Your Dual Relationship with Worry

When I was training to become a psychologist, I had my first experience working with a client who struggled with worry. This man worried a lot about losing his job. He obsessed over every tiny error or shortcoming he displayed at work and overlooked all his good accomplishments on the job. My supervisor wanted me to learn to use cognitive restructuring with this client, which, you may recall, is a method by which people can find and correct the “errors” in their thinking that cause distress.

The supervisor expected me to become good with these techniques, so I worked hard at it. I helped my client become aware of how he was “maximizing” all the negatives in his mind and “minimizing” all the positives so that his job seemed less secure than it probably was. And one day, we had a session in which the man seemed to show some good progress. “I see what you mean,” he told me. “I’ve been overlooking all the good things I do at work, and overemphasizing the things that can use some improvement. My boss seems okay with the idea that I need more experience and training, and he seems happy with most of the results I get even though I’m new. So I guess I’ve really been exaggerating the risk of getting fired.”
I smiled, happy for his progress, and looking forward to describing it to my supervisor. Then he continued, once again getting upset, “So you see, that’s what really worries me. Look at all the unnecessary worry I’ve been doing! That can’t be good for my health! What if it gives me a stroke, all this worrying about nothing?”
My heart sank as I realized we hadn’t made as much progress as I thought! But I should really thank this man, if he happens to be reading this book, for giving me such a clear example of the two stances of the worry relationship. On the one hand, he took the thought about losing his job very seriously and worried intensely about it. On the other, when he realized that this worry was unrealistic, he worried about how much worrying he was doing! And, when I saw him the following week, he had thought of some more reasons to believe that he might get fired and was back to worrying about that. He was treating these thoughts the way you might respond to a piece of cactus stuck in your hand—too painful to leave alone and too painful to remove!
This man—and most people who struggle with chronic worry—didn’t have a problem that he worried about. He had the problem of worrying.

The Two-Sided Relationship with Worry

If you struggle with chronic worry, odds are that you associate the worries with danger, in two ways.

Sometimes, you take the content of the worry thought as an important prediction of danger. It might seem to you that thoughts such as What if I lose my job? or What if I have cancer? are valid warnings about trouble with your employment or your health, a sign of trouble in your external world. In response, you either try to protect against that hypothetical danger or you try to prove that there isn’t any danger, so that you can feel better and stop worrying.
Both of those responses tend to fail.
Other times, you recognize that these thoughts are “irrational” or unlikely, and you don’t take the content of the worry so seriously. Instead, you wonder why you keep having such grim and unlikely thoughts. You might take the presence of the thought as a sign that something is going terribly wrong in your mind, in your internal world. You may think that you shouldn’t have such thoughts at all, that the thoughts themselves are a sign of you losing control of yourself. You might fear that such thoughts might even make you ill. In response, you try in various ways to suppress or rid yourself of the thought.
This response also tends to fail.
Your relationship with worry may take two different forms. Let’s take a closer look at how each one works.

Stance 1: Treat the Worry as an Important Warning

This is the first stance. You take the content of your worry seriously, and:

1. Look for ways to disprove the threats, and reassure yourself that the feared catastrophes won’t come to pass; and/or you
2. Think of ways you could protect against the feared events, and either use them or “keep them in mind” as a future defense.

People will frequently take both steps above, even though, if you could prove an event wasn’t going to happen, you wouldn’t need to defend against it. So a person having thoughts of getting sick and missing work might try to soothe himself this way: “I won’t get sick, I had a flu shot, and anyway I have lots of sick time left over.”
Let’s look at some of the common ways people use this stance.

Arguing with the Worry

You might get into a debate with your own thoughts, the same way you might if you were arguing with another person. It’s a game of “point-counterpoint” and often sounds like this.

Me: What if I lose my job and we all end up on the street?

Also Me: That’s not going to happen—they need me at the firm!

Me: What if it does?

No matter what evidence or ideas you bring to the argument to reassure yourself, the other side of the debate always has a strategy for topping your argument, as we see here.

Also Me: It’s really unlikely I’m going to lose my job, but if I do, I’ll just find another one. We’d get by.

Me: But what if you don’t?

This “what if” argument is a central part of chronic worry, and we’ll take a good look at how it works, and what to do about it, in chapter 6.
These debates you have with yourself are really circular. When you’re debating these worries, do you bring in any new evidence since you last had the debate?
Probably not! Instead, you find yourself repeating the same tired old points, having pretty much the same debate each time. The same thoughts keep getting repeated, again and again, without any progress, new ideas, or problem solving. No wonder it gets so annoying! If it were a television program, you’d turn it off or change the channel—but this TV set doesn’t have any controls!
If you find yourself arguing with yourself, there’s one thing you can count on—you’re not going to win this argument.
How does the debate end? There’s no real conclusion. It ends when your attention is drawn to something else. Given how tedious this ongoing repetition of worries can become, it’s no wonder you lose interest!
But it’ll probably be back, same as before, the next time your mind is idle.

Ritualistic Responses

You might take this a step further and engage in private, subtle behaviors you hope will end the debate. So a person who worries about choking and gagging may continually drink small amounts of water, either hoping to keep his throat “open” this way or trying to prove that there isn’t any problem. A person who worries about leaving the stove or coffee pot on might linger in the kitchen before going to work, playing with the on-off switch, or even unplug it. A person who fears dying in a plane crash may touch the skin of the airplane while boarding, “just for luck.”

These responses are a lot like superstitions.
Here are some common ones.

• Singing or humming a song to yourself
• Praying with the expectation of a clear, reassuring answer from God (preferably in writing!)
• Thinking about other people’s problems and telling yourself to be grateful
• Snapping your fingers
• Putting your worries in a “worry jar” or something similar
• Relying on luck—your lucky shirt, lucky breakfast, and so on
• Counting something—the number of letters in a word; the number of words in a sentence; the number of people in line; the total of the numbers in a license plate

People generally recognize that such responses won’t really alter anything in the external world, but they continue to use them, perhaps with the thought, It can’t hurt! If you use them occasionally, with a sense of humor and without ascribing any real power to them, they probably won’t hurt your cause. However, if you find yourself in a pattern wherein you feel more nervous if you refrain from your ritual, and feel as though you “must” follow this habit, then it probably does hurt.

Internet Research (Googling)

The Internet has opened up new frontiers for people who struggle with worry. Before there was an Internet, you had to visit a library or a bookstore to research your worries. Now, with the click of a mouse, anyone with fingers can enter a couple of search terms and see what comes back.
The irony is that people do this hoping to find out that they have nothing to worry about. So if you’re a person who worries that your cough might be a sign of cancer, or that your garage door opener might be set off by someone’s microwave, you might go to the web hoping to find a page that says it’s not so. This might work—there’s a chance that you’ll find some web pages with useful information for you.
However, if you want to eliminate all doubt, if you’re hoping to find conclusive evidence that proves you don’t have cancer or your garage door can’t ever open by accident, you’re likely to be disappointed. As much as you might like to get absolute proof that this problem isn’t occurring now, and can’t ever occur in the future, that evidence is not available, because we can’t prove that something will never happen. When you struggle mightily to feel sure, it’s like you’re hoping to find a web page with your photo and name on it, and a message saying that you’re guaranteed to be okay. That page is not available! Even if it were, that wouldn’t be the end of it. If you ever did find such a page, you’d probably find yourself wondering, “How can they be so sure?”

Consult Experts

This comes up most frequently about health concerns, but people with other types of worries—about finances, real estate, taxes, child rearing, career planning, and so on—also get caught up in this.
If you consult an expert about a worry—maybe a cardiologist about your heart, or an accountant about your taxes—a consultation with one expert should generally be enough. In some cases, with really complex issues, maybe a second opinion will seem necessary. But if you find that you get caught in a pattern of seeing a variety of professionals about your concern, and remain too doubtful to actually use any of the recommendations—if you come away from the consultations with more questions or hypothetical reasons to distrust the answers you received—then you’re probably caught up in a cycle of seeking more and more professional reassurance, and feeling less and less sure as a result.

Consult “Non-Experts”—Friends, Family, Coworkers, and Neighbors

In addition to, or often in place of, consulting experts, worriers frequently ask loved ones, relatives, friends, and coworkers for reassurance. They don’t ask these people for reassurance because they have some special expertise or knowledge of the topic. They ask these people because it’s convenient and free!
Because of this, they put even less confidence in the reassurance they receive from these “civilians” than they do in the expert opinions they received. The discussions they have with family or friends often devolve into something like the argument they have in their heads, with the worrier trying to find flaws in the reassurance being offered. They wonder if the other person is just saying what they want to hear, or humoring them to get them to change the topic. If you engage in this pattern, you probably don’t ask just once. You might ask repeatedly, asking the question in different ways to see if you get the same answer. Reassurance has a very short shelf life and lasts only a little while before you start seeking a fresh supply.
This kind of reassurance seeking can be a burden on a marriage, friendship, or other relationship. The party being asked for reassurance often becomes increasingly concerned that he or she doesn’t really know what’s helpful to do—to continue to answer the questions or “call the question” and encourage the asker to find his own answers.

Avoidance

Another way that people take their worries seriously is with the use of avoidance. It’s very common for people to avoid what they fear, even when they recognize that their fears are exaggerated or unrealistic, and even when the avoidance comes with a significant disadvantage.
You might avoid conversations with your boss, even though such contacts might help your career and facilitate your work. You might avoid group activities where you fear being observed and judged, like open house at your children’s school or a neighborhood block party, even though this limits your social life; you might avoid answering the phone, or making calls; you might avoid going for your annual physical; you might avoid a task because you feel compelled to do it perfectly and worry you’ll have trouble finishing it. You might avoid certain locations or activities for fear of having a panic attack there.
If you fear public speaking, you’re likely to avoid requests to address a group, be it at work, your child’s school, or a civic organization. If you fear plane crashes, even if you are familiar with the safety statistics showing that flying is the safest form of travel, you’re likely to avoid flying or endure it with great discomfort and the use of alcohol or tranquilizers. Highway driving, dogs, elevators, being alone, sitting in the middle of a pew—if you worry about it, there’s a good chance you avoid it.
This is a real problem when you yourself recognize that your worry is based on an “irrational” fear. “I know it doesn’t make any sense,” people say. “That’s what really bothers me about these thoughts!”
Your recognition that your worries are exaggerated or unrealistic doesn’t help you if you continue to avoid what you fear anyway. If you avoid the object of your worries, you will become more afraid of them. What you do counts for much more than what you think.

Cognitive Restructuring Taken Too Far

If you’ve ever worked with a cognitive behavioral therapist, or read any self-help books based on cognitive behavioral therapy, you’ve probably tried cognitive restructuring. When you do cognitive restructuring, you identify the mistaken thoughts that fuel your upset and replace them with thoughts that are more realistic. Then, hopefully, you are less bothered by these new thoughts.
Proponents of cognitive restructuring have identified a number of these “errors of thinking” in order to help people identify and change them. These include such errors as:

• Overgeneralizing—believing that one bad moment means the whole day is going to be terrible
• Mind reading—thinking you can tell what others are thinking, especially about you
• Maximizing bad probabilities and Minimizing your ability to adapt to difficulties
• Fortune telling—thinking you know what the future holds
• Black and white thinking—thinking of extremes without recognizing the middle ground

Cognitive restructuring can be very helpful with a variety of problems. For instance, a speaker who gets nervous on seeing people in the audience who yawn or look at their watches probably has some thoughts to the effect that they do this because he’s boring, and that’s why he feels nervous. However, if the speaker can review these thoughts and recognize that there are many reasons why audience members might do such things—they didn’t sleep well, they have to leave early for another meeting, and so on—then he might become more accepting of their yawns and watch checking without necessarily taking such behaviors as negative comments on the quality of his presentation.
However, it’s likely to cause you more trouble if you use it in an effort to abolish your bad thoughts, and become “sure” that your worries will not come true. This is where you might find yourself crossing over into the second stance. A successful public speaker might still experience the same thoughts as a nervous one when she observes yawns during her presentation and just not pay them any mind, treating them like background noise while she goes on with her talk. However, if a speaker tries to eliminate these thoughts from her mind, on the grounds that the thoughts are mistaken and should not present themselves, then she’s likely to end up talking more to her worries than to her audience. In this case, cognitive restructuring may work just like arguing with your worry and bring you back to the original problem.
If you want to use cognitive restructuring, be guided by the results you get. If you find that these methods help you recognize that your worries are exaggerated and unrealistic, and you become less bothered by them, then you’re getting good results and can expect to continue to benefit from using them. However, if you find that your efforts to identify and remove the “errors” in your thinking lead you to argue more with your thoughts in an effort to remove all uncertainty, then you’re probably trying too hard to purify your thoughts. It might help to do the cognitive restructuring with a lighter, more permissive touch. (It might also help to use some of the acceptance-based methods I’ll introduce in chapters 8 to 10 in place of cognitive restructuring.)
Now let’s look at the other stance in this dual relationship with worry.