https://www.eyrie.org/~eagle/reviews/books/0-593-33045-5.html
Review: Unwinding Anxiety, by Judson Brewer
| Publisher: |
Avery |
| Copyright: |
2021 |
| ISBN: |
0-593-33045-5 |
| Format: |
Kindle |
| Pages: |
268 |
Unwinding Anxiety is a non-fiction self-help book about how to
reduce anxiety. The author is a board-certified psychiatrist specializing
in addiction and substance abuse, who has subsequently done clinical and
research (and commercial, more on that later) work in anxiety. His
previous book, The Craving Mind, was a pop science treatment of
addiction research. This book is more deliberately structured as a
self-help guide.
(The cover will assure you that he has an M.D. and a Ph.D. I don't include
honorifics and degrees in author listings as a small protest against the
weird social rules about which degrees count and which don't.)
There are a lot of self-help books out there about anxiety. There are a
lot fewer that say something relatively original. I think this is one of
the latter, but I certainly have not done a survey of the subgenre, and
it's possible the ideas here are only new to me. Brewer makes three basic
claims in this book, all of which I found personally useful:
Anxiety can be usefully analyzed as a habit. The rumination loop and
other related anxiety behaviors such as excessive analysis,
reassurance-seeking, and negative anticipation take the form of deeply
ingrained habits triggered by stimuli.
Raw willpower is not a useful way to break habits in general and
anxiety habits in particular. In order to displace the habit, you have
to retrain the part of your brain that runs habits on autopilot.
Attempting to override it with willful effort is exhausting and likely
to fail.
Habit loops in general, and anxiety loops in particular, can be
defused and replaced using mindfulness techniques.
This is not the way Brewer lays out the book. He goes to some effort to
lead the reader slowly through three techniques for handling anxiety (for
which he uses the metaphor of "gears," like for a bicycle or car) by
introducing them one at a time and encouraging the reader to become
thoroughly familiar with each one before moving on to the next. Since this
is a book review, I'm going to give you the whole argument at once so that
you know where this book is going. This may be less helpful in practice;
if you're trying to use this technique on your own anxiety, you may want
to read the book instead and not jump ahead.
Brewer's three gears are:
Identify your habit loops and recognize when they're happening. (This
part felt the most similar to traditional cognitive behavioral therapy
to me.)
Focus on how those habit loops make you feel. Rather than trying to
force the habit loop to stop, let it happen but pay very close
attention to the outcome and its effects on you.
Find and focus on a different reaction that provides better rewards
than the anxiety habit loop. Brewer suggests curiosity.
For me, the point where I thought "okay, you have my attention" is when
Brewer described the way many people, particularly people without anxiety,
tell people with anxiety to "just stop thinking about it" or "just do the
thing you're anxious about anyway and you'll see it will be fine" and then
described in detail why he believes that doesn't work. This is one of the
few discussions of anxiety I've read where the author goes out of his way
to stress that you cannot simply think your way out of anxiety and that
repeatedly trying to do so and failing is exhausting and demoralizing.
Everyone is different and I know some people find cognitive behavioral
therapy very helpful, but I find the constant effort to challenge
cognitive distortions more draining and demoralizing than useful. His
second gear, of not directly confronting the habit loop but instead
watching its effect and thinking about its outcome, feels so much more
approachable to me. Assuming, of course, it works.
Brewer's approach is essentially just mindfulness, although he mostly
avoids the (to me at least) somewhat off-putting typical introduction to
mindfulness via religious practice or general well-being and instead ties
it to a theorized model of how habits work in the human brain. His
contention is that habits, including anxiety, exist because at some point
they provided a reward that was sufficiently compelling to make the
habit-following part of your brain seek that reward. You were getting some
benefit (a sense of control, a sense of being prepared, temporary
reassurance, etc.) out of the anxiety reaction, which is why the anxiety
habit formed in the first place. Once that habit is in place, it can
continue without the reward. (Although in my experience there is probably
still some short-term reward.)
Rather than trying to force yourself to stop following the habit, Brewer
instead suggests letting the habit happen but then focusing (via
mindfulness) on how following the habit makes you feel, whether it
improves your sense of well-being or worsens it, and whether other actions
produce different feelings. The goal, in other words, is to undermine the
assumption of reward and to challenge any short-term reward with the
long-term discomfort that made you want to stop being anxious.
This avoids using your conscious brain to exert direct willpower, which is
exhausting and usually unsuccessful since the habit-following part of your
brain is stronger (for various evolutionary psychology reasons he explains
and that I found at least partly credible). Instead, you are using its
strengths of observation and classification. You pay close attention to
the ways in which the habit loop makes you feel bad, which in theory
provides feedback to the habit-following part of your brain that can
dislodge the habit. If the habit is recognized as no longer rewarding, it
will weaken.
Brewer's background is in addiction treatment, so he is predisposed to see
addiction in everything and one should probably be a bit cautious about
his enthusiasm. He claims a great deal of success with this approach in
clinical settings, mostly with addiction but also with anxiety, but this
is always hard to verify. (Few doctors who write self-help books
rigorously document their failures.) He apparently also has a company that
produces various phone apps that assist with this technique. I'm rather
cynical about anyone who talks about products their company has produced
in self-help books of this type, and I'm also rather cynical about anyone
who calls himself "Dr. Jud," but the book doesn't seem to be a sales pitch
and there's no direct information in it about how to get the apps.
For me, the first two parts of the book were the most useful and the
conception of anxiety reactions as habits made a surprising amount of
intuitive sense. I thought the third part of the book, where he tries to
describe a better in-the-moment reaction that you can try to build into a
more beneficial habit, to be the weakest. It's mostly stock mindfulness
advice that I've seen in other places, and you will be entirely
unsurprised to learn that Brewer meditates and has studied meditation. I
think it's clear that, for him, a feeling of curiosity works as an anxiety
replacement; I'm not sure that's universal and I'm not sure it works for
me.
That core idea that anxiety reactions are a type of addictive habit that
have outlived their useful rewards but continue because habits are hard to
change felt both useful and at least a little bit true, though. Your
mileage may, of course, vary, but I've been trying out various ideas from
this book since I first started reading it, and I think it's helping. If
any of this clicks with you and you're also prone to anxiety, it might be
worth a read.
One warning, though: Brewer's previous work on addiction includes binge
eating, and while it's not a primary focus, he uses several weight loss
and disordered eating examples and has a very traditional medical attitude
towards weight. I'm somewhat dubious of the addiction model of weight gain
in general, but more to the point, it's rather off-putting in a book
supposedly about anxiety. It's something I was able to skim over, but be
aware going in if you're likely to find this obnoxious.
I do think this book is a case of an addiction researcher seeing
everything through the lens of addiction, and I'm a little dubious this is
the right model for everyone's anxiety. But this is one of the good
reasons why there are a lot of books about anxiety: Different approaches
suit different people. This one made more sense to me than most; maybe you
are similar.
I can't really recommend or not recommend a book like this, since I think
so much will depend on whether you are one of the people for whom this
specific explanation will click, but I'm glad that I read it and I think
it's good to know that this model of anxiety exists.
Rating: 8 out of 10
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