Statistics suggest that approximately one in five adults suffers from an anxiety-based condition of which a prominent feature is some form of worry.
What is Worry?
We could define worry as:
- A chain of thoughts
- Accompanied by feelings of anxiety
- About future events
- Where the outcome is uncertain and
- Where there is a focus on potential negative consequences
- In the hope of reducing danger
Therefore we can help contain excessive worry by a range of means including disrupting a negative chain of thoughts, focusing more on the present (including on the task at hand), accepting uncertainty about the future, not overly focusing on negatives, having realistic views about the actual danger we face and further developing anxiety management strategies. This blog is focused on a range of strategies to help reduce unproductive worry and its impact on us.
Worry-related stress relates to our perception of:
- The risk of a negative outcome
- How bad that outcome would be
Therefore our worries will be particularly intensified if we have an exaggerated view of the likelihood of a negative outcome or of the potential harm which might result.
A realistic view of the actual dangers we face will help contain worry. Therefore it may help to ask ourselves how likely is it that a particular event will happen and if it did, what would be the worst thing about that. We can also ask whether worrying will alter the likelihood of a negative event occurring. We might then test our negative predictions and factor in our experience to our future predictions. Research suggests that approximately 95% of feared outcomes which people worry about do not actually happen.
Commonly, worry is experienced as repetitive concerns about particular circumstances such as worry about the welfare of family or friends, about work or school, about home-related issues, about finances, about health issues or about a forthcoming event. Worry is sometimes compounded by concerns about the worry itself, or worrying about worry. For example, people may view their worry is uncontrollable or as harmful or as indicating a failure to cope. This can create a vicious cycle where worry just leads to more worry.
The single most important strategy in countering worry is shifting from a focus on our worrisome thoughts to taking some productive action.
For example, rather than worrying about our health or finances, we can think of what we might do to improve our circumstances. If we are concerned about our relationship with a family member, we could think of what we might do, even symbolically, as an action to help improve that relationship.
What Makes Worry Worse?
Thoughts which may compound the negative effects of worry include:
- Catastrophizing: This commonly involves an escalating pattern of increasingly exaggerated concerns about what negative outcomes may occur.
- Overvaluing worry as a coping strategy: we may have an inflated view of the potential of worry to help us cope or be prepared for possible negative outcomes. Worry may commonly be merely adding further to the stress we are experiencing.
- Anticipating negative events as a form of control: this may include anticipating the worst in the hope that we will be ready for even the most adverse outcome. In fact, this strategy tends to make the lead-up to challenging events extraordinarily stressful.
- Misinterpreting worry as a failure to cope: such judgements typically only add to one’s stress.
- Intolerance of uncertainty: Much of life involves uncertainty and we will typically experience a greater level of well-being if we are focused on what we can productively or enjoyably do in the present rather than having exaggerated expectations of predicting or controlling an uncertain future. We can nonetheless take constructive action in the present to sensibly reduce future risks.
- Other common thinking errors: Apart from catastrophizing, common thinking errors include selectively focusing on negative rather than positive information, jumping to conclusions, overgeneralising from past negative experiences, all-or-nothing thinking or personalising situations whereby we take excessive responsibility for the outcome of situations including events over which we had minimal control. Such distress-inducing thinking patterns can lead us to feel as bad as if our exaggerated negative thoughts were true. This is because our emotional reactions to a particular situation or set of circumstances are affected by our subjective perception of those circumstances, not by the objective situation itself.
Behaviours which may compound the negative effects of worry include:
- Overly seeking reassurance: if we do not receive that reassurance we may worry more. If we do receive that reassurance we may think that is the reason that we have managed with a situation. Either way, this can lead us to overly focus on receiving reassurance from others in future rather than finding our own ways of coping with a situation.
- Avoiding situations related to worry: if we avoid challenging work or social situations which we are worried about we will typically not be further developing our coping skills and strategies for managing more effectively with such situations. Furthermore, our avoidance of situations may further convince us that they are in fact dangerous as opposed to being merely challenging and potentially uncomfortable.
- Overly seeking information as a form of control: for example, if we repeatedly and persistently seek information on the internet to allay a health concern we may be at risk if intensifying unrealistic fears rather than seeking reliable and balanced information in a contained way.
- Use of alcohol, drugs or comfort eating: such means of attempting to reduce intrusive thoughts or anxiety represent another form of unhelpful avoidance which commonly compounds worry and may lead to worsened additional problems.
Attitudes Which Contribute to Worry and Ways to Address Them
- Fears of failure or perfectionism: people are more prone to worry if they have harsh expectations of themselves or unrelenting standards related to their performance. Aiming to do one’s absolute best all the time would inevitably lead to anxiety. It is worth comparing our expectations of ourselves to what we would consider to be acceptable in terms of other’s performance. It is worth considering what things are so worth doing that they are worth doing less than perfectly, which also enables us to get more things done. As commonly emphasised by successful entrepreneurs we can learn much from our failures. In general, it helps to separate our sense of self-worth from our performance on a task or activity. As Mark Twain suggested, we might treat success and failure as twin imposters.
- Fears of disapproval: It is also important to separate our sense of self-worth or self-acceptance from the perceived approval we receive from others. Others will vary in their subjective opinion of us, but that does not mean that our inherent worth changes as a result. When people experience social anxiety or avoidance and worry about others’ potential disapproval it can be helpful to face avoided social situations, to take risks such as venturing alternative opinions and to practise asserting oneself in conflict situations. It can then help to compare one’s experience of such interpersonal situations to what you might have predicted. Whenever facing potentially challenging situations it is worth giving oneself credit for one’s efforts and for any ensuing benefits such as improved social interactions and increased enjoyment.
- Exaggerated fears of discomfort: in general, discomfort is uncomfortable as opposed to dangerous. If we have avoided or shied away from situations as a result of anxiety it can be helpful to gradually face such situations and recognize the progress that comes from allowing oneself to experience a degree of discomfort. It generally helps to face challenging situations whilst staying in the moment or “being in our own skin” rather than trying to block out our feelings; we can then develop further emotional strength and resilience. Gaining increased confidence in facing challenging situations and dealing with any ensuing anxiety is commonly the most effective way of reducing worry in the longer term. We can then perceive a wide range of situations as being less threatening and dangerous.
Other attitudes more common amongst those with more disruptive patterns of worry include:
- Viewing worry as uncontrollable: given that worrying is influenced by a conscious desire to improve our future circumstances it involves a degree of will and at least partial control. Perhaps the most effective way of gaining an increased sense of control over-worrying is to repeatedly practise disrupting a chain of worrisome thoughts by initiating some other activity which engages our attention. This might include some activity which either practically or symbolically could help improve the circumstances that we are worried about. Otherwise, it can involve engaging in any alternative pleasurable task. Disrupting worries in this way has been found to alter our brain functioning in a manner to reduce future worries.
- Another way of increasing our sense of partial control over worrying is to postpone our worry to a period later in the day. For example, one may set aside 30 minutes in the evening to sit in a particular “worry chair” and to postpone contemplating one’s concerns about a particular situation to that time. Containing or limiting worry as opposed to attempting to completely block it or stop it can sometimes be a more effective way of gaining a sense of further control over worry.
- Viewing worry as dangerous: People may be concerned that worry in itself may lead to some serious harm either mentally or for their physical health. This may be influenced by hearing that there can be long-term physical complications from prolonged stress reactions. Reactions such as intrusive thoughts, reduced energy and increased physical tension are uncomfortable more than dangerous. A person may fear developing debilitating physical ailments or losing their mind from worry. In a therapy context people may be encouraged to challenge such fearful predictions by attempting to lose control and to actually “lose” their mind in a particular way such as deliberately inducing a psychotic state. After a brief experiment people typically abandon their efforts as it becomes evident how unrealistic such fears are. People can consider whether friends or others who have acknowledged tendencies to worry appear to be uncommonly plagued by harmful physical illnesses and conditions.
Additional Strategies to Counter Worry
Prediction testing: Given that worry commonly involves overestimating the risk of danger or likely harm it can help to make a prediction as to how a particular situation will unfold and then face that situation and see what actually happens.
- Characterise persistently intrusive thoughts as a visitor: for example, if particular thoughts return you might say to yourself, “There’s Fred again”, and pretend that the thoughts are a visitor who might be invited to sit in the room or to be alongside you whilst you nonetheless engage in another activity.
- Convert the worrisome thought to a picture: rather than thinking over and over the worrying thoughts, it may be helpful to instead form of picture or envisage a scene which involves the challenging situation you are worried about and then imagining yourself dealing with it in some way.
- Grieve when facing losses you cannot change: for example, if someone has been diagnosed with a very serious illness which would likely markedly reduce life expectancy, it is natural to allow oneself to grieve whilst contemplating potential or likely losses including a curbing of realistic future hopes and altered plans. Allowing oneself to grieve can help gain greater acceptance of a seriously adverse situation which may, in turn, help the person to make the most of what opportunities remain.
- Gratitude exercise: you may imagine losing absolutely everything which is important to you including family members, your home, your job, and even your senses of sight and hearing. Allow yourself to imagine only regaining these, one by one, but only after fully experiencing and expressing gratitude for each thing which is to be returned.
- Generating other positive emotions: given that positive emotions tend to “wash away” residual negative feelings, it can help to do anything which involves the experience or expression of other positive emotions including love, faith, trust, hope, joy, forgiveness, compassion and awe.
- Anxiety management strategies: given that worry is associated with anxiety, any strategies which reduce arousal or tension levels may be helpful including breathing and relaxation strategies or coping self-statements (e.g., “I’ll be okay”, “Let it be”, “Focus on now”, “I’ll get through it”, “Breathe”, etc). However, it is important to combine such strategies with other techniques which more directly challenge worry-inducing thoughts and behaviours.
People typically make the greatest progress by repeatedly facing challenging situations whilst allowing themselves to tolerate associated discomfort and testing their predictions about feared outcomes. It seems that progress is more reliable if it is allowed to be gradual and imperfect, but is nonetheless backed up by genuinely appreciating and acknowledging one’s efforts.
The Most Important Strategy
The most important thing to remember when addressing patterns of worry is to repeatedly practise ways of interrupting a chain of worrisome thoughts by taking some alternative action, preferably by doing something which is productive or enjoyable.
Please also listen to a podcast below that expands on these themes further.
For a demonstration on a useful therapy technique to combat worry, watch this video from Chris Mackey.