The Anxiety Equation in Cognitive Behavioural Therapy: A Structured Way to Challenge Anxiety

Anxiety can feel overwhelming and unpredictable, like it appears out of nowhere and takes over.

But from a Cognitive Behavioural Therapy (CBT) perspective, anxiety isn’t random or mysterious. It follows a pattern, and understanding that pattern helps us manage it better.

A very useful way to understand this pattern is The Anxiety Equation, created by Bruce M. Hyman and Cherry Pedrick. This model gives a simple but effective formula:

Anxiety = (Overestimation of Threat × Underestimation of Coping) ÷ Tolerance of Uncertainty

At first, this might seem too simple. But it really captures the key thought patterns that keep anxiety going.

The equation shows that anxiety isn’t just about fearing something bad. It’s about how we judge danger, how confident we feel in handling it, and how comfortable we are with uncertainty.

The important thing is that each part of this equation can be questioned and changed. That’s where CBT really makes a difference.

Understanding the Logic Behind the Equation

CBT is based on the idea that our thoughts, beliefs, feelings, and actions are all connected. Anxiety grows not just because of what happens, but because of how we understand those events.

The Anxiety Equation shows anxiety as the result of three factors working together. If someone greatly overestimates danger, doubts their ability to handle it, and finds uncertainty hard to bear, anxiety can spike.

But if even one of these changes, anxiety goes down.

This is good news.

It means anxiety comes from how we think, and those thoughts can be looked at and adjusted.

Overestimation of Threat

The first part of the equation is about how we judge danger. When we’re anxious, we often overestimate how likely something bad is to happen and how serious it would be.

For example, someone getting ready for a presentation might think, “I’m going to mess this up, and everyone will think I’m useless.” A person feeling anxious might see a racing heart as a sign of a serious health problem. Or someone in a relationship might believe a late text means they’re being rejected.

In all these cases, the mind treats a maybe as a sure thing and a small worry as a disaster.

From a cognitive perspective, this shows thinking errors like imagining the worst, overestimating risks, and focusing only on threats. An anxious mind looks for danger and pays too much attention to worst-case outcomes.

The goal isn’t to convince someone that bad things never happen, but to adjust their view.

What is the realistic chance?

What evidence is there?

Are there other explanations?

What usually happens in similar situations?

When people start checking their fears against real life, anxiety often eases. Behavioural experiments are especially helpful. Instead of just thinking about fears, they try things out. Usually, the results are much less scary than expected.

As threat estimation becomes more accurate, the numerator of the equation decreases.

Underestimation of Coping Ability

The second part of the equation focuses not on the event, but on the self. Even when a feared outcome is possible, anxiety escalates when a person believes they would be unable to cope with it.

Many anxious thoughts focus on feeling unable to cope: “I couldn’t handle it,” “I’d fall apart,” “I’d never get better,” or “The anxiety itself would be too much.”

This is called low coping self-confidence. People see themselves as fragile and think the distress would be unbearable or never end.

Yet when we examine people’s histories, the evidence often contradicts this belief. Most individuals have coped with significant stressors in the past—loss, disappointment, embarrassment, health scares—and have survived them. The anxious mind discounts this resilience.

In therapy, we help find proof of coping. We ask:

What have you dealt with before?

What helped?

If the worst happened, what would you actually do?

Who would you reach out to?

What steps would you take?

These aren’t just empty reassurances. They’re real exercises to build resilience. Clients start to realise that even tough situations can be handled.

An additional layer involves fear of anxiety itself. Many people believe that experiencing intense anxiety would be catastrophic. However, anxiety, though unpleasant, is not dangerous. It peaks, plateaus, and eventually subsides.

When clients experience this directly through exposure-based work, their belief in their coping capacity strengthens dramatically.

As people feel more able to cope, anxiety goes down—even if the threat stays the same. That’s because the top part of the equation gets smaller.

Tolerance of Uncertainty

The bottom part of the equation is the tolerance of uncertainty. This is key because it divides the top part. Even if the threat feels moderate and self-doubt is mild, anxiety can be strong if uncertainty feels unbearable.

Uncertainty is inherent in life. We cannot guarantee outcomes in relationships, careers, health, or social interactions. However, some individuals experience uncertainty as inherently unsafe. They equate “not knowing” with “something bad will happen.”

This intolerance leads to actions like asking for too much reassurance, checking things over and over, researching symptoms too much, constant worrying, and avoiding situations. These actions ease discomfort for a while, but make the belief that uncertainty is dangerous stronger.

In CBT, increasing tolerance of uncertainty is a central intervention.

Rather than attempting to eliminate doubt, therapy helps individuals learn to live alongside it. Exercises might include deliberately delaying reassurance, reducing checking behaviours, or intentionally leaving minor uncertainties unresolved.

Over time, clients discover that uncertainty does not cause catastrophe. They learn that they can function without complete certainty. As tolerance expands, the denominator of the equation increases, and overall anxiety decreases.

How the Variables Interact

What makes The Anxiety Equation helpful in therapy is how the parts work together. They don’t act alone.

Think about someone with health anxiety. They might see a headache as a sign of a brain tumour (overestimating threat). They might think they couldn’t handle a serious diagnosis (underestimating coping). At the same time, they might find it unbearable not to know for sure if they’re healthy (low tolerance of uncertainty). This makes their anxiety strong and long-lasting.

If therapy targets only reassurance about the headache, anxiety will return with the next symptom. But if therapy addresses threat inflation, builds coping confidence, and strengthens uncertainty tolerance, the overall structure shifts.

This is true for social anxiety, panic disorder, generalised anxiety disorder, and OCD, too. The fears may be different, but the equation stays the same.

Challenging the Anxiety Equation in Practice

When working with clients, the equation helps us understand anxiety together. Instead of asking, “Why are you anxious?” we ask: How likely is this outcome? How bad would it be?

Are we underestimating your ability to cope with it?

Are we struggling with not knowing for sure?

This reframing transforms anxiety from an identity (“I am an anxious person”) into a process (“My mind is inflating threat, doubting coping, and resisting uncertainty”).

From there, interventions become targeted. Cognitive restructuring challenges exaggerated danger. Behavioural experiments test predictions. Exposure builds coping confidence. Uncertainty training reduces compulsive reassurance seeking.

Importantly, this work is gradual. Anxiety does not disappear overnight.

However, consistent shifts in any one component of the equation create measurable change.

The Role of Behaviour in Maintaining the Equation

Avoidant behaviours often maintain all three components. When someone avoids a feared situation, they never gather corrective evidence about threat probability. They never experience themselves coping successfully. They also reinforce the belief that uncertainty must be eliminated.

This is why exposure-based strategies are central to CBT for anxiety. Exposure is not about forcing distress; it is about disconfirming inaccurate predictions. When someone enters a feared situation and discovers that the outcome is manageable, the entire equation begins to weaken.

Over time, repeated exposure helps people learn new things.

The threat feels less real. Coping feels easier. Uncertainty feels less scary.

A Compassionate Perspective

Even though the equation is clear and logical, it’s important to approach it with kindness. Anxiety happens for good reasons. It’s often shaped by life experiences, personality, and what we’ve learned.

The goal isn’t to judge anxious thoughts but to look at them gently. The anxious mind is trying to keep us safe. CBT helps update old beliefs.

When clients see their anxiety as a solvable equation rather than a personal flaw, hope increases. They move from feeling trapped to feeling empowered.

Final Thoughts

The Anxiety Equation offers a clear and easy way to understand and tackle anxiety. By seeing that anxiety comes from overestimating threat, underestimating coping, and low tolerance for uncertainty, people find many ways to make changes.

CBT doesn’t promise a life without uncertainty or discomfort. Instead, it gives tools to handle them differently.

As threat feels more real, confidence in coping grows, and uncertainty feels easier to bear, anxiety naturally goes down.

Anxiety can feel strong, but it’s not unbeatable. When we break it into parts, we can work on it step by step and make real progress.

If you’re dealing with anxiety, understanding your own version of this equation might be the first step to taking back control.

If you’re ready to take the next step, Contact me here to book your FREE call

Alexandra Kalogeropoulou (BSc, MSc, PG Cert, PG Dip).

BABCP-Registered Cognitive Behavioural Therapist with over 10 years of experience supporting clients in London and all over the UK. Specialises in treating anxiety and depression using evidence-based approaches. Alexandra is committed to providing compassionate, expert care for her clients.