Getting Rid of Anxious Thinking
Margaret has been suffering from anxiety and depression for over two years, with very few periods of respite. She is taking a variety of medications, which she doesn’t think is helping, and came to see me for a different kind of help.
It is often more difficult working with someone who is on medication, as it is not always clear what might be the symptoms of her depression and what might be the side effects of drugs. In Margaret’s case, there was debilitating fatigue, which could result from either.
We had talked previously about the need to avoid negative thinking (which is itself exhausting). I had taught her ways to help with this, including avoiding anything that could trigger it unnecessarily—Margaret had been horrifying herself with world events on rolling news channels.
I reminded her about the importance of positive expectation—a vital component of the human givens therapy toolkit—to expect that each day will be a better day, for instance.
“Oh, I do that,” she said, in a rather flat voice.
“You do?”
“Yes. Every day I wake up and say to myself, ‘Perhaps the anxiety has gone!’”
There is a subtle distinction to be made here. Waking up and thinking: “I am going to get up and have a shower and it will energise me for the day,” is a form of positive expectation.
However, thinking “Perhaps, the anxiety has gone!” is entirely different. It requires a person to look to see if the anxiety is still there or not.
Imagine someone saying, “Does your shoulder feel itchy?”
You might immediately answer, “No.”
“Are you sure?” they persist.
You focus on your shoulder for a little longer and, sure enough, it may start to feel itchy. When we focus on whether we have an itch, pain, or negative thoughts running through our heads, we unwittingly bring them about and proceed maintain to them.
Cognitive philosopher Andy Clark has suggested a nice metaphor: “You might infer that your fridge light is constantly on just because the light is on every time you look inside. But actually, it is the act of looking (opening the door) that turns on the light.” 1 When we pay attention to an itch, a tremor, or an unhelpful set of thoughts, we are, in effect, opening the fridge door to find the light. What’s more, to look for the itch, pain, or negative thoughts, we have to imagine what they are like; so we are more likely to find them (and bring them into being).
Prediction machines
There is even more to it than this. What we expect to find affects our actual physical experience, now and in the future. Our brains predict what will happen next, based on our past experiences. If we have nonchalantly watched mobile cranes unloading heavy material in the street, we won’t panic when we next see one, and we’re not terrified that the load will land on our heads. We cease to pay it undue attention. But if we once did have a near miss, the chemical cascade that triggers and accompanies the fight-or-flight response would probably be activated the next time, too.
As Clark also explains, it isn’t our senses that govern what we experience; we don’t see, hear, touch, taste, or smell something and react accordingly. We have already predicted what we will experience (and how we need to deal with that). The signals from our senses merely confirm or refute our predictions. In the latter case, we must update our expectations and predictions accordingly. For example, if we expect something we are lifting to be light and then find it is heavy, we have to adjust our grip and record that experience for next time.
But if we expect to feel anxiety when we wake up and we look and find it, there is nothing to correct. It is only when we stop looking that the brain learns that, on waking up, there is no anxiety there to feel. The body’s predictive mechanism no longer expects those symptoms.
And that, as I explained to Margaret, is why thinking, “I am going to get up and have a shower and it will energise me for the day,” could be a powerful aid to changing her depressive predictive programming.
