When someone is struggling with anxiety, it can feel impossible to turn off their mind. Thoughts race, worries seem to play on a loop, and before long, this becomes emotionally exhausting. I’ve worked with so many people who feel like they are stuck in this cycle, overwhelmed by endless worry and frustrated by how hard it is to break the pattern.
If you have read blog posts on my website you will have about cognitive behavioral therapy (CBT). CBT can be very effective. It focuses on the actual content of your thinking and how your thoughts can affect your emotions and behavior. For some deep seated, long standing core beliefs, CBT isn’t enough and this is where metacognitive therapy, or MCT, can becomes helpful. Instead of focusing on what you think, MCT is about how you relate to those thoughts. With MCT, the spotlight shifts to how you think about your thinking. It’s a subtle shift that can make a big impact.
Many people carry a deeply held belief that worry keeps them prepared or protects them from bad outcomes, so the worry sticks around longer than it needs to. In sessions, I work with you to gently question those beliefs and help you respond differently when worry pops up. What I want to share in this post is how metacognitive therapy can be an effective extra layer when treating anxiety, and how it can help you feel like your thoughts don’t always have to be in charge.
Understanding How We Think About Thinking
When I begin MCT work with a client, one of my first points is this: thoughts themselves are not the enemy. What often creates distress is how we respond to them. In traditional CBT, I might have you look closely at what a thought is saying. With metacognitive therapy, the question is about how you view or relate to your thoughts. Maybe you believe that worrying is useful. You might feel that if you don’t analyze every possible outcome, something awful could happen.
Over the years, I’ve noticed how powerful these beliefs about thinking can be. For example, many of my clients believe that running through worst-case scenarios is a way to stay prepared, but this strategy ends up feeding chronic rumination and exhaustion. My aim is to help people notice when they get caught in these thought patterns and begin taking a step back from the mental tug-of-war.
I often explain that thoughts are just events in the mind, not commands or predictions. By practicing new ways of responding to your thoughts, rather than focusing all your attention on them, you start to build a friendlier relationship with your inner world.
The Role of Cognitive Attentional Syndrome in Anxiety
If you’ve sat with a worry that won’t let go, replayed a conversation over and over, or felt desperate to figure something out in your head, you know how exhausting that cycle can be. Metacognitive therapy calls this pattern Cognitive Attentional Syndrome, or CAS. CAS is a mix of worry, rumination, and trying hard to control your thoughts.
Here’s what I often see happen in CAS: A worry begins, and soon you feel you need to think through every angle, every what-if, just to feel safe. You may end up pushing aside other thoughts, replaying the same scenarios, or rehearsing possible responses for future situations. All this focus pours energy into the anxiety, reinforcing the brain’s habit of worrying. Eventually, worrying feels automatic, as if it’s the default way to handle stress.
When I work with clients, I help them notice when CAS is taking over. This awareness allows you to interrupt the cycle. It isn’t about trying to stop unwanted thoughts, since everyone has them. The key is to stop giving those thoughts so much power and attention. You have a choice in how much you engage with any anxious thought.
Core Metacognitive Techniques That Help Calm an Anxious Mind
There are three main metacognition skills that I see make a big difference for people feeling stuck in anxiety. These include detached mindfulness, attention training, and challenging old beliefs about worry.
Detached mindfulness is all about letting your thoughts move through your mind without reacting to them. Like clouds drifting by, you notice them but don’t feel the need to grab hold. With some practice, it gets easier to observe a thought without being dragged into it.
Attention training helps you shift your focus intentionally. If you’re used to being bullied by your thoughts, this skill teaches you to choose where your attention goes. For example, you might decide to try grounding techniques such as focus on the sounds around you or the feeling of your feet on the floor instead of the worries in your mind. This practice builds your ability to stay present, which makes it much harder for anxiety to take over.
Finally, I work with people to gently question their long-held beliefs about worry. Maybe you’ve always believed it was necessary to worry in order to be prepared. In sessions, we look at whether that belief is truly helping or whether it’s just making life tougher. Over time, these exercises help you develop healthier, more balanced ideas about your own thoughts.
Many people who work with me appreciate that my approach is based on years of experience working with anxiety and worry. I often combine elements from several evidence-based methods, including both MCT and CBT. This means you can expect practical strategies that fit your unique concerns and situations.
Practical MCT Exercises for Common Anxiety Challenges
Here are some common anxiety-related concerns I see and a simple exercise for each issue:
– Anxiety: Try setting a timer for two to five minutes in the morning. Sit quietly, letting any thoughts come and go. The goal isn’t to stop thinking but to observe your thoughts without responding or jumping in. Think of fishes swimming and a hook trying to catch them. Don’t get trapped by that hook that wants to trap you in an anxiety cycle, notice it and swim on by.
– Rumination: When you notice yourself stuck in replay mode, try to notice what set it off. Then gently shift your attention to your senses by naming five things you can see or five different sounds you hear.
– Worry: Write down three top beliefs you have about worrying. For each one, ask yourself if it’s actually making things better or just feels that way. Many clients realize worry isn’t really changing the outcome.
– Panic: If panic shows up, bring your attention to the room. Look for and count all the red objects you can see. This gives you something physical and neutral to focus on so your attention shifts from physical symptoms.
– Social Anxiety: Before or after a social event, practice detached mindfulness. Notice any anxious thought but don’t follow it. For instance, if you think “They’re going to judge me,” simply notice that’s a thought and let it move on.
– Health Anxiety: When you feel a strong urge to check a symptom or search online, try pausing to tell yourself, “This urge is about worry, not actual danger.” Move your attention to something physical, like stretching or walking.
– OCD: Identify a checking behavior and delay doing it for one minute. Sit with the feeling that comes up. Over time, stretch the delay a bit longer as the urge weakens.
One techniques that works well in most situations is to recognize a thought and notice the emotion it is bringing up for you and ask yourself “What does my own personal history tell me about this thought?” then ask “Have I dealt with it this the past, or is it a worry that has never actually happened in reality?”.
These small steps add up with practice. The goal with each is not to control or erase thoughts, but to treat them differently and loosen their grip. Even though some exercises might feel unfamiliar or strange at first, they are simple enough for most people to try at home in between sessions.
Awareness Is The Start of Change
What I appreciate most about using metacognitive techniques for anxiety is that it encourages a new relationship with your thoughts. You don’t have to fight or fix every worried idea that pops up. Becoming aware, and learning to step back instead of feeling driven to react, breaks up old cycles.
When people realize they can let thoughts come and go without always trying to solve or eliminate them, I often see a shift begin. Over time, anxiety no longer takes up as much space in your life. Freedom from worry isn’t about clearing your mind completely. It is about responding to it in a new way that feels less stuck and overwhelming.
For personalized anxiety treatment, contact me on the form below. I see clients in my office in Northbrook, a North Shore Chicago suburb, or virtually across IL, FL and the UK.
Feeling stuck in constant worry or overthinking can be exhausting, but it’s possible to change how you respond to anxious thoughts. I use techniques from cognitive therapy and metacognitive therapy to help people build awareness of the thinking habits that keep anxiety going. My goal is to support you in creating a healthier relationship with your mind—not by controlling every thought, but by learning to shift your attention and beliefs about worry. If you’re ready for therapy that offers more than just quick tips, anxiety counseling may be a helpful next step. I see clients in my office in Northbrook, a North Shore Chicago suburb, or virtually across IL, FL and the UK.
If you have any questions, or would like to set up an appointment to work with me and learn how to reduce anxiety, please contact me at 847 791-7722 or on the form below.
If you would like to read more about me and my areas of specialty, please visit Dr. Sarah Allen Bio.
Dr. Allen’s professional licenses only allows her to work with clients who live in IL, FL & the UK and unfortunately does not allow her to give personalized advice via email to people who are not her clients.
Dr. Allen sees clients in person in her Northbrook, IL office or remotely via video or phone.
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