How To Break The Chronic Worry Cycle By Accepting Uncertainty
“Some men storm imaginary Alps all their lives, and die in the foothills cursing difficulties which do not exist.” ~Edgar Watson Howe
It's one thing to worry about traffic making you late for an important appointment.
Or about a heavy thunderstorm blowing down the big tree over your house.
Or about your teenager taking the car out alone for the first time.
These situations merit a bit of worry. A negative outcome is possible.
But if you are a chronic worrier, then you've experienced worry on steroids — the kind of worry that is your constant companion and puts your stomach in knots. It's the worry that cycles in your head like a worn out tape playing over and over again with the same dire messages about things that rarely come to pass.
Chronic worry is debilitating and exhausting, and it can lead to generalized anxiety and even a full-blown depression if the cycle isn't broken. It robs your peace of mind and joy in life, even when there is nothing unpleasant or difficult actually happening in your world.
Some worry is good when it is proportionate to the actual situation you are worrying about. It is part of our survival instinct and can prod us into finding solutions and protecting ourselves from danger.
But if your worry is out-of-proportion to the thing you are worrying about, or if you are worrying about the possibility of something happening with very little or no evidence that it will come to pass, then your worry is a problem. It can negatively impact your relationships, your career, and your overall health.
Why Do Worriers Worry?
According to Robert L. Leahy, PhD, the author of The Worry Cure: Seven Steps to Stop Worry from Stopping You and the director of the American Institute for Cognitive Therapy in New York City, there is both a genetic and early environmental component to being a worrier.
Dr. Leahy suggests that people who were over or under-nurtured by parents can develop an overall view that the world is inherently dangerous (for the under-nurtured) or a risky place (for the over-protected). These particular worriers tend to believe they are especially fragile and not emotionally equipped to handle uncertain situations.
Dr. Leahy also finds that people who come from divorced homes are 70% more likely to have generalized anxiety disorder — characterized by chronic anxiety, exaggerated worry, and tension. And he suggests that situations in which a child must play a caretaker role to an under-functioning parent (reverse parenting), may also predispose someone to chronic worry.
As mentioned above, chronic worriers often have generalized anxiety disorder (characterized by excessive, uncontrollable and irrational worry about everyday things that is disproportionate to the actual source of worry, lasting for more than six months). According to Dr. David Carbonell of anxietycoach.com, generalized anxiety disorder involves these four processes:
- arguing with your thoughts;
- worrying that you’re worrying so much;
- constantly imagining negative “what if’” scenarios;
- and desiring to eliminate all doubt that the bad thing will never become reality (no uncertainty).
A word commonly associated with chronic worry and generalized anxiety is “hyper-vigilance.” People falsely assume that intense focus on the issue can help them keep a perceived problem from spiraling out of control. Worry offers a false sense that they are on top of the problem.
“People worry because they think something bad will happen or could happen, so they activate a hyper-vigilant strategy of worry and think that ‘if I worry I can prevent this bad thing from happening or catch it early,'” Dr. Leahy says.
Another hallmark of chronic worry and generalized anxiety disorder (GAD) is the belief that every problem or concern should have an immediate solution. Worriers have a low tolerance for ambiguity and uncertainty.
Albert Ellis, the founder of Rational-Emotive Behaviour Therapy (REBT), identified one of the most common dysfunctional beliefs of worriers as this: “There is invariably a right, precise, and perfect solution to human problems and it is catastrophic if this perfect solution is not found.” (Reason and Emotion in Psychotherapy, 1962).
A number of recent studies reveal that intolerance of uncertainty is a trait linked to GAD and other problems. Researchers have learned that some chronic worriers prefer the certainty of a negative outcome actually happening to the uncertainty of not knowing. They feel more comfortable coping with the perceived problem than fretting about it.
The quest for certainty with chronic worriers rarely provides the comfort and satisfaction they seek. Worriers have a tendency to waste time and energy in futile and repetitive attempts to find a “perfection solution” where there isn't one. The search for certainty also leads to procrastination and avoidance since taking action (ie: going to the doctor when you fear cancer) could involve risk and negative outcomes.
Treatment for Chronic Worry
Cognitive behavioral therapy (CBT) (which is based on the idea that thoughts control our feelings and behaviors rather than outside circumstances or people) has been a traditional treatment for chronic worry and GAD. The goal is to help people recognize false worry beliefs and thought patterns which are irrational or unrealistic, and then replace them with more rational and realistic views.
Psychologist Michel Dugas, Professor and Director of the Anxiety Disorders Laboratory in Health in the Department of Psychology at Concordia University, has focused his treatment work on the concept of “intolerance of uncertainty” within CBT. Dugas' treatment outcome studies provide evidence that his approach, based on acceptance of uncertainty, is more effective than traditional CBT for generalized anxiety and worry. In fact, 77% of chronic worriers were significantly better at the end of treatment.
Dugas' approach involves five key components:
1. Worry awareness training
The worrier keeps a daily journal of worry topics to identify them when they arise and recognize main themes that appear as worry.
2. Coping with uncertainty
The worrier works to cut back on the number of attempts at doing or thinking about ways to reduce uncertainty. They work to challenge their beliefs that uncertainty is intolerable. The worrier also practices deliberately embracing uncertainty in worry-related situations.
3. Challenging positive beliefs about worry
The worrier challenges the notions that worry is a positive character trait that helps with problem-solving, is motivating, protects you from negative feelings, or prevents negative events. Challenging these beliefs about worry may involve evaluating the pros and cons in detail about a specific worry to sort out helpful and unhelpful instances of worry.
4. Problem-solving training
The worrier works to develop a positive and confident attitude toward problems, viewing them as challenges rather than threats, while developing specific planning skills to meet the challenges.
5. Imaginary exposure to core fears
For worries that can't be solved through problem solving techniques, the worrier reverses the idea of mental avoidance by “habituation” — repeatedly visualizing the feared catastrophic outcome and accepts his negative feelings until they are reduced. The bad outcome is visualized for periods of around 30 minutes until you grow bored with the idea and the anxiety naturally settles down.
The goal for chronic worriers is to be able to distinguish between worries about real, current problems and problems related to hypothetical situations. The worrier needs to learn to discern problems that are actually solvable and those that are not.
Worries that are solvable can be addressed using traditional problem-solving techniques, which involves cultivating a positive and confident attitude toward problems, thus creating the right frame of mind to work on solutions. After the attitude shift, one can use four steps to handle the problem:
- Define the problem and goals;
- Brainstorm possible solutions;
- Weigh the consequences;
- Create a plan of action and implement solutions.
Of course, getting to the implementation stage requires that worriers move beyond procrastination and avoidance and take positive action despite some degree of uncertainty and risk. Once the action is taken, the worrier learns that risk is not as painful as they might have perceived it to be.
If you are a chronic worrier, I encourage you to address your worry using the techniques I describe above. Begin by accepting that worry is a counter-productive emotion that plays no role in helping you find answers or solutions.
If you find that your worry has spiraled into a full-blown anxiety disorder or depression, find a counselor trained in cognitive behavior therapy to help you learn techniques to disengage from worry and reclaim your life.