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Karen, 47, was a chronic worrier. She suffered from multiple sclerosis, which was well-controlled at present but left her feeling vulnerable and exquisitely sensitive to changes in bodily sensations. Even before MS was diagnosed, Karen struggled with feelings of low self-esteem. During childhood she recalled how her mother had favored her older sister, buying her new clothes, treating her to electrolysis—luxuries she denied Karen.
"My mother would buy her beautiful clothes," Karen related, "and I would get a scarf." In school, she remembers spending her days crying, afraid her mother wouldn't pick her up after school, fearing abandonment. She also feared that her mother, a nonregistered alien, might be deported, leaving her alone. She did poorly in school and felt inferior, although now, looking back, she realizes she could have done much better had she believed more in herself. She remembers being told by her mother that she just couldn't do anything right and shouldn't expect much in life. An early talent for singing was left undeveloped.
Presently, she stills fears abandonment. Her husband, a podiatrist, is supportive and attentive. But Karen is bothered by worries, which she recognizes are irrational, that her husband is having affairs with his female patients. She worries constantly about whether her husband’s patients are attractive and buxom. The larger fears are compressed into many minor annoyances which fill her days with a chronic pattern of brooding and worrying. Even minor annoyances as a newly placed kitchen floor which didn't quite match the original sample sets off a cycle of worry and rumination.
Like Karen, many of us suffer from nagging worries that serve no other purpose than create unnecessary anxiety and apprehension. Though many people with chronic worrying, especially if it is compounded by other psychological issues, may benefit from professional help, there are a number of steps we can take ourselves, each in about a minute’s time, to help ourselves get off the worry train.
As we noted in our last blog on the Minute Therapist, the fact that bad things happen and that you should prepare yourself to face adversity doesn’t mean that worry serves any constructive purpose. You needn't be motivated by worrisome feelings to protect your family with a life insurance policy or to draft a will. Worry is not needed for preparedness.
Breaking the Worry Chain
Interrupt the behavior chain leading to worrying. Hum a favorite tune whenever you're reminded of a worrisome thought. Find other competing responses to worrying, such as reading an engrossing book, exercising vigorously, or calling a friend on the phone. Humor is a great antidote to worry. Read a humorous book or watch a funny show whenever you fall into a worry pattern.
Talking Sense to Yourself
Take charge of what you say to yourself about future events. If you face a challenging situation which brings up self-doubts, tell yourself, "I've been through situations like this before, and I'll get through it again. I just need to focus on what I need to do to get through today."
One patient coped with threatening situations by reminding herself of the popular 1950s song, "Que Sera, Sera." She adopted a "whatever happens, happens" or “whatever will be, will be” attitude that diffused irrational fears and worries. She told herself, "Okay, so the worst happens. If it happens, it happens. I'll deal with it then."
Store Your Worries Away
Some people say they just can’t seem to push worry thoughts out of mind. Ironically, trying to rid your mind of worry thoughts may actually make it harder keep them out of mind. It’s like trying not to think of pink elephants when someone asks you not to think about them. So how about not trying to rid your mind of worry thoughts? Tell yourself, “It’s okay to have worries, but I don’t need to think about them right now.” Instead, store them away in that mental attic of yours to be opened at a later time. Tell yourself, "Okay, I know this is upsetting me. But I'll think about it tomorrow. Or maybe Tuesday night, after ______[fill in your favorite TV show).” By that point in time, you may not remember what you were worrying about in the first place. Or you may find your worries are just not as pressing as they had seemed only a day or two earlier.
Splitting Yourself
Perhaps you're not ready to smoothly navigate social situations with total grace and confidence, but you know you can dress to the hilt. Tell yourself, "Okay, so I may say something that sounds stupid. But I can make sure I look good." It's also helpful to focus your efforts on what you are doing, not on how well you do it. Tell yourself, "Okay, so I wasn't the biggest hit at the party. At least I was there. It's the experience that counts, not whether or not it was a total success. Nobody is keeping score.”
Practicing Self-Relaxation
There are many natural methods to help relax your nerves, from diaphragmatic (belly) breathing to meditation. See the earlier Minute Therapist blog, “Anxiety, Fears, and Things That Go Bump in the Night,” for some suggestions.
Dispute Disturbing Thoughts
Take a hard look at the thoughts bouncing around in your head. When you bring a disturbing thought into the open, you give yourself the opportunity to challenge and refute it. Tell yourself, "Hey, why do I believe that the end of the world is always just around the corner? I've felt this way before, but somehow I always managed to survive. The world would have ended countless times already if my thinking about this was logical.”
Or, “I won’t think about that today. I’ll think about that tomorrow. Tomorrow is another day.”
Stop calculating what could go wrong in the future. Spending time calculating what could go wrong in the future is a way of not taking action in the present.
Worry Shifting
Shift the focus of your worry around. If you're worried about your health, give yourself permission to worry about some minor problem, like a traffic ticket. By focusing your worrying efforts on a minor problem, you may come to realize how useless and silly your worrisome behavior really is.
Schedule Worry Time
This technique works because it does not require you give up worrying. It just requires that you schedule worry time rather than let yourself worry round the clock. We are not saying, “Don’t worry” (you can add “be happy” if you like). We’re just saying bag it. Put your worries in a bag to be opened at your scheduled worry time. Schedule private time for yourself when you free of other demands and let the worries commence. Set a timer for a half hour of worry time. Just let the worries pass through you. Don’t fight against them. But at the end of worry time, bag them again and keep them bagged until your next worry time.
Take Worry-Free Breaks
The other side to scheduling worry time is to schedule worry-free intervals. Set a kitchen timer or stop watch on your smart phone to schedule worry-free intervals. Don't permit yourself to worry until the worry-free period has elapsed. Gradually, increase the time interval for worry-free periods until you are spending more time not worrying than worrying.
Changing Your Response to Worry
Nagging, worrisome thoughts create anxiety. The more you worry about something, the more uptight and tense you feel. Anxiety is a bodily response to the perception of threat or danger. To worry about something is to expect something bad to happen, which makes you feel anxious. You then react to anxiety by worrying more, such as when you tell yourself, "Oh, my God, something must really be wrong for my chest to tighten up like this.” Recognize that worrying feeds anxiety by practicing alternative thoughts, such as saying to yourself, "Okay, I know I'm feeling tense. Whenever I think these thoughts, my body tightens up. If I just stay cool and talk sense to myself, I'll begin to relax. Anxiety is just a cue to relax, not to think I'm falling apart."
Substitute a Coping Thought for a Worry Thought
Pay attention to the thoughts bouncing around your head: Ask yourself, “What's going through my mind that making me worried? What thought keeps replaying in my mind?”
- Stop the worry thought (“There I go again thinking that worrying thought. Just stop it. Right now.”)
- Substitute a coping thought: “I’m worried that ______(fill in something bad) is going to happen to _____(fill in a name). Worrying about _______ (fill in the name) means that I care about what happens to him/her. That’s good, but worrying about it will just make me feel anxious. What can I do to help _____ (fill in a name)? Doing something rather than worrying about something is the most effective antidote to worry.
Clutter Treatment
There is a type of worrier who must have everything in its place, all perfectly arranged, in order to feel (at least relatively) secure. Someone who might put the Odd Couple's Felix Unger to shame. Someone whose idea of clutter is to place socks of different colors next to each other. Someone who endorses beliefs such as these:
- Everything must go according to plan.
- It's terrible when things get messed up.
- Everything should be in its own place.
- I must always be on time.
- I must be in control at all times.
Clutter treatment helps break this obsessive need for structure. The assignment is to experiment with a cluttered environment for a trial run of say a week’s duration. The game rules are simple:
1. Do not make the bed in the morning.
2. Do not hang up your clothes. Leave them lying around.
3. Do not do the dishes until the following day.
4. Do not throw out the garbage until it overflows its container.
5. Do not replace the cap on the tube of toothpaste.
By accepting a cluttered environment, compulsive worriers learn to relax their perfectionist standards. They learn the roof won't cave in if their clothes aren't perfectly arranged. After a week or so, order can be restored. By this time, hopefully, compulsive worriers may be better able to relax their excessive need for order and organization and tolerate imperfection in themselves and others.
Breaking the Worry Pattern
A worry pattern is kept intact because the worrier maintains the erroneous belief that to stop worrying is to invite disaster. One way to break a worry pattern is to perform a natural experiment that puts that belief to the test. Then see if the fearsome consequences hold up in the face of reality.
Take Ross, a 37-year-old stockbroker, who was adept at using therapy as a foil for not making changes in his life, a defense mechanism I call therapizing. Ross devoured books on psychology and would find case descriptions he believed fit him to a tee. Being psychologically minded, he theorized at an abstract level about how events in his life fit certain psychological patterns. He also was able to joke about his problems, using laughter as a defense for the pain that lay beneath the joking exterior. What was more difficult was breaking through his defenses—therapizing, intellectualizing, laughing it away—to deal with deeply set fears and self-doubts.
Ross didn't grow up feeling confident of his ability to handle challenges and stresses. While his father hadn't been overly critical or judgmental, he had rarely bestowed any approval or emotional support. Ross came to believe that there must be something wrong with himself to explain why he had lacked his father's approval, and because of these perceived inadequacies he was bound to fail in life. As an adult, his thinking was dominated by a basic assumption that "You must always look out for things to go wrong."
Ross's cognitive structure was dominated by various "don't rules" (e.g., Don't take chances. Don't get close to anyone. Don't let your guard down. Don't ever be late.), as well as compulsively repeating numerous minor rituals, such as rechecking door locks and strictly organizing his clothes (e.g., ordering shirts and slacks by color). If his pants weren't perfectly pressed, he would obsessively worry that his boss would think he was sloppy and fire him on the spot.
Ross began to challenge these self-defeating rules—the "don'ts" and the compulsive rituals. He began disputing negativistic thinking by talking sense to himself and performing experiments to see whether his worry beliefs tested out. One assignment required him to arrive ten minutes late for a scheduled appointment. He was to report back whether the reactions of the person he was meeting confirmed his worst nightmarish fears. He discovered that his lateness was not even noticed by others. "I began to realize," he told me afterwards, "If I'm late, I'm late. I stopped allowing myself to worry about it. I stopped telling myself, "Oh, my God, it’s the end of the world if I'm late on occasion.”
Shift Your Frame of Reference
Imagine a friend confides in you that he or she is worried about the very same thing you are worried about. What would you say to the friend to help the person cope with the situation? Would you sit down with the friend and come up with helpful strategies? Now, turn the tables. Talk to yourself in the same way you would talk to your friend.
Check the Facts
Worries often stem from exaggerated expectations of negative outcomes. The mind tends to run to “worst case” scenarios, whether it concerns threats to our health, finances, family, or work. Perform a fact-finding mission to arm yourself with facts to counter worrisome concerns. Is that mole on your leg cancerous? Do you stay up worrying about? Or do you seek information from your medical provider? Do you worry the stock market will crash? Yes, it could happen (as most anything could happen). But get the facts—how has the market performed over the course of the past forty, fifty or sixty years? Do the facts conform to your worst case expectations? What can you do to re-balance your investments to mitigate risk?
Connect to Others
Don’t go it alone. Think something, say something. When you are worried about something, tell someone with whom you have a trusting relationship, “Something’s been on mind lately. Is it okay if I talk to you about it?”
The Worry (and Guilt) Smack Down
Banish worry and guilt by replacing faulty thoughts with worry-free and guilt-free thoughts. Focus on what you can think and do to smack down worry. It only takes a few moments, a minute perhaps, to grab hold of a worrisome or guilt-inducing thought and turn it into a constructive thought. More about combating guilt in our next blog.
© 2017 Jeffrey S. Nevid
