Latest news with #AddictedtoAnxiety
Yahoo
10-07-2025
- Health
- Yahoo
Why do I hate my job? Am I drinking too much? What people really ask a shrink
Owen O'Kane worked as a nurse in palliative care for 10 years before retraining as a psychotherapist. He eventually rose to become a clinical lead for the NHS. O'Kane now works in private practice and is the author of four books including 'How to be Your Own Therapist' and 'Addicted to Anxiety'. He appears as an expert on BBC One's 'Change Your Mind, Change Your Life'. People tend to come into therapy with the most 'respectable' version of their story. The problem they start with isn't the real issue. For example, someone might start off by saying 'I want to work on public speaking and confidence', but once I get to know them, they may also be dealing with issues around self-worth – or 'imposter syndrome' – where they wonder whether they are good enough, or will be 'found out'. It's rare for a therapist to be shocked by a client's story: we've heard it all. That's not to say we're immune, however, and sometimes a person's story can bring up something from a therapist's own past. This isn't necessarily a bad thing – the best therapists in my opinion are those who have walked the walk. Mostly, our job is to 'be alongside' the client and help them understand their story, their symptoms, where they have got stuck and how to find a way through. Hope is at the centre of everything. Feelings of shame, helplessness or even 'unlovability' can underpin many everyday issues. More often than not, these relate back to adverse childhood events, or some degree of trauma that's never been dealt with. Anxiety has always been common, but these days I am seeing more of it. Diagnosable conditions such as panic disorder, OCD, PTSD and generalised anxiety disorder have been around for years, but an increasing number of people are reporting what I'd call more chronic everyday anxiety – feeling overwhelmed, burnt out, or struggling with uncertainty. There's a risk that if this chronic anxiety isn't dealt with, it can lead to a more serious acute condition. Even a statement like 'I'm feeling anxious about the climate' usually has a link to the person's own story – 'am I safe?', 'Can I cope?', 'I don't know how to manage the uncertainty'. Here are the five most common everyday problems I see in my treatment room: When a client starts the conversation with a statement like this, my job is to try to unpick it. 'What does this look like?' I'll ask – and am usually met with a list of the factual things that are going on, such as: 'I'm too busy at work, I've got too much on, I'm worried about paying my mortgage.' Of course, everyday life events can contribute to feeling stressed, but it's the person's internal reaction to these events that's the important thing. Many people struggle with uncertainty and not knowing how things are going to turn out. The adrenalin from this is making them feel on edge or perhaps making it hard for them to sleep. There are two approaches that can help. The first is practical: to try to break down the contributing problems, to make them feel more manageable, to prioritise and focus on what small next steps would be useful. But the second, deeper part is to challenge the person to look at their beliefs about how things 'should' be when they are proclaiming that life 'isn't fair' or 'it's all too much'. Perhaps it would be more helpful for a person to have a more flexible approach to their problems. Maybe it's OK not to know what's around the corner, that it's acceptable for things to be a bit untidy and that it's OK to ask for help. The client is probably contributing to their problems more than they realise and it's the act of trying to take total control that creates more internal turmoil. Whether they are referring to their intimate relationships or broader interactions with friends or colleagues, it's not unusual for people to struggle. Relationships are the one area where we can be 'hit' quite strongly, and they can often hold a mirror up to parts of ourselves we don't like. There's another layer in that relationships can also be conflictual, and each person will have their own version of events as they go on the attack or run to their own defence. We're all familiar with the blame game – 'he did this, she did that' – but the trick is to notice the feeling evoked in yourself when a person does something you don't like. 'He makes me angry,' a client might tell me. I will respond: 'no, you are angry. You are responsible for your own emotions. You can't rely on another person's behaviour to dictate whether you feel rejected, not seen or not heard.' All this can be difficult to acknowledge. The first step is to be aware of the above, and the second is to ask yourself whether you are willing to take some responsibility in the conflict. (I'm not talking about situations such as domestic violence, abuse or coercive control when responsibility may lie with the other person). My suggestion in any relationship challenge is a four-step process: Understand what has been activated in you. Never react in the moment. Is there another perspective you might consider? Speak to the person when you can balance rationality and emotion. I once worked with a client who was going to end her relationship with a boyfriend because he didn't call her for three days while he was on holiday. She was convinced he was seeing someone else, and was moments from leaving him a voice message to end the relationship. The day was saved when she received a call from him, informing her he was in hospital with a burst appendix. 'So why are you staying?' is always my first question. What my client really wants me to say is 'oh, that's terrible' so they can go into every tiny detail of how awful their job is, but we could sit there for the next 10 years doing that. People tell me they stay in horrible jobs because 'someone has to pay the bills', but the real reason is that they are stuck in their mental state. Again, it comes back to the need for stability and security: people don't like to make changes, and they like predictability, even if it's bad. Earlier in my career, I worked with patients who were dying. This, more than anything, made me realise that life is short. If something is making you miserable – in this instance, your job – then it's not negotiable. There will be an alternative role out there for you that pays the same amount, or possibly even more. Don't use your fear of change or attachment to the old routine as an excuse to remain unhappy. I advise my clients to do a cost-benefit analysis about the factors that might make them leave or stay. Yes, understand that change is scary, but how does that stack up against five more years of misery? It's just possible a new job will make you happier than the one you have now. Plus, if you do find a new role, the realisation that the process wasn't so bad after all will give you invaluable confidence and resilience to help you in the longer term. We aren't necessarily entering the realms of addiction here; this situation could refer to any behaviour that becomes unhelpful and which comes at a cost. It could be drinking or drugs, but it could also be too much sex, shopping or work. Psychologists call these 'maladaptive coping strategies'. An example might be the person who finds it impossible to perform well at work after a bottle of wine at night but feels they 'need' the alcohol to relax and fall asleep. The first thing to realise is that this might be a way of coping, but it may also be creating more challenges and difficulties. My role is to understand what the person in front of me is trying to soothe, repress or avoid. And when I ask my client what that is, most people can answer the question quite easily. Many agree when I suggest they are mostly 'trying not to feel'. 'Do you think it might be useful to start to feel?' I will ask the client. 'Are there other ways you can self-soothe and ease some of the pain in your life?' These are different for everyone: some people might go to the gym, others take long walks, take up painting, join a book club, meditate, but there are invariably alternative solutions. Clients often complain that their relationships aren't progressing, their jobs aren't fulfilling and that life was supposed to be better than it is. Of course, none of this is helped by social media, which leads a person to the assumption that everyone is doing better than they are, which almost certainly isn't true. People rarely share a sh-- day or put a rubbish photo on Instagram. The upshot of this is that many clients internalise their dissatisfaction and blame themselves. They start to believe that if only they had loads of money, a better job, a bigger house, or were thinner or more beautiful, they would be happier. But the truth is, I rarely see this happen. If you try to use the external world to heal internal wounds, this just won't work: it's a bottomless pit. The first thing I do as a therapist is to challenge these beliefs. I ask clients to recall a time when they received the big promotion, the expensive car – and to ask how long the feelings of subsequent feelings of wellbeing lasted. The answer is usually: not long. Once the person is aware of the evidence that none of this worked, they are able to start exploring how they really feel about themselves and begin working on the things that are really standing in the way of their happiness. As told to Miranda Levy Broaden your horizons with award-winning British journalism. 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The Guardian
09-02-2025
- Health
- The Guardian
Can we break the anxiety habit?
Key work events make me anxious. They give me chest pain, a churning stomach and disrupted sleep; my thoughts run through all the mistakes I could make and replay every bad experience in my past. Why put myself through this, I reason, which inevitably means that when, say, a high-stakes meeting is on the horizon, those feelings are worse, more intense, more prolonged. It's a vicious cycle and one I admit early on when interviewing the anxiety expert Owen O'Kane. O'Kane doesn't seem surprised and why should he be? I bet everyone tells him about their anxiety. My dread, avoidance and catastrophising interior monologue are bog-standard these days: research by the Mental Health Foundation in 2023 found that 60% of UK adults reported experiencing 'anxiety that interfered with their daily lives in the past two weeks'. We're anxious about global geopolitics, the climate and the cost of living; our health, jobs, relationships and what strangers think of us. It takes children out of school and adults out of work. It's an uneasy background thrum everywhere, something I have assumed to be a product of our ill-adapted, threat-seeking brains being constantly confronted with every terrible thing in the world through the shiny rectangles clutched in our sweaty hands (US psychologist and author Jonathan Haidt recently characterised a whole demographic of smartphone natives as 'the anxious generation'). So the title of O'Kane's latest book, Addicted to Anxiety, and the question it poses ('Have you ever considered you might be addicted to anxiety?') feel sort of confronting. Is O'Kane saying our anxiety is our own fault? He doesn't look like a provocateur when he logs on to Zoom – his sweet dog is slumbering in the corner and there's collage art reading 'Love is the answer' on the wall behind him – so I wonder, did he have any, well, anxiety, about how it would be received? 'I really agonised about the book and the title,' he says. 'Then when I started to write it, I said, no, I believe whole-heartedly this is the book I want to write.' He's aware it might sound tough. 'Did I want people to stop and think and did I want them to catch their breath for a moment? Yes, 100%. Because I don't think there's enough of that. There are so many false promises about healing your anxiety forever, never worry again… There's so much bullshit out there; I just think I don't want to be part of that.' O'Kane has seen enough anxiety to know we need something better than the 'bullshit'. In his career as an NHS lead psychotherapist, he saw soaring levels of anxiety both in practice and reported in his reading. ('It was really clear that the research was telling us more and more people are anxious, younger population groups, older population groups and everything in between.') He also observed it in his personal life. 'With family members, with people I meet in the street, talking about their kids struggling, or their husband…' His 'aha' moment in terms of framing anxiety as an addiction came when he was running a small NHS anxiety group, which was making promising progress. He told the group that he noticed everyone seemed to be doing well, 'I fed back the changes and noticed there was this deadly silence in the room. Then someone joked: 'That's made me a bit frightened that you said that.'' Another man, a former drug addict, jumped in. 'He said: 'Bloody hell, I thought it was hard to give up the drugs. But this is bloody addictive.' The minute he said that, everyone in the group laughed, so they got it. And the thing was, I also got it. I thought, this is the one thing we don't talk about enough. We talk about the ways you think, what happens in the body when you're anxious, we talk about the process, but we never really think about that attachment to anxiety.' O'Kane is at pains to stress that anxiety in itself is not bad: throughout the book, he describes the importance of treating the 'anxious self' with compassion and gratitude. 'It's an important part of our humanity,' he says, and welcoming it rather than pushing it away creates a sense of ease and understanding; it's just doing its job, after all. 'Anxiety is designed to protect us and keep us safe. Without that mechanism, we would get into all sorts of bother,' he says. In his own life, growing up in Northern Ireland at the height of the Troubles, anxiety was 'about survival', he explains. 'To let your guard down or not be cautious or not be watching out for the next problem did lead to actual and real danger.' But for him, and for anyone inclined to or wired for high levels of anxiety, it's easy to end up with 'a mechanism that will just keep playing out threat, threat, threat'. So we're all anxious beings and circumstances or susceptibilities make us more so, but what makes anxiety addictive? 'It's not an official diagnosis,' O'Kane acknowledges in the book. 'There are no 12-step programmes for anxiety addiction.' But anxiety does have a lot in common with mainstream addictions which, he says, 'come with a promise: I will make you feel better; I will stay with you; I will get you out of this situation; I will take away your pain.' The mechanisms of anxiety, he argues, make similarly big promises. 'I will protect you; I will keep you safe; I will stop bad things from happening. So, who wouldn't want that? Who wouldn't think that's a really good thing to stay attached to?' There's a sort of magical thinking involved: we believe our anxiety is essential to keep us safe, so we get hooked on the feelings, sensations and thoughts – the altered state, actually – it creates in us. Anxious people don't 'wake up each day thinking 'I need my anxiety hit,'' he writes, but they do 'attach to their anxiety as if it's a safety blanket.' It's odd to think of what anxiety provokes in the body and the mind – unpleasant physical symptoms, irrational thoughts, self-sabotaging behaviours – as comforting, addictive coping mechanisms, but that's what they are, O'Kane suggests. They offer short-term relief from threat. 'I can guarantee nothing will go wrong if you avoid that dinner party; I can promise you that you won't feel rejected if you don't apply for that other job. Those promises are alluring. But, of course, the problem is, the more hooked and attached you become, then the bigger the anxiety becomes and you get caught in this almost circular loop.' So how do you break that cycle? The book provides a step-by-step guide, helping sufferers to acknowledge and accept their anxious selves, offering DIY techniques for deactivating their physical symptoms, accepting the emotions they are experiencing and detaching from anxious thoughts. Perhaps the most muscular part of the process is tackling what O'Kane calls the 'rascals' – the behavioural strategies that offer short-term relief, but actually strengthen your anxiety longer term. These might include making excuses not to confront or do things that make you anxious, getting angry, impatient or argumentative, using substances to dull your anxious feelings, resorting to compulsive behaviours and rituals or constantly seeking reassurance from others. Why do they need a firm hand? 'I guess the robustness is because your anxious self needs to know that you're in charge. Anxiety is a really powerful mechanism. It's a life-saving mechanism, so it's not weak. Negotiating with it has to be equally strong.' This is where the language of addiction is most helpful, O'Kane says, 'because most habits are addictive'. The parallels with addiction and recovery break down for O'Kane around the notion of powerlessness. The whole book – subtitled How to Break the Habit – is about precisely how much power we have over anxiety. 'It's about breakthroughs,' as O'Kane puts it. He has reservations about the notion of powerlessness in mainstream addiction treatment anyway, though he understands people find it useful. But with anxiety, the narrative of powerlessness is particularly unhelpful. 'When it comes to this, you're not.' His own story is proof of that. In addition to spending his formative years in, effectively, a war zone, O'Kane describes in the book and in a very moving TED talk he gave in 2022, the fear, shame and pain of growing up in Northern Ireland both gay and Catholic and being ferociously bullied and humiliated. In one anecdote in the talk, he describes being called queer and spat on by a group of boys, then instructed by a passer-by to 'wipe that off quickly before anyone sees you'. He landed in adulthood, he says, with 'primal, hardwired responses to look out for threat even when it's not there.' Rebuilding a positive, functional relationship with his anxious self came through therapy and his psychotherapy training; he maintains it with 'healthy choices'. O'Kane says he's 'unapologetic' about his wellbeing now: he eats well, maintains good sleep hygiene, plays the piano, walks his dog, exercises and meditates daily, a practice he describes as 'a safety check'. He regularly reminds himself: 'Whatever is going on in my life, I'm not that thought, I'm not that emotional state, I'm not my ego, I'm not the fear.' Recovery, he says, is also about 'not over-attaching to my story'. That's apparent when I say I found some of those anecdotes very sad. 'I see them differently,' he says. 'I just try and see it as, OK, that was my experience and my story… then I had to salvage what I could from that.' His experiences deeply inform his practice, of course, and his special interest in anxiety; he returns often to the phrase 'walking the walk' to describe that. O'Kane didn't need to include his story at all. He's a highly respected professional and a bestselling author with a public profile; on the book cover Davina McCall calls him 'A force for good', and Scottish singer Lewis Capaldi, who has Tourette Syndrome and suffers from anxiety, a 'Huge help'. But, he writes, he didn't want to be the 'Big Man', in Northern Irish parlance; the lofty expert. Why was that important? 'It's a big ask, to ask people to explore their own humanity and to make changes in their life,' he says. 'If I'm not willing to give some of me in that, I shouldn't be doing the job.' I find his writing generous, wise and very persuasive, particularly his description of anxiety as an 'intolerance of uncertainty': he identifies it as a compulsion to control; a focus on past and future to the detriment of the now. But – and it's probably the rascally part of me asserting itself – I occasionally found myself thinking as I read, isn't anxiety an appropriate response to the state of the world and a mark of caring about it? If we're not desperately anxious about everything around us all the time, won't that stop us from taking action? 'The climate is what it is,' O'Kane writes at one point, but does it have to be? 'I never advocate avoidance,' he says. 'The book isn't, 'It's all lovely, let's pretend it's not happening'; it's about, 'We work with what is.'' It would be 'sociopathic' he says, not to be distressed by, for example, the recent LA fires, 'but it would be equally unhealthy if I spend every moment of my day worrying about that – then I miss so many other parts of life.' Nice as it would be to see anxiety as reflective of selfless concern for the world, in his experience, he believes, 'For somebody who struggles with anxiety, it's never driven by altruism; it's driven by almost an obsession to try and control what's happening.' There's a danger, too, he says of trying to 'justify a highly anxious existence based on the state of the world. If the world's chaotic and we're operating from an internal chaotic state, two negatives don't make a positive.' The aim, rather, is to work on creating what he calls 'a steady inner platform' to manage whatever the external world throws at us. In service of that, Addicted to Anxiety includes a list of 'lifestyle stabilisers' including the likes of 'get enough sleep' and 'try to work in environments you enjoy (there is always choice if you explore it carefully).' This is self-evidently sensible advice, but is it always accessible to everyone? I know anxious insomniacs who would love to get enough sleep and work is about economic necessity above fulfilment for most of us. O'Kane's list is evidence-based, he counters; science shows this stuff makes a difference. When it comes to work, 'I believe there are choices out there for every single person,' he says. 'I meet people who say, 'I really hate what I do' and they languish and they stay in it, and I say, 'I have to be that voice for you: if you're prepared to stay in that situation at the cost of your wellbeing and health, that's a choice you're making.'' In jobs he's hated, he says, 'I've always made the decision, even though it hasn't always been comfortable or practical to move and do something different. I've done it because I thought, I'm not compromising. I guess with a lot of these things, when you work in palliative care for 10 years…' This, I think, is really the inarguable core of his writing: O'Kane has the urgent perspective of someone who has seen, again and again, that life really is too short: 'Way too short to play these games with ourselves.' He's helped 20-year-olds with months to live make decisions about how they want to spend their final days, which gives him a powerful certainty that there's always a choice. That's really the message of this book – we don't have to remain in thrall to anxiety; we have choices. 'So much of this is about getting out of your own way.' Addicted to Anxiety by Owen O'Kane is published by Penguin at £18.99. Buy it for £17.09 from
