I just came back from the Annual OCD Conference in Austin. Something I kept hearing over and over again was anxiety and fear tolerance over anxiety and fear reduction.
As a therapist specializing in the treatment of Obsessive-Compulsive Disorder and anxiety, this notion is something I know and impart often. But the conference speakers discussed it with such eloquence — and such frequency — that they got me thinking about it a little more deeply.
What I’ve learned in all my years of being a therapist is that willingness is essential for lasting change to take place. We must be willing to tolerate the anxiety and fear. This is a significant detail, because without the willingness to experience discomfort, change, thoughts, sensations and/or feelings, nothing can be achieved. This is true for all forms of anxiety: we have to be willing to be anxious, regardless of intensity or duration, and we have to practice living life in spite of it.
Anxiety is a valuable emotion that we need. The goal must not be to eliminate it, get rid of it, and/or make it stop. Let’s repeat that. Anxiety is a valuable emotion that we need — and need to get better at feeling. When we’re swept up in its cycle is when we can lose our bearings, and the situation can spiral.
When we resist our anxiety, what happens? It comes back, and it often returns stronger than before.
What do I mean by resisting our anxiety? When we fight our anxiety, we …
- Interpret anxiety’s physical sensations as dangerous: “why is my heart racing, I must be having a heart attack,” “I can tell my stomach pains are worse: I better not leave the house,” “there goes that buzzing in my head again. Why does this always happen to me?”
- Judge how we’re feeling: “it’s so dumb that I’m scared to fall asleep without mom anymore. I’m such a loser, and it’s so stupid to feel like this.”
A better goal, then, is to improve our tolerance of it so that we can respond differently. We do this by accepting the uncomfortable sensations like swirly stomachs, racing hearts and thoughts, and feeling unsettled. (When we’re really willing, we can practice wanting the anxiety, but for now, let’s focus on accepting it). We refrain from overanalyzing why it’s there, what it means, and what we need to do to get rid of it. That only puts us “in the content,” as I like to say, and we get caught up in the aforementioned cycle. We focus on the problem rather than on the solution.
Let me give you an example.
Many people know that I used to have a terrible fear of flying. I’ve progressed to being tolerant of flying mostly because there are places I want to go (among other reasons). Nonetheless, I still feel anxious when I do it. On the flight home from the conference, we encountered some intense (at least to me) turbulence, and there was visible lightning in the distance. The pilot came over the speaker to announce that there’d be some rough weather as we got closer to Cleveland.
Now that’s what I call an open invitation for some anxiety. Cue heart pounding, sweaty palms, and clenched stomach.
I didn’t go so far as to want the anxiety, but I absolutely have had enough experience to know that anything but allowing my pounding heart, sweaty palms, and clenched stomach was a losing game. I was able to accept the uncomfortable physical sensations, knowing they didn’t mean I was truly in danger. Progress! I had to tolerate all of this in order to get home to my kids and dog, which was vitally important to me. And for that, I was willing to accept the discomfort.
It’s important not to use the presence or absence of anxiety or worry as a marker of progress, health, wellness, stability and/or the brilliance of your therapist (ha!). Instead, use your ability to tolerate thoughts, feelings, and sensations associated with worry and anxiety as your marker. Use your increased willingness to be uncomfortable as you move toward this goal.
Tough, right? Yes, but not impossible. This is where a CBT therapist trained in Exposure and Response Prevention or Acceptance and Commitment Therapy can be very helpful.
Curious about how this might work for you? Let’s connect.