To help relieve anxiety, you've probably heard of CBT – that's Cognitive Behavioural Therapy, which involves changing how you think about stuff in order to benefit your feelings and behaviour.
For instance, if you see an upcoming work presentation as a banana skin and you begin catastrophising about all the ways it could go wrong and ruin your life, your CBT therapist might work with you to form a more realistic and less melodramatic interpretation of the challenge, which ought to lower your anxiety levels.
However, there's now an important new off-shoot of CBT called meta-cognitive therapy.
Where CBT is largely concerned with what you're thinking, meta-cognitive therapy focuses on what you think about what you're thinking (hence the word 'meta' in its name). It's not the thoughts themselves, but how your mind responds to them that's the real focus here.
For instance, when it comes to anxiety, the idea is that by changing what you think about your anxious thoughts, you'll start to feel calmer.
How effective is meta-cognitive therapy?
Although meta-cognitive therapy is far less well-known than CBT, it's already gathered an impressive amount of research support.
For instance, for a paper published in 2021, psychologists in Norway collaborated with Prof Adrian Wells – the British psychologist who developed meta-cognitive therapy – to follow the long-term outcomes of dozens of patients with generalised anxiety disorder who had either participated in traditional CBT or meta-cognitive therapy.
The patients who underwent meta-cognitive therapy had already shown superior improvements compared with those who did CBT, both at the time they finished treatment and two years later.
For the 2021 paper, the researchers caught up with most of the same patients nine years later – and the meta-cognitive group again recovered better from anxiety.
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How to use meta-cognitive therapy to relieve anxiety
Meta-cognitive therapists make a distinction between the positive thoughts you have about your anxiety-related thoughts and the negative thoughts you have about them.
The idea of having positive thoughts about anxious thoughts might sound like an oxymoron. But in fact many people who experience persistent anxiety have 'positive' thoughts about their worries and fears, like "as long as I spend enough time worrying about the work presentation, it will help stop anything really bad from happening" or "my worries about the presentation will help me to prepare for it".
Unfortunately, these kinds of thoughts can trap you in a worry cycle.
If you recognise the 'positive' type of thinking about anxiety, you can take some self-help steps to try to challenge yourself. For instance, you could spend a little time questioning these beliefs you have about worrisome thoughts.
Will time spent fretting about bad outcomes really lower the probability of those bad outcomes happening? Of course not – for instance, worrying about having a car accident or your plane crashing will not keep you safe.
Worrying about your work presentation being a disaster also won't prevent it from being a disaster (only knuckling down to some serious prep will do that).
Starting gently at first, you could even try engaging in some little experiments –seeing what happens if you let yourself stop worrying about upcoming events. Over time you'll hopefully come to see that worrying by itself doesn't protect you.
What about the negative thoughts that people have about their anxious thoughts? These include things like "I can't stop my fearful thoughts"; "I can't stop myself from worrying"; and "my mind won't stop racing –I must be going mad".
If you recognise these thinking about your anxious thoughts, again there are a few basic self-help steps you could try out.
Bear in mind that being scared of your anxious thoughts and trying to shut them down is only likely to make them worse –you're effectively training your mind to be scared of them, which will only make them stickier.
Meta-cognitive therapists would encourage you to try to detach yourself from your worrisome thoughts rather than fighting them.
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Dr Pia Callesen, who is a leading researcher on meta-cognitive therapy, proposes a lovely metaphor – imagine your anxious thoughts as being like trains arriving at a railway station. Rather than climbing on board, simply let them arrive and then move on.
I've given just a flavour of the kind of techniques used in meta-cognitive therapy, but there are many more. Lying beneath them all is an empowering principle, which is that your mind has evolved to deal with difficult emotions. You really just need to get out of its way.
Your mind is trying to actively intervene in your anxious thoughts – thinking you need to have them, or that you need to control or shut them down – so much that you cause yourself unnecessary problems.
You risk trapping yourself in cycles of worry about worry or fear about fear.
So, try if you can to recognise that a degree of worry and trepidation is normal and to not become too distressed by it; allow it to pass and it probably will.
How to use meta-cognition to let go of worries
Another important principle is to recognise that there are things in life that you can control and many others that you cannot.
When anxiety begins to coil itself around you once more, pause to consider whether it is focused on the controllable or the uncontrollable. If it's the latter, acknowledge that you are having the anxious thought or feeling and then let it pass (like the train passing through the station).
If the anxiety is focused on something you can control, try to get out of your head and make some concrete plans that will surely make you feel better.
For a work presentation, this might start with planning a specific time when you will do the background reading that is required. Make a plan to do the prep, and then make sure you follow through.
Of course, self-help can only do so much. And if your anxiety problems are severe, it is important that you consult a mental health professional – if you like the sound of the principles and techniques I've described perhaps someone trained in meta-cognitive therapy might be able to help you.
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