Practice guide4–6 minutes5 sections

What to Do with Anxious Thoughts

Begin step 1

What to Do with Anxious Thoughts is a short visual guide for moments connected to anxious thoughts.

It covers one core idea: an anxious thought demands attention and presents a prediction as a fact.

You will say: “My mind predicts...”, then choose what fits next.

The aim is a little more distance, attention, and freedom to act by values.

Edited aspractice guide·5 focused visual steps
Working edition 1Published July 22, 2026Last reviewed August 2, 2026Editorial standardsSuggest a correction
01
A passenger looking through a rain-speckled train window while the landscape moves softly beyond the glass.

Step 1 of 5

Check your starting point: What to Do with Anxious Thoughts

When a prediction sounds so convincing that it feels like a fact…

Notice what fits this situation today:

  • Anxious forecasts contain cognitive distortions
  • Attention can be redirected
  • Kindness reduces secondary threat
  • I am not sure yet—I just want to understand
Next: An anxious thought demands attention and presents a prediction as a fact
02
A passenger looking through a rain-speckled train window while the landscape moves softly beyond the glass.

Step 2 of 5

An anxious thought demands attention and presents a prediction as a fact

  • An anxious thought demands attention and presents a prediction as a fact.
  • Distance through naming distortions, shifting the spotlight of attention and a benevolent inner voice reduces fusion.
  • Reappraising the threat as a challenge and acting on your values returns direction, even if the fear remains.
Next: Say: “My mind predicts...”
03
A passenger looking through a rain-speckled train window while the landscape moves softly beyond the glass.

Step 3 of 5

Say: “My mind predicts...”

  • Pause for a few seconds. Check whether this practice feels safe enough right now.
  • Say: “My mind predicts...”.
  • Check evidence and alternatives.
  • Select one value step.
  • Notice what changed in your body or thoughts. Do not grade yourself—collect information.

Quick check after the practice:

  • What changed, even by 1%?
  • What stayed the same?
  • What do you need now: continue, stop, or ask someone for support?
Next: What this may change: What to Do with Anxious Thoughts
04
A passenger looking through a rain-speckled train window while the landscape moves softly beyond the glass.

Step 4 of 5

What this may change: What to Do with Anxious Thoughts

A little more distance, attention, and freedom to act by values.

The useful shift is more clarity, less autopilot, and one available choice.

Next: Choose a next step: What to Do with Anxious Thoughts
05
A passenger looking through a rain-speckled train window while the landscape moves softly beyond the glass.

Step 5 of 5

Choose a next step: What to Do with Anxious Thoughts

You do not have to resolve this whole situation today. You worked directly with “What to Do with Anxious Thoughts” and chose one possible response.

Choose what fits now:

  • “Save one next step”
  • “Come back later”
  • “I need support from a person”

After this guide

Keep the next step small.

A little more distance, attention, and freedom to act by values.

Where to go next

Choose the next useful idea

Choose one if it fits what you need now.

Sources & evidence

Where this guide comes from

The book is the editorial starting point. The research below checks or qualifies the broader ideas used in this guide.

Adapted from

Why Has Nobody Told Me This Before?

Chapter 25, “What to Do with Anxious Thoughts” · source pages 181–194

View publisher record (opens in a new tab)
Written by
Julie Smith (opens in a new tab)Clinical psychologist with NHS and private-practice experience; not a medical doctor.
Edition used
Michael Joseph, an imprint of Penguin Random House UK, 2022 · ISBN 9780241529737
Formal review
The edition does not identify a formal peer-review or clinical-review panel. Publisher praise is not formal review.
Public endorsements — not formal review

Lori Gottlieb (opens in a new tab) — Psychotherapist and author

Editorial limitations of this book source
  • Broad popular self-help reference, not an individualized formulation or treatment plan.
  • Exercises involving exposure, breathing, nutrition, or inward attention are not suitable for every reader.
  • Scientific claims paraphrased for a general audience still need claim-level checking against primary research.
  • The source PDF contains an unrelated and medically unreliable second book after page 308; that material is excluded.

Research context

Supporting and qualifying references

Reviewed 2026-08-04

  1. 01

    Randomized Controlled Trial · 2023

    Effects and Mechanisms of a Web- and Mobile-Based Acceptance and Commitment Therapy Intervention for Anxiety and Depression Symptoms in Nurses (opens in a new tab)

    What it supports: A structured ACT program improved symptoms in nurses, with psychological flexibility, defusion, and values among studied mechanisms.

    Limits and disclosures

    Limit: Single occupational sample, wait-list comparison, attrition, and a multi-component program; does not validate isolated values prompts.

    Disclosure: No product-specific conflict identified in the PubMed record.

  2. 02

    Systematic Review And Meta Analysis · 2014

    Meditation programs for psychological stress and well-being: a systematic review and meta-analysis (opens in a new tab)

    What it supports: Mindfulness meditation programs showed small improvements in anxiety, depression, and pain compared with nonspecific active controls.

    Limits and disclosures

    Limit: Heterogeneous programs and populations; limited or insufficient evidence for several other claimed outcomes.

    Disclosure: Independent evidence source; not specific to the books or NotMyNoise.

  3. 03

    Peer Reviewed Meta Analysis · 2018

    Cognitive behavioral therapy for anxiety and related disorders: A meta-analysis of randomized placebo-controlled trials (opens in a new tab)

    What it supports: CBT is moderately efficacious for anxiety and related disorders compared with placebo controls.

    Limits and disclosures

    Limit: Evidence supports structured therapy, not the clinical equivalence of a short educational guide.

    Disclosure: No relationship to NotMyNoise identified.