Have you tried everything for your anxiety over the years, and it has not gotten better? This blog is going to unpack some of the reasons as to why that could be.

Anxiety is actually not mysterious – it follows a very clear, predictable pattern.

The interventions to help you break this pattern are well-researched and extremely effective. If you feel like your anxiety just won’t quit, it doesn’t mean you can’t get better or that all hope is lost. It most likely means you have not had the proper tools to empower you on the path to recovery.

First, let’s define what I mean by anxiety.

Anxiety is characterized by excessive worry, fear, and apprehension about real or potential events. It is time consuming; causes distress; and leads to avoidance and safety behaviors.

Anxiety is a cycle that starts with a thought (i.e. what if the plane goes down?).

That thought is then misinterpreted as dangerous.

People who struggle with anxiety tend to overestimate the likelihood of a negative event happening and how catastrophic that outcome would be. They also underestimate their capability to handle it if something bad did happen.

This misinterpretation of that thought then leads to behaviors (i.e. Googling stats about plane crashes; taking a Xanax before the flight; paying attention to every bump of turbulence, etc.).

Most people get hung up thinking that the initial thought is the problem – it’s not!

You can’t control what thoughts come into your mind. Everyone has intrusive thoughts, scary thoughts, and unwanted thoughts from time to time. It’s totally human and normal.

The problem begins when you misinterpret this thought being important or meaningful. That is when anxiety starts.

Common misinterpretations of our thoughts include: all thoughts mean something (they don’t); if we think a thought, it makes it more likely to occur (it doesn’t); or that if we have an egodystonic (unwanted) thought about something scary or taboo, that it says something about us as a person (not true).

Once we misinterpret a thought, there are typically either mental or physical compulsions; avoidance; or safety behaviors that follow.

Although these behaviors may temporarily provide relief, they actually fuel the anxiety cycle.

Going back to the airplane example. If you dedicate a lot of energy to doing a flurry of things to reduce your anxiety in the moment, you are unintentionally reinforcing the idea that YES, planes are dangerous and YES, you need to do those things to protect yourself and THANK GOD you did all those things – because otherwise, you would have had a panic attack or maybe the plane would have gone down.

The more energy you put toward disproving an anxiety thought, you’re actually neurologically reinforcing the idea that this thought is true threat and that you need to do something about it to make it better. In reality, the passage of time and letting things play out could (and likely would) solved your problem.

If your main focus is on “fixing” the anxiety, herein lies your problem.

The experience of anxiety is actually not your issue! This is a sign of your brain doing what it is designed to do – which is to respond to the information you are giving it about what is threatening, so that it can keep you safe.

If your brain has learned that planes are dangerous because you behave as though they are dangerous, then your anxiety is a totally expected and natural byproduct of this.

People tend to focus on the coping skills for the acute experience of anxiety, moment-to-moment, which ends up offering short-term relief, while inadvertently fueling the long-term problem.

Focusing on how to bring down anxiety moment-to-moment is like cutting the top off of all of the weeds in your garden without pulling them at the root.

Sure, the weeds might be gone for a little bit and things might look prettier for a while; but they are always going to come back later, and pulling weeds becomes a full-time job.

Similar to anxiety, if you are always pulling out every coping tool in an attempt to get rid of worry or intrusive thoughts or fear, you might feel a little better in that moment. However, these strategies do not get to the root of your fears at a deeper level.

The most important part of anxiety recovery is identifying the compulsive behaviors that you do in response to your anxiety triggers, and working on a progressive plan to reduce and eventually stop doing these behaviors.

Anxiety needs your behaviors to be there at all. If you do not engage in compulsions/avoidance/safety behaviors, anxiety fizzles out in time. Once you stop sending your brain the message that there is an emergency, your brain gets the message that you don’t have to be on high-alert.

You are anxious about the things that matter most to you, not about the things that actually pose the greatest risk to you.

Read that again. People with anxiety tend to think that the things they are most scared of pose the greatest threat. This is false! Your level of anxiety is not always directly correlated with how threatening something truly is.

Our amygdala (the alarm system of the brain) is wrong all the time. Someone who is terrified of planes may have no issue with driving every day, despite driving is being statistically FAR more dangerous than flying. See what I mean?

Now, back to why your anxiety might not be getting better.

Traditional talk therapy focuses on analysis of our problems, which involves using logic. There is absolutely a place for talk therapy – I am not solely an ERP therapist. I do a lot of talk therapy in my practice! I love this part of my work.

Even in ERP treatment, we do talk, a lot! 🙂 We talk about life and your kids and your job and sometimes we gossip about pop-culture and we definitely laugh a lot too. But when we are working specifically on how to help you with your anxiety, we are focusing more on tangible skills and behavioral planning instead of just going around and around and staying stuck in the same place.

Talk therapy on its own is ineffective for clinically defined anxiety and OCD. Going to therapy to exclusively talk about anxiety is actually just doing a lot of compulsions in a very expensive setting.

Rumination, reassurance seeking, and endless mental review end up happening over and over again in conversation with your therapist. The focus ends up being coping skills for the anxiety part of the cycle described above – which is a few steps too late in the process.

If you’re solely focused on putting out each and every anxiety fire, you’re missing out on the part where you can prevent the cycle from happening at all.

Disclaimer: when I talk about therapy not working for anxiety, there is a very specific definition of anxiety I am talking about – scroll back up. We tend to lump in a lot of things into the anxiety definition, like stress, burnout, overwhelm, and general life challenges.

These things respond well to coping skills and self-care interventions discussed in talk therapy. It is important to highlight this distinction about what we really mean when we say anxiety! Anxiety and stress are two different things.

Talking endlessly about anxiety without a really solid understanding of your core fears, your triggers, your safety behaviors, and a plan to face these fears keeps you stuck in the same place for years on end.

You might learn coping skills that help you diffuse intense moments, but then you end up just coping moment to moment for years and years instead of getting to your anxiety at its root so that you don’t have to feel as anxious long-term.

Here’s what it boils down to: if you want to experience less fear and anxiety, you cannot just talk about your fear and anxiety. You have to change your behaviors.

Anxiety treatment requires you to take a leap of faith and do things that feel bad initially in order for you to feel better later. Feeling better doesn’t happen right away.

It happens with repeated consistency, commitment, and time. We live in a world where everyone wants a quick-fix. Anything worth having is typically earned with some effort.

Usually we like to feel “ready” or feel good about something before we act – but anxiety recovery does not work like that. It is paradoxical and counterintuitive.

But IT WORKS. The research on exposure and response prevention therapy for anxiety/OCD is some of the most supportive research for any mental health condition. I mean, wow?!

You can get better. I’ve done it myself and can personally attest to it.

I know for a fact that the things I ask of my clients are extremely difficult to do. I get it. I don’t take that lightly. I also know how much better life is once you do the work to recover. Every ounce of difficulty is 1000000% worth it.

In closing – if you’ve been struggling with anxiety forever and it’s not getting better, it is not because you can’t recover.

You can recover. It doesn’t have to feel this way forever. You just need the right support! Follow me on Instagram @syracusetherapy for more content like this!

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