A question that clients often ask me is: “You really believe phobias, anxiety, and depression come from inappropriate thinking? And that we can learn to think differently?”

Example – Appropriate Thinking

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I offer this example. About five years ago my husband and I were in a car crash. It was as we were driving home from a week away on business. It was quite terrifying as we realized there was no way to avoid the other car which turned across our lane, apparently without the driver seeing us.

We were both fortunate that while injured, our injuries were not too serious. But our car was totaled. The people in the other car experienced shock, but no injuries.

After the accident, the road was closed, the police and ambulance arrived, our car was towed away and the police took us to a local rental car location where we promptly hired a car and drove the rest of the way home. While we took it slowly, and stopped several times, the immediate effect of the crash was not to make us avoid traveling by car. We just wanted to get home by the most practical means available – driving.

As we all know though, the adrenaline rush after an accident can buoy us along. It can mask injuries, dull pain, sharpen our wits, and generally help us to keep functioning rather than curl up in a ball on the side of the road! But when reality hits, and we see how serious the situation really is, that changes right? We reassess and develop heightened anxiety?

Well, my husband and I both spent about two weeks at home recovering from various minor injuries. During that time neither of us could really drive. We did think about the accident – and talk about it a lot! – but we focused on how well my husband had minimized the damage, how the car had protected us as it was designed to do, and how grateful we were that things were not worse. After a couple of weeks, we packed our stuff into a rental car and drove back to where we were working. Neither of us contemplated not taking the car. We were both a little hesitant when we reached that same intersection – the local police had told us that it is a place where accidents are more frequent – but after our initial wariness (which translated into greater care and attention) we really did not give it much more thought.

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About 100 people die in road accidents each day in the US. 1.3 million people die in road crashes each year worldwide. Realistically, travel by car is more dangerous than flying. And yet fear of flying is pretty common! (For an interesting look at flying stats, conditioned thinking and modern piloting methods see Chapter 7 of the book Outliers by Malcolm Gladwell.)

Despite the reality of the statistics, neither I nor my husband stopped traveling by car, stopped driving, or cut down on the number of road trips we made. We did not replace our totaled car with a tank, or even a large truck. The slight risk that we face each time we drive was something we put aside and got on with life. We also believed that more times than not, we will have enough control over the situation to be able to avoid the worst car driving outcomes. One day we may be wrong, but we are not going to live life based on that unlikely outcome.

Anxiety vs Incentive

Part of the reason for this is that without a car we probably would not be able to live where we live in Massachusetts. We need to be able to drive if we are to see family and friends. We need to get to appointments with doctors and dentists, and we both need to be able to work.

I know that at the time of the accident I made a conscious effort not to generalize that specific experience, not to use that one event as evidence that I should never go in a car again. Even as I projected forward, I visualized future rides being fine. If my mind swirled, I cut off at the earliest stages any thought that one accident might lead to another. I focused on other things, and above all maintained a healthy belief that while another accident is possible, it is unlikely. My belief is that if it happens again, I will deal with the consequences – whatever they may be.

This is an example of how preventing anxiety or a phobia came from appropriate thinking.

Alternative Outcomes

What about the other end of the spectrum, when we take an unlikely event and make it the center of all our thinking. We reinforce our anxiety about the focus of our fear every day. Confirmatory evidence receives weight and attention and we ignore contradictory evidence. This is known as confirmation bias. We scan the news for details of accidents, and don’t notice that all the miles of travel without incident don’t show up in the news!

Instead of imagining that future drives will be fine, imagine if I had started focusing on all the ways a drive could go wrong:

  • The driver of our car or another car could lose consciousness
  • The brakes could fail
  • Another driver may be texting, eating or screaming at the kids in the back of their car
  • I could fall asleep at the wheel
  • Someone could tamper with my car
  • The engine could catch fire (only a real concern if you are still driving a Ford Pinto!)
  • Another vehicle could cross into my lane out of control

I could go on building this list all day.

My Experience of Inappropriate Thinking

In the case of the car crash, I maintained a healthy belief that the future did not hold a series of life-threatening crashes in store. But not all my experiences have led to this outcome. As a young person, I developed a phobia. I became terrified of me and others being sick. Actually, that is too passive. I created a phobia. In therapy, we searched for the “trigger” – the traumatic event that “made” me phobic. We explored various theories, and maybe one of them was the correct one. Maybe it was a combination. But I did not have such exceptional childhood experiences. I did not have a serious illness that caused prolonged periods of vomiting. In fact, I was hardly ever sick in any way!

Other people with my experiences do not develop a phobia, but, in all likelihood, other people with my thinking about my experiences will develop anxiety, a phobia or depression.

Some people will say “your problem is genetics,” or that I have a “pre-disposition to anxiety”. But then you would think every potentially anxiety creating event would have made me anxious. For example, although bitten by a dog, I never developed a fear of dogs. I believed I had probably provoked the dog and knew that I would be more careful in future. But someone else being bitten by the dog could have turned that into a phobia by their thinking.

If I have a genetic or psychological pre-disposition then why am I not now phobic – or at least anxious – about driving in cars? And how did my emetophobia, social anxiety, and fear of the dentist all go away? If I have a genetic pre-disposition, how was it that I was emetophobic and had social anxiety but was not claustrophobic (like my Mum) or agoraphobic? Nor did I suffer depression, or a host of other mental afflictions that family members suffered.

When I say it is faulty thinking, I am not saying it is my fault. It is likely that although my parents were not emetophobic, they may have inadvertently increased my focus on the fear of vomiting. They did that by joining in when I would ask them if I looked pale, feverish, or otherwise sickly. My parents probably did it by checking the sell by dates rather than teaching me the “sniff, taste, eat” test. As caring parents, they did it in a host of ways that were not intentional but were powerful.

Perspective – Adjust or Struggle

Consider also the time factor. The reality is that for most people a bout of sickness feels crappy for a couple of hours. If they are unlucky a couple of days. Most of us can stand even the most unpleasant things for a couple of days. But when we are children, two days seems like forever.

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Were you ever bullied at school and longed for the weekend to be safe at home? If you experienced bullying on Wednesday then the weekend seemed a lifetime away.

I have always contended that we create a sense of time based on the lifespan we have experienced so far. When you are 5, three months to Christmas is a significant amount of time compared with the time that you can remember. But when you are fifty-five, three months to Christmas seems like no time to get ready! (See my post on perspective.)

It is similar when we are ill. If you get sick on Thursday and you will be better by Saturday, that is not so bad. But as a child that is a lifetime. If at that time, we start catastrophizing the experience and start thinking of it as something that will not end, but will last forever, then it is terrifying. If, as we get older, we don’t retrain our thinking and learn to evaluate the experience with an adult’s perspective, we continue to be afraid now of something that we learned to fear when much younger, even though the reality of it has changed.

Maybe our limited attention spans and hunger for instant gratification and relief are also factors. But these are all learned behaviors too, and they can be unlearned.

So yes, I do believe that phobias, anxiety, and depression are thinking errors. And, however hopeless we are and helpless we feel, I believe we can learn to change our thinking and build new habits. It takes willpower, practice and effective training! I did it, you can too!

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Originally published at www.alle2thrive.com