American Institute for Cognitive Therapy : AICT In The News

What if?
If you learned to worry well, would it change your life?
Aileen Brabazon takes us down the slippery slope of worry and up the other side to firmer ground.

Published in Glow Magazine, May-June 2006 ( www.glow.ca )

The other day, I had a bad case of the what-ifs. Faced with an important interview, it started: What if I blush? What if my hands start shaking or I say something silly? I worked myself into such a state that I nearly canceled my appointment. Worry is like an emotional crystal ball that allows you to peer into the future and predict potentially negative outcomes. Human beings are hard-wired to worry — depending on how you do it, worry can help you succeed or make you sick. Read on to find how to be a better worrier.

Worry as motivation

Worry can be productive when it pushes you to solve problems that may prevent unwanted events. “When you’re studying for an exam, there’s a certain amount of anxiety that goes with it that is healthy and improves performance,” says Dr. Eilenna Denisoff, a psychologist at the Anxiety Disorders Clinic at the Centre for Addiction and Mental Health in Toronto. “A bit of worrying can be motivating,” she says.

Meanwhile, unproductive worry is anything but useful. In his book The Worry Cure: Seven Steps to Stop Worry From Stopping You (Random House of Canada, 2005), Dr. Robert Leahy, director of The American Institute for Cognitive Therapy in New York, describes this worry as a string of what-ifs that don’t lead to any concrete, practical solutions and typically sound like “What if I don’t know what to say and mumble like a fool? What if they don’t like me?” While the occasional bout is fine, getting too wrapped up in unproductive worry can be harmful. “It can lead you down the road of trying to find perfect solutions to a future that never occurs,” says Leahy. “And when we worry, we don’t enjoy the present moment. In fact, our worry may even keep us from getting things done, simply because we are worried about how unpleasant the outcome will be.”

WORRYING WAYS
Everyone worries, though not everyone copes with it in the same way. If you’re a non-worrier, you take a fairly balanced approach to a what-if. If it can’t be solved right now, you weigh the likelihood of it happening and conclude that you’ll deal with it when and if it does occur.

But if you’re a worrier, you process things much differently. “Classic worriers can’t turn their minds off,” says Dr. Henny Westra, an associate professor of psychology at York University in Toronto. But constantly ruminating about worst-case scenarios can stress you out. So why do it? It’s due in large part to needing certainty and believing you won’t be able to cope with problems when they arise. It’s an attempt to avoid dilemmas and negative emotions, which is a big reason why worriers keep on worrying, she says.

“While worriers may acknowledge the downside of such stress, it doesn’t tend to stop them from worrying, says Westra. “Their thinking is, I would worry if I gave up worry because then what would happen to my children, my motivation and so on.”

WOMEN AND WORRY

Lucky us, women are twice as likely to be chronic worriers and be diagnosed with an anxiety disorder. There are several reasons why. For one, 40 percent of anxiety disorders are caused by genetic factors. “Also, women have always been in charge of child rearing, so they have to consider the welfare of somebody who is helpless,” says Leahy. As well, the demands on women to be super at everything — mom, professional, wife and friend — can only encourage worry. Denisoff also suspects women’s elevated worry rates may have to do with the way they’re socialized as children. Boys are more frequently told not to be afraid, so they overcome more of their fears. Girls are more often protected from what they’re told is dangerous, so fear and anxiety are more likely to stay with them.

DON’T WORRY, BE HAPPY

If only it could be that easy. Expecting a worrier to stop ruminating is like telling someone not to think or feel, says Leahy. It’s impossible to simply turn off worried thinking. “If you tell yourself not to think about something, it’s immediately on your mind,” says Denisoff. Fortunately, there are ways to rein in the what-ifs. Start by listing your worries to identify which are productive and which aren’t. Take action on your productive worries and deal with the others using the following tips.

1. Set aside worry time . Schedule 20 to 30 minutes a day to worry. During that time, write out your concerns. After a while, you’ll realize your worries are repetitive and you’ll get bored of them. This will give you a sense of control over what may seem to be out-of-control concerns, says Leahy.

2. Challenge your worried thinking. “Write out and look at the evidence for and against the belief that something terrible is going to happen,” says Leahy. Also, keep a journal to note what you worried about five years ago, five months ago and five days ago. “Most worriers can’t remember what they’ve worried about in the past, which means they handled it,” he says. Keeping track of your what-ifs will help you understand that not everything you worry about will happen.

3. Stay in the moment. “Being aware and staying in the moment is a good antidote to worry,” says Leahy. One way of taking a mindful approach is to acknowledge your worry and release it, as opposed to controlling, Suppressing or being afraid of it, he says. Since worry often has to do with the future and sometimes the past, staying in the moment means there’s nothing to worry about. There are different approaches to mindfulness, such as meditation and yoga — experiment to find what works for you.

4. Just do it. “A lot of worry is an attempt to avoid unpleasant emotions,” says Leahy. “The same is true with procrastination: the avoidance of discomfort.” The aim is to accept it and not let high levels of frustration stand in the way of your goals. Make a list of what you want to accomplish and the steps you need to take to get there, then take them. “Do the things you’re avoiding and you’ll find that, rather than worry about them, you can cope with them,” he says. “Even if they’re unpleasant, you’ve made some progress by getting them out of the way.”

Calling Chronic Worriers

How much worry is too much? You may want to consider seeking professional help when worry affects year social life, interferes with your ability to function at work or negatively impacts your relationships, says Dr. Eilenna Denisoff.

The old warning ‘You’ll worry yourself sick has some truth to it. Worry is the central component of anxiety disorders, social phobia and obsessive compulsive disorder, According to Dr. Henny Westra, an associate professor of psychology at York University in Toronto, anxiety disorders are the most common mental health problem in the country – up to 25 percent of Canadians will suffer from one in their lifetime. Excessive worry is also at the core of depression. “About 80 percent of chronic worriers eventually become depressed – you can worry yourself into depression.” says Dr Robert Leahy.
Chronic worriers may also grapple with health concerns such as insomnia, irritable bowel syndrome, aches, pains and chronic fatigue, says Leahy. Excessive worrying can leave you stressed out, uptight and tired – trying to solve all the problems of tomorrow zaps your energy.

Too Worried?
Take the Penn State Worry Test to find out

Enter the number that best describes how typical or characteristic each item is of you, putting the number next to the item. One is not at all typical, five is very typical.
1. If I don’t have enough time to do everything, I don’t worry about it. (R)
2. My worries overwhelm me.
3. I do not tend to worry about things. (R)
4. Many situations make me worry.
5. I know I shouldn’t worry about things, but I just cannot help it.
6. When I am under pressure I worry a lot.
7. I am always worrying about something.
8. I find it easy to dismiss worrisome thoughts. (R)
9. As soon as I finish one task, I start to worry about everything else I have to do.
10. I never worry about anything. (R)
11. When there is nothing more I can do about a concern. I don’t worry about it anymore. (R)
12. I’ve been a worrier all my life.
13. I notice that I have been worrying about things.
14. Once I start worrying, I can’t stop.
15. I worry all the time.
16. I worry about projects until they are done.

Your total score: _____

(R) indicates a reverse score. To reverse score your question, if you give an answer of 1 (“not at all typical”), score it as a 5. If you answer 2, score it as a 4. If you answer 4, score it as a 2. If you answer 5, score it as a 1. A score of 3 remains unchanged.

Add up your scores on the test — and be sure to note which items are reverse scored (see above for how to reverse score your responses). People with some problems with worry score an average above 52, and really chronic worriers score above 65. Non-anxious people average around 30. It is also quite possible to score below the clinical range (somewhere between 30 and 52) but still feel that your worries are bothering you. If your scores are elevated, you might want to examine which areas in your life are the main sources of your worries.
Reprinted with permission from The Worry Cure (Random House of Canada, 2005) by Dr. Robert L. Leahy.