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Davina McCall

addicted to anxiety owen o’kane

Addicted to Anxiety

Owen O’Kane is a psychotherapist, Sunday Times bestselling author and former NHS lead for Mental Health. He is a resident therapist for BBC Radio 5 Live and a regular contributor to press and media.

www.owenokane.com

@owenokaneten @owenokaneten

How to Be Your Own Therapist

Addicted to Anxiety owen o’KAne

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To everyone who has shared their anxious self with me. It’s been a pleasure and honour to meet that loyal, protective and caring part of you. I hope you now realise it’s not a total pain in the a**!

Chapter

Reclaiming Your Life and Relapse Prevention

Chapter 9: Unaddicted to Anxiety: Preparing for the Road Ahead 251

Chapter 10: Hope and the Future 286

Your Anxious Self

Introduction

In my thirty years of working in physical and mental health, I haven’t witnessed anxiety levels as high as they are now. We have become ‘generation anxious’. And the research backs this up.

Across the board, we are seeing higher incidences of anxiety with our children, teenagers, parents and older people. Workplaces are struggling to cope with levels of illness linked to anxiety. School absenteeism has increased , and reported cases of clinical anxiety are growing globally according to news headlines.

None of this is surprising off the back of a global pandemic, economic challenges, wars, political instability, climate change and a world filled with uncertainty. In short, the world feels like a scary place to live right now.

But that’s only one part of the problem. How you manage the uncertainty and anxiety of life presents a greater challenge.

Have you ever stopped to consider that you might be addicted to anxiety?

Yes, just let that settle for a moment. It’s a lot to take in.

I’ve used the word ‘addicted’ deliberately because I believe anxiety has an addictive component that’s rarely talked about or dealt with clinically. And in my experience, this may be part of the solution. Habits form, but they can also be transformed.

Many years ago, I was leading an anxiety therapy group in an NHS service. As the weeks progressed, I noticed that most of the group participants were beginning to improve. I fed this back to the group, but I immediately noticed a hesitancy and unease move into the room.

I explored what was going on and it soon became clear that many of them felt anxious about the prospect of not being anxious! The responses were startling:

‘What if I’m letting go of the one thing that keeps me safe?’

‘I’m not sure I’m ready.’

‘This is all I’ve known, and it feels like you are taking something away.’

‘But this is who I am.’

The most amazing moment occurred when one of the group, Daryl (a recovering cocaine addict), joked that letting go of his anxiety was harder than weaning off cocaine. ‘I’m bloody hooked,’ he said. The group laughed and in this moment of camaraderie and banter, it was obvious everyone knew what he meant. As did I. The notion of being ‘hooked’ on anxiety made sense.

There are a few moments as a therapist when you know something significant is happening for you – it’s like a sixth sense. Every fibre of my being was curious about what this might mean. I had to dig for more.

There are many models and theories on anxiety that offer great insights, but the addictive component of anxiety is often missed. I suddenly remembered an interesting fact that the chemicals produced in the body during an episode of anxiety are comparable to those produced when excited. It’s therefore understandable that there’s a possibility of unconscious dependence on this reaction (if I feel anxious, it will keep me safe).

When the laughter in the therapy room settled, I asked Daryl to explain what he meant. He knew I was intrigued, but equally, I could see he was also having a moment of insight. He recounted that

when he was addicted to cocaine, it was a means of escaping the reality of his painful inner world. His childhood was traumatic and full of pain. Drugs helped him feel a combination of numbness, excitement, distraction and freedom for short periods. This led to dependence.

When he described his anxiety, it was a similar picture. Whilst it didn’t give him the same ‘high’ as drugs, the anxiety process temporarily helped him deal with not feeling safe or certain. Letting go of these processes felt non-negotiable because, short term, they removed any sense of threat and provided a sense of control. The problem was, longer term, he was unknowingly contributing to the maintenance of his anxiety. It was a different type of ‘being hooked’. He was describing being addicted to the process of anxiety. And in that moment, Addicted to Anxiety, this book, was born.

Every other book on anxiety you read will tell you that anxiety is something that is happening to you. It is normal. It is not your fault.

I won’t argue with any of these propositions because there is truth in all of them.

That said, I believe there’s a danger that if you unreservedly believe anxiety is something that is

happening to you or is out of your control, you may feel powerless or submissive. But you aren’t.

If you live with anxiety and experience the debilitating symptoms it comes with, I promise you there is a way forward. But it does mean beginning to actively let go of the many patterns that you’re addicted to when it comes to the maintenance of your anxiety. Yes, anxiety is an experience that’s happening to you but there is every possibility that many of your actions, behaviours and responses are fuelling the fire and keeping it going. You may see them as a way of dealing with your anxiety or easing the symptoms. But there is every possibility that you are stoking the fire of anxiety.

You’re unknowingly addicted to maintaining a process that’s giving you a short- term sense of safety but a lifetime of suffering. I know that’s a lot to take in, so catch a breath here and let that settle. Hopefully, you’ve taken a moment to make sense of what I’ve just said. Are you ready for the next piece of news?

• I believe today can be the start of change for you.

• I believe I can help you get to a place of recovery.

Why I think I can help

Firstly, I should say, I am no stranger to anxiety. People often think that therapists are fully ‘sorted’ and have all the answers. Don’t be fooled. We are humans and we are all works in progress. Therapists go through tough periods too. I think some of the best therapists I have worked with have experienced varying levels of adversity in their lives. I grew up in Northern Ireland during a period known as ‘the Troubles’. It was a severe period of sectarian violence between Protestant and Catholic paramilitaries. In short, a war zone with some of the worst atrocities in modern times. I once gave a TED Talk titled: Bombs, Bullets, Bullying and a Piano . I grew up in a culture of fear. I learnt to be anxious. Learning to play piano helped me self-soothe. Apart from the war-zone childhood, I was also a sensitive gay kid growing up in a country where sexuality outside of ‘norms’ was deemed sinful and shameful by churches. I thought I was ﬂawed. Alongside this, there was also a lot of bullying, and the normal challenges faced by anyone growing up in an economically and socially deprived area. I would be lying if I said it was an easy childhood.

But I do need to acknowledge that there was always a presence of love and some wonderfully kind people interspersed within both my family and social networks.

So, fast forward to adulthood. Despite the presence of love, my nervous system was hardwired for threat. In short, I understand anxiety. Many people will have similar stories, with different contexts, I’m sure.

But I don’t whine or self-pity about this part of my story any more (believe me, I did in the past). My lived experience gives me a deeper understanding of anxiety, which I believe strengthens my work. It’s the reason I write books. It’s the reason I am passionate about recovery. I believe when you have walked the walk you can talk the talk from a place of raw honesty, with the knowing that hope is around the corner.

Apart from my lived experience of anxiety, I should mention that I’m a psychotherapist and former palliative care specialist with thirty years’ experience in physical and mental health. I am a former NHS Mental Health Lead and author of three best selling books on mental wellbeing. I’m a speaker at conferences and corporate events and even contribute to a BBC radio show as a resident therapist. I get around, as they say.

I love what I do and feel a responsibility to use all these platforms for the greater good of easing human suffering. I know that might sound a little nauseatingly pious, but, ultimately, I believe we all have some sort of role to play, whatever that might be.

Anxiety and trauma are my key areas of interest. All my work is inﬂuenced by clinical training, personal experience and a very humane approach to the human condition. I’ll avoid psychobabble, lecturing, guru speak and platitudes wherever possible. That stuff drives me up the wall, so I’ll avoid putting you through it.

How will the journey to recovery happen?

This book is divided into three sections:

Chapters 1–3: The Root of the Problem

Chapters 4–8: Breaking the Habit

Chapters 9–10: Reclaiming Your Life and Relapse Prevention

Everything will be clearly explained and laid out in a way that I know works effectively. Change does

not happen unless you understand the problem, so I’d encourage you to follow the book as it’s laid out. There’s often a temptation to rush, particularly if you are anxious. There might even be some impatience: ‘Just get me to the solution.’ Trust me, we will get there.

I am not using a specific traditional model of anxiety or therapy, but I of course acknowledge the brilliance of many of these models and their inﬂuence on my work. This is my approach. It is a humane, integrative approach to tackling anxiety. I want to share it because it works.

There will be a process for each stage and throughout I’ll share stories, examples and specific tools that help. Each chapter will end with a summary of key areas covered.

Names of any persons, specific institutions or organisations have been anonymised to protect privacy and confi dentiality. Any similarities with stories, events or people are coincidental, as all details have been tweaked or amended accordingly.

Please note that I am offering guidance and suggestions in this book but if your symptoms are overwhelming and getting in the way of your life, please always seek the support of a professional therapist or medical practitioner. Please also note that

anxiety can be linked to other mental health conditions, health issues, substance use, medication, neurological issues and neurodivergent diagnosis. Always speak to a professional for specific advice on anxiety that is secondary to another issue. This book will be useful for anxiety generally, but its focus is on anxiety as the key issue.

If you have moments of desperation and hopelessness or feel any desire to harm yourself or have thoughts of ending your life, always speak to someone immediately. There is always a way through. I have provided a list of support organisations at the end of the book. In the ﬁrst instance speak to your doctor or call emergency services.

I want to remind you again that your anxiety can improve, and life can be better than it is today. Full disclosure here though. Anxiety will not disappear.

Anyone who promises this is not being honest. It is an essential part of the human condition. Sometimes it’s useful and necessary. Sometimes it’s a pain in the a**. We are working on recovery and reclaiming your life rather than anxiety ruling your life.

That all said, you will need to put the work in. There is no manifesting your way out of anxiety.

There isn’t a way to heal your anxiety in one day. There isn’t a vitamin pill or magic course that banishes it forever. There is no cold-water immersion programme that will totally resolve the issue. Yes, some stuff helps so I’m not knocking any of it. But it’s just not that simple.

We live in a culture of false promises, unqualified information and manipulation of mental health issues as a means of commercial gain. It’s a multibillion-pound industry.

I’m sorry to be blunt, but that’s the truth. Lots of information out there is unhelpful.

If I experienced a heart attack, it wouldn’t make me a qualified cardiologist, so I shouldn’t and wouldn’t enter that arena as an ‘expert’. Nowadays a weekend course or a personal experience seem to warrant the badge. Caution is needed. This is your health and wellbeing. Sharing experiences and encouraging conversations are to be applauded. There are some amazing people doing great work. Claims beyond that should always be researched for clinical credibility and accuracy.

Recovery from anxiety, in my experience, is a combination of breaking patterns of mind, body, emotions, behaviours and energy that will lead you to a breakthrough in the long term.

This book is about getting you unaddicted from your anxiety processes.

It is a book about taking responsibility. It is a book about getting to know your anxious self.

It is a book that will help you befriend your anxious self.

It is a book of hope, redemption and getting your life back. I’m glad you’ve picked up this book.

seCTIon 1 The Root of the Problem

CHAPTeR 1

Meeting Your Anxious Self

It’s ironic that as I sit down to begin this opening chapter, I’m feeling a little anxious about writing this book. Let’s dive straight in as I share the following events that happen over a few minutes.

I’m in my local library and I start to observe other people in the room, wondering what they are doing. Is anyone else writing a book? Wouldn’t it be great to be a student again? Do I recognise the guy sitting near me from my dog walks? Classic avoidance and procrastination of course, but I somehow manage to justify this mind-wandering. It’s taking me away from a feeling that’s hovering in the background.

Yes, anxiety is in the neighbourhood. He’s an old mate of mine and has been for as long as I can remember. He’s a part of my humanity. He’s a part of me.

And although I’m conscious anxiety is looming, I’m equally aware that I’ve jumped on the fear train without managing him.

Suddenly I can feel my stomach churning, and a heaviness descending upon my chest and entire body. My anxiety is no longer hovering; he’s in the room. I’m tense and in a state of expectancy. But I don’t know what I’m expecting. It’s as if I’m waiting for something to go wrong. It doesn’t seem wise to move away from this state.

Surely, these feelings must be here for a valid reason? I start to muse whether anyone else in the room has these moments (I know they do). Maybe some of them are feeling similar right now?

My mind then moves to an avalanche of practical thoughts about the task at hand: writing this book. I ruminate about the title, content, deadlines and how I will structure the book.

Then the wind direction changes as my thoughts get a little heavier. I start to question my ability to write another book, even though this is my fourth. Self- doubt moves in like a bargain hunter at the January sales, grabbing at every chance to fi nd the next ‘What if?’ opportunity. And there are many:

• What if I fail?

• What if it’s not as successful as the other books?

• What if I get writer’s block?

• What if it doesn’t help the reader?

• What if my editor thinks it’s rubbish?

I think you get the message. I’m on the fast train to negativity and it’s an express service!

Anxiety rarely comes alone. It brings a few cousins along for the ride, namely: ego, self-doubt, catastrophising, fear, dread and a few others we will meet throughout the course of the book. It’s like watching the television series Long Lost Family. You never know what’s going to be uncovered!

My attention suddenly shifts focus again. Apart from my mind racing, I’m mindful that new feelings have moved in. I’m fearful. I’m doubtful. I’m vulnerable.

I’m feeling exposed.

And then suddenly I gasp, like coming up for air after a few moments under water. I intuitively stop to regulate my breath and step back from my anxiety. This is something I’ve learnt to do, and you will learn this also.

I manage to break the ﬂow of my anxiety cycle and then suddenly I feel calmer and clearer.

In this steadier state, I soon realise my anxiety is here because I’m in a new situation writing this book. It is exposing. There is risk. It could go wrong. So why wouldn’t it present me with all the worstcase scenarios to prevent me from harm, hurt, failure or even humiliation? It makes sense.

My anxiety is serving the function of protecting me. But it isn’t necessary or helpful at this moment. I need my anxiety to hear this, so I remind him of a few facts:

• This book is important.

• Many of the doubts presented aren’t true.

• We have managed well before.

• It’s safe to do this work.

• We will cope.

• I am grateful for his support.

• He can stand down as I don’t need him right now.

He backs off like a puppy in training. I have been working with him for a long time so there is mutual respect at this stage, and he has learnt to trust my wiser judgements.

I return to writing, laughing to myself. This

wasn’t how I planned to open the book, but my anxiety clearly had other ideas. If I was going to feature him in this book, he was always going to attempt a centre-stage moment.

Let’s not be fooled here, he will be back. But these days I’m not scared of him any more. I understand his motives. I know his moves. I know how he thinks. I’m familiar with the emotions he brings. I’m aware of the behaviours he elicits. He’s addictive, cunning, persuasive and demanding. If he believes he can take charge, he will do his damnedest. But I’m constantly reminded his intentions are well meaning. He is not my enemy. He is simply a highly protective part of me that sometimes works way harder than he needs to. And that makes total sense to me as someone who grew up in an environment of constant fear. If we recap quickly on the example I’ve shared, you will see systemically the anxiety process:

• New task of writing a book triggers anxiety.

• Anxiety believes new task could present risk or threat.

• Anxiety mobilises his armour.

• Creates a state of alarm in the body (physical symptoms).

• Activates a series of primary ‘What if?’ thoughts (overthinking/worry).

• Goes deeper, activating self-doubt, fear, catastrophic thoughts.

• Self-realisation kicks in and I stop, breathe and step back to interrupt the cycle.

• I negotiate and reinform my anxious self that he is not needed.

• An addictive episode of anxiety has been avoided, hence creating new patterns that serve well longer term.

Let’s be honest, it could be very tempting to stick with the anxiety narrative. I’d shorter term feel less threatened. I could stop writing today and go off and do something nice. I’d feel less pressure. I could avoid some of my responsibilities.

So, yes, there would be a short-term hit, but at what cost?

So, I decide to thank my anxious self for showing up for me today as I start this book. I kindly refuse to get too involved with its offerings and I get on with my purpose.

I disrupt the cycle before it starts to feel vicious or uncomfortable. You have the power to do the same.

ReFleCTIon MoMenT

Now I’ve given a little insight into how my anxiety functions, I have a few questions for you to consider. I really encourage you to take a few minutes here and make some notes separately if it’s helpful for you.

• Have you ever consciously met your anxious self (deliberately taken time to get to know that part of you)?

• Have you ever tried to avoid this part of yourself?

• Have you ever considered that your relationship with your anxious self may be unhealthy?

• Have you ever explored how addicted you might be to his/her/their daily appearances promising safety and protection from hurt or harm?

• Have you ever wondered whether you are intimidated by this part of yourself and are frightened of it?

• Have you ever wondered who is in the driving seat of your life, you or your anxiety?

I know these questions are tough to consider and might evoke uncomfortable responses. But if we are going to do the work on getting you unaddicted to anxiety, we need to start by getting you to bravely meet that part of yourself.

It’s worth remembering that you may have been hooked on listening to your anxious self’s rants and threats for years, therefore getting to know and understand it is crucial.

Your

anxious self

You will note from the outset that I’m referring to your anxious self as a part of you that you may have developed an unhealthy dependence on. Your anxious self is, of course, the process of anxiety, which I believe many people get addicted to. Throughout the book, if I’m referring to anxiety, anxious self, anxious part or anxiety processes, they are all one and the same. There are simply moments when I choose to use language that’s appropriate to the part of the process I’m working on.

Lots of expert books and models of therapy on

this topic (which I have the utmost respect for) will describe this very differently. My route is unapologetically different based on my observations and findings over thirty years of clinical experience in both mental and physical health.

My approach is a multifactorial mix of psychology, neuroscience, humanity, physiology and a degree of spirituality (in the bigger-picture sense, not religion).

Human beings are complicated. There can’t be one solution. We need to accept and get to know the many parts of ourselves. And anxiety is one such part. But it’s a part that can cause real problems for millions of people.

Many helpful alternative books on this subject use scientific/neuroscientific language focusing on the physiology of the mind and body. Many will focus on thinking errors as a maintenance for anxiety. Some will focus on behaviours. Some will focus on life experiences.

I’ve noticed the one common ground for most models offering treatment for anxiety is that anxiety is something happening to you. Whilst I agree with this to a point, I don’t believe it’s the entire picture.

I believe you have a bigger role to play in the

maintenance of your anxiety than you might realise. I know, this is a bombshell to drop, but I’ll explain.

I believe many people are addicted to the process of anxiety (which is your anxious self) because it promises safety, less risk and protection. And that makes total sense to me. I know it doesn’t offer the same ‘high’ as drugs or any other substances, but why would you let go of something that’s promising to protect you?

I refer to anxiety as a humane part of you because that’s exactly what it is. If you think of anxiety solely as a mechanical/physiological process within the body, then you risk relating to it like a kidney or lung! It becomes functional, impersonal and something you don’t have a relationship with.

That’s not how it is. Your anxious self comes with an entire bag of tricks and a mini personality of its own! Its aim is to help you, but it often creates significant distress. It can relate to you via your thoughts, emotions, reactions, behaviours, body, spirit and your entire experience. It has its own voice and way of relating to you. Subsequently, you have a way of relating back and often that’s addictive.

• Sometimes you hate it, but you won’t let it go.

• Sometimes it terriﬁes you, but you listen to it anyway.

• Sometimes you know what maintains it, but you keep giving it what it needs.

• Sometimes it makes no sense, but you believe it regardless.

• Sometimes you know you need to be in charge, but you give in to its demands.

• Sometimes you are addicted to it.

The bottom line is: I need you to recognise and meet your anxious self.

How would you recognise your anxious self?

I’m talking about the anxious self as a multifaceted entity ingrained into your being. That’s my experience of it with most people. However, everyone’s experience of anxiety will be different but with common identifiers.

• One person might worry about many things. Another might focus on health worries.

• Someone might experience a lot of physical anxiety in their chest. Another might have tummy symptoms.

• Someone might experience anxiety in the morning. Another at bedtime.

In short, there is no set formula or predictability. Sometimes it may even come in a different guise. If let be, it literally can have a mind of its own sometimes.

Before identifying the key aspects of anxiety, I think it’s important to clarify the difference between anxiety and stress as this confuses people. Stress is normally an internal response to an external stimulus. For example, on a particular day you miss your bus to work, your boss is angry you’re late, you receive a call that one of the kids is ill and, to top it off, you arrive home and the dog has pooped on the carpet! It’s normal to feel stressed in such moments and some of the symptoms might mirror anxiety.

Anxiety has a different ﬂavour to it. There will be moments when an episode can be related to a trigger event. But there are other moments when it