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How ACT Helps with Anxiety
Anxiety is maintained by avoidance—we avoid situations, people, or experiences that trigger anxiety, which provides temporary relief but keeps us stuck. ACT offers a different approach: willingness to experience anxiety while doing what matters. The goal isn't to eliminate anxiety, but to develop psychological flexibility so you can live according to your values despite anxiety.

Defusing from Anxious Thoughts

Exercise 1: Defusing from "What If" Thoughts

Common anxious thoughts include:

"What if something terrible happens?"
"I can't handle this"
"Everyone will judge me"
"I'm in danger"
"I'll lose control"
"Something bad is going to happen"

What anxious thought shows up most often for you?

Now practice defusion. Rewrite the thought as: "I'm having the thought that..."

Example: Instead of "Something terrible will happen" → "I'm having the thought that something terrible will happen"

Notice: This is an anxious prediction, not a fact about the future. Your mind is trying to protect you, but you don't have to believe every anxious thought.

Can you recognize this thought as your mind's attempt to protect you, even if it's not helpful?

Willingness to Experience Anxiety

Exercise 2: Making Room for Anxiety

Anxiety comes with uncomfortable physical sensations: racing heart, tight chest, shallow breathing, sweating, trembling. Our instinct is to try to make these sensations go away. ACT teaches expansion—making room for anxiety sensations rather than fighting them.

What physical sensations do you experience when anxious?

What do you typically do to try to avoid or eliminate anxiety? (Examples: avoiding situations, seeking reassurance, safety behaviors, distraction)

Has avoiding anxiety made it go away permanently, or has it kept you stuck and limited your life?

💡 Expansion Practice:
1. Notice where you feel anxiety in your body
2. Breathe into that area
3. Imagine making space around the sensation
4. Say to yourself: "I'm willing to make room for this anxiety. I don't have to like it, but I can allow it while I do what matters."

Values-Based Exposure

Exercise 3: Approaching What Matters Despite Anxiety

Traditional exposure therapy says "face your fears to reduce anxiety." ACT says "approach what matters to you, even if anxiety comes along." The goal is valued living, not anxiety reduction.

What situations, activities, or experiences has anxiety caused you to avoid?

Which of these avoided situations connects to something you value? (Examples: social events connect to friendship value, public speaking connects to career value, trying new things connects to growth value)

Choose ONE situation you've been avoiding. What value would you be honoring by approaching it, even with anxiety present?

Remember: You're not approaching this situation to eliminate anxiety. You're approaching it because it matters to you. Anxiety might come along—and that's okay. You're choosing values over comfort.

Willingness Practice Ladder

Exercise 4: Building Your Willingness Ladder

Create a ladder of values-based actions, starting with easier ones and building up to more challenging ones. Rate each action by how much anxiety it would trigger (0-10).

Anxiety Rating (0-10)	Values-Based Action (What I'll approach despite anxiety)	Value It Connects To

This week, I commit to practicing willingness with:

💡 Tip: Start with lower-anxiety items to build confidence. Remember: the goal is not to feel less anxious, but to do what matters despite anxiety.

Accepting Uncertainty

Exercise 5: Tolerance of Uncertainty Practice

Anxiety often involves a need for certainty. "What if" thoughts are attempts to predict and control the future. ACT teaches acceptance of uncertainty as part of being human.

What uncertainties trigger your anxiety? (Examples: "What if I fail?" "What if they don't like me?" "What if something goes wrong?")

Can you accept that you cannot have 100% certainty about the future?

What would you do if you were willing to live with uncertainty?

Uncertainty Acceptance Phrase:
"I cannot know for certain what will happen. I'm willing to live with uncertainty and do what matters to me anyway."

Present Moment Awareness

Exercise 6: Grounding in the Present

Anxiety pulls your attention to imagined future threats. Present moment awareness brings you back to right now, where you're actually safe.

5-4-3-2-1 Grounding Exercise (use when anxiety feels overwhelming):

5 things you can SEE around you right now
4 things you can TOUCH or feel
3 things you can HEAR right now
2 things you can SMELL
1 thing you can TASTE

Practice this now and notice: Are you actually in danger right now, in this present moment?

Dropping Safety Behaviors

Exercise 7: Identifying and Releasing Safety Behaviors

Safety behaviors are subtle avoidance strategies that provide temporary relief but maintain anxiety long-term. Examples: checking repeatedly, seeking reassurance, always having someone with you, avoiding eye contact.

What safety behaviors do you use to manage anxiety?

Choose one safety behavior you're willing to drop this week as a committed action toward freedom:

Remember: Dropping safety behaviors will likely increase anxiety temporarily. That's okay. You're practicing willingness to experience anxiety in service of freedom and valued living.

Weekly Practice Log

Reflection

What did you learn from completing this worksheet?

What's one ACT skill you'll practice this week?

What committed action will you take in service of your values, even if anxiety is present?

Remember: Anxiety tells you to avoid, stay safe, seek certainty. ACT says you can approach what matters, live with uncertainty, and build a meaningful life with anxiety along for the ride. You don't need anxiety to disappear to live fully.

Day	What I Approached Despite Anxiety	Anxiety Level (0-10)	Value I Honored
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday

ACT for Anxiety: Practice Worksheet