PDF Summary:Unwinding Anxiety, by Judson Brewer

Anxiety is sneaky. It lives in our thoughts and habits, and it can show up as a stomachache or a 3 a.m. Netflix binge. But according to Dr. Judson Brewer, you can recognize and counteract anxiety using mindfulness—the practice of paying close attention to the present moment without analyzing or judging it.

In Unwinding Anxiety, Brewer explains how anxiety becomes a habit and how it spawns additional habits that only make things worse. Brewer draws on his background as a psychiatrist, neuroscientist, and mindfulness researcher to show why mindfulness succeeds where traditional methods like willpower, substitution, and avoidance fail.

In this guide, we’ll walk through Brewer’s three-step method for treating anxiety while expanding on the techniques he mentions and offering some additional psychological insights from experts such as Daniel Goleman and Brené Brown.

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Step #1: Recognize Your Anxious Patterns

You can’t solve a problem you haven’t noticed yet, so the first step to treating anxiety is to recognize the behavioral and thinking loops that create and result from anxiety. To do so, Brewer says, you need to practice mindfulness so that you’re more aware of your thoughts and actions.

What Mindfulness Is

Brewer borrows his definition of mindfulness from mindfulness proponent Jon Kabat-Zinn, who says that mindfulness means: “Paying attention, on purpose, in the present moment, non-judgementally” [sic]. Brewer distills this definition down to two components: awareness and curiosity.

Awareness means recognizing what you’re doing as you’re doing it. Anxiety and its related behaviors easily become automatic, but awareness allows us to notice when we’re switching into autopilot. Physiologically, our brains have a system called a default mode network that takes over when our minds wander or when we’re caught in common thought patterns (such as anxious worry about the future or depressive rumination about the past). Brain scans show that mindfulness quiets the default mode network—in other words, it deconstructs the thinking loops that create anxiety and depression in the first place.

Curiosity means looking deeper into what exactly you’re doing, why you’re doing it, and what you’re getting out of it (in other words, noticing the trigger, behavior, and result). Brewer says that curiosity also means looking at your thoughts and behaviors with gentle interest rather than judgment or criticism. This distinction is important because mindfulness involves observing objectively—which you can’t do if you’re berating yourself for your thoughts and actions. Brewer says there’s a common misconception that mindfulness involves clearing your mind or getting rid of thoughts—but that’s not actually possible, nor is it the goal of mindfulness. In fact, being mindful includes noticing your thoughts without trying to control or change them.

Mindfulness in Action

Brewer explains mindfulness in general terms, and while he gives many examples of awareness and curiosity in practice, these examples are spread throughout the book in service of various related arguments. Because mindfulness is the core principle of Brewer’s approach to anxiety, it’s worth pausing here to look at an extended example of how it helps you recognize and break down your anxious patterns.

First, mindfulness helps you notice anxiety as soon as it arises. Say you wake up in the morning feeling anxious. Without mindfulness, you might not realize why you feel that way and you might even beat yourself up for being in a bad mood. With mindfulness, you might notice the anxious feeling and realize that you feel stressed because you have to pay bills today.

Second, mindfulness helps you interrupt anxious thoughts. When you remember the bills, you might start worrying—Do I have enough money to pay them? Did I already miss a due date? Without mindfulness, you might not even notice these thoughts—you might just feel your stress increasing without knowing why. With mindfulness, you might notice these thoughts and realize that they aren’t actually helping you.

Third, mindfulness helps you focus on action rather than worrying. Without mindfulness, you might sit down to pay the bills only to find yourself browsing social media 30 minutes later without knowing how you got there. With mindfulness, you might notice the initial impulse to check your feeds, or you might realize what you’re doing after only a few minutes of checking posts. Plus, instead of beating yourself up for being lazy, you might notice that the impulse to check social media is actually a manifestation of the anxiety you feel about paying bills.

Step #2: Analyze Your Behaviors and Their Results

Brewer says that one of the benefits of treating anxiety as a habit is that doing so allows us to analyze the rewards of our anxious behavior. In a habit loop, a reward is any result that reinforces the behavior. For example, if you feel anxious and eat some potato chips, you enjoy a salty snack, your body enjoys a dopamine hit as it processes the carbohydrates, and your mind (possibly) enjoys a brief respite from whatever caused the anxiety. These short-term rewards are part of the reason we get addicted to anxiety even though it has numerous long-term consequences.

Brewer argues that a key step in breaking the anxiety habit is changing the value we place on anxiety’s rewards. He suggests that if we recognize that these short-term benefits aren’t actually that fulfilling, we’ll be less apt to continue thinking and behaving anxiously. Then, if we substitute non-anxious behaviors that offer better rewards, we’ll learn to choose those behaviors over anxious ones.

Updating Your Reward Value

According to Brewer, the trick to seeing that anxiety is unrewarding is to realize that our brains often overestimate the value of anxiety-related rewards. In other words, he claims that if you pay close enough attention, you’ll notice that potato chips don’t taste that good and that generally, the more of them you eat, the less you enjoy them and the worse you feel. The problem is that the brain takes a lot of factors into account when assessing reward value, and some of these factors aren’t directly relevant to the actual quality of the reward.

For example, if you enjoy looking at Instagram posts, your brain’s Instagram reward calculation might take into account Instagram’s informational and entertainment values, as you’d expect. But it’s also taking into account:

• Your emotional associations with your friends and family who post on Instagram.
• Your attachment to other things you care about (and follow on Instagram)—hobbies, sports teams, world events, and so on.
• Any stake you might have in people seeing and liking your posts.
• All previous instances of browsing Instagram in order to assuage anxious feelings.

This means that when your brain is weighing whether to open Instagram (or to keep browsing for a few more minutes), it’s assessing a lot more than just the enjoyableness of the experience itself. If you don’t realize that, you might find yourself using the app when you didn’t really mean to, or continuing to scroll even though you’re bored with the posts. The problem here is that your brain set a relatively high reward value for Instagram and then never bothered to reassess that value.

Anticipation Muddles Reward Value

Reward value is further complicated by the way the brain assesses the anticipation of a reward relative to the reward itself. In Atomic Habits, James Clear explains that our brains give us a pleasurable dopamine spike both when we receive a reward (say, stumbling across a funny cat video) and when it thinks we’re about to receive a reward (say, when we open Instagram or pull out our phones). Crucially, the brain puts a much stronger weight on craving something than on actually receiving that thing.

The purpose behind this anticipatory spike is to motivate us to act—in a survival sense, our brains want us to be excited to go get food, not just to feel good when the food happens to end up in our mouths. The side effect, however, is that we conflate our cravings for something with the thing itself and then have a hard time telling how pleasurable that thing actually is once we have it.

On the other hand, Brewer says, if you’re mindful, you can figure out how rewarding your behaviors actually are. For example, if you find yourself scrolling through Instagram when you’re anxious, simply pay attention to what that’s like. How much do you enjoy the posts? Are you really interested in peoples’ updates? And when you’re done, do you feel more or less anxious than before? Do you feel guilty for having spent your time this way?

In many cases, you might find that anxiety-driven behaviors (such as procrastination via social media, problem eating, substance use, and so on) aren’t actually very rewarding in their own right. When you look at the behavior itself and notice how it makes you feel moment by moment, you might find that you don’t even like it very much, or that you like it in much smaller doses than you thought. Realizing this makes it much easier to change unwanted behaviors.

(Shortform note: As always, it’s important to be non-judgmental while assessing a behavior’s reward value. The point isn’t just to deconstruct “bad habits” so you can change them. It’s possible that you’ll find that you genuinely love checking Instagram. If that’s the case, you can stop feeling guilty about it and even build time into your schedule to do it more mindfully instead of cramming it in thoughtlessly as a response to anxiety. As Nir Eyal argues in Indistractable, the problem isn’t what you’re doing per se—the problem is when you distract yourself from one thing by doing another, as is common in anxiety. The point is that any activity has value if you’re mindful about it, and any activity can function as a coping mechanism if you’re not.)

Step #3: Use Better Rewards to Change Behaviors For Good

Brewer says that once you’ve recognized a behavior loop and mindfully assessed its reward value, the key to changing the behavior is replacing it with something more rewarding. He argues that mindfulness is, in itself, an ideal replacement behavior for three reasons:

First, it’s always available. You can be mindful regardless of your circumstances, location, or resources. You don’t need any particular item, substance, or environment in order to practice mindfulness.

(Shortform note: Here it’s important to distinguish between mindfulness and meditation, since the two are often conflated. As Brewer explains, meditation is one technique for practicing mindfulness, but it’s not the only technique. Whereas mediation often does require a specific environment (typically somewhere quiet to sit) and a stretch of uninterrupted time, you can practice mindfulness anytime and anywhere, even when engaged in demanding activities like driving, public speaking, intensive work, and so on.)

Second, it’s inherently rewarding—more so than whatever behavior you might be trying to change. Brewer says that mindfulness feels good in its own right, and that it promotes other positive feelings such as openness, creativity, and joy that are also rewarding.

Furthermore, unlike the behaviors it replaces, mindfulness’s reward value never fades. For instance, the first time you drink when you’re anxious, the alcohol might actually do a decent job making you feel relaxed. But over time, not only will you need to drink more to get the same effect, but intoxication itself will become less rewarding as its novelty wears off. (Shortform note: This is called hedonic adaptation—a phenomenon whereby we get used to pleasurable stimuli, which then makes them less pleasurable. According to experts, mindfulness helps with hedonic adaptation, too: It encourages you to savor your pleasurable experiences and it helps you notice when they’re getting stale.)

Third, it breaks the anxious habit loop instead of reinforcing it or creating new loops. As we’ve seen, many anxiety-driven behaviors (like drinking) obscure the true causes of anxiety and give you bad habits and material consequences that spawn more anxiety. In contrast, mindfulness has no such side effects. It causes no harm, doesn’t fuel habits, and short-circuits rather than reinforces the anxiety loop.

(Shortform note: You might notice that as a whole, Brewer’s approach to treating anxiety is circular. In other words, he says that you should develop mindfulness so that you can notice your anxious habit cycles, analyze them, and replace your anxiety-driven behaviors with… mindfulness. This circular logic isn’t necessarily a problem, and may in fact be a feature: If mindfulness is the tool for both detecting and breaking problematic cycles, then presumably the mindfulness you apply in step three will also help you discover additional problematic cycles, unwind those, and so on.)

Part 3: Mindfulness and Curiosity Practices

Now that we’ve covered the theory behind dismantling our anxious behavior loops, we’ll delve into some specific practices that can help us through the three steps. First, we’ll look at a fundamental tool for mindfulness, and then we’ll explore some practices for cultivating curiosity and expanding mindfulness throughout your daily life.

Mindfulness 101: Watching the Breath

One basic mindfulness tool—and the core of many meditation practices—is paying attention to the breath. Brewer recommends that when you notice yourself getting anxious—or are about to do some other behavior you’d rather change—you should pause and become aware of your breathing. Pay attention to the physical sensations of breathing (such as its length, depth, and so on), and focus on the part of your body where you most feel the breath.

Brewer argues that watching the breath breaks the anxiety habit loop and automatically replaces it with mindful curiosity. In other words, if you watch your breath whenever you start to feel anxious, then instead of feeding the anxiety by engaging with it—through worrying, coping behaviors, active avoidance, and so on—you instead relate to your anxiety as a neutral observer. Doing so disarms the anxiety and starves the habit cycle that gives rise to it in the first place.

(Shortform note: In general, when watching the breath, you shouldn’t try to breathe in any special way. The goal isn’t to change or control the breath, but simply to observe it. In fact, when practicing mindfulness, one of your goals is to remain neutral to whatever you observe. For example, in Mindfulness in Plain English, Henepola Gunaratana describes mindfulness as the act of standing back and watching whatever’s going on in your body and mind. He explains that you should practice mindfulness without expecting any particular result, without straining or rushing, and without judging your thoughts or feelings.)

That said, watching the breath doesn’t automatically make anxious thoughts and feelings go away—and that’s not the goal. In fact, once you’ve used your awareness of the breath to adopt a mindful attitude, Brewer suggests that you pay attention to where in your body you most feel the anxiety. He says you can imagine breathing into that area to focus your attention there, and you can even imagine breathing out some of the unpleasant sensation.

(Shortform note: As with the breath itself, you shouldn’t try to change or control your anxious thoughts or feelings. The goal in this exercise is to be curious about those thoughts and feelings and to observe them as closely as you can. As noted above, trying to control mindfulness to produce a specific result only undermines the process—and doing so might also exacerbate anxiety. In Radical Acceptance, psychologist Tara Brach argues that we typically resist painful or unpleasant feelings like anxiety, which only creates more problems and pain. The solution, she says, is to see things as they are (through mindfulness) and to accept them as they are (rather than fighting against or trying to avoid or change unpleasant experiences).)

Cultivating Curiosity

One of the benefits of observing the breath is that doing so encourages curiosity—which, as we’ve seen, Brewer considers an ideal antidote to anxiety. He also offers several additional practices that are specifically designed to help you respond with curiosity even in difficult circumstances.

For example, Brewer recommends that when you’re stressed, anxious, or otherwise upset and you feel closed down, you say “hmm” out loud to yourself—just as you would if you encountered something interesting or surprising. He argues that saying “hmm” triggers you to become curious about whatever’s going on.

Similarly, he says that deliberately widening your eyes can trigger a curious (rather than fearful or angry) response. He points to research suggesting that we open our eyes wide when we’re trying to take in information and narrow them when trying to block out sensory input (as when something disgusts us) or focus on action (as when we’re fighting or fleeing).

(Shortform note: Many contemporary therapists recommend similar tricks to calm the body and promote desired emotional states. For example, some experts suggest that adopting a serene half-smiling expression and turning your open hands palm-up can reduce anger and frustration and increase feelings of peace and acceptance. Similarly, evidence shows that breathing such that your out-breath is longer than your in-breath triggers your body to enter a state of calm—which can help counteract the fight-or-flight instinct that drives anxiety in the first place.)

Everyday Mindfulness

Once you start practicing mindfulness in response to anxiety, Brewer recommends that you incorporate mindfulness throughout your daily life. He suggests that doing so lowers stress, increases your enjoyment of life, and helps you spot new anxiety loops as they arise. To that end, he offers a few more techniques designed to strengthen and expand your mindfulness practice.

Noting

Noting is a technique for avoiding distraction when you’re trying to be mindful. Brewer explains that if you’re watching the breath or other bodily sensations and you notice yourself thinking, feeling strong emotions, or feeling the urge to do something else, you should simply note the distraction by naming what it is—“thinking,” “feeling,” “hearing,” “soreness,” and so on—and gently return to your practice. Doing so encourages you to be mindful by paying close attention to whatever’s going on right now and also gives you distance from your thoughts and emotions by showing you that you can experience and acknowledge them without getting caught up in them.

(Shortform note: Noting can also help you recognize patterns in your thinking, which, as we’ve seen, is a key step in treating anxiety. Still, as meditation teacher Andy Puddicombe explains, you don’t need to note every single thought you have—just the ones that distress you or threaten to distract you from your mindfulness.)

Loving Kindness Practice

Finally, Brewer recommends extending your mindfulness by taking up loving kindness practice—a meditation technique whereby you offer positive wishes toward others and/or yourself with the goal of developing compassion, love, and joy. Brewer says that loving kindness is a powerful antidote to anxiety because it relaxes you, reduces stress and self-judgment, and engenders positive, gentle emotions.

More Benefits of Compassion

Brewer presents loving kindness meditation with a focus on stress relief and self-compassion. In the context of anxiety treatment, the idea is that practicing loving kindness will make you feel calmer and will help you avoid self-judgment. But practicing loving kindness has further benefits as well. For example, in 10% Happier, journalist Dan Harris outlines the following benefits that he learned from interviewing the Dalai Lama:

• Practicing feeling compassion actually makes you a more compassionate person.

• In turn, being more compassionate helps you make friends and advance at work.

• Likewise, compassion helps you make better, more objective decisions because you can see beyond your own immediate self-interest.

Similarly, in The Gifts of Imperfection, Brené Brown argues that compassion makes you a better communicator. Plus, scientific research suggests that loving kindness meditation can strengthen your brain, slow aging, reduce migraines, along with various other health benefits.

Part 4: Troubleshooting

Now that we’ve discussed the whys and hows of mindfulness as an anti-anxiety technique, we’ll end by looking at some of the obstacles you might encounter while trying to work with anxiety.

First, Is Anxiety Ever Beneficial?

To start with, Brewer points out that some people are uncomfortable with the idea of completely getting rid of anxiety, believing that a little anxiety is a necessary motivator. He dismisses this idea, arguing that the research it’s based on has been debunked and that many elite athletes and other performers appear totally relaxed when at their best.

Why We Resist Change

This desire to hold on to a little anxiety is part of what psychiatrist David Burns calls outcome resistance—his term for when therapy fails because on some level patients don’t want to change even though they think they want to (this is opposed to process resistance, where therapy fails because patients want to change but are unwilling to do the necessary work).

Burns argues that when beginning treatment (whether through formal therapy or self-help), you first need to weigh the pros and cons of the disorder you’re trying to change (in this case, anxiety). In particular, he suggests listing the positive side effects of anxiety and asking why you would want to let go of these.

The idea is that by honestly assessing what we’re getting out of anxiety, we can see that there are benefits—for instance, anxiety can keep you from taking risks, and some risks are harmful. But we can also see that these benefits are generally outweighed by the drawbacks they come with—for example, in extreme anxiety, you might perceive leaving your home or interacting with others as risks, which can severely limit your life. Plus, as we’ve seen, even if anxiety does motivate you to do work, by shutting down your brain, it makes your work less effective.

Burns believes that if you take the time to consider all of your motivations—including your motivations to stay the same, not just your motivations to change—you can avoid outcome resistance because you’ll have made a fully informed decision. Note that this recommendation fits well with Brewer’s suggestions to mindfully examine your behaviors. The same techniques you’d use to assess a behavior’s reward value can help you examine the pros and cons of your anxiety as a whole.

Roadblocks to Change

Even if you fully buy into the goal of eliminating your anxiety, you might run into additional roadblocks, such as overthinking and beating yourself up.

Overthinking

Brewer warns that it’s easy to overthink things when you’re trying to change anxiety. Overthinking can take several forms:

• Getting stuck in the conceptual stage—that is, mapping out habit loops without actually doing anything about them.
• Applying old knowledge and habits to try to change anxiety. As we’ve seen, a lot of habit change strategies don’t work on anxiety. Plus, as Brewer points out, there’s no sense in trying to change anxiety using the same behaviors and thought processes that created it in the first place.
• Viewing mindfulness as knowledge instead of a skill. You have to practice regularly in order to get any benefit.
• Trying to figure out why you’re anxious—which doesn’t actually matter. He says you don’t need to diagnose a root cause in order to fix the problem, and obsessing about why you’re this way or why you haven’t gotten better only makes the situation worse.

(Shortform note: While Brewer warns against “overthinking” anxiety, there may be some benefit to combining mindfulness with a more analytical approach. In Emotional Intelligence, Daniel Goleman argues that to defeat anxiety, you need to actively challenge your anxious thoughts—he suggests asking yourself how likely a feared outcome is, determining what you could do to prevent that outcome or deal with it if it occurred, and questioning whether your worrying is actually helping you. Similarly, in Cognitive Behavior Therapy: Basics and Beyond, Judith S. Beck argues that treating mood disorders like anxiety requires identifying and correcting automatic thoughts and finding and reprogramming the core beliefs that lead to these thoughts.)

Beating Yourself Up

Finally, any kind of change comes with the danger that you’ll beat yourself up if things don’t go smoothly or you slip up. But as we’ve seen, harsh self-judgment is part of the anxiety loop, meaning that if you let it run free, you’ll only create more anxiety for yourself.

Plus, Brewer says that a negative attitude (frustration, pessimism, and so on) makes behavior change harder. If you tell yourself that changing your habits is impossible, you’re less likely to succeed. If you tell yourself that change is painful, you’re more likely to avoid doing the work (and more likely to revert to anxiety-related habits).

(Shortform note: Similarly, if you shame yourself for your anxious behaviors or for being anxious in the first place, you might not even try to change because you won’t believe it’s possible to do so. Likewise, as Brené Brown argues in The Gifts of Imperfection, shame can make you feel like you don’t deserve to do any better than you’re doing.)

To rewrite self-critical attitudes, Brewer recommends learning to see apparent failures—such as reverting to an old, unwanted behavior—as learning opportunities. In other words, even when you make a mistake, as long as you respond with curiosity (rather than frustration, self-recrimination, or similar), you can still keep moving forward. Brewer says if you approach habit change with this learning mindset, you’re less likely to beat yourself up and more likely to stay positive even when things don’t go perfectly.

How to Avoid Perfectionism

When attempting to treat your anxiety—or make any kind of behavioral change—it’s important to avoid perfectionism. As Brené Brown points out, if you expect yourself to be perfect, you’ll only undermine your efforts to change, because as soon as you make a mistake, you’ll conclude that it’s because you weren’t good enough—which only restarts the cycle of anxiety.

When it comes to avoiding perfectionism, it might help to remember that failures often lead to creative insights and new ideas for solving problems. In fact, in Designing Your Life, Bill Burnett and Dave Evans recommend becoming immune to failure. Doing so doesn’t mean not failing—it means changing your attitude toward failure. Burnett and Evans explain that if you build your life around curiosity and experimentation (as Brewer recommends), you’ll experience more failures than if you played it safe and stayed on autopilot. Moreover, they point out that these failures are beneficial because they give you information and ideas that can fuel future successes.