It is a surprisingly common experience in anxiety.

You know the presentation probably won’t be a disaster. You know your friend is unlikely to be angry because they took a few hours to reply. You know the physical sensation you are noticing is probably harmless. You may even be able to explain, quite logically, why your worry does not really make sense.

But you still feel anxious.

For some people, this becomes frustrating in itself. They understand what is happening. They have challenged the thought. They have told themselves not to worry. So why hasn’t the feeling changed? Part of the answer is that knowing something and feeling safe are not quite the same thing.

Anxiety is not just a thinking problem

Thoughts are important in anxiety. If we believe something bad is about to happen, we are much more likely to feel anxious. But our threat system is also influenced by what we have learned through experience, what we pay attention to, how our body is responding and what we do when we feel afraid.

Consider someone who becomes very anxious speaking in meetings. They might know that nobody is expecting them to be perfect. They might have spoken successfully many times before. They might even recognise that the thought, “If I stumble over my words, everyone will think I’m incompetent”, is an exaggeration. None of that necessarily stops their heart racing when somebody asks for their opinion.

This does not mean that logical thinking is useless. Cognitive strategies can be very helpful in anxiety treatment. It simply means that sometimes the anxious response is being maintained by more than the thought itself.

Sometimes the brain has learned a different lesson

Our responses to situations develop over time. Imagine someone who was frequently criticised for getting things wrong. As an adult, they may genuinely believe that making a small mistake at work is normal and unlikely to have serious consequences. At the same time, being evaluated by somebody else might still set off a strong threat response.

Or someone may know that their partner taking longer than usual to reply to a message does not mean the relationship is ending, while still experiencing an immediate rush of anxiety. The conscious conclusion may be, “This is probably okay.” The learned prediction may still be, “Something is wrong.” That difference can help explain why insight does not always produce an immediate emotional shift.

What we do when we feel anxious matters too

Anxiety has a way of changing our behaviour. We avoid. We check. We rehearse conversations repeatedly. We seek reassurance. We overprepare. We scan our body for signs that something might be wrong. These behaviours often make complete sense in the moment because they reduce uncertainty or anxiety. The catch is that they can also prevent us from learning something new.

Take the person who is frightened of speaking in meetings. If they stay quiet whenever they feel anxious, they may feel immediate relief. But they never get to discover what would have happened if they had spoken. Their brain is left with the old prediction intact.

Avoidance can therefore reduce anxiety in the short term while helping maintain fear over the longer term. This is one reason exposure-based approaches are used in the treatment of a number of anxiety disorders. Rather than simply trying to convince someone that a feared situation is safe, therapy can help them gradually have experiences that challenge what they have come to expect.

“But I already know why I do it”

This is another thing psychologists hear quite often. A person may already know that they seek reassurance because they find uncertainty difficult. They may understand that avoiding social situations has made their anxiety worse. They may be able to trace their fear of disappointing people back to experiences much earlier in life. That understanding can be useful. But understanding a pattern is different from changing it.

Most of us can probably think of something we understand perfectly well and continue to do anyway. Psychological therapy is therefore not always about discovering the “right” explanation.

Sometimes the important work is practising a different response when the familiar feeling appears. That might mean allowing uncertainty without immediately checking. It might mean saying something in the meeting despite feeling anxious. It might mean noticing a worrying thought without spending the next hour trying to solve it. Or it may involve working with beliefs and emotional responses that have developed through earlier experiences. What that looks like will differ from person to person.

New experiences can be more powerful than reassurance

If somebody is anxious, our natural instinct is often to reassure them. “You’ll be fine.” “There’s nothing to worry about.” “It probably won’t happen.” Reassurance can certainly feel comforting. But when someone repeatedly relies on reassurance to feel safe, it can sometimes become part of the anxiety cycle.

Instead of learning, “I can cope with not knowing”, the person may inadvertently learn, “I can cope once somebody confirms that everything is okay.”

A similar principle applies in therapy. The aim is not necessarily to eliminate every anxious feeling or convince yourself that nothing bad could ever happen. It may be more useful to learn, through experience, that uncertainty can be tolerated, anxiety can rise and fall without needing to be immediately removed, and feared situations are often more manageable than anticipated.

Research into exposure therapy has increasingly emphasised this kind of new learning, rather than viewing treatment simply as repeatedly facing something until the fear disappears.

So does changing your thoughts still matter?

Absolutely.

Cognitive approaches remain an important part of evidence-based treatment for anxiety, and psychological guidelines continue to recommend cognitive behavioural approaches for anxiety disorders. But effective therapy is not always about simply challenging or changing a thought. Sometimes it is about examining whether a prediction is actually accurate. Sometimes it is about noticing what you do because of that prediction. Sometimes it is about testing it. And sometimes it is about understanding why a situation feels particularly threatening to you in the first place.

For someone who has already spent years thinking about their thinking, simply generating another rational response may not be the piece that is missing.

When anxiety starts getting in the way

Feeling anxious does not automatically mean that something is wrong. Anxiety is a normal human response to threat, uncertainty and situations that matter to us. It becomes more of a concern when anxiety is persistent, feels difficult to manage, leads to significant avoidance, or begins interfering with work, relationships, study, sleep or everyday life.

In these situations, working with a psychologist can help identify not only what you are anxious about, but what may be keeping the anxiety going.

At The Victorian Psychology Clinic, psychologists consulting from our Essendon and Moonee Ponds locations and via telehealth work with a range of anxiety-related concerns. Treatment will differ depending on the person, the nature of their anxiety and the factors contributing to it. If you are considering seeing a psychologist for anxiety, you can learn more about anxiety therapy at VPC or view the psychologist profiles to find a psychologist whose experience and approach may be a good fit.