The Anxiety Paradox

It’s not uncommon to see clients experiencing anxiety state their treatment goal in no uncertain terms: 

“I want to get rid of my anxiety.” 

It’s understandable, of course: anxiety can be incredibly burdensome to deal with. Many of us have dealt with anxious thoughts for so long that when it comes to getting help, the last thing we want to hear is that the fight to extinguish anxiety often fuels it, granting it greater potency in the long term. 

What a wildly annoying paradox!

Anxiety, at bottom, can be understood as a heightened fear of things that are beyond our control. When we’re anxious, being in control = safety.

Normally, in response to this fear, we engage in behaviors or thought patterns that allow us to feel a sense of control. Unfortunately, while many of these behaviors and thoughts provide short-term relief, they prove unhelpful in the long term.

Unhelpful Ways We Deal with Anxiety

Examples of these patterns include:

• Avoidance
  • What it looks like: Simply avoiding anxiety-producing situations. For example, someone with social anxiety might avoid social situations to avoid panic.
  • The problem: avoiding anxious stimuli reinforces to our brain that a perceived threat is as dangerous as we fear it to be. While avoidance might provide temporary relief, it precludes us from overcoming the sources of our anxiety over time and limits our life experience.
• Constant reassurance-seeking and information-gathering
  • What it looks like: Constantly looking for external reassurance that our anxiety is unfounded. For example, with regards to medical anxiety, this can look like excessive Googling of symptoms, scheduling PCP/emergency room visits, reliance on AI to understand what we are feeling/experiencing, or asking friends and family to reassure us. 
  • The problem: These behaviors often result in worsening anxiety. With reassurance, we might find some immediate relief, but the anxiety will return when a new anxious thought arises. Information-gathering is similarly unhelpful, as our minds become preoccupied with anticipating and researching the worst-case scenarios, rather than tolerating uncertainty. As a result, our anxiety becomes exacerbated rather than assuaged, and we start to spiral.
• Overplanning and perfectionism
  • What it looks like: Carefully planning for and anticipating every situation, or needing things to be just right to feel okay.
  • The problem: Trying to control every variable and outcome leads to exhaustion and increases our anxiety when things inevitably don’t go perfectly to plan. It also prevents us from learning to be more flexible and adaptable, which is important for healthy functioning.
• Rumination or thought suppression
  • What it looks like: Overthinking situations or reviewing past scenarios over and over in a subconscious effort to regain control over them, or attempting to block these thoughts entirely.
  • The problem: When we ruminate, we become stuck replaying scenarios over and over again. Our brain is not great at separating a truly threatening situation from a distressing thought, so rumination is a bit like re-living the contents of our thoughts, which gets us caught in the anxious spiral. Blocking out our thoughts, in a similar way, makes their hold on us stronger and more persistent.
• Self-medication
  • What it looks like: using substances like alcohol or other drugs to numb or relax us.
  • The problem: These behaviors provide relief in the moment, but can lead to dependence, addiction, and secondary health problems. 
• Restricted or stress-eating
  • What it looks like: Restricting our diet or using food to cope with stress.
  • The problem: Using food as a form of coping can lead to disordered eating, or a complicated or shame-based relationship with food, which can pose other complications.
• Aggression & irritability
  • What it looks like: Lashing out at others or becoming overly confrontational as a way to exert power in social situations by controlling the situation.
  • The problem: This can be quite damaging to our relationships, leading to isolation, disconnection, and increased distress. 
• Hypervigilance
  • What it looks like: Being constantly on guard to anticipate possible threats, being easily startled, or having a persistent sense that something will go wrong. (This can sometimes be linked to trauma.)
  • The problem: Maintaining a state of hypervigilance taxes our sympathetic nervous system, leading to exhaustion, sleep issues like insomnia, and other negative health outcomes caused by chronic levels of stress.

The Problem: In Summary

The overall problem with these strategies, unfortunately, is twofold: (1) the world is inherently unpredictable and often can’t be controlled; (2) exerting control provides transient relief, but doesn’t deal with our core fear, which then returns in new iterations every time we feel a sense of uncertainty. 

To feel relief from anxiety, we have to learn to tolerate uncertainty and experience safety even when we can’t control our environment. Treatment for anxiety, therefore, often involves a level of exposure to uncertainty, learning to accept uncomfortable feelings, and challenging distorted thought patterns, which build our tolerance over time.

When we understand things in this way, we gain appreciation for another kind of paradox: over-supplying ourselves with coping tools for anxiety creates a greater dependence on mitigating unpleasant emotions, which is just another form of avoidance. It’s critical to build capacity for distress rather than continue to prop up the illusion of control.

Helpful Ways We Deal with Anxiety

Nonetheless, there are many ways to improve anxiety. Therapeutic approaches such as cognitive behavioral therapy (CBT) and acceptance and commitment therapy (ACT) can be helpful. There are also many ways to self-regulate at home.

Examples include:

• Deep breathing: Often, the anxious person’s least favorite coping mechanism. (Because it never seems to work fast enough for us!) While not a cure (and your mileage may vary), taking deep breaths with long, slow exhales can help reduce heart rate and induce a calmer state.
• Mindfulness and meditation: Mindfulness practices have been shown to reduce anxiety. They can help us find presence in our bodily experience rather than our thoughts, and they can draw awareness to our thoughts as separate from objective reality. (For more information on mindfulness and an activity you can try yourself, visit my blog “What’s the Point of Mindfulness?”)
• Progressive Muscle Relaxation (PMR): It can be helpful to consciously tense and relax different muscle groups in your body, bringing awareness to how stress manifests as tension in the body. By systematically relaxing these muscle groups, the mind often quiets in turn. With anxiety, we habituate to states of heightened bodily tension. PMR helps us to tackle these uncomfortable somatic states that exist beyond our normal level of awareness without engaging the mind in the same way it’s used to working.
• Regular exercise: Even a 20-minute walk outside during the day can improve anxiety.
• Healthy diet: Reducing sugar intake and excess caffeine can have a positive impact.
• Adequate sleep (7-8 hours per night): Sleep improves our brain and body’s ability to tolerate stress. When we’re tired, we tend to have a smaller buffer against stress.
• Limiting alcohol and other substances: Staying away from using substances to numb or dull anxiety is important to avoid overcomplicating our issues and risking our anxiety coming back worse than before.
• Social connection: Abundant research supports the beneficial impact of social connection on our ability to tolerate anxiety. It can be helpful to spend more time with people in contexts outside of ordinary venting or reassurance-seeking.

Closing Thoughts on Anxiety

While anxiety can be difficult to deal with, there are many forms of support out there! If you struggle with anxiety, know that you’re not alone! It’s one of the most commonly encountered experiences in the therapy room. Implementing some of these activities while also pursuing treatment with a licensed professional can make a big difference.