Recently, someone on the Facebook page asked if anyone had used rationality to target anxieties.  I have, so I thought I’d share my LessWrong-inspired strategies.  This is my first post, so feedback and formatting help are welcome.  

First things first: the techniques developed by this community are not a panacea for mental illness.  They are way more effective than chance and other tactics at reducing normal bias, and I think many mental illnesses are simply cognitive biases that are extreme enough to get noticed.  In other words, getting a probability question about cancer systematically wrong does not disrupt my life enough to make the error obvious.  When I believe (irrationally) that I will get fired because I asked for help at work, my life is disrupted.  I become non-functional, and the error is clear.

Second: the best way to attack anxiety is to do the things that make your anxieties go away.  That might seem too obvious to state, but I’ve definitely been caught in an “analysis loop,” where I stay up all night reading self-help guides only to find myself non-functional in the morning because I didn’t sleep.  If you find that attacking an anxiety with Bayesian updating is like chopping down the Washington monument with a spoon, but getting a full night’s sleep makes the monument disappear completely, consider the sleep.  Likewise for techniques that have little to no scientific evidence, but are a good placebo.  A placebo effect is still an effect.

Finally, like all advice, this comes with Implicit Step Zero:  “Have enough executive function to give this a try.”  If you find yourself in an analysis loop, you may not yet have enough executive function to try any of the advice you read.  The advice for functioning better is not always identical to the advice for functioning at all.  If there’s interest in an “improving your executive function” post, I’ll write one eventually.  It will be late, because my executive function is not impeccable.

Simple updating is my personal favorite for attacking specific anxieties.  A general sense of impending doom is a very tricky target and does not respond well to reality.  If you can narrow it down to a particular belief, however, you can amass evidence against it. 

Returning to my example about work: I alieved that I would get fired if I asked for help or missed a day due to illness.  The distinction between believe and alieve is an incredibly useful tool that I immediately integrated when I heard of it.  Learning to make beliefs pay rent is much easier than making harmful aliefs go away.  The tactics are similar: do experiments, make predictions, throw evidence at the situation until you get closer to reality.  Update accordingly.  

The first thing I do is identify the situation and why it’s dysfunctional.  The alief that I’ll get fired for asking for help is not actually articulated when it manifests as an anxiety.  Ask me in the middle of a panic attack, and I still won’t articulate that I am afraid of getting fired.  So I take the anxiety all the way through to its implication.  The algorithm is something like this:

  1.       Notice sense of doom
  2.       Notice my avoidance behaviors (not opening my email, walking away from my desk)
  3.       Ask “What am I afraid of?”
  4.       Answer (it's probably silly)
  5.       Ask “What do I think will happen?”
  6.       Make a prediction about what will happen (usually the prediction is implausible, which is why we want it to go away in the first place)

In the “asking for help” scenario, the answer to “what do I think will happen” is implausible.  It’s extremely unlikely that I’ll get fired for it!  This helps take the gravitas out of the anxiety, but it does not make it go away.*  After (6), it’s usually easy to do an experiment.  If I ask my coworkers for help, will I get fired?  The only way to know is to try. 

…That’s actually not true, of course.  A sense of my environment, my coworkers, and my general competence at work should be enough.  But if it was, we wouldn’t be here, would we?

So I perform the experiment.  And I wait.  When I receive a reply of any sort, even if it’s negative, I make a tick mark on a sheet of paper.  I label it “didn’t get fired.”  Because again, even if it’s negative, I didn’t get fired. 

This takes a lot of tick marks.  Cutting down the Washington monument with a spoon, remember?

The tick marks don’t have to be physical.  I prefer it, because it makes the “updating” process visual.  I’ve tried making a mental note and it’s not nearly as effective.  Play around with it, though.  If you’re anything like me, you have a lot of anxieties to experiment with. 

Usually, the anxiety starts to dissipate after obtaining several tick marks.  Ideally, one iteration of experiments should solve the problem.  But we aren’t ideal; we’re mentally ill.  Depending on the severity of the anxiety, you may need someone to remind you that doom will not occur.  I occasionally panic when I have to return to work after taking a sick day.  I ask my husband to remind me that I won’t get fired.  I ask him to remind me that he’ll still love me if I do get fired.  If this sounds childish, it’s because it is.  Again: we’re mentally ill.  Even if you aren’t, however, assigning value judgements to essentially harmless coping mechanisms does not make sense.  Childish-but-helpful is much better than mature-and-harmful, if you have to choose.

I still have tiny ugh fields around my anxiety triggers.  They don’t really go away.  It’s more like learning not to hit someone you’re angry at.  You notice the impulse, accept it, and move on.  Hopefully, your harmful alief starves to death.

If you perform your experiment and doom does occur, it might not be you.  If you can’t ask your boss for help, it might be your boss.  If you disagree with your spouse and they scream at you for an hour, it might be your spouse.  This isn’t an excuse to blame your problems on the world, but abusive situations can be sneaky.  Ask some trusted friends for a sanity check, if you’re performing experiments and getting doom as a result.  This is designed for situations where your alief is obviously silly.  Where you know it’s silly, and need to throw evidence at your brain to internalize it.  It’s fine to be afraid of genuinely scary things; if you really are in an abusive work environment, maybe you shouldn’t ask for help (and start looking for another job instead). 

 

 

*using this technique for several months occasionally stops the anxiety immediately after step 6.  

New to LessWrong?

New Comment
31 comments, sorted by Click to highlight new comments since: Today at 3:43 PM

The approach looks a bit like comfort-zone expansion. The difficult thing seems to connect it to noticing the problem near its occurrence, right?

[-][anonymous]8y30

It's similar, I think. In the case of anxiety, you could model it as "Having a comfort zone that is too small and inconsistent," and you wouldn't be off the mark by too much.

I'd like to see the executive functioning post. Your formatting and article flow seems quite good to me.

[-][anonymous]8y50

I'll do my best to get it up by the end of the week. If I forget, feel free to harass me.

I'd still be interested in seeing this.

Seconding this. It seems like a super-important topic, so if you have something to say about it, please do.

[-][anonymous]8y60

An important comment that I couldn't fit in the post, and that I may expand on later: the framework here may closely resemble other frameworks without Less Wrong jargon. I know that, and it's fine. I firmly believe that people should seek recovery or coping mechanisms in an environment where they are comfortable. I am comfortable here, the jargon clicks with my brain, and I understand the conversation here at a higher level than anywhere else. I am safe here and this is the framework I like. If you like it here, this may help you. At the very least, it's a case study on "using LW for mental health."

Yup, this is very similar to Cognitive Behavioral Therapy. But that just shows that the technique works, and I totally endorse the sentiment of "getting people to do this is the most important thing, and if dressing it up in LW language gets people to do it, then great".

I actually just recently made a small flowchart about "how to react to (negative) emotions" that's pretty similar, though aimed at all emotional reactions, not just irrationally anxiety-inducing ones. Someone may find it useful. ("Adjust belief" basically refers to the kind of techniques in your post, and overlaps heavily with "test belief".)

The first part of the flowchart (Emotion --> Action Required --> No --> Notice and let it go) reminds me a bit of my reading and practice of meditation. It is quite revealing when you are able to sit and "watch" your thoughts/feelings. The flow of emotion/cognition can be very chaotic.

I don't meditate as often currently, but I do use the technique of quickly observing the thoughts and feelings I can recognize at any given moment and making a rational choice to ignore the ones that are not helpful or are out of my control. I find it a useful habit.

Yeah, that part's explicitly intended to be done using something like mindfulness techniques.

[-][anonymous]8y20

I think there should be a part for just resting. This could be a very mentally exhausting loop

What do you mean? It's seems obvious to me that you could rest anywhere during the process. There are no time limits implied.

You're not the first one who has said something similar, which makes me feel that the flowchart gives a slightly misleading impression (but I don't know how to fix that). Because for me personally, the actual mental process involved in "following" it is very quick and effortless - I get an emotion, I focus on it, and most of the time I know almost instantly what the appropriate action is. It's the opposite of exhausting, because instead of having to struggle against every single flash of negative emotion I get, most of the time I just automatically go "okay, don't need to do anything here, it's okay to have this feeling" and that's it.

Admittedly, if you don't yet have the skill for doing that, it might take more effort and practice. I'm not sure of exactly what the required skill is, but I think that having practiced mindfulness meditation has a big role in it.

[-][anonymous]8y20

In some ways, coping mechanisms are kind of like hiccup cures: whatever happens between "feeling crappy" and "feeling better" is said to "work." And many people try an algorithmic approach, only to hate it. The goal is to find something that genuinely reduces the time between feeling crappy and feeling better. That looks different for many people, and most people need multiple techniques.

I like the flowchart; it's similar to how I got over my road rage issues.

Nice first-time post! Good formatting and flow.

Meta-comment - you can always ask experienced LWs who you know to read a draft post, or ask for feedback on the Open Thread before making a post.

I appreciate the focus on how this technique works for you, there's always a lot of danger of other-optimizing with self-help approaches.

As a person with an anxiety disorder myself, I can attest to the power of childish-seeming anxieties, and the need to treat them as quite serious things.

To address some of the concerns expressed about being actually fired, it might be helpful to get an external perspective from a non-coworker before trying experiments in cases where one is not highly confident that the alief is irrational.

[-][anonymous]8y10

Thanks for the feedback!

Last paragraph: yes, that's a good idea.

An approach of the form "Will I get fired if I do X? The only way to know is to try" sounds too dangerous unless you already know you won't, in fact, get fired.

[-][anonymous]8y40

I hope I specified, but this is especially for situations where you are trying to make your behavior-influencing feelings match up with what you know to be reality. But thank you! I agree!

Tangentially relevant news from today..

[-][anonymous]8y20

Environment can dramatically improve (or damage) mental health, even if it's just giving idiosyncrasies a place to thrive.

Good article, many interesting thoughts! Rationalizing the reasons behind anxiety might work for some people, but for me this is rarely the case. Usually it just pushes me into what you called "analysis loop" where I let the negative thoughts circle and circle around my mind, obsessing over the reasons, consequences etc. I'll try to describe some methods I have used, maybe somebody here also has experiences with them.

The first method I use is what I call the "depersonalization method", though it probably has a better (and official) name. Basically I assume that everybody else thinks exactly the same way as I do and then I analyze my actions as a detached observer from the outside. Using the "I will get fired if I take a sick-day" example this would mean imagining myself as my boss and what would I do with such an employee (me). Since I know that sick workers might infect their colleagues, have worse productivity etc then I would not fire such an employee. Thus I most likely won't be fired, a belief reinforced by at least one example without too much theorizing and obsessing. This method of course has a big flaw, namely others might not be as rational as me or have other standards, but I find this rarely to be the case.

Another tip to avoid the "analysis loop" is to ignore any analyzing thoughts at the onset of anxiety and concentrate fully on some task at hand. Anxiety is closely related to fear, an emotional reaction, and rational thoughts do not always have the power to calm the fears, they might even have the opposite reaction of amplifying them. Because of that I try to bluntly ignore the anxious thoughts which I can return to and analyze at a later time when my mindset is more calm. To improve the ability to ignore thoughts I recommend mindfulness meditation or just plain practice. Actually you almost described the same method in the paragraph about "doing the things that makes anxiety go away". "If you find that attacking an anxiety with Bayesian updating is like chopping down the Washington monument with a spoon, but getting a full night’s sleep makes the monument disappear completely, consider the sleep." Falling asleep requires ignoring the offending thoughts.

[-][anonymous]8y00

Rationalizing the reasons behind anxiety

that's called rummination. It's pathlogical.

[-][anonymous]8y00

I've also had luck with what you describe in the second paragraph. Pretending that someone is being a Me, and thinking about how I'd react to that behavior from the outside.

One aspect of both rationality training and EA I feel interacts poorly with anxiety is that it can make it easy to implicitly get into a frame of fixing yourself or doing things because you are bad. Even the title of this site is a fairly negative frame. Opportunity/obligation distinction seems relevant. One thing I have done to combat this in myself is inverting biases so I can make sticky a positive/opportunity version.

[-][anonymous]8y40

Oh, definitely. I've heard the term "scrupulosity" thrown around to describe this.

It's pretty obvious that this site wasn't put together with mental illness in mind. That's not a criticism, and other rationalist types have injected some community awareness about that.

The thing about mental illness, as opposed to just ordinary bias, is that the techniques for coping with the former can look inane or obvious when you're in the mindset of the latter.

I think the process could be improved by adding a step 2:
2) Feel into the emotion in your body and locate it.

Focusing is using that step to great effect. I also know other techniques that use that step for dealing with emotions.

[-][anonymous]8y00

That sounds a lot like grounding.

A lot of people use the word grounding to mean many things.

As I would use the word, it's a bit more specific because you connect with the emotion with whom you are working and not simply with the ground under you. Connecting with the emotion makes it easier for the mind to clear it.

Elaborate please.

Eugene Gendlin found that people having certain skills manage to get better in therapy while people who don't have the skills don't get better in therapy. One of those is the ability to connect to what he calls the felt sense. Locating the emotion in the body and feeling it physically does create that connection.

Focusing itself is based on a lot of scientific research and the Focusing book is worth reading if you want details.

The Lefkoe method would be another method that uses what I describe here as step 2. The same goes for Silvia Mind.

Based on my experience with different change work techniques and the scientific studies on which Focusing is based, I think that the step of feeling into the emotion is very useful for helping the body to process the emotion.