Worry, Worry, Worry!

We all worry, however at times worrying takes over our lives.

“Worry is a special kind of fear. To create worry, humans elongate fear with anticipation and memory, expand it in imagination, and fuel it with emotion. Worry is what humans do with simple fear once it reaches the cerebral cortex. We make it complex.” “Worry = vulnerability + powerlessness” (Edward Hallowell)

Unfortunately, our brain is not always our best friend. Our lower brain emotional centers and our verbally driven cerebral cortex did not evolve to issue warm and fuzzy thoughts- instead they are overly sensitive alarm systems!

Questions to ask yourself: What is the difference between “good” (adaptive) worry vs. “bad” (maladaptive) worry? How much worry is a natural part of living versus how often do we needlessly torment ourselves? How often has your worry actually saved you from something?

“Worry gives a small thing a big shadow.” (Swedish proverb)

Most worriers are not passively inundated by worry. Although they may not realize it, most people actively seek worry. Rumination is persistent and repetitive thinking that is usually looking backward and more associated with depression; worry is persistent and repetitive thinking that is usually looking forward and more associated with anxious apprehension. (The word “rumination” describes what a cow does when “chewing its food” or chewing, swallowing, regurgitating and then chewing it again-a well-chosen word to describe the ruminative thinking process.

Some Beliefs and Assumptions That Fuel Worry:

Intolerance for uncertainty: “If I think about this enough, I should feel a sense of certainty.” intolerance for discomfort: “If I can just think this through, I won’t have to feel this way.” inflated sense of responsibility and culpability: “If bad things happen, it’s my fault.”

Distorted risk assessment/emotional reasoning: “If it feels likely, it is likely. If it feels dangerous, it is dangerous.“

Perfectionism–mistakes are unacceptable: “Mistakes mean I wasn’t in control and screwed up.”

Pessimism/presumed incapability: “Bad things will happen to me and I won’t be able to deal with it.”

Misconstrued virtue: “Worry shows how deeply I care about my children.“

Overvaluation of the thought process: “Because I have a thought, it is, therefore, an important thought, and I must give it my full attention and get it settled. I can anticipate and avoid discomfort by worrying.”

”Meta-worry” or worry about worrying: “I’m making myself sick. I’m going to bring on an early heart attack. I’m out of control. I’m weak. If my faith was stronger, I wouldn’t worry. If I had gone to the gym more this wouldn’t happen.  If I didn’t drink wine or eat ice-cream this would never happen”. 
Implicit magical beliefs: “Worry prevents bad things from happening. It keeps loved ones safer.”

The limits of reassurance: If reassurance doesn’t work the first time, it’s probably not going to work so don’t keep trying to make it work. The temporary relief you feel when reassured simply sets up your next need for reassurance. Plus, when you go looking for reassurance enough, you will usually uncover something new to worry about!

The limits of worry suppression: What we resist persists. Often, the more we try to directly suppress worry, the more we worry.  Indeed, control of thought content is the problem, not the solution.  An ironic process actually takes place as we are inclined to think about that which we are striving not to think about.

Worry and insomnia often become a vicious circle. When you worry, sleep onset is delayed and when sleep onset is delayed, you worry about not sleeping. Then, as another example of ironic processes, the more important it becomes that you must sleep and the more you strive to make yourself go to sleep, the less readily you fall asleep. For occasional insomnia, accept that it’s okay if you stay up, it’s okay if you “just rest,” and it’s okay if you’re tired and not at your best tomorrow.

Predictability diminishes worry by increasing our sense of power, even if the predictions are dire.  For example, some people who have for many years lived in consuming fear of cancer only to develop cancer have commented that dealing with the reality of cancer is actually easier than dealing with the uncertainty that they might get cancer.

Strategies for Reducing Chronic Worry or Rumination:

Reframe most thoughts as “mind junk” rather than important data that must be examined carefully. Distinguish “good” and “bad” worry whenever possible. Don’t be your own worst enemy by indulging yourself in worries and by rationalizing your continuing to do so.

Learn to accept the presence of a worried thought without having to take it so seriously and without having to get rid of it. How do you (overtly and covertly) value and seek worry? How do you worry about worry and (overtly and covertly) try to avoid it? In other words, how do you get locked into a vicious circle of (overt and covert) approach and avoidance?

Try using “scheduled worry” periods. Instead of indulging your worries by giving them your full attention whenever they intrude or by trying to avoid them, set up two or three 15-20 minute periods per day when you give your worries your complete attention. When worries intrude at other times during the day, try to defer them to your next scheduled worry period.

Learn mindfulness meditative techniques that encourage being a passive observer of worried thoughts rather than having to be an active participant in the worrying process. For example, picture your worried thought written on a banner pulled by an airplane and watch it fly around your mind without reacting to it; or, picture your worries as bubbles that burst as they rise into your consciousness.  Seek cognitive therapy that focuses on common cognitive distortions that fuel worry. Examine irrational beliefs that often highlight worry, such as: “The world should be fair and just.” “I must be liked by everyone.” “To be worthwhile, I must be thoroughly competent & exceptional.” “I should be free of pain, hassle or discomfort at all times.” “I cannot bear it when things are not as I would like them to be.” “I can avoid discomfort by worrying.”

Strive to relinquish the need for control and certainty. The quest for both may seem irresistible and compelling at the moment, but, over time, it is entirely futile and merely perpetuates worry.

Try methods to dampen bodily and cognitive mobilization. However, remember that your goal is to do such things while worried thoughts still rattle around your mind, not to do such things so effectively that you somehow eliminate worried thoughts! Learn relaxation and breathing skills. Practice meditation or inspirational readings. Take a yoga class or use yoga videotape regularly. Exercise or dance. Get a massage. Listen to your favorite music. Cultivate humor in yourself and others; rent a funny movie. Always have in progress a book that you enjoy reading. Converse with a confidant. Keep a journal. Keep a record of irrational worries and rational rejoinders. Minimize stimulants; minimize alcohol. Use a rocking chair. Learn and practice good sleep hygiene. Contribute your time and energy to someone else. Make healthy relationships your priority-if not now, when?

Have a plan for action–not the “right plan” or the “perfect plan”–just a reasonable plan. What is the perceived threat to your vital interests? How are you vulnerable? Do you really have the facts? One can’t escape one’s own imagination or run away from what “could” happen. Arousal of the “fight or flight” response with no place to go leads to “freeze” (i.e., inhibition of action). Once you have a plan, don’t keep checking on it-store it. In general, some kind of action is usually preferable to spinning your wheels. Likewise, some kind of large muscle activity is usually better than thinking even more.

Learn to take a mindful approach to moment-to-moment living. 1. Stay in the here-and-now instead of “catastrophizing” and “what-ifing” about what could happen. (Try focusing on your senses and surroundings more than your thoughts.) 2. Stay in the here-and-now instead of dwelling on the past. (Ruminating about the past tends to evoke and perpetuate a depressed mood). 3. Temper an aversive here-and-now by “putting yourself into” something positive remembered in your past or envisioned in your future. (Do so not to get rid of worry, but to put it into better perspective.)

Ask yourself these questions when you’re stuck in worry mode: “What’s the evidence?” “Am I trying to control things that I can’t possibly control?” “Am I overestimating the risk the way I usually do?” “Will this even matter to me next year, next month or next week?” “On my death bed, will I regret not having worried more about this?”

Notice the mistakes you tolerate or excuse in others and give yourself the same latitude. Do not rationalize your perfectionism as a virtue. Instead of perfection, give yourself permission to strive for consistent adequacy punctuated by occasional mistakes.

Look for what is good in your life: “Just imagine how happy you’d be if you lost everything you have right now… and then got it all back.” (Bertrand Russell)