In this article
Most people I speak with have tried Cognitive Behavior Therapy (CBT).
They’ve written down their thoughts, challenged them and replaced them. But somehow the anxiety is still there.
And if that’s you, let me explain exactly why classical CBT doesn’t work for most people with anxiety.
During my struggle with anxiety, I had 5 therapists. Each one of them gave me something different, but most focused on immediate relief. Breathing exercises. Relaxation. EMDR.
But one of them actually sat me down and taught me about CBT.
I learned how our thoughts create our feelings and how we feel dictate how we behave.
So if we could change our thoughts… we could change how we feel, right?
That made a lot of sense and actually gave me this incredible sense of hope and urgency. All I needed to do was just to change my thoughts and I’d be anxiety free!
I learned about something I now teach everyone in my Mentorship Program: cognitive distortions or “thinking errors”. Incredibly helpful to know about so you can identify the mistakes in your own thinking.
I started asking myself “Is this thought true? Or is it helpful?”, and – you know what – almost always I realized it wasn’t.
I KNOW I’M PROBABLY NOT GOING TO DIE.
But, but but… why do I still feel my heart beating so fast out of nowhere?!
Shouldn’t this feeling go away now I’m changing my thoughts?
I was trying to monitor my thoughts constantly (freaking headache – the average human has 60K thoughts a day…).
I was trying to analyze and replace my negative, unproductive, thoughts constantly. But I still had panic attacks. I still felt anxiety from the moment I woke up till the moment I went to bed.
Surely, by now, I should feel better, right? I should feel calm.
(For the pros: that’s another cognitive distortion, isn’t it? ;))
I didn’t feel better. I didn’t feel calm. And most people with anxiety actually don’t.
Why CBT didn’t work.
If you suffer from “chronic anxiety”, your nervous system is highly sensitized.
Your whole survival mechanism is on high alert, constantly scanning for threats and danger.
Your baseline cortisol levels are higher. Small amounts of stress hormones are released throughout the day – sometimes with peaks like panic or DR/DP.
There aren’t always thoughts leading up to that.
Do you recognize that?
Maybe you wake up with anxiety or panic and you have no idea what you’ve supposed to have thought in order to get this.
Maybe you’re doing OK at work and out of nowhere you feel heart palpitations. What was the thought leading up to that? No idea.
Because a sensitized nervous system isn’t driven by thoughts.
When sensitized, your body can lead too. Your whole system believes you’re in danger so it’s going to release chemicals, at times that feel random.
Your thoughts don’t have too much to do with that. You can understand anxiety rationally but you can never think yourself out of anxiety. That just doesn’t work.
Rationally you understand you’re safe. You understand that catastrophe probably isn’t going to happen. And that’s helpful – but when anxiety shows up the rational brain shuts off.
When the survival brain kicks in, logic goes out the window and we tend to forget everything we’ve learned. Now, suddenly, that catastrophe seems very likely – and we start to respond in accordance to it.
If you know a little bit about how anxiety works, you know that behavior drives a sensitized nervous system. You keep yourself in the anxiety cycle by your own behavior.
Meaning: we need to behave differently in order to fully recover from anxiety. Not just think differently.
We need to stop engaging in behavior that validates or confirms a threat to the nervous system, like resistance and avoidance.
The more you fight your feelings, the more you validate them as a threat.
The more you avoid situations, the more you validate danger.
Here’s where traditional CBT often goes wrong…
CBT turns into Resistance
Though traditional CBT doesn’t tell you to fight anxiety directly, it does often turn into that.
We’re told to evaluate and challenge our negative thoughts – but with what goal?
It’s to change how we feel. It’s to make sure the discomfort, the anxiety, goes away. We use CBT as a way to make sure we get back in control, or feel calm again – without anxiety.
That just confirms to the nervous system that anxiety is dangerous. And it keeps your nervous system sensitized.
With anxiety recovery, the intention is crucial. If you behave with the intention to make anxiety go away, you’re keeping it alive.
CBT often becomes one of those things.
Because, anxiety isn’t maintained by wrong thoughts.
It’s maintained by learned responses.
Behavior Keeps Anxiety Alive
Your nervous system, with its one job of keeping you safe, is constantly watching you behave to determine whether you’re safe.
So again, not how you think but how you behave.
You can tell yourself all day that “I’m safe!” but if you still behave like you’re in danger, your anxiety isn’t going anywhere.
Now, what do you think that constantly monitoring, evaluating and trying to change your thoughts tell your nervous system…?
It says there’s a problem. There’s a threat. We need to do something about it.
You keep anxiety alive, using traditional CBT, because you make it a “big deal”.
You try yet another thing with the intention to make anxiety go away and you keep anxiety highly relevant and important.
Both types of behavior keep your anxiety alive. Which is why CBT hasn’t worked for you. I did that too.
And even though the more effective forms of CBT include exposure (meaning you go out and change your behavior) the intention behind it still matters.
Because there’s a big difference. Are you going out hoping the anxiety doesn’t show up?
Or are you going out and living your life… even if it does?
One is still control. The other is freedom.
One tells your nervous system: this needs to go.
The other teaches it: this isn’t a threat.
Acceptance vs. CBT
What’s proven to work for anxiety recovery is changing your behavior through acceptance or non-resistance.
It’s learning how to respond in a new way, that doesn’t confirm to the nervous system that you’re in danger.
In short, simple terms, it means that you act and behave as if anxiety isn’t a problem – and it stops being one.
If you allow the discomfort to be, your system slowly stops reacting to it and creating more of it. That’s the paradox.
So the goal of “acceptance” – and our method for that matter – is different from CBT.
CBT = trying to “fix” your thinking, so anxiety goes away
Acceptance = understanding your nervous system is sensitized, and allowing your thoughts and feelings to be.
Acceptance doesn’t focus on controlling the individual thoughts and symptoms – making sure they go away – but on the one thing we can actually control: our response.
Behavior first – even though we feel like crap.
Traditional CBT says we need to change how we think, so we feel better, and when we feel better we can behave differently.
Acceptance says to behave differently even though you feel uncomfortable.
Recovery starts when your goal is no longer to feel better but to respond differently, no matter how you feel.
For example:
You feel your heart racing.
CBT says:
“What’s the thought? Let me challenge it.”
Acceptance says:
“Let it race and keep doing what I was doing.”
The first keeps you engaged, trying to understand it – or make sure the discomfort goes away.
The other teaches your system there’s no danger.
CBT tries to make anxiety make sense.
Acceptance removes the need for it to make sense.
When you truly know what anxiety is, and how to respond properly to it, you change your relationship with it.
You become indifferent to it. If it shows up, it shows up. If it doesn’t, it doesn’t.
You understand that, when sensitized, you’re going to have a lot of negative, catastrophic, thoughts. And you understand that’s there to keep you safe.
But you don’t have to engage with it. You can just let them pass and go on with life.
This changed EVERYTHING
Maybe similar to yourself, I felt really bad and frustrated about not being able to control my negative thoughts.
I was really frustrated that CBT didn’t work for me, and that frustration just increased my resistance, increasing my anxiety.
Learning about the third wave of Cognitive Behavioral Therapy, and specifically ACT (Acceptance and Commitment Therapy) changed everything.
In our method we use parts of many forms of CBT, but the overall goal is always to become OK with anxiety.
Not OK that anxiety in this intensity will show up for the rest of your life, but that it’s a basic human emotion – and we fuel it ourselves.
The intention changes – and so do the results.
So, learning about negative thinking patterns and challenging them can be extremely helpful and it’s part of the recovery journey, but the goal behind it is different.
The same tool can either keep anxiety alive or help you break free, depending on why you’re using it.
If you’re challenging thoughts to feel better, you’re still in a fight and you’re still engaging with them all the time.
If you’re defusing them so you don’t get pulled in, while allowing them to show up, you’re stepping out of the loop.
The resistance needs to come down. Your relationship with anxiety needs to change.
That means your behavior has to change too. Even though you won’t feel like it.
Behavior first, feeling second.
So whatever you do, as long as it’s with the intention to make anxiety go away…
Or to make anxiety really important…
Or to experience as little as possible…
…is keeping it alive.
Thanks for reading!
This article is for education and is based on lived experience. It is not medical advice and does not replace a doctor or therapist. If you have new or changing symptoms, get them checked by a doctor. If you are in crisis, contact your local emergency number.
