# Anxiety and Rationality

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](https://wiki.lesswrong.com/wiki/Alief)_ 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](/lw/i3/making_beliefs_pay_rent_in_anticipated_experiences/) 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](/lw/21b/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.