10 Signs You’re Stuck in a Mental Rabbit Hole (And Not Actually Solving Anything)

Overthinking doesn’t usually feel like a problem at first.

Some people call it ruminating. Others call it worrying, overthinking, or being stuck in their head.

Whatever word you use, the experience is often the same.

It feels like responsibility. Like you’re being careful. Like you’re trying to make the right decision.

But many people we work with tell us they know they ruminate too much— but they just don’t know how to stop. Others don’t use that word at all. They say things like:

• “I can’t get this thought out of my head.”
  
  

• “I worry about this constantly.”
  
  

• “I know I’m spiraling, but it feels risky to stop thinking about it.”
  
  

That’s because a mental rabbit hole often looks like problem-solving on the outside—while keeping anxiety going underneath.

Here are some signs that what you’re doing isn’t actually solving anything, even though it feels like it should.

1. You feel mentally exhausted, not clearer

You’ve spent a lot of time thinking about the issue, but instead of feeling resolved, you feel drained, fatigued, or overwhelmed.

Problem-solving usually leads to a sense of direction and an ability to decide and move on. But mental rabbit holes leave you tired from going over it repeatedly. 

2. You can’t fully be present because the thought keeps pulling you back in

Even when you’re doing other things, the thought is always there—running in the background, waiting for your attention.

You might be able to distract yourself briefly, but it never really feels gone.

3. Your body feels tense or on edge while you’re thinking about it

This isn’t the same as having a calm reflection period.

Your nervous system is activated—hypervigilant, alert, scanning for danger or certainty. The urgency in your body matches the urgency in your thoughts.

4. “But what if…” keeps showing up

The details of the thing you are worried about may look different, but the structure stays the same.

There’s always another angle. Another possibility. Another scenario to consider. Anxiety is very good at convincing you that this version of the question is the one that finally matters.

5. You keep revisiting the same information without gaining clarity

This can look like:

• Replaying conversations
  
  

• Reviewing facts you already know
  
  

• Weighing the same options over and over
  
  

• Venting about the same situation
  
  

You’re not learning anything new—you’re just looping.

6. You can’t seem to decide and move forward

Sometimes the problem is genuinely unanswerable. Other times, it is answerable—but committing to a decision feels impossible.

You stay stuck not because you lack options, but because anxiety keeps you spinning instead of choosing.

7. You keep researching or asking for reassurance—and it makes things worse

You might Google, ask friends, replay memories, or even turn to tools like ChatGPT—hoping that this time you’ll finally feel certain.

Instead, you end up with more information… and more uncertainty.

8. Time disappears when you’re thinking about it

Hours go by. Sleep gets disrupted. The thought takes over so completely that it’s hard to focus on anything else.

Mental rabbit holes don’t just take up mental space—they take up time.

9. You know it’s excessive, but you feel unable to stop

You recognize that the thinking isn’t helping. You may even wish you could stop—but the pull to keep analyzing feels stronger than your ability to disengage.

10. You feel worse afterward, not better

This is one of the clearest signs. Instead of relief, you’re left feeling more confused, anxious, frustrated, or even guilty and ashamed for getting pulled in again.

A mental rabbit hole promises relief if you just think a little more—but it never delivers.

Why Mental Rabbit Holes Are So Convincing

Mental rabbit holes feel productive because anxiety frames them as necessary.

Thinking becomes a way to:

• Avoid regret
  
  

• Avoid discomfort
  
  

• Avoid uncertainty
  
  

• Avoid making the “wrong” choice
  
  

In other words, rumination often functions as a protective behavior. It feels safer to stay in your head than to sit with not knowing.

The problem is that anxiety is never satisfied. The more you respond, the more it asks for.

A Gentle Reframe

Here’s the truth, if thinking were the solution, you would have thought your way out of this by now.

A mental rabbit hole feels like you’re doing something—but it usually only leads to more confusion and overwhelm. Anxiety promises relief if you just think a little more. The opposite happens.

Closing Thought

Learning to recognize when you’re stuck in a mental rabbit hole is an important first step—not so you can force yourself to stop thinking, but so you can relate differently to the urge to keep going.

Overthinking and rumination often show up as a promise of relief. Anxiety convinces you that if you just think a little more, things will finally settle. But more thinking rarely brings the relief it promises.

With time, support, and practice, it is possible to change this pattern.

If you want help learning how to work with rumination and worry more effectively, we invite you to schedule a free 15-minute phone consultation with one of our therapists to see if we’re a good fit for you.

After a Rough Flight: When You’re Not Sure You Can Do It Again

You took the flight.

You got where you needed to go.

And instead of feeling relieved or proud, you feel exhausted. Discouraged. Maybe even a little defeated.

A lot of people who are anxious about flying will take a flight but have so much anxiety during it that they don’t know if they can keep doing it.

They might say “that was really hard…too hard.” Or “I don’t know if I can do that again.” or “Why does this feel like such a big deal for me?”

If that’s where you are right now, I see you. And keep reading to learn about how to not let your anxiety get the best of you when flying.

What People Usually Mean by a “Rough” Flight

When someone says they had a rough flight, they’re not always talking about the plane itself.

Sometimes the flight was turbulent.

Sometimes it was smooth.

What made it “rough” was the anxiety.

A rough flight might look like:

• Feeling panicked or on edge the entire time
  
  

• White-knuckling through takeoff, turbulence, or landing
  
  

• Constantly monitoring your body for signs of panic
  
  

• Crying quietly (or not so quietly)
  
  

• Feeling stuck on the tarmac and counting the minutes
  
  

• Never really relaxing for a second
  
  

From the outside, it may not have looked like you were struggling.

But on the inside, it was exhausting.

The Post-Flight Mental Spiral

After a rough flight, it’s very common for your mind to start spiraling.

Maybe you start thinking:

• “That was awful.”
  
  

• “I barely got through that.”
  
  

• “What if next time is even worse?”
  
  

• “I don’t think I can do that again.”
  
  

This is often the moment when anxiety starts telling a bigger story—one that goes beyond this flight and turns into questions about your future, your limits, or what this says about you.

That story can feel convincing, especially when you’re worn down.

Why Flying Again Doesn’t Always Make It Easier

Many people are surprised—and frustrated—to find that their fear of flying hasn’t improved, even though they’ve continued to take flights.

They’ll say things like,

“I’ve flown so many times. I’ve done exposure. And it never got better.”

What they’re usually describing isn’t exposure in a therapeutic sense—it’s endurance.

White-knuckling through flights, bracing for anxiety, monitoring every sensation, and just trying to “get through it” can absolutely prove that you can fly. But it doesn’t teach your nervous system that you can handle it.

In fact, when you endure a flight by staying on high alert the entire time, your body learns something very different:

This was dangerous, and I had to work extremely hard to survive it.

That’s why flying again doesn’t feel easier. You’re not failing at exposure—your nervous system just hasn’t had the chance to learn anything new yet.

Why White-Knuckling Leaves You Feeling Worse, Not Better

When you brace your way through a flight, you may get to your destination—but you also leave the experience feeling depleted.

You might logically know you “did it,” but you also know how miserable it felt.

For many people, that’s the real fear—not the plane itself, but the idea of having to endure hours of intense anxiety again, plus all the anticipatory anxiety leading up to it.

Enduring anxiety doesn’t build confidence.

It builds avoidance.

What a Rough Flight Does Not Mean

A rough flight does not mean:

• You’re back at square one
  
  

• You’ll always feel this way when you fly
  
  

• You’ve failed
  
  

• This anxiety will never change
  
  

It means your nervous system worked very hard—and it didn’t yet have the tools it needed to respond differently.

One difficult experience doesn’t define your future relationship with flying.

Using This Moment Differently

As uncomfortable as this moment is, it’s often an important one.

For many people, a rough flight is the point where they realize:

I don’t want this to keep controlling my life.

I want travel to feel different than this.

I might need more than willpower or white-knuckling.

That realization isn’t a failure. It’s information.

It can be the moment where the question shifts from “how do I force myself to get through this?” to “what do I need so this doesn’t have to feel this way next time?”

Everything about this is workable.

If You’ve Made Progress with Flying Anxiety Before

If flying has felt more manageable in the past and this flight felt especially hard, that doesn’t erase the progress you’ve made.

Flying is a unique fear because most people don’t do it often enough for confidence to build consistently. Old anxiety responses can resurface easily, especially after a stressful experience.

Setbacks happen. They’re part of the process—not proof that things aren’t working.

Closing Thought

If you’ve just had a rough flight and are feeling unsure about the future, this doesn’t mean you’re stuck like this forever.

It means your anxiety is asking for something different—different skills, different support, a different way of responding.

And that is possible.

If you want help learning how to change your relationship with flying anxiety—so future flights don’t have to feel this overwhelming—we invite you to work with us.

We help people learn how to fly with more peace and confidence through various ways, such as individual therapy, on demand courses, and in-person workshops to help you learn how to fly with more peace. 

When Anxiety Pulls You Into Imagined Problems

Anxiety doesn’t always show up as panic or fear. Sometimes, it shows up as thinking.

You’re lying in bed replaying a conversation from earlier in the day. You’re mentally rehearsing how something might go wrong tomorrow. You’re running through scenarios that haven’t happened—but feel urgent, convincing, and hard to ignore.

Worrying can feel confusing. On one hand, you may recognize that you’re spiraling or that your fears don’t fully make sense. On the other hand, it can feel irresponsible—or even risky—not to pay attention to them.

And before you realize it, you’re absorbed in a mental loop that feels almost impossible to step out of.

Anxiety’s Favorite Trick: Turning “What If” Into “Right Now”

One of the most frustrating parts of anxiety and OCD is that it doesn’t always feel irrational.

Often, it feels like you’re doing exactly what you should be doing:

• Preparing
  
  

• Problem-solving
  
  

• Making sure nothing bad happens
  
  

But anxiety has a way of pulling your attention out of the present moment and into imagined scenarios—future threats, past mistakes, or unanswered questions—and convincing you they require immediate action.

These are what we can think of as imagined problems.

Not “imaginary” in the sense of being made up or silly. Anxiety is very good at using logic, evidence, and things that could happen—or have happened before—to keep you stuck in a mental loop.

They’re imagined because they aren’t happening right now—even though your body reacts as if they are.

What Are Imagined Problems?

Imagined problems can show up in a few different ways.

Sometimes they’re future-oriented:

• What if the plane crashes?
  
  

• What if I get sick?
  
  

• What if something goes wrong and I can’t handle it?
  
  

Other times, they feel more present-focused, even though there’s no clear evidence that something is wrong.

For example, you might be driving and suddenly worry that you hit someone with your car. You’re fairly certain you didn’t—but you noticed someone in your peripheral vision, and now doubt takes over. There are no external cues that an accident occurred, yet your mind treats the possibility as serious enough to keep analyzing, replaying, and questioning.

Being absorbed in the imagination can also look like:

• Replaying something you said to figure out what it “meant”
  
  

• Mentally rehearsing how you’ll handle a future situation
  
  

• Analyzing a thought, sensation, or feeling to determine what it says about you
  
  

• Running worst-case scenarios in an attempt to feel prepared
  
  

This doesn’t mean you lack insight or intelligence. It means that once you’re triggered, your mind moves very quickly toward imagined danger—and it can be hard to stay anchored in the world around you.

Why Imagined Problems Feel So Real

Your brain’s number one job is to keep you safe.

So even when you know your worrying is irrational, your brain is still doing what it believes is necessary to protect you.

When your mind detects potential danger, it doesn’t wait to confirm whether the threat is real. It reacts as if it is.

That’s why:

• A thought can cause your heart to race
  
  

• A future scenario can trigger nausea or dread
  
  

• A mental image can feel physically overwhelming
  
  

Your nervous system doesn’t differentiate very well between something happening right now and something vividly imagined.

For example, if you imagine someone dragging their nails across a chalkboard, you may instantly feel goosebumps or discomfort—even though you know it’s not actually happening. Your body still reacts.

That’s how powerful the mind–body connection is.

So when anxiety pulls you into an imagined scenario, your body responds accordingly—and that physical reaction makes the problem feel even more real. This is why telling yourself to “just stop thinking about it” rarely works

How People Get Stuck in Imagined Problems

Most people don’t realize they’ve crossed from reality into imagination because it happens quickly and automatically.

Another concern we often hear from clients is the belief that they don’t have any control over this process. This is something we actively work on in therapy—helping people learn how to relate differently to their thoughts, rather than feeling at the mercy of them.

People tend to stay stuck because ignoring worry feels dangerous. There’s often a fear that if you don’t analyze the thought, prepare enough, or think it through fully, something catastrophic could happen—or you’ll miss an important warning.

From the inside, this doesn’t feel like anxiety. It feels like responsibility.

How to Tell When You’ve Slipped Into an Imagined Problem

To stay grounded in the present moment, you’ll need to practice slowing your thinking down.

The next time you feel pulled into worry, try asking yourself:

• Is this happening right now, or is it hypothetical?
  
  

• Am I responding to something in front of me—or something in my head?
  
  

• Is engaging with this leading to clarity, or more looping?
  
  

• Am I trying to solve uncertainty, or respond to reality?
  
  

These questions won’t automatically shut your thoughts down. Instead, they help you identify when you’ve slipped into your imagination. Once you recognize that, the next step is choosing whether to keep engaging—or to move on.

How to Step Out of the Imagination

Stepping out of imagined problems does not mean:

• Pushing thoughts away
  
  

• Reassuring yourself
  
  

• Proving the thought wrong
  
  

• Trying to feel better immediately
  
  

Instead, it means redirecting your attention.

Some gentle ways to practice this include:

• Naming the process:
  “This is my mind pulling me into an imagined scenario.”
  
  

• Redirecting to what’s required right now:
  What actually needs your attention in this moment?
  
  

• Allowing uncertainty to exist:
  Without answering it, fixing it, or resolving it.
  
  

• Returning to the present without urgency:
  Not because the thought is unimportant—but because it isn’t happening now.
  
  

This is a skill that needs to be practiced—not once, but over and over again. There is no quick off-switch. You will mess up. That’s part of learning something new. Don’t let that be the reason you give up.

What Progress Actually Looks Like

You’re not going to eliminate anxious or triggering thoughts altogether.

The goal is to respond more effectively so you can move on with your life instead of getting pulled into mental loops.

Progress often looks like:

• Noticing the loop sooner
  
  

• Spending less time absorbed in it
  
  

• Redirecting attention more quickly
  
  

• Feeling less pressure to solve every thought
  
  

Closing Thought

Learning to notice when anxiety has pulled you into imagined problems—and practicing coming back to the present—is a powerful skill that can reduce suffering across many forms of anxiety and OCD.

It takes time and consistent effort, but with practice, it does get easier.

And if this pattern feels familiar or overwhelming, working with a therapist trained in evidence-based approaches can help you build these skills in a supportive, structured way over time.

Traveling With Someone Who’s Afraid of Flying? How to Support Them Without Accidentally Making It Worse

Flying with someone who’s anxious about flying can feel like a big responsibility. You want to help. You want them to feel safe. You want the trip to go as smoothly as possible. But it’s not always obvious how to support someone in the middle of fear — and even the most well-intentioned attempts can sometimes make things harder.

If you’re traveling with a partner, friend, or family member who struggles with flight anxiety, then keep reading. My goal is to help you show up in a way that feels supportive, without feeling like you have to tiptoe around their feelings. Supporting someone through fear is deeply meaningful and challenging at the same time. And if you aren’t sure how to do it, then I want you to know that it’s absolutely a skill you can learn.

Why Flying Feels So Intense for Them (A Quick, Helpful Context)

Someone with flying anxiety isn’t just “nervous about flying.” Their brain is reacting as if the flight itself — or the enclosed space, or the lack of control — is a genuine threat. Once that alarm system switches on, their body can quickly move into panic mode.

They may experience:

• a pounding heart
  
  

• shaky hands
  
  

• racing thoughts
  
  

• tunnel vision
  
  

• nausea
  
  

• an overwhelming sense of urgency or dread
  

And the important piece to remember is this: your loved one is doing the best they can. But their nervous system is simply reacting in a heightened way. When you hold this context in mind, it becomes easier to respond from a place of understanding rather than frustration.

5 Common Mistakes People Make — And What To Do Instead

Here are five things that seem helpful on the surface but often backfire — along with what to try instead.

1. Suggesting They “Have a Drink to Relax”

Alcohol might seem like a quick fix, but for anxious flyers it often makes things worse. It can elevate anxiety, cause dehydration, interact poorly with medication, or leave them feeling out of control — which is the exact opposite of what their nervous system needs.

What to do instead:
Ask what tends to help them feel more grounded. Some people prefer light conversation. Others may want distraction, breathing exercises, or quiet. Let them tell you what actually feels supportive.

2. Saying “Calm Down” or “You’re Fine”

If calming down were that easy, they would already be doing it. Telling someone to relax when they’re panicked often leaves them feeling misunderstood or dismissed, even if you had good intentions.

What to do instead:

Offer something specific and doable, like:

• “Do you want to take a couple of breaths together?”
  
  

• “Do you want to squeeze my hand?”
  
  

• “I’m right here. You’re doing great.”
  
  

Supportive actions go much further than trying to talk their anxiety away.

3. Trying to Talk Them Out of Their Fear

Most anxious flyers already know that flying is statistically safe. Their fear isn’t always about safety — it’s about the physical sensations happening inside their body.

Trying to “fix” their thinking (like “flying is safer than driving!”) often leaves them feeling invalidated.

What to do instead:

Stay with simple validation:

• “I can see this is really intense for you.”
  
  

• “I know this is hard, and I’m right here.”
  
  

You don’t need to have all the answers. You just need to stay connected and help them feel supported.

4. Cutting the Timing Too Close

Someone who’s anxious about flying does not need the added stress of rushing through the airport. Running late spikes stress for almost everyone — but for an anxious flyer, it can tip them straight into panic.

What to do instead:
Give yourselves extra time. Arriving early helps keep the pace slow, predictable, and manageable, which is incredibly grounding for someone whose body is already in a heightened state.

5. Not Realizing How Your Behavior Affects Them

When someone is already overwhelmed, their tolerance for small irritations drops quickly. Loud chewing, tapping, rushing, pacing, or even too much talking can feel overwhelming.

This isn’t personal. Their nervous system is simply overloaded.

What to do instead:

Be mindful of your energy and pace. A calm, steady presence can help them regulate their own nervous system. And if they seem more irritable than usual, try not to take it personally — it’s usually about fear, not you.

How You Can Actually Help (What Works Best)

Now that we’ve covered what not to do, here are some things that genuinely make a difference.

1. Ask What They Need Ahead of Time

A simple, “What helps you the most during takeoff?” opens the door for understanding how you can best support them. They may want silence, reassurance, distraction, or something very specific. Asking ahead of time prevents guessing in the moment, which can be stressful for both of you.

2. Allow Extra Time

Let them set the pace. An anxious flyer who feels rushed will almost always spiral faster. Moving slowly and intentionally through the airport helps them stay more grounded.

3. Stay Grounded Yourself

You don’t need to have special training to be supportive. Your ability to mirror a calm demeanor is enough. If you stay calm, they’re more likely to feel calmer, too.

4. Keep Reassurance Simple

Short, steady reassurance is far more effective than trying to explain why everything is fine:

• “You’re okay.”
  
  

• “I’m here.”
  
  

• “You’re doing really well.”
  
  

These kinds of statements land better than long explanations or attempts to rationalize fear away.

5. Celebrate Small Wins

Small wins are a big deal for an anxious flyer. They might not be great at giving themselves credit for getting through challenging moments, so be that voice for them that is cheering them on. Even if they struggled with anxiety throughout the entire flight, it’s still a win that they chose to fly anyway and did something that’s hard for them.

Sharing positive comments like this well show them support and build their confidence for future flights.

A Note for You, Too

It’s completely okay if this feels hard for you at times. Supporting someone with flight anxiety takes patience, emotional energy, and flexibility. You may feel unsure, drained, or even anxious yourself — and none of that means you’re doing anything wrong.

You’re helping someone you care about do something incredibly brave. Your support and presence matters more than you realize.

If Your Loved One Is Ready for More Help

If the person you’re traveling with wants more structured support, we offer a variety of resources, including:

• In-person workshops
  
  

• Online courses
  
  

• Individual services for flight anxiety
  
  

You can learn more about our services for fearful flyers here

Whether you’re supporting someone you love or preparing for a trip together, you don’t have to guess your way through it. There are tools, strategies, and support available to make flying feel more manageable — for both of you.

Why Anxiety and OCD Often Spike Before Your Period — And What You Can Do About It

Many of the women I talk with in my practice describe something similar each month. As their period approaches, their anxiety or OCD symptoms feel different — thoughts get stickier, emotions feel more intense, and even small stressors are harder to handle than usual. For women who already live with anxiety or OCD, this isn’t just the usual premenstrual discomfort; it’s a noticeable spike in anxiety that reliably shows up right before their period.

If you’ve experienced this, it can be unsettling. You might find yourself wondering why your symptoms suddenly feel so intense or why you’re reacting so differently to things that typically feel manageable. But this pattern is extremely common, and there are real biological and psychological reasons behind it.

This blog will walk you through why this spike happens, how to identify your own pattern, and what tools can help you move through this part of your cycle with more understanding and support.

What’s Happening in the Body During the Premenstrual Phase

During the second half of your menstrual cycle (the luteal phase), your body goes through a series of hormonal changes as it prepares for your next period. Estrogen and progesterone rise and fall, and for some women, those shifts have a noticeable impact on:

• mood
  
  

• emotional sensitivity
  
  

• sleep
  
  

• energy levels
  
  

• anxiety
  
  

• intrusive thoughts
  

These hormonal fluctuations also influence neurotransmitters, including serotonin — a key player in mood and anxiety regulation. If you already experience anxiety or OCD, your system may be more sensitive to these changes, which can temporarily intensify symptoms.

PMS vs. When Symptoms Feel More Intense

Most women are familiar with PMS (Premenstrual Syndrome) — a cluster of physical and emotional symptoms that happen in the days before a period and typically improve soon after bleeding begins.

Some women, however, experience symptoms that feel more significant. A smaller percentage experience PMDD (Premenstrual Dysphoric Disorder) — which is a more intense form of premenstrual mood disruption that can include marked irritability, mood swings, sadness, anxiety, or feeling overwhelmed, often with noticeable impact on daily functioning.

You don’t need to diagnose yourself, and this blog isn’t meant to help anyone do that. But having a general understanding of the spectrum can make it easier to recognize when symptoms feel beyond what’s typical for you — and when it might help to talk with a medical provider.

Why Anxiety and OCD Tend to Feel Worse During This Week

At our practice, we hear a very similar story from many women. A few days before their period:

• intrusive thoughts feel more frequent or intense
  
  

• anxiety spikes more quickly
  
  

• urges to check or mentally review feel stronger
  
  

• emotions feel closer to the surface
  
  

• stress tolerance is lower
  
  

• physical sensations (like tension or restlessness) feel amplified
  
  

Then, within a day or so of bleeding starting, they describe feeling more like themselves again.

Noticing this pattern can be incredibly helpful. Instead of assuming the worst or that your progress suddenly disappeared, you can recognize, “My mind and body are more sensitive right now…and this phase will pass.”

How to Support Yourself During This Part of Your Cycle

Once you understand why this spike happens, the next step is figuring out how to work with your body and mind during this phase. Here are a few ways to make this week feel more manageable.

Step One: Track Your Cycle and Your Symptoms

To help you make sense of the premenstrual spike, it helps to actually see the pattern. It helps to track your cycle and symptoms for at least two full menstrual cycles. 

It doesn’t have to be complicated — you’re simply paying attention to when your period starts, and then noting the days where anxiety, intrusive thoughts, or emotional sensitivity feel stronger. It’s also important to track other things like sleep changes or irritability, just to get a fuller picture.

There are several apps that make this really easy, such as Clue or Flo. But if you prefer pen and paper, you can use this printable cycle tracker if that feels more your style.

What matters most is giving yourself a way to notice the pattern. 

Tracking helps you see what’s actually happening instead of guessing, and it makes it easier to understand why certain days feel harder. 

It also allows you to anticipate the part of the month when you may need a little more support — and it gives you helpful information to bring to your doctor or therapist if you choose.

Step Two: Build a Plan for Your High-Sensitivity Week

Once you notice the pattern, you can build a supportive plan for that stretch of the month that feels reasonable. 

1. Adjust Demands Gently

You might find it helpful to:

• simplify non-essential tasks
  
  

• protect your sleep
  
  

• plan ahead for easy meals
  
  

This doesn’t mean you need to “lower the bar” for yourself but just give extra grace for a week when you may be struggling more than usual. 

2. Use Cognitive Tools Intentionally

During this phase, your brain may interpret things in a more catastrophic way. A few helpful strategies:

• Name what’s happening: “This is the part of my cycle where my symptoms usually flare.”
  
  

• Create some distance from thoughts: “I’m noticing my mind jumping to worst-case scenarios.”
  
  

• Remind yourself of the temporary nature of the spike: “This feels strong right now, and it will pass.”
  
  

You’re not trying to eliminate negative thoughts. You’re simply acknowledging them and making space for them to be there.

3. Emotion Regulation Tools

This is where small, simple practices make a big impact:

• Mindfulness: For a few minutes per day, practice mindfulness. If you do not regularly engage in mindfulness, it can be useful to use an app (like Headspace or Calm) to guide you through the process.
  
  

• Grounding practices: Feel your feet on the floor, name 3 objects in the room that you can see, take a steady breath.
  
  

• Self-validation: “My system is more sensitive right now — that makes sense.”
  
  

• Distress tolerance skills: such as intense exercise to release built up emotions or use sour or spicy candy to notice other intense sensations.

4. Movement and Routine

Movement helps regulate your mood and this is an especially important week to make it a priority — even in small ways:

• a short walk
  
  

• light yoga
  
  

• gentle cardio
  
  

5. If You’re Doing ERP

If you’re currently doing exposure-based work for anxiety or OCD, you might notice that exposures feel harder during this week. It can be helpful to:

• adjust to lighter exposures
  
  

• keep the structure without overwhelming your system
  
  

• talk with your therapist about pacing
  
  

Don’t just stop exposures all together. Consistency matters more than intensity.

Step Three: When to Talk With a Medical Provider

If your symptoms feel severe, disruptive, or consistently difficult during this phase of your cycle, it may be worth talking with a medical provider. You don’t have to navigate the medical side of this alone.

Here are a few options you can ask about:

1. SSRIs

SSRIs are commonly used as first-line treatment for more severe PMS or PMDD symptoms. Even if you’re already on an SSRI, some providers consider:

• adjusting the dose during the luteal phase, or
  
  

• using a “luteal-only” dosing schedule
  
  

This is always something to discuss directly with your doctor, psychiatrist, or OB/GYN.

2. Calcium Supplementation

Some research shows that calcium supplements may help reduce PMS-related mood symptoms. This is another conversation to have with your provider.

3. Hormonal Options

For some women, hormonal birth control can help stabilize fluctuations across the month. Your medical provider can help you determine whether this might be appropriate.

This Spike Doesn’t Mean Something Is Wrong With You

Premenstrual anxiety or OCD spikes can feel discouraging — but they are also predictable, explainable, and manageable with the right support.

Noticing your pattern helps you respond with clarity instead of panic. With awareness, tools, and medical support when appropriate, this week of the month becomes something you can prepare for rather than something that blindsides you.

Ready for Support?

If you’re noticing a pattern of heightened anxiety or OCD before your period, you don’t have to sort through it on your own. 

Our therapists at State of Mind Therapy in Bloomington can help you understand what’s happening in your cycle and figure out the next steps that make sense for you.

👉 Schedule your free 15-minute phone consultation to get started.

5 Questions to Ask Yourself as You Head Into a New Year With Anxiety or OCD

As the year winds down, many people living with anxiety or OCD feel a familiar pressure: “I should have made more progress by now.” Or, “Next year has to be different.”

But growth with anxiety and OCD doesn’t follow a neat, linear path. It’s often slow, subtle, and easy to overlook—especially when your brain is wired to pay more attention to the negatives.

That’s why taking time to pause, reflect, and actually notice what shifted this year matters. Not from a place of perfection or comparison, but from curiosity. From honesty. From a desire to understand yourself a little more clearly as you head into a new year.

Below are five questions we love asking clients this time of year. Think of them as an opportunity to reflect and recognize your progress and set intentional direction for what’s next.

1. What did I handle this year that would have felt impossible a year ago?

People often underestimate themselves because they’re comparing where they want to be—not where they started.

Maybe you took a flight, even if your anxiety was through the roof as you boarded the plane.
Maybe you ate at a restaurant despite the emetophobia monster whispering all kinds of worst-case scenarios in your head.
Maybe you went to work, made a phone call, or attended a family event even with intrusive thoughts swirling.

These might not feel “big enough,” but they’re often the exact moments where real change begins: doing something your anxiety insisted you couldn’t.

Ask yourself:
“What did I do this year that younger-me simply wasn’t ready for?”

You might surprise yourself with the answer.

2. How did I handle setbacks differently this year?

Setbacks are not evidence that you’re failing. They’re evidence that you’re human.

And one of the strongest markers of progress is not whether you had setbacks—it’s how you responded to them.

Maybe you bounced back faster.
Maybe you didn’t spiral as long.
Maybe you didn’t shame yourself as harshly.
Maybe you reached out for support instead of hiding.
Maybe you resumed an exposure after taking a break instead of quitting entirely.

These shifts are subtle but powerful.
They show resilience.
They show learning.
They show growth.

Ask yourself:
“Did I respond differently this year, even in small ways?”

3. What actually supported me this year (and what didn’t)?

Anxiety and OCD recovery involves a lot of trial and error. Some strategies help. Others… not so much.

Instead of guessing again next year, look at what you already learned:

• What coping skills actually grounded you?
  
  

• Which routines lowered your baseline stress?
  
  

• What habits made things harder?
  
  

• Who in your life energized you—and who drained you?
  
  

• Did scrolling, Googling, or reassurance-seeking pull you deeper into anxiety?
  
  

• Did therapy, exercise, mindfulness, or exposure work support you more than you realized?
  
  

This isn’t about criticizing yourself. It’s about gathering data so you can move into the new year with feeling proud of where you’ve come and getting clarity on what you want to work on the upcoming year.

Ask yourself:
“What helped me feel more like myself—and what made things made me feel worse?”

4. What do I want my relationship with anxiety or OCD to look like next year?

Notice the wording here. It’s not “How do I get rid of anxiety?” or “How do I stop having intrusive thoughts?”
Those aren’t goals—they’re unrealistic demands that set you up for frustration.

A better question is:

“How do I want to relate to anxiety when it shows up?”

Maybe next year you want to:

• allow anxiety to be present without immediately responding
  
  

• delay or reduce compulsions instead of doing them automatically
  
  

• move toward things that matter even when the noise in your head is loud
  
  

• practice accepting uncertainty a little more often
  
  

• build the muscle of willingness, not perfection
  
  

Think about what you want your internal world to feel like—not just what you want to eliminate.

5. What’s one small, doable step I want to take in the new year?

Not five steps. Not a full plan. Just one step.

Growth happens by stacking small actions, not by trying to overhaul everything at once.

Your next step might be:

• scheduling a therapy consult
  
  

• joining a group
  
  

• practicing one exposure a week
  
  

• setting a limit on reassurance-seeking
  
  

• building a simple mindfulness routine
  
  

• reducing avoidance in one specific area
  
  

• tracking your wins so you can actually see them
  
  

Choose a step that feels meaningful—but realistic. A step that nudges you forward without overwhelming you. A step your future self would look back on and say, “That made a difference.”

Looking Back, Then Looking Ahead

Reflection doesn’t erase the challenges of the year, and it doesn’t magically make anxiety disappear. But it can help you reclaim the narrative. It can help you see the small, steady ways you’re growing—even in moments that didn’t feel like growth at all.

Your progress counts.
Your effort counts.
Your resilience counts.

And the new year isn’t a pressure point.
It’s simply an invitation to move one step closer to the life you want—at your own pace.

If You’re Ready for Support in the New Year

If you’re ready to make 2026 a year of more peace, courage, and clarity, we’re here to help. Our therapists specialize in anxiety and OCD and offer:

• cognitive behavioral therapy (CBT)
  
  

• exposure and response prevention (ERP)
  
  

• acceptance and commitment therapy (ACT)
  
  

• support for emetophobia, intrusive thoughts, fear of flying, and general anxiety (just to name a few)
  
  

You can get started with a free 15-minute phone consultation and explore whether therapy is the next step for you.

You don’t have to navigate 2026 overwhelmed or feeling alone. We’d love to support you as you take your next small, meaningful step.

Emetophobia and the Holidays: How to Move Through the Season Without Letting Fear Take Over

Many of the people we talk with in our sessions feel a mix of excitement and dread as the holidays approach. You want to enjoy the season. You want to make memories, show up for your kids, and be part of the joy. But if you live with emetophobia, this time of year brings a kind of pressure that other people don’t see.

For many, winter means sickness season.

It means more gatherings, more travel, shared meals, kids touching everything, and family members who don’t think twice about hygiene in the kitchen. It means your mind jumping ahead to every “what if.” And even if nothing is happening yet, it can feel like your anxiety is already two steps ahead of you.

So if your fear spikes this time of year (even if you feel like you’re spiraling at times) the holidays can still be meaningful. This season doesn’t have to be defined by anxiety, even when anxiety is loud.

What This Season Often Looks Like When You Have Emetophobia

You might notice your shoulders tense before you even arrive at a gathering. Maybe it’s the worry that someone’s kids were just sick, or the way your in-laws let little ones help cook without washing their hands. 

Maybe it’s the fear that you’ll all get sick before the event and have to miss it — or that you’ll catch something while you’re there. 

And once you’re home, your mind might keep spinning, wondering what germs were passed around and how long it will be before the next wave hits.

For some people with emetophobia, the fear becomes so consuming that the safest choice feels like not participating at all.

Some haven’t traveled home in years.
Some avoid gatherings they actually want to attend.
Some feel like their worry overshadows the joy their kids deserve.

And if you’ve ever gotten sick during the holidays or watched it happen to others, your brain stores that. It builds associations that sound like “this happened before, so it might happen again.” 

That’s not a failure on your part. That’s how a fearful brain tries to prepare you: by imagining every worst-case scenario in advance.

But preparation and fear are not the same thing.
And fear doesn’t get to decide what this season means to you.

Something You May Need to Hear Right Now

You’ve gotten through so many winters already…including the hard ones.

Yes, maybe there was a year when your family was sick.
Maybe there was a trip that got derailed, or a holiday that felt stressful from start to finish.
But even then, you still made it through. You handled it. You adapted. You recovered.

Your fear will never give you credit for that — but you can.

It’s not about getting rid of fear altogether. It’s about reminding yourself that you’re capable, resourceful, and stronger than this fear wants you to believe.

You’ve proved that more times than you realize.

This Season Can Be an Opportunity — Even If It Doesn’t Feel Like One

Every holiday event you say yes to, every moment you show up for, every time you choose connection over avoidance — those are opportunities for exposure. 

And with every exposure opportunity, you have a choice. You can choose to face it with a “bring it on” attitude or you can white knuckle your way through it. 

But only one of those will actually move the needle in your recovery. 

Instead of viewing this season as something you have to “survive,” you can choose to see it as:

• an opportunity to be the parent or partner you want to be
  
  

• a chance to reconnect with the parts of life you’ve missed
  
  

• moments where you remind yourself you can tolerate discomfort
  
  

• a step toward the life you want, not the life fear dictates
  
  

You don’t have to love every moment. You just need to keep moving toward the ones that matter.

Grounding Reminders for When Anxiety Gets Loud

1. No amount of worry will change the outcome.

You can think about every possible scenario and it still won’t give you more control.
If something happens, you will handle it then — the same way you have handled difficult moments before.

2. Set boundaries with reassurance-seeking.

This means not asking people for details about their recent illnesses, their symptoms, or their kids’ timelines. When someone casually mentions that their child “was sick last week,” you don’t need to ask follow-up questions. More information doesn’t create more comfort — it usually creates more anxiety.

3. Choose intentional exposures that align with your values.

Not overwhelming ones — just deliberate steps like:

• staying at an event a little longer than you planned
  
  

• eating food someone else prepared
  
  

• letting your kids participate without constant correction
  
  

• choosing not to clean or sanitize something immediately
  
  

These moments add up and build confidence. 

4. Stay connected to why you care.

Fear tries to make everything about risk.
But this time of year is also about joy, connection, family, tradition, and meaning. So try to remember that you’re moving toward something — not just away from fear.

5. Progress doesn’t mean the fear disappears.

Fear may still show up. Background anxiety may still buzz. That doesn’t mean you aren’t growing. The goal is to turn down the volume, not eliminate it entirely. You can feel afraid and still move forward.

If You Tend to Avoid This Time of Year

Avoidance is your nervous system’s way of protecting you — it’s trying to keep you safe in the only way it knows how. 

But avoidance also has a cost. 

It limits your life. It keeps you from the moments you actually want. It shrinks your world.

This season might be an opportunity to take one step — even a small one — back into the things you value.
You don’t need to overhaul your entire holiday.
You just need to take the next meaningful step.

You can do that.
You’ve done harder things.

You Get to Choose What This Season Means for You

Fear will always suggest the safest option is to shut down, stay home, or prepare for the worst. But you get to decide whether that’s the only story you want to live by.

You can feel afraid and still show up.
You can participate in moments that matter to you.
You can have a holiday season that isn’t ruled by worst-case scenarios.

And each time you take a step toward the life you want, fear loses just a little bit of its power.

Want Support This Season for Emetophobia?

If emetophobia makes winter and the holidays overwhelming, support is available. At State of Mind Therapy in Bloomington, we help people understand their fear, build confidence, and take meaningful steps toward the lives they want to live.

You can start with a free 15-minute phone consultation.

We also offer an Emetophobia Therapy Group for adult women, which has been especially helpful during this season.

Support Group for Women Living with Emetophobia​
​

Share your email and you’ll be taken to the group inquiry form.

Continue to Inquiry Form →

Should I Cancel My Flight? How to Move Through Panic When Every Part of You Wants to Back Out

If you’ve ever sat in the airport parking lot with your heart pounding and your mind begging you to turn around, you’re not the only one who’s been there.

And if you’ve ever wondered, “Should I just cancel?” — that moment is one of the hardest parts of flight anxiety.

A lot of people describe that moment in different ways, but the theme is always the same:
not being able to walk through the airport doors, freezing at the gate, or getting right up to boarding and feeling like your body is shutting down.

By the time you reach the airport, you’ve often spent days or even weeks thinking about the flight, imagining everything that could go wrong, and trying to brace yourself for it. So when you’re standing in front of the place where it all becomes real, your fear response kicks into high gear.

In that moment, the thought “Should I cancel?” feels urgent, reasonable, and protective.

But that urge is not a sign… it’s fear doing exactly what fear does.

My goal in this blog is to help you understand why this moment feels so overwhelming and show you how to move forward even when every alarm in your body is going off.

Why Your Brain Pushes You to Cancel at the Last Minute

When something feels threatening — being trapped, losing control, having a panic attack in public, not being able to escape — the nervous system flips into protection mode.

Your heart races.
Your muscles tense.
Your mind starts scanning for exits.
Your body tries to get you out of what it believes is danger.

This is your fear response doing its job…but a little too intensely.

And because these sensations feel so big, it’s easy to interpret them as a warning:

• “If I feel this panicked now, imagine how bad it’ll be on the plane.”
  
  

• “I can’t handle this for hours.”
  
  

• “This panic won’t stop unless I leave.”
  
  

These thoughts feel like truth, but they’re not danger signals…they’re fear signals.

And fear tends to be a very dramatic storyteller.

The Fear That Stops People: “If I get on the plane, this panic won’t stop.”

This is the belief that convinces most people to back out.

I’ve worked with many people who have made it all the way to the jet bridge, felt that surge of panic, and turned around at the last second. It’s such a painful moment for them…the panic response is one thing. But the shame and remorse that follows hurts just as much.

The fear says:

“If I stay, this panic is just going to keep rising until something terrible happens.”

But here’s the part your nervous system forgets:

Panic always peaks.
And panic always comes down.

Your body cannot stay at that level forever. It physically can’t.
It feels endless — but it’s temporary.

What actually prolongs the fear is escaping from it.

Every time you get out of the line, off the plane, or away from the airport, your brain learns:
“That was the right call. That really was dangerous.”

Which only makes the next attempt feel harder.

Why Anticipatory Anxiety Makes Everything Feel Impossible

One big reason this moment feels so intense is because your brain assumes that how you feel right now is exactly how you’ll feel the whole flight.

But anxious brains are terrible at predicting the future.

You might think:

• “If I’m shaking now, I’ll lose it at 30,000 feet.”
  
  

• “If I feel trapped here, I’ll feel ten times worse in the air.”
  
  

• “If panic is rising, that means I can’t handle being up there.”
  
  

But none of that is based on what actually happens. It’s based on a feeling.

And most fearful flyers actually feel more anxious before the flight than during it.

Once the anticipation drops and the plane settles into the routine of the flight, the nervous system usually quiets down.

You won’t know what the flight feels like until you’re on it — and anticipation is rarely an accurate predictor.

Play the Tape Forward (This Is One of the Most Helpful Tools You Can Use)

When panic hits, your brain zooms in on this moment only — the sweating, the shaking, the dread.

But decisions made in panic rarely take you where you want to go.

This is where “playing the tape forward” becomes powerful.

So ask yourself this, if you fly, how will you feel later when you land?

Most people say they feel proud, relieved, lighter, more capable, more free.

Now ask yourself, if you cancel, how will you feel on the drive home and the days following?

Most people would say they would feel ashamed, regret, frustration, disappointment, feeling stuck, wishing they had tried harder.

Something I often tell clients is:

“If you’re going to feel miserable either way, you might as well feel miserable on the plane — and still get where you want to go.”

The discomfort of anticipation is temporary.

The regret of canceling lasts much longer.

“How Do I Actually Move Forward When I Feel Frozen?”

When fear spikes, your brain focuses on the future and how long and terrible the flying experience will be.
”I’ll be in the plane for hours!”….”the plane will be bumpy”….”I will be stuck in the plane for hours with no option to leave!”

That’s overwhelming.

Instead, come back to one simple question: “what is the next best step I can take?”

Not the whole flight.
Not the whole experience.
Just the next thing.

…Right now, the next best step is packing my bag.

…Right now, the next best step is getting in the car.

…Right now, the next best step is walking into the airport.

…Right now, the next best step is sitting at the gate.

…you get the idea.

Fear loses power when you focus on the next best thing.

You don’t need to be calm. You just need to keep moving.

Reclaiming Your Agency: This Is a Choice You’re Making

When you’re afraid of flying, it can make you feel powerless. Like you have no choice and are just stuck (and for hours).

But you’re not.

You bought the ticket.
You chose the trip.
You want what’s waiting for you on the other side.

So when your mind says, “You can’t do this,” remind yourself:

“I chose this. I want this. I’m doing this for me.”

You Don’t Need Certainty to Board the Plane

One of the biggest myths anxious flyers believe is:

“I have to feel ready before I can fly.”

But readiness rarely comes first.
Willingness comes first.
Confidence comes second.

You don’t need certainty.
You don’t need to erase fear.
You don’t need to predict how the flight will go.

You only need enough willingness to take the next step. And you’ve done things while afraid your whole life.

Imagine the Moment You Step Off the Plane

You’re tired.
You’re relieved.
You’re proud.
Your world just got bigger.

This version of you already exists — your fear just tries to hide them.

And that version of you is absolutely capable of this.

Take one small step toward that version of you today.

If You Want Support Before Your Flight

Our Fearful Flyers Blueprint gives you step-by-step tools to handle:

• anticipatory anxiety
  
  

• panic on the plane
  
  

• fear of being trapped
  
  

• fear of losing control
  
  

• fear of physical sensations
  
  

It’s the support I wish every anxious flyer had before their next trip.

👉 Enroll in the Fearful Flyers Blueprint
(Get the tools, strategies, and confidence you need for your next flight.)

How to Stop Reinforcing Emetophobia: 7 Practical Ways to Reduce Safety Behaviors

When you live with emetophobia—the intense fear of vomiting—it’s easy to fall into habits that feel protective. You might wash your hands more often than necessary, avoid certain foods, keep separate towels, or constantly scan your surroundings for signs that someone might be sick. These habits, called safety behaviors, can make you feel more in control in the moment.

But here’s the hard truth: the more we rely on safety behaviors, the more power anxiety holds over our lives.

The good news is that you don’t have to give them all up at once. Small, intentional changes can help you begin to break the cycle of anxiety and reclaim a sense of freedom and flexibility again.

What Are Safety Behaviors?

Safety behaviors are anything we do to try to prevent or escape a feared situation—or to quickly bring our anxiety down.

They can be physical (like washing or checking), mental (like reassuring yourself or replaying events), or situational (like avoiding certain places or people).

For emetophobia, safety behaviors might look like:

• Overwashing your hands or cleaning surfaces after being around others.
  
  

• Using separate towels, cups, or utensils “just in case.”
  
  

• Avoiding restaurants, social events, or travel.
  
  

• Scanning loved ones for signs of nausea or illness.
  
  

• Keeping medication nearby “for emergencies.”
  
  

• Asking for reassurance (“Do you think I’ll get sick?”).
  
  

Each of these behaviors can provide some relief and make you feel “better.”. You feel safer—temporarily. But that relief is exactly what keeps anxiety reinforced. The brain learns: I survived because I did the ritual, not because the situation was actually safe or manageable on its own.

Over time, the list of “things I need to do to feel safe” gets longer. And your world gets smaller.

Why Reducing Safety Behaviors Helps (Even if It’s Uncomfortable)

It’s not about getting rid of anxiety completely. It’s about learning that you can handle it without relying on rituals or avoidance.

When we start reducing safety behaviors, our brain gets new evidence:

“I felt anxious and nothing terrible happened.”

“I didn’t wash my hands right away, and I was okay.”

“I shared a bite of food, and I could handle the discomfort.”

That’s the process that rewires fear—through exposure, not avoidance. The goal isn’t to stop washing your hands forever or to ignore hygiene altogether. It’s to make those actions a choice rather than a requirement.

Step 1: Identify Your Personal Safety Behaviors

Start with awareness. Make a quick list of your go-to “just in case” habits. Try grouping them by theme:

• Checking: scanning others for signs of sickness, taking your own temperature, monitoring how your body feels.
  
  

• Cleaning: washing hands, changing towels, sanitizing, avoiding “contaminated” items.
  
  

• Reassurance: asking loved ones, “Do you think I’ll get sick?” or Googling symptoms.
  
  

• Avoidance: skipping events, avoiding certain foods, or delaying travel.
  

Then, for each one, ask yourself two questions:

1. What am I afraid will happen if I don’t do this?
   
   

2. What do I feel immediately after doing it?
   
   

If skipping it brings anxiety—and doing it brings quick relief—it’s probably a safety behavior.

Step 2: Choose One Small Target

You don’t need to tackle everything at once. Pick just one safety behavior to focus on. Maybe it’s:

• Using the shared hand towel instead of your own.
  
  

• Sharing a drink with your child.
  
  

• Not seeking answers to your worry questions.
  
  

• Waiting a few minutes before washing your hands.
  
  

Start with something you can imagine doing, even if it feels uncomfortable. The goal is progress, not perfection.

Step 3: Use the “Delay Technique”

When the urge to do a safety behavior hits, try delaying it—just a little.

Set a timer for 1–2 minutes and tell yourself:

“This is an urge, not an emergency.”

“I can feel uncomfortable for a few minutes.”

During the delay, resist the urge to seek relief. Maybe take a few slow breaths, focus on what’s around you, or remind yourself of your bigger goal—to live more freely.

Often, you’ll notice that the urge passes or weakens. Over time, you can increase the delay to five or ten minutes. The more you practice, the less automatic the behavior becomes.

Step 4: “Do It Anyway” (Micro-Exposures That Build Confidence)

Sometimes, the best way to shrink fear is simply to do the thing anxiety tells you to avoid.

If you always pour out a drink your child touched—try taking a sip.

If you usually wash your hands the moment something feels “off,” wait one minute before doing so.

If you avoid eating leftovers or certain foods, plan a small experiment: eat a few bites and notice what happens afterward.

These small moments of courage teach your brain a new lesson: discomfort isn’t danger.

Each time you “do it anyway,” you’re building your capacity to handle the unknown—without needing to feel 100% calm first.

Step 5: Challenge Your Thinking

When it comes to fears around getting sick, it’s easy to rationalize certain behaviors because “other people do them” or “it’s just good hygiene.”

But you have to remember, that even if it’s “rationale” in some ways or to other people, you are still dealing with a phobia that thrives off of “feeling better.” So you need to challenge your rationalizes and be honest with yourself about what is truly “normal” and what is a safety behavior.

Try asking yourself: 

• “If I change this routine, what real consequence would happen?”
  
  

• “Is this about germs—or about anxiety?”
  
  

• “Would I tell a friend this was necessary?”
  

Sometimes it helps to literally respond to your anxiety out loud:

“Nice try, brain. I don’t need to check that again.”

“We’re learning something new here. I’m okay to feel uncertain.”

The tone matters—gentle but firm. A little sass can break the fear loop and bring your rational mind back online.

Step 6: Differentiate Comfort from Safety

Comfort isn’t the enemy. In fact, some grounding or soothing can help you stay with discomfort long enough to learn from it.

Healthy comfort might look like:

• Holding a fidget object, hair tie, or small stone.
  
  

• Taking slow breaths.
  
  

• Listening to calming music.
  

What we want to watch for are comforts that turn into avoidance tools. If you feel like you “need” a certain object, temperature, or action to be okay—or if skipping it would spike your anxiety—that’s a sign it’s acting as a safety behavior.

The goal is to keep what helps you stay present, not what helps you escape.

Step 7: Expect Setbacks—and Keep Going

Letting go of safety behaviors takes time. You’ll have moments where you slip back into old patterns. That’s normal.

Each small step still matters. Every time you delay a ritual, tolerate discomfort, or choose flexibility over control, you’re teaching your brain something powerful:

“I can handle uncertainty.”

That’s the foundation of real progress with emetophobia—not total calm or control, but confidence in your ability to cope.

What Progress Really Looks Like

You might notice:

• You wash less often or with less urgency.
  
  

• You catch yourself mid-check and stop.
  
  

• You share food or eat something new and handle the anxiety.
  
  

• You think about sickness less often—or recover faster when the thought pops up.
  
  

These are all signs that your fear is losing power and your flexibility is growing.

Progress isn’t about never feeling anxious. It’s about no longer letting anxiety run the show.

Ready for Support?

If you’re ready to stop letting emetophobia control your choices, our therapists can help.

We use evidence-based approaches like CBT, ERP, and ACT to guide you through reducing safety behaviors and facing anxiety with more confidence.

👉 Schedule your free 15-minute consultation to get started.
You don’t have to face this alone—and you don’t have to wait until you feel ready. The first small step counts.

Support Group for Women Living with Emetophobia​
​

Share your email and you’ll be taken to the group inquiry form.

Continue to Inquiry Form →

Should You Bring “Just-in-Case” Medication When You Fly? What Most Anxious Flyers Don’t Realize

For many anxious flyers, the question isn’t just “Should I take medication before I fly?”

It’s:
“Should I at least bring medication… just in case?”

If that’s you, you’re not alone. I talk to so many people who pack an emergency pill in their bag (even if they never plan to take it) because the idea of not having it feels unbearable.

Before we go further, one important note:

This isn’t medical advice. Always talk to your prescriber about what’s right for you, especially because “anxiety medication” can mean very different things. Daily medications like SSRIs (Zoloft, Prozac, Lexapro) serve a totally different purpose than fast-acting benzodiazepines (Xanax, Klonopin, Ativan).

What I’m talking about here is specifically the quick-acting, “take-it-on-the-plane” type.

And with that said… let’s talk about the hidden role “just-in-case” meds tend to play in the fear-of-flying cycle.

The Three Groups I Usually See When It Comes to Flight Anxiety + Medication

Over the years, I’ve noticed people generally fall into one of these categories:

1. Medication works well for them.

Great! They feel calmer, it does what it's supposed to do, and it aligns with their goals.

2. Medication doesn’t help much.

They take it… and still feel anxious, panicky, or shaky.
Some even feel sedated but still terrified inside.

3. They don’t take it—but feel like they must bring it.

This is the “just-in-case” group.
The pill never leaves the bottle… but the idea of flying without having access to it feels terrifying.

This last group is where I see the biggest unexpected pitfalls—and it’s usually the part of the anxiety cycle people haven’t been taught to recognize.

Why “Just-in-Case” Medication Feels Necessary

People who bring medication just in case typically fear:

• “If I panic and don’t have it, I won’t be able to handle it.”
  
  

• “I might completely lose control.”
  
  

• “I’ll have a meltdown in front of everyone.”
  
  

• “What if something happens and I have nothing to calm me down?”
  
  

It’s not the medication itself—they’re afraid of their own internal experience.

And that fear becomes the real issue.

The Hidden Problem with Safety Behaviors

Here’s the tricky part:

Even if you never take the medication, bringing it “just in case” sends your brain a powerful message:

“Flying is scary and I can’t handle it.”

This reinforces the fear loop:

1. You feel anxious.
   
   

2. You reach for a safety behavior (medication, alcohol, rituals, checking, etc.).
   
   

3. Your brain concludes: “Good thing we did that, otherwise something bad would have happened.”
   
   

4. Anxiety strengthens.
   
   

Safety behaviors, even small ones, feed the belief that you’re incapable of coping.

And if you are wanting to work on changing your fear of flying, we have to start by breaking that cycle.

A Quick Story From My Practice

I worked with a woman who had relied on medication for every single flight.

The problem was that even with the medication, she was still anxious. It wasn’t actually helping. But the idea of flying without it felt unimaginable.

Through our work together, she practiced flying without taking the medication—and eventually felt ready to get on a plane without even bringing it.

After her most recent trip, she messaged me:

“You helped me get my life back.”

And what changed wasn’t the flight itself or even that she had zero anxiety—it was the belief that she could handle her anxiety rather than outrun it.

When Medication Can Be Helpful

Let me be clear, I’m not anti-medication.

There are absolutely times when fast-acting medication makes sense. For example:

• You have to fly soon and haven’t learned skills yet
  
  

• You’re early in the process and medication is part of your plan
  
  

• Your provider has recommended a short-term strategy
  
  

What matters is your long-term goal.

If you ultimately want to fly confidently without medication, it’s important to treat it as a temporary support…not something you rely on to feel safe.

So… How Do You Start Moving Away from “Just-in-Case” Medication?

Here’s a small reframe that can help:

Instead of asking,
“How do I guarantee I won’t feel anxious?”

Try asking:
“What would help me handle anxiety if it shows up?”

That shift is the work.

You don’t have to throw away your safety behaviors all at once.
Tiny steps work beautifully.

Here are a few possible “first steps,” depending on where you are:

• Bring the medication, but delay taking it
  
  

• Practice feeling anxiety at home without immediately fixing it
  
  

• Learn skills for riding out discomfort rather than numbing it
  
  

• Watch what your mind predicts—and practice not responding to those urges
  
  

You get to choose the step that matches what you are willing to do.

Why Skills Matter More Than Substances

One of the biggest lessons I teach inside the Fearful Flyers Blueprint is to:

• stop fearing the sensations of anxiety
  
  

• put less effort into trying to eliminate anxiety entirely
  
  

• learn how to experience discomfort without spiraling
  
  

• build genuine confidence instead of relying on control strategies
  
  

Medication’s goal is often “make this feeling go away.”

My approach is more like “let’s help you not fear the feeling in the first place.”

That shift changes everything.

A Personal Moment That Taught Me This Lesson

I used to rely on alcohol to get through flights. It wasn’t something I took “just in case”—I felt like I needed it.

But when I flew while pregnant, drinking wasn’t an option.

I was nervous… but also curious.

And you know what?

I was okay.

Not because I numbed discomfort—but because I allowed myself to feel it.

It was the first time I truly saw:

I could handle this without trying to change how I felt.

That moment shaped how I now help anxious flyers.

The Bottom Line: Bringing Medication Isn’t “Bad”… But It Might Be Holding You Back

If medication truly helps you and aligns with your goals—great.

But if the only reason you bring it is fear that you can’t handle your own anxiety, then it’s worth exploring whether this safety behavior is actually reinforcing your fear.

Confidence doesn’t come from eliminating anxiety. It comes from learning that you can handle it even when it’s uncomfortable.

You’re far more capable than your fear lets you believe.

Want Support Building Confidence Without “Just-in-Case” Meds?

👉If you’re ready for structured, step-by-step support, you’ll love the Fearful Flyers Blueprint. It’s where I teach the exact skills that help you fly confidently, without relying on safety behaviors.

What If You Actually Wanted a Panic Attack? (Stay With Me...)

You’ve probably had that moment after a panic attack — heart racing, mind replaying everything, scanning for clues about what caused it.

Was it the caffeine? The lack of sleep? Maybe I’m coming down with something?

Your brain starts its investigation. And soon you are spiraling down the anxiety rabbit hole.

But here’s the trap: the more you monitor and try to prevent panic, the more your body stays on alert — waiting for the next wave.

That constant threat monitoring becomes its own kind of panic.

What if the real shift isn’t about prevention at all? What if you actually wanted it?

I know that sounds backwards….but stay with me.

When You Dare Panic to Show Up

Think about what happens when you stop trying to push something away and, instead, lean toward it.

What if you said, “Go ahead, anxiety. Give me your best shot.”

That single moment of daring can change everything.

Because you’re no longer acting like someone under threat — you’re calling panic’s bluff.

Because panic sounds convincing.

It tells you you’re in danger, that something terrible is about to happen, that your body (or mind) is spinning out of control.

But how many times has panic made those promises and not delivered?

How many times has it said, “You’re going to lose it,” only for you to still be going about your daily life and still in one piece?

The Wizard Behind the Curtain

Panic loves to act like the Great and Powerful Oz — with its loud and scary voice, flashing lights, and terrifying predictions.

But if you’ve ever seen The Wizard of Oz, you know how that story ends.

Dorothy (well to be fair, Toto did it first) finally pulls back the curtain, and what’s behind it?… a nervous man frantically pushing buttons, trying to look big and scary.

That’s anxiety. It yells, “You’re in danger!” and you start believing it — until you call its bluff. Until you stop running and say, “Go ahead. Show me what you’ve got.”

That’s when you realize the truth: there was never a real wizard.

Just your nervous system trying (and failing) to protect you with bad (or maybe they are pretty good) special effects.

Anxiety Is Full of It

Anxiety convinces you of all the worst possibilities, but its track record is terrible.

It swears your heart racing means a heart attack….but has it? It insists you’ll lose control — but have you?
It tells you the panic will never end — but did it? 

When you start meeting those sensations with defiance and willingness instead of fear, the power dynamic flips.

You go from “Oh no, it’s happening” to “Oh good, there it is. Let’s see what you’ve got.”

You might even add a little humor:
“Nice try, anxiety. You said the same thing yesterday, give it to me again.”

How to Stand Up to the Bully

I’m not here to promise that you can intimidate panic into leaving, but you can stop letting it run the show.

When you stop hiding, you stop feeding it.

Try this mindset next time you get scared of your panic or anxiety sensations:

• Heart racing? “Good — prove how strong you are.”
  
  

• Stomach tight? “Bring it. I can handle discomfort.”
  
  

• Thoughts spinning? “Say what you want, I’m still here.”
  
  

It’s not about liking the sensations — it’s about seeing through them.

Every time you practice that courage, you feel stronger. You start to expect the challenge — and you might even learn it’s not as bad as the Powerful Oz made it seem.

That’s how panic and anxiety lose their power

Not because it disappears, but because it no longer stops you. 

The Freedom That Follows

When you stop trying to control panic, you start getting your life back.

You show up to the things you used to avoid. You stop spending your days on “what if” patrol. And you finally realize that taking back your life starts with shifting how you think about anxiety in the first place. 

If you’re ready to stop letting the anxiety boss you around and start calling its bluff, we can help.

👉 Schedule your free 15-minute phone consultation to get started with one of our therapists.

How to Stop Beating Yourself Up After Anxiety or OCD Setbacks

You had been doing better for a while…maybe making progress with anxiety, sticking with your therapy work, facing some fears. And then something happened.

You went down the internet rabbit hole looking for answers.

You canceled plans.

You avoided the trigger.

You gave in to the compulsion or safety behavior you swore you’d stop doing.

Now, instead of just feeling anxious, you feel disappointed in yourself. And the shame spiral begins. Your mind spins with thoughts like:

“Why did I do that?” 

“I should be past this by now.”

“Everyone else seems to handle things better than I do.”

This experience is common. And can also be a place where your progress can either slow down or deepen.

Because what happens after a setback matters more than the setback itself.

And that starts with how you treat yourself in the moments that follow.

Why Self-Blame Feels So Automatic

If you live with anxiety or OCD, you probably crave certainty and control. It’s uncomfortable not to know how things will turn out, and when a setback happens you might cancel plans, avoid a trigger, or repeat a compulsion. When this happens, blaming yourself can feel like the quickest way to regain that control.

Self-criticism often comes from a reasonable place: If I caused this, I can fix it.
It’s an attempt to take ownership, to make sense of what went wrong. In that sense, the intention behind it isn’t exactly a bad thing,  it’s about wanting to feel capable again.

But as researcher Kristin Neff has found, self-criticism triggers the same threat systems in the brain that anxiety does. When you attack yourself, your body reacts as if you’re in danger — heart rate up, cortisol released, mind on high alert. It’s your brain’s misguided way of saying, “Let’s get control of this problem.”

The trouble is, that state doesn’t lead to learning. It actually keeps you frozen in shame.
Over time, self-blame becomes a habit — shaped by perfectionism, family messages about “tough love,” or a culture that treats mental health struggles as personal failings.

There’s a difference between accountability and attack.
Accountability sounds like: “That didn’t go the way I hoped — what can I learn for next time?”
Attack sounds like: “I can’t believe I did that again — what’s wrong with me?”

Setbacks and compulsions are part of the process of recovery. You are learning new ways of thinking, feeling, and responding. How on earth could you do that with zero mistakes along the way?

Learning to meet setbacks with curiosity rather than contempt is what allows you to pick yourself up and keeping moving forward.

A 3-Step Self-Compassion Reset

When I talk with clients about self-compassion, I’m not talking about fluffy self-love or pretending everything’s fine. I mean learning how to turn toward yourself when things are hard, instead of away.

Here’s a simple, three-step reset to help you practice that shift.

Step 1: Notice and Name What’s Happening

The first step is awareness. Most people don’t realize when they’ve moved from feeling anxious to criticizing themselves for feeling anxious.

Notice it. Label it gently.

Labeling it might sound like: “I’m having a hard moment” or “I’m feeling shame” or “I’m stuck in a loop right now.”

If guilt shows up, separate it from shame.

• Guilt says, “I did something that doesn’t fit my values.”
  
  

• Shame says, “There’s something wrong with me.”
  
  

That difference may sound subtle, but it’s so powerful. Guilt helps you learn; shame you us down.

Imagine you just gave in to a compulsion or avoided a social situation you’d been working toward. This is the moment to pause and name what’s happening — not to justify or fix it, but simply to see it clearly.

Awareness is always the first door out of self-blame.

Step 2: Remember Your Humanity

When you’ve had a setback you can quickly feel like you’re the only one who keeps “messing up,” the only one who can’t get it together.

But suffering and setbacks are part of being human.
They’re part of recovery, too.

This step is about helping you to remember that you are human and not the only one who struggles.

It might sound like “Other people struggle with _____” or “I’m not the only one who feels this way.”

I often tell clients: You were probably taught to treat others how you want to be treated. Try flipping that. Treat yourself how you treat others.

Would you talk to your best friend the way you’re talking to yourself right now? Probably not.

This small mental shift interrupts the isolation and opens the door to perspective.

Step 3: Respond With Care

Once you’ve recognized what’s happening and reminded yourself of your common humanity, the final step is to respond with care.

That could sound like:

“This is really hard, and it makes sense that I feel this way.”

“I’ve been here before — this won’t last forever.”

“What’s one small thing I can do right now that’s helpful?”

Sometimes “care” looks like taking a break from rumination and walking outside. Sometimes it’s reaching out to a therapist or friend. Sometimes it’s saying, I’m doing the best I can right now.

Being tender with yourself isn’t weakness. Think of it like sore muscles after a hard workout: it’s evidence that you’re using new emotional muscles, stretching beyond old patterns.

And what do you do with sore muscles? Sometimes you might ice them. Take a rest day. Or maybe you keep going. You do what you need to do to care for yourself.

So if you feel emotionally tender, try to see it as a sign of strength and growth — with permission to be gentle towards yourself. 

Putting It All Together

Here’s what this might look like in real life.

Let’s say you’re working on exposure therapy for contamination OCD. You’ve been doing well, but one day the anxiety feels stronger, and you give in to the handwashing ritual. Your inner critic jumps in immediately:

“Great, now you’ve ruined everything. You’ll never get better.”

You catch yourself — that’s Step 1.

You take a breath, remembering that setbacks happen to everyone in recovery. You reflect on what you want to do differently next time — Step 2.

And then you say quietly, “I had a tough day. It’s okay to start again tomorrow.” — Step 3.

That response changes the trajectory of the rest of the day. Instead of spiraling into shame, you’ve turned it into a an opportunity to learn something about yourself. You’ve kept yourself in the game.

The Bigger Shift

To extend compassion to yourself isn’t about letting yourself off the hook. It’s about building resilience — the capacity to stay in the process without tearing yourself apart every time you slip.

Each time you meet yourself with understanding instead of blame, you build strength in your recovery process. Flare ups don’t keep you down for long.

And that’s what creates real, sustainable change.

If this is something you want support with, our therapists can help.

At State of Mind Therapy, we use evidence-based approaches like ERP and ACT to help people relate differently to anxiety, OCD, and shame — so you can keep moving forward without beating yourself up along the way.

Schedule a free 15 minute phone consultation to get started.

Why Trying to “Feel Calm” on a Flight Might Be the Wrong Goal

You booked your trip weeks ago, but the closer the flight gets, the more anxious you feel. You’ve tried all the things like googling tips, watching videos, maybe even practicing breathing or distraction…but the worry still sits heavy in your chest.

You might find yourself thinking, I just don’t want to panic on the flight, or I wish I could make this anxiety go away.

It’s frustrating, because the harder you try to get rid of it, the louder it seems to get.

Here’s the tricky truth: the goal isn’t to get calm—it’s to stop fighting the anxiety altogether.

When Fighting Anxiety Makes It Louder

Many people I work with don’t expect to love flying. They just want it to not feel so hard. And to get through the flight without that spiral of dread or panic.

But the more we focus on not having anxiety, the more we end up tangled in it. Every racing heartbeat or thought of “what if I panic?” becomes something to monitor or fix. And when anxiety doesn’t immediately settle, the mind takes that as proof that something’s wrong.

That cycle of scanning, reacting, and judging keeps your nervous system on high alert.

The more we fight anxiety, the more space it takes up.

The Real Goal: Allow, Don’t Eliminate

Instead of trying to get rid of anxiety, what if the focus became learning how to allow it—how to make space for discomfort while still doing what matters?

Here’s how I often describe it:

“The goal is to learn how to not be afraid of anxious thoughts or sensations. Let your values guide you—why you’re taking this trip, who or what you’re flying toward—and make room for the feelings that show up along the way.”

When you practice allowing discomfort instead of fighting it, anxiety often loses its intensity over time. It may still be there, but it stops being the main character. Calm starts to show up naturally as a side effect—not as something you have to force.

How Things Shift When You Let Go of the Fight

One of my clients used to spend days preparing for flights—checking the weather, reviewing safety statistics, packing special items “just in case.” During the flight, he’d monitor every sound, every change in altitude, and cycle through a long list of relaxation routines.

It was exhausting.

When he stopped trying to perfect the process and instead practiced letting the anxiety ride along, something shifted. He told me afterward, “I didn’t love it, but I actually fell asleep on the way home.”

He hadn’t found a way to “get calm.” He’d found a way to stop struggling.

I’ve lived that shift myself.

For years, I dreaded flying so much that I secretly hoped trips would get canceled. Once I learned how to let the anxious feelings exist without making them the enemy, everything got lighter. I still didn’t love turbulence, but the anticipation lost its grip. I could actually look forward to the trip again.

The Bigger Picture

This isn’t just about flying.

That same “I have to get rid of this feeling” pattern shows up in all forms of anxiety:

• Panic: avoiding caffeine, checking your pulse, searching for a “cure all” to prevent a panic attack.
  
  

• OCD: avoiding certain shows or conversations to prevent intrusive thoughts, trying to stay calm so the anxiety doesn’t spiral into rumination.
  
  

• General anxiety: over-researching or asking for reassurance before making a decision, hoping to finally feel “sure enough.”
  
  

In each case, the pursuit of certainty or calm keeps the brain locked in a neverending loop. We end up avoiding the life we actually want to live.

Learning to allow discomfort (rather than eliminate it) is what breaks that cycle.

Practicing This in Real Life

If you’ve ever wondered what it would be like to test these skills in a real airport setting, that’s exactly what we do in our Navigating Flight Anxiety at MSP Airport Event. We walk through practical grounding exercises that help you notice sensations, orient to your surroundings, and practice being present—not to erase anxiety, but to help you see that you can move with it instead of against it.

For many people, this experience is the first time they realize: I can feel anxious and still do the thing anyway.

The Takeaway

You don’t have to wait until you feel calm to fly.

You don’t have to love every minute of it.

You just need to practice allowing what’s here and choosing what matters more.

When you stop chasing calm and start focusing on allowing, you give your nervous system permission to reset naturally. And with each flight—or any anxiety-triggering moment—you build confidence that you can handle it, whatever “it” looks like that day.

Ready to practice these skills in a supported, real-world way?

Join us for the Navigating Flight Anxiety at MSP Airport Event—a hands-on experience to help you approach your next flight with confidence and curiosity.

Plan for Joy: Let Your ‘Why’ Be Bigger Than Your ‘What Ifs’”

If you’ve ever booked a trip and then immediately thought, “What if I can’t do it?” you’re not alone. Excitement and fear often travel together.

The brain loves to imagine every possible scenario: What if I panic? What if there’s turbulence? What if I have to get off the plane? These thoughts make sense—your brain is trying to protect you. But protection and peace aren’t the same thing.

What if instead of planning to avoid anxiety, you planned to make space for joy? What if your reason for going—the people you love, the experiences you want, the life you’re building—could matter more than your what‑ifs? That’s where freedom starts.

Why your brain clings to what‑ifs

Anxiety hates uncertainty. When something feels unpredictable, your brain fills in the blanks with worst‑case scenarios. It’s not trying to hurt you—it’s trying to prepare you.

But preparation can quietly morph into over‑control: checking the forecast for turbulence, memorizing plane models, sitting on cancellation pages just in case.

These behaviors can feel responsible, but they actually feed anxiety. They teach your brain that you need certainty before you can be safe, when the truth is: you can handle uncertainty. The more you seek control, the less confident you feel.

The power of your why

Your why is the part of you that wants this trip for reasons deeper than fear—the connection, meaning, adventure, or growth it represents. Maybe it’s visiting a friend you haven’t seen in years, or watching your child’s face light up at their first view of the ocean.

Your why is your compass. It gives anxiety a context.

When your what‑ifs get loud, your why is what helps you keep going. It reminds you: “I’m not flying to feel calm. I’m flying because what’s waiting for me matters.”

Psychologically, focusing on your why activates the same motivational centers in the brain that help you follow through on goals. It’s not just poetic—it’s neurological.

Planning for joy (not control)

Planning is useful when it’s based on values—not when it’s based on fear. You can plan with anxiety in mind without letting anxiety drive the plan.

• Anxiety‑based planning: Reading every turbulence report, tracking weather hourly, mapping the entire airport terminal before you go.
  
  

• Values‑based planning: Downloading a favorite playlist, picking a snack that feels comforting, planning something enjoyable at your destination.
  
  

One kind of planning drains energy; the other builds anticipation. The difference isn’t in how much you prepare—it’s in why you’re preparing.

When the what‑ifs show up

They will. That’s okay. The goal isn’t to eliminate anxious thoughts; it’s to recognize them and choose what you focus on.

Try this in the days before or during your flight:

1️⃣ Notice → Name it. “That’s my what‑if voice.”

2️⃣ Reconnect → Choose your why. “I’m choosing connection, not control.”

3️⃣ Ground → One step, one breath, one moment.”

You can even write your why in your notes app or on a sticky note for the plane. When fear gets loud, you’ll have something stronger to answer it.

The reward of choosing your why

No one conquers flight anxiety by eliminating fear. You outgrow it by letting meaning lead. When you land—heart still beating, but proud—you realize that courage isn’t the absence of what‑ifs. It’s moving toward what matters in spite of them.

Every time you do, your world gets a little bigger.

Try this this week:

• Ask yourself: What’s my why for this trip—or this season of life?
  
  

• Write it down and revisit it when worry shows up.
  
  

• Plan one small thing that represents joy or meaning, not control.
  
  

If your what‑ifs are making it hard to move forward, we can help you reconnect to your why—and build the tools to travel with confidence.

The Trap of Needing to Know: When 100% Certainty Keeps You Stuck

If you’ve ever felt like you can’t relax until you’ve planned, checked, and confirmed every possible detail—where you’re going, what’s on the menu, how it will go—you’re not alone.

The need to be 100% sure is one of anxiety’s most convincing traps. It can feel responsible, even protective. But the truth is, that kind of certainty-seeking often drains your energy and strengthens the very anxiety you’re trying to avoid.

Why your brain craves control

Uncertainty feels uncomfortable because our brains equate “unknown” with “unsafe.” When we don’t know what will happen, anxiety fills in the blanks with worst-case scenarios. Your mind then jumps into problem-solving mode by double-checking, Googling, over planning, or asking for reassurance—all in the name of “being prepared”.

It’s easy to believe this helps. For a moment, having a plan (or three) offers relief. But it’s temporary.

The more we chase certainty, the more fragile our confidence becomes. The comfort we’re creating isn’t real—it’s what you might call fake certainty: a false sense of safety built on trying to prevent a feared outcome.

The hidden cost of over-control

Trying to be sure about everything can start to consume your life. Clients often say to us, “I just feel better when I know what to expect.” But when every outing or decision requires full research and backup plans, anxiety—not confidence—is in charge.

Taylor Swift said it best:

“You should think of your energy as if it’s expensive. As if it’s a luxury item. Not everyone can afford it. Not everyone has invested in you in order to be able to have the capital for you to care about this.”

Anxiety spends that precious energy quickly. It convinces you that every uncertainty deserves your full attention. But most don’t. You can care deeply without giving your energy to every possible “what if.”

Planning vs. over-controlling

Planning is useful when it helps you take reasonable action in the present. Over-control happens when you plan to eliminate all discomfort or guarantee nothing goes wrong.

For example, if there’s a snowstorm coming, preparation might look like packing your car with warm gear and driving slower than usual. Over-control would look like staying up all night researching every possible accident route or checking the forecast every 10 minutes. One is effective planning; the other is anxiety pretending to be helpful.

How to let go (without feeling reckless)

Letting go doesn’t mean being careless. It means recognizing that total certainty is impossible—and choosing to trust yourself instead.

Here’s what that process looks like in therapy and real life:

1️⃣ Notice the impact.
Start by asking: Is this actually helping me feel more capable—or just momentarily less anxious? Seeing that over-control isn’t effective makes change feel less “reckless” and more reasonable.

2️⃣ Practice acceptance.
Try saying: “I don’t have to know right now…and that’s okay.” You’re not denying the discomfort; you’re allowing it. Compassion helps you soften around the not-knowing instead of fighting it.

3️⃣ Test it in small ways.
Skip checking the restaurant menu. Let someone else choose the plan. Go for a walk without mapping the exact route. These small “uncertainty reps” strengthen your tolerance—what we call the mental gym for anxiety.

What real confidence looks like

Confidence doesn’t come from being sure—it comes from knowing you can handle not being sure. When you build that muscle, your world opens up. You say yes to experiences that used to feel too risky, and you find energy for things that actually matter to you.

Because certainty isn’t safety. Flexibility is.

Try this this week:

• Ask yourself: Where do I spend too much energy trying to be 100% sure?
  
  

• Try one “uncertainty rep” in a small, safe way.
  
  

• Reflect: How did I handle it? What did I learn about myself?
  
  

If your mind keeps chasing certainty, therapy can help you learn how to let go with compassion and build real confidence in its place.

Take the next step by scheduling your free consultation with State of Mind Therapy.

Stop Should-ing Yourself (and 6 Other Word Swaps That Calm Anxiety)

Words matter more than we often realize. They don’t just describe what’s happening. They also shape how we think, feel, and respond.

One small shift in your words can add weight to anxiety, keep you stuck in cycles of avoidance, or pile on shame. On the other hand, shifting your language can open the door to growth, courage, and relief.

That’s why, when we’re working with clients, we often pause to notice the language they use about themselves and their struggles. Sometimes we’ll even lighten the moment with a playful phrase—like, “don’t should all over yourself.” It gets a laugh, but it also leads to a rich discussion about how our words aren’t neutral. Our language can either fuel anxiety or help us loosen its grip.

Below are seven of our favorite word shifts. We’ve included examples for general anxiety, OCD, and even flight anxiety, plus a tiny practice you can try right away.

1) “I should…” 

You’ve probably said things like:

• “I should be further along than this.”
  
  

• “I should be able to handle my anxiety.”
  
  

Why it backfires: “Should” statements add pressure and judgment. They carry an undertone of shame…as if you’ve already failed. In ACT terms, “should” fuses you to a rigid rule and disconnects you from values-based action in the moment.

Try instead: Turn “should” into “could” or “would like to”.

• “I want to take a step forward.”
  
  

• “I could work on this today.”
  
  

• “It would like to practice this skill.”
  
  

Examples:

• OCD: “I should stop ruminating” → “I’d like to practice redirecting my attention for 2 minutes.”
  
  

• Flight anxiety: “I should be able to get on a plane” → “I could get on a plane”
  
  

Practice: When you hear “should,” ask: “how could I rephrase this to be more gentle and acknowledge the choices I have?”

2) “I’ll try…” 

One of my favorite phrases is “trying is lying.” I first learned this when working in a chemical dependency treatment center, and it has stuck ever since.

Why it backfires: “Try” is a built‑in escape hatch. “I’ll try to face my fear” often means “I’m not committing, and if it doesn’t happen, I still get credit.” Your brain hears the loophole and defaults to avoidance when anxious.

Try instead: Replace “try” with do or will. Keep it specific and small:

• “I will sit with this urge for 60 seconds.”
  
  

• “I will board the flight and practice paced breathing during taxi.”
  
  

• “I will let this intrusive thought be and return to my task.”
  
  

Practice: Write a one‑line “will” statement for today. If it feels too big, shrink the action until it’s doable in under 2 minutes.

3) “But…” 

“But” is a word that cancels what came before:

• “I totally get what you’re saying, but…”
  
  

• “I know it’s not likely, but it’s possible.”
  
  

Why it backfires: In relationships, “but” invites defensiveness. In anxiety work, it dismisses what you already know and trust. It keeps you stuck in either/or thinking.

Try instead: Use “and.”

• “I totally get what you’re saying, and I want to share my perspective.”
  
  

• “I know I’m not likely to get sick, and I know that it’s possible. Anything can happen.”
  
  

Why it helps: “And” creates space for both/and truths—discomfort and action. Validation AND limits. Fear AND values.

Practice: Catch one “but” today and replace it with “and.” Read the sentence aloud. Notice how different it lands.

4) “I always…

All‑or‑nothing words fuel hopelessness:

• “I’ll always feel anxious.”
  
  

• “I’ll never get better.”
  
  

Why it backfires: Absolutes trick your brain into treating a temporary state as a permanent identity. This makes your motivation drops and lead to more avoidance.

Try instead: Ground in time‑limited, present moment language:

• “Right now, I feel anxious.”
  
  

• “Sometimes anxiety shows up.”
  
  

Examples:

• OCD: “I always give in to compulsions” → “Sometimes I give in, and sometimes I practice resisting.”
  
  

• Flight anxiety: “I never handle turbulence well” → “Right now, turbulence feels intense, and I can use my tools.”
  
  

Practice: Add the phrase “right now” to one stuck thought and see how it changes your next step.

5) “I can’t…” 

When we say “I can’t,” it’s often not about ability, but instead, it’s about avoidance: “I can’t stop worrying. I can’t face that fear.”

Why it backfires: “Can’t” reinforces powerlessness and turns effort into a pass/fail test. Your nervous system hears “impossible” and stops experimenting.

Try instead: Say “won’t” or “I don’t want to”

• “I won’t choose to shift my focus right now.”
  
  

• “I don’t want to practice my exposure today.”
  
  

It may sound harsher at first, but “won’t” or “I don’t want to” is more honest. It puts the decision back in your hands, and with ownership comes possibility: you can choose differently next moment.

Where this shows up:

• Rumination: “I can’t stop thinking about it” → “I won’t step out of the thought loop yet.”
  
  

• Avoidance: “I can’t fly” → “I don’t want to face my fear of flying.”
  
  

Practice: Practice owning your decision to not do something. You’re not perfect. You’re not always going to challenge yourself even when you know it’s the best thing for you in the long run. But own it.

6) Add “Yet”

“Yet” is small but powerful. Add it to the end of a sentence and the whole story changes:

• “I can’t handle this… yet.”
  
  

• “I don’t know how to face my fear… yet.”
  
  

Why it helps: “Yet” cues growth and psychological flexibility. It reminds your brain that ability is built with reps, any progress doesn’t happen overnight.

Practice: Pick one skill you’re building (exposure step, sitting with uncertainty, tolerating uncomfortable sensations). Write a “yet” mantra for it and put it on your phone lock screen for a week.

7) “Panic attack” 

Words around panic shape how frightening it feels. And the word “attack” sounds like danger is coming for you. No wonder it’s terrifying.

Try instead: Call it what it is physiologically: an adrenaline wave. The body released a big dose of adrenaline and your system will metabolize it with time.

Why it helps: This shift acknowledges intensity without the story of being under attack. One client told us that hearing this for the first time completely changed how she approached getting on a plane because it allowed her to see panic as temporary and ride it out with skills instead of bracing for disaster.

Bonus swap: “My anxiety” → “My mind is telling me…”

This one isn’t a single word, but it’s a powerful diffusion move. Instead of “my anxiety is ruining my day,” try, “my mind is telling me this is dangerous.” You’re not arguing with thoughts—just noticing them as mental events. That distance makes room for choice.

Practice: For one day, try using the phrase “My mind is telling me…” Notice how it changes your urge to engage with them.

Final Thoughts

These may seem like small changes, but don’t forget: language matters. The words you use shape your relationship with anxiety, panic, OCD—and with yourself. When you shift “should” into choice, “but” into “and,” or “panic attack” into “adrenaline wave,” you’re not just changing vocabulary—you’re changing how your brain and body respond in the moment.

Pick one language shift to practice this week. Keep it visible. Tell a supportive person what you’re trying. And if you notice the old words sneaking back in, that’s normal. Smile, correct the sentence, and keep going. Skills grow with reps.

If you’d like a guide as you build these habits—or you’re ready to apply them to exposure work for anxiety, OCD, or flight anxiety—we’re here to help.

Ready to shift your language—and your relationship with anxiety? Schedule your free 15‑minute consultation with one of our therapists today.

5 Ways to Catch Yourself Ruminating (and What to Do Instead)

You’ve probably said it before: “I just can’t shut my brain off.”

Maybe it’s endless what-ifs about the future. Or replaying a past conversation on repeat. Or mentally checking and reviewing to confirm you “didn’t do something wrong.”

Whatever the flavor, rumination can feel like being trapped on a Ferris wheel that never stops spinning, or like trying to solve a puzzle where none of the pieces actually fit.

The tricky part? Rumination often feels productive. Clients tell us all the time, “I’m just trying to figure it out,” or “if I keep thinking about it, maybe I’ll finally feel certain.” But instead of helping, rumination keeps you stuck in anxiety and OCD.

The good news: with awareness and practice, you can step off the ferris wheel. Here are five ways to catch yourself ruminating (and what to do instead).

1. Label Rumination for What It Is

Many people say, “I’m just worrying” or “I’m overthinking.” But in reality, they’re ruminating.

Here’s the difference:

• Obsessions show up automatically (you don’t control the thought about germs, your health, or whether you made a mistake).

• Rumination is what happens next—when you engage with the thought by mentally reviewing, analyzing, or checking.

Think of rumination like opening the door to an unwanted visitor. The thought will always knock. But whether you invite it in and serve it tea—that’s rumination.

Try this: The next time you notice yourself spinning on a thought, gently label it: “This is rumination.” Naming it helps you create distance and makes it easier to choose a different response.

2. Notice Your Attention vs. Awareness

Here’s a simple way to think about it:

• Awareness is what’s in the background (like noticing the sound of traffic outside or the feeling of your feet on the floor).

• Attention is what you choose to focus on (like reading these words).

Rumination hijacks your attention, pulling you deeper into the spin. Many people don’t realize how much their anxiety symptoms are maintained by where they’re directing attention—not just by the content of their thoughts.

Try this: Practice asking yourself: “Where is my attention right now?” If it’s locked on an intrusive thought, gently shift it. Redirecting your attention is like exercising a muscle…the more you do it, the stronger it gets.

3. Pause at the Choice Point

When a thought or fear shows up, you arrive at what we call the choice point.

You have two options:

• Engage with the thought (and keep ruminating), or

• Acknowledge it and redirect your attention elsewhere.

This doesn’t mean ignoring the thought. It means noticing it without feeding it.

Try this next time:

1. Acknowledge the thought: “I’m noticing the urge to figure this out.”

2. Allow the feeling with compassion, even if it’s uncomfortable.

3. Redirect your attention to something else—reading, working, or simply breathing.

4. Let the thought hang out in your awareness without needing to solve it.

The more you practice acknowledging you have a choice, the more you train your brain that you don’t have to follow every thought down the rabbit hole.

4. Watch Out for Mental Compulsions in Disguise

Rumination isn’t always obvious. Sometimes it shows up in sneaky ways:

• Positive self-talk (“I’ll be okay”)

• Excessive prayer or repeating phrases

• Googling symptoms or searching for reassurance

• Replaying a moment to “make sure” nothing bad happened

These behaviors feel like problem-solving, but they only strengthen anxiety and OCD.

Try this: If you catch yourself doing one of these, pause and ask: “Am I ruminating right now, even if it looks helpful?” Awareness is a critical first step in helping you make a different choice.

5. Give Yourself Permission to Slip Up

Here’s the truth: breaking free from rumination isn’t about being perfect. You will slip up—and that’s okay!

Noticing and interrupting rumination is hard work. But every time you catch it and redirect your attention, you’re strengthening mental flexibility. Over time, the urge to ruminate loses its grip.

Try this: When you catch yourself mid-rumination, instead of criticizing yourself, say: “There’s ruminating again. Let’s try redirecting.” Compassion makes the practice sustainable.

Putting It Into Practice

Breaking free from rumination isn’t about shutting off your brain (if only it were that east, right?)….it’s about learning to step off the ferris wheel.

With practice, your “attention muscle” gets stronger, your anxiety symptoms lighten, and exposure to your triggers becomes less overwhelming. Many of our clients notice real changes within just a few days of practicing consistently.

If rumination has been keeping you stuck, you don’t have to figure it out alone. Our therapists at State of Mind Therapy specialize in helping adults with anxiety and OCD build practical tools to break free from unhelpful thought loops.

👉 Schedule your free 15-minute phone consultation today and take the first step off the mental Ferris wheel.

Not Every Anxious Thought Deserves a Response: 4 Ways to Practice Non-Engagement

When Your Brain Says “What If…”

If you live with anxiety or OCD, you know how relentless the “what if” thoughts can be.

What if I get sick?
What if I embarrass myself?
What if something terrible happens?

Clients often ask me: “If I’m not supposed to argue with these thoughts, what am I supposed to do? Just let them be there? What do I say instead?”

It feels counterintuitive, because anxiety makes us feel like we have to do something about the thoughts. But here’s the thing: not every thought deserves a response. In fact, the more we debate, reassure, or try to “logic our way out,” the more stuck we get.

The Problem With Engaging Anxious Thoughts

Picture anxiety as that one person who can never let a debate go.

Anxiety says: “What if you get sick?”
You say: “No, I’m fine, I’ll be okay.”
Anxiety comes back: “Yeah, but what if the person next to you was just exposed?”
You counter again. Anxiety answers back.

And on and on it goes. It’s like having a devil and angel on your shoulder, only the devil has an endless supply of “yeah, but…” comebacks.

You probably don’t even realize how much time you spend in this internal debate. All day long, you’re stuck in a cycle of:

• Debating (“It’s fine, I’ll be okay… but what if…”)
  
  

• Ruminating (turning thoughts and scenarios over and over again to try and “solve the puzzle” in your mind)
  
  

• Reassuring yourself (over and over)
  
  

• Googling or checking (seeking certainty from outside sources)
  
  

This is why the practice of non-engagement responses is so powerful. It’s a way of acknowledging the thought without feeding it, so the conversation ends.

Think about when you set a firm boundary with your child: “That’s my answer. End of story.” You’re not being harsh—you’re being clear that the discussion is over. You need that same firm boundary with your anxious thoughts.

4 Non-Engagement Affirmations for Anxious Thoughts

1. Uncertainty

“I can’t know for sure, and that’s okay.”

Anxiety is fueled by the desperate need for certainty. But the truth is, most of what we worry about is unanswerable. We’ll never get 100% certainty.

Leaning into uncertainty—rather than trying to erase it—is a game-changer. It means saying: “Yes, I’d like to know for sure. But I can move forward even if I don’t.”

Example: Instead of Googling symptoms, you pause and say, “I don’t know why I have this headache, and that’s okay.”

2. Possibility

Anxiety craves 100% certainty. But unfortunately, nothing in life is without risk. Every time you try to reassure yourself that nothing bad will happen, your anxiety mind comes back with “yea but it could.” You just can’t seem to shake it if there is the slightest possibility.

So instead of reminding yourself of the likelihood that it won’t happen, try leaning into the possibility by agreeing with.

For instance, “yes, people could be judging me. Anything is possible.” This helps to pivot away from seeking certainty and towards accepting it.

3. Difficulty

This strategy is about validating the worst case scenario. Instead of debating with your worry thought, you validate that it would indeed but difficult if it happened. “Yep, that would be hard.”

So lets say you are worried about having a panic attack on a plane. Your worry mind might say “What if I get so anxious that I have a panic attack and embarrassed myself?” You could respond with “that would be uncomfortable and challenging, no doubt about it.”

Oddly enough, this ends the conversation. No need to debate back and forth, you are just simply acknowledging how difficult the situation would be if it were to occur.

4. Acknowledgment

Acknowledgment is like of like saying “hello” to someone as you pass them by on the street. You are stopping to chitchat and you are not ignoring them, you are simply saying “I see you” and continuing on.

Acknowledging your inner thoughts or feelings like this helps to create distance between you and the experience. Instead of spiraling into emotion, you name it for what it is: just a thought.

• “I’m having an anxious thought about the idea of the plane going down. Period.”
  
  

• “I have a nervous feeling about messing up. Period.”
  
  

And that word—period—is important. It means end of story. No adding reassurance, no debating, no “but maybe it’ll be fine.” Just acknowledging that you are experiencing a feeling or thought and stopping there.

The Power of “Less Is More”

When it comes to anxiety, our instinct is to do more: more debating, more checking, more relaxing, more figuring out. But the real power lies in doing less.

Non-engagement strategies are not about finding the perfect response. They’re about stepping out of the endless back-and-forth and reclaiming your mental energy.

Not all of your thoughts deserve airtime. Some of them are just noise. And the more you practice not engaging with them, the easier it gets to see your thoughts for what they are—just thoughts, not facts.

Final Note

If you’re feeling stuck in cycles of anxious thoughts, know that you’re not alone—and that support is available. At State of Mind Therapy, we specialize in helping adults with anxiety, OCD, and phobias learn how to step out of the worry spiral and into a fuller life.

Schedule a free consult below to see if we are the right fit for you.

What OCD Really Is (And Isn’t): Busting Common Myths

When someone casually says, “I’m so OCD” because they like things tidy or color-coded. Whenever we hear someone say that we have a knee-jerk reaction that wants to scream, please stop. OCD is not a personality trait. It’s not a funny quirk. And for people who live with OCD, those offhand comments can feel deeply invalidating.

Nobody with true OCD would describe it as cute. They’re often carrying shame, confusion, or fear about what their brain puts them through. Many hide their struggles because they know others won’t understand. And unlike quirks or preferences, OCD is a diagnosable mental health disorder — one that can be exhausting, time-consuming, and isolating.

Let’s bust some of the most common myths about OCD so you can better understand what it really is — and why finding the right treatment matters.

Myth #1: OCD Is Just About Cleanliness or Hand-Washing

This is probably the most common stereotype. While contamination fears and hand-washing rituals are one possible presentation, OCD goes far beyond being a “germaphobe.”

Some people experience fears about causing harm, intrusive sexual or religious thoughts, doubts about their relationships, or fears of losing control or doing something impulsive. Others may struggle with perfectionism, needing things to feel “just right,” or mental rituals that aren’t visible to anyone else.

OCD themes are diverse, and the compulsions don’t always look like checking locks or washing your hands all day. Sometimes they’re hidden — replaying events in your head, silently counting, or seeking reassurance from loved ones.

Myth #2: OCD Is Just a Quirk or Personality Type

We’ve all heard someone say, “I’m just a little OCD.” But OCD isn’t an adjective. You wouldn’t say, “I’m so diabetes.” OCD is a disorder that causes significant distress and impairment.

In fact, one diagnostic criterion is that obsessions and compulsions are time-consuming — often taking up more than an hour a day — or cause major disruption to daily life. For some, it means spending hours checking or redoing tasks. For others, it causes them to be late because they can’t get out the door without completing a series of rituals.

If organizing your desk makes you feel good, that’s a preference. OCD compulsions, by contrast, don’t feel optional. They’re driven by overwhelming anxiety or doubt. People with OCD usually recognize that their behaviors don’t really make sense — but they feel like they have to do them anyway in order to feel safe.

Myth #3: OCD Is Just Anxiety

While OCD often involves anxiety, it’s not the same as generalized anxiety or “overthinking.” OCD is categorized in the DSM under Obsessive-Compulsive and Related Disorders, not as an anxiety disorder.

Why? Because OCD isn’t always anxiety-driven. Sometimes the dominant emotion is disgust, or even shame. And OCD goes beyond worry. It can make a person doubt their own common sense or the kind of person they believe they are (which is why OCD is often called “the doubting disease.”) Even if someone logically knows they locked the door, the doubt feels so strong and convincing that they can’t move on without checking again (and again, and again).

Myth #4: If You Don’t See Compulsions, It’s Not OCD

Many assume OCD is visible — repeated hand-washing, checking stoves, non-stop googling. But not all compulsions are external. Some are entirely mental: silently praying, counting, reviewing memories, or mentally “undoing” a thought. And others just straight up avoid doing things where they would need to do a compulsion (because they don’t want to deal with the ritual and/or don’t want others to see them ritualizing).

A person may look calm on the outside but be battling a storm of intrusive thoughts and mental rituals inside. Just because you don’t see it doesn’t mean it isn’t happening.

What OCD Really Is

At its core, OCD involves:

• Obsessions → intrusive, unwanted thoughts, images, urges, or sensations.

• Compulsions → behaviors (external or internal) done to neutralize the obsession, reduce distress, or prevent something bad from happening.

For example, someone might have the intrusive thought: “What if I screamed something offensive in this meeting?” Even though they don’t want to, the feelings and thoughts feel so real that they may mentally rehearse responses, sit on their hands, avoid being in meetings, or replay the meeting afterward to check if they slipped.

This is why OCD is considered ego-dystonic — the obsessions are the opposite of someone’s values. A person with harm-related OCD doesn’t want to hurt anyone. In fact, they’re often horrified by the thought. That’s what makes OCD so distressing.

There Is Hope — OCD Is Treatable

When new clients come to us, they’re often carrying shame, exhaustion, and hopelessness. They’ve had intrusive thoughts they’re afraid to share with anyone. Some have even seen therapists before who didn’t understand OCD — and walked away feeling more misunderstood than helped.

That’s why we always start with education: OCD does not define who you are. Your thoughts don’t mean anything about your character. And no matter how scary your obsessions feel, there is effective treatment.

The first-line treatment for OCD is Exposure and Response Prevention (ERP), a form of CBT that teaches you to face fears without doing compulsions. At first, this feels counterintuitive — after all, compulsions are what bring temporary relief. But ERP helps break the cycle of doubt and teaches the brain a new way forward.

Other well-supported approaches for OCD include Acceptance and Commitment Therapy (ACT), which focuses on building psychological flexibility and following your values, and Inference-Based CBT (I-CBT), which helps people resolve the doubt that fuels obsessions.

Clients often describe these approaches as empowering. Instead of endless talking, they leave sessions with a structured plan. They realize that the very things they’ve been doing to cope (like doing rituals and compulsions) are what keep them stuck. Learning how to resist those rituals is challenging, but it’s also the path to freedom.

Finding the Right Help

One of the most heartbreaking things we hear from new clients is: “I’ve been in therapy before, but no one ever taught me how to treat my OCD.”

Unfortunately, OCD is rarely covered in graduate training programs, which means many therapists simply aren’t equipped to treat it effectively. If you suspect you have OCD, it’s crucial to find someone with advanced training and experience in ERP and other evidence-based treatments.

At State of Mind Therapy, we specialize in OCD and related disorders. We know how isolating and exhausting this cycle can feel — and we also know how treatable it is with the right approach.

Next Step

If you’re wondering whether your experiences could be OCD, we encourage you to schedule a free 15-minute phone consultation. It’s a simple, pressure-free way to talk through what’s been going on and learn how specialized therapy could help.

You don’t have to keep carrying the weight of doubt alone — effective help is out there. Schedule a free 15 minute phone consultation with one of our therapists to see if we are the right fit for you.

Help for Fear of Vomiting: How Therapy Can Help You Take Back Control

A Fear That Feels Impossible to Explain

Nobody likes to vomit. That’s a given. So when you tell someone you have a fear of vomiting, they might say, “Well yeah, I don’t like to get sick either.”

That’s the thing about emetophobia (aka the fear of vomiting), it’s incredibly misunderstood. Even in my personal life, when I share that I specialize in treating this phobia, people often respond with confusion. They don’t realize it’s a real, diagnosable condition. But it is. And for the people who experience it, it can be absolutely debilitating.

When you live with emetophobia, it’s not just about disliking vomiting. It’s an intense fear that runs your life.

It can feel like you would literally rather die than throw up.

It’s the feeling that vomiting (or seeing someone else vomit) is always lurking around the corner. Maybe from a virus, spoiled food, pregnancy, alcohol, or even motion sickness from a car or plane ride.

The fear isn’t just about the possibility of getting sick. It can also be about feeling like you can’t escape the situation if you (or someone else) was sick. And the anxiety and panic that comes from “being stuck” in that situation feels unbearable. 

Emetophobia can impact everything: what you eat, where you go, the choices you make about relationships, parenting, and travel. And since we all need food to survive, this fear can actually become medically concerning.

But the hardest part? You might look totally fine on the outside. People may have no idea how much mental chatter you’re managing in the background.

The constant what-ifs looping in your mind can sound like:
Who here has been sick in the last two weeks?
Does that person look pale or off?
Why does my stomach feel weird right now?

You’re doing all this internal scanning, all day long. It’s isolating, exhausting, and often invisible. And again, because so few people understand it—it can feel like you’re the only one. Or worse, that others might judge you for it.

But here’s the good news: even if you’ve tried therapy before and it didn’t help, this fear can get better. The key is using the right kind of therapy approach. 

What Emetophobia Really Looks Like

There’s no one way this fear shows up, but there are a lot of common patterns.

Some people are afraid of getting sick themselves. Others are terrified of seeing someone else get sick. Either way, the anxiety leads to a lot of calculating, controlling, and avoiding.

You might feel uneasy around children or people who are around children (daycare workers, teachers, etc.) because kids are often sick. You might feel nervous around people who are drinking or pregnant. You might even avoid public transportation or air travel, not because you don’t want to go somewhere, but because being enclosed triggers that fear: What if someone gets sick and I can’t escape?

Fall and winter can be especially tough with the rise in norovirus and other bugs. You may feel some relief in the spring or summer, but for many, this fear is present year-round.

Many people with emetophobia develop strict eating habits—only trusting certain foods, avoiding specific textures or temperatures, and cooking meat until it’s well beyond done.

Expiration dates might feel like a line you absolutely can’t cross. And when your stomach makes an unexpected noise or feels even slightly off? It’s enough to trigger a wave of anxiety that’s hard to shake.

There’s often a lot of mental scanning—both of your own body and of the people around you.

You might:

• Constantly check others for signs of illness
  
  

• Ask loved ones for reassurance (“Do you think this will make me sick?”)
  
  

• Overanalyze food expiration dates, especially for shelf-stable or pantry items
  
  

• Keep a “safety kit” with you—water, mints, medication, or distraction tools
  
  

• Avoid the word vomit altogether
  
  

• Feel like you can’t care for a sick child or partner, even if you want to
  
  

• Put off or avoid having children altogether, due to fear of morning sickness and germs
  
  

When your brain starts treating every queasy moment or sick-looking person as a full-on emergency, life becomes very small, very fast.

Why This Fear Feels So Stuck

If you’ve tried to logic your way through this, tried a million relaxation strategies, or even been in therapy and felt like it didn’t help—there’s a reason.

Emetophobia isn’t something that gets better through traditional talk therapy alone. It often needs a different approach—one that targets the patterns that keep the fear alive.

That includes:

• Avoidance (which reinforces the belief that you couldn’t handle it)
  
  

• Reassurance seeking (from Google, from ChatGPT, from loved ones)
  
  

• Safety behaviors (like always having a mint or sitting near an exit)
  
  

The more you try to not feel anxious, the more your brain stays convinced that vomit = danger = emergency. And that cycle keeps the fear alive.

This doesn’t mean you’re stuck forever. It just means we need to approach the fear differently.

How Therapy Can Help You Take Back Control

The right therapy can help you retrain your brain’s response to perceived threat.

Evidence-based treatments like CBT (Cognitive Behavioral Therapy), ERP (Exposure and Response Prevention), and ACT (Acceptance and Commitment Therapy) are some of the most effective approaches we have for emetophobia.

And because I know you are already wondering this, let me tell you that therapy doesn’t mean you’ll be asked to throw up to “get over it”. That’s not how this works.

Instead, we focus on helping you:

• Understand your specific core fear (Is it about losing control? Being judged? Feeling trapped?)
  
  

• Break the mental loop of avoidance and checking
  
  

• Learn how to sit with body sensations without assuming the worst
  
  

• Rebuild trust in your ability to handle uncertainty
  
  

• Regain a sense of freedom and choice in your life

At State of Mind Therapy, we also offer a bi-weekly online support group specifically for adult women with emetophobia. This group gives you the chance to feel less alone in your experience, connect with others who truly get it, and share challenges in a space that’s understanding—not judgmental.

The goal of treatment and your recovery isn’t to make you love the idea of vomiting. It’s to help you stop letting the fear run the show.

This work is about agency. About gently increasing your tolerance for discomfort. About learning that you can be okay, even if you feel a little off. You don’t have to wait until the fear is gone to start living again.

A Small Shift You Can Try Today

Here’s one gentle reframe you can carry with you the next time you have an anxious moment:

“This is a sensation. Not a certainty.”

Just because your stomach feels weird doesn’t mean something bad is about to happen. You can notice the sensation without jumping to conclusions.

Start small. You don’t need to do this perfectly.

Even just naming the fear by saying “this is my emetophobia talking” can start to create some space between you and the panic spiral.

Final Thought

If this fear has taken up too much space in your life… you’re not alone. And you’re not beyond help.

You deserve support that actually addresses the root of your fear and gives you a blueprint on how to get unstuck. 

If you’re curious about how to start loosening emetophobia’s grip on your life, I’d love to invite you to schedule a free 15 minute consultation with one of our therapists. 

Your fear might feel big right now. But it’s not bigger than your capacity to heal.

Start where you are. You don’t have to face it all at once. 

Ready to take the next step?

Book a free consultation with a therapist on our team. We’d love to help you figure out whether we’re the right fit.

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