I’d like to talk about the term “Choice Point.” It comes from the Acceptance and Commitment Therapy, or ACT model.

A Choice Point refers to a moment in time when you can choose behavior that moves you toward your values or behavior or one that moves you away from them. In the most simplistic terms, behavior that aligns with your values helps move you toward being the person you want to be and a more fulfilling life. In contrast, behavior that doesn’t align can move you away.

When talking about anxiety, moving away from your values can represent avoidance. (Note I said “can,” because I don’t want to generalize.) It might be situational avoidance (a place, person, situation) or mental avoidance (memory, thought, feeling). When you clarify your Choice Points, you notice an opportunity to change how you respond to your anxiety.

The idea is simple but not easy — we all have thoughts and feelings that can derail us. It’s also important not to judge your behavior.

If behaving differently was as easy as it sounds, I’d be out of a job! Plus, anxiety disorders are mental illnesses. When used in cognitive behavioral therapy, Choice Points represent one way of keeping your values in front of you.

Let’s look at some examples. 

Examples of Choice Points

If you have an anxiety disorder, you know that your thoughts often center around worst-case scenarios or never-ending “what if” questions. You might get stuck in the spiral, unable to take action to get out of it.

A therapist can help you learn to notice when the spiral starts to happen and clarify your Choice Point to help you decide how you want to proceed.

In these examples, you’re practicing being sure enough, which is a concept I talk about often.

You’ve written an email…

You’ve read it twice to ensure it’s coherent and proofread it for mistakes. But your anxiety about it being perfect won’t let you send it. It may tell you that you’ll be a failure if it still has an error. It says you should read it again. You do. It looks fine, but anxiety tells you to check it yet again. The cycle repeats, and you become so paralyzed that you cannot send the email.

When the anxious thought comes in, you’re at a Choice Point. At that point, ask yourself, “will checking it another time make me any more sure? Can I be that this is where it needs to be?”

Out of the blue, you get a funny feeling about your partner (or kids, friend)…

This is your Choice Point.

Do you react to the thought by contacting them to make sure they’re all right or do you react to the thought by noticing it … and letting it pass, because you are sure enough that nothing has changed since this morning?

Do you check your phone compulsively…

for fear that you’ll miss something “important” or are you able to put your phone away (and I mean away) when you’re out with friends?

Do you get a Covid test…

(or have a loved one get one) even though you (or them) are asymptomatic and haven’t been exposed just because the possibility is there?

Do you have back-ups plans for your back-up plans…

because you need to prepare for any and every possibility?

Do you check yourself in the mirror…

every time you pass or after every meal to make sure your body hasn’t changed?

There are many other types of situations with Choice Points, and truly each person has individual ones.

Why Should I Care About Choice Points?

While Choice Points are helpful, they, in and of themselves, aren’t the problem. It’s their function: to highlight choices and where you may be avoiding an opportunity to tolerate some uncertainty.

In isolation, these examples above may not be a big deal, but what’s the cumulative impact of all this checking/controlling/needing to know for sure? The more you consistently choose behavior that moves you away from your values, the more you’re training your brain to continue doing so.

In the above examples, the brain is trained out of tolerating uncertainty. For someone with anxiety sensitivity or an anxiety disorder, this can be especially dangerous, because it has the potential to increase over-and-above behaviors in order to satisfy that urgent need to know

I’m suggesting that you start building your tolerance for uncertainty in little ways (that’s the “being sure enough” piece). For people with anxiety disorders, where the stakes seem higher not to check or control, something that can help them make the choice to accept uncertainty is remembering their bigger want, or their “why,” which is articulated through the Choice Points.

And if you’re stuck, please reach out.