Postive what-if thoughts lead to joyful possibilities

The Positive What-if Thought

Positive what-if thoughts are the very opposite of catastrophic thoughts. What if people find something positive in me that they both like and respect? What if my boss sees my progress, my dedication, and loves my work? What if I grew as a person, not in spite of setbacks, but because of them? What if I decide to set aside my insecurities, so that they no longer limit me?

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positive affirmations for anxiety

Affirmations for Anxiety

Learning Objectives

  • Understanding Anxiety: To understand the nature of anxiety and how it feeds off of negative thoughts.
  • Utilizing Affirmations: To understand the purpose of positive affirmations in combating anxiety and how to use them effectively.
  • Recognizing False Perceptions: To recognize the discrepancy between perception and reality, specifically in the context of anxiety.
  • Applying Affirmations to Daily Life: To learn how to incorporate affirmations into daily life as a strategy to reduce anxiety.
  • Creating Personal Affirmations: To understand how to create personalized affirmations that resonate with individual circumstances and beliefs.

Anxiety is a parasite that lives in your thoughts. But it only lives if you feed it. Anxiety thrives by sending you worries, catastrophic thoughts, and harsh self-judgments. These negative thoughts feel true, but leave you feeling pessimistic, ineffectual, and depleted. If I am weak and anxiety is strong, then why am I trying?

Affirmations for anxiety counter negative thoughts by providing positive statements to replace negative thoughts. Think about it. The mind lives in its thoughts like fish live in the sea. Philosophically speaking, thoughts are the lens through which the mind sees reality. But eventually, the mind forgets about the lens, and mistakes its own perception as reality. If your thoughts are negative, then the world is negative.

Using Affirmations for Anxiety

Some people believe that just by repeating affirmations, they can fortify their resistance and reduce anxiety. Unfortunately, the mere repetition of affirmations is probably useless. The cognitive model of psychotherapy says that there is a close connection between thoughts and feeling. To change your feelings, you should change your thoughts and beliefs. Have and BELIEVE positive thoughts and positive feelings will follow.

To use affirmations most effectively, you must first allow the affirmation. If you treat the affirmation as a hypothesis, to be sustained or falsified by the evidence, you’re missing the point. Say, for example, that the affirmation is “I always survive, and I will continue to survive.” If you search your mind for evidence from your life that argues against the affirmation, then you are attacking the affirmation. Essentially, you are attacking yourself.

Instead, affirmations are intended to put you in contact with some bedrock reality that you already know to be true. The statement “I always survive…” is intended to fortify determination and resolve in the face of adversity. The affirmation puts you in contact with some fundamental truth about yourself or about life, a truth that stands in opposition to anxiety’s false claims and illusions.

Second, once you’ve made contact with the bedrock reality behind anxiety’s illusions, let the inspiration flow. Feel it, let it rise up, let is suffuse your entire awareness. Close your eyes and tune in to your feelings if you so desire. Affirmations represent possible futures that you are CHOOSING to make real. They are expressions of your free will, of your creativity, and of your ability to make constructive decisions and be effective in your own life. Think of affirmations as positive self-talk that’s intended to replace negative self-talk and inspire you to move forward and make changes in yourself and your life. The positive self-talk can’t flow if you muzzle it.

Third, affirmations work best if you choose to revisit them throughout the day. For convenience, you can write affirmations on notecards and carry them in your wallet, purse, or pocket. You can also post affirmations where they will frequently be seen. You might choose, for example, to put a list on your bathroom mirror, so that you see them every morning and evening. You could print up a whole list and post them on your refrigerator door or your bedroom door. You might even choose to download an app for your phone that sends you positive affirmations randomly throughout the day.

You can also use affirmations whenever you feel anxiety rising up. But note that affirmations are not intended to fortify a wall against your anxiety. Affirmations do not serve resistance. The root cause of panic attacks, for example, is anxiety about anxiety. The dread of a panic attack causes the person to monitor bodily signals, like heart rate, leading to a vicious circle that actually causes the panic attack.

Example Affirmations for Anxiety

The key to making affirmations work for you is to select those that resonate with you, that speak to you in some deep way. Below are some examples, categorized according to theme. Many more could be written.

Affirmations for Anxiety: Persevering Adversity

  • I’ve survived worse, and I will survive now.
  • I can take this one day at a time.
  • My small steps today make for big changes tomorrow.
  • Once step at a time gets it done.
  • I can make a plan and work a plan and revise a plan.
  • I choose to persevere and refuse to become discouraged.
  • My thinking is flexible enough to deal with changing situations and demands.
  • If something doesn’t work, I can go a different way.

Affirmations for Anxiety: Building Confidence

  • Affirmations that build confidence help you believe in yourself enough to take action.
  • I have some positive attributes that other people enjoy.
  • I can capitalize on my good points.
  • It’s not where you start, it where you end up that counts.
  • I grow though challenges.
  • My anxiety is giving birth to courage.
  • I have an enormous contribution to make, and I will.
  • There is so much potential inside of me, and I can feel it surfacing.

Affirmations for Anxiety: Unmasking Illusions

  • I don’t need to believe what the anxiety parasite tells me to believe.
  • I can stand apart from my anxious thoughts and simply observe them.
  • Anxious thoughts are only thoughts, they are not reality.
  • Catastrophes almost never happen, and they’re not worth worrying about.
  • I choose to be present in the here and now, rather than lost in my thoughts.
  • It’s what I feel when I’m calm that’s real, the anxiety is only illusion.

Affirmations for Anxiety: Connecting with Joy

  • By suspending thought and being present, I can cherish the simple beauty around me.
  • So many positive things are happening in the world every single moment.
  • I feel so much potential inside of me.
  • I choose to slow down, be present, and feel the joy of mere existence.

Affirmations for Anxiety: Coping with Panic Attacks

  • I have survived every attack, and I will survive all future attacks.
  • I don’t have to believe everything my mind thinks or my body feels.
  • I can stand back and dispassionately observe anxiety in my mind and body.
  • I choose to be okay with any panic attack that happens.
  • If I refuse to believe the anxious thoughts, then panic is just arousal in my body.
  • I choose to put myself in situations can I know cause my body to become anxious.

Creating your Own Affirmations for Anxiety

Any number of positive affirmations for anxiety could be written. In general, affirmations are effective if they…

  • Resonate with you.
  • Are worded to be short and direct.
  • State some deep truth succinctly.
  • Put you into connection with values that energize you.
  • Encourage you to take the next step and go forward.
  • Play your strengths.
  • Build on past success or accomplishment or achievement as evidence.
  • Are worded as “I statements,” as in “I choose to…”
  • Present anxiety as making false statements and illusions, which is exactly how anxiety works.

In contrast, affirmations that state what you must NOT do are really statements of resistance to anxiety and to anxiety about anxiety. Statements like ‘I must not worry” and “I must not have a panic attack” indicate how deeply entrenched anxiety is in your life and thoughts. Human beings are intended to grow. Your life should be about living, loving, and growing, not about trying not to be anxious. Stating what you must not do positions anxiety as the most important reference point in your life, a contradiction, since anxiety is exactly what you most wish to eliminate. Focus on becoming and you can literally outgrow anxiety.

Reading Comprehension Questions:

  1. Question 1: Which of the following statements is true?
    • A) Affirmations for anxiety work by completely eliminating negative thoughts.
    • B) Affirmations for anxiety replace negative thoughts with positive statements.
    • C) Affirmations for anxiety validate our negative thoughts.
    • D) Affirmations for anxiety ignore both positive and negative thoughts.
  2. Question 2: Which of the following statements is true?
    • A) The text suggests affirmations should be rejected if they do not match our current beliefs.
    • B) The text suggests affirmations should be repeated mindlessly to work.
    • C) The text suggests affirmations should be tested against our life experiences.
    • D) The text suggests affirmations should be allowed and believed to make a positive impact.
  3. Question 3: Which of the following statements is true?
    • A) Affirmations are meant to act as a wall to block out all anxiety.
    • B) Affirmations serve as reminders of the root cause of anxiety.
    • C) Affirmations act as a tool to deny the presence of anxiety.
    • D) Affirmations put us in touch with fundamental truths about ourselves, countering anxiety’s illusions.
  4. Question 4: Which of the following statements is true?
    • A) Affirmations should be revisited once a week.
    • B) Affirmations are most effective when written on notecards and carried around.
    • C) Affirmations should be written but not looked at again.
    • D) Affirmations should be ignored during times of increased anxiety.
  5. Question 5: Which of the following statements is true?
    • A) Affirmations for anxiety should be lengthy and detailed.
    • B) Affirmations for anxiety should focus on the negative aspects of anxiety.
    • C) Affirmations for anxiety should focus on what you must not do.
    • D) Affirmations for anxiety should be short, direct, positive, and resonate with the individual.


  • 1. B) Affirmations for anxiety replace negative thoughts with positive statements.
  • 2. D) The text suggests affirmations should be allowed and believed to make a positive impact.
  • 3. D) Affirmations put us in touch with fundamental truths about ourselves, countering anxiety’s illusions.
  • 4. B) Affirmations are most effective when written on notecards and carried around.
  • 5. D) Affirmations for anxiety should be short, direct, positive, and resonate with the individual.
agoraphobia symptoms

Agoraphobia Symptoms and Treatment

Overview and Definition

Agoraphobia symptoms manifest whenever feelings of entrapment, helplessness, or embarrassment arise. Agoraphobia is defined by the Diagnostic and Statistical Manual of Mental Disorders as a fear of situations where escape might be difficult or impossible, or where help might be unavailable if something went wrong. In contrast, agoraphobia has usually meant simply a fear of open spaces, but this usage is now obsolete.

Examples of Agoraphobia

Examples of agoraphobia include anxiety about traveling on bus, plane, subway, or other public transportation. Even being a passenger in a car can be difficult, simply because the person is not driving. Agoraphobia symptoms can surge in crowded spaces, like bars, restaurants, shopping centers and grocery stores, concerts, movie theaters, or any gathering of people. Simply waiting with others and standing in line can be hard.

Avoidance in Agoraphobia

All the agoraphobic situations listed above are actively avoided, unless the person can be absolutely sure an escape route is available. They may, for example, sit only at the edge of the row in a movie theater closest to the exit door. The agoraphobic person may eventually refuse to leave the safety of their own home unless accompanied by a friend, parents, or other support person, who might provide help and assistance should something go wrong. The internet makes agoraphobia somewhat easier, since subject can order groceries online, have food and other supplies delivered, even work remotely.

If someone with agoraphobia encounters a stressful situation outside their home, they can experience panic symptoms, like rapid heartbeat, choking, sweating, trembling, or nausea.

Agoraphobia and Panic Disorder

What causes agoraphobia? How do agoraphobia symptoms develop?

Agoraphobia tends to develop secondary to panic disorder. Panic attacks typically occur suddenly and may occur without any warning whatsoever. The anxiety of a panic attack onsets and peaks without about ten minutes. The attack peaks with full-blown activation of the fight or flight response. Panic attacks are subjectively experienced as terror, like the terror you feel in the worst nightmare that you’ve ever had. Panic attacks onset and peak in about ten minutes and often less. You begin to feel the panic symptoms and you immediately begin looking for an escape. Perhaps you fear having the panic attack in the presence of others. Perhaps you fear going crazy and knocking people down as you flee the triggering situation. Once the symptoms start, ten minutes or less gives you a very narrow windows to escape the triggering situation.

Whether you manage to escape or not, you make up your mind not to return to that situation. This is called generalization, and it’s a major mechanism by which anxiety expands and takes over one’s life. If the panic attack symptoms happened on a bus, then you start to avoid all buses. If the panic attack happened in a grocery store, you start to avoid grocery stores. Eventually, you may refuse to leave your home at all. Why? Because you feel safe inside your home. Whenever your leave, you begin to fear having panic attack symptoms and actual panic attacks.

Some people, however, experience agoraphobia symptoms with no history of panic attacks. In such cases, the avoidance is related to fear of crime, terrorism, disease, accidents, or just fear of the occurrence of random catastrophic events. A history of trauma may well predispose subjects to the development of agoraphobia, since trauma is often induced by random catastrophic events, like automobile accidents.

Agoraphobia Diagnosis

Agoraphobia is typically diagnosed by a mental health professional or physician. You will be asked specific questions about your agoraphobia symptoms, such as how frequently they occur and how intense these symptoms are. Here are some examples:

  • Are there some situations that you avoid because they make you feel anxious? What are they?
  • What do you do to cope with these situations?
  • Is there someone that you feel safer with, who makes it easier to go into these situations?
  • Have you ever experienced a panic attack? How did your avoidance get started?

By asking these questions, your mental health professional or physician is looking for the essential features of an agoraphobia diagnosis, namely the anxious avoidance of situations where escape might be difficult or impossible. All anxiety disorders tend to shrink life down to a narrow safety zone. Be as forthcoming and honest as possible. This interview is your chance for better life.  

Agoraphobia Treatment

Agoraphobia is rarely treated in any single way. Fortunately, there are many ways to treat agoraphobia and agoraphobia symptoms.

Lifestyle Changes and Self-Care

Effective agoraphobia treatment may include lifestyle changes like healthy eating, regular exercise, and avoidance of drugs and alcohol. Healthy eating increases feelings of general well-being. Some subjects report positive effects to magnesium and zinc as dietary supplements. Exercise burns away stress hormones and promotes a feeling of relaxation throughout the day. Foods and drinks that contain caffeine and other stimulants, like coffee, tea, and soda, can be reduced or eliminated. Stimulants raise the level of background arousal in the body, which makes anxiety symptoms, like muscle tension, more likely. Meditation, dance, deep breathing, or any calming activity that reduces anxiety provides an opportunity for self-care. Finally, in-person and online support groups can provide reassurance and practical advice.

Exposure Therapy

If your agoraphobia symptoms developed due to a history of panic attack symptoms, then it makes sense to treat panic disorder as a means of treating your agoraphobia. Panic attack treatment may involve medications, but also frequently involves graded exposure to the situations that provoke anxiety. You agree to put yourself in situations that evoke moderate anxiety and remain in the situation until the anxiety subsides. For example, if you have a fear of parking lots because of all the cars circulating through, you might go to a mostly vacant parking lot that causes moderate to moderately high anxiety. You would do this over and over again, until your anxiety is greatly diminished. Next, you try another parking lot, one where there are somewhat more cars. You visit and remain in this parking lot until the anxiety is greatly diminished. Avoidance prevents your nervous system from learning that situations you experience as dangerous are, in fact, safe. Eventually, your nervous system learns that parking lots are mostly safe, and you’re able to enter, park, and leave with minimal or no anxiety or panic symptoms.

If your agoraphobia symptoms are so intense that exposure to actual situations is impossible, then you can use guided imagery. This is exposure in imagination, which typically results in less intense anxiety symptoms than exposure to real life situations. Once the agoraphobia symptoms have diminished somewhat, guided imagery can be followed by graded exposure to real life situations. The fundamental idea is to take “baby steps” that build confidence and don’t evoke so much anxiety and panic that the person drops out of therapy.

Cognitive Therapy

Cognitive means thought, so cognitive therapy is about modifying the thoughts that accompany anxiety and the situations that trigger anxiety. Cognitive therapy can be used to provide more focus to exposure therapy. The common thread to all agoraphobia symptoms is fear that escape will be difficult or impossible, but the exact reasons may be different. Maybe one person fears going crazy during a panic attack and having to be restrained or hospitalized, while another person fears that they’ll be too nervous to drive out of the parking lot. Fears of being trapped, helpless, and embarrassed are commonly reported. Knowing the exact catastrophic thoughts is necessary to effective exposure therapy for agoraphobia, panic attacks, and other anxiety disorders.


Medications for agoraphobia symptoms are prescribed by your general practitioner or psychiatrist. These may be used as the sole intervention for agoraphobia symptoms or in combination with psychotherapy. No drugs are specifically FDA-approved to treat agoraphobia or panic, but certain medications have been found to be effective and can be used off-label, meaning with the approval of a physician. Three main classes of medication are prescribed: SSRI and SNRI antidepressants, anxiolytics, and sedatives.

Despite their name, antidepressants often treat the symptoms of both anxiety and depression. Since anxiety is what the anxiety disorders have in common, SSRI’s can treat both agoraphobia symptoms and panic symptoms. Commonly used SSRI medications for agoraphobia and panic include Fluoxetine (Prozac), Citalopram (Celexa), and Escitalopram (Lexapro). Every cell in the nervous system relies on a certain kind of neurotransmitter to transmit signals between neurons. SSRI means Selective Serotonin Reuptake Inhibitor, meaning that these drugs make more serotonin available for brain neurons which use that neurotransmitter. SNRIs make more norepinephrine available in the synapse between neurons. They are Selective Norepinephrine Reuptake Inhibitors. Commonly prescribed SNRIs include Duloxetine (Cymbalta) and Venlafaxine (Effexor).

Benzodiazepines like Alprazolam (Xanax) and Lorazepam (Ativan) can be used with panic attack symptoms. Benzodiazepines are fast acting and can be very effective at reducing or even eliminating anxiety. Benzodiazepines work by increasing the effect of GABA, the principal inhibitory neurotransmitter in the brain. Unfortunately, they can interact with alcohol, may cause dependency and withdrawal, and have a long-term risk of dementia. As such, benzodiazepines are prescribed mainly for short-term use.

Finally, Buspirone (Buspar) is a commonly prescribed anxiolytic drug that has almost no side-effects.

Agoraphobia Treatment Effectiveness

Approximately one-third of subjects with agoraphobia are completely cured by some combination of treatments and remain symptom-free. Another one-half experience improvement but have periods when agoraphobia symptoms exacerbate to become more problematic, perhaps during periods of substantial life stress. The final approximately 20 percent do not respond well to treatment and continue to meet diagnostic criteria for an agoraphobia diagnosis.

anxiety as a paraside

Anxiety Symptoms as a Parasite

Everything in the universe wants to survive and reproduce. So does anxiety. In this article, we consider anxiety symptoms as evidence of a parasite, one that’s feeding on your joy in life. Of course, anxiety is not really a parasite, not in the sense of a disease or insect that’s invaded your brain. But let’s explore the metaphor and see whether it’s useful.

Like every parasite, anxiety’s survival comes at the expense of the host. Infected individuals don’t think about being infected with anxiety. Of course, they realize they are anxious, worried, panicked, but they don’t recognize their anxiety to be a feeding parasite. Why? Because their anxiety exists and functions at a psychological, rather than physical, level. If you found a tick with its head embedded under your skin, you’d immediately recognize it for what it is, and you’d remove it. That’s much harder to do with anxiety. 

Recognizing Anxiety Symptoms

How do you know when anxiety is feeding? Pay attention to your individual anxiety symptoms, the way anxiety manifests inside of you. These symptoms become your personalize signal that anxiety is setting in, that the parasite is working on you. Typically, you’ll notice anxiety symptoms in some area of insecurity. A tick looks for a point where the skin is thin and highly vascularized. Likewise, anxiety looks for an area of vulnerability, perhaps your health, your relationships, your finances, or your work. Once anxiety finds some area of insecurity, it burrows in, and the anxiety symptoms begin. Since it’s not a physical thing, like a tick, you may not even recognize that it’s there. Anxiety symptoms may be physical, as with tension or trembling. Anxiety symptoms may be cognitive, as with worry or catastrophic thoughts. Anxiety symptoms may be emotional, as with dread and foreboding. But they all start as subtle variations of these.

An example: Say there’s a pain in your side. Anxiety sends you the thought, “This could be something.” But you shrug it off. Your health has always been good. Anxiety sends you the thought, “Your boss isn’t happy with your current project.” But you shrug it off. You can’t please everyone. Anxiety sends you the thought, “You and your significant other have been fighting a lot lately.” Now you think, “Hmmmm, my significant other has been working late a lot…I wonder if they just don’t want to spend time with me anymore.” You consider further possibilities regarding your significant other, some of which are horrifying, like an affair.

Anxiety is smiling now, because it’s beginning to get a reaction. You see, anxiety was able to create two prominent anxiety symptoms: First, there was the worry because you and your spouse have been fighting. Second, you escalated that worry into a catastrophic thought. Worse, these anxiety symptoms were not detected as such. Instead, you took them seriously. That is, you mistook worry and catastrophic thoughts as what’s called “realistic anxiety,” something you really need to solve. You may even believe you’re just thinking through, but from anxiety’s perspective, it’s beginning to burrow in. Just like a tick, it’s found an area that’s highly vascularized, where your insecurities can be tapped into and amplified. The resulting worries are like inflammation around the entry point, around the head of the tick. The anxiety symptoms have begun to multiply.

Worry is Stage 1, the baseline level of anxiety intensity. Some people remain at this level indefinitely. Although worry is the lowest clinically significant level of anxiety, it’s worth pointing out that worry can involve considerable suffering. Worry can be interfere with sleep. Worry can also induce chronic muscle tension, resulting in chronic exhaustion.

Eventually, your worries may become so amplified that they form catastrophic thoughts, as shown in the example above. Catastrophic thoughts begin with the assumption that the worst has already happen. What if my marriage fails? What if I have cancer? What if my boss fires me? What if I fail my classes? Why do catastrophic thoughts produce such intense anxiety symptoms? Catastrophic thoughts assume the worst and then ask for a plan. Of course, the thoughts are catastrophic precisely because they describe scenarios that cannot be remedied. As such, catastrophic thoughts create intense suffering, and tend to produce produce physical anxiety symptoms, and possibly panic attacks. At this point, however, your anxiety is still about some area(s) of vulnerability.  

Anxiety about Anxiety Symptoms

Eventually, anxiety symptoms burrow in so deep that you begin to dread the symptoms themselves. This is the start of anxiety about anxiety. You stop thinking about your work, your health, your relationships, your finances. Now you just want to know “When is this damn anxiety going away?” Now its got you. No longer does it need to bombard you with worried and catastrophic thoughts about your favorite vulnerability…it just needs to show up, and you automatically go into a posture of submission, dread, and retreat. 

This is a significant inflection point in the development of your anxiety syndrome, Stage 2, because your anxiety has become self-sustaining. Your dread of the symptoms, your reactivity, becomes its food, its sustenance. When you feel anxiety about anxiety, that’s the parasite sucking away at your motivation and joy. As your vital spirit passes over into the plump, swollen body of the tick, life shrinks down. Few things in life bring joy because most things are infected by the parasite. Some people even reach the point that they no longer leave the house. 

Ironically, many people come into psychotherapy defending the parasite. These people have reasons why nothing will change. When I suggest ways they can begin to excavate the parasite, they give me reasons why my suggestions are doomed to fail. My response is “When you came into therapy, you were looking for new ways of thinking and feeling, and that’s what I’m giving you. When you tell me that my suggestions are pointless, you’ve gone over to the other side, you’re doing the work of the parasite now. You came in seeking hope and courage and now you’re taking even those away. The parasite has you believing the hopelessness and helplessness, and that’s keeping you stuck.”

For many anxiety sufferers, this is a come-to-Jesus moment, because they know it’s true. There’s an old saying that people “prefer the devil they know over the devil they don’t know.” Many sufferers are so accustomed to going through life with the parasite attached that they’ve lost sight of boundary between it and them. It’s thoughts are their thoughts. Rather than question their catastrophic thoughts, they immediately believe them. So they start justifying and creating reasons why they cannot change, why the parasite must remain attached.

Eventually, however, people recognize that they have a disease, a parasite. At this point, they declare “You’re right, I have to beat it, I have to beat (or control) this anxiety.” They are recognizing the presence of the parasite and committing to its defeat. Maybe you commit to visiting the grocery store tomorrow, after procrastinating for weeks, just because the grocery always leads to a panic attack. Maybe you tell yourself that you’ll finally set that doctor’s appointment, even though you’re afraid of bad medical news. Maybe you’ll drive over that bridge that makes you feel faint. Maybe you develop a whole list of changes you’re going to white-knuckle through. You’ve given in before, but you’ll never give in again. Not this time. Sounds great, right?

Wrong. In fact, your commitment to beating anxiety is just another trap, another way for anxiety to feed. This trap frames your struggle to free yourself as a struggle of strength. If that’s true, then why haven’t you freed yourself already? From this perspective, the only answer is because you’re weak. You’ve been weak for weeks, months, maybe years, and now suddenly you’re expected to rise above your past defeats and be strong. Exactly how do you, in your weakened, bled-dry state, intend to go head-to-head against the parasite that’s been sucking away at your vital juices (hope, courage, joy) for so long? 

Unfortunately, it won’t happen, and it won’t happen because the parasite knows how to your courage against you. Anxiety is seeking your reactivity, your physiological arousal. Anxiety wants to create a high stakes showdown, a shootout at the O.K. Corral. Anxiety wants you to mess with it, because anxiety loves to threaten total thermonuclear war (panic). Anxiety knows that as your reinforce your resistance, it’s because you perceive there’s so much as stake, because the threat is so high. And if the threat is high, then so is the anxiety. This is the parasite actively feeding. The more you fight to excavate the head of the tick, the deeper it burrows. Eventually, many people stop fighting and just live within the boundaries of a small life. 


What does victory even look like when you can’t go war? The answer is obvious. Victory is not about straining and grunting to tolerate anxiety. Victory is about actually being calm. 

So you stop fighting and just accept the thoughts and feelings, understanding what they are and where they come from. They come from a parasite that wants to get you worked up. When you sense worry, you shrug and tell yourself that’s the parasite trying to feed. When you sense catastrophic thoughts, you shrug, come back to reality, and recognize that the parasite is trying to feed. When you feels anxiety about your throat tightening up to the point you can’t breathe, you shrug and recognize that the parasite is trying to feed. Recognizing the parasite at work helps keep you in contact with reality, keeps you grounded. This is also called mindful awareness. You are observing your own mental processes in the moment. 

Once you understand that the parasite is trying to feed, the next step is to be okay with the symptoms, whatever they are and whatever they become. To do this, you try to stay in observer mode. When you are observing the symptoms, you are not caught up in experiencing them, or actually, struggling not to experiencing them, as with distraction, suppression, and even various medications. You are no longer trying to escape. All escape is based on the underlying assumption that “I must not experience this, I absolutely cannot experience this.”You’re now working directly on the cause of the symptoms. You are now treating the disease. You tell yourself that “I can, I will, I want to experience the symptoms.” Maybe you even muster up some gratitude.

So how do you maintain observer mode? Let’s assume you have panic attacks, because that’s probably the worst case scenario. When you feel the symptoms coming on, get a pencil and paper. Practice observing the symptoms as closely as possible. If your heart beating fast, write that down. If it changes, write that down. If you notice you’re starting to sweat, write that down. If your hands are trembling, write that down. Let the whatever happens happen and just observe it as it moves along. To the extent that you can, practice being okay with the symptoms. 

Easier said than done? Of course it is. But remember, even though you’ve may have experienced hundreds of attacks, you haven’t died yet and you haven’t suffocated, and you haven’t gone crazy. You only believe these lies in experiencing mode. So see if you can introduce doubt and be okay with the symptoms. No one says “I’ve observed hundreds of panic attacks.” That’s because observation involves distance and detachment, which makes it possible to know your anxiety intimately. You’ll discover that the symptoms occur in an orderly sequence, a predictable sequence, a boring sequence. You can’t be anxious and bored at the same time. 

How do you apply the acceptance idea with worry? First, practice recognizing that you’re worrying. Otherwise, you’ll be immersed in your worries for long stretches of time. Practice coming up for air. Surface. Again, that’s just mindful awareness. Whenever you feel yourself going into another deep dive, surface. That’s you leaving the future and coming back to the present moment, where the possibility for joy is. Also, be comfortable with the fact that you’ve just worried. That addresses worry about worry. 

Next, ask if your worries are realistic.  Just because something can go wrong, doesn’t mean it will go wrong. Some worries are realistic. If possible, take action. 

Practice exposure and acceptance to worry by worrying intensely. You can also grab and pencil and paper and take the initiative on your worry. Set aside 30 minutes to worry as hard as you can. Write down every single worry and catastrophic thought. Be as creative as you can. Elaborate previous worries in new directions. Don’t worry just about disappointing your boss, write down disappointing your coworkers and your spouse. As you do so, observe yourself in this process. Say “Ah, here I am worrying.” Give yourself compliments. “That was a great one…never thought of that before.” Take joy in your inventiveness. After the 30 minutes is up, do something you really enjoy. This rewards you for detaching from worry. 

Before ending, let me comment on something you may have noticed, a lurking contradiction. You’re not really practicing acceptance of the anxiety symptoms as a means of getting the anxiety to go away. That’s really just more fear and escape, and that fuels anxiety about anxiety. If you’re telling yourself that you’re working on your anxiety, but you’re secretly desperate, you have to bring that desperation to the surface and acknowledge it. What you ought to be practicing is being okay with the anxiety symptoms, whatever they are. If I’m choking, well…I’ve done that before, so no worries. If I’m having catastrophic thoughts, let me catch myself and recognize that thousands of times these thoughts have never happened. Most of the time, the anxiety symptoms do go way down when you practice just being okay with them. That’s called “opening a space.” And when the symptoms don’t reduce, practice framing it as another great opportunity to practice being okay. 

gratitude expands attention and treats anxiety

Gratitude Treats Anxiety

Learning Objectives

  • Understand the role of gratitude in treating anxiety.
  • Learn the three stages of cultivating gratitude.
  • Identify the connection between gratitude, mindfulness, and conscious choices.

Gratitude is a feeling of appreciation or thankfulness experienced after receiving kindness or generosity. Gratitude is different from indebtedness, in that a debt must be repaid. In contrast, gratitude is maximized when there is no expectation for repayment. As such, gratitude promotes improved relations between the giver and the recipient. Anxiety shrinks attention. Gratitude treats anxiety by expanding attention to include positives, thereby allowing appreciation and promoting bonding between giver and receiver.

There are several stages of gratitude. First, there’s recognizing that something good has been received. Second, there’s an internal feeling of appreciation, the emotional response. Third, there are follow up behaviors that express appreciation in some way.

Neglect of Life’s Positives is a Symptom of Anxiety

Most clients seeking therapy for anxiety disorders arrive with little sense of gratitude. They just want their anxiety, their panic attacks, their worries, their depression, to go away. And who could blame them. In the face of overwhelming negative emotions, reacting to the positives of life doesn’t seem nearly as important as avoiding the next panic attack, for example, or being able to sleep despite an onslaught of worries.

In fact, people with anxiety issues have little opportunity for gratitude. The nature of anxiety prevents gratitude. Anxiety creates a chronic perception of threat, in the form of catastrophic thoughts, worries, racing thoughts, and panic attacks. Anxiety increases arousal and narrows the scope of attention as a means rallying the organism to best cope with threat. As the scope of attention shrinks down, the good things in life—your relationships, your kids, your friends, your career, your knowledge and achievements—all of it naturally falls off your radar. Without any awareness of the good things in life, there is no emotional response. And without any emotional response, there is no gratitude. Anxiety actively preempts and prevents gratitude by excluding the positive things from your awareness. With enough anxiety, everything in life seems negative.

Step 1. Gratitude Expands Attention

Gratitude treats anxiety by opening up and expanding your attention. The first step is to make a list of the positives things in life. Recall that unless you have awareness of the positives, you cannot feel gratitude as an emotional response.

In this sense, a gratitude exercise promotes contact with reality, and contact with reality is always good. Gratitude takes us back to the foundations of our lives. You have a place to eat, sleep, and live. Millions of people worldwide do not. You have family that loves you. Millions of people worldwide do not. You have educational opportunities. Millions of people worldwide do not. You have good friends, you have a car to drive or access to public transportation. Millions of people worldwide do not. You have opportunities to advance in your career. Millions of people worldwide do not. You have time to advance your interest in a hobby. Millions of people worldwide do not. You have a spouse and a family. Millions of people worldwide do not.

You might not have all of the items listed above, but odds are you do have some of them. Everything you do have is an opportunity for gratitude, because nothing in life is guaranteed.

And that’s only the beginning. Now that you know what you have in the present, dig deeper. Go back in time and identify acts of kindness that still have consequences for your life. Perhaps someone wrote a letter of recommendation that secured a scholarship that led to your graduation from a training program which led to you being hired for a job that ultimately made possible a spouse and a family and service to society. What does that mean? Well, it means that your letter of recommendation set into motion a series of events that ultimately led to marriage and children. Wow, a letter set into motion a chain of events that played out over years and made possible the life you have now. That’s pretty cool.

Once a list is made, you suddenly have concrete evidence that huge swaths of your life are actually pretty good.

That’s not what anxiety tells you, of course. So when anxiety is whispering in your ear that threats saturate your life, you have strong evidence that it simply isn’t true. This evidence is important, because you’re inclined to believe what anxiety tells you.

Step 2. Respond with Appreciation

You can now take the second step of gratitude, which is to respond emotionally with appreciation. You can respond to the positives that exist in your life now. Assuming you dug deep enough, you may in fact discover that the entire fabric of your life has been made possible by acts of kindness that laid the foundation for everything you’ve done and achieved, as the letter of recommendation example illustrates. Gratitude treats anxiety.

That’s a lot of gratitude, if you take the exercise seriously. The goal is not to be grateful today and then anxious and negative again tomorrow. Instead, the goal is to change your awareness of the positives that exist in your life and their foundations in the kindness of others, and to develop an enduring emotional appreciation that persists day after day after day.

You may still feel anxious, or at least the temptation to be anxious, of course, but you now have a competing narrative that opens up, not shrinks, your scope of attention, a narrative that amplifies the positive, a narrative that is powerful because it is true. If you take it seriously, you begin to recognize the false narrative created by anxiety for what it is, an illusion.

Having a competing narrative strongly grounded in truth brings you to a crossroads. You have the narrative created by anxiety and the narrative created by gratitude. Further, you have the ability to hold both of these in your mind simultaneously. These narratives are incompatible. Both cannot be true. You are going to base your mood on something. Perhaps it should be the positives in life rather than the negatives. Where are you going to put your faith? Which of these narratives will guide your life? Choose and commit.

Step 3. Express Appreciation

The third step of gratitude involves taking some action based on the appreciation you feel. There are many actions you could take, but it is important to do something. Once you take action on a belief, particularly if that action is something that happens between you and another person, that belief tends to be cemented into your identity.

Lets say, for example, that you write a letter of appreciation to your old mentor, recognizing them for having secured your admission to a training program and set into motion a series of events that allowed you to build a life. You’ll feel great for having written this letter, and so will the recipient. Your letter of appreciation solidifies the bond that exists between the two of you. You are both more likely to be there for each other going forward.

Reading Comprehension Questions

1. What is the main difference between gratitude and indebtedness?

  • A. Gratitude requires repayment, while indebtedness does not.
  • B. Indebtedness promotes improved relations, while gratitude shrinks attention.
  • C. Gratitude is maximized when there is no expectation for repayment, while a debt must be repaid.
  • D. Indebtedness is an emotional response, while gratitude is a cognitive process.

2. How does anxiety affect the scope of attention?

  • A. It broadens the scope of attention.
  • B. It narrows the scope of attention.
  • C. It has no effect on the scope of attention.
  • D. It shifts the scope of attention to only positive things.

3. How does gratitude help in treating anxiety?

  • A. Gratitude minimizes the perception of threats.
  • B. Gratitude expands attention to include positive aspects.
  • C. Gratitude removes all the negative emotions associated with anxiety.
  • D. Gratitude changes the brain chemistry.

4. What is the second step of gratitude as described in the text?

  • A. Responding emotionally with appreciation.
  • B. Making a list of positive things in life.
  • C. Expressing appreciation in some form.
  • D. Overcoming anxiety.

5. What does the practice of mindfulness contribute to the experience of gratitude?

  • A. It helps to ignore negative thoughts created by anxiety.
  • B. It assists in noticing what is real and good in life.
  • C. It creates a false narrative of life.
  • D. It forces one to express gratitude for positive things.


C. Gratitude is maximized when there is no expectation for repayment, while a debt must be repaid.
B. It narrows the scope of attention.
B. Gratitude expands attention to include positive aspects.
A. Responding emotionally with appreciation.
B. It assists in noticing what is real and good in life.