Anxiety - Leaning In is The Way Out

(Yup, that’s me on the Colorado Trail)

Anxiety Umbrella

Anxiety is an umbrella term. There are several types of clinical anxiety disorders that fall under the umbrella, such as Generalized Anxiety Disorder, Social Anxiety disorder, and Panic Disorder. There is also conceptual debate about PTSD, OCD, and others as falling under the anxiety umbrella despite DSM classifications.

Clinically, I find it helpful to distinguish anxiety into two main categories: specific and general. Specific anxiety regarding a specific select thing(s) (e.g., social, situational, illness, phobia). General anxiety is pervasive - almost as if a thread of anxiety was sewn throughout all aspects of life.

Anxiety Narrows Life

Regardless of anxiety “type,” I often see that lives have “narrowed” in an effort to avoid the discomfort of anxiety. Typical behavioral responses to feelings of anxiety are avoidance and reassurance/safety-seeking, both of which provide temporarily relief. Unfortunately, this is very reinforcing for anxiety. And the cycle repeats itself until life becomes quite narrow in an effort to avoid discomfort or anxiety. 

So how do we expand life back out and extinguish anxiety? By exposures - aka the“leaning in.”

Therapy for Anxiety

For specific anxiety, exposure is a well-respected therapeutic approach, robust in empirical support. This is the “leaning in.” This is useful for illness anxiety (hypochondria), social anxiety, phobias, and even PTSD.

When anxiety is more general, I like to focus on patterns of cognition (thought), and then use exposure for specific thought patterns, such as the “What If’s.” I’ve also anecdotally found General Anxiety to have deeply and rigidly formed core beliefs or fears (e.g., fear of failure, not being valuable, good enough). Gently eliciting, facing (exposure), and challenging those fears can be beneficial. Or at the very least, I want to discredit the whispering voice of self-criticism or doubt that is often present with general anxiety. 

Lean Into The Anxiety

Leaning in feels counterintuitive. But it is an effective way to reduce anxiety. 

We as humans tend to seek comfort, ease, and safety. It is a protective mechanism. Sometimes avoidance or safety-seeking is the right response. However, if we repeatedly use avoidance when anxiety spikes, reinforcement builds the pairing between anxiety and some form of stimuli (places, people, actions, etc). This association might develop over time, or more acutely in the case of trauma. If you took a Psych 101 class, you’ll remember this as a Conditioned Response. But you aren’t here for an etiological discussion - the summation here: when there is an identifiable anxiety, we can lean into it to help extinguish the anxiety. 

“Leaning In” Through Backpacking 

To explain the above, let’s use a real-life example. Any time I can talk about backpacking I will, so here we go. 

My current clients know I took a one-month leave this summer to backpack the 486mile Colorado Trail. Spending a month solo in the mountains elicits a natural anxiety response. There is, after all, inherent benefit in anxiety - protection, preparation, attention. 

I began backpacking several years ago when I lived near the Appalachian Trail in Connecticut. At first, I was not comfortable being alone. I was on guard for bears. Sleeping at night in the forest was not restful - every sound elicited a heightened anxiety response. 

My anxiety lessened with repeated exposure to what made me anxious or uncomfortable. 

Over the years and thousands of miles backpacking, my high level of anxiety about bears and mountain lions dropped. I had exposure to bears, experience dealing with them, and that voice in my head saying “a bear is going to rip through your tent” became significantly less credible. Even after a freak illness last year on the Appalachian Trail, I developed confidence that I could handle the “worst case scenario.” That is a component of exposure - if the wheels do fall off, are you capable of handling it? Surviving it? Likely the answer is yes. 

What initially scared me was soon comfortable. The more I leaned in, I became comfortable with extended solo camping. This last trip through Colorado, I had a goal to face my anxiety around “night hiking” - which is hiking in the dark. I started with “graded exposure” - first with others, then a couple miles apart from others, and by the end of the trip I was hiking just me and my headlamp in the dark under the stars. I worked on assessing the credibility of the automatic thoughts; the time I was convinced a mountain lion was stalking me, I didn’t panic. I’ll take that as a win.

For folks reading this, you might not have backpacking experience, and the fears I described might seem quite credible. So let’s use more common examples seen in anxiety disorders:

Social Anxiety - how often does the little voice in your head whisper that someone is judging you, that you don’t fit in, that you’re “different” or “not good enough,” or you’ll be awkward or that no one will talk to you at that social event? Do you avoid social gatherings, networking, or even lingering in your living room with roommates? We can lean into the anxiety and extinguish it.

Illness/Health Anxiety - if you have been medically cleared but still have anxiety about developing an illness, and spend excessive time checking your heart rate, blood pressure, oxygen levels - or diving into google with convincing outcome that you have that rare illness. Maybe you avoid situations, places, or activities? We can lean into the anxiety and extinguish it. 

Phobias - life might be narrowed by intense fear of a specific thing such as bridges, airplane flying, or crowds. Of all the anxieties, phobias greatly respond to exposure and response prevention (ERP) therapy. We can lean into the anxiety and extinguish it. 

General Anxiety - let’s identify thoughts and beliefs that are limiting your life. Fear of failing - let’s lean into it. Fear of being judged? Let’s lean into it. Fear of the worst happening - let’s activate and challenge the heck out of those thoughts. 

How willing are you to let anxiety narrow your life? It doesn’t mean you need to solo backpack across the Rocky Mountains of Colorado. But if your anxiety is stopping you from living a fulfilling, vibrant life, you can change that. If your anxiety is stopping you or limiting your life, we can work on that together.

“Night hiking” is how I experienced each of the above sunrises. I would have missed them if I did not lean into my anxiety!