You CAN Change Your Worry Habit
That doesn’t mean you’re stuck without hope of a solution. Worry is actually a manageable, workable problem. The reason people have so much trouble with worry is that worry literally tricks you. It goads you, tricks you into responding in ways that you hope will help but which actually make your troubles more severe and more persistent.
If you have struggled with worry for a long time, and find yourself unable to solve the problem, this is why. You don’t have trouble solving this problem because you’re too weak, too nervous, too stupid, or too defective somehow. You have trouble solving this problem because you get tricked into trying to solve it with methods that can only make the problem more severe and more chronic. I’m going to help you uncover this trick, find evidence of it in your own life, and learn how to handle worry in a more effective manner.
I usually don’t pay much attention to those doubts. I know they’re there, because I can’t know what the future really holds, but they don’t usually bother me too much. I just go on about my business and figure that I’ll respond to events as they arise. That, literally, is life.
How do you struggle against the doubt? You might try hard to prove to yourself that the feared event simply won’t happen. This usually results in arguing with yourself and feeling more anxious as a result. You try to “stop thinking about it,” only to get the same results that come from banning books—it increases your attention to and interest in the unpleasant idea! You might try to do something to protect against the feared event and then find yourself worrying about whether or not that protection will be sufficient. You might bother your friends and family with repeated requests for reassurance. However, when they do tell you that you’ll be okay, then you worry that they’re just humoring you so you’ll stop talking about it.
And you get dug in, deeper and deeper, with more doubt and fear, and more unsuccessful struggle against it.
If you were planning on cooking a special meal for your boss and her husband tonight, and experienced the thought What if I get stuck in a traffic jam on the way home?, you might try and remove that doubt by making sure it couldn’t happen. You could set your GPS to give you notices of traffic delays; you could check the Highway Department website for notices, or call their 800 number; you could take local roads, even though that would make for a longer trip. You could call your spouse and ask what she thinks your chances are of getting stuck, trying to get some reassurance. You could develop a backup plan by identifying a restaurant that could deliver on short notice, and keep their phone number handy. That might remind you that you’re very dependent on your cell phone, and you might start monitoring its battery strength very closely.
If you had a winter cold that lasted longer than usual, and experienced the thought What if I have cancer or some other terrible illness?, you might try similar methods to clear your mind of the worry. You might consult your physician, which is usually not a bad idea, but if that didn’t clear your mind of this worry you might consult several other doctors as well. You might read up on your symptoms on various Internet sites. You might look at the obituaries, to see if anyone your age had died of cancer recently. You might look at a medical encyclopedia. You might ask the neighbors if they knew of any colds going around.
In each case, you could expend a lot of time and effort trying to prove to yourself that you have “nothing to worry about,” that there is no chance of getting caught in a long traffic jam or of having cancer.
Unfortunately, you probably won’t get much relief from these efforts because you can’t really prove that something won’t happen. You can recognize that it’s very unlikely, but there’s no way to prove to yourself that some calamity isn’t going to happen tomorrow, because just about anything, no matter how improbable, is possible if your rules of evidence are loose enough.
So I can’t prove that nothing will make me late for dinner tonight because it’s impossible to be sure. The thought just doesn’t bother me. However, if I did feel really bothered by the thought, I would probably be tempted to try to get rid of that thought, and that’s where I might run into trouble.
None of us knows the future. We know everyone dies (so far!), but we don’t know when, and we don’t know how. Most likely, tomorrow will be pretty similar to today. But if you try to prove it won’t be different, you can’t. And if you take your failure to prove that it won’t be different as evidence that something bad will happen, you’re in for a lot of worrying. Here’s an example from my own life.
Shortly after my son was born, he developed jaundice—his skin was yellow. It’s common among newborns, pretty harmless, and generally disappears within a few days. If treatment is necessary, the standard treatment is light therapy, in which the child wears a special light for several days. My son needed the light therapy.
Our conversation with our pediatrician went very poorly. My wife asked what would happen if the light didn’t fix the problem. He said this was unlikely, that it almost always worked, and mentioned some really rare problems that could develop if it didn’t. She asked what we could do then, and he mentioned a few minor procedures that would probably help. She asked what we’d do if those failed. The doctor said that was unlikely, but that in an extreme situation, a complete blood transfusion—the replacement of all the blood in our son’s body—would probably solve the problem. She asked if that was safe, and he said that the blood supply is generally safe, but that there’s always the risk of contracting AIDS, hepatitis C, and other diseases from a blood transfusion.
What an agonizing ten minutes that was! We had gone, in seconds, from arranging pretty routine care for our beautiful son, to contemplating the prospect that he would get AIDS before his first birthday. And it was all foolishness—not because we were fools, but because we all did what came naturally in our roles as parents and doctors. My wife asked for concrete answers to remote, hypothetical questions in an effort to calm her worries. The pediatrician answered them literally and completely, hoping to remove our doubts. I did nothing because I couldn’t figure out how to make it better. The result was that we spent time vividly worrying about a terrible problem that was almost (but not quite) guaranteed not to happen. For several days, until the jaundice began to slowly fade, we lived with intermittent thoughts of our son contracting a dread disease.
I say “almost (but not quite) guaranteed not to happen” because you can’t ever get a satisfying guarantee that something won’t happen. Even if it’s something that appears impossible, you won’t get the certainty you want. Here’s an example of what I mean.
Does your car have a flat tire? (Don’t look out the window!)
When I ask people this question, as we sit in my office, they almost always say no. But they can’t see their car from my office. How do they know?
They don’t know for sure. It’s just that they didn’t have a flat the last time they looked at their car, and that’s good enough for them. Unless they have a particular issue of worrying about getting a flat, they assume that the tires are still okay.
But with the particular topics they worry about, they want to feel absolutely certain that they don’t have a problem, and so they continually try to prove that the problem they fear doesn’t, and won’t ever, come to pass. If they wanted to be sure of not having a flat, they would probably want to go down to the parking lot during the session to check, and would likely mention their doubts as we talked, looking for reassurance.
There’s a way out of this problem, and I’ve written this book to help you find it. If you’re like most people who struggle with worry and anxiety, you probably have mixed feelings about even reading this book. You hope that it has some answers, but you also worry that it will create more trouble for you. You might figure that you have enough worries on your own, you don’t need any help thinking up new ones! Maybe you looked at it in the bookstore and quickly scanned a few pages (or scanned some sample pages online), ready to toss it back on the shelf if you started to feel anxious reading it.
People are often so used to using distraction and other ways to try to avoid unpleasant thoughts that the idea of reading a book about worry seems worrisome! It goes against their natural instinct of seeking to avoid worry.
So you might feel more anxious when you first start to read these words. In fact, it’s very likely. I understand how uncomfortable that is, but I want you to be aware that it’s not a bad sign at all. The first time people come to see me for help with anxiety and worry is usually the most anxiety-provoking visit. They hope they’ll get a good result, they’re afraid that they won’t, and they’re particularly afraid that our conversation will lead them to worry more rather than less. It’s anticipatory anxiety, the kind you’re likely to experience just before you become engaged in a task.
Have you ever stood on a beach at the water’s edge, trying to get used to the temperature of the water before you go in? You might stand there a while, feeling cold, splashing some water on your ankles, trying to get used to it, but probably feeling colder for all your effort, standing there in the breeze and feeling the difference between your skin temperature and the temperature of the water. You won’t really acclimate to the water temperature until you get in it, and then you will feel more comfortable. Your natural desire to feel comfortable first causes you to experience more discomfort as you literally postpone and delay the moment of relief that comes with getting in the water.
That’s how it usually works with worry. It’s okay to feel nervous at the outset, and actually very predictable. Don’t be tricked by that nervousness—it will fade. Come on in, the water’s okay!
He noticed a headache and vaguely wondered if he was giving himself a cerebral hemorrhage with all his worrying. He wasn’t sure what a cerebral hemorrhage was, or how you got one, but what if this was how it happened, sitting at your desk and worrying? He felt thirsty, and remembered some warnings he’d heard about getting dehydrated on long airplane flights. How long is too long without water? he wondered. Maybe dehydration contributes to cerebral hemorrhage. He pushed his chair back and got up, deciding to head for the water cooler. His back hurt. He remembered sleeping poorly last night, and hoped he’d have better luck tonight. He wondered if he’d be better off going to bed earlier, or later. What if he got so tired that he became ineffective at work?
Walking toward the water cooler, he remembered that his boss would be in all day. He’d have to pass her office on the way to the water cooler. What if she looked up and saw him walk by? What if she wondered why he wasn’t in his office, working, and thought that maybe he was losing his edge? What if she called out “Hi Scott” as he was walking by, and what if he couldn’t think of anything to say, and just stared or mumbled? He had a performance review in three months. What if she took a good look at him today and realized how anxious he was? He had a long history of good work, good evaluations, and steady promotions, but what if he was topping out now, and it became obvious to her, and to everyone else? What if they had already noticed?
Scott decided he wasn’t that thirsty. He went back to his office. He resumed trying to work on his report and made some revisions. But it wasn’t too long before he had the thought What if I get dehydrated and have a seizure? He tried to distract himself by playing solitaire on his computer, but the worrisome thoughts kept breaking through. Finally, he opened his browser so he could search for information about seizures, dehydration, and cerebral hemorrhages.
And on and on it goes. Scott’s actually a healthy guy, a productive and valued employee, with a good family and an apparently happy life. Scott is also a worrier.
He’s tried hard to control his worry, and he’s tried many things. He took medication for a while but didn’t like the way it made him feel, and he worried about long-term side effects, even though the doctor said there probably wouldn’t be any. He drinks more now than he used to, in an effort to fall asleep without tossing and turning. It helps him fall asleep faster, but he doesn’t feel rested when he wakes, and he worries about becoming an alcoholic. He exercises and monitors his diet to keep himself as healthy as possible, but finds he’s got an unhealthy mind in a healthy body. He thought about trying meditation, but was afraid of letting his mind go blank, expecting that it would get filled with more worrisome thoughts. He spends a lot of time trying to distract himself and avoiding unpleasant thoughts. He doesn’t watch the news anymore, or read newspapers, because he’s afraid of unpleasant topics. He avoids television shows about hospitals and other medical settings.
Scott feels best when he’s not worrying. Sometimes he’ll go for days, even weeks at a time without significant worry. That feels good to him. But sooner or later, he notices how good he feels and realizes that he hasn’t been worrying. And then, the thought occurs to him: What if I start worrying again? You can guess the rest. He resumes worrying. He tries to stop. He fails to stop, and the cycle repeats. Sometimes he’s filled with despair, as he alternates between worrying about possible problems that never seem to materialize and worrying about how much worrying he does.
Scott is a chronic worrier. He has a strong case of it, but there’s hope and help for him, and for you as well, if this is your burden.
Ann won’t go to a party or other social occasion without her husband, because she fears getting into a conversation and becoming too anxious to talk. She usually has a glass of wine, or two, before going to a social event. What if I can’t think of anything to say, and people just look at me, waiting for me to talk? she worries. She pictures herself trapped in a social encounter, becoming visibly nervous and alarming others at the party with her excessive sweating, trembling hands, and inability to speak. As long as her husband will be with her, she figures she can ride it out because he will keep the conversation going while she calms herself or takes a bathroom break.
The idea that she could excuse herself for a bathroom break calms her a little, but she worries about that as well. She has never actually taken a bathroom break for this purpose. She has the idea that should she do so, she wouldn’t be able to go back to the bathroom again during that party, because people would wonder why she was going so frequently. Since she thinks she can only do this once, like using a “get out of jail free” card in Monopoly, she figures she has to save it for emergencies, and so she really can’t use it at all!
Ann feels very self-conscious about her anxiety and tries to keep it to herself. She worries what her employer and coworkers would think of her if they knew how anxious she gets about everyday conversations. Her boss has asked her on several occasions to lead a discussion at a staff meeting, and each time Ann has begged off with some excuse. She worries that she’s running out of excuses. What if my boss stops believing me? she worries.
Therapy for social anxiety disorder would probably be very helpful for Ann, but she dreads the moment of sitting down with a stranger who will ask intrusive questions. What if I start panicking right there in front of the therapist? she worries. I’ll look like a crazy person! The worries she has about her nervousness are what prevent her from getting the help she needs. If she can find some way to relate differently to those worries, that will be the key that enables her to move forward with her life.
If it’s literally true—the harder I try, the worse it gets—then this probably means there’s something wrong with the methods you’ve been trying. Not with you. And it means you’ve been looking in the wrong place if you’ve been blaming yourself for your worry troubles.
The very efforts people make to stop their worries are what strengthen and maintain them. Seeing how the worry trick operates in their lives—and yours—will be a valuable help in solving this problem. The next chapter will introduce you to a new way of thinking about your relationship with chronic worry.
If you have struggled with worry for a long time, and find yourself unable to solve the problem, this is why. You don’t have trouble solving this problem because you’re too weak, too nervous, too stupid, or too defective somehow. You have trouble solving this problem because you get tricked into trying to solve it with methods that can only make the problem more severe and more chronic. I’m going to help you uncover this trick, find evidence of it in your own life, and learn how to handle worry in a more effective manner.
What Is the Worry Trick?
The trick is this: you experience doubt, and treat it like danger.
We all live our lives as if we know what’s going to happen. Most days, when I leave for the office, I tell my wife and son what time I’ll be home. I say it like we can count on it, but of course I don’t really know for sure. I might end up booking an extra appointment and staying late; I might be home early because my last appointment cancels; I might return some phone calls that become lengthy conversations; I might have a flat tire, or get stuck in a traffic jam. If it’s a really bad day, I might even die unexpectedly.I usually don’t pay much attention to those doubts. I know they’re there, because I can’t know what the future really holds, but they don’t usually bother me too much. I just go on about my business and figure that I’ll respond to events as they arise. That, literally, is life.
Danger or Discomfort?
If you or I have a doubt that really bothers us, though, we’re likely to respond very differently. We’re likely to treat that doubt as if it were a sign of danger, rather than the usual discomfort we can feel about uncertainty. When you get tricked into treating the discomfort of doubt as if it were danger, this leads you to struggle against the doubt, trying to remove the unwanted thoughts from your mind.How do you struggle against the doubt? You might try hard to prove to yourself that the feared event simply won’t happen. This usually results in arguing with yourself and feeling more anxious as a result. You try to “stop thinking about it,” only to get the same results that come from banning books—it increases your attention to and interest in the unpleasant idea! You might try to do something to protect against the feared event and then find yourself worrying about whether or not that protection will be sufficient. You might bother your friends and family with repeated requests for reassurance. However, when they do tell you that you’ll be okay, then you worry that they’re just humoring you so you’ll stop talking about it.
And you get dug in, deeper and deeper, with more doubt and fear, and more unsuccessful struggle against it.
Fear of the Unknown
People sometimes talk about “fear of the unknown” as if it were a special category of fear. Everything about the future is unknown! It’s not the unknown part that people find scary. It’s when they consider the future and think that they do know what will happen, and that it’s going to be bad. That’s when they get afraid.If you were planning on cooking a special meal for your boss and her husband tonight, and experienced the thought What if I get stuck in a traffic jam on the way home?, you might try and remove that doubt by making sure it couldn’t happen. You could set your GPS to give you notices of traffic delays; you could check the Highway Department website for notices, or call their 800 number; you could take local roads, even though that would make for a longer trip. You could call your spouse and ask what she thinks your chances are of getting stuck, trying to get some reassurance. You could develop a backup plan by identifying a restaurant that could deliver on short notice, and keep their phone number handy. That might remind you that you’re very dependent on your cell phone, and you might start monitoring its battery strength very closely.
If you had a winter cold that lasted longer than usual, and experienced the thought What if I have cancer or some other terrible illness?, you might try similar methods to clear your mind of the worry. You might consult your physician, which is usually not a bad idea, but if that didn’t clear your mind of this worry you might consult several other doctors as well. You might read up on your symptoms on various Internet sites. You might look at the obituaries, to see if anyone your age had died of cancer recently. You might look at a medical encyclopedia. You might ask the neighbors if they knew of any colds going around.
In each case, you could expend a lot of time and effort trying to prove to yourself that you have “nothing to worry about,” that there is no chance of getting caught in a long traffic jam or of having cancer.
Unfortunately, you probably won’t get much relief from these efforts because you can’t really prove that something won’t happen. You can recognize that it’s very unlikely, but there’s no way to prove to yourself that some calamity isn’t going to happen tomorrow, because just about anything, no matter how improbable, is possible if your rules of evidence are loose enough.
So I can’t prove that nothing will make me late for dinner tonight because it’s impossible to be sure. The thought just doesn’t bother me. However, if I did feel really bothered by the thought, I would probably be tempted to try to get rid of that thought, and that’s where I might run into trouble.
Can You Predict the Future?
A husband who worried a lot about auto accidents would probably get very nervous whenever his wife didn’t arrive home at the expected time. He might call her cell phone to verify that she was okay. And if she happened to have her phone turned off, or buried so deep in her purse that she couldn’t hear it, his attempt to make himself more comfortable would result in more doubt and fear. Then he might turn on the TV, to see if there were any news stories about car crashes. He might think about calling local hospitals to see if she was there. He might drive around to see if he could spot her car somewhere, and even as he drove around, he’d worry about missing a call from the hospital on the landline (if they still have one).
He might just stay home, pacing and worrying, and wondering if he should do something.How Worrying Backfires on You
This is a central irony of worry, that your efforts to stop worrying so often backfire on you. All too often, when you try to “talk yourself out of” a worry, you’re likely to fail. Then you take your failure to prove that nothing bad will happen as evidence that something bad will happen. You get more worried as a result of your effort to stop worrying. That’s the heart of the trick.None of us knows the future. We know everyone dies (so far!), but we don’t know when, and we don’t know how. Most likely, tomorrow will be pretty similar to today. But if you try to prove it won’t be different, you can’t. And if you take your failure to prove that it won’t be different as evidence that something bad will happen, you’re in for a lot of worrying. Here’s an example from my own life.
Shortly after my son was born, he developed jaundice—his skin was yellow. It’s common among newborns, pretty harmless, and generally disappears within a few days. If treatment is necessary, the standard treatment is light therapy, in which the child wears a special light for several days. My son needed the light therapy.
Our conversation with our pediatrician went very poorly. My wife asked what would happen if the light didn’t fix the problem. He said this was unlikely, that it almost always worked, and mentioned some really rare problems that could develop if it didn’t. She asked what we could do then, and he mentioned a few minor procedures that would probably help. She asked what we’d do if those failed. The doctor said that was unlikely, but that in an extreme situation, a complete blood transfusion—the replacement of all the blood in our son’s body—would probably solve the problem. She asked if that was safe, and he said that the blood supply is generally safe, but that there’s always the risk of contracting AIDS, hepatitis C, and other diseases from a blood transfusion.
What an agonizing ten minutes that was! We had gone, in seconds, from arranging pretty routine care for our beautiful son, to contemplating the prospect that he would get AIDS before his first birthday. And it was all foolishness—not because we were fools, but because we all did what came naturally in our roles as parents and doctors. My wife asked for concrete answers to remote, hypothetical questions in an effort to calm her worries. The pediatrician answered them literally and completely, hoping to remove our doubts. I did nothing because I couldn’t figure out how to make it better. The result was that we spent time vividly worrying about a terrible problem that was almost (but not quite) guaranteed not to happen. For several days, until the jaundice began to slowly fade, we lived with intermittent thoughts of our son contracting a dread disease.
I say “almost (but not quite) guaranteed not to happen” because you can’t ever get a satisfying guarantee that something won’t happen. Even if it’s something that appears impossible, you won’t get the certainty you want. Here’s an example of what I mean.
Me: What if the law of gravity gets repealed, and we float upside down in the air, banging our heads?
Scientist: That’s impossible because (insert highly technical proof), quantum mechanics, law of thermodynamics fundibulum, and blah blah blah.
Me: But what if it does happen?
Worry Always Gets the Last Word!
Let me ask you something now.Does your car have a flat tire? (Don’t look out the window!)
When I ask people this question, as we sit in my office, they almost always say no. But they can’t see their car from my office. How do they know?
They don’t know for sure. It’s just that they didn’t have a flat the last time they looked at their car, and that’s good enough for them. Unless they have a particular issue of worrying about getting a flat, they assume that the tires are still okay.
But with the particular topics they worry about, they want to feel absolutely certain that they don’t have a problem, and so they continually try to prove that the problem they fear doesn’t, and won’t ever, come to pass. If they wanted to be sure of not having a flat, they would probably want to go down to the parking lot during the session to check, and would likely mention their doubts as we talked, looking for reassurance.
There’s a way out of this problem, and I’ve written this book to help you find it. If you’re like most people who struggle with worry and anxiety, you probably have mixed feelings about even reading this book. You hope that it has some answers, but you also worry that it will create more trouble for you. You might figure that you have enough worries on your own, you don’t need any help thinking up new ones! Maybe you looked at it in the bookstore and quickly scanned a few pages (or scanned some sample pages online), ready to toss it back on the shelf if you started to feel anxious reading it.
People are often so used to using distraction and other ways to try to avoid unpleasant thoughts that the idea of reading a book about worry seems worrisome! It goes against their natural instinct of seeking to avoid worry.
So you might feel more anxious when you first start to read these words. In fact, it’s very likely. I understand how uncomfortable that is, but I want you to be aware that it’s not a bad sign at all. The first time people come to see me for help with anxiety and worry is usually the most anxiety-provoking visit. They hope they’ll get a good result, they’re afraid that they won’t, and they’re particularly afraid that our conversation will lead them to worry more rather than less. It’s anticipatory anxiety, the kind you’re likely to experience just before you become engaged in a task.
Have you ever stood on a beach at the water’s edge, trying to get used to the temperature of the water before you go in? You might stand there a while, feeling cold, splashing some water on your ankles, trying to get used to it, but probably feeling colder for all your effort, standing there in the breeze and feeling the difference between your skin temperature and the temperature of the water. You won’t really acclimate to the water temperature until you get in it, and then you will feel more comfortable. Your natural desire to feel comfortable first causes you to experience more discomfort as you literally postpone and delay the moment of relief that comes with getting in the water.
That’s how it usually works with worry. It’s okay to feel nervous at the outset, and actually very predictable. Don’t be tricked by that nervousness—it will fade. Come on in, the water’s okay!
Meet the Worriers
Before I tell you any more about chronic worry, I want to introduce you to two worriers. It’s a characteristic of humanity that all of us find it easier to observe and understand the patterns of other people than we do our own patterns. Perhaps hearing about other people’s experience with chronic worry will help you better understand your own. In particular, having the chance to consider other people’s experience with chronic worry may make it easier for you to catch on to those instances in which worry tricks you into responding in ways that make things worse.
These people don’t actually exist as described below. They’re composites of many, many clients I have worked with over the years. However, the details of their struggles accurately depict what it’s like to wrestle with different forms of chronic worry.Case 1: Scott
Scott sat at his desk, looking at his computer monitor and occasionally making a few keystrokes, but his mind wasn’t on it. He wasn’t making much progress on his report, and he worried about that. What if I keep getting so worried that I can’t work? he worried. Visions of security personnel coming to his office to remove him and his belongings from the workplace flashed across his mind. Would his staff line up in the hallway and watch him leave? Would he go straight home and tell his wife? Would she leave him in disgust? Would he stop at a bar instead, and drink himself silly? What if he got into a drunken fight at the bar, hurt someone, and got arrested?He noticed a headache and vaguely wondered if he was giving himself a cerebral hemorrhage with all his worrying. He wasn’t sure what a cerebral hemorrhage was, or how you got one, but what if this was how it happened, sitting at your desk and worrying? He felt thirsty, and remembered some warnings he’d heard about getting dehydrated on long airplane flights. How long is too long without water? he wondered. Maybe dehydration contributes to cerebral hemorrhage. He pushed his chair back and got up, deciding to head for the water cooler. His back hurt. He remembered sleeping poorly last night, and hoped he’d have better luck tonight. He wondered if he’d be better off going to bed earlier, or later. What if he got so tired that he became ineffective at work?
Walking toward the water cooler, he remembered that his boss would be in all day. He’d have to pass her office on the way to the water cooler. What if she looked up and saw him walk by? What if she wondered why he wasn’t in his office, working, and thought that maybe he was losing his edge? What if she called out “Hi Scott” as he was walking by, and what if he couldn’t think of anything to say, and just stared or mumbled? He had a performance review in three months. What if she took a good look at him today and realized how anxious he was? He had a long history of good work, good evaluations, and steady promotions, but what if he was topping out now, and it became obvious to her, and to everyone else? What if they had already noticed?
Scott decided he wasn’t that thirsty. He went back to his office. He resumed trying to work on his report and made some revisions. But it wasn’t too long before he had the thought What if I get dehydrated and have a seizure? He tried to distract himself by playing solitaire on his computer, but the worrisome thoughts kept breaking through. Finally, he opened his browser so he could search for information about seizures, dehydration, and cerebral hemorrhages.
And on and on it goes. Scott’s actually a healthy guy, a productive and valued employee, with a good family and an apparently happy life. Scott is also a worrier.
He’s tried hard to control his worry, and he’s tried many things. He took medication for a while but didn’t like the way it made him feel, and he worried about long-term side effects, even though the doctor said there probably wouldn’t be any. He drinks more now than he used to, in an effort to fall asleep without tossing and turning. It helps him fall asleep faster, but he doesn’t feel rested when he wakes, and he worries about becoming an alcoholic. He exercises and monitors his diet to keep himself as healthy as possible, but finds he’s got an unhealthy mind in a healthy body. He thought about trying meditation, but was afraid of letting his mind go blank, expecting that it would get filled with more worrisome thoughts. He spends a lot of time trying to distract himself and avoiding unpleasant thoughts. He doesn’t watch the news anymore, or read newspapers, because he’s afraid of unpleasant topics. He avoids television shows about hospitals and other medical settings.
A Chronic Worrier
Scott’s tried therapy several times, and was diagnosed with generalized anxiety disorder. He had a therapy that focused on his early childhood and life experiences; it helped him understand himself better but didn’t do anything about his worrying. He had cognitive behavioral therapy, which helped him to evaluate his thoughts and find the errors in his thinking so that he could correct them; that seemed to help, but over time he found himself more focused on his thoughts, arguing with himself about whether or not a thought was exaggerated, trying to get all the “errors” out of his thoughts, feeling frustrated and apprehensive when he couldn’t. He felt conflicted about writing his thoughts down and evaluating them, because sometimes it seemed to cause him more trouble, and he gradually drifted out of therapy.Scott feels best when he’s not worrying. Sometimes he’ll go for days, even weeks at a time without significant worry. That feels good to him. But sooner or later, he notices how good he feels and realizes that he hasn’t been worrying. And then, the thought occurs to him: What if I start worrying again? You can guess the rest. He resumes worrying. He tries to stop. He fails to stop, and the cycle repeats. Sometimes he’s filled with despair, as he alternates between worrying about possible problems that never seem to materialize and worrying about how much worrying he does.
Scott is a chronic worrier. He has a strong case of it, but there’s hope and help for him, and for you as well, if this is your burden.
Case 2: Ann
Ann worries about social encounters. She’s usually okay with seeing people she already knows well but gets nervous about meeting new or unfamiliar people, encounters with bosses and people in authority, and group activities.Ann won’t go to a party or other social occasion without her husband, because she fears getting into a conversation and becoming too anxious to talk. She usually has a glass of wine, or two, before going to a social event. What if I can’t think of anything to say, and people just look at me, waiting for me to talk? she worries. She pictures herself trapped in a social encounter, becoming visibly nervous and alarming others at the party with her excessive sweating, trembling hands, and inability to speak. As long as her husband will be with her, she figures she can ride it out because he will keep the conversation going while she calms herself or takes a bathroom break.
The idea that she could excuse herself for a bathroom break calms her a little, but she worries about that as well. She has never actually taken a bathroom break for this purpose. She has the idea that should she do so, she wouldn’t be able to go back to the bathroom again during that party, because people would wonder why she was going so frequently. Since she thinks she can only do this once, like using a “get out of jail free” card in Monopoly, she figures she has to save it for emergencies, and so she really can’t use it at all!
Ann feels very self-conscious about her anxiety and tries to keep it to herself. She worries what her employer and coworkers would think of her if they knew how anxious she gets about everyday conversations. Her boss has asked her on several occasions to lead a discussion at a staff meeting, and each time Ann has begged off with some excuse. She worries that she’s running out of excuses. What if my boss stops believing me? she worries.
Fearful of Being Judged
Ann’s fears have to do with being judged by people. In particular, she worries about looking so anxious that people think there’s something wrong with her, avoid her, and probably gossip about her when she’s not around. One of the ironies of Ann’s fear is that she simultaneously believes I am unworthy and also Everyone is very interested in observing and evaluating me.Therapy for social anxiety disorder would probably be very helpful for Ann, but she dreads the moment of sitting down with a stranger who will ask intrusive questions. What if I start panicking right there in front of the therapist? she worries. I’ll look like a crazy person! The worries she has about her nervousness are what prevent her from getting the help she needs. If she can find some way to relate differently to those worries, that will be the key that enables her to move forward with her life.
Thinking It Over
Ann and Scott—and the millions they represent—have different kinds of worries, focused on different fears. What they have in common is how they relate to their worries. They struggle to bring their worries to an end and find that their worries increase rather than disappear.
“The harder I try, the worse it gets!” they notice, and feel more frustrated and incompetent as a result. They tend to think that this means they’re terribly ineffective, that they can’t execute a simple strategy of clearing their mind. They think it means there’s something wrong with them.If it’s literally true—the harder I try, the worse it gets—then this probably means there’s something wrong with the methods you’ve been trying. Not with you. And it means you’ve been looking in the wrong place if you’ve been blaming yourself for your worry troubles.
The very efforts people make to stop their worries are what strengthen and maintain them. Seeing how the worry trick operates in their lives—and yours—will be a valuable help in solving this problem. The next chapter will introduce you to a new way of thinking about your relationship with chronic worry.
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