Dr Blake Stobie created our Tackling Panic series. We talked to him about his clinical work and his love for CBT, particularly hearing about how it can help people beat their panic attacks.
Worry, like most aspects of mental health, lies on a continuum. Around 86% of adults consider themselves to be worriers, and for approximately 5% of us, worrying can reach a point where it becomes problematic, impacting our physical and emotional health.
Generalised anxiety disorder (GAD) is an anxiety disorder characterised by chronic, excessive or uncontrollable worry that persists for six months or more. Symptoms include a persistent sense of dread, difficulty concentrating and feeling constantly on edge. But in reality, many people experience significant symptoms of generalised anxiety without meeting the strict criteria for a diagnosis of GAD.
Earlier in the history of humankind, worry had great evolutionary value for us as a species: thought processes that focused on imagining future dangers and presuming the worst would be advantageous, making sure we directed appropriate attention to serious threats like predators or food shortages.
But worrying is no longer adaptive in this way. Clinical research on worry outcomes found that 85% of the things people worry about actually have a positive or neutral outcome. And of the 15% of worries that do have a negative outcome, 80% of people report handling the situation better than they expected.
Worriers tend to pay more attention to perceived threats and find it difficult to sit with any uncertainty, which often triggers worry. Once the process of worry is set in motion, it’s inclined to persist. The trouble is that, once a worry is resolved, worry-prone people tend to move straight onto a new worry, without really registering that their most recent fear didn’t come to fruition. They’re too busy engaging with the new worry to notice, so they never learn that worrying didn’t pay off, and the worry process simply maintains itself.
Cognitive behavioural therapy (CBT) offers a pragmatic approach to managing worry, helping people to change the cognitive processes underpinning worry. For anyone struggling to switch off from worry, the strategies below are a good place to start.
1. Schedule some dedicated time for worrying each day. Having half an hour of “worry time” planned into your afternoon can help you give yourself permission to let go of worry for the rest of the day. If a worry pops up outside of your allocated worry time, note it down then give yourself permission to let it go until the scheduled time. When your worry time arrives, take out your list of worries and work through them.
2. Establish whether your worry is real or hypothetical. The worry, “I have a job interview tomorrow and haven’t prepared my presentation” is real and current: you can address this worry by taking steps to write and practice your presentation. The worry, “What if I never manage to get a job” is hypothetical. Because it can’t be problem-solved, the focus needs to be on getting distance from it. It’s a hard task, but for hypothetical worries, try to let them go and only return to them if they become real threats.
3. Take your worry through to its endpoint. When we worry, most of us get stuck at imagining the absolute worst outcome, but we don’t wind that mental movie on to think about what that would be like. Being stuck at the point of “getting fired” in your mind would feel bad, but fast-forwarding beyond that time would help you see that life would go on beyond that moment.
4. Check-in with likelihood, awfulness and coping. When we’re trapped in a spiral of worry, we tend to overestimate both the likelihood and awfulness of what will happen. On top of this, we underestimate our ability to cope. Try to step back and be objective about how likely your worry is to come to fruition and, if it did, how awful it would be. Finally, hone in on your own coping resources.
At Unmind we have various resources to help people get a handle on their worries, including an in-depth educational series on worry. To find out more about this, and other CBT-based series, click here.
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