Monday, February 26, 2007

The worry of worry

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'Worry gives a small thing a big shadow'
Swedish proverb

Three am in the morning and thinking about blogging. I must be a Bloggerholic, right? Well, yes and no. I conceived the idea for this post early this morning as a consequence of my experience. Something woke me up at three and from that point I couldn't get back to sleep. My brain was in overdrive. I was thinking about school issues, family concerns, finances, work...you name it, my brain was processing it like a Red Bull intoxicated hamster on a wheel. Worry, worry, worry. Something that we all deal with from time to time.

Worry has been defined as 'a chain of thoughts and images, negatively affect-laden and relatively uncontrollable; representing an attempt to engage in mental problem-solving on an issue whose outcome is uncertain but contains the possibility of one of more negative outcomes' (Borkovec, Robinson, Pruzinsky, & DePree, 1983, p. 10). My early morning thoughts? Uncontrollable? Yep. Negative? Guilty as charged.

Worry can be a perfectly normal experience. Yet worry is also a key diagnostic feature of DSM-IV Generalised Anxiety Disorder and is also common in other psychological disorders. What differentiates normal worry from pathological worry? At what point does worry become a problem in itself?

It can be argued that worrying brings benefits. When I'm lying there at 3am, thinking things through, is it helping me to avoid future problems by working out possible solutions? I admit I'm one of those 'what if?' individuals, who like to think through every potential outcome from a situation. From that point of view, worry could be deemed to be beneficial process, preparing me to cope with whatever comes my way. Others might believe worry helps them be organised and make less mistakes.

Is it what we worry about that's important? Apparently not. It's the way we think about our worry. Worry is more likely to be more problematic where the worrisome thoughts seem excessive, uncontrollable and harder to resolve (Craske, Rapee, Jackel, & Barlow, 1989). Chronic worriers worry about worrying: they fear worrying may make them sick, that their worries may end up controlling them, that they might go mad because they can't stop or ignore their worries.

There are a number of strategies that we can use when worrying seems to be out of control. Like most things, they require practice.

Note worry
It's important to notice when we're worrying and to take action early.

The use of worry periods
This involves setting up a 30 minute worry period to take place at the same time (not close to bedtime!) and place each day. If you catch yourself worrying outside of this period, you remind yourself of the worry period and postpone the worry until then (write it down if you think you might forget), returning to current moment experiences. The 30 minute worry period should then be used to think about your concerns and engage in problem-solving. The worry period challenges any concern that worry is uncontrollable and, with time, can help reduce both the frequency and duration of worry episodes.

Changing the way we think about our worries
Examine the nature of your worrying thoughts. What do they concern? What underlying evidence exists for them? What is the likelihood of them happening? Could you handle that? What can you do to minimise any impact? Asking such questions allows you to discover that you would have ways of coping with the event if it happens. The answers to these questions can be used to create alternative ways of thinking about the worries. Note them down next to your worries. Then whenever a specific worry pops up, remind yourself of the newer, more adaptive thoughts you generated.

Use relaxation techniques
Relaxation techniques including imagery, progressive muscle relaxation and breathing exercises may prove helpful.

Seeking professional help
The strategies above may prove to be helpful but can take considerable practice. Of course, no strategy works for everyone. Moreoer, if worry is associated with conditions such as anxiety or depression or remains uncontrollable and distressing, it may be advisable to seek professional help for a more comprehensive approach.

Resources

Borkovec, T., Robinson, E., Pruzinsky, T., & DePree, J. (1983). Preliminary exploration of worry: Some characteristics and processes. Behaviour Research and Therapy, 21, 9-16. (Abstract)

Craske, M., Rapee, R., Jackel, L., & Barlow, D. (1989). Qualitative dimensions of worry in DSM-III-R generalised anxiety disorder subjects and nonanxious controls. Behaviour Research and Therapy, 27, 397-402. (Abstract)

8 comments:

The Little Student said...

What a great post, especially appropriate for us graduate students. Thank you!

Alison said...

"like a Red Bull intoxicated hamster on a wheel..."

That used to be me! You're absolutely right about practicing the techniques. I now have very little worrying. If it does happen, I used breathing/relaxation (usually back to sleep in less than 5 minutes) and the famous, never fail words," If this is worth doing anything about it, it will have to wait till tomorrow."

Action is the cure for any real concerns, when you can ( which is never in the middle of the night). Not real concerns? That's where the practicing comes into it's own - you can learn to just let go of stuff that's useless worrying.

Cathy said...

That was really good. I am going to try this 30 minute worry thing and see how it works. Now I am worrying that it won't...:)

Dr. Deborah Serani said...

I can really relate to all that you mentioned....I guess it's always good to know that we are not alone when we experience things. Your insights, as usual, are pitch perfect and the link is a great one. I think that worrying does enable us to find solutions to things....but with everything else in life finding the balance of it all ain't easy!

sisiphusledge said...

I think I want to join in and say "Me too, me too" to the first part of your post. My worries do help me prepare for eventualities and I would argue that they are indeed useful. I don't think that I worry excessively and in fact when I have experienced anxiety in its worst form, there has been absolutely nothing worrying me. Try explaining that to your relatives....they just don't get it..they keep trying to find a reason for your anxiety. Nope, there is none. Period. None.None.None. Yet when I worry about things I don't feel particularly anxious, at least not in the way I did when I experienced the worry free excessive anxiety.
Your post is excellent.

regards,
Sisyphus

HP said...

Hey Little Student,
Thanks. Good for us no-longer students too!

Hi Alison,
I wish I could master that. Nope, once awake and brain active, there's no stopping it.
Practice, right?

Hi Cathy,
You made me laugh so much!

Hi Deborah,
I think you hit the nail on the head when you mentioned balance. Worry is a tool for me, I do use it to nut things out but I guess there's that line beyond which it becomes a problem (as with anything).

Hi Sisiphus,
Great point about worry and anxiety. There is often no connection between the two and that's when I think anxiety is the most distressing, when you can't identify a reason for it. Thanks for the comments.

AlvaroF said...

Hello HP,

I hope you solve the computer problem soon...sorry I cannot be of much help there.

In terms of dealing with anxiety, I see it as a physiological state we can learn to identify and manage independent of the underlying cause that may have helped trigger that state. Certain forms of biofeedback can be very helpful to develop that "muscle".

marvin said...

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