Behavioral Therapists Treat Worry

David A. Clark Ph.D.

At the start of a new year, it’s only natural to wonder what lies ahead. Maybe you have concerns about a health problem, financial strain, job insecurity, relationship discord, or loneliness. And you’re worried! It doesn’t help that everyone is talking about the future, making predictions about the economy, politicsclimate change, technological advances, and the like. Possibly friends and family are sharing with you their New Year’s resolutions. Fitness centers are filled with new members determined to get in shape or lose a few pounds. Has all this talk about change and the future fueled your worries? Maybe you’re determined to have a better year; to be more positive and to look to the future with optimism and a grateful heart, but your worried mind hijacks your best efforts. It’s hard to be positive when a negative outcome seems more likely. All you can think about are the problems you face, the possibility of future calamity, and a sense of dread about the coming months. If this sounds familiar, you’re likely caught in a worry loop. Has worry become your habitual way of thinking? If so, consider two strategies that can calm a worried mind.

Take Stock of Control

Worry is fueled by exaggerating how much influence and responsibility you have over a problem. In The Negative Thoughts Workbook1, I make a distinction between responsibility and control. Responsibility is thinking you play a significant role in causing a problem and control is how much influence you think you have in determining a desired outcome. For example, you are worried about the possibility of a life-threatening illness like cancer. You would like a guarantee of many more cancer-free years. But you have only limited influence in making this happen. You can eat well, exercise, not smoke, and use alcohol in moderation but this won’t guarantee many cancer-free years. Much of this is beyond your control. The same with parenting. You can do all the right things as a parent but that does not guarantee a healthy, well-adjusted child. Our children make their own choices and are endowed with their own biological predilections.

What are you worried about at the start of this new year? Whatever your worry concern, start by writing down your most desired outcome. Now take a long hard look at how much influence you have over making this outcome happen. Who else has some influence over this outcome? What other factors are beyond your control? You’ll be more worried if you have unrealistic expectations about what you can control because you’ll be exaggerating your personal responsibility. Recognizing the limits of your control allows you to accept the uncertainty of life, which in turn will reduce your tendency to worry. Know what you can and can’t influence and control.

Balance the Probable Against the Possible

It’s easy to confuse what is possible with what is probable. It is possible that today is your last day at work, that your toddler will get hurt at daycare, that you’ll receive bad news at your annual medical checkup, or that you’ll have an accident on the way home from the grocery store. We can all think of innumerable ways that bad things could happen. At any moment something bad is possible but is it probable? Worry is fueled by assuming what is possible is also probable.

Let’s take travel as an example. Many people are anxious and worried about taking a trip to a foreign country. So many things could go wrong. Your flight could be delayed, you could miss your connection, you could forget an important document like your passport, you could have a panic attack in flight, there could be a problem with your hotel reservation, you could get mugged, get lost, or get food poisoning. All of these misfortunes run through your mind days or weeks ahead of the trip. As the departure date approaches, your worry intensifies and you consider canceling the trip. You decide it’s better to lose your deposit, maybe disappoint your family, than suffer long periods of intense anxiety and worry.

But avoidance (cancellation) is not your only option. There are so many things that can go wrong on a trip. They are all possible but not all are equally probable. To reduce your worry, start by separating the more probable from the least probable. A delayed flight, a tight connection, and having a panic attack in flight are higher probability events, while getting mugged, being lost, and having food poisoning are much less likely. When worry besets you about the trip, shift your attention to the more probable misfortunes. Work out a contingency plan for dealing with the more probable misfortunes should they occur. Your worry won’t be eliminated but it will be diminished by focusing on problems that could occur rather than the catastrophes that are possible but much less likely to occur.

Conclusion

We all worry but for some, worry is so frequent and intense that it threatens their mental health. If you are a worrier, the beginning of the new year can be especially difficult. Fortunately, you don’t have to get stuck in perpetual worry. Cognitive behavior therapists have developed new strategies that can unlock the grip of worry. Having a realistic understanding of your level of responsibility and control over an issue while accepting that uncertainty is a fact of life can ease worry caused by futile attempts to control the uncontrollable. As well, keeping your eye on the probable rather than on the unlikely, and often exaggerated, possibilities can reduce unhealthy worry. Healing of a worried mind is possible if you take the right approach and practice effective strategies with patience and understanding.

To find a therapist, please visit the Psychology Today Therapy Directory.

References

1. Clark, D. A. (2020). The Negative Thoughts Workbook: CBT Skills to Overcome the Repetitive Worry, Shame, and Rumination that Drive Anxiety and Depression. Oakland, CA: New Harbinger Publications.

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