Shaking and numbness and sweat, oh my! What do we call it when what we fear is fear itself? None other than the little-known, but hugely important concept of anxiety sensitivity. This week, Savvy Psychologist Dr. Ellen Hendriksen explains what it is and offers three tips to take it down. 

When FDR famously proclaimed there is nothing to fear but fear itself, little did he know was forecasting a psychological phenomenon known as anxiety sensitivity.

The term wasn’t coined until 1985, but when the concept was defined, it was kind of a big deal. I’ll stop short of calling anxiety sensitivity the mother of all anxiety disorders (which sounds like a Freudian comic book villain), but high anxiety sensitivity puts you at greater risk for developing a problem with anxiety, from panic to PTSD to phobias and beyond.

So what exactly is this fiendish phenomenon? It’s a belief that the physiological experience of anxiety itself, like a racing heart, sweating, or shaking, is dangerous and could lead to devastating outcomes. In other words, it’s the tendency to interpret anxious sensations as catastrophic—it really is fear of fear.

For example, someone with high anxiety sensitivity might fear the dizziness that comes with being anxious, thinking it means they’re going to snap and have a mental breakdown. Another might fear the pounding heart that comes from walking into a room of strangers, thinking a heart attack is around the corner. Yet another might interpret their nervous trembling as a sign that they’re losing control of their faculties.

Of course, most, if not all, people find anxiety-related sensations uncomfortable—most would prefer to avoid getting clammy on a first date or feeling our heart pound through our chests before giving a wedding toast. The distinction is that those low in anxiety sensitivity can be anxious, but interpret the sensations as transient and harmless.

For example, someone with low anxiety sensitivity may interpret a racing heart as “I’m pumped! I’m ready—let’s do this!” Butterflies in the stomach might be met with, “Eh, who doesn’t get nervous before a big speech?” Shaking before accepting a big award might be chalked up to an overly air-conditioned venue.

Now, if you recognize yourself as someone who definitely has this anxiety sensitivity thing going on, does that mean you’re doomed to a full-blown anxiety disorder? Not necessarily. While anxiety sensitivity definitely increases your chances, it’s impossible to predict who exactly will develop a problem with anxiety.

Think of it this way: picture a pizza. If an entire pizza represents the causes of an anxiety disorder, one or two slices might be genetics, two or three slices might be family environment.  Life circumstances determine several pieces: bullying might steer you toward social anxiety, a car crash toward PTSD.  Anxiety sensitivity is often one of the remaining slices—not a sole cause, but definitely a contributing factor. (I bet you’ll never look at pizza quite the same again).

OK, so what to do?

f you see yourself here, the good news is that you have a shot at prevention.  Here are three ways to lower your anxiety sensitivity (and your risk down the line):

Tip #1: Exercise. Is there anything exercise can’t do? It gets us in shape, makes us live longer, improves our mood, and, stay with me here: gets us used to being uncomfortable, which is crucial for reducing anxiety sensitivity.

What happens to your body when you exercise? A pounding heart, sweating, feeling short of breath, shaky muscles, turning red. What does that remind us of? None other than anxiety.

But here’s the key: we interpret those sensations differently when we exercise. We pull apart the discomfort from the negative interpretation. If anything, when we feel the shaky muscles and ragged breathing of exercise, we feel positive: virtuous, accomplished, and strong.

So each time we exercise, we get used to feeling discomfort that’s really similar to anxiety, but interpreting it as something temporary, controllable, and even gratifying.

For example, a 2008 study found that a two-week exercise program resulted in greater reductions in anxiety sensitivity than two weeks of carrying on as usual. And, I can’t believe I’m saying this, but adding my line of work, cognitive behavioral therapy, didn’t add anything above and beyond—plain old exercise was just as effective.

Another study similarly found that both a low- and high-intensity aerobic exercise program reduced anxiety sensitivity after just a week, but those who were assigned the high-intensity condition got the best bang for their buck, with their sensitivity reducing further and faster.

The take home? The way to still the mind is to move the body.

Tip #2: Think back to childhood. Did you love the playground swings as a kid? Would you wait in line again and again to go on roller coasters or the Tilt-a-Whirl? Did you love the thrill of going faster and faster on your bike or skateboard? Or maybe you tried the “dizzy bat” game (no, not the drinking version—we’re talking about childhood here) where you put one end of a baseball bat on the ground, your forehead on the other end, spun around, and then tried to walk?

If you used to do any of these things, you probably remember them with a smile. And therein lies the secret. Making yourself feel woozy and your stomach feel flip-floppy used to be fun.

Now, you don’t have to get out your old plastic wiffle bat, but try this for starters: do some gentle neck rolls. Drop your right ear toward your right shoulder, and then, in one slow, fluid motion, rotate your head so your chin rolls to your chest, then roll your left ear to your left shoulder, and finally tilt your head back toward the ceiling. Gently round and round you go. Focus on the sensation of movement and slight dizziness, but think of it as relaxing or amusing, rather than threatening.

For more practice, you could spin around in a desk chair, take a turn on the swings at your local playground, or anything else that makes you say, “Wheeeeee!” where you might previously have said, “Yikes!”

Whatever you try, the key is to reinterpret body sensations as exciting or harmless, rather than as a sign of impending disaster.

Tip #3: Rethink the consequences.  When you find your mind jumping to the worst-case scenario, think about what other, more benign things might also be possible. For example, I had a client who felt dizzy whenever she looked down from a height, like a bridge or a balcony, and interpreted her dizziness as an existential crisis: “Does this secretly mean I want to jump off the bridge? What if I freak out and and kill myself?” By contrast, when she started thinking about her symptoms as simple vertigo, her fear disappeared.

For you, try to interpret body symptoms differently. For example: “When I can’t keep my mind on a task, I might be developing dementia,” becomes, “When I can’t keep my mind on a task, I must have a lot on my plate.”  Or, “When I’m really tired after a long day, it makes me feel fragile and vulnerable to burnout,” becomes, “When I am really tired after a long day, I know I’ll feel better with a bath and good night’s sleep.”