By: Stan Popovich
If you struggle with anxiety and OCD, you know how exhausting it can be to fight your own mind. Intrusive thoughts, constant “what ifs,” and the need for certainty can take over your day, and the more you try to control them, the stronger they often come back.
Acceptance and Commitment Therapy (ACT) and Dialectical Behavior Therapy (DBT) offer a different approach. Instead of trying to eliminate thoughts, they help you relate to them differently, manage intense emotions, and focus on what truly matters, even when anxiety and worry are still there.
How ACT Helps with Anxiety & OCD
The main goal of ACT is to stay present, open up to experiences, and take value-based action despite discomfort. ACT can be helpful for people with anxiety and OCD, though it works differently from traditional treatments. OCD often thrives on trying to control, suppress, or fix intrusive thoughts. ACT teaches individuals to notice these thoughts without trying to neutralize them, reducing the power OCD has over behavior.
Instead of trying to eliminate obsessions, ACT helps people step back from their thoughts, see that thoughts are not facts, and make choices based on values rather than anxiety or compulsions. Certainty is not required to live a meaningful life, and anxiety does not need to disappear before taking action. ACT emphasizes accepting discomfort and uncertainty while reducing engagement in rituals, avoidance, and reassurance-seeking.
For OCD, this means allowing intrusive thoughts to be present without engaging with them and shifting toward value-based action instead of fear-driven responses. In practice, this involves noticing intrusive thoughts, allowing anxiety to be there without performing compulsions, and choosing meaningful actions anyway. Over time, continuing behavior while OCD is present reduces its power, and anxiety becomes more manageable.
Thoughts Are Not Facts
Thoughts are words, and when words are inside our heads, we call them thoughts. We also experience images and memories, and we rely on these inner experiences to make sense of our lives. Thoughts can tell us who we are, what to do, and what to avoid, but they are not facts; they are simply mental events created by our mind.
From an ACT perspective, it is helpful to step back and notice thoughts rather than automatically believing or following them. This process is called cognitive defusion, which means seeing thoughts as thoughts, not commands or truths. When we practice defusion, we create space between ourselves and our thinking, allowing us to respond more flexibly instead of getting caught up in what our mind says.
In ACT, thoughts are sometimes called “stories”, which are mental narratives that help us make sense of our experiences. The goal is not to stop these stories, but to notice them, step back, and choose whether following them helps us live in line with our values.
The Struggle Switch
The Struggle Switch is the tendency to resist, fight, or try to control uncomfortable thoughts and feelings, which often ends up making them stronger. It can be thought of like a switch: when the switch is ON (struggling), you try to push away anxiety, fear, or urges with thoughts like “I shouldn’t feel this” or “I need this to stop,” which usually intensifies and prolongs the feeling. When the switch is OFF (acceptance), you allow the experience to be there with thoughts like “This is uncomfortable, but I can handle it,” which often helps the feeling settle more naturally.
For example, if you feel anxious, turning the switch ON might sound like “Why am I like this? I need this to stop,” which increases anxiety, while turning it OFF might be “I’m feeling anxious, and that’s okay,” which allows it to gradually lose intensity.
Thought Defusion
Thoughts can sometimes take over our attention, especially when they are upsetting, leaving us feeling stuck and unable to focus on anything else. This is called being fused with thoughts. Trying to push thoughts away often makes them feel stronger and return more quickly. Thought defusion is a skill for creating space between you and your thoughts so they have less control over you.
A helpful way to imagine this is to see your thoughts like a hat on your head. In defusion, you create distance by placing the thought outside of you, like placing it on a table next to you and observing it from a distance.
The goal is not to get rid of thoughts, but to relate to them differently—letting them come and go without getting pulled around by them. This makes it easier to focus on what you are doing and what matters to you.
Thought Defusion Techniques
1. File your thoughts away: Visualize folders with labels for types of thinking such as predicting, regretting, comparing, doubting, and so on. Bring attention to your thoughts and file them into the corresponding folders; however, do not try to block the thoughts.
2. Name the story: Think of repetitive thoughts as familiar stories. Pay attention to how often they recur. You may notice the “I’m not going to make it” story or the “I’m a failure” story. See how these phrases come up all the time.
3. Zoom out: When you’re fused with a thought, picture yourself rising high above the Earth. Notice how small your worries look from space. Does your thought feel as significant from this distance?
4. Name the process: This means saying something like “I’m noticing I’m worrying,” “I’m having anxious thoughts right now,” “I’m getting stuck in overthinking,” or “I’m obsessing about this right now.” This helps you step back from the thought process itself instead of getting caught up in it.
Noticing and Naming Your Thoughts
“Noticing and naming” is a simple mindfulness skill where you observe your thoughts, feelings, and physical sensations as they arise and label them in a neutral way without getting caught up in them. Instead of reacting automatically, you first become aware of what is happening, then quietly name it.
Some examples of noticing your anxiety include “I’m noticing anxiety,” “Here is anxious thinking,” and “I am having the thought that…”. This process creates space between you and your internal experience, helping you see thoughts as passing mental events rather than facts. By doing this, you reduce the impact thoughts and feelings have on your behavior and are better able to pause, step back, and choose how you want to respond.
Urge Surfing
Urge surfing is a skill for experiencing urges—such as anxiety-driven impulses or compulsions—without acting on them. Instead of resisting, suppressing, or giving in, you notice the urge, allow it to be present, and observe how it changes over time. Urges often build, peak, and then naturally fade, even when they feel intense in the moment. The focus is on staying present with the experience rather than trying to get rid of it or act on it immediately.
In practice, this means noticing the urge (“I’m having the urge to”), paying attention to how it feels in the body, and allowing the sensation to be there without reacting. You stay with it as it rises and peaks, like a wave, and then observe it passing away on its own.
How to “Drop Anchor” When Anxiety Shows Up
Imagine you have a boat that is just entering a harbor when you hear a radio warning that a storm is coming. You want to drop anchor quickly, because if you don’t, the storm could pull your boat back out to sea. Dropping anchor doesn’t stop the storm, but it helps keep the boat steady until it passes. When difficult emotions show up, you “drop anchor” to steady yourself so the emotional storm doesn’t take you over.
The ACE Method: A Simple Way to Handle Anxiety
ACE (Acknowledge, Connect, Engage) is a simple way to respond to difficult thoughts and feelings in the moment.
Acknowledge what is happening by noticing and naming your thoughts and feelings (“I’m feeling anxious” or “I’m noticing the thought that something bad might happen”). Your goal is to acknowledge that these feelings are present without struggling against them.
Connect with your body by grounding yourself in the present moment, such as focusing on your breath, your feet on the ground, or other physical sensations. The goal is to give you more control over your physical actions so you can act more effectively while the emotional storm continues to bother you.
Engage by taking action based on what matters to you. For example, if you feel the urge to avoid something, you might say, “I’m noticing anxiety and the urge to avoid,” take a moment to feel your feet on the ground, and then still take a small step forward. This means focusing on what you are doing right now, staying aware of what you are doing as it happens, and continuing to act even when uncomfortable thoughts or feelings are present. In summary, you notice what’s happening, ground yourself, and keep moving toward what matters—even while discomfort is present.
ACE helps you respond to anxiety in a healthier way instead of getting stuck in it. It teaches you to notice what you’re feeling, stay grounded, and take action based on what matters to you. Over time, this can help you feel more in control and less pulled around by anxiety or worry.
Understanding Willingness
Willingness means choosing to make space for uncomfortable thoughts, feelings, and sensations without trying to fight, avoid, or control them so you can still do what matters to you. It’s not about liking anxiety or wanting distress, but rather saying, “This is here right now, and I’m going to move forward anyway.” Instead of getting stuck trying to eliminate discomfort, willingness shifts your focus to living your life alongside it. For example, if anxiety shows up before a presentation, willingness means allowing the anxiety to be present while you give the presentation anyway. Willingness creates space, and values help guide what you do next.
Values: Choosing What Matters
Values are what truly matter to you and guide how you want to live, act, and show up in your life; they are ongoing directions rather than goals you complete. You identify what matters most—such as relationships, personal growth, or health—and let those values guide your actions so your choices are meaningful rather than driven by fear or anxiety. For example, choosing to spend time with a friend even when feeling anxious because your friend is important to you.
In Summary
When you stop fighting your thoughts and allow them to be there, they often lose intensity and show up less often; pushing them away usually makes them stronger. The goal isn’t to get rid of thoughts, but to respond to them differently so they no longer control your actions or hold you back.
How DBT Can Help with Anxiety
DBT (Dialectical Behavior Therapy) is about learning how to handle tough emotions without letting them control your life. One of the main ideas is balance—you can accept yourself as you are and still work on making changes. Instead of fighting reality or getting stuck in “all-or-nothing” thinking, DBT teaches you how to stay flexible and deal with situations in a more steady, grounded way.
DBT focuses on skills such as distress tolerance, mindfulness, and emotional regulation, which help individuals stay grounded when anxiety peaks.
Mindfulness in DBT teaches you to stay present, become more self-aware, and observe your thoughts without judgment. It helps you notice intrusive or anxious “what if” thoughts as they arise and recognize that they are just mental events—not facts or threats that require action.
For example, if a thought like “What if I said something wrong?” comes up, you can label it as “just a thought” or “an OCD thought” and gently return your attention to what you’re doing. Instead of analyzing, arguing with, or trying to neutralize the thought, you allow it to pass.
Distress Tolerance is about getting through intense emotional episodes—like anxiety spikes, panic, or OCD urges—without reacting in ways that make things worse. It’s often described as “crisis survival” skills: learning how to endure distress in the moment rather than trying to immediately eliminate it. This is especially helpful for anxiety and OCD, where the urge to escape, avoid, or perform a compulsion is strong. Instead, distress tolerance helps you stay with discomfort safely, reducing impulsive reactions and breaking the cycle over time.
DBT emotion regulation skills help bring your attention back to the present moment when OCD thoughts feel intense or overwhelming. These skills include sensory grounding, such as noticing what you can see, hear, and feel around you; physical grounding, like pressing your feet into the floor or holding an object and focusing on its texture; and descriptive grounding, where you calmly describe your surroundings in detail to shift attention away from intrusive thoughts. You can also use temperature-based grounding, such as holding something cold or splashing water on your face, to help interrupt anxiety and reconnect with the present moment.
How Your Mind Sees Things as They Happen
Here is an example of how your mind views everything that you see.
For example, you look at a picture of a house. What comes to your mind if you look at the picture in a positive way? Next, what comes to your mind if you look at the picture in a negative way?
You get two different viewpoints when you look at the house. One viewpoint is positive and the other viewpoint is negative.
Our brain is a natural storyteller with everything we see and everything that happens. When we see anything, our brain tries to make sense of things. Sometimes our brain lies to us because it tries to make sense of things without having all of the evidence. Sometimes that story is wrong, and we can’t believe everything our brain tells us. Our brain is also biased based on our interpretation of our good and bad experiences from the past.
For example, let’s say you lose your health benefits and you have to reapply to get those benefits. Our brain suddenly creates a story that says you will lose a lot of money. Your brain is trying to make sense of what is happening but it’s bringing up your past fears and anxieties which is based on the story your brain is creating for you right now.
This creates a lot of fear and anxiety. There is no evidence that says you will lose any money right now. Nothing has happened yet; the anxiety that you will lose your money right now is slightly exaggerated.
As a result, you need to ask yourself “What is the other story/viewpoint that is happening right now? This is when you use thought defusion, evidence-based therapy, CBT, ACT, etc., which helps you to see the situation without the fear and anxiety. This helps us to see the current event with actual evidence of what is happening right now and not what we may think.
In summary, we can’t believe everything our brain tells us. You need to look at things realistically right now. Do not focus on future hypotheticals, assumptions, and what-ifs. Focus on what you can do in the present.
When you label an event or thought that creates anxiety and fear, the story your brain is creating may not be accurate unless you have the evidence in front of you right now that backs up your concerns.
Nothing is 100 percent certain. A person may be ninety-nine percent correct in predicting what may happen, but all it takes is that one percent to make a world of difference. What may seem real isn’t usually accurate in terms of the facts of a given situation and may not be the entire truth.
No one can predict the future with one hundred percent certainty. There are small circumstances and factors that may happen down the road that you can’t predict, which may work in your favor.
How This Fits the Managing Fear Framework
This approach reflects a core step within the Managing Fear Framework: respond intentionally in the moment so fear does not control your thinking, decisions, or actions.
You may not eliminate worry completely, but you can learn to manage it with structure, perspective, and confidence.
If fear or anxiety is holding you back, A Layman’s Guide to Managing Fear provides practical strategies from a flexible, multi-approach system to help you feel calmer, more confident, and in control. Even small, consistent steps can build clarity, resilience, and lasting hope.
