Areas › Worry and anxiety
Worry and anxiety
Anxiety is not a character flaw and it is not weak faith. It is a body doing what it was built to do, at a moment when it is not needed. The practices here work on the loop itself: what worry promises and never delivers, what avoiding costs you, and how to let the body come down.
What works for this
Cognitive behavioural therapy
The treatment with the largest trial base for anxiety works on what you do about worry rather than on what you worry about. Catching it, postponing it, and testing a prediction instead of arguing with it.
One move, today
Pick one worry you had today. Write the exact thing you feared would happen, then write what actually happened. You are collecting evidence, not arguing.
What matches
16 practicesThere is a particular good feeling in getting out of something you were dreading. Give it a name at home, because it is exactly what makes tomorrow harder.
Children recognise this straight away when it is put plainly: the lovely feeling when you find out you do not have to go. Adults know it too, in the…
When the fear is about being seen, being asked, being judged, you can build the steps out of real moments: the doorway, the corridor, the dining hall, answering once in a lesson.
Fear of a whole building cannot be practised. Fear of walking into the dining hall at half past twelve can. Make each step small enough to be boring…
Next rung: remark on something in the room. The plant, the noise outside, the length of the queue. Nothing about the person yet, just something out loud about where you both are.
It is the lowest stakes opening there is, because the subject is neutral and the other person can pick it up or leave it. Most of the time a small…
Being articulate is not the same as being alright. Plenty of people who talk easily one to one are barely holding it together in the rooms that actually frighten them.
This is where families and clinicians get it wrong most often. Someone speaks well in a quiet office, so the fear gets marked down as mild, and the…
Say out loud, before you start, that there will be bad weeks. Then when one turns up it is a thing you expected rather than proof the whole plan was nonsense.
Setbacks get read catastrophically when nobody warned you: back to the beginning, all that for nothing. Agree in advance what happens instead. You…
Benzodiazepines turn the volume down. They do not change the setting the volume keeps returning to, and it is worth saying that plainly before someone starts one.
They work by strengthening the braking system the brain already runs, which is why they act quickly and why they need that braking chemistry to be…
Sleeping tablets, sedatives, antihistamines and alcohol all pull on the same brake. Whoever is prescribing needs the whole list, including the things that do not feel like medicine.
People rarely mention a nightly drink or a sleep aid bought off the shelf, because neither feels like part of the treatment. Together they can add up…
If you have been given a drug from one category for a problem in another, it is fair to ask which part of it is doing the work. Often the useful effect is a side effect that has been borrowed.
The common example is an antipsychotic given in a small dose for sleep, where the drowsiness comes from its antihistamine action rather than from…
Saying that you do not know, and then showing where you would look, beats an answer improvised on the spot. It also teaches the person asking how to check things for themselves.
Name the limit, name the source you would go to, and offer to come back with what you find. Systematic reviews and an ordinary scholarly search will…
The worst symptom is not always the one that costs the most. Ask what actually stops you doing things, and start there.
Someone might rate their racing thoughts as the worst of it and still be turning down every meeting because they go red in the face. If you are…
Being told not to worry has never once stopped anybody worrying, including you. If a friend said it to you tomorrow you would carry straight on.
This is worth saying to a parent who feels they are failing at comforting their child. They are not bad at it. The words simply do not do that job…
Say the coping sentence aloud instead of thinking it. Some people generate very little of that inner commentary on their own, and hearing it in the room does the job the inner voice was supposed to do.
Out loud, in your own words, something like: my brain is doing the thing again, this is chemistry, it is here because I care. Say it in the car, in…
You will not talk a driven person out of worrying, so give the worry a better job. If someone frets about their revision, have them fret about whether they are also taking breaks and sleeping, since those are part of the revision.
This works because it uses the drive rather than fighting it. The same conscientiousness that produces the twelfth hour at the desk will produce a…
A great many people worry silently and look perfectly calm doing it. Families are often astonished to find out how much has been going on.
If someone in your house goes quiet, spends longer alone, or seems flat rather than agitated, that can be worry rather than indifference. You will…
Whatever approach the anxious person is learning, teach it to the people they live with. A skill that only one person in the house knows gets overridden by everyone else's habits.
Families have a settled way of responding to distress, usually built out of love, and it will win against anything learned in an hour once a week. So…
With a child, make it a job rather than a lesson. They are the detective, the worried thought is the claim, and the task is to collect what supports it and what does not before deciding anything.
Two columns on a page, in their handwriting, not yours. Ask what a friend would notice, what happened the last three times, what would have to be…