You’ve done everything right, downloaded the apps, tried the breathing exercises, journalled, meditated, gone to bed at the same time every night, googled every technique, saved every Instagram post about nervous system regulation, and told yourself to think more positively more times than you can count.
And the anxiety is still there.
That’s because coping with anxiety and resolving anxiety are two fundamentally different things, and most of what we’re handed is the first one dressed up as the second.
Coping strategies work. That’s the honest truth and it’s worth saying clearly before anything else. Breathing exercises regulate your nervous system in the moment, journalling externalises the spiral, exercise metabolises stress hormones. These things have real physiological effects and they’re worth doing.
But they are management tools. They address the symptom, the activation, the spiral, the physical response without touching what’s generating it. And what generates anxiety doesn’t go away just because you’ve learned to manage its output more efficiently.
Think of it this way: if a tap in your kitchen was running constantly, you could get very good at mopping up the water. You could develop an excellent mopping technique, buy better mops, mop faster. And the floor would be less wet, but the tap would still be running.
Coping is the mop, it’s useful, but it’s not the fixed tap.
Reassurance-seeking deserves particular attention because it feels so unlike a coping mechanism. It feels like common sense.
When you’re anxious, you look for certainty. You ask someone if you’re okay, you google the symptom, replay the conversation looking for evidence that it went fine, check, ask again. And for a moment sometimes a few minutes, sometimes a few hours, the anxiety reduces.
But here is what’s happening underneath that relief: every time you seek reassurance and feel better, your brain logs two things: the threat was real enough to check on, and checking made it better. Which means next time the anxiety rises, the pull to check is stronger, not weaker, and the window of relief gets shorter (Salkovskis, 1996).
Reassurance-seeking is a compulsion in the clinical sense. It maintains the very anxiety it’s trying to resolve. The more you do it, the more you need it.
Avoidance is like reassurance-seeking’s quieter cousin. You don’t go to the thing that makes you anxious but cancel, rearrange, and find a reason not to. And the relief is immediate and real.
But your nervous system has now logged that situation as a confirmed threat, one serious enough that you had to leave or not show up. The anxiety around it doesn’t reduce over time, it grows because you never gave your nervous system the experience of being in that situation and surviving it (Barlow, 2002).
Avoidance is the most effective short-term anxiety reduction strategy available. It is also one of the most reliable ways to ensure the anxiety gets worse over the long term.
A word on this because it comes up constantly. Telling yourself everything is fine when your nervous system is convinced it isn’t doesn’t work, not because positive thinking is useless in all contexts, but because anxiety is not primarily a thinking problem.
As covered in earlier posts, the part of the brain running the anxiety doesn’t respond to logic or reassurance, it responds to experience, to feeling safe repeatedly over time. Layering positive thoughts over an activated nervous system is a bit like putting a motivational poster on a faulty smoke alarm. The poster is nice and cute but the alarm is still going off.
This is the part that tends to shift something when people really hear it.
Anxiety is comes up basically because your mind has learned at some point, that a certain level of vigilance was necessary, and has been maintaining that vigilance ever since, even when the original reason for it is long gone.
The coping strategies don’t ask what the anxiety is about, they ask how to make it quieter. And that’s a reasonable short-term goal, but not a resolution.
Resolution involves understanding why your mind has learned to stay on high alert in the first place, what it was responding to, what it’s still protecting you from. And through that understanding, through new experiences, through working with the patterns rather than around them, gradually teaching it that the level of vigilance it’s been maintaining is no longer needed.
That is a fundamentally different project from learning to breathe through it.
The distinction between management and resolution doesn’t mean coping strategies should be abandoned. They have a place particularly in the early stages of therapeutic work, when the nervous system needs some immediate regulation before deeper work is possible.
But they work best as a bridge.
Therapeutic approaches that address what’s underneath rather than just managing what’s on the surface include integrative psychotherapy, which draws on multiple modalities to work with both the conscious and unconscious patterns maintaining anxiety. Psychodynamic approaches explore the origins of the anxiety and the relational patterns connected to it. ACT works with the relationship to anxious thoughts and feelings rather than trying to change or suppress them (Hayes, Strosahl & Wilson, 1999). Somatic approaches work with what the body is holding, not just what the mind is thinking (van der Kolk, 2014).
Exposure-based approaches including CBT with an exposure focus and Exposure and Response Prevention (ERP) are particularly relevant where avoidance and compulsive behaviours have become part of the anxiety pattern. Rather than managing the discomfort these situations produce, exposure work gradually and systematically confronts the avoided experience, allowing the nervous system to learn through direct evidence that the threat is not as dangerous as it has been treating it. ERP specifically targets the compulsive responses, the checking, reassurance-seeking, neutralising that maintain the anxiety loop, and has a strong evidence base across anxiety presentations (Foa & Kozak, 1986).
Clinical hypnotherapy sits within this, working with the subconscious patterns and learned threat responses that conscious coping strategies cannot reach. Trancework addresses the anxiety at the level where it is actually operating, rather than at the surface where its symptoms appear (Yapko, 2012).
The question worth sitting with is what the anxiety has been trying to tell you and what it would take for your nervous system to finally feel safe enough to let it go.
If any of this resonates and you’re wondering whether therapy might help, you’re welcome to book a free 15-minute call to explore working together.
Not sure if therapy is right for you yet? Read: How to find the right therapist.
Integrative Therapist (Psychotherapy & Hypnotherapy), working with anxiety, relationships, habits & compulsions, and the not-enough feeling.
A 3-step free guide to understanding and interrupting repetitive patterns in your relationships, behaviour and emotional responses.
