There is a condition called generalized anxiety disorder, which isn’t really a disorder, but which describes people who seem to be worrying all the time. Some typical worries: that this mole on my arm may be malignant, that the children will be kidnapped on the way to school, that an intruder will break in through an unlocked door, that I offended a friend of mine inadvertently, that I will be fired , that a terrorist will set off an attack in a sports arena my family will be attending later on today, and so on. Most other people have some sort of worry that preoccupies them off and on throughout a typical day. The bible says that life is a struggle; and so it seems to be. Still, some people worry more than others.
Recently, a patient asked me why he worries constantly. One worry (in his case a health worry) seems to be displaced temporarily by another worry only to return when the other worry dissipates. He wanted to know whether I thought he enjoyed being miserable. He understood very well that he worried about things which did not bother other people, for example, whether the plane he was going to travel on next week was likely to crash.
Of course, no one enjoys being miserable. My patient worries because, intentionally, or not, he tries to anticipate any conceivable danger so he can, if possible, take measures to lessen the danger. He has trouble understanding why other people do not worry more than they do. Shouldn’t they worry about cancer, and airplane crashes? He is not reassured by being told that the particular cancer he is worrying about occurs once in 200,000 people, and that the chance of his dying in an airplane crash is about one in 2 million. He thinks, with his luck, that one is likely to be him.
It all started a very long time ago.
In prehistoric times there were these two cousins who lived in the same cave. One was named Bernie and the other was Charlie. Bernie was a worrier. He worried about whether the fire was going to go out, whether his son was going to return safely from the forest, whether that giant cat who ate the neighbor who lived in a nearby cave was going to come back, whether those mushrooms over there were poisonous and so on. Charlie, on the other hand, was more relaxed. He figured the fire didn’t usually go out unless everyone fell asleep at the same time, his nephew George was likely to come home safely from the forest just like he did every other day of the week, the mushrooms looked pretty much like the mushrooms they always ate, and the saber-toothed tiger that ate the neighbor came by maybe once every ten years, and he was probably stuffed right now, anyway, and so on. Charlie, everyone agreed, knew how to enjoy life.
Unfortunately, we are all descended from Bernie. A lot of the things Bernie worried about never happened, but some of them never happened because he worried about them. (Some bad mushrooms showed up from time to time. They looked just like the good mushrooms.) Charlie did okay most of the time. He was sensible for the most part, besides being a good-time Charlie. But when it came to survival. Bernie had an edge. He, and all the other Bernies who lived back then, were more likely to survive long enough to have children, and their children were more likely to survive because all the Bernies worried about everything that could endanger them. Charlie, and all the other Charlies, did not seem to put themselves in any obvious danger but they tended to die off just a little earlier. Luckily, every once in a while, one of the Bernies’ children seemed to look and act just like their uncle Charlie.
There are still Bernies and Charlies around– but there are more Bernies.
The problem for me, as a therapist, is to point out the real dangers that my patient should worry about. There are real things that are likely to go wrong from time to time, and we should be prepared. Someone who senses that he is likely to be fired should start looking for a job as early as possible. He should worry about losing his job. There are certain (very few) medical illnesses that require immediate attention. When they appear, the affected individual is supposed to worry about them.
People should not be worrying about very unlikely events, such as dying in a plane crash.
None of this explains why my patient worries all the time and other people do not. There are particular events and experiences in his past that incline him to worry. But that is another story.
(c) Fredric Neuman Follow Dr. Neuman's blog at fredricneumanmd.com/blog