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Unwinding Anxiety

New Science Shows How to Break the Cycles of Worry and Fear to Heal Your Mind

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A step-by-step plan clinically proven to break the cycle of worry and fear that drives anxiety and addictive habits

We are living through one of the most anxious periods any of us can remember. Whether facing issues as public as a pandemic or as personal as having kids at home and fighting the urge to reach for the wine bottle every night, we are feeling overwhelmed and out of control. But in this timely book, Judson Brewer explains how to uproot anxiety at its source using brain-based techniques and small hacks accessible to anyone. 

We think of anxiety as everything from mild unease to full-blown panic. But it's also what drives the addictive behaviors and bad habits we use to cope (e.g. stress eating, procrastination, doom scrolling and social media). Plus, anxiety lives in a part of the brain that resists rational thought. So we get stuck in anxiety habit loops that we can't think our way out of or use willpower to overcome. Dr. Brewer teaches us map our brains to discover our triggers, defuse them with the simple but powerful practice of curiosity, and to train our brains using mindfulness and other practices that his lab has proven can work.

Distilling more than 20 years of research and hands-on work with thousands of patients, including Olympic athletes and coaches, and leaders in government and business, Dr. Brewer has created a clear, solution-oriented program that anyone can use to feel better - no matter how anxious they feel.

*This audiobook includes a PDF of the behavioral tendencies questionnaire from the book.

In psychology, the spread of emotion from one person to another is aptly termed social contagion. Our own anxiety can be cued/triggered simply by talking to someone else who is anxious. Their fearful words are like a sneeze landing directly on our brain, emotionally infecting our PFC, and sending it out of control as we begin to worry about everything from whether our family members will get sick to how our jobs will be affected.

When we can’t control our anxiety, that emotional fever spikes into panic (defined online as “sudden uncontrollable fear or anxiety, often causing wildly unthinking behavior”). Overwhelmed by uncertainty and fear of the future, our PFCs—the rational thinking parts of our brains—go off-line. Logically, we know that we don’t need to store a six-month supply of toilet paper in our basement, but when we’re running through the grocery store and see someone’s cart piled high with Charmin, their anxiety infects us, and we go into survival mode. Must. Get. Toilet. Paper. Our PFC comes back online only when we’re out in the parking lot trying to figure out how to fit all that toilet paper into our car or carry it onto the subway.

So how do we keep our PFCs online in uncertain times? How can we avoid panic? Too many times, I’ve seen my anxious clinic patients try to suppress or think themselves out of anxiety. Unfortunately, both willpower and reasoning rely on the PFC, which at these critical moments has shut down and isn’t available. Instead, I start by teaching them how their brains work so that they can understand how uncertainty weakens their brain’s ability to deal with stress, priming it for anxiety when fear hits. Learning that uncertainty triggers anxiety, which in turn can lead to panic, allows them to be on the lookout. And simply knowing that this is their survival brain kicking into high gear (even if it is a little misguided because it doesn’t have enough information) helps put my patients a little more at ease.

But this is only the first step. Our brains are constantly asking “what if?” When we log on to social media and scroll for the latest information, all we see is more speculation and fear. Social contagion knows no physical boundaries and can be spread from anywhere in the world. Instead of desperately searching for information, we need to add something more reliable to help us work with our emotions. Ironically, the antidote to panic relies on our survival instincts—leveraging these same learning mechanisms that lead to worry and anxiety in the first place.

To hack our brains and break the anxiety cycle, we must become aware of two things: that we are getting anxious and/or panicking and what results from anxiety/panicking. This helps us see if our behavior is actually helping us survive or in fact is moving us in the opposite direction. Panic can lead to impulsive behaviors that are dangerous; anxiety weakens us mentally and physically and also has more long-term health consequences. Becoming aware of these damaging effects helps our brain’s learning system determine the relative worth of behaviors: more valuable (rewarding) behaviors are placed higher in a reward hierarchy in our brain, and thus are more likely to be repeated in the future, while the less valuable (unrewarding) behaviors fall to the bottom. Once we are aware of how unrewarding anxiety is, we can then bring in the bigger, better offer, or BBO.
Since our brains will choose more rewarding behaviors simply because they feel better, we can practice replacing old habitual behaviors such as worry with those that are naturally more rewarding. For example, early on in the COVID‑19 pandemic, public health officials warned us to stop touching our faces, because we can more easily catch a virus if we’ve touched a doorknob or contaminated surface and then touch our face. If you notice that you have a habit of touching your face (which many of us do: one study published back in 2015 found that we do this, on average, twenty-six times an hour), you can be on the lookout for when you carry out that behavior. With that trigger, you can step back and notice if you are starting to worry as a mental behavior (“oh no, I touched my face—maybe I’ll get sick!”). Instead of panicking, you can take a deep breath and ask yourself, “When was the last time I washed my hands?” Just by taking a moment to pause and ask such a question, you give your PFC a chance to come back online and do what it does best: think (“oh, right! I just washed my hands”). Here you can leverage certainty: if you’ve just washed your hands, haven’t been in public, and so forth, the likelihood that you’re going to get sick is pretty low.

Understanding these simple learning mechanisms will help you “keep calm and carry on” (which is how Londoners dealt with the uncertainty of constant air raids in World War II) instead of getting caught in anxiety or panic in the face of uncertainty. At times when your mind starts to spin out in your worry du jour, you can pause and take a deep breath while you wait for your PFC to come back online. Once it’s up and running again, you can then compare the feeling of anxiety to that of calmness and think clearly. To our brains, it’s a no‑brainer. More important, once you are able to tap into your brain’s power to overcome anxiety, you can broaden your learning to work with other habitual tendencies as well. It simply takes a little practice so that the bigger, better offers become new habits not just for anxiety, but far beyond.

Judson Brewer M.D., Ph.D., is an internationally renowned addiction psychiatrist and neuroscientist. He is a professor in the School of Public Health and Medical School at Brown University. His 2016 TED Talk, “A Simple Way to Break a Bad Habit,” has been viewed more than 19 million times. He has trained Olympic athletes and coaches, government ministers, and business leaders. His first book, The Craving Mind, was published in more than sixteen languages. His second book, Unwinding Anxiety, was an instant New York Times bestseller. View titles by Judson Brewer

60 Minutes

TED Talk

About

A step-by-step plan clinically proven to break the cycle of worry and fear that drives anxiety and addictive habits

We are living through one of the most anxious periods any of us can remember. Whether facing issues as public as a pandemic or as personal as having kids at home and fighting the urge to reach for the wine bottle every night, we are feeling overwhelmed and out of control. But in this timely book, Judson Brewer explains how to uproot anxiety at its source using brain-based techniques and small hacks accessible to anyone. 

We think of anxiety as everything from mild unease to full-blown panic. But it's also what drives the addictive behaviors and bad habits we use to cope (e.g. stress eating, procrastination, doom scrolling and social media). Plus, anxiety lives in a part of the brain that resists rational thought. So we get stuck in anxiety habit loops that we can't think our way out of or use willpower to overcome. Dr. Brewer teaches us map our brains to discover our triggers, defuse them with the simple but powerful practice of curiosity, and to train our brains using mindfulness and other practices that his lab has proven can work.

Distilling more than 20 years of research and hands-on work with thousands of patients, including Olympic athletes and coaches, and leaders in government and business, Dr. Brewer has created a clear, solution-oriented program that anyone can use to feel better - no matter how anxious they feel.

*This audiobook includes a PDF of the behavioral tendencies questionnaire from the book.

Excerpt

In psychology, the spread of emotion from one person to another is aptly termed social contagion. Our own anxiety can be cued/triggered simply by talking to someone else who is anxious. Their fearful words are like a sneeze landing directly on our brain, emotionally infecting our PFC, and sending it out of control as we begin to worry about everything from whether our family members will get sick to how our jobs will be affected.

When we can’t control our anxiety, that emotional fever spikes into panic (defined online as “sudden uncontrollable fear or anxiety, often causing wildly unthinking behavior”). Overwhelmed by uncertainty and fear of the future, our PFCs—the rational thinking parts of our brains—go off-line. Logically, we know that we don’t need to store a six-month supply of toilet paper in our basement, but when we’re running through the grocery store and see someone’s cart piled high with Charmin, their anxiety infects us, and we go into survival mode. Must. Get. Toilet. Paper. Our PFC comes back online only when we’re out in the parking lot trying to figure out how to fit all that toilet paper into our car or carry it onto the subway.

So how do we keep our PFCs online in uncertain times? How can we avoid panic? Too many times, I’ve seen my anxious clinic patients try to suppress or think themselves out of anxiety. Unfortunately, both willpower and reasoning rely on the PFC, which at these critical moments has shut down and isn’t available. Instead, I start by teaching them how their brains work so that they can understand how uncertainty weakens their brain’s ability to deal with stress, priming it for anxiety when fear hits. Learning that uncertainty triggers anxiety, which in turn can lead to panic, allows them to be on the lookout. And simply knowing that this is their survival brain kicking into high gear (even if it is a little misguided because it doesn’t have enough information) helps put my patients a little more at ease.

But this is only the first step. Our brains are constantly asking “what if?” When we log on to social media and scroll for the latest information, all we see is more speculation and fear. Social contagion knows no physical boundaries and can be spread from anywhere in the world. Instead of desperately searching for information, we need to add something more reliable to help us work with our emotions. Ironically, the antidote to panic relies on our survival instincts—leveraging these same learning mechanisms that lead to worry and anxiety in the first place.

To hack our brains and break the anxiety cycle, we must become aware of two things: that we are getting anxious and/or panicking and what results from anxiety/panicking. This helps us see if our behavior is actually helping us survive or in fact is moving us in the opposite direction. Panic can lead to impulsive behaviors that are dangerous; anxiety weakens us mentally and physically and also has more long-term health consequences. Becoming aware of these damaging effects helps our brain’s learning system determine the relative worth of behaviors: more valuable (rewarding) behaviors are placed higher in a reward hierarchy in our brain, and thus are more likely to be repeated in the future, while the less valuable (unrewarding) behaviors fall to the bottom. Once we are aware of how unrewarding anxiety is, we can then bring in the bigger, better offer, or BBO.
Since our brains will choose more rewarding behaviors simply because they feel better, we can practice replacing old habitual behaviors such as worry with those that are naturally more rewarding. For example, early on in the COVID‑19 pandemic, public health officials warned us to stop touching our faces, because we can more easily catch a virus if we’ve touched a doorknob or contaminated surface and then touch our face. If you notice that you have a habit of touching your face (which many of us do: one study published back in 2015 found that we do this, on average, twenty-six times an hour), you can be on the lookout for when you carry out that behavior. With that trigger, you can step back and notice if you are starting to worry as a mental behavior (“oh no, I touched my face—maybe I’ll get sick!”). Instead of panicking, you can take a deep breath and ask yourself, “When was the last time I washed my hands?” Just by taking a moment to pause and ask such a question, you give your PFC a chance to come back online and do what it does best: think (“oh, right! I just washed my hands”). Here you can leverage certainty: if you’ve just washed your hands, haven’t been in public, and so forth, the likelihood that you’re going to get sick is pretty low.

Understanding these simple learning mechanisms will help you “keep calm and carry on” (which is how Londoners dealt with the uncertainty of constant air raids in World War II) instead of getting caught in anxiety or panic in the face of uncertainty. At times when your mind starts to spin out in your worry du jour, you can pause and take a deep breath while you wait for your PFC to come back online. Once it’s up and running again, you can then compare the feeling of anxiety to that of calmness and think clearly. To our brains, it’s a no‑brainer. More important, once you are able to tap into your brain’s power to overcome anxiety, you can broaden your learning to work with other habitual tendencies as well. It simply takes a little practice so that the bigger, better offers become new habits not just for anxiety, but far beyond.

Author

Judson Brewer M.D., Ph.D., is an internationally renowned addiction psychiatrist and neuroscientist. He is a professor in the School of Public Health and Medical School at Brown University. His 2016 TED Talk, “A Simple Way to Break a Bad Habit,” has been viewed more than 19 million times. He has trained Olympic athletes and coaches, government ministers, and business leaders. His first book, The Craving Mind, was published in more than sixteen languages. His second book, Unwinding Anxiety, was an instant New York Times bestseller. View titles by Judson Brewer

Media

60 Minutes

TED Talk