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June 30, 2021
I had a lightbulb moment when I realized that one of the reasons so many people fail to see that they have anxiety is the way it hides in bad habits.
You see, anxiety hides in people’s habits. It hides in their bodies as they learn to disconnect from these feelings through myriad different behaviors.
A problem can’t be solved by the same consciousness that created it. —INTERNET MEME ATTRIBUTED TO ALBERT EINSTEIN
We all get anxious—it’s a part of life—yet how we deal with it is critical.
Anxiety is born when our PFCs don’t have enough information to accurately predict the future.
Notice how fear itself does not equal anxiety. Fear is an adaptive learning mechanism that helps us survive. Anxiety, on the other hand, is maladaptive; our thinking and planning brain spins out of control when it doesn’t have enough information.
you need to learn how to safely discharge the excess energy associated with that “I almost died” adrenaline surge, so that it doesn’t lead to chronic or post-traumatic stress and anxiety. Simply talking to someone doesn’t count here; you may really have to do something physical, like shout, shake, dance, or engage in some type of physical exercise.
Like a seed needing fertile soil, the old survival brain creates the conditions for anxiety to sprout in your thinking brain (chronic). This is where anxiety is born. Fear + uncertainty = anxiety.
From a scientific standpoint, the impact of having too much information to make choices when planning has been dubbed choice overload.
as the scenarios become more worst-case (which tends to happen as the PFC starts to go off-line, ironically due to the ramping up of the anxiety), your fight/flight/freeze physiology can get triggered to the point that just thinking about these possible (but highly improbable) situations can make you feel that you’re in danger, even though the danger is only in your head. Voilà! Anxiety.
When we can’t control our anxiety, that emotional fever spikes into panic (defined online as “sudden uncontrollable fear or anxiety, often causing wildly unthinking behavior”).
To hack our brains and break the anxiety cycle, we must become aware of two things: that we are getting anxious and/or panicking and what results from anxiety/panicking.
Since our brains will choose more rewarding behaviors simply because they feel better, we can practice replacing old habitual behaviors such as worry with those that are naturally more rewarding.
“continued use despite adverse consequences”—well, that could mean continued use of anything.
Trigger: Thought or emotion Behavior: Worrying Result/reward: Avoidance, overplanning, etc.
the definition of anxiety is “a feeling of worry, nervousness, or unease, typically about an imminent event or something with an uncertain outcome.”
In the dictionary, worry is defined as both a noun (“I am free of worry”) and as a verb (e.g., “I worry about my children”). Functionally, the act of worrying is a mental behavior that results in a feeling of anxiety (nervousness or unease). On top of this, the feeling of anxiety can trigger the behavior of worrying, which becomes cyclical: Trigger: Anxiety Behavior: Worry Result: Feel more anxious
when the distraction doesn’t work, you’re left with having to come up with another solution. This can lead to more worrying, and that worry thinking becomes its own trigger. Not much of a reward, is it? And here’s the kicker: even though worrying doesn’t work, our old brain keeps trying. Remember, our brain’s job is to help us survive, and because at some point it linked problem-solving with worrying, it thinks worrying is the best way to go. Our brain keeps pulling that worry slot machine lever hoping that it will hit the solution jackpot.
Trigger: Get another email about how behind I am on my RVUs Behavior: Think about how the system sucks and is only getting worse Result: Get more cynical, become burnt out
Part 1 (first gear) will help you get started mapping out your own anxiety “habit loops.” Part 2 (second gear) will help you tap into your brain’s reward system to systematically work with anxiety (and other habits). Part 3 (third gear) will help you tap into your own natural neural capacities to step away from anxiety-related habits (e.g., worry, procrastination, self-judgment), and into new ones (e.g., curiosity and kindness), potentially for good.
Nobody can go back and start a new beginning, but anyone can start today and make a new ending. —MARIA ROBINSON
Trigger: Anxiety in the late afternoon Behavior: Start drinking Reward: Numbing, forgetting, feeling intoxicated
Trigger: Wife speaks a certain way Behavior: Worries that there might be conflict Result: Anxiety
John was really excited to have discovered this, because for years it had caused strife in their relationship. When his wife’s tone changed, John got anxious, and he would react by yelling at his wife. She in turn would get confused, wondering why he was yelling, and would react to his reaction, and so on. Trigger: Anxiety Behavior: Yells at wife Result: Marital strife
First Gear First gear is all about recognizing our habit loops and seeing the different components clearly: trigger, behavior, and reward. To be clear, reward is a brain term, as in it’s the result of the behavior that at some point was rewarding, that’s why the behavior got reinforced in the first place. The behavior might not seem that rewarding right now, so you can simply think of the habit loop as a trigger, a behavior, and a result.
Trigger: See a new book about anxiety (or habit change) Behavior: Devour the book in one sitting Result: Understand the concepts, but fail to change the habit
Kabat-Zinn’s definition of mindfulness is “the awareness that arises through paying attention in the present moment, on purpose, nonjudgmentally.”
Our brains are brilliant at making associations. That’s how we learn. We associate cake with yummy goodness, and then when we see cake, we automatically eat it. If we get food poisoning at a restaurant, we quickly learn to avoid that establishment. In fact, the association between that restaurant and yuck can be so strong that we may even feel nauseated when we simply pass by the store. Yet this brilliance goes only so far. A restaurant sign isn’t poisonous in itself, but we learn to associate it with a DON’T GO THERE sign in our minds. And our minds—being the good associative learning
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correlation does not equal causation.
[Mindfulness is] the awareness that arises through paying attention in the present moment, on purpose, nonjudgmentally.
Mindfulness is not about stopping, emptying, or ridding ourselves of anything. Thoughts, emotions, and physical sensations are what make us human. And thinking and planning are both crucial things to master. If I wasn’t able to use my thinking brain to take a clear clinical history and make a solid diagnosis, I would have one heck of a time providing good care for my patients. So rather than changing or not having the thoughts and feelings that make up our experience, mindfulness is about changing our relationship to those thoughts and emotions.
Don’t forget, not all habits are bad. They become bad only when they are tripping us up or slowing us down instead of helping us move forward.
“I am having an anxious thought” vs “I am anxious?”
As a clinician, I see perseverative thinking as possibly the top issue tripping up my patients. And more often than not, this type of thinking has grooved a deep pattern in their brains to the point that they have identified with their habits: “I am a smoker.” “I am anxious.”
People who are depressed perseverate about the past. People who are anxious perseverate about the future. Regardless of content (past/future), mindfulness jumps in and helps to dismantle the process of perseveration—so much so that the National Health Service in the United Kingdom has adopted one type of mindfulness training (mindfulness-based cognitive therapy) as a first-line treatment for depression.
Approach: You tend to be optimistic and affectionate and might even be popular. You are composed and quick thinking in everyday tasks. You’re more likely to be attracted to pleasant things. You put faith into what you believe, and your passionate nature makes you popular with other people. You have a confident posture (that is to say, you walk proudly). At times you might have the tendency to become a little greedy for success. You crave pleasant experiences and good company.
Avoid: You tend to be clear-thinking and discerning. Your intellect allows you to see things logically and identify flaws in things. You are quick to understand concepts and tend to keep things organized and tidy while getting things done quickly. You pay attention to detail. You might even have a stiff posture (that is to say, you walk stiffly and hurriedly). At times you might notice that you are overly judgmental and critical. You may come across as a perfectionist.
Go with the flow: You tend to be easygoing and tolerant. You are able to think about the future and speculate on what might happen. You think about things deeply and philosophically. At times you get caught up in your own thoughts or fantasies. As you daydream, sometimes you might become doubtful and worried about things. At times you might notice that you find yourself going along with what others suggest, perhaps becomin...
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You must let the pain visit. You must allow it to teach you. You must not allow it overstay.
The more rewarding a behavior is, the stronger the habit.
To change a behavior, you can’t just focus on the behavior itself. Instead, you have to address the felt experience of the rewards of that behavior.
Trigger: Time of day, stress, hunger, etc. Behavior: Mindlessly eat a snack Result: Hmmm, how did those chips taste? I wasn’t really paying attention.
If you really pay careful and close attention—without making any assumptions or relying on past experience to guide you—and you see that a behavior is not rewarding right now, I promise you that you will start to get less excited about doing it again.
The world is filled with panaceas sold to you to make you avoid pain and feel good. Clothes, cars, pills, experiences—all are packaged and tied with neat little bows of “this will relieve your aches and pains,” “this will make you feel good,” or “this will help you forget your worries.” But if you stay in your comfort zone, you will never grow. Life is going to throw all sorts of stuff at you, and either you get sucked into creating habits of indulgence, distraction, and numbness through clothes and pills, or you can learn to roll with the punches, even leaning into them as a way to grow
people step out of habit loops by becoming disenchanted with them, but they have to be aware of the cycle (first gear) and the current reward value of the behavior (second gear) to do this. And the more often they bring awareness online and feel disenchanted, the more they groove the disenchantment pathway in their brain. Repetition works when you are lifting weights and building your biceps; it also works when you are strengthening your mental muscles.
Once they’ve described the scene of the binge—perhaps how they were out of control or on autopilot—they will often describe how they woke up the next morning feeling bloated, hungover, or mentally and physically exhausted. And that’s what we focus on: the result of the binge, the morning-after part. What did your body feel like? Awful. What was your emotional state? Awful. What was your mental state? Awful.
Trigger: Getting into an argument with a family member Behavior: Bingeing Result: Feeling physically, emotionally, and mentally awful (with no improvement in family relations)
Dr. Dweck defines fixed mindset as when you believe your basic intelligence and abilities are immutable: you’ve got what you’ve got and have to utilize them the best you can. Growth mindset, on the other hand, is a belief that your abilities can be developed and improved over time.
In her book, Mindset: The New Psychology of Success, Dweck advises, “If parents want to give their children a gift, the best thing they can do is to teach their children to love challenges, be intrigued by mistakes, seek new strategies, enjoy effort, and keep on learning. That way, their children don’t have to be slaves of praise. They will have a lifelong way to build and repair their own confidence.”
