The 3 best ways to tackle anxiety, according to a leading expert

You might expect a cognitive psychoanalyst, former NHS mental health lead and author of How to Be Your Own Therapist and Addicted to Anxiety, to offer fairly familiar advice to anyone struggling with anxiety. Yet Owen O’Kane’s view is refreshingly different. Rather than seeing anxiety as something to eliminate, he argues that it is something we need to embrace. In fact, contrary to the popular brain-based advice that dominates social media, he believes the most effective place to begin is not the mind but the body. Here, he tells New Scientist the three things we should be doing to reframe our relationship with anxiety – and live well alongside an anxious mind.

1. Rethink your relationship with anxiety – it’s trying to help you out!

Scientific studies on anxiety will often point to treatments that help you to “switch off this part of your brain” or “reduce this or that hormone”. I fundamentally believe that is the wrong way to deal with anxiety. Before we even start thinking about the brain, we have to form a better relationship with our anxiety. We need to get to know it. Work with it. Negotiate with it. Understand why it is there.

There is a part of you that is sometimes scared, and when that feeling bubbles up, it will manifest itself as anxiety to get your attention. It does that so that you respond – it’s a helpful mechanism that protects you from harm. If you think of anxiety as a person, it feels like it’s doing the right thing. If you’re worried about mucking up a presentation, it’s saying “okay, I can make sure you don’t feel bad about this, that it doesn’t go wrong. I can get you out of here in 30 seconds”.

But if you treat your anxiety like an enemy, that’s exactly what it will become. This heightened sense also means you could lose a job or opportunity. But, if you’re still thinking of it as a person, your anxiety doesn’t care about your losses, it’s doing its damnedest to make you safe.

If you don’t start by forming a relationship with anxiety and understanding that yes, it’s uncomfortable, but that’s because it’s making you pay attention, then everything else is just a sticking plaster. It will push your anxiety down but it’ll come back up eventually. Anyone who promises you tools to get rid of anxiety is lying to you. Anxiety has to be there, and you have to accept that to improve anything.

2. Think about changing your body, not your brain

Many psychiatrists focus immediately on the brain, trying to help you change your thoughts. But my key starting point is the body. Most people can feel anxiety somewhere in their body – in their heart, their shoulders, their neck. When anxiety is presenting itself in the body, the body is in a state of alarm. It sends a message to the brain that something isn’t right. The brain will then accept that information and subsequently, the prefrontal cortex – the part of the brain that helps us be a bit more rational and measured – is suppressed.

When you’ve noticed your body reacting, do whatever works to release that state of threat. It might be breathing, or exercise or an ice bath. Whatever regulates your body. And do it with the understanding that you’re not doing it to get rid of the anxiety, but so that you can send a new message to the brain to switch off this threat response so that your prefrontal cortex can get back online and enable you to work with the anxiety in a much more measured, calm way.

3. Write about what really happened to increase your tolerance for uncertainty

We have several thousand thoughts each day, according to neuroscientists. And studies suggest that a significant percentage of these are negative, critical or fearful in nature. That’s a lot of dark, scary thoughts. Most of them aren’t factual but when you’re in a state of anxiety, you’re going to be dealing with these thoughts as if they are scientific evidence, creating a loop of anxiety.

After you have accepted that anxiety is trying to help you, and worked out what helps your body regulate, I would encourage you to start taking note of what happened when these anxious thoughts came up. List the spiral of worries and think about how many came true. Start examining the evidence. This can allow you to be a bit more rational about them next time they appear.

Someone with anxiety might say: but what about that x per cent of the time when the bad thing does happen? I tell them they can’t have certainty all the time, the world we live in is uncertain. The definition of anxiety that I agree with is that it’s an intolerance of uncertainty. You have to get comfortable with not knowing and being ok with the idea that not everything has to be perfect. That’s a bit of a dance, but for someone with a lot of anxiety, the reality is that there isn’t any other choice, you can either stay as you are, or you can try this alternative view of uncertainty. Ask yourself what it would be like to let that control go, to surrender to the unpredictability. All of this is very difficult, but every time you change the way you react to anxiety, you are creating new neural pathways in the brain that will help you live more comfortably with anxiety.

As told to Helen Thomson