Rethinking Anxiety: From Something to Fix to Something to Understand
By Lyndsay Babcock
Clinical Psychologist
Many people who come to The Self Centre present with anxiety, sometimes formally diagnosed, sometimes something they have come to recognise in themselves over time. Most people are familiar with the feeling. A sense of unease, a tightening in the body, a mind that moves quickly through possibilities, often landing on what could go wrong. It feels like fear, and in many ways it is experienced that way. But clinically, it can be more helpful to understand anxiety not simply as fear, but as a system of prediction that has become biased toward threat.
Anxiety is about prediction, not just emotion
The brain is constantly trying to anticipate what might happen next.
This is a normal and necessary function. It helps us plan, prepare, and stay safe.
When anxiety is elevated, this system becomes more sensitive. It begins to fill in uncertainty quickly, often with worst-case scenarios. Not necessarily because those scenarios are likely, but because uncertainty itself feels difficult to tolerate.
In this context, anxious thoughts are not random.
They are attempts to resolve uncertainty.
This is why they can feel urgent, repetitive, and compelling. They are not always trying to tell you what is true. They are trying to create a sense of certainty in situations where certainty is not available.
Why anxiety persists, even when you understand it
This way of understanding anxiety helps explain some of the more confusing experiences people describe.
Reassurance often provides only temporary relief.
The difficulty is not just the content of the thought, but the discomfort of not knowing.
Anxiety tends to move from one topic to another.
Once one uncertainty is resolved, the system searches for the next potential risk.
People who are capable, thoughtful, and good at problem-solving often feel more anxious.
They are able to generate detailed and believable predictions, which can make the thoughts feel even more convincing.
From a behavioural perspective, anxiety is maintained by avoidance and safety behaviours. These reduce distress in the short term, but limit the opportunity for the brain to update its predictions over time (Craske et al., 2022).
What we are looking for in therapy
At The Self Centre, the aim is not to eliminate anxious thoughts.
It is to understand the system that is generating them, and to gently shift how someone relates to that system.
We are often paying attention to patterns such as
- how quickly the mind moves to resolve uncertainty
- how much weight is given to anxious predictions
- what behaviours follow those thoughts
- and how the body responds in moments of perceived threat
From there, the work becomes less about “stopping anxiety” and more about creating flexibility.
What actually helps
There are several well-supported approaches that help shift these patterns. While they differ in style, they share a common direction.
Cognitive Behavioural Therapy (CBT)
CBT helps people step back and examine the accuracy and usefulness of their thoughts.
This can include
- identifying patterns of thinking
- testing predictions over time
- and gradually reducing avoidance behaviours
There is strong evidence supporting CBT as an effective treatment for anxiety, with lasting outcomes for many people (Hofmann et al., 2012).
CBT can be particularly helpful when thoughts are being treated as facts rather than as mental events.
Acceptance and Commitment Therapy (ACT)
ACT takes a different approach.
Rather than challenging thoughts directly, it focuses on changing how people relate to them.
This includes
- noticing thoughts without becoming caught up in them
- allowing uncertainty to be present
- and continuing to act in ways that align with values
ACT is well supported in the literature and is particularly helpful when people feel stuck in cycles of overthinking or trying to control their internal experience (A-Tjak et al., 2015).
Dialectical Behaviour Therapy (DBT)
DBT offers practical skills for managing intense internal experiences.
This includes
- grounding and mindfulness
- tolerating distress without escalating
- and regulating emotional responses
These skills are especially useful when anxiety feels overwhelming or difficult to contain.
A more useful goal
Across these approaches, there is a shared shift.
The goal is not to eliminate anxiety.
The goal is to change how you respond to it.
This might look like
- noticing anxious thoughts without immediately acting on them
- allowing uncertainty to exist without needing to resolve it
- staying engaged in life, even when anxiety is present
Over time, this allows the brain to update its predictions in a more flexible and accurate way.
Anxiety is not a sign that something is wrong.
It is a sign that your system is working hard to create certainty and keep you safe.
When people begin to understand this, they often stop trying to get rid of anxiety altogether.
Instead, they begin to relate to it differently.
And this is often where meaningful change begins.
References
A-Tjak, J. G. L., et al. (2015). A meta-analysis of the efficacy of acceptance and commitment therapy. Psychotherapy and Psychosomatics.
Craske, M. G., et al. (2022). Rethinking exposure therapy: An inhibitory learning approach. Behaviour Research and Therapy.
Hofmann, S. G., et al. (2012). The efficacy of cognitive behavioral therapy: A review of meta-analyses. Cognitive Therapy and Research.