Worst Case Thinking and How to Stop
Barbara Heffernan • May 20, 2025

Does your brain always jump to the worst case scenario?

The Catastrophizing Mind
Something unexpected happens—or something expected doesn't happen—and suddenly you've constructed an elaborate story that leads to disaster, an unbelievably horrible future. Your whole body is feeling it, and you're completely lost in this narrative.
This thought pattern creates genuine pain that is largely avoidable—yet it's extraordinarily common, a widespread human condition that persists until we learn how to interrupt it.
In this article, I'll discuss why our brains engage in catastrophic thinking, why we get hooked by these thoughts, and how to tame this worst-case scenario thinking.
Why Our Brains Catastrophize
The fact that you jump to worst-case scenarios isn't because you're defective. Humans have numerous cognitive biases—ways our thinking naturally skews—that contribute to catastrophic thinking.
Catastrophic thinking is one of the top ten cognitive distortions humans experience.
Catastrophic thinking is one of the top ten cognitive distortions humans experience.
There are six key reasons your brain gravitates toward catastrophic thinking:
1. **Survival Prioritization**: The human brain evolved to prioritize survival. Our brain focuses on ensuring our survival and therefore constantly scans for potential dangers.
2. **Future Projection**: The human brain is remarkably skilled at projecting into the future. If we didn't possess this ability to think ahead and were solely focused on survival, we would simply address immediate problems. However, we combine this future-thinking capacity with all its inherent uncertainty with our survival bias, causing us to anticipate distant threats that we can't address today and may never materialize.
3. **Negativity Bias**: We pay substantially more attention to negative aspects of our lives than positive ones. This negativity bias likely evolved from our survival focus. Instead of appreciating positive events and envisioning positive outcomes, we tend to ignore positivity, focus on problems, and create troubling narratives.
4. **Story Affinity**: Our brains love stories. The human mind is naturally drawn into narratives. Consider the movies you watch—if everything went smoothly for the characters with no conflict, how long would you remain engaged? Not very long. Our brains are captivated by stories containing conflict, resolution, and further complications. The most compelling books and narratives present one problem after another, and our brains find this engaging.
There's an element of self-entertainment in catastrophizing. This might sound difficult to believe—and you're welcome to disagree in the comments—but in a way, we entertain ourselves with these terrible stories. It's somewhat similar to watching a frightening movie that leaves you tense throughout, only to exit the theater questioning why you chose to see it. Some people enjoy such experiences; others are sensitive to them. With catastrophizing, we create this experience internally without even visiting a theater.
5. **Neural Highways**: The brain creates "superhighways" of thought. Neurons (brain cells) that communicate with each other begin to do so with increasing speed and efficiency. The pathways between them become myelinated—a sheath forms around them—allowing information to flow rapidly between different brain regions when we repeat patterns. If our response to surprising events is catastrophizing, this becomes a superhighway.
The good news is that these patterns can be rewired, which we'll address shortly.
The good news is that these patterns can be rewired, which we'll address shortly.
6. **Negative Core Beliefs**: We develop negative core beliefs at a young age based on stressful situations we encounter. For some, this might involve extreme trauma; for others, it could be "little-t trauma"—neglect or persistent low-level stressors.
These experiences can generate beliefs such as: "I'm powerless," "I'm unsafe," "I'm in danger," "Other people are dangerous," "Nothing works out for me," "I'm always unlucky," "People don't like me," "My needs don't matter," "I'm not worthy," or "I'm not lovable."
These beliefs arise from traumas—whether major or minor—in childhood and become deeply embedded in the brain. These negative core beliefs often form the theme of what you catastrophize about, and they become myelinated along with other stress responses.
This might sound hopeless, but it isn't. Before discussing solutions, let's explore why we get hooked by catastrophic thinking.
Why Catastrophic Thinking Hooks Us
Catastrophic thinking hooks us because our bodies physically respond to the stories in our minds.
Briefly consider the movie scenario again: If you watch an action film with car chases and tense moments, your pulse likely increases and you might feel anxious. If the movie is sad, you might cry.
Briefly consider the movie scenario again: If you watch an action film with car chases and tense moments, your pulse likely increases and you might feel anxious. If the movie is sad, you might cry.
We have physical reactions to imaginary stories, and our catastrophic thinking triggers stress chemicals in our bodies. As we imagine these scenarios, we're partially living through them. The physical responses we experience are remarkably similar to what we would feel if the situations were actually occurring.
These physiological anxiety sensations then tell your brain, "Yes, you should worry about this. Yes, you need to fight, flee, freeze, panic, or run away." Your physical body contributes to the thought pattern, intensifying it.
The behaviors you engage in—whether avoidant or compulsive (the two common behavioral responses to anxiety)—further contribute to this cycle, making it worse.
When people claim it's "all about your thoughts," that's not entirely accurate. Further, sometimes we can't control our thoughts. We can't always control our thoughts, but if we understand this cycle, we can calm some of those physiological sensations and change certain behaviors, which in turn will reduce catastrophic thinking.
Four Skills to Tame Worst-Case Thinking
Here are four skills to develop that will help you calm this habit of worst-case thinking. I'm deliberately calling them "skills" and referring to catastrophizing as a "habit" because overcoming bad habits and creating new ones requires practice. All of these techniques will require practice. They may be challenging at first and sometimes tedious, but with practice, they'll become more accessible, particularly during "amygdala hijack" moments when your emotional brain takes over.
**1. Build Awareness**
Developing awareness of when you're catastrophizing is crucial. If we're unaware of what we're doing, how can we change or stop it?
This might require practice. You might become completely absorbed in a disaster scenario before eventually recognizing, "Oh, I'm just imagining this. It's not actually happening."
Even if you can't reach that level of awareness, you might notice, "I'm completely stressed about this, and my partner or friend is telling me to calm down, but I don't want to calm down." That's the moment to pause and ask, "Am I catastrophizing? Does this story deserve this much power right now?"
Whether you can stop it or not at this point, questioning its value is important—until you're convinced it's not worth doing, you're unlikely to stop it.
Build awareness of when you're catastrophizing, and with practice, you'll recognize it earlier. Then you can label your thought even if you can't stop it. Often we can't control our thoughts, but we can label them: "This is a cognitive distortion," "This is a distorted thought," "This is catastrophizing."
Labeling helps us gradually separate from our thoughts. Even if you're convinced you must think through this catastrophic situation, ask yourself if you need the physical stress response you're generating. Is there a way to consider these possibilities without all the physical anxiety?
**2. Investigate Your Patterns**
This skill involves cognitive investigation—exploring why you get upset about specific things. We've discussed why the human brain generally catastrophizes, but why do you personally do it? What are your triggers, and what are your negative core beliefs?
Sometimes people struggle to identify their negative core beliefs. I offer a free PDF (click here to access) that guides you through identifying your negative core belief and provides three tools to begin overturning it.
How does your catastrophizing relate to your personal story? Some people are triggered by social situations, others by work, natural disasters, or major world events. Some people are triggered by everything (more characteristic of generalized anxiety disorder).
Your worst-case thinking might be very specific—perhaps about public speaking (a common phobia) or health anxiety. Whatever form it takes, investigate your triggers and their origins.
**3. Challenge Your Stories**
When you have a catastrophic story, try writing down the major events. Here are several methods for challenging the story (the last being my favorite):
As you note the components of your catastrophic story, ask yourself aloud or in writing:
- Is this actually happening?
- What's the likelihood this will happen?
- Is there anything I can do about this right now?
If you're dealing with a real problem, there's probably something you can do about your current situation, but it's highly unlikely you can address all the problems in your catastrophic story. Focus on what you can do now.
Then ask yourself:
- What other endings could this story have?
I often recommend developing a different story with a positive ending, and another with a neutral ending. Realistically, most situations in life end with a mix of good and bad elements.
Then ask yourself:
- What other endings could this story have?
I often recommend developing a different story with a positive ending, and another with a neutral ending. Realistically, most situations in life end with a mix of good and bad elements.
Journal or use your phone's audio recorder to create a structure for questioning these stories, considering different outcomes, and bringing your focus back to the present moment and what you can do now.
**4. Change Your Behaviors**
The fourth skill involves changing the behaviors that accompany your catastrophic thinking and contribute to the neural pathways in your brain. We want to rewire these patterns, and behavior change is one of the most effective approaches to do so.
Consider the cycle that catastrophic thinking leads to physical sensations which impacts your behavior.
catastrophic thinking → physical sensations → behaviors
The first skill listed above, Awareness, addresses the entire cycle. The second and third skills focus on the thinking aspects of the cycle.
In order to address the behavioral aspect , we need to develop new behavioral responses to our anxious thinking.
Most commonly, the behaviors that arise from anxious thinking are either compulsive or avoidant.
catastrophic thinking → physical sensations → behaviors
The first skill listed above, Awareness, addresses the entire cycle. The second and third skills focus on the thinking aspects of the cycle.
In order to address the behavioral aspect , we need to develop new behavioral responses to our anxious thinking.
Most commonly, the behaviors that arise from anxious thinking are either compulsive or avoidant.
So sometimes a new behavior means not engaging in a compulsive behavior. For example, if you have health anxiety and habitually search the internet for symptoms, finding yourself in a rabbit hole of possible diseases, that's a behavior. Stopping this behavior is essential for recovery because these compulsive actions contribute to the cycle by providing momentary relief. That brief relief reinforces the cycle and keeps you stuck.
The same applies to avoidance. If you're panicking about giving a presentation at school and call in sick, that avoidance might initially give you relief, reinforcing to your brain that avoidance is appropriate. It reinforces that the situation is genuinely threatening and should be avoided. The temporary relief perpetuates the cycle.
Instead of avoiding, the behavior to develop is to do the thing you're avoiding. If you're engaging in compulsive behaviors, the skill to develop is not doing those things.
As you consider this CBT cycle of how thoughts affect behaviors and feelings, and how behaviors affect feelings and thoughts, you can introduce a behavior like diaphragmatic breathing, which immediately impacts your physiology. Our physical state can change remarkably quickly when we alter our breathing and actions.
Learning diaphragmatic breathing is an excellent tool for interrupting this cycle. People often try to practice diaphragmatic breathing during an amygdala hijack, when it's generally less effective. I recommend truly learning proper diaphragmatic breathing technique—a very even inhale and exhale, not a deep breath followed by a quick release. It's a slow, even breathing pattern that expands your lungs, pushes down your diaphragm, and extends your stomach outward.
I have a detailed video on this technique that I'll link here.
I recommend that you practice five minutes at a time, three times daily, every day. Try it for two weeks and observe any changes, then continue for another two weeks. This is about habit formation—we want diaphragmatic breathing to become our automatic breathing pattern.
Diaphragmatic breathing aims for a state of alert relaxation rather than alert stress or complete relaxation to the point of sleep. This middle ground is achievable, but it requires consistent practice.
Summary: Key Points
If you frequently catastrophize, there's nothing wrong with you—it's a common human pattern supported by our brain's natural tendencies. We get hooked because of anxiety chemicals and our love of stories.
The four skills to develop are:
1. Building awareness of when you're catastrophizing
2. Investigating your personal triggers and negative core beliefs
3. Challenging catastrophic stories and creating alternative endings
4. Changing behaviors that reinforce the cycle
If you found value in this article, please share with someone else who might benefit!
How does catastrophic thinking affect your life, and which of these skills do you think might help you the most? I'd love to hear your thoughts in the comments below.
Blog Author: Barbara Heffernan, LCSW, MBA. Barbara is a licensed psychotherapist and specialist in anxiety, trauma, and healthy boundaries. She had a private practice in Connecticut for twenty years before starting her popular YouTube channel designed to help people around the world live a more joyful life. Barbara has a BA from Yale University, an MBA from Columbia University and an MSW from SCSU. More info on Barbara can be found on her bio page.
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In this blog, I'll discuss why and how this happens. I'll also go into some super interesting scientific research on movies that is demonstrating how strongly our brains and bodies respond to "made-up" stories. And most importantly, I'll provide guidance about how to use this information to calm your own anxiety. Whether your anxiety starts with worrying thoughts or a physical feeling, this will help! approach to understanding anxiety will be tremendously helpful for your recovery. The Cognitive Behavioral Therapy Cycle If you've watched my videos or read other blogs, you're hopefully familiar with the cognitive behavioral therapy cycle. The basic principle is that your thoughts impact your feelings and behaviors, your feelings impact your thoughts and behaviors, and your behaviors impact your thoughts and feelings. All these elements cycle together in an interconnected loop. While we generally think about anxiety as starting with a problem—an external problem confronts us and we respond with thoughts that feed the anxious cycle—this isn't always the case. For some people, sensory information actually triggers the initial response. It could be a smell, sight, or sound that directly triggers anxiety without any conscious thought process. Understanding where your personal cycle typically begins matters for healing, which I'll address at the end of this article. However, regardless of where your cycle starts, it will cycle through all components: thoughts, feelings, and behaviors reinforcing each other. Two Pathways: External Problems and Sensory Triggers **When External Problems Trigger Anxiety** Let me start with anxiety that begins with external problems. The problems that most commonly impact our anxiety share certain characteristics: they involve significant uncertainty, focus on outcomes we desperately want but can't completely control, and require us to project into an uncertain future. We might focus intensely on getting the job, achieving happiness, or attaining whatever we define as success. Because there are elements outside our control and enormous uncertainty involved, we begin projecting into the future, imagining potential obstacles and complications. This forms the basis of cognitive anxiety—anxiety that originates with our thoughts. This process leads to catastrophic thinking—imagining we'll encounter one problem after another and wanting to prevent all these potential problems. Since none of these imagined problems are occurring right now, we can't actually prevent any of them in the present moment, yet we feel compelled to anticipate every possibility. This mental process fuels increasing anxiety. As we fuel anxiety through catastrophic thinking, we generate intense physical symptoms. These are fight, flight, and freeze responses driven by the amygdala and other primitive brain regions. These physical symptoms then convince the rest of our system that we truly do need to be anxious, creating a self-reinforcing cycle where physical symptoms validate our anxious thinking, which increases both anxious thoughts and anxious behaviors. The entire cycle—thoughts, feelings, and behaviors—spirals out of control. **When Sensory Information Triggers Anxiety** The other pathway occurs when anxiety starts with physical sensations triggered by sensory information, often without conscious awareness. Many people experience sudden panic attacks and report, "I wasn't anxious, I wasn't thinking about anything worrying, and suddenly I started having this panic." However, once those physical symptoms appear, they typically trigger the cognitive component of the cycle. The moment you notice these physical sensations, cognitive worry often begins: "Oh no, why am I having this symptom? Something must be wrong with me. Maybe this really isn't anxiety. Maybe there's something else wrong with me." If we could experience those physical symptoms and simply acknowledge, "Oh, that's happening again," without creating a worry narrative around them, we wouldn't be feeding the anxious cycle. I'll discuss at the end of this article why anxiety triggered by sensory information happens, often completely beneath conscious awareness. I want to mention that whether your anxiety starts with external problems leading to catastrophic thinking, or it starts with physical feelings triggered by sensory information, the cycle operates similarly. Many people experience sudden panic attacks and say, "I wasn't anxious, I wasn't thinking about anything worrying, and suddenly I started having this panic." However, once you have those physical symptoms and pay attention to this pattern, you'll begin to see the cycle. Once you experience those physical symptoms, you enter cognitive worry: "Oh no, why am I having this symptom? Something must be wrong with me. Maybe this really isn't anxiety. Maybe there's something else wrong with me." If we could experience some of those physical symptoms and simply think, "Oh, that's happening again," without worrying about it, we wouldn't be feeding this cycle. I hope this makes sense. I'll discuss at the end why anxiety triggered by sensory information happens, often without your conscious awareness. The Evolutionary Basis of Our Physical Response Humans evolved, and our brains evolved, with a primary focus on survival. Our brain developed to keep us safe and alive. The amygdala, which plays a key role in this process, primes us to fight, flee, or freeze whenever there's a threat. Here's the crucial point: **the amygdala cannot differentiate between real and imagined threats**. This is where we need our frontal lobe to intervene, calm the amygdala, and recognize, "This isn't actually a dinosaur chasing me." I have several videos about amygdala hijacks and being triggered, which will be useful if you're interested in this topic. The key point is that made-up stories trigger the same physical response as if the situation were actually happening. The Movie Research Connection Let's consider movies. We know they're not real, yet we still respond physiologically. I'm someone who jumps constantly during movies when something scary or shocking happens—I have a very external expression of it. Not everyone does, but many people do, and we all feel something. Current research on movies and their effects on our brain and body is fascinating. The research demonstrates measurable physical responses to movie events. We know movies aren't passive experiences, but the fact that they trigger measurable changes is remarkable. Researchers can measure hormonal changes and electrodermal activity (the amount of sweat on your skin). These are subtle changes that vary with different emotions. Electrodermal activity is one tool researchers use to observe physiological changes in humans tied to emotions while watching movies. Heart rate and blood pressure are measured during movies. There are now numerous studies using fMRIs to examine brain imaging and brain activity while people watch movies. When we watch scary movies, our innate fight, flight, and freeze response activates, preparing us for immediate danger even though the danger isn't real and isn't physically present. Simply being frightened by the story triggers measurable spikes in adrenaline and cortisol levels—our stress chemicals. This provides a powerful example of how our bodies respond to imaginary threats, responding the same way to those anxious made-up stories in our minds. Positive Research Findings There's also positive research about movies. Watching comedies and laughing actually lowers blood pressure—we should all watch more comedies! Heart rates can reach 40 to 80% of their maximum rate (the range doctors recommend for exercise) and can remain elevated for extended periods during movies, which could actually be beneficial. Another key finding is that heart rates and electrodermal activity—all physiological data—fluctuate with the narrative arc. As the story changes, so does people's physiology. Some research shows that audience members' heartbeats begin to beat in synchrony with each other, which is fascinating. This makes me think about how when we're next to someone who's anxious, we probably feel more anxious ourselves. We pick up on each other's moods, emotions, and sometimes physiological states. Brain Imaging Research fMRI studies show that stressful movies can trigger the same neural circuits involved in anxiety—the same brain circuitry that fires together during anxious feelings. Movie watching actually recreates emotional states accurately—the same emotional states we experience in real life. There are increasing fMRI studies examining brain function during movies, mapping brain areas that activate with different emotional states. Researchers are using this in studies of affective and emotional disorders, including anxiety. This research definitely connects to those made-up stories in our minds. How to Calm Your Anxiety What do you do about this? How do you calm your anxiety? I have numerous videos on this topic—I'll provide highlights here and point to areas you might want to investigate further. **1. Increase Awareness of the Thought-Feeling Connection** To calm your anxiety, first increase your awareness of the connection between your thoughts and feelings. Use this growing awareness to separate the physical feeling from the "made-up story." I use "made-up story" in quotes because I know there are real problems, but they're being projected into the future where what you're worrying about isn't happening right now. Separate that physical response as much as possible from those thoughts. The intense physical response triggered by catastrophizing isn't congruent with the present moment—sitting here in this environment right now. It's also unnecessary for solving the problem. In fact, it can interfere with actually solving the problem. **2. Understand Your Personal Anxiety Cycle** Really understand your anxiety cycle. Does your cycle start with external problems? Does it start with internal feelings? Does it start with sensory experiences? If external, what types of events trigger it? What are you anticipating? How does this impact your thoughts, feelings, and behaviors? How does this cycle work for you? Behaviors can either contribute to anxiety or help you calm down. Become intimately aware of your personal anxiety cycle. **3. Prioritize Calming Your Physical System** Calming your physiological state is one of the most powerful interventions available. It truly communicates to older brain parts—the amygdala and ancient areas that don't have language centers—that you're actually safe. Essential tools include diaphragmatic breathing and grounding techniques. I recommend practicing these regularly on a daily basis, preferably when you're not highly anxious. Begin doing them regularly every day, and you'll develop the ability to access them during more anxious states. This builds over time like a habit, like a muscle that grows stronger. **4. Identify Helpful and Harmful Behaviors** Identify behaviors that contribute to your anxious cycle and those that break it. Consider how your behaviors—whether compulsive or avoidant—contribute to your anxiety. If you're afraid of something and avoid it, you're communicating to your primitive brain, "This is really scary; I better run away." Identify what those behaviors are and what behaviors you can implement to cut the cycle, calm yourself, and change the pathways. Behavior is actually the most powerful way to change your brain circuitry and create new neural pathways. Habitual physical reactions get different brain regions working together rapidly. Your brain develops neural pathways where this event leads to this feeling, leads to this thought, and it accelerates with repetition. Habits of anxiety and habits of relaxation are equally important. **A Practice Exercise** One thing you can practice—this is just one idea among many—is actually calming your body while thinking about the situation that frightens, triggers, or worries you. Think about that situation while doing diaphragmatic breathing or grounding techniques and observe what happens. If you haven't seen my free webinar, " Rewire Your Brain for Joy and Confidence ," it explores the concept of neural pathways and what you can do to change them to feel less anxious and focus more on joy. It covers what behaviors you need to change, and I think you'll find it helpful. Conclusion and Future Content Pay attention to what behaviors you can implement to help break the cycle. These can include diaphragmatic breathing and grounding techniques, as well as taking walks, petting animals, and similar activities. I know some viewers would like more information about the actual physical symptoms of anxiety, but including everything would make this article too long. My next article will focus on the physical symptoms of anxiety, so make sure to subscribe to my channel. Another question many viewers have is, "I don't have a story." People who feel their anxiety is triggered by internal feelings or external sensory information often feel there was no story when it started. I'll address this in an upcoming article about "what if there is no story." In that article, I'll discuss how past experiences link sensory information with emotional responses. These connections become deeply embedded in our brain and can be positive or negative. Positive sensory experiences can evoke emotions (like the smell of your grandmother's cooking), but for people prone to anxiety, many things can trigger anxiety beneath conscious awareness. How does the connection between thoughts and physical sensations show up in your anxiety? Have you noticed parallels between your responses to movies and your anxiety responses? I'd love to hear your thoughts in the comments below.

Understanding this mismatch can help you lower your anxiety! There is an evolutionary mismatch between our world now, a delayed return environment, and the world in which our brain evolved, an immediate return environment. Our brain is a wonderful predictive machine, unless it gets trapped trying to control things it can not control, which is easy in a delayed return environment.

Sometimes is seems that anxiety runs in families, but not everybody has it. Other times, someone might have anxiety when no one else in their family does. In this blog, I'll discuss the current state of research regarding whether anxiety is genetic and inherited. I will also address whether this knowledge matters, and if it does, why it matters. The role genetics plays varies by specific anxiety disorder. Toward the end of this article, I will provide a summary of current research findings for generalized anxiety disorder, panic disorder, specific phobias, agoraphobia, and social anxiety disorder (the five anxiety disorders that primarily apply to adults in the DSM-5-TR). I will also include obsessive-compulsive disorder because, while it's no longer classified as an anxiety disorder, many readers ask about OCD, and there is significant overlap. Before examining specific disorders, it's important to understand the research methodology and findings in general terms. I'll break down concepts like "familial aggregation" and "concordance rates in twin studies" to provide an accessible and understandable overview. The Science Behind Anxiety and Genetics Anxiety is a common human experience. However, it becomes a disorder when it is excessive, interferes with daily life, or impacts overall functioning or happiness. Anxiety disorders are prevalent—research shows that up to a third of the population will experience an anxiety disorder at some point in their life. Family history and genetics are definite risk factors, but they are not determinants. There is no gene for any anxiety disorder that directly causes the condition . Overall, family conditioning, family history, and genetics can be viewed as influences that increase the likelihood of developing a disorder, but they are not determinative. How Researchers Decide If There Is a Genetic Link When anxiety disorders cluster within families, researchers call it "familial aggregation." Research indicates that having anxiety in a first-degree relative can increase your risk of developing an anxiety disorder anywhere between three and 17 times compared to someone without that family history. However, families influence us in many ways. We learn from our parents' behavior, we mimic others' coping mechanisms, and we adopt patterns of behavior from those around us. These behaviors can be passed down through generations without necessarily indicating a genetic link. To determine whether anxiety truly has a genetic component, researchers often turn to twin studies. A common method involves comparing incidence rates between identical twins (who share exactly the same genetic structure) with fraternal twins (who are as genetically different as any two siblings). Most siblings share approximately 50% of the same genes, while identical twins share 100%. For clarity when reading research, it's helpful to know that identical twins are called "monozygotic," and fraternal twins are called "dizygotic"—terminology that can make research studies confusing for non-specialists. In research literature, you might encounter sentences like this regarding obsessive-compulsive disorder in twins: "There is a concordance rate of 0.57 for monozygotic versus 0.22 for dizygotic twins." To break this down for you, this sentence means that if you're an identical twin and your twin has OCD, you have a 57% chance of having that disorder, whereas if you're a fraternal twin and your twin has OCD, you have a 22% chance of having it. The concordance rate represents the likelihood that one twin will have the anxiety disorder if the other twin has it. Since OCD appears approximately twice as common in identical twins, this suggests a significant genetic contribution. However, it's important to note that even in identical twins, there remains a 43% chance that the other twin won't develop OCD . The Role of Epigenetics To summarize, most anxiety disorders appear to have both genetic and familial links, yet other factors play a very important role. These additional factors include the environment you grew up in, the environment you are in now, specific life experiences, and epigenetics. Epigenetics refers to environmental factors or life experiences that trigger gene expression. Epigenetic factors play a crucial role in determining whether particular genes become activated. This principle applies across many conditions, not just mental health disorders. The developing field of epigenetics highlights an important truth: our genes do not determine our destiny. Does It Matter If Anxiety Is Inherited? This brings us to the question: Does it matter whether anxiety was inherited through family behavior or genetics? I believe this information can be a double-edged sword. In my work as a psychotherapist, I've observed that when individuals focus on their belief that their disorder is genetic, they often believe nothing can be done about it. They adopt the mindset: "I inherited this; I will always have it." If this belief prevents someone from seeking help, or doing the work needed to recover, then awareness of genetic components may not be beneficial... because regardless of the cause, anxiety is treatable . Many people can achieve full recovery, and most others can experience significant improvement. In terms of treatment approaches, the specific trigger or genetic predisposition matters less than commitment to recovery. While you might face additional challenges with family patterns of anxiety or intergenerational trauma, recovery remains possible. Whether the source was trauma or generational stress, effective tools and techniques exist. On the positive side, understanding the inherited aspects of anxiety can help people avoid feeling defective. It reduces self-blame for having an anxiety disorder. When we understand anxiety in the context of its prevalence in the general population and its presence in family histories, this understanding fosters self-compassion. And self-compassion, in turn, aids healing. An additional benefit of knowing about familial risk is the potential for earlier treatment seeking. Earlier intervention correlates with better outcomes. S pecific Anxiety Disorders and Their Genetic Components Here's a summary of research findings for specific anxiety disorders: **Generalized Anxiety Disorder: Research indicates approximately a six-fold increase in the likelihood of developing generalized anxiety disorder if you have a first-degree relative with the condition. Twin studies suggest genetics contribute about 30% to GAD development. Researchers exploring specific genes associated with anxiety disorders have identified a potential link to a gene called RBFOX1, though this research remains preliminary and inconclusive. **Panic Disorder: Research shows a wide range in family aggregation odds ratios. If a family member has panic disorder, you are between three and 17 times more likely to develop it yourself. This wide range limits specific predictive value, but clearly indicates increased risk. Some genetic studies have identified a possible link to the NPSR1 gene for panic disorder. However, anxiety disorders are generally considered polygenic, meaning they involve multiple genetic regions. **Specific Phobias: Research on specific phobias varies considerably, with family influence accounting for approximately 30% to 60% of risk. This variability likely stems from the diversity of specific phobia types and triggers. **Social Anxiety Disorder: Twin studies show an inheritability rate of around 27% due to genetic components. A family history of any anxiety disorder increases the likelihood of developing social anxiety. **Agoraphobia: Research indicates a person is 2-4x more likely to have agoraphobia if a close relative has it (as compared to someone without agoraphobia in the family). However, there is a high "co-morbidity" rate between agoraphobia and panic disorder: meaning that most people with agoraphobia also have panic disorder. There is research that shows that agoraphobia without panic disorder does not aggregate in families. This could indicate that the genetic link is actually that of panic disorder. **Obsessive-Compulsive Disorder: As discussed previously, twin studies suggest a significant genetic component in OCD. The likelihood of developing OCD if a family member has the condition increases dramatically if that person developed OCD in childhood. Childhood onset of any anxiety disorder increases the chance of genetic transmission, but this effect is particularly pronounced with OCD. Key Takeaways * Family history increases risk of an anxiety disorder by 3-17 times but it doesn't guarantee anxiety. * Twin studies demonstrate a genetic component to the inheritability of anxiety disorder. However, even with identical twins this is not determinative. * Epigenetics matters—environment activates genetic predispositions. * No gene has been found to determine any anxiety disorder * Your genes are not your destiny— recovery is possible! * Many people achieve complete relief from anxiety symptoms and m ost others experience significant improvement with treatment, whether there is a genetic component or not. * Neuroplasticity allows your brain to create new, healthier patterns. * Early treatment leads to better outcomes. If you haven't yet viewed my free webinar, " Rewire Your Brain for Joy and Confidence ," I encourage you to explore it. I discuss how our brains become wired when we repeatedly connect thoughts and behaviors with specific feelings. This contributes to anxiety, negative self-talk and destructive thought patterns. While these patterns often develop early in life, neuroplasticity allows us to change our brain wiring. We can alter which brain regions activate and which neurochemicals are produced. By changing behaviors, we can transform our environments, and even deeply ingrained patterns can be rewired. I encourage you to watch the webinar and seek help if you're struggling with anxiety — effective treatments exist. This article covers more technical material than my usual content, so I am interested in your feedback. My next video and article with address "Why do I have anxiety?"—a common question I receive. Many wonder why they experience anxiety while their siblings don't, whether it's genetic or behavioral. That forthcoming article will explore the various causes of anxiety beyond heretability. How has understanding the genetic components of anxiety affected your perspective on your own experience? I'd appreciate hearing your thoughts in the comments below.

Scientifically proven, simple technique to calm an amygdala hijack. This blog describes this simple technique, provides the scientifically proven benefits of using this technique and shares 7 steps to implement this technique in the most effective way! Based on Lieberman's scientific research on affect labeling.
The Technique: Affect Labeling
Affect labeling is putting into words what emotion you are feeling.

Understanding the Fawn Response The Fawn response is a behavior developed in childhood, often connected to complex trauma. It could even be little "t" traumas on an ongoing basis, where as a child, you learned to subjugate yourself to the caregiver in order to stay in relationship and survive. This becomes a deeply ingrained survival behavior which can become habitual. As you grow up, it gets applied to all situations. This blog will go through nine components required for healing. - The first three focus on internal work - The next three are more practical, action-oriented techniques - The last three address deeper psychological work Internal Work (Components 1-3) # 1. Recognize that fawning developed because it was necessary at the time Understand that fawning was a survival strategy, and it might have been the very best choice available to you. It may also have been, in many ways, the only choice. Even today as adults, there are situations where choosing a fawning-type behavior might actually be the best choice. This is important to understand because we don't want to eliminate this response entirely—we want to get to the point where it's not an automatic go-to reaction. Instead, we want to reach a place where you can consciously think, "I'm choosing to do this right now." Acknowledging that this developed as a survival strategy helps prepare you for the next two components. [ For more information on what the fawn response is and why it developed, read this blog] # 2. Begin to acknowledge and validate your own feelings If you grew up in an environment where you learned to fawn, my guess is that not only were your caregivers not paying attention to your feelings, but you also had to subjugate your own feelings to the point where you weren't aware of what you were feeling. As an adult, it's necessary to begin recognizing and identifying your emotions: "I'm feeling angry" or "sad" or "frustrated" or "irritated." Begin to acknowledge and even verbalize what you're feeling. The simple act of labeling your emotion calms down your fight-flight-freeze response and increases activity in the areas of the brain that help you solve problems. There is research that shows this happening via fMRIs! # 3. Practice self-compassion Understanding why this behavior developed can help you practice self-compassion. Changing these behaviors is hard and takes time. If you find yourself automatically fawning and later yelling at yourself, try not to do that—you're basically re-traumatizing yourself for a behavior you learned for survival. Instead, try noting it with self-compassion: "Interesting, I fell into that pattern again." And then connect this to the next step by adding, "I fell into that pattern again because of this situation." Observe with compassion rather than judgment. Practical Tools (Components 4-6) # 4. Identify situations that trigger fawning behavior Notice which situations trigger your fawning behavior. As you review these situations, see if there are patterns similar to those you experienced as a child. They may reflect situations that were emotionally or physically dangerous, or that created a rift between you and your caregivers. Identifying these situations helps you understand what patterns became embedded in your emotional brain. As you observe these patterns, bring in self-compassion and that observer mindset. This approach is much more productive than criticizing yourself. As you identify these patterns, you can connect them to current situations: "This situation at work with a difficult authority figure is recreating this childhood pattern for me." You are bringing in your frontal lobe to analyze the emotional reaction, which helps you realize, "That was threatening to my very existence when I was a child, but it is not threatening to my existence right now." This recognition is crucial because automatic fawning behaviors come from a need to survive immediate danger. The uncertainty of longer-term consequences (like losing a job) might be problematic, but it's not an immediate survival threat. Differentiating between then and now helps calm your fawn response. # 5. Keep a journal to track people-pleasing behaviors Keep a journal for 30 days. Journal on this question: "Did I say or do something today to please someone else that was at my own expense?" As you review the events of each day, you might realize, "I didn't do it this situation, but I did do it in those five situations." Again, maintain self-compassion with no judgment—just observe and be aware this will take time. This question gets at the heart of the issue: What did you do today that ignored your own values or needs in order to stay in relationship with someone else, avoid criticism, or prevent rejection? Verbalizing this through an audio journal or writing it down utilizes different parts of your brain that help you comprehensively understand what's happening. # 6. Practice emotional regulation tools daily Implement diaphragmatic breathing, grounding exercises, or any techniques that calm your physiology. Practice these regularly, not just in the middle of triggering events. You can weave these practices throughout your day. Set an alarm for three different times during the day, and when it goes off, simply take three deep diaphragmatic breaths. No one needs to know you're doing it—you can do it anywhere, and it's free. While it might not feel immediately helpful, you're stimulating a different part of your nervous system that helps you realize, "In this situation, it would not be life-threatening if the relationship were severed. I'm not in a situation where my immediate survival is at stake." When you feel safe enough, your normal breathing pattern will naturally be diaphragmatic. It's all a feedback loop—a body-based technique that communicates to the rest of your brain. The fawn response is differentiated from the fight-flight-freeze response. Sometimes they're grouped together, but I think it's more useful to separate them (I'll cover this topic in the future if you're interested—let me know in the comments). The fawn response uses different parts of the nervous system and brain because it's largely about staying in connection with others. That said, knowing whether your underlying response is fight, flight, or freeze beneath the fawn behavior can be helpful. People who fawn typically have either a flight response (wanting to run away) or a freeze response. Fighters rarely develop the fawn response. I recently created videos and blogs about calming the fight-flight-freeze response that might be useful for you. Deeper Work (Components 7-9) # 7. Recognize your negative core beliefs Identify what beliefs developed when you were young that led you to fawn, and what beliefs developed as a result of fawning. A common belief for people who fawn is "my needs don't matter," or even " I don't matter." Other common beliefs include "I'm not good enough," or "I'm powerless." A general feeling of being in danger is also common. Identifying these negative core beliefs and beginning to use tools to rewire them is extremely helpful. [I have a free PDF that helps you identify these beliefs and learn tools to rewire them. You can find it by clicking here ]. # 8. Learn to recognize and separate from limiting thoughts Notice when your behavior is driven by your negative core beliefs, whether you're fawning or not. You might operate from these beliefs almost all the time, even when not actively people-pleasing. Begin to separate yourself from these thoughts. Not all of our thoughts are true. Not all of our beliefs are true. We can "diffuse" from our thoughts by using our observer mind: "Interesting, I'm thinking that again, but I know it isn't necessarily true." A helpful technique is to "practice as if." If you feel like your needs don't matter, pretend that they do matter. Ask yourself, "What would I do right now if my needs mattered?" You can practice this approach in small ways. Your behavior, even if it is coming from a place of pretense, will actually begin to rewire these beliefs. # 9. Establish healthy boundaries I've placed this component last because establishing healthy boundaries isn't simply about saying "no." (Sometimes saying no is a healthy boundary, but sometimes it's not—and boundaries encompass much more than that). Healthy boundaries require a deep understanding of yourself and your values, and an understanding of where you end and others begin. To truly understand healthy boundaries requires deep inner work. The other components we've discussed, particularly emotional regulation, are prerequisites for establishing boundaries. Until you develop a certain level of emotional regulation, it's nearly impossible to implement healthy boundaries. When your amygdala is firing with the fight-flight-freeze response, your response is automatic and happening too quickly for your rational brain to intervene. Your rational mind might know "I should be saying no right now" or "I should leave this conversation," but the panic response has already set in, and your brain is focused solely on keeping the relationship intact and staying safe by avoiding conflict. This is why healthy boundaries aren't just about learning more information. You've probably read extensively about boundaries and have cognitive awareness of what healthy boundaries might look like. Then you get frustrated when you can't implement them because no one talks about the fact that boundary-setting starts with emotional regulation. Healthy boundaries also require healing negative core beliefs and knowing (even if you don't yet feel it ) that you can be safe without maintaining a toxic relationship, you can be safe even when there's conflict. A Structured Approach to Healing In my boundary program , I've designed an approach which walks you through the CORE components of healing and establishing helthy boundaries. The program helps you: develop the emotional regulation you need to begin to set boundaries identify and heal the negative core beliefs that are driving unhealthy boundaries learn assertive communication (as opposed to passive or aggressive) understand how to set boundaries and consequences and begin to do so! (For more info on the boundary program, click here) Learning assertive communication is essential because people with fawn patterns often use passive communication. Assertive communication represents the middle ground between passive and aggressive communication. It embodies the principle "I'm okay, you're okay." Many people who fawn misinterpret assertive communication as aggressive, and since they don't want to be like their aggressive abuser, they default to passive communication. But there is a healthy middle ground. As always, I'd love to hear your thoughts and questions—please comment below. I truly hope this is helpful, and I'll see you next week.

All anxiety disorders are driven by an amygdala hijack. This blog explains how this work, why it is a problem and what to do about it. If your anxiety is controlling your life, ruining your happiness, and maybe even impacting your health, know that it is not all in your head. Your nervous system has been hijacked, and understanding this can really help you on your path to recovery.