Not Every Feeling is an Emergency

How to Turn Down our Inner Alarm

“What happens if I step out into this street in front of a car?”

It’s scary when those kinds of thoughts pop into your head. You start to wonder, what in the world is wrong with me? Why would I think about something so disturbing. It turns out that 94% of people have similar intrusive thoughts. They’re normal.

But in a subset of folks who have Obsessive Compulsive Disorder, us included, those thoughts go from blips on the radar that we’re able to quickly move on from, to sirens imploring us to do something about them. Many people get OCD wrong. They see the compulsions—the obsessive cleaning or hand washing— and assume that’s the issue. But the real cause comes much earlier. It’s the thought and feeling that pops into your head, and causes an inordinate amount of stress and anxiety. The compulsion is the quick fix solution, to help restore order and ease the anxiety.

We all have this mechanism. You’re walking down the street and you suddenly feel like you might have left the stove on. You either sit with it, convincing yourself it’s unfounded, or run home and check to see that you didn’t. What we have is a prediction error. Part of your brain says the stove is on and you have to resolve that feeling. We’ve got two options to address it:

1. Update the internal model. Sit with the feeling so your brain decides the prediction was wrong. That the stove likely isn’t on and you can move on with your walk.

2. Act on the external world. Go check the stove. Make the world match what your brain was demanding.

For OCD, we have the same options, but the problem is the danger signal is amplified 100x. The brain generates an alarm that doesn’t match external reality (”your hands are contaminated, you might die”) and the person tries to close the gap by acting. They wash their hands and the alarm quiets, briefly, before coming back louder.

Recent research argued that OCD patients can’t generate the internal feeling of “this is resolved.” The prediction-error machinery keeps firing regardless of how many times the external world has been corrected. The compulsion is a doomed attempt to find a state the brain will accept as safe.

Claire Gillan’s recent work frames compulsivity as a transdiagnostic trait. The same prediction-error dysfunction shows up across OCD, eating disorders, addiction, and anxiety. Different surface behaviors. Same underlying mechanism: the brain trying to use external action to manage an internal signal it has lost the ability to update.

The treatment that actually works for OCD is exposure and response prevention. It helps because it forces the internal update. You feel a controlled and milder version of the alarm in a safe environment, and you don’t wash your hands. You just sit there, waiting for the brain to eventually learn the alarm was wrong. You’re not teaching it that hand-washing makes the alarm stop. Your brain learns that the alarm was a false positive. You learn to address the internal model.

The same mechanism is playing out in all of our brains, and modern life is training us to run a milder version of the OCD loop.

The External Coping Mechanism

Think about the way technology has helped us deal with our internal feelings. Consider:

• Boredom standing in line? Check the phone.

• Loneliness? Open social media to see our “friends” or chat with an AI bot.

• Uncertainty about whether our workout was good enough? Open the watch.

• “Did I lock the door”? Pull up the camera feed.

• Discomfort of silence on a walk? Put on the podcast.

• Anxious about something? Scroll on an app to distract yourself.

Each of these addresses the underlying feeling by acting on the world. That’s not necessarily a bad thing. Sometimes, we do need to update our model by acting in the real world. If you’re really hungry, food is great. If you’re lonely, having coffee with a friend is wonderful. But if we constantly outsource our internal feelings to something that provides temporary relief, we’re training our brain to expect that the external action is the only way to make the internal signal stop.

That our phone is the solution to the feeling. We never train our internal model to update, to learn that this feeling is just a blip that I can sit with, instead of a command that needs to be addressed right now. In turn, we lose the capacity to sit with any feeling or inner voice long enough for our brain to discover it was a false alarm. Every uncomfortable signal becomes an emergency we need to immediately quelch.

No, I’m not claiming everyone now has OCD. As someone who’s had a lifetime of dealing with it, the disorder is much greater than just feeling anxious and checking our phone. But, for the everyday person, we’re training up the compulsion. We’re feeding those intrusive thoughts, giving them more power than they need to have.

When you always update the external, the internal model atrophies. You lose the capacity to sit with a prediction error long enough for the brain to discover it was a false alarm. Every uncertainty becomes something to fix, not something to wait out. Every uncomfortable signal becomes an emergency.

That is what experiential avoidance is, in the language of Steven Hayes and Acceptance and Commitment Therapy. Three decades of research has shown experiential avoidance to be one of the strongest predictors of anxiety disorders, depression, PTSD, and substance abuse. The mechanism is not mysterious. You teach the brain that the internal signal cannot be tolerated, and the brain responds by treating every internal signal as intolerable.

Turning down the Alarm

The fix is structurally identical to Exposure and Response Therapy. We need to learn to sit with our internal world so our brain discovers that not every alarm needs attending to. Over time, our brain recalibrates.

It’s the essence of dealing with discomfort in sport. When we’re new to running or swimming, the alarm rings early and loud. At the first hint of discomfort, our brain screams “This hurts! Go back to the couch. You can’t do this!” Over time, we realize that we’re not going to die when we get a little out of breath. You’ve recalibrated your internal model and moved the alarm to go off closer to when there’s actual danger.

We can either make our internal world foreign, or we can adjust the alarm. This is what mindfulness is, mechanistically. It’s the phone-free walk, sitting with the awkward silence, dealing with boredom standing in line. It’s wrestling with the blank page instead of having AI fill it for you.

It’s accumulating enough small moments where you don’t reach for the fix. Enough reps that your brain learns the default: not every feeling needs a response. True toughness is being able to sit with the feeling and decide: is this alarm real and worth responding to, or should I let this crazy thought or feeling just float on by.

-Steve