20 Years of Anxiety Treatment in 15 Minutes
Clinical psychologist Dr. Thomas Smithyman shares 21 lessons about anxiety drawn from two decades of experience. His central message is that progress doesn't require eliminating anxiety first: it comes from changing how you respond to it, facing discomfort gradually, and building confidence in your ability to cope.
1. Don't Let Calm Become a Requirement
Smithyman compares anxiety to an annoying houseguest. If your day can only begin once that guest leaves, anxiety is deciding what you do.
"Yep, I feel it. It's uncomfortable, but I can live my life anyway."
It's natural to prefer feeling calm. But when calm becomes a condition for living, anxiety gains more influence. The goal is to make room for the feeling while continuing to do what matters to you.
2. Be Your Own Good Coach
Imagine a coach who yells every time a child makes a mistake. That child would likely become anxious rather than learn confidently. Smithyman says harsh self-talk can have a similar effect: it may seem motivating, but it often keeps you on edge.
A good coach still encourages improvement, but does so with kindness and belief in your ability to grow. Try to speak to yourself in a way that acknowledges mistakes as part of learning rather than proof that you're inadequate.
"Anxiety eases when you treat yourself like someone worth supporting."
3. Redirect Anxious Energy
Smithyman describes anxiety and excitement as "siblings" because they can feel similar in the body: both may bring a faster heartbeat and a burst of energy. The difference, he suggests, is often where your attention goes—toward potential risks or potential rewards.
Rather than always trying to force yourself from anxiety into calm, consider directing that energy toward the possibilities in front of you. Ask what you might gain, learn, or become stronger by facing.
"You need to aim that energy you have in a better direction."
4. Take Small Steps Into Discomfort
Avoidance can offer short-term relief, but repeatedly pulling back from uncomfortable situations can make your world smaller. Smithyman recommends approaching fears gradually, in steps small enough to manage.
Trying to make a huge leap can feel overwhelming. If you freeze, that doesn't mean you're incapable; the step may simply have been too big.
"Microdose the discomfort. Feel a little of it and then get used to it. Then repeat."
Small, repeated steps can build tolerance over time, even when progress initially feels almost invisible.
5. Separate Yourself From Anxiety
There's a difference between defining yourself as an anxious person and noticing that you're experiencing anxiety right now. Smithyman suggests naming what is happening more specifically: anxious thoughts are appearing, or sensations of fear are moving through your body.
That language creates a little distance between you and the experience.
"You are the person observing the anxiety."
The point isn't to deny the feeling. It's to remember that anxiety is something you experience, not the whole of who you are.
6. Ride the Emotional Wave 🌊
Smithyman compares fighting an emotion to punching an ocean wave: rather than stopping it, you may end up getting knocked under. A different approach is to observe and "ride" it.
When anxiety appears, notice the sensations in your body and how they change. Emotions rise, peak, and fall; watching them rather than battling them can make them easier to tolerate.
"Life gets a lot easier when you stop resisting and you start riding the wave."
7. Act Without Guarantees
Life rarely gives complete certainty. Waiting until every risk disappears can keep you from taking meaningful steps, and even careful planning can't prevent every unexpected problem.
Smithyman encourages learning to act while things still feel uncertain and to cope with the emotions that arise if events don't go as hoped.
"Show up anyway. Show up before you're ready."
This doesn't mean ignoring real risks. It means recognizing that absolute safety isn't a prerequisite for progress.
8. Save Your Energy for Real Problems
Picture someone wandering through the woods pouring water everywhere because a fire might start. Without knowing whether or where there will be a fire, they spend enormous energy preparing for possibilities.
Smithyman says worry can work the same way. Many feared events never happen, and constantly rehearsing them consumes time and attention. His advice is to trust that your future self can address actual problems when they arise.
"Save your water for real fires."
9. Practice Coping With the Unknown
Anxiety often pushes us to eliminate every doubt, but certainty isn't something we can guarantee. Smithyman proposes a different mindset: acknowledge what you would prefer, while trusting yourself to cope if something else happens.
"I don't know what will happen. I prefer X would happen, but if Y happens, I will find a way to cope."
This is not giving up on planning or control. It's building confidence in something more dependable than prediction: your ability to respond.
10. Understand Anxiety as a Learned Response
Smithyman says a highly alert nervous system may have learned that vigilance was necessary in an earlier environment. That sensitivity can be an understandable survival response, not a personal failing.
The difficulty is that the response may continue even after circumstances have changed. Instead of being angry with yourself, he suggests gently helping your nervous system learn about your present life.
"Show it gently that life is different now. And so are you."
You may now have more maturity, experience, knowledge, and tools than you had when those patterns first developed.
11. Let Anxiety Be—or Befriend It
Smithyman describes two helpful ways to respond when anxiety appears. You can let it remain in the background while you continue with your day, or you can turn toward it with curiosity and kindness.
The response he discourages is fighting to shut it down, which he says can make it feel louder.
"Stop treating anxiety like an enemy."
Seeing it as a part of your experience that you don't need to fear or fight can make space for a gentler response.
12. Take Anxiety With You
People often postpone meaningful actions until they feel better. But that moment may not arrive on its own. Smithyman emphasizes that tension and racing thoughts can be present at the same time as you take a step forward.
"Don't stop, just bring it with you."
The aim is not to pretend the sensations aren't there, but to avoid letting them automatically decide whether you participate in your life.
13. Build Confidence by Getting Through Difficulty
If you face a fear and everything goes well, you may feel relieved—but your mind may still ask, "What if it goes wrong next time?" Smithyman says a deeper kind of confidence can grow when something difficult does happen and you discover that you can get through it.
"Confidence doesn't come from avoiding the feared outcome. It comes from surviving it."
His point is to build coping skills rather than depend on perfect outcomes. You don't need everything to go smoothly to learn that you can handle challenges.
14. Notice What You Feed Your Mind
Smithyman encourages viewers to consider whether their media habits are adding unnecessary fear. He gives the example of clients becoming suddenly frightened of home invasions after binge-watching crime shows.
What you repeatedly watch can affect what feels threatening or likely. If certain content leaves you persistently on edge, consider reducing it or taking a break.
"Be deliberate about what you feed it."
15. Schedule Worry Time
A worry arriving in your mind doesn't mean you must immediately spend time on it. Smithyman suggests setting aside a regular daily worry period and postponing worries until then.
When a concern appears, you can write it down and remind yourself:
"I will think about this during worry time."
You're not necessarily dismissing the concern; you're choosing when to give it attention. By the time your scheduled period arrives, some worries may no longer seem as important.
16. Count Your Breaths
For anyone who finds meditation intimidating, Smithyman offers a simple attention exercise:
- Count one as you inhale and two as you exhale.
- Continue counting each inhale and exhale up to 50.
- If you lose count, notice that your attention wandered and start again at one.
"If you lose count, then you know that you were lost in thought. And catching that is the whole point."
The counting gives your mind a task, while paying attention to your breath brings attention back to your body.
17. Notice Who Keeps You on Edge
Some relationships leave you feeling you must stay small, avoid criticism, or watch for someone's next angry reaction. Even during calm moments, you may still be bracing for what comes next.
Smithyman acknowledges that such relationships can have positive aspects: the person may be fun, exciting, or kind when in a good mood. But those benefits can come with an emotional cost.
"The right people don't make you shrink. They help you expand."
He encourages valuing relationships in which you can feel more settled and more like yourself.
18. Fire Your "Insecurity Guards"
Smithyman imagines mental security guards who do their job backward. They turn away positive evidence—"It was just luck" or "They were only being polite"—while giving criticism immediate VIP access.
"You don't need tougher guards. You need fair ones."
The lesson is not to reject all criticism or accept every compliment uncritically. It's to stop automatically dismissing the good while treating every negative judgment as definitive. Letting positive feedback in can help you grow.
19. Let People Opt Out
You can't be liked by everyone, and you don't have unlimited time or energy for everyone. Smithyman suggests showing people who you are and allowing them to decide whether they connect with you.
When someone doesn't, he recommends silently reframing the experience:
"Thank you for showing me you're not one of my people. All the best."
That perspective can free your attention for people who understand and appreciate you, rather than keeping you focused on winning over everyone.
20. Let Trusted People In
Staying silent about your feelings may look like strength, but Smithyman says it is often driven by fear of judgment or rejection. He notes that suppressing emotions can affect the body and prevent you from receiving support.
The important distinction is choosing people who have earned your trust. Opening up can help people feel closer, encourage them to share too, and provide support that helps you settle.
"Real strength is letting people in."
21. Reframe Your Life Story
Most of us tell ourselves a story about our lives and may assume it is the only truthful interpretation. Smithyman suggests that the same experiences can be understood in different ways depending on where we place our attention.
For example, are you "behind," or are you exploring a difficult path? Was a setback simply failure, or could it also be an obstacle you're learning to overcome?
"You don't have to force optimism here."
The goal is not to invent a falsely positive story. It's to recognize that how you organize and interpret your experiences shapes how it feels to live them.
Smithyman notes that these 21 insights are part of a longer list of 50, linked in the video description. The video is educational and is not a substitute for individualized clinical care; consult a health care provider for guidance specific to your situation.
Need a summary like this?
Get instant summaries with Harvest