You will be pleased to know that finally, in the healthcare professions, worry is now being looked at in a different way. Once the territory of; eccentric aunts, uncles, grandmothers, bank managers, midwives and lawyers. Worry now has it’s very own clinical name:- “Generalised Anxiety Disorder.”
“What does that mean in plain English?”
Bones appear to be the best way to illustrate what I mean. In English we have “Bones of Contention” resulting in long-standing arguments. Then if there is an ‘issue’ in the house this is announced by one of the individuals stating, “I have a bone to pick with you!”.
And here you have a dog, ‘worrying at a bone.” Imagine him going from one end to the other, turning the bone over and going back the other way. (Eloquently described by C.Paolini in his book Inheritance)
“Always he returned to the same set of doubts, worrying at them like a dog with a bone, only with nothing to show for it other than a constant and increasing sense of anxiety”
“A working Definition of Worry” – Crystal Ball Gazing
Every worry thought takes you spiralling into imagined scenarios of absolutely terrible events. You feel as though you will never manage, that you will be out of control. The final outcome will be disastrous. But!!! Remember all of these throughts are based on predictions created by your fear based imaginations.
Focus on the word ‘prediction”. Is it true that you can read the future, is it true that any crystal ball gazers can read the future, no! Otherwise instead of having this look on his face he would be happily cruising the Carribean having had a lottery win.
Believing you can read and predict the fuure is not based in fact and it is not rational. Anxiety creates room for irrational thought and irrational thought creates anxiety, Remember to stay focussed in what is Fact, Truth & Reality. Worry provides you with nothing, it is not a friend.
“The Gifts of Worry.”
“Nothing isn’t quite right. You can have a whole collection of the following bonuses. Yes, all of these can be yours. Just keep worrying”.
- stomach and bowel problems
- excessive anxiety
- muscle tension
- fatigue, feeling wound up or restless
- concentration difficulties, irritability
- difficulty sleeping (don’t forget sleep in the brain’s food)
NB: There are of course medications that can help with sleep, but these are really only recommended in the short-term. Learning how to switch your mind off and not worry is better for you, especially in the long-term.
Many people experience anxiety over certain things; health, finances, what other people think of you. However, there is a difference between appropriate concern and worrying. Concern is associated with action, worry is a never ending cycle with no apparent outcome, taking you nowhere.
“Just stop worrying!”……”Yeah Right”
If you are reading this, to help you understand a loved one who worries themselves sick. The first thing to learn about worry is that there is no point at all, anywhere in the universe, in telling a worrier to stop worrying. Let me demonstrate to you WHY.
All the while you are reading this paragraph, I do not want you thinking about camels. You must focus and not visualise any images you have seen of camels. Including National Geographic covers, cushion covers, travel brochures, camels in or out of the zoo, camels sauntering past pyramids. Nothing just focus.
Right, I think I have got that point across, you can’t trick the brain in that way. This is why I have great difficulty with the New Age school of positive thinking. The assumption being that if you tell yourself to stop worrying and just feel at one with the universe, that all will be well in your world. Again, “Yeah Right!”
Remember the Bobby McFerrin song “Don’t Worry Be Happy” (Great youtube clip) when you listen to the lyrics a little closer the main message is: that worrying does not help fix anything.
“..In every life we have some trouble..
When you worry you make it double, don’t worry be happy…
In your life expect some trouble, but when you worry you make it double, don’t worry, be happy…” Bobby McFerrin (1989)
The sentiment being, life is full of difficult and painful times, that you will have to deal with. So wait and deal with them when they are real not part of your fear driven imagination. In the words of the French philosopher Michael de Montaigne
“Worry Beliefs, Myths & Fairytales.”
However, there are a lot of reasons WHY people continue to worry and are not prepared to give up worrying. You see, there is a lot of mythology attached to worrying, it is like a superstitious belief system. Worriers worry that if they stop worrying this will ensure that something bad will happen.
One of my favourite quotes from a client of mine goes a little like this. She was worrying about her teenage daughter going out in a car with boys to a party. When I asked her about the purpose of her worrying she stated,
“Someone in this family has to worry. God knows what would happen if I didn’t worry, the whole family would fall apart. It’s not that I want to do the worrying, but given that her father refuses to worry I have to!”
Then what happens to cement the essential nature of worrying is when the worry and the universe collide. Let me explain. Teenage daughter goes out with friends, older boys driving and they are off to a party and there will be alcohol.
Visualise mother at window worrying, father in bed asleep or watching sport on television.
Father says, “Relax, you know those kids are responsible, the parents are there, they have a designated driver, stop worrying.”
Then as circumstance would have it the teenagers are involved in an accident not of their own making. So the content of the worry and the event collide. The worrier then receives further ‘evidence/reinforcement”- perceptually speaking – that there was and always will be a need to worry.
When in reality ‘worry’ is a thinking process and last time I looked thinking cannot move matter, nor can it control what occurs in the world. You could be planning a wedding, and worry constantly about whether it is going to rain or not, but no matter how much you worry, you will not impact on the weather.
The example above does illustrate how worry is maintained and the belief in it’s importance. But this is “superstitious behavior”.
Testing the effectiveness of worry.
Try this: Put a glass of fluid in a glass on the very edge of a bench or tabletop. Stare at the glass and worry about it falling off, the bright orange soft drink staining the carpet, glass shattering and going all through the carpet. Then imagine that it is one of the most expensive glasses you have in the house, and breaking this one would spoil the set. Keep looking and keep worrying.
Q: Has the glass moved?
A: Of course not, because thought will not move an object.
Suggestion: Now move the glass with your hand into the centre of the surface, where it is less likely to be knocked, bumped or fall.
Observe how much more relaxed you feel.
You were concerned and you acted upon that.
Action not thought, prevents.
Yes, but “What if?” I can hear you thinking this from here.
What if? we just sit back and don’t worry about the kids at all, and don’t worry about money.
Then, what if we lose the house because we are not worrying about our finances? Recognise this thinking?
It is easily recognisable as worry. Essentially “WHAT IF?” is the mantra of the worrier.
Those two magical words “What if?” are tone of the main triggers of worry. What if this happens? What if that happens? Oh my Goodness, what if they? What if she? What if? What if? What if? All this thinking will do is exhaust you as you continue to produce adrenalin in response to your worrying. Breaking down your immune system with each additional What if?
You are continuously switching on your flight/flight mechanism, for imagined threat not real threat, which is what Mother Nature designed the response for:- jumping from the burning building, killing the Sabre Tooth tiger at the cave entrance.
The internal workings of Worry.
I like the use of spirals to explain patterns of human thought. Particularly when discussing worry, for those of you that are masters of worry you will of course relate to that constant going around and around, particularly at 3 or 4 in the morning. Going nowhere, changing nothing, just round and around the ‘worry spiral.’ Just like these dominos. Flick your thoughts into a negative gearing and they will continue to tumble in that direction. As a client once described to me, “like watching water go down a toilet bowl.”
What activates this phenomenon is “What if?” Nothing in the external world needs to occur for the worrier, the whole process can be activated by one thought. “What if?…. Then predict a negative catastrophic outcome and away you go, spiraling down
In summary the thoughts would look like this:
For the worrier, there is always something to worry about and if there isn’t, the other gift the worrier possesses is the ability to create something to worry about. For instance, they are able to worry about how much they are worrying and if they’re not worrying, they can worry about having forgotten something that they should be worrying about! Whew!
Now, what was that you were worried about?
Did you know that:
- 40% of our worries never happen.
- 30% are about pleasing everybody (not possible).
- 10% are about health, but we are not doctors.
- 12% are water over the dam, or under the bridge.
- Therefore, only 8% could possibly be helpful.
Thomas S. Kepler
Apparently the origins of these statistics are anecdotal. However, they have a certain resonance about them. The one I draw your attention to is that no matter how much you worry, it will not cure ill health, it will not pay your expenses, it will not keep your family safe. Worry accesses information, from your over active, fear-based imaginations.
A common form of worry is ‘Health Anxiety’. Used to be called hypochondria. People will spend hours on the Internet researching and fuelling worry. If you are not feeling well, go to your doctor. Worrying as I have said many times will not help or change anything. In fact there is research to suggestion that the strain on your system caused by worry can work to make things worse.
Worry Behaviour: – What it looks like & What Children See?
I wanted to draw your attention to this aspect of worry, not just because it is educational, but because this is what children observe. If you are a worrier, there is a 37.7% chance that one or more of your children are genetically predisposed to worry, just like you were. So, as with almost everything there is ‘nature’ and ‘nurture’ working together. Hence, children learn about how to manage, or not manage life’s challenges, through watching their parents just as you would have.
It’s called Role-modeling. Yes, every furrowed brow, every time your hand clutches your face, they’ve got their eyes peeled, because that is how they survive. Children know they are safe when the adults are ok.
They hear all the gasping and sighing, they see the tears, the shoulders rounded down. Some of you may like to pace – something they could do with you perhaps?
Not only do they see all of this gesturing, they also notice that lots of people around them (1 in 5 statistically) appear to be doing some form of it. His sister twirls and twirls her hair around her finger endlessly, in between biting her nails. Her mother rubs her brow over and over, in between sighs and cups of tea. If her father has a tendency to worry also, he might be sitting on his own drinking, unapproachable and grumpy.
Hence, when they witness the behaviour of worry they start to believe that to worry is important because it’s what the grown-ups do, it must be really important and vital. They learn that the world is a dangerous place, full of potential disasters and these are to be addressed in part by engaging in worrying.
Because it seems that some of the most important people in their lives worry, so it must be the right thing to do.
I think you’ve got the picture of how worry is passed on from one generation to another. There are excellent books available @amazonbooks.com for children who worry. Have a look if you are concerned.
The wisdom of the grandmother can come in handy with a family of worriers, unless of course she is one. They tend to say things like:.
“Now let’s all just wait to worry shall we!”
(Lindsay a wise woman 2013)
This Homegrown Wisdom reminds us again that nothing bad has happened, it is your worry filled imagination that is creating the difficulty at this point in time. Technically called ‘anticipatory anxiety’. This is where the worrier demonstrates another magical power: we discussed earlier; the ability to predict what will happen in the future. So because they can do this they can see the disaster in their mind’s eye, and become anxious in anticipation of the completely made-up catastrophe occurring. All this without a crystal ball!
Worry Cognition: The Thinking of Worry.
I have described for you all the behaviours that are attached to worrying. This section now concentrates on the thinking itself.
The content of the thinking and HOW the thinking is working against you.
Just to remind you worry by definition is:-
The prediction of catastrophic negative outcomes.”
A form of thinking that can only work against you. Believing that you can read the future is irrational and non-factual and yet worriers spend hours ruminating on thoughts that are not based in fact.
The new research on Worry is fantastic. With the biggest,contribution coming from the, cognitive sciences. Within this philosophy it is vital to believe, that all of the adverse and unhelpful physical, behavioural and emotional responses are controlled and created by the brain. (Unless in the case of physical or neurological disorders such as Parkinsons, where it is a disease process in operation.)
WHY? Because our heads are attached to our shoulders.
YES That simple! The Cognitive Behavioural therapists illustrate it this way:
This diagram provides another depiction of how the circular inter-connectedness of the essence of being human. We are all made up of our physical system, we think and have beliefs (cognition), we have emotions (mood regulation systems) and then there’s what we do (our behaviour).
Here’s an example using a diagnosis of breast cancer (My own diagnosis in 2009)
The Reality – the breast cancer diagnosis remains there. The worrying about what will happen creates anxiety, which in turn impacts on the body, exhausting and straining the immune system and your ability to cope.
You see, the reality is not the problem, reality just is. Terrible things happen to us that we cannot change. Once the diagnosis has been made and adequately verified it is part of a shocking reality that needs to be managed. When the cognitive theorists talk about the ‘problem’ they refer to the response mechanisms, not the actual event. That is described as a trigger or stimulus. Let me show you.
It’s as Simple as :
A (Event) + B (Cognition) = C (Response: Biology, Emotion, Behaviour)
In a Nutshell:
Something happens (external trigger) or in the case of the worrier, nothing needs to have happened (internal trigger e.g. “What if?”). You then start to think about it. As you are doing this you are thinking about the event in a certain way (evaluating the situation). How you evaluate is very much based on your conditioning and belief systems, your rules about how the world should be. Then the brain activates a set of responses, including a physical response (tension, stomach upsets) an emotional response (anger, fear, distress) along with a behavioural respone, what we do (Worry, drink too much, avoid people).
Yes, another circle and because of that this is how worry feeds off itself. As you can see it is the set of responses that then result in a problem. You feel bad both physically and emotionally and you end up doing things that are not helpful. This is why people go to therapists, because they feel bad and want to ‘Feel Good’ about themselves and the world. So it is the responses that the individual wants to go away. Particularly such responses as anxiety, depression, anger and irritability, to name a few.
The key to change lies in the WAY and HOW we think. Therefore, intervention takes place in the cognitions (thinking). Hence, Cognitive Behavioural Mood Therapy (CBT). Working with the thinking, to improve how someone feels physically and emotionally and to assist with problematic behaviours.
Always ask yourself:
How is this thinking helping me?
- It might never happen
- It could be worse
- Don’t make a mountain out of a molehill
- There will be a solution.
And in the words of the Dalai Lama:
“If there is a solution to a problem, there is no need to worry, and if there is no solution, there is no need to worry.”
And in the words of Gwendoline Smith: “If all else fails take a pill.” (I’m not joking).
P.S.: Don’t forget the breathing exercise, yoga, meditation, even just going for a walk all contributes to relaxing your physical self.
David Burns is a cognitive practitioner recognised as having made significant contributions to the science. He created the following list, of what he calls “Thinking Errors.” Essentially these are distorted thinking patterns that warp the way we view the world. They interfere with our ability to interpret and manage reality, by corrupting our perceptual filters. A darling client of mine Sarah once said, “Learning about the thinking errors and staying aware of them is like installing anti-viral software.” Couldn’t have put it better myself.
Distorted Thinking Patterns (Cognitive Distortions)
All-Or-Nothing Thinking – You see things in black-and-white categories. If your performance falls short of perfect, you see yourself as a total failure.
Overgeneralization – You see a single negative event as a never-ending pattern of defeat.
Mental Filter – You pick out a single negative defeat and dwell on it exclusively so that your vision of reality becomes darkened, like the drop of ink that colors the entire beaker of water.
Disqualifying the positive – You dismiss positive experiences by insisting they “don’t count” for some reason or other. In this way you can maintain a negative belief that is contradicted by your everyday experiences.
Jumping to conclusions – You make a negative interpretation even though there are no definite facts that convincingly support your conclusion.
A. Mind reading. You arbitrarily conclude that someone is reacting negatively to you, and you don’t bother to check this out.
B. The fortune teller error. You anticipate that things will turn out badly, and you feel convinced that your prediction is an already-established fact.
Magnification (Catastrophising) or Minimization – You exaggerate the importance of things (such as your goof-up or someone else’s achievement), or you inappropriately shrink things until they appear tiny (your own desirable qualities or the other fellow’s imperfections). This is also called the “binocular trick.”
Emotional Reasoning – You assume that your negative emotions necessarily reflect the way things really are: “I feel it, therefore it must be true.
Should Statements – You try to motivate yourself with shoulds and shouldn’ts,
as if you had to be whipped and punished before you could be expected to do anything. “Musts” and “oughts” are also offenders. The emotional consequence is guilt. When you direct ‘should’ statements toward others, you feel anger, frustration and resentment.
Labeling and Mislabeling – This is an extreme form of overgeneralization. Instead of describing your error, you attach a negative label to yourself: “I’m a loser.” When someone else’s behavior rubs you the wrong way, you attach a negative label to him: “He’s a such a loser.” Mislabeling involves describing an event with language that is highly colored and emotionally loaded.
Personalization – You see yourself as the cause of some negative external event, which in fact you were not primarily responsible for.[David Burns. Author: Feeling Good]
No, the list wasn’t written for you, although I wouldn’t mind betting that’s what it feels like. So these are the ways of thinking that create difficulty for you. Activating all sorts of responses such as fear, anxiety, anger, frustration, upset. You name it and sure enough one of these thoughts will be sitting in your thinking process somewhere. Here’s an example.
- You need to familiarise your self with the distorted thinking patterns.
- Once you know them, this will help you recognise how you are thinking.
- Challenge your thinking. You may find that you are constantly jumping to negative conclusions, predicting catastrophic negative outcomes. ‘Mountains out of molehills’ is the homegrown description.
|Situation, Trigger, Event.When? Where? Who?What happened?||Automatic thoughts, assumptions.Spontaneously what you were thinking, before & during the event.||FeelingsOne wordSummaries(0-100%)||Behaviour. What did you do in response to the event/emotion?||Thinking errors.|
|Phone call to goback for a second mammogram.||Bad things are always happening to me!I’ll go there and they will tell me I have cancer.It will be one of those cancers, that are hard to treat.
Oh no! Then I’ll have to have chemotherapy and all my hair will fall out.
Then I’ll have to be off work for months and I won’t be able to afford my rent.
I shouldn’t have to be dealing with this. It’s not fair.
(90% out of a possible 100%)
|Went to bed, cried myself to sleep.
Didn’t tak to anyone about what had happened.
Didn’t sleep well, woke up worrying.
|All or NothingOver Generalising
So as you can witness, the thinking errors have completely contaminated my thinking. Based on predicting catastrophic, negative outcomes, continuing to ‘what if?’, activating more anxiety. Then because I am now feeling so anxious, I can tell myself, “I feel terrible, something bad must be about to happen.” – emotional reasoning.
A Few Strategies
Here is a little template, you may want to copy it on a card and carry it around with you, referring to it when you feel yourself getting anxious.
At all times during this ordeal you want your thinking to, as much as possible, remain rational and helpful to your well-being and the well-being of your family. Once your thinking leaves this domain it becomes irrational. In other words not based in fact, reality and the truth, you will experience unpleasant emotional and physical side-effects.
For instance telling yourself and so believing that there shouldn’t be cancer, that bad things shouldn’t happen, and even if it has to be there nice people shouldn’t get cancer is an ideal, in reality cancer knows no bounds. Cancer is not going to respond to a should, it just is.
“Life does not respond to should, or the sense of universal justice.
Reality just is.!”
When you predict negative outcomes via the Fortune Telling thinking error, you are believing that you can predict the future. That is not a fact, nor is it real and neither is it the truth. So essentially, the thinking illustrated on the above thought record is not based in what is real, factual and true. Hence it is not helpful.
Another one of my wonderful clients designed this slightly more advanced thought record, although you need to practise these things one step after another.
|Situation, Trigger, EventWhen? Where? Who? What happened?|
|Automatic thoughts, assumptions. Spontaneously what were you thinking before and during the event?||Feelings(one word summaries)0-100%||BehaviourWhat did you do in response to the event or emotion?||Thinking errors||Rational Alternative ThoughtsFact OpinionReal IdealTrue Helpful|
So give this a try, what you will find is that when you look at your thinking and challenge its validity you will experience a shift in the levels of your distress. True story, this wonderful stuff works, I see it work everyday. Sometimes there can be benefit from just seeing your thoughts on paper, without necessarily doing the work with the thinking errors. However, I do recommend that you familiarise yourself with them as they will assist with all aspects of your life, work and interpersonal relationships will be enhanced.
The Thinking Errors need to become a part of your everyday thought processing. It is essential to get to know them as you will then be able to become consciously aware of what is interfering with your thoughts and distorting your perception of reality. Once reality is distorted it then becomes perceived as dangerous. Then your responses reflect the perceived danger and you ‘fight/flight’ mechanism is activated and the anxiety comes with that. Because the reality is perceived as catastrophic your anxiety levels will reflect that and become overwhelming.
In the thought record above you will notice the column that asks that you to rate your feelings on a 0 – 100% scale. What is being measured here are units of distress. This is a helpful technique, because it allows you to give the discomfort a number, which then allows you to measure evidence of change.
For instance your boss might call you into his/her office and there is no meeting scheduled. You immediately become anxious, let’s say 90% out of a hundred. So very distressing. Going into the meeting with these levels of anxiety is not desirable. You are more likely to stammer, forget what you were thinking, as your mind goes blank and all you are aware of is your heart pounding in your chest.
The predicted Nightmare
This has happened How?
A(trigger): Boss call you into their office.
B: You think…” OMG this is a disaster”
What if he fires me?
And then what if I have to leave immediately?
And what if I can’t get another job?
And the kids have been signed up for private school
And what if we can’t pay the mortgage
OMG this is a disaster I can’t cope!!
C (Response) Anxious fearful (90%)
Stomach pains. Sweaty hands, hyperventilatoin.
Well, if I was thinking like this I would be feeling overwhelmed with anxiety. However what is obvious is that all of the thinking is based on “PREDICTING NEGAIVE CATASTROPHIC OUTCOMES.” None of this thinking is based in fact, or is in anyway helpful. It is all based on fortune telling, emotional reasoning with a negative mental filter.
The Actual Story:
Invited into Manager’s office.
Manager invites you to sit down and says;
“Stephanie has handed in her resignation as she is relocating for personal reasons. I would like to offer you her position, which would of course be a promotion and coming with that additional responsibility.
Would you be interested in considering the position, which we feel you would be great for the job, prior to advertising externally?”
Mmmmmmmmmmmmmmm…. You hadn’t predicted that lovely outcome had you? That is because worry will always predict a negative outcome. The thoughts are pessimistic not optimistic.
How bad is this really.
I would now like to introduce you more formally to the wonderful word ‘helpful’. It reminds me of this symbol. It is globally recognised as the sign of “People helping People”. Only terrorists show no respect for this symbol of humanity, because of their fanatical, dangerous belief systems.
The word is not judgemental, it’s not based in ‘shoulds’ or shouldn’ts’, neither does it make statements about what is normal or abnormal. It merely begs the question, ‘is this helpful?’ So next time you find yourself on the “Worry Wheel”, ask yourself.
Well, I hope you’ve found that helpful. By the way, when you look at your prompt card – you may want to write one out, also to carry around with you – because you are trying to develop a new way of thinking, look at it for 15 seconds minimum.