When you already know it is irrational
ACT for anxiety
Knowing a fear makes no sense has never once made it go away. ACT works on what the fear is costing you instead.
The trap
Anxiety is not really a feeling problem. It is an avoidance problem.
The feeling itself is unpleasant but survivable. What does the damage is everything you stop doing in order not to feel it: the motorway you no longer take, the meeting you let someone else run, the invitation you decline, the conversation you keep postponing. Each avoidance brings immediate relief, which is exactly why it repeats — and each one makes the world slightly smaller.
Ten years of that and the anxiety has not got worse. Your life has just got narrower around it.
Why arguing with it does not work
Almost everyone who comes to me for anxiety already knows, intellectually, that the plane will probably not crash, that the lump is probably nothing, that they will probably not be sacked. Knowing has changed nothing. Being told again, by a therapist, will not change it either.
Worse, reassurance is itself part of the machinery. Checking, googling, asking your partner "are you sure?" — each of these relieves anxiety for about ninety seconds and strengthens it for the next round. The relief is the reward that trains the behaviour.
What ACT does instead
- Stops the fight. We give up trying to make the anxiety smaller, because that effort is a large part of the problem.
- Loosens the grip of the thought. "What if I panic in the meeting" becomes a sentence you notice rather than a prediction you obey.
- Maps the cost. We list, honestly, what avoidance has taken from you. This is often uncomfortable and often the turning point.
- Moves outwards. Then you start doing the avoided things again, at a size you can manage, deliberately taking the anxiety with you rather than waiting for it to leave first.
That last part is the crux. You do not wait to feel ready. Readiness is not coming. You go, feeling exactly as anxious as you feel, because the meeting matters or your daughter's assembly matters or you would like your Saturdays back.
What this helps with
- Generalised anxiety — the worry that moves from topic to topic and never lands
- Panic and the fear of panic itself
- Social anxiety and the endless post-mortem afterwards
- Health anxiety, checking and reassurance-seeking
- Work anxiety, presentations, performance
- Anxiety alongside drinking — extremely common, and each one feeds the other
Where anxiety and alcohol meet. A great many people I see are drinking to manage anxiety, and are then more anxious the next day because of the drinking. If that is you, we work on both — treating either one alone tends not to hold. More on alcohol.
Related
Common questions
Will I have to do exposure work?
In a sense, but not the grim endurance-test version. In ACT you approach avoided situations because they lead somewhere you want to go, not to prove you can tolerate distress. The difference in how that feels is substantial.
Can I do this if I am on medication for anxiety?
Yes. Many people do both. Decisions about medication are between you and your GP; the therapy works alongside whatever you decide.
How long does anxiety work usually take?
Focused work on a specific anxiety often runs to six or eight sessions. Longstanding generalised anxiety, particularly with avoidance built up over years, usually takes longer.
Talk it through first
The first step is a short phone call. No commitment, no pressure — just a conversation about what is going on and whether I am the right person to help.
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