Strategies for managing and transforming anxiety
In the same way that sustained inflammation in the body can have long-term consequences on physical health, chronic anxiety can erode our resilience and sense of self. So intentionally managing it is an important part of living a good life. Techniques range from short-term coping strategies to habit work to transformative revamping of our self-concept. There’s no one best way because it all depends on context, our preferences, and how much bandwidth we have to do the work. Here are some options.
Coping strategies (short-term)
This category is all about flattening out the anxiety spikes in the absence of planning and longer-term self-development. I’m personally much more interested in lasting change that addresses anxiety at its roots, but if you’re in a bind, there are some things you can consider.
This is a lot of what you’ll see when you search for “how to manage anxiety” (which I encourage you to do!). Take slow, deep breaths, count in your head, maintain a healthy diet and sleep schedule, go for a walk, close your eyes and relax for a few minutes, get a massage, journal, and so forth.
Some of them are part of a healthy lifestyle, which improves everything, not just anxiety. Others are truly palliative and tap into the nervous system’s ability to move from an aroused state to a calm state. Some of them are habit-forming, too, which boosts their effectiveness in recurring tense situations.
And then there are the things that we do because they’re easy in some sense: self-medicate, run away (avoidance), treat ourselves harshly to “toughen up”. You won’t see these listed in search results, but let’s be real: sometimes they work and there’s a reason why people use them. I’m not judging. It’s just best to avoid them if possible because they have negative side-effects and tend to be band-aids placed on underlying issues. They tend not to be part of a path towards a healthier experience.
We can delve deeper.
Habit forming (medium-term)
Medium-term strategies for addressing anxiety avoid the investment and difficulty required for transformative change while still giving longer-term results. The catch is that there is a baseline amount of effort we must regularly put in to keep up those habits. This can be very effective when applied with discipline [2, 3].
Cognitive behavioral techniques
When it comes to anxiety, there is often a gap between our expectations and reality. We think things are more dangerous in some way than they are. But we can make intentional and structured choices around them. It’s all about reminding yourself that what you are experiencing is a belief rather than a factual indication of reality.
I’m not talking about positive affirmations, but rather something more along the lines of Cognitive Behavioral Therapy (CBT) [4]:
- “It’s just a spider, those are physical sensations, there’s no real danger”
- "My feelings are a wave against the shore”
- "You’re anxious, allow yourself to feel that way and move forward anyway”
Longer term, this is a process of intentionally developing the relationship we have with our self so that we’ll feel that such statements are true. Simply saying these things to ourselves in the moment is not enough. That’s why this is a mental muscle that must be worked out to keep strong.
Formally learning the technique from a skilled practitioner makes a big difference. Some therapists are trained in using CBT as an intervention (e.g. for depression or anxiety). However, know that it is not especially trauma-informed, meaning that if trauma is at the root of your struggles, the work of CBT may actually end up feeling invalidating.
Another cognitive approach is embodied by the Stoic philosophy [5]. The central idea being to focus on what is under our control and let go of worry about the rest. Easier said than done, but it gets easier with practice! Practice, practice, practice.
Growth mindset
We tend to act as if our mindset is fixed, but we can choose to adopt what Carol Dweck calls a “growth mindset” [6]. This is a habit of seeing our experiences not as reflections of who we are but of who we can become with effort.
Feeling disempowered is a recipe for anxiety. A growth mindset helps us stay focused on opportunities that are paths away from feelings of inevitability. The cliché about it is changing our language, e.g. from “I can’t do this” to “I haven’t understood how I can do this yet”. The “yet” is the key word there. And not just saying it, but deeply feeling that it is true about ourselves. We’re not there yet.
The broader approach involves intentionally catching ourselves in fixed mindset thinking and offering alternatives. You can practice this regularly to stretch your beliefs about yourself and the world around you, taking advantage of neuroplasticity to rewire your brain [7]. Eventually, it becomes an instinct where the gap between a fixed-mindset thought and the corresponding growth-mindset thought is mere seconds.
It's actually quite liberating once you get the hang of it! Although it does take effort to maintain because of the messaging we receive and internalize throughout the day while living in a competitive society.
Self-compassion
Much has been written at this point about the benefits of self-compassion [8, 9]. In our competitive society, we tend to self-flagellate in the privacy of our minds in order to maintain certain standards in life. This is effective up to a point, but all too often disconnects us from an intrinsic sense of self-worth. It is also hypocritical in that we tend to be compassionate towards others who we care about but reject compassion towards ourselves.
It's important to note that compassion is not about letting anyone off the hook or being lazy. In fact, the most compassionate action could be one that initially makes someone feel terrible, like ending a relationship. Compassion is about being aware of suffering and embracing the will to act so as to relieve that suffering. When applied to one’s self, this means comforting and supporting yourself during difficult times to boost your resilience, all while keeping yourself honest.
This compassionate intention doesn’t come for free, though. It’s a muscle that has to be exercised and a great way to do that is through “metta”, or loving kindness meditation. Unlike mindfulness meditation, which is ideal for developing non-doing, non-judgement, and focus, metta is very active.
It starts by centering on the breath and then transitions to visualizations in which you focus on an “image” (animal, person, place, etc.) and develop your intentions around it. Classic categories are “stranger”, “loved one”, “yourself”, and “difficult person”. Metta helps us develop a more grounded self that trusts the road we walk in life. This in turn reduces feelings of anxiety and disconnection.
It’s kind of hard to learn on your own, so I would suggest joining a meditation group or doing a training like the 8-week course offered at Stanford’s Center for Compassion and Altruism Research and Education (CCARE) [10].
If you keep it up, it is a tool that you can take with you into any challenging situation that comes your way.
Transformative change (long-term)
Transformative change is an intentional restructuring of an aspect of the mind at a deeper level. It’s more renovating, less redecorating. And it starts when we notice that we have taken on anxiety as part of our identity. We might see anxiety as something that we must have in order to survive. Or it is so familiar that we automatically use it without thinking. It could be weaponized as well, e.g. “give me what I want or I’ll flip out”.
All these scenarios indicate that we are holding on to something at a deeper level that we feel justifies being anxious. And to some extent, we can choose what to do with those deeply-ingrained beliefs, even though it feels like we can’t.
This is when we turn to psychotherapy and its cousins. Far too many people see going to therapy as a failure, as if improving yourself through deeper psychological insight were a bad thing. Absolute nonsense. Once we let go of that belief, we gain access to the power of therapy to enact transformative change.
The real work for addressing persistent anxiety is all about healing wounds. Our anxieties may come from a lack of trust in ourselves, others, or authority. They may be triggered by a past trauma that hasn’t fully resolved. Sometimes, vivid anxieties are fueled by a system of unresolved traumas, requiring a methodical disentangling of them, like trying to safely clear out a mine field.
It’s no surprise that a well-trained professional is generally a must for this kind of work. While your mind is transforming, you may experience different kinds of temporary instabilities like mood swings or a brief spell of paranoia. And that's an expected part of the process. It's the psychological discomfort of pulling off a band-aid.
A note on trauma
What is it? The result of an experience that our nervous system decides is a significant threat that must be remembered and avoided in the future, rational or not. The mind locks that experience into our memory and hooks up reminders of it to our internal alarm system. [11]
A dog bites you when you’re a kid. Your mind goes “never again” and makes sure that whenever you see or interact with dogs in the future, you feel anxiety or fear to keep you from being bitten again. It’s pretty good for that purpose. But later on, you can decide that you don’t need it anymore. The event can range from a bee sting to sexual assault to witnessing mass casualty. The underlying psychology is the same.
Below are two modalities for healing trauma and other deep diving. It’s important to remember that your mind wants to heal and it’s up to you to be ready for it and get out of its way. Easier said than done, I know. You have to start somewhere and build out your healing journey.
Eye Movement Desensitization Reprocessing (EMDR)
This is best known as a trauma-focused therapy. It was discovered by Francine Shapiro [12] by accident, believe it or not. The story goes that she was sitting on a park bench deep in thought and noticed that moving her eyes back and forth to follow a group of birds flying around was soothing somehow. She experimented with it and developed the technique that is now widely used.
First, you and the therapist identify the trouble spot you want to address. You then alternate bilateral stimulation (following a finger or a dot of light on a light bar back and forth) with talking about what comes up in your mind (thoughts, emotions, memories, etc.). The bilateral stimulus has a strange way of engaging the mind’s natural healing mechanism, facilitating deeper processing.
Over the course of multiple sessions, you let yourself float back to difficult memories and the therapist helps you observe them with agency. That now, long after those experiences, you can choose how to feel about them. The results can be very surprising given that the causal mechanism behind moving the eyes side-to-side is still unclear. More often, it takes months to see real change. But once that change really happens, it’s permanent.
Internal Family Systems (IFS)
IFS [13] can be used to address trauma, but I think of it more as an intuitive approach to developing self-knowledge. IFS sees the mind as the sum of many experiences, all of which lead to the development of internal voices or “parts”.
In an IFS session, with or without a therapist, we explore these parts, give them names, and describe them in as much detail as we like. Some common parts that emerge are a protector, exiled part, wounded child, distractor, and an angry part. Some people can identify multiple protectors. And then, the natural question is: what are they protecting? Parts don’t know about the whole. They just do their thing and they generally do it well, whether or not it’s what you want for yourself.
The detective work of IFS is like that of a team leader on a listening tour getting to know their organization. It can be comical at times to see what characters are rattling around in there, but also sad to find wounded parts that have been suffering alone for a long time. A common situation is that there is a protector in the way of you talking directly to the wounded part. So to access the wounded part, you first have to gain the protector’s trust.
Mapping out those parts enables us to identify the root causes of anxiety (and other ailments) and then make intentional choices about where we need to heal, what past experiences we need to reframe, and so on.
One of the many long-term benefits of IFS is that when you have a strong reaction to something, you can always ask, “who is speaking now?” If you know your parts well, one of them will usually claim ownership. You’ll be much less anxious if you know what’s going on in there!
Finally, IFS self-therapy is a powerful modality and involves a solo session in meditation. It’s a great way to check in with yourself and see who (what part) needs your attention the most that day.
Community and social support
We are wired to connect. Finding community can be very effective for managing mental health struggles in general. The contradiction is that anxiety makes it difficult to feel safe when connecting with others. So it’s not always straightforward, but well worth the investment. Affinity groups, support groups, fitness groups, spiritual groups, whether in-person or online, are all great outlets.
The reason why this item is in the long-term category is that the most nourishing bonds are those formed over time that encourage us to develop ourselves communally. I’m not talking about casual friendships, but rather deeper connections where we allow ourselves to be vulnerable. Regularly having the experience of intimacy and safety builds up our tolerance for uncertainty, reducing the bite of anxious moments. Our close friends need not even be there when we’re facing a challenge. It’s the way our brains rewire around feelings of safety that makes life feel easier.
So while you’re delving into your mind, don’t forget to connect!2
