Play with worry

Let’s talk cognitive process. Your process for any task is your series of steps to achieve your end. Your process for brushing your teeth or cleaning your kitchen may seem to you like “that’s just how you do it,” but if you surveyed the next 10 people you encounter it is very likely that their process for those tasks are not as similar as you were expecting.

For worriers, the mental process of worrying might otherwise be described as thinking. Where does your worry end and your thinking start?

To sort this one out, first off, bring attention to and get control over any functional worry that you experience. 

Worry as a function is a cognitive form of experiential avoidance, similar to thought control or thought suppression. In thought control and thought suppression, individuals make active attempts to stop thinking about the stimulating topic and distract themselves. When worrying as a cognitive avoidance, you might feel like you are thinking a lot about the topic and even feel completely preoccupied with it. This form of worry is problematic when you don’t feel like you get to choose to think about it and when the thinking you are doing is not becoming problem-solving. If you have fallen into the habit of worrying as experiential avoidance, you probably don’t know what you feel about the content that preoccupies you. Another clue is that you can’t stop thinking about it, but you don’t want to talk about it. You feel an aversion to anyone asking you about it, you don’t want to discuss it in psychotherapy, and if you were to try to write out what you are worried about, it would either be very hard to do or feel very uncomfortable for you.

Here are some questions to ask yourself if you are experiencing worry as experiential avoidance:

  • If I didn’t feel anxiety, what would I feel? (examples: sadness, anger, guilt, fear, regret, jealousy, embarrassment, NJR)
  • If I was going to take action on this topic, rather than worrying about it, what is my next step?
  • Is there anything I can actually do differently?

We’ll also discuss mental compulsions, rumination, and post-event processing over the next several weeks. These are triggered thinking patterns. There are external circumstances or internal thoughts, feelings, and sensations that make these responses more likely in your thinking. To overcome mental compulsions, rumination, and post-event processing, observe what triggers it, what keeps you fused to the content when it arrives, and what you feel. We can work together to challenge the beliefs that keep you fused to the content and to stay present to the feelings. You’ll need to be ready for trigger, ready to get distance when the fused thoughts show up, ready to show compassion to your feelings, and ready to bring yourself back to the present moment.

Finally, let’s sort through what maintains the rest of your worrying. This part is some combination of habit and belief in the utility of worry.

Here are some possible beliefs that maintain worry:

  • Worry reduces painful emotions. (This is functional worry.)
  • Worry increases my self-esteem, by making me feel in control.
  • Worry prevents catastrophe, because I have control over what I worry about.
  • Worry helps me solve problems.
  • Worry motivates me, because it makes me aware of everything that could go wrong.

Her are some workable functions of worry:

  • Short-term reduction in painful emotions.
  • Short-term reduction in uncertainty.
  • Short-term increase in self-esteem.
  • Short-term increase in self-efficacy.

Here are some unworkable functions of worry:

  • Long-term increase in painful emotions.
  • Long-term increase in sensitivity to uncertainty.
  • Long-term reduction in self-esteem.
  • Long-term reduction in self-efficacy.
  • Long-term narrowing of options.

To break the habit of worry, you have to work at it and you also have to have compassion on yourself during the process. If your teeth-brushing process did not involve flossing and your dentist told you to floss, would you think, “Well, that’s your opinion…” or “I’m just a bad person for not having this step in my routine?” I hope not. The more helpful response would be, “That seems like it would be helpful, and it will be challenging to change this habit. But, I care about my health, so I’m going to try. What can I do to help myself be most likely to change this habit?”

Try to think about your mind and your mental habits this way too. There is nothing inherently wrong with you if your mind happens to worry a lot. But, it is a habit that causes a lot of suffering and sensitizes you to other suffering-inducing response mechanisms, like avoidance and rumination. The habit or process of worrying can also just make life feel more urgent, less safe, and more stressful than it needs to be.

Worry can occur when you have the feeling of uncertainty about an unanswerable question and you try to make the uncertainty dissipate by answering the question. Worry is productive when the question is answerable and the attempts to answer it result in problem-solving. Worry is not productive when the question is unanswerable and the attempts to answer it creates more questions plus worry about worry (that is, “what if I can’t stop worrying?”). Read more about productive and unproductive worry here.

Scheduled worry time is the most of effective intervention for worry as a function. 

When the main function of your worry is to avoid or suppress uncomfortable sensations and feelings (that is, experiential avoidance), the best thing you can do is go towards it until it is boring. Write out all of your fears and then say them over and over until it is no longer distressing.

Notice the dimensions above. Scheduled worry time should challenge the idea that worrying is reasonable. The time orientation and content don’t matter. If your worry is not also maintained by actual problems to solve or beliefs about the utility of worry, scheduled worry time should challenge the function of your worrying and break your habit.

Scheduled worry time involves setting aside 10 minutes per day twice per day to worry aloud. During this exercise, you should plan what you will worry ahead of time, writing down everything you worry about in the format:

“What if _(catastrophic thought)__?”

Do not problem solve or answer the question, just write a list of the things you worry about. As an example, the list might include:

  • What if I don’t get where I need to be on time?
  • What if my car breaks down?
  • What if my child gets sick?
  • What if something terrible happens to me?
  • What if there’s something wrong with my mind?
  • What if I feel embarrassed at the upcoming event?
  • What if I’m not prepared for the thing I need to prepare for?
  • What if ____ is mad at me?
  • What if I do something that causes people to dislike me?
  • What if I fail?
  • What if I make a mistake at the thing I’m trying and maybe I don’t fail but it has some other catastrophic consequence?
  • What if worrying so much means something bad about me?
  • What if anxiety isn’t my problem?
  • What if I’m anxious forever?
  • What if this technique doesn’t work?

Your list can be as short or long as you want it to be and you can add to it over time. It’s important that you continue to worry out loud, in a mirror for 10 full minutes, even if you only have a minute or two of worries. By repeating the worries over and over you will likely start by feeling anxious, but finish the task feeling bored.

The point is four-fold:

  • Contain the worries to one part of the day and have a place to “put” worries that pop up in the middle of the day, thinking “Oh. Let me get back to whatever I’m doing. I’ll worry about that later.”
  • Desensitize yourself to the thoughts themselves, by hearing them out loud in your own voice.
  • Learn to see your worries as chatter, that just pops up when you feel anxious, not as content that is important to respond to.
  • Cue yourself to respond to the thoughts as worry when they intrude in your mind at other times, not as content that is important to respond to.

When you’re ready to commit to breaking the habit of worry:

1. Start with scheduled worry time and observes in your experience over 5-7 days.

2. Identify the beliefs you have about worry and the workable vs. unworkable functions it has in your life.

3. Once you are tracking your worries, differentiate between answerable and unanswerable questions, in order to turn unproductive worry into productive worry.

4. Take action on answerable questions that have solutions.

5. In everyday life, notice worries as they arrive and redirect your attention back to the present moment.