|
If you've searched up any of these, you're not alone:
You've probably tried most of the list already. An app, a laminated index card of breathing ratios, the memorized five senses drill, maybe a PRN prescription for the worst moments. And somewhere around the fortieth time none of it held when it actually mattered, you started to wonder if the problem is you - if you're just too anxious for what apparently works for everyone else. The problem isn't you. The problem is the techniques. We don't teach coping skills at Indy OCD. Not because we think you can't handle them, and not because we're contrarian for its own sake. We don't teach them because, in the moment anxiety actually spikes, they don't do what people think they do - and they often make the anxiety cycle worse, not better.
Anxiety Is the Result of Something You're Doing Here's the frame we work from: anxiety isn't weather that rolls in and has to be waited out. Anxiety is a result - the product of something you are doing, moment to moment, usually some version of scanning, checking, analyzing, or trying to resolve an uncertain threat. Clinically, that's a compulsion. Mental compulsions get their own name - rumination - but they're not a separate category from physical ones like checking or reassurance-seeking. Same mechanism, same function: reduce distress now, at the cost of confirming the threat was worth taking seriously. That distinction matters, because it changes the question. If anxiety just happens to you, the goal is to soothe it. If anxiety is produced by something you're doing, the goal is to stop doing that thing. Why Coping Skills Miss the Point Box breathing, 5-4-3-2-1 grounding, progressive muscle relaxation, guided meditation mid-spiral - these are all, functionally, counter-actions. A second thing you do to try to override the first thing you're already doing. Picture pressing the gas pedal - the checking, the analyzing - while someone hands you a second pedal, the brake, for your other foot. Maybe the car slows a little. You're still on the gas. You haven't stopped the thing generating the anxiety; you've added a competing input and hoped it wins. It often backfires further, because the coping skill itself becomes something to monitor. Am I breathing right? Is this working yet? Why isn't my heart rate coming down? That's not calming your system - that's the same compulsive checking, just wearing a fancier hat. Coping Skills Can Function Like Compulsions - Because They Are A compulsion is anything done to reduce distress or neutralize a perceived threat. It doesn't matter whether it looks like a compulsion (checking locks, counting, biting nails) or looks like self-care (breathing exercises, grounding, a PRN pill). Popping a Xanax, Klonopin, or Ativan the moment anxiety spikes serves the identical function: it ends the distress right now, and in doing so teaches your nervous system that the spike was dangerous enough to require intervention. Same with the "safety bag" - ginger chews, essential oils, a cold pack, noise-cancelling headphones, carried everywhere "just in case." The bag isn't neutral. It's a compulsion you wear on your shoulder, and its presence alone can maintain the belief that you couldn't handle a spike without it. None of this is about willpower or discipline. It's about structure: relief now, reinforcement of the alarm later. Every one of these tools follows the same trajectory every compulsion follows - needing more precision, more frequency, or more backup over time to produce the same relief. We're Not Saying These Are Worthless Meditation as a general practice has real support - for baseline stress, attention, sleep. Progressive muscle relaxation can help with general tension or sleep onset. We're not telling you to toss the app or the essential oils. The claim is narrower: these tools aren't built for the moment anxiety is actively spiking, and using them as the direct response to that spike tends to reinforce the cycle you're trying to escape. A general wellness practice and an emergency anxiety intervention are not the same thing, even when they look identical from the outside. What We Teach Instead: Disengagement Our approach is Exposure and Response Prevention (ERP), and the skill it teaches is disengagement, not counteraction - noticing when you've started checking, analyzing, or reaching for anything (mental or physical, prescribed or in a bag) to make the feeling go away, and practicing letting it exist without responding to it. Not fighting it, not breathing it away, not grounding out of it. Declining to feed it. This is uncomfortable to hear - it sounds like we're taking away the one thing that's ever given you relief. The relief was always temporary, and it was always priced in reinforcement. Real change doesn't come from getting better at managing the spike. It comes from the spike no longer needing to happen, because you've stopped running the process that generates it. (More on that process in Why You Can't Stop Thinking About This.) If you've built a whole toolkit and you're still anxious, that's not a failure of effort. It's a sign the toolkit was built for the wrong problem. Schedule an intake appointment with a therapist trained in ERP to learn what disengaging actually feels like. Christopher Toomer is a Licensed Clinical Social Worker specializing in Exposure and Response Prevention (ERP) and Eye Movement Desensitization and Reprocessing (EMDR) therapy for OCD and anxiety disorders. He provides evidence-based treatment for adults and children 8+ at Indy OCD in Carmel, Indiana. Comments are closed.
|