Playing the Anxiety Mental Game

Anxiety Mental GameIn July, I had the privilege of traveling to Chicago to observe a two-day intensive live Anxiety & OCD treatment group led by Reid Wilson, Ph.D. There were eight people in the group with anxiety and OCD, many of whom had been suffering for years with chronic anxiety, panic, social anxiety, depression, obsessive thoughts, mental rituals and/or compulsive behaviors. I was skeptical the morning of the first day. Reid Wilson was making some big claims like “You will need to trust me. You can listen and think you will work on it later…and you will fail. Or you can listen and act – today – and begin your healing.” Given the severity of this group’s long-standing problems with anxiety and OCD, I didn’t believe that these folks could achieve significant progress by the end of a two-day, 16 hour treatment group. Boy was I wrong!

Steps To Playing the Anxiety Mental Game

Dr. Wilson spent the first four hours introducing the concepts behind the Anxiety Mental Game and enhancing motivation to play the game. He said, “You have OCD or Anxiety. You’ve been working on it, struggling with it, worrying about it, trying to control it, and you haven’t won yet.” Dr. Wilson said the only way to win against anxiety is to follow some paradoxically absurd strategies. He outlined three steps:

  • The first step is to identify how anxiety is ruining your life and to identify how your future will be different if you face your fears. This step creates your reason or motivation for wanting to play this game. You need to have a compelling reason because this game is hard.
  • The second step is to understand the principles behind playing the anxiety game. You need to be able to gain a mental shift from “I must avoid anxiety at all costs” to “I want to seek out anxiety (frequency), I want it to be strong (intensity), and I want it to last (duration).” And you need to learn that “whatever happens, I can handle it.”
  • The third step is to provoke anxiety. Instead of avoiding, resisting or simply tolerating anxiety (which is where anxiety wins), you need to proactively invite more anxiety into your daily life. This means being able to genuinely believe and tell yourself, “I really want anxiety to keep happening. I win if it keeps happening” and then to go out and actually create opportunities (called “exposures” or “behavioral experiments”) to feel anxious.

You might be thinking, “I am already doing the things that make me anxious. How can doing more of them help?” The difference is you are probably muscling through your daily life if you aren’t actively avoiding. You are probably telling yourself, “This is uncomfortable. My anxiety is unbearable. I can’t handle this anymore. I need relief from anxiety.” And you might go into anxiety-provoking situations with some subtle safety behaviors to try to protect yourself, like over-preparing, not talking, leaving early, sitting in a place where you won’t be noticed or distracting yourself during the situation.

Preparing to Play The Anxiety Mental Game

To prepare for the Anxiety Mental Game, the group members were asked to identify and review their hierarchy of anxiety-provoking content and to pick one item that they would practice experiencing at lunch time. Every time the group member could enthusiastically say things to themselves when they felt anxious like “Excellent! Just what I wanted,” or “I can handle this,”  or “Give me your best shot. I want my life back,” they would get a point. Dr. Wilson gave each group member a clicker to keep track of their points. After lunch, they came back and reported on how many points they had accumulated. Some of the folks had 80+ points in just two hours!

In addition to the new self-talk, the participants were also coached about where to put their attention while they were playing the Anxiety Mental Game. Dr. Wilson said, “The problem is not what you think it is. The problem is not the content of your fears. The problem is where you put your attention. You will either pay attention to the content (i.e. your list of anxiety-provoking fears, worries and other negative thoughts) or you will pay attention to anything else. You will decide – moment by moment. You have to choose to withdraw your attention from your content. That is your job here.”

Rules for Winning the Anxiety Mental Game

Winning the Anxiety Mental GameThe way to win the Anxiety Mental Game is to change your frame of reference from “This is serious and dangerous” to “This is a mental game.” The new rules you need to learn are:

  1. Do not pay attention to your content.
  2. Accept obsessive and anxious thoughts when they pop up.
  3. Want to make yourself uncertain about the content.
  4. Want to be anxious and stay anxious.
  5. If necessary, make rules and follow them (to get you through the exposures).

By the end of the two-day treatment group, all the group members reported some amount of reduction in their anxiety and fears. Through the exposures, they learned that “This is hard and I want it” and “I can handle this.” By observing the group members’ improvements, I became a believer in the power of playing this mental game to beat anxiety and OCD.

You can listen to Reid Wilson talking about the Anxiety Mental Game by clicking to listen to this Anxiety Mental Game podcast. If you are interested in learning to play the Anxiety Mental Game, call us at (408) 384-8404 to set up an appointment with one of our therapists.