Worry

Is my worry excessive?

Worry is a normal aspect of everyday living. It can help motivate us to act on or problem-solve an issue. It can overcome procrastination by helping us to prioritise.

However, worry has become a problem if there is a pattern whereby one worry, when dealt with, is quickly replaced by another, and if this is experienced as regularly causing excessive levels of anxiety or stress. It may feel like a ‘whirlwind’ of worry.

Excessive worry can create considerable distress, can consume our thinking and lead us to avoid dealing with the thing that is concerning us.

This leaflet briefly describes one model of unhelpful worry and suggests some simple strategies that can be useful in combating it. The leaflet isn’t intended to replace counselling/therapy or to meet everyone’s needs but hopefully it may be a sufficient beginning for some.

A CBT model of worry

Cognitive behavioural understandings of worry tend to emphasise the vicious cycles that worriers can find themselves trapped in. That is, the unhelpful ways in which worriers respond to worry thoughts and how this creates and maintains further worry. So, the worry itself is not seen as the issue, but the unhelpful responses to worry are the real problem.

This model then suggests that the key is not to try to remove the worry itself but to learn to worry more effectively and reduce the time spent in unproductive worry.

Acceptance of a level of uncertainty and discomfort is crucial as is deciding on positive action rather than circular thinking or avoidance behaviours.

Some simple strategies

The following strategies are not intended to each work alone but when put together can initiate the recovery process:

1. Distinguish productive from unproductive worry
2. Stay with the negative emotion
3. Challenge cognitive distortions
4. Overcome avoidance 
5. Be aware of your worry rules

1. Distinguish productive from unproductive worry

Consider for a moment whether you would label the following worries as productive or unproductive:
  a)  I am worrying how I will cope with my 2 and 4 year old daughters as teenagers with boyfriends;
  b)  I’ve been to the bank and there is less money in there than I expected.

Although there is always room for some ambiguity you will most likely have labelled a) as unproductive and b) as productive. This can be a useful benchmark for deciding whether a particular worry would be helped by further thinking. 

2. Stay with the negative emotion

It is natural to want to avoid feeling bad. However we can become so stuck in pre-empting and avoiding even the smallest of negative feelings that we don’t face up to things that we otherwise would.

The chain reaction of physiological changes that happen in our bodies when we get anxious (sometimes called ‘fight or flight’ response) is useful to us in emergency situations. We think and react more quickly when this is happening. It is not harmful for us to have these reactions every now and then. The sensations are less helpful if we pay them too much attention in social situations or when things need a more practical response. So it can be useful when experiencing anxiety to allow ourselves to feel the sensations rather than respond by trying to ‘think them away’.

Facing up to something despite the bad feelings can allow us to get used to something and so reduce the intensity of the feelings on subsequent occasions. For example, if someone who is nervous of public speaking takes on a job that involves giving speeches every day we can envisage that in a month’s time that person is becoming less nervous and more confident.

3. Challenge cognitive distortions

A ‘negative automatic thought’ is a thought that just pops into your head, is short and snappy like a catchphrase, and tends to contain emotive words. We usually experience these when we notice a mood shift, but we aren’t always listening out for them. Typical examples of negative automatic thoughts in worriers might be:

• ‘What if I can’t do it?’ (black and white thinking);
• ‘What if they see I’m an idiot?’ (labelling);
• ‘If I fail this one thing then its all utterly ruined and I’ll never get a decent job!’ (catastrophising);
• ‘What if they think that I don’t like them?’ (mind-reading).
  

If you can learn to catch the negative automatic thought in the moment it comes to you and recognise the distortion in the thought, then you have already begun to question it and accept only the grain of truth in it.

4. Overcome avoidance

Avoidance is an unhelpful response to worry because it stops us discovering that we could cope. Avoidance takes many forms. It can be more obvious avoidance such as putting off a piece of work or avoiding going to a party, or it can be more subtle such as avoiding eye contact or seeking reassurance (avoiding trusting our own opinion).

All avoidance serves to undermine our confidence. It may be helpful to set a hierarchy of easiest to hardest avoidances to face up to, and gradually attempt to do each one for a week or two, before moving up to a harder one.

Other helpful behavioural strategies can be: to apply a written problem-solving approach to worries that seem productive; or to use a decision-making tool (list advantages and disadvantages but give each a rating of 0-10 for importance and score the total for each option).

5. Be aware of your worry rules

Finally, it can be important to start to notice themes in your worries. These might point you to underlying assumptions / rules you have that provoke you to worry. For example a rigid assumption:

• ‘I need to worry to show that I care’
• ‘I must worry in order to be prepared for disappointment’, or
• ‘I must worry so that I can solve any problems’.
  

If we can spot a rule then we can question it. We can ask ourselves, for example, whether this is the best way to show that we care, whether we need always to prepare for disappointment, and whether problem-solving can’t be done without worrying.