Calming Anxiety When Nothing Works: Joshua Fletcher (Transcript)

Read the full transcript of psychotherapist Joshua Fletcher’s talk titled “Calming Anxiety When Nothing Works”, at TEDxManchester, April 21, 2025.

Listen to the audio version here:

The Reality of Anxiety

“Here’s an anxiety hack that can instantly calm you down. Take this bucket of water, six magic words to stop anxiety, something cold on our wrists, neck, chest, or head. Best ways to break a panic attack. If you can’t lower this compound, then you get anxiety even though I’m feeling anxious. But you struggle with anxiety attacks, panic attack grabs all. I’m about to hypnotize you to completely release any anxiety. Experiencing fastest way to break a panic attack is to put an end to your anxious overthinking. Here’s a quick anxiety relief technique. Trying to put this ice pack on the back of your neck, your left hand put it on top of your head, tilt your eyes backwards, dead weight. Just let that finger pull very strange, but simple technique, a nervous system reset feeling triggered. That is your nervous system being dysregulated.”

Joshua Fletcher: Anyone feeling calm?

This talk is for anyone who struggles with anxiety, particularly those people who struggle every day, maybe struggle with panic, fear of fear, fear your symptoms. Maybe you think you’re going crazy or something’s going wrong and you feel like you’re broken in some way. If you’re anxious right now like I am, whether you’re in this room or it’s 2 a.m. on YouTube, that’s okay. That feeling is welcome here. You are not broken.

The Experience of Panic and Overthinking

Anyone in this room ever had a panic attack? Fun, aren’t they? They’re really, if you’ve never had one, I highly recommend them. If you thought Breaking Bad was good, just feeling like you’re losing your mind, going crazy, your heart’s pounding, senses dissociation and detachment, and the sudden urge to escape because you might humiliate yourself, all in the back of an Uber.

Anyone here guilty of overthinking? Got a few whoops for the overthinkers. Here’s a pro tip: save all of that overthinking for the moment you get into bed at night. That’s where you solve all of life’s problems.

Anyone ever had an intrusive thought? You never get fun intrusive thoughts like winning the lottery or pillow fighting Ryan Gosling. They’re always something really bad, grim in nature, whether it’s, you know, “What if I lose control?” Violence, sex, taboo, bizarre, the folly of existence itself. It’s a bit like watching Manchester United. And that’s how you lose half the audience.

And again, anyone anxious ever whilst feeling anxious googled a headache? Fun isn’t it? Yeah, your threat response isn’t interested in the fact that you’re dehydrated and been staring at screens all day. Oh no, it wants you to scroll to the bottom to the fun ones right at the bottom. Yeah, you’ve got all those, and meanwhile you set it, it sets you off.

My Story

I’m Joshua Fletcher, also known as Anxiety Josh, and I’m a psychotherapist and author who specializes in the topic of anxiety and anxiety disorders. Many years ago on a Tuesday morning, I was at work and I was making a cup of tea, milk and tea bag first because I’m a psychopath, and I was doing that and suddenly I looked up. I looked up and everything looked weird. It felt strange. I was hit with this whoosh of adrenaline. I didn’t recognize my own hands, my voice, everything looked like clay, and I thought I was going crazy. I’d actually just experienced when my first ever panic attacks, but that was the incident that led me to joining the one-in-five club, which is I developed an anxiety disorder.

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Understanding the Amygdala

To understand anxiety disorders, you’ve got to understand the role of the amygdala, which is a small almond-shaped part of our brain that is one of the oldest parts, the fastest and the dumbest parts of our brain. It’s responsible for triggering anxiety, fight or flight, and all the fun symptoms that we have. My amygdala is firing off now. I’m having intrusive thoughts literally right now about throwing up on the front row. So I’m not actually going to do it. I’m aiming for the second row. Get a good trajectory on there.

Yeah, and it’s to understand the amygdala. It’s really important because we are bombarded with information about “turn off your anxiety now.” It doesn’t quite work like that. You know, it’s the amygdala. How many of you have had one of those pavement dreams, sidewalk dreams? Well, you know, you’re nice and relaxed and asleep and then suddenly you dream you fall off a curb and then you bulk up in bed. Anyone else had that? Well, thanks because I was going to be really embarrassing to take that to a Freudian therapist. “Keep dreaming of curves.” No.

And it’s that’s it. The amygdala steps in just in case, just in case that was a real curve. If you’re watching a scary movie and the fellow with the chainsaw comes out, he’s like, “Yeah, I’m going to kill you,” the amygdala fires off just in case, just that split second. If your hilarious friend likes to make you jump, so again for that split second, the amygdala jumps in just in case. It operates on a “just in case” mentality, and it gets you to prepare for threat.

You know, I did it the other day. I was walking through Manchester and almost hit by a taxi because I was scrolling. I looked up and thankfully the amygdala jumped in and saved me because I was being a moron. You know, I didn’t choose to do that. I let back. I didn’t consciously choose to do that. It was there to save me. But sometimes that amygdala gets confused, particularly with the stresses of life, which leads to things like panic disorder, which is the fear of fear.

When the Amygdala Gets Confused

If you have panic attacks, and then you suddenly fear those panic attacks, you’ll build your life around those panic attacks.

If you have GAD, your amygdala is firing off all day every day, and then your cognitive brains kind of say, “What if it’s that, what if it’s that, what if it’s that?” and you start worrying about stuff that never used to bother you because the amygdala and the cognitive brain are like, “We’re trying to work out why all this is happening now.”

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Anyone with OCD, I’ve also been diagnosed with OCD. You’ll probably experience intrusive thoughts, then the amygdala decides after prolonged stress you have an intrusive thought that’s so horrible, and the amygdala then adds to that intrusive thought and you start to worry about what it means about you because the amygdala just in case that thought is the threat. And for a lot of people with OCD, things 1 in 20 in the UK, there’ll be a few OCD edge in here. Hi, you see it’s okay.

And yeah, you’ve got to understand that the amygdala wants to look after you just in case. To calm anxiety, we’ve got to turn off the amygdala. Lots of my clients tell me, “Josh, can I have my amygdala removed?” I’m like, “No, it doesn’t quite work like that,” but I can understand the frustration.

The Problem with Fixing Compulsions

To turn off the amygdala, we need to show it that anxiety itself is not dangerous. If you are someone who is anxious a lot of the day, you probably fall into fixing compulsions, which is “I’m anxious and that’s not acceptable. I must get rid of it now.” I did this for years. I never left the house because I was scared of how I felt and I wouldn’t do anything until I was fixed.

So I did it all. Started with the deep breathe in the tap in the magnesium supplements, the CBD oil, the honestly I spent so much money. I tried to be hypnotized. There are all these things, anything but to feel a feeling of anxiety that I didn’t like. I tried it then you’ve got the magic of self-optimization culture and social media, you know, “Here’s five things you can do to get rid of a feeling.”

No, the amygdala is always watching and it’s going, “You is this feeling I’m giving you a threat in itself? Okay, I’ll look out for that,” and you end up in a cycle. If you’re anxious and then suddenly you want to get rid of it because yes, it is uncomfortable. I know I’ve ended up in a knee with panic attacks. I know how bad anxiety feels. But looking back, I was trying to get rid of it and I was resisting a feeling, and the amygdala, that just tells the amygdala that anxiety itself is a threat. And when we misinterpret and fear the anxious response, that’s the cornerstone of most anxiety disorders.

You’ve got to understand the nervous system really quickly. There’s a phenomena called the autonomic state shift. So when we’re really anxious,

We’re in the sympathetic state and when we’re really relaxed we’re in the parasympathetic state – sympathetic, parasympathetic. And there’s a phenomenon when that switches that’s called the autonomic state shift.

Here’s the problem that a lot of people don’t – what they don’t tell you: You cannot observe the exact moment the autonomic state shift happens. You cannot observe the exact moment anxiety disappears. And anxious people try it all the time with coping techniques. “I’ll try this. Is it gone yet? I’ll try this. Is it gone yet?” And it doesn’t work like that and I tried to do this for so long.

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It’s a bit like when you’re driving along and someone cuts you up, you’re really angry and you go on this revenge arc in your imagination, you know, you’re going to get him back. You know, let’s get him sacked from their job and burn down – maybe just me. So yes, that’s quite concerning. Then your favorite song comes on the radio and you think “oh” and then you sing along and the next thing, you know, “oh I’m not really bothered about that anymore.” The autonomic state shift happened and it’s the same with anxiety.

But if you’re trying to observe autonomic state shift, you get into trouble. Trying to observe it only leads to trouble. I’m standing by that.

How I Got Better: Willful Tolerance

So, what do we do? How I got better: Willful tolerance. I wrote down all my fixing compulsions and I do this with my clients. What are we doing that’s resisting everything? Most common compulsions of checking, seeing how you are, comparing how you feel, and trying to fix yourself. Write those down and then you practice being anxious. I’m going to practice being anxious, but you have to do this compassionately.

The Power of Compassion

And this is the second and final ingredient to get better: Compassion is so important. Anxious people berate themselves. They have a huge internal critic and you’ve got to be your friend. I’ll start you off: You have tolerated everything life has thrown at you up until this moment of listening to me, whether it’s anxiety or tragic life events. Your tolerance skills are a hundred percent. I just invite you to do it willfully.

You Are the Coping Technique

Learn that you are the coping technique. If you struggle with anxiety, stop giving the credit to everything else around you, whether it’s scrolling through that and doing magical things and trying to find everything external from you. You can tolerate anxiety. You are the coping technique. You can do this and that’s how I got better, but you can’t do it without being your friend.

So I invite you to willfully tolerate your anxiety, whoever you are, whether you’re in here or watching on YouTube. You are the coping technique and believe in yourself. And you will get better. I did and so can you.

I’m Joshua Fletcher, also known as Anxiety Josh, and thank you very much.