4 Ways Therapists Say People With Anxiety Get Stuck – And How To Get Unstuck

Nearly 1 in 5 Americans have anxiety. So when my therapist said I was one of them, it wasn’t a surprise. As a recent cancer survivor, busy mom of five, and a journalist immersed in terrible global news, I’d heard that before. But I hadn’t learned that feeling unsafe and out of control are actually two of four ways people with anxiety get “stuck.” That part was new — a pattern to the chaos?Suddenly, the condition wasn’t just “anxious” versus “calm” — there were patterns and triggers I could understand. My therapist was referencing principles from cognitive behavioural therapy (CBT), schema therapy, and attachment theory, said Dr. Nicolette Natale, psychiatrist and chief marketing officer at Recovered.org in Bellmore, New York. For non-therapists, this means anxiety often stems from four common “cognitive distortions” or “core beliefs,” Natale explained. “Individuals who have generalised anxiety disorder may ruminate or get stuck on thoughts associated with fear/safety and lack of control, whereas someone with social anxiety may deal with more thoughts about self-worth or fear of judgment,” she said.“CBT suggests that our thoughts, feelings and behaviours are connected, and that certain ‘thinking traps’ or belief systems often maintain anxiety,” said Stacy Thiry, a licensed mental health counsellor at Grow Therapy.Here’s what I discovered about the four ways anxiety traps us — and how to break free.“When people believe that in the future they won't be safe enough, they feel anxious,” said Eran Magen, assistant clinical professor at the Yale School of Medicine Department of Psychiatry.The Four Ways People With Anxiety Get StuckFeeling Unsafe“If someone gets stuck in fear/safety, they might constantly scan their environment for danger, catastrophise situations, or live in a near-constant state of hyper-vigilance,” Thiry said. You might not even realise you feel this way. “Looking at these thoughts with curiosity instead of fear is a major step,” Natale said. “When people believe that in the future they won’t be safe enough, they feel anxious,” said Eran Magen, assistant clinical professor at the Yale School of Medicine Department of Psychiatry. He added that people in this situation might not trust themselves to be able to create a safe environment, or they might mistrust other people or factors, such as the weather. Safe might mean accepted in a social setting, physical safety or something else entirely.Feeling Out Of ControlThe pandemic, global unrest and events in our personal lives can leave anyone feeling unsure of what’s next. “If it’s lack of control, they might obsess over plans, schedules, or the future, because not knowing what’s next feels intolerable,” Thiry said.Blaming Ourselves“Self-esteem/self-blame often shows up as intense self-criticism: ‘I should have done more,’ or ‘It’s my fault things turned out this way,’” Thiry said. “For those stuck in self-blame, self-compassion is essential, but it’s not always intuitive. It helps to reframe your inner dialogue. Ask yourself: ‘Would I say this to someone I love?’ And for those struggling with trust, relational work, whether with a therapist or through secure relationships, can help slowly challenge those internalised fears.”Distrusting Others“Distrust of others might look like chronic relationship anxiety, difficulty letting people in or assuming the worst in social settings,” Thiry said. Maybe others have let you down in the past, or maybe you perceive they will in the future. Living in a world where you can’t trust others is isolating — but you aren’t alone.Identifying the sources of your anxiety through journaling is a good first step.How To Get UnstuckNotice And Name It“Start by paying attention to what your anxiety sounds like in your mind. Does it focus more on your external environment (‘Something bad is going to happen’)? Or more on yourself (‘I’m not good enough,’ ‘I’m going to mess this up’)?” Thiry asked. “Journaling can help you spot patterns, especially if you track your anxious thoughts across a few days or weeks.”Stuck on how to notice those thoughts? She recommends the following questions:“Try asking yourself:What am I afraid of at this moment?Who or what do I feel is responsible?What do I believe about myself when I’m anxious?What do I believe about others or the world?”One you notice them, you can name these fears: “‘Ah, this is my fear of losing control showing up again,’ creates a little bit of distance between you and the anxiety. And that distance is where healing begins,” Thiry said. “If you’ve identified one or two of these core categories in yourself, you’re already halfway there.”Normalise It“Normalise the heck out of it. Your brain isn’t broken, it’s just trying to protect you in the only way it knows how,” Thiry said. “First, please know: You are not alone.”“Let’s stop pathologising ourselves for being anxious in an anxious world. Anxiety isn’t just a ‘you’ problem, it’s often a response to our environment, our history, and how safe (or unsafe) we’ve learned the world to be,” Thiry said. Challenge The WorryIf you realise you are anxious about work, Magen explained, you might notice it’s really about not having enough money for your expenses. “We can begin to challenge this worry. We might realise we’ve never actually run out of money before, that we have friends and relatives who would help us in case of emergency, that we have discretionary spending... or that our income has been steadily increasing over the past 10 years.” He said this helps counter and “loosen” the anxious thought.“A vast number of patients in my practice have benefited from work we have done to catch ‘the stories’ that we tell ourselves, and realise what is real, and what is made up,” said Dr. Alex Dimitriu, who’s double board-certified in psychiatry and sleep medicine and founder of Menlo Park Psychiatry & Sleep Medicine in California. Wait LongerPeople with anxiety aren’t always great at playing the long game, Dimitriu said. “With this loss of nuanced thinking and tendency towards hurried solutions, people with anxiety are bad at holding a course – when that is exactly what is needed for most interventions to work,” he said. “People with anxiety get ‘stuck,’ because they overthink and question everything, and don’t have the patience to work on a solution that may take time — they give up too easily, or they are too doubtful to start.” Dimitriu said you need to stick with something at least two months to see if it helps.Thiry said if traditional therapy isn’t working, try something else: “You might benefit from somatic work (like EMDR or somatic experiencing), trauma-informed care, or even nervous system regulation practices.” Change Your Standard Of Success Trying to “fix” your anxiety? That might not happen. Instead, Thiry suggests teaching your mind and body that “safety, control, worth and trust are possible, even when they don’t feel guaranteed.”“Also, revisit what you’re asking of yourself. Are you expecting to never feel anxious again? Or are you learning how to respond to anxiety in kinder, more skilful ways? The latter is much more realistic, and empowering,” Thiry said. “And sometimes, the most healing thing we can do is admit: ‘I’m exhausted. I need rest. I need softness. I need to stop fighting myself.’ That shift, from performance to permission, is often where the real work begins.”Related...I Tried 'Mindful Walking' To Help Manage My Anxiety – 10 Minutes A Day Was Life-ChangingDeficiency In This Vitamin Can Cause Anxiety, NHS WarnsThis Common Herb May Help To Fight Alzheimer's, Anxiety And Poor Sleep

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