One of the most common problems I see in my clinical practice is Worrying; people sometimes say ‘I have always been a worrier’. Most of us have worried about something at some point in our lives, so we can all relate to the experience.

I think of worrying as stemming from the FEAR ‘family’ of feelings, in which I might also include Health Anxiety, Social Anxiety, Existential Anxiety, Generalised Anxiety and Worry Ruminations. Head of the ‘Family’ is Big Fear/Terror, in which a sense of acute danger to self or loved ones, is experienced, potentially life-threatening or risk of violation eg rape. This triggers the well-known response from the ‘panic button’ in the brain: escape, fight or freeze. However, the other Anxieties mentioned above can be chronic and more pervasive, filtering into different aspects of our lives and tormenting us persistently…..

The habit of worrying and ruminating usually focuses on the Past or the Future, eg ‘What Ifs?’ These troubling thoughts are repetitive and exhausting,:

Physically – agitation generating low but continuous levels of adrenaline, perhaps nausea, insomnia, teeth grinding, headaches, irritable bowel and other unwelcome symptoms.

Mentally – impacting creativity, concentration, enjoyment, relationships, and peace of mind.

Dwelling on the Past is usually unproductive, because we cannot change our words or actions; at best, occasionally it may be possible and appropriate to offer a retrospective apology. However, if we worry about what others may have thought about our words or actions, we can get stuck in a quagmire of uncertainty – almost impossible to be sure because sometimes people choose to tell us what they think we want to hear, sometimes they can’t remember, sometimes they have their own agenda, etc…..All unsatisfying. So, really difficult, time-consuming and tiring to verify accurately. Also, this form of reassurance seeking can become addictive, meaning we need more and more of it to feel just a llittle bit better…..

Turning now to the other main driver of Worrying, the Future, which can seem full of What Ifs?, this is a Closed Book. We dwell in the Present and that is our only place of certainty. We may be tempted to think that preparing ourselves for something bad that might happen will somehow make it easier to bear or cope with, when/if it does, but anecdotal evidence does not appear to support this concept.

This is not to say we should only live in the moment and ignore reasonable safeguards to protect us against dangers we can anticipate. For example, Road Traffic Accidents are possible and we therefore take steps to mitigate the risks (seat belts, obeying rules of the road, ensuring car is serviced, insurance, choosing cars with good safety features etc). Generally, in our daily lives, it makes sense to use knowledge and experience to minimise risks, and we mostly do this automatically, perhaps avoiding trouble spots late at night in city centres, for example. I see this as different from the intrusive What If? type of thinking that saps our physical energy and psychological well-being, as described above. These are a form of intrusive thoughts, a kind of mind-game we can become habituated to playing which takes up our time and robs us of precious peace of mind. Further, some research has shown that only a tiny % of what we worry might happen (with no evidence), actually does happen.

Therefore, it might be helpful to consider the following when a worry tries to take over your mind:

1. Is there anything practical I can do about this NOW?
2. What actual evidence do I have that this thought is realistic and true? (rather than catastrophic, biased, emotionally-led)
3. If I had to bet I was right (that my worry was justified because I really believe it to be definitely going to happen). How much would I bet (and be prepared to lose if I was wrong and it didn’t happen)?
4. What was the last thing I worried about? Was that worthwhile? Did it actually happen as I worried it might?
5. How does it benefit me to worry about this? What does it gain me?