It’s All In My Head and I Wish It Would Leave!

If you struggle with chronic worry, there’s a good chance you think you’re unusual. When people come to my office for help with worry, that’s usually how they think about themselves. This is a problem experienced by millions of people, all thinking they’re the only one.

Everybody worries. It’s part of the human condition. The only people who don’t worry are dead people. Everybody experiences thoughts, generally exaggerated and unrealistic, that occur to them about bad things that could happen in the future.
I say the thoughts “occur to them” because worries aren’t thoughts that you deliberately seek out. In fact, you probably try not to have them! The thoughts arise spontaneously, often against your will, or when some chance event reminds you of an unpleasant topic.
This is quite different from the deliberate thinking you do when, say, you consider buying a car. There, you consciously compare possible purchases on the basis of reliability, fuel economy, durability, safety, appearance, price, and so on. You review facts to help you make a decision. Worry is more like the intrusive comments of an annoying coworker who keeps interrupting your work with negative remarks and innuendoes that you find disturbing and unhelpful.

The Comparison Game

If you’re a chronic worrier, you might think you’re one of a small group because you don’t see anyone who resembles your vision of yourself. Instead, you see people who seem so cool, calm, and collected that it appears they never worry, and this makes you feel inadequate by comparison.

My clients often tell me this. Seeing others who appear to be worry-free leads them to feel bad about themselves. I often feel the same way, if I’m at a party or a conference surrounded by people who seem super confident.
I usually figure I’m wrong about this, though, and if you have similar kinds of thoughts, you probably get fooled the same way I do. When you see people who appear to be cool and confident, you make this judgment from their outward physical appearance—the look on their face, their eye movements, how they hold their shoulders, the tone of their voice, their use of gestures, and so on. They look like they don’t have a care in the world. You see their outer appearance and compare it to how you feel inside.
This is how you get fooled. You compare what you experience through your nerve endings to what they display on the outside. It’s apples to alligators—no comparison.
What is different for some people—and this is a big difference—is how they respond to worry. That’s the ball game, how you respond to it, not whether or not worrisome thoughts occur to you.
It may surprise you to hear that what you worry about, the specific content of your worrisome thoughts, isn’t usually all that important. What’s most important is how you relate to your worrisome thoughts, whatever their content may be.

The Content of Worries

There are differences in the content of worries and the subjects that people worry about. Some people worry mostly about ordinary events, problems that occur to most people at some point in their lives. It’s common to worry about such topics in response to negative changes in life circumstances. During an economic downturn, for instance, lots of people experience thoughts about what they’d do if they lost their jobs or had trouble paying the rent or mortgage. They might have similar worries about losing their jobs or homes when there’s some other change, like a new boss or landlord, which increases the uncertainty in their business relationships.
Sometimes people respond to these worries by developing a plan of action, and then the worry often fades and can be considered to have served a useful purpose. It identified a potential problem and led you to prepare a solution.

Are You an Equal Opportunity Worrier?

Other times people experience worry not in response to negative developments, but quite the opposite—they worry when good things happen!
A parent might experience worries about losing a job, even when the economy is good and his work evaluations excellent, or when a child gets accepted at his first choice of (an expensive) college and congratulations would be in order. A person leaving for a dream vacation, who’s never forgotten to turn off the coffee pot and doesn’t usually ever give that a thought, may be plagued by worries about that coffee pot after having boarded the plane. “Good” events, maybe a job promotion or the arrival of a new child, can often be the trigger for persistent, unrealistic worries about other possible problems in life.
People worry in response to these positive events out of a superstitious thought that now would be a particularly “bad time” for the event to occur. Thoughts such as Wouldn’t it be ironic if the problem happened now, and Now I have so much more to lose are what often convert good developments into occasions for worry.
So people may experience an upsurge in worry in response to good events or bad. Worry usually has a very poor record for predicting what actually happens in the future because worry is based on ideas of what “would be bad” rather than what is likely. If worry was your stockbroker, you’d fire him!
Other times people get caught in a pattern of worrying about bad possibilities that seem far less likely, not only to most people but also to the worrier as well, at least most of the time. These are the kinds of worries that people sometimes identify as “irrational” or illogical worries. This might include worries about making some kind of mistake—leaving the stove on, accidentally pouring insecticide into the sugar bowl, driving over a pedestrian without noticing—that appears to be an extreme, unlikely, even bizarre possibility. However, the possible result of such an error seems so terrible to the worrier that he or she strives to “make sure” that it doesn’t happen, and this effort to be sure becomes a chronic worry activity.
To summarize, there are differences in the kinds of content people worry about. Some people experience occasional worry about fairly ordinary problems and don’t find this worry to be an ongoing problem, just an occasional nuisance they can dismiss. In fact, it often signals them to take some appropriate action and can therefore be considered to be helpful.
Others, however, have much more difficulty with worry. Sometimes people worry about ordinary possibilities but find themselves unable to dismiss those worries from their minds, and worry endlessly about fairly ordinary problems. Other times people worry about possibilities that seem extreme and unlikely, so much so that that it leads them to become chronically obsessed and preoccupied.
It’s not the content of the worries themselves that distinguishes ordinary from chronic worrying. The key is how we respond to worry, how we relate to it. This is what distinguishes a person with only modest, occasional worry from a person with chronic, persistently upsetting worry. It’s the relationship we establish with worry, how we try to live with it and manage it, that defines the kind of worry we have.
Let’s take a look.

Ordinary Worry: A Workable Relationship

Ordinary worry is sometimes unrealistic, but the unrealistic worries come and go. They don’t form a consistent pattern over time. A student may worry about a test sometimes but doesn’t anticipate flunking out every time there’s a quiz. An employee may worry as her annual review approaches but doesn’t anticipate getting fired every time she meets with her boss.

Ordinary worry is an occasional part of your life, one that doesn’t usually interfere too much with your activities. Sometimes it can help focus your attention on issues that need a solution and lead you to do some planning and problem solving. This kind of worry typically ends when you have identified a solution and taken action. That’s a good thing!
Other times it doesn’t particularly identify a problem and lead to a solution so much as it reflects a general state of anxiety. For instance, when you’re not feeling well because of several days of the flu, or you’re overtired, or you’re suffering a major disappointment in work or love, you may get more caught up in worries that you would ordinarily dismiss.
The ordinary worry relationship is similar to the kind of relationship you may have with a neighbor or coworker with whom you’re not closely tied. You see them but don’t interact very often, probably less than once a day. When you do, you say hello and are superficially nice, but you don’t have a strong emotional attachment to that person, good or bad. It doesn’t ruin your day if you have a disagreement with them. It doesn’t make your day if you have a nice encounter with them. They’re just not that important to you.
People who have this ordinary kind of relationship with worry might get into struggles with worries, but only occasionally. They know the worries pass, so they usually don’t usually spend a lot of time and energy responding to the worry. They just don’t care that much about the worrisome thoughts that occasionally come and go. And, perhaps the most important distinction, they don’t worry about how much they worry.
The dysfunctional relationship of chronic worry, however, is something else entirely.