NEGATIVE BELIEFS ABOUT WORRYING: "WORRYING IS DANGEROUS"

INTRODUCTION

Readers ask yourself this question: if you felt your worrying couldn't harm you or wasn't dangerous, how much would your worrying bother you? Chances are, you wouldn't feel as bad if you thought your worrying was harmless, as opposed to thinking your worrying is harmful. So in this entry we will look at changing your beliefs that:

"Worrying will make you go crazy"

"If i keep worrying I will have a nervous breakdown"

"I'll get sick if i don't stop worrying"

"Worrying will damage my body"

"I'll go nits if I keep worrying"

"Worrying will make me ill"

CHANGING YOUR BELIEF

As in the previous blog entry, before we start changing your belief that worrying is dangerous and harmful, we need to know how much you believe it?

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

If you do not think you hold this belief at all, still work through this entry just to be sure, but chances are you can move on quickly from this entry to the next.

To change your belief that your worrying is dangerous, you need to do something you are already familiar with from blog entry 3. That is, challenge or dispute your belief. This means dissecting the belief that your worry will cause you physical or mental harm, by evaluating if it is really accurate and true, and examining what evidence you base your belief on. In this way you will be like a detective, trying to get to the facts of whether worrying really is dangerous to you.

Often people experiment with this belief too, just as you did in the last blog entry. Such an experiment might involve pushing your worrying to the 'max'. This means trying your hardest to lose control of your worrying. Typically people predict that trying to push their worrying to the limit ill be awful, and that something terrible will happen. Often people are surprised that nothing bad actually happens and they experience their worry as harmless. However, it is recommended that this approach be used with the guidance of a mental health professional, and so is not used in this blog.

Now that you have challenged your belief that worrying is dangerous/harmful:

Rate again how much you believe your worrying is dangerous/harmful?

0% 10% 20% 30% 40% 50% 60% 70% 80% 90%

If there is some weakening (however small) of your belief that your worrying is dangerous compared to

what it was at the start of this blog, congratulate yourself. If there's no change yet, thats okay

Remember, changing your beliefs takes time and persistence. Just going over the evidence for and against your belief once may not be enough. You need to practice this strategy until the evidence for your belief is weak and the evidence against your belief is strong. A good gauge of when you have done enough work on this belief may be when your belief is relatively weak - say about only 20%.

SUMMARY

• Negative beliefs regarding worrying being dangerous make your worrying worse.
• To change these beliefs you can challenge them - look at the evidence for and against the beliefs
• In order to change your belief that worrying will cause you harm, you need to persist until the evidence for your belief is weak and the evidence against your belief is strong.
• Once you have achieved this ask yourself: What does this all say about my worrying?
• It should show you that your worrying is, in fact, harmless

NEGATIVE BELIEFS ABOUT WORRYING: "WORRYING IS UNCONTROLLABLE"

INTRODUCTION



Okay readers, ask yourself this question: if you believed you had control over your worrying, how much would your worrying bother you? Chances are, you wouldn't feel as bad if you thought you were in control of your worrying, as opposed to thinking that your worrying is in control of you. So in this entry we will look at changing your beliefs that:

"I have no control over my worrying"

"Once I start worrying I can't stop"

"My worrying in uncontrollable"

"My worrying will never end"

"My worrying controls me"

"I can't do anything to stop my worrying"

CHANGING YOUR BELIEF

Before we start changing your belief that woryring is uncontrollable, we need to know how much you believe it. How convinced are you that your woryring is beyond your control? Do you believe it fully and whole-heartedly? Do you mostly believe it? Hlaf the time? Occasionally? Or maybe this is not a belief you even hold? Even if you think you do not hold this belief, I encourage you to still work through this entry to be sure it is not a belief that is lurking at the back of your mind without you realising. Chances are you can move on quickly from this entry to the next.

How much do you believe that your worrying is uncontrollable?

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

To change your belief that your worrying is uncontrollable, you need to do two things.

Firstly, you need to challenge or dispute your belief. That means taking apart the belief that you can't control your worrying, by evaluating if it really is accurate and true, and examining what evidence you base your belief on. In this way you will be like a detective, trying to get the facts of whether worrying really is uncontrollable.

Secondly, you need to experiment with your belief. That means doing things to see if worrying really is uncontrollable. If you are able to do things that show your belief isn't true - that in fact you can control your worrying - it is going to be hard to hold onto your belief. In this way you will be like a scientist with a prediction that worrying is uncontrollable, which needs to be tested.

EXPERIMENTING WITH YOUR BELIEF

Now its time to do a bit of experimenting with your belief that worrying is uncontrollable. Like any good scientist, if you have a prediction about something, the best thing to do is to conduct an experiment to see if its true.

Remember in entry 2 you did an experiment where you were asked to suppress a thought:

Try not to think of a pink elephant for the next 60 seconds!

Try it again now!

Chances are you can't, and thoughts of pink elephants keep popping into your head.

Suppressing worrisome thoughts means trying to get all thoughts related to whatever you are worried about out of your mind (e.g. "What if i fail my exam?), but you make a decision not to 'chase' the thought any further at that particular time. Not chasing the worrisome thought further means that you don't try to anticipate the worst or run scenarios and solutions related to your initial thought through your head over and over again (e.g. "It will be a disaster, I will be a failure, I will get kicked out of uni, I won't be able to find a job, naybe I should pull out of my course." etc.) Instead you postpone your worrying until a later time. Can you see the difference between supressing thoughts and postponing worrying?

It makes sense that if you are able to postpone worrying, then your worrying can't be uncontrollable, and this belief is not true.

OVERVIEW OF BLOG ENTRIES

You will notice that the next three entries (parts 3, 4 and 5) target your negative beliefs about worrying and then your positive beliefs about worrying. Your beliefs about worrying need to be dealt with first, before dealing with your specific worries. The reason for this is that the beliefs people hold about worrying are often what distinguishes someone with normal levels of worrying, from someone with more problematic generalised anxiety. Therefore, changing these beliefs is very important in overcoming your generalised anxiety. Also, looking at your specific worries is not the best place to start, because while working on one worry may help to decrease that particular worry, it is likely you will just start worrying about something else.

It is in entries 6, 7 and 8 that your specific worries will be addressed. Two main techniques for dealing with your worries will be taught. The first is how to challenge your worries and the second is how to disengage from, or let go of, your worries. How to become more tolerant and accepting of ucertainty will also be addressed here, as your worries will often relate to this issue.

Entries 9 and 10 will teach you skills to help you with the way you respond to your worries. For example, using problem-solving skills is a more helpful way of responding to your worries than using some of the unhelpful strategies you may be used to. Also, using relaxation can be helpful in dealing with unpleasant physical sensations, like tension, that are often linked to your worrying. Finally, in entry 11 i will put all helpful strategies you have learnt throughout this blog together in a self management plan which will help you maintain and improve on the gains you make.

RECAP

TREATMENT FOR WORRYING

Let's recap and put all the information we now know about worrying together, and then have a look at how you can overcome your worrying.

When your worrying is triggered by something external or internal:

1) Very specific worries related to the trigger are set off, and tend to take form of "What if" questions. It is likely that the fact your respond with worrying so quickly, is because you believe that at times worrying can be helpful to you. That is, you hold some positive beliefs about worrying.

2) However, if you keep on worrying, your worries may start to focus more on worries-about-worrying and how uncontrollable and harmful your worrying is. This is because you also hold some negative beliefs about worrying.

3) You experience distressing emotions and unpleasant physical sensations when you worry, which make you feel worse and make you believe even more that your worrying is harmful to you.

4) You engage in unhelpful strategies like trying to control your worrisome thoughts. These often don't work and will make you feel worse, making you believe even more that your worrying is uncontrollable.

5) You may engage in other unhelpful strategies like trying to avoid worrying. This may make you feel better in the short term, but in the long run it will limit your opportunity to find better ways of coping with life than worrying.

From what you know about the process of worrying, it makes sense that to overcome worrying and generalised anxiety, you need to do three things 1) address your beliefs about worrying; 2) deal with the specific worries you have; and 3) learn to use helpful rather than unhelpful strategies.

OVERVIEW OF WORRYING PART 2

POSITIVE BELIEFS ABOUT WORRYING



While worriers may hold negative beliefs about worrying (i.e. that worrying is uncontrollable and harmful), they also often hold positive beliefs that worrying is beneficial and "good." It is these positive beliefs about the usefulness of worrying that can keep worriers worrying. Some positive beliefs may be:

• Worrying motivates me to do things
• Worrying helps me find solutions to problems
• Worrying prepares me for the worst
• Worrying helps me avoid bad things
• Worrying prevents bad things

UNHELPFUL STRATEGIES

In an attempt to decrease or stop worrying in the short term, people often use certain strategies. However, in the long term, these strategies actually keep worrying going, making such strategies "unhelpful". There are two main types of unhelpful strategies.

The first type of unhelpful strategy is avoidance. This may take form of avoidance of a feared outcome or avoidance of worrying itself. For example, if someone was given the oppurtunity to take on a new and important project at work, a person with generalised anxiety may worry "What if I can't go the job? What if i fail?" In order to avoid this feared negative outcome, they may pass the opportunity on to another colleague. An example of avoiding the act of worrying may be avoiding the television news because you know that the news tends to trigger episodes of worrying, or constantly contacting a loved one to allay fears that something bad has happened to them. This last example is known as reassurance seeking.

The problem with avoidance is that people limit their opportunity to be exposed to their worrying, and learn that the outcome isn't as bad at they thought, that worrying isn't uncontrollable or dangerous, and that there are other ways of coping besides worrying. Avoidance limits a person's opportunity to have experiences that disconfirm their worries and their beliefs about woryring. This keeps worrying going because their worries go unchallenged.

The second type of unhelpful strategy is thought control. People with generalised anxiety often attempt unsuccessfully to control their worrisome thoughts in a number of ways. These may include trying to suppress their worries (i.e. telling themselves to "Stop worring"), trying to reason with their worrisome thoughts (i.e. "The likelihood of these things happening is so small"), distracting themselves (i.e. focusing attention on another task) or thinking positively (i.e. "Everything will be ok"). These attempts at controlling their worries often do not work for various reasons.

For example, it is widely known that trying to suppress a thought has the opposite effect of making that thought occur more. For example, try not to think of a pink elephant for the next 60 seconds and see how well you do.

Again, trying to reason with your worries is often useless, because no matter how small the chance is of something happening your need for certainty will not be able to tolerate this small chance, and the answer to all your reasoning attempts will always be, "But it still could happen!" These ineffective thought control strategies not only keep the worrying going becuase they are not good at stopping the worrisome thoughts, more importantly they fuel one of your negative beliefs about worrying - that worrying is uncontrollable.

OVERVIEW OF WORRYING

INTRO

Most clinicians and researchers agree that worrying is a central feature of generalised anxiety disorder. As we discussed in my last entry, one of the common things that people with generalised anxiety disorder experience is chronic worrying.


The aim of this entry is to provide an overview of what worrying is, what triggers worrying, what keeps it going, and most importantly, how to treat it effectively.







UNDERSTANDING WORRYING


You can think of worrying as a self-talk activity, where we 'talk to ourselves' about possible future negative events that might happen and of which we are afraid. We discuss the event with ourselves and we think about how we might deal with it should the event happen. As such, worrying is a type of vigilance for threat, and an 'attempt' at mentally 'solving problems' that haven't yet happened. We say 'attempt' because often a good solution is not found, and people are left thinking they will not be able to cope should their worst fears happen. We say 'solving problems' because people often think that worrying is problem-solving, when in fact effective problem-solving is a very different type of activity (which you will read about in entry 9)





"WHAT IF..." WORRIES


People with generalised anxiety are often having an internal conversation about things they fear might happen. In this way, worrying often occurs in the form of "What if......" questions. The questions play in your mind like a song and the words may sound like these:



"What if I can't get to my appointment on time?"
"What if I fail my exam?"
"What if I can't do the job?"
"What if I can't provide for my family?"
"What if something happens to my child?"
"What if my husband/wife/partner has an accident?"
"What if I get anxious during my interview?"
"What if my face turns red?"
"What if I get sick?"



As you will have noticed, the abbove examples of worrisome thoughts are about external things (e.g., work, family, etc) or internal physical things (e.g., illness.)


What are the "What if..." questions you often ask yourself? (What external things or internal physical things do you tend to worry about?).




WHAT TRIGGERS WORRYING?


Worrying can be triggered by various things. Some triggers may be more obvious and linked to external things for example:



*Seeing a certain image (e.g., in the newspaper or on the T.V. news)

* Hearing certain information (e.g., on the radio or in a conversation)

* Being put in a certain situation (e.g., having to make decisions, perform a task, lead others)


Some triggers may be less obvious. These may be thoughts or images that seem to just pop into your head out of the blue. An initial "What if....." question that comes to mind for no apparent reason, can even be a trigger for worrying. For example, the thought "What if I left the iron on?" might pop into my head. If i think "I probably didn't" and decide not to worry about it, chances are i will forget about it, and the thought will slip my mind. However. if instead I start to 'chase' the thought further (e.g. "The ironing board might catch fire and that will spread to the whole house." "The house might burn down and then i will lose everything."), then the original "What if..." question has now triggered a worry episode.

Write down any external images, information, and situations, or any internal images or "What if...." thoughts, that have triggered worrying for you.

WHAT MAINTAINS WORRYING?

People who describe themselves as chronic worriers are often disturbed that they seem to spend much of their waking hours worrying excessively about a number of different life circumstances. They do not understand why this activity continues. They often ask, "Why do i do it?" and "What keeps my worrying going?"

NEGATIVE BELIEFS ABOUT WORRYING

In addition to the specific things people worry about, people with generalised anxiety disorder may also worry about that fact that they are worrying. In this case, such worriers are often concerned that worrying is "bad" and they hold negative beliefs about the activity of worrying. For example, they may believe that:

* Worrying is uncontrollable, and will take over and result in a loss of control (e.g. "I won't be able to control my worrying, and it will never stop".)

* Worrying is dangerous, and will cause either physical or mental harm (e.g. "If I keep worrying like this I will go crazy/have a breakdown/become ill.")

Holding these negative beliefs about worrying makes the process of worrying very distressing for you, and this will even keep your worrying going. Researchers believe that it may be these negative beliefs about worrying that are unique to people with generalised anxiety disorder.

What worries-about-worrying do you have? (What are the disadvantages of worrying?)

OVERVIEW OF GENERALISED ANXIETY PT 2

WHAT CAUSES GENERALISED ANXIETY?

So, how does one become a chronic worrier? There's no simple answer, of ocurse, as everyone is different. However, there are some important factors that have been identified. These factors can generally be divided into biological and psychological causes.

BIOLOGICAL FACTORS
No single gene has been associated with generalised anxiety. Based on twin and family studies, it does seem that individuals may inherit a vulnerability to develop an anxiety disorder. These studies have reported a general vulnerability to develop an anxiety disorder, and interestingly, also a mood disorder. Notice that researchers tell us that this is a general vulnerability, rather than a specific vulnerability for a specific type of disorder. In addition, it has been found that people born with a particular 'anxious' type of temperament, may be more likely to develop an anxiety disorder later in life.

PSYCHOLOGICAL FACTORS

However, it is important to remember that while our biology may make us vulnerable to developing an anxiety disorder, not all people with this vulnerability go on to develop problematic anxiety. A great deal depends on the lifestyle of that person, the types of life stressors they have encountered, and how they cope with such stressors.

Stressful, traumatic, and often uncontrollable life events may contribute to the development of generalised anxiety. When such events occur, some people may come to believe that life is dangerous and unpredictable, and that worrying about possible future negative events is a way of coping with the uncertainty of life. They may think that worrying helps them achieve a greater sense of certainty and control, beacause they would be better prepared for anything.

Anxiety may also develop when the people around you give you information about what is threatening and how to cope with those threats. For example, a child may have seen a parent constantly worrying about current circumstances and potentially negative future events, and may learn to follow the parent's behaviour. Alternatively, you may have been told that "Worrying is good and shows that you are a conscientious and prepared person". These sorts of indirect and direct messages may increase your chances of developing generalised anxiety.

Finally, anxiety is made worse when one begins avoiding things they have some concern about. Avoidance will quickly make something that is intially a slight concern for a person, become a source of anxiety. If the people in your life (i.e., parents, siblings, peers, spouses/partners) support your avoidance of various things, this may make your anxiety worse in the long run. People usually support a person's avoidance because they don't want the person to feel any distress. However, experiencing a small amount of distress and learning how to solve or cope with the problem is likely to stop more severe anxiey in the long run.

To summarise part one of my blog:

* Anxiety and worrying are common experiences for most human beings
* Anxiety can be helpful to us and only becomes unhelpful when it is out of proportion to the situation.
* There are different types of anxiety, such as intense fear, ad less intense but longer lasting anxiety like worry or nervousness
* This blog focuses on generalised anxiety, addressing the worrying or nervous type of anxiety
* Problematic generalised anxiety is excessive worrying about a variety of things, is experienced as uncontrollable and intrusive, and causes great distress and difficulty for the individual.
* The exact causes of generalised anxiety are unclear, but it is likely to be a combination of biological vulnerability and environmental influences that contribute to its development.