Not Seeing What You Don't Want to See
I have been suggesting that you are generally over-estimating the risk of bad things happening and underestimating how well you would be able to cope. However, now I am going to argue that you might underestimate certain risks and expose yourself repeatedly to problems that could really hurt you. Furthermore, you might overestimate how well you will be able to cope in the event of negative outcomes. I will propose that you need to take your blinders off and actually face some things that you may believe are not dangerous or problematic. In fact, I am going to argue that there are certain things that you do not worry enough about. This is because, like many people who are anxious, you may be doing the following:
•You evaluate risk by relying on your emotion-If you don't feel anxious, it's not risky
•You estimate risk by relying on unusual dramatic events-if you are not reading about it in the news, it's not risky
•You ignore "baseline" information-the real "averages" and "odds"
•You assume that because nothing bad has happened so far that you are safe
•You focus on what you think will happen the next time-"The next cigarette won't kill me"
•You ignore "cumulative risk"-how risks build up over time
•You want to avoid thinking about things that are upsetting-so you avoid thinking of real problems-"I'd rather have a drink"
•You do not want to experience the discomfort of making a change-"Its too hard"
•You prefer to procrastinate about things that are not affecting you right now-"I'll wait until I'm ready"
In fact, the same processes that make you worry about things that are unlikely will lead you to avoid thinking about or doing anything about things that are actually risky. I have observed that many of my patients over the years who are chronic worriers (about things that seem rather trivial or unlikely) are likely to avoid thinking about or doing anything about the following preventable risks:
1. Obesity
2. Smoking
3. Alcohol abuse
4. Unsafe driving
5. Unprotected sex
6. Inattention to medical care
7. Financial irresponsibility
You Use both Worry and Avoidance to Handle Your Anxiety
Worry is a tool that you use to "manage" your anxiety by trying to "think through" things. You worry in order to "protect, prepare and solve problems". Let me repeat-when you are worrying you are less physically aroused and less anxious. Worry is your technique for managing your anxiety. You may also avoid thinking about preventable risk---because not thinking and avoiding are also ways in which you manage your anxiety.
You worry and you avoid in order to eliminate your anxiety----for right now.
Sometimes Risky Behavior Reduces Your Anxiety
Let's consider Rachel. She was in a car accident and barely escaped with her life. Over the next five months she had flashbacks about the accident and thought, "I'm going to end up getting killed in a car accident". Even though she wasn't driving a car, while she lived in New York, she worried about this daily. She began drinking heavily-hanging out in bars until three in the morning and smoking excessively. Rachel would get drunk at the bar and invite strange men to her apartment where she would have unprotected sex. Although she was worried and anxious since the car accident, she was now engaging in very high-risk behavior.
Think about the preventable risks that Rachel was taking---- drinking, smoking, and unsafe sex. Why would someone who worried about safety engage in such unsafe behavior? But consider that Rachel is trying to eliminate her anxiety--- so drinking reduces her anxiety temporarily, smoking makes her feel less anxious right now, and unsafe sex feels good for the moment. Rachel was focusing on eliminating her anxiety for today---and not thinking about the longer-term risks that she was incurring by her behavior.
Let's consider the seven examples of risk that I have identified above---risks that are epidemic in our country-and risks that you can avoid.
Preventable Risks
How risky are these behaviors?
People who are anxious and worry ironically expose themselves to preventable risks on a daily basis-and hardly ever think about these things. Someone may worry about a blemish on her face, but not worry about the fact that she is smoking or is facing possible eventual financial ruin. If we look at many of these preventable risks---such as smoking, drinking, overeating, and avoiding medical treatment-we will find that many of the people who engage in these preventable risks are worriers---who worry about something else.
How serious and widespread are these seven preventable risks? Let's take a look.
Obesity
•55% of adults are overweight and 33% of adults are obese
•325,000 people die each year from obesity
•Obesity has been increasing over the past 20 years (due to increased sedentary activities (e.g., television, computers), labor-saving devices, fast foods, high-fat food, larger portions)1
•Obesity among children and teens is three times higher than in 1980
•50% of restaurant purchases are for fast-food
•The health consequences are severe for obesity: diabetes, cardiovascular disease (stroke, heart attack), cancer (breast, endometrial, colon), high blood pressure, high cholesterol, higher mortality
•There are $99 billion in direct medical costs per year due to being overweight (1995)2
Smoking
•Smoking is the single largest preventable cause of premature death and disability in the United States.
•Every year 350,000 Americans die prematurely from diseases caused by cigarette smoking -- such as lung cancer, emphysema, and coronary heart disease.
•Nicotine
addiction is the "most widespread example of drug dependence in our country," according to the U.S. Public Health Service.
•Three-quarters of the adults who currently smoke started their habit before the age of 21.
•Nine out of ten smokers say they want to quit.
•To date, 36 million Americans have quit smoking.
•Smoking accounts for 85-90 percent of emphysema mortality in America and is a leading cause of peripheral vascular disease.
•Lung cancer, already the number one cause of cancer mortality in American men, in 1986 surpassed breast cancer as the leading cancer of American women.
•In 1985 lung cancer killed an estimated 38,600 women -- approximately 84 percent of the 46,000 women who were diagnosed with the disease that year.
•Smokers who have a heart attack have less chance for survival than a person who does not smoke. And by continuing to smoke after a heart attack, the person's chance for a second attack increases.
•Smoking results in $53.7 billion in total annual costs.
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