By: Kyle Kermott, Psy.D.
For many years, psychologists have understood that depression and anxiety often go hand-in-hand. In fact, the Nation Alliance on Mental Illness (NAMI) estimates that up to 60% of individuals who report having depression also report having some symptoms of anxiety. Many health care professionals are finding that it’s more common to see patients who report having both disorders, than either one on its own.
The Anxiety and Depression Association of America (ADAA) states that anxiety is the most common disorder in the United States, with nearly 40 million individuals endorsing symptoms for the disorder on a yearly basis. Like depression, anxiety is a pervasive illness, affecting multiple parts of people’s daily lives from their sleep, ability to concentrate, physical comfort, capacity to work, and ability to create and maintain relationships (to only name a few). People who struggle with anxiety are three to five times more likely to go to the hospital. But despite all of this, only about 37% of individuals who report anxiety symptoms get treatment – with an even smaller percentage of individuals gaining relief from their symptoms.
The disparity between the commonality and challenges of anxiety, and the rates of effective treatment highlights an important problem: we haven’t been very good at healing anxiety.
Standard practice dictates that a patient, having identified negative, anxious thinking that they want to eradicate, needs to meet that thinking head-on. An example of this is the technique called “reframing,” which is a major component of Cognitive Behavioral Therapy (CBT). In using the reframing technique, a patient is encouraged to first evaluate their anxious thoughts for their validity. And if the anxious thoughts are found to be invalid – which they usually are – then a patient is told to change (or “reframe”) those thoughts into more useful ones. This pattern can be repeated, and is usually carried out until a patient reports that they have eliminated their negative thinking.
Sometimes this type of treatment works. And when patients elect to come into therapy, many times they are looking for this type of direction. They want to be guided through changing their thoughts. But research is finding that this way of working has major drawbacks when attempting to achieve long-lasting relief from anxiety.
The problem with trying to alter anxious thoughts by repeatedly pressuring the thoughts to change is that this practice can actually increase the anxiety.
Psychologists have found that anxiety can build on itself. An individual attempting to “reframe” their anxiety soon finds that they start feeling anxious about their anxiety. They feel anxious that their efforts at changing their thoughts aren’t working, which can cause more worry and fear. So what started as anxiety about work, can then turn into a complex situation where the person is anxious that they will never be rid of their work anxiety! And so on.
Like depression, anxiety is extremely uncomfortable. And because of this discomfort, it makes sense that therapists and patients alike will want to get rid of the anxiety, usually as quickly as possible. But contemporary research about the treatment of anxiety is finding that, in order to gain long-term relief from anxiety, we need to turn the old way of doing things on its head.
In order to get relief from anxiety, one shouldn’t attempt to alter their anxious thoughts. Instead, one needs help in learning to accept their anxiety.
At first blush, this seems like a recipe for disaster, and you might be thinking that what I’m suggesting will only lead to greater levels of anxiety. When, in fact, the opposite is true.
As we’ve seen, if an individual fights their anxiety, their symptoms don’t always go away, and many times the symptoms will get worse. But if someone learns to accept their anxiety, then something remarkable begins to happen: the anxiety starts to go away.
At its root, anxiety is built upon a foundation of fear (which is usually unconscious). An individual has fear that they will fail in their job, will not find a partner, will become hurt or injured, will be caught off guard by some future tragedy, etc. And these fears are given their power through constantly ruminating over them, and constantly trying to change them. By repeatedly going over these anxious thoughts in our minds, the fears take on greater and greater influence in our minds. But if one can learn to accept their fears, then this stops the rumination, and it stops the growth of anxiety. Acceptance decreases the stronghold anxiety has over the mind.
If rumination and efforts to modify our thoughts are gasoline to the fire of anxiety, acceptance is ice cold water.
And the wonderful things about acceptance are its endurance and availability. One can practice acceptance right here and right now. And once someone begins to practice acceptance, this practice permeates one’s life and sets the individual up for lasting relief from their symptoms.
Contact us to learn more about how acceptance practices can help with anxiety. If you or a loved one is suffering from anxiety, then we are here to help. We are happy to provide more information about how therapy with us can be helpful in finally getting some relief from the exhausting relentlessness of anxiety.
Kyle Kermott, Psy.D. is a Clinical Psychologist practicing in Irvine, and serving the surrounding areas of Newport Beach, Costa Mesa, Tustin, and Orange County. As a therapist, he specializes in therapy for depression and anxiety.