" that there is no conflict. Just be patient and don't freak out. If you "behave" as though you have honestly accepted, your amygdala will see it.
The good news is that once you get the basic concepts about how fear works, you can nip it in the bud. And how do we nip it in the bud?
Behavior is what causes the problem, but behavior is also what breaks the anxiety loop.
Get trained on how to identify, select & implement appropriate, un-anxious behavior. If you can't do this alone, celebrate that admission. Phew! You're off the hook. Get support.
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1. "The results suggest that participation in MBSR is associated with changes in gray matter concentration in brain regions involved in learning and memory processes, emotion regulation, self-referential processing, and perspective taking. "(Source: Holzel et al, 2010: Mindfulness practice leads to increases in regional brain gray matter density; Journal: Psychiatry Research Neuroimaging) back
2. "Although thought suppression is a popular form of mental control, research has indicated that it can be counterproductive, helping assure the very state of mind one had hoped to avoid. Suppression, which spans a wide range of domains, including emotions, memory, interpersonal processes, psychophysiological reactions, and psychopathology. " (Source: Wenzlaff, R. M., & Wegner, D. M. (2000). "Thought Suppression", Annual Review of Psychology, 51(1), 59–91.) back