Do the physical twinges of anxiety make you even more anxious? For instance, for some people, even though the sweaty palms, racing heartbeat and shaky limbs are a result of exercise — and not an impending panic attack — they still experience intense anxiety about their anxiety.

This is called anxiety sensitivity. According to authors and clinical psychologists Margo C. Watt, Ph.D, and Sherry H. Stewart, Ph.D, in their excellent book Overcoming the Fear of Fear: How to Reduce Anxiety Sensitivity, anxiety sensitivity is “the tendency to respond fearfully to bodily sensations associated with fear and anxiety.” Put simply, it’s “the fear of fear.”

People who are prone to anxiety sensitivity tend to catastrophize, or automatically assume that the worst will happen. For instance, you might fear that your trembling might catch the attention of others or a racing heart might mean a heart attack.

In their book, Watt and Stewart outline a cognitive-behavioral approach to reducing anxiety sensitivity. Here are a few tips you might find helpful.

Changing your Thoughts

The stories we tell ourselves can heighten our anxiety. But the good news is that our stories also can diminish our anxiety. According to the authors, we either turn up or turn down the volume on our physical sensations depending on what we say to ourselves when we’re experiencing these sensations. Here’s how to pinpoint negative thoughts and adjust them.

  • Identify dysfunctional thoughts. Knowing the stories you tell yourself will help you figure out how your thoughts are perpetuating your anxiety. To get at these thoughts, think of a recent experience, and zero in on your thoughts. “What were the major kinds of thoughts going through your mind just before, during, and after the episodes of anxiety or panic? This is an example of a catastrophic thought: “If other people noticed my anxiety and panicky feelings, it would be terrible and I could never face them again.”
  • Challenge your thinking. Watt and Stewart cite psychologist William James: “The greatest weapon against stress is our ability to choose one thought over another.” They suggest readers treat their thoughts as guesses, not facts. Examine the evidence for your thoughts, and ask yourself these questions: “What are the true odds of this happening? Has this ever happened before? What’s the evidence it won’t happen?” They also recommend de-catastrophizing. In other words, they say “So what?” They write: “What if the worst-case scenario did happen? What would you do? Could you survive? What would you do if you saw others faint, shake or turn red? What would you say to others if they expressed similar fears?”
  • Substitute healthy thoughts. The goal is to replace negative thoughts with realistic, reasonable and helpful thoughts. For instance, if your heart starts to race, and you initially think that you might be having a heart attack, you might say: “It’s unlikely that I’m having a heart attack. This is probably anxiety, and the best thing I can do for myself right now is to breathe and try to relax. I shouldn’t fight my body but should work with it. I can just ride it through.”

Changing Your Behaviors

Another way to reduce anxiety sensitivity is to expose yourself to the physical sensations — a process called interoceptive exposure. According to the authors, the aim is habituation, which “refers to decreased response to a stimulus after repeated presentations.” In other words, the more you expose yourself to these physical sensations, the more accustomed you become to them. Over time, they lose their power.

There are many interoceptive exposure techniques, such as hyperventilating, breathing through a narrow straw or spinning around while standing. “The main goal in doing exposure exercises is to learn new ways to respond to your own physiological sensations.” That’s why it’s important not to avoid or escape the sensations when you’re doing these exercises.

Changing Your Lifestyle

Healthy habits also are important for shrinking anxiety sensitivity. Watt and Stewart use the metaphor of our bodies as vehicles. Vehicles require regular maintenance, and so do our bodies.

But as the authors point out, “Interestingly, we’re more apt to attend to maintaining our cars and trucks than our own bodies, the vehicles we live in 24/7, even though neglecting proper maintenance of our bodies comes at a much higher cost.”

According to the authors, if our bodies had a user’s manual, it would say the following:

  • A vehicle works best when it has proper fuel, which translates into nutrition.
  • A vehicle works best when it has good ventilation for clean air and cooling effects, which translates into breathing, such as diaphragmatic breathing.
  • A vehicle works best when it is operated regularly, which translates into regular physical activity.
  • A vehicle works best when it has a break from operation, which translates into rest and sleep.

Do you struggle with anxiety sensitivity? What helps you reduce anxiety sensitivity?