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Key points
- Anxiety boils down to trying too hard to make sure bad things don't happen (an over-aversion to risk).
- Short-term avoidance of anxiety leads to long-term increases in anxiety, so avoidance makes anxiety worse.
- Anxiety gets better by recalibrating your risk tolerance and allowing normal, healthy risks in life.
At its core, anxiety is all about an intolerance of risk. All forms of anxiety, in one way or another, boil down to trying too hard to make sure that bad things don't happen. The opposite is also true: The way that anxiety gets better is by allowing a healthy level of risk in your life.
That is why all successful therapy for anxiety really comes down to building risk tolerance.
I often use the simple, straightforward example of a dog phobia; if someone is afraid of dogs, they probably try to avoid dogs. Anytime they see a dog, they are probably afraid of being bitten by a dog and so when they encounter dogs, they try to stay away from them. They may run away from dogs or avoid going over to houses where they know there will be dogs.
These types of avoidance behaviors stem from the person's intolerance of the risk of being bitten by a dog. They are not willing to take that risk, and so they try too hard to make sure that they never get bitten by a dog.
But because short-term avoidance of anxiety leads to long-term increase in anxiety (see this article for more on why that happens), there are costs to making sure they do not get bitten by a dog: It worsens their anxiety in the long run and they probably miss out on certain social events where dogs might be present.
If they want to not pay those costs anymore and get over their dog phobia, there is no way around it: They are going to have to spend time around dogs and be willing to take the risk that they will get bitten. Doing so is what we call Exposure Therapy, which is one of the most well-researched and effective treatments for all types of anxiety.
This is the way to free yourself from any type of anxiety: Take some healthy risks that your brain says you should not take.
Now a dog phobia may not really carry too high a cost because it may not impair your life all that much. But take another common example that can be much more painful and crippling: contamination OCD. Contamination OCD is the stereotypical “germophobe” kind of OCD. People with contamination OCD worry about contaminating themselves or others, usually with any form of sickness or disease and this leads them to avoid touching certain surfaces and compulsively wash their hands. I have seen many cases where it gets so severe that people rarely leave their homes or spend hours per day washing themselves and their possessions. It can be quite brutal.
Like the dog phobia example, people with contamination OCD are too intolerant of risk.
Living a normal, healthy life in modern society means that there will be some level of risk of contamination with germs and thus some risk of sickness. It is unavoidable.
Folks with contamination OCD try too hard to avoid this risk and it comes with enormous cost to their lives. To overcome this, there is no way around it: They are going to have to take the risk of getting sick. This again is the idea behind Exposure Therapy (which for OCD is typically called Exposure and Response Prevention, or ERP for short).
The things we do in Exposure Therapy for contamination OCD often come as a shock to most people, even those who do not suffer from this type of OCD. In order to practice taking the risk of getting sick and teaching the brain that it is not dangerous, what we do is we touch all kinds of gross things such as public toilets or trash from trash cans. Then we touch clean items, often things throughout a person's house, and we don't wash them or wash our hands.
Now most of the time when I tell people about that kind of therapy, their initial reaction is “that's crazy, couldn't I get sick from doing that?” My answer is “Yes! There is a small risk of getting sick from doing that sort of thing. I think the risk is quite small and in fact I have done sessions like that with clients hundreds of times without issue, but the risk is certainly not zero. But in my mind, the far bigger risk is allowing your OCD to continue because of how much suffering it causes. If we do exposures like this, there is a small risk that you will get sick. However, if we do not do things like this, there is a guarantee...not a risk, but a guarantee... that you will continue to have OCD. Which one is really worse?"
If they then take that risk and do those types of exposures, it teaches their brain that the risk really wasn't so dangerous, and that is what relieves the anxiety and frees up the person's life.
So the next time you feel anxious, ask yourself: "What is the risk I am afraid of taking? Can I recognize that risk is an unavoidable, acceptable part of life and that I am going too far in trying to avoid this risk? How can I take the risk in a healthy way so that I stop suffering from this anxiety?" Try it and see how tolerating risk gives you freedom and improves anxiety.
