Worry -- And How Not To
©1990, C.S. Clarke, Ph.D.
Worry as a stressor is a direct source of headaches, insomnia, ulcers and other gastric distress, paranoia, generalized anxiety disorders, depression and phobias. Most stress experts believe that it is an indirect source of disorders involving the immune system, such as cancer. We can literally worry ourselves to death. For example when worry leads to depression and the depression becomes deep and unrelieved, our immune systems break down to the point where even a cold virus could become a killer.
Worry is the mental counterpart of anxiety, although worry often includes angry thoughts and images. That is to say, we worry about things we fear may happen. For the Type A/Hostile Personality, worry most definitely includes angry thoughts and images, since in this personality type, anxiety is usually immediately converted into anger.
Worry is defined by Webster as "a mental distress or agitation resulting from concern, usually for something impending or anticipated." It's an excellent description, and there are two aspects of the definition that bear a close consideration:
1. Worry is a mental (or cognitive) activity.
2. Worry is usually about something that might or might not happen in the future.
(Also please note for our exploration of worry herein that it is also often about events at a distance in space rather than time. E.g. What's happening at home while you're at the office. So, worry is a way -- a poor one -- to try to control the future or events and other people at a distance.)
There are several different forms of cognitive (thinking) activity, some conscious and some unconscious. The conscious processes include self-talk, imagery, abstract reasoning, learning and memory storage and direction of intentional behavior, among others. Any conscious activity can be easily identified and immediately and directly controlled; and what we do consciously affects the unconscious as well. So, in considering worry, we know that:
1. We can identify and control our worries.
2. By controlling our conscious worry, we can affect the reservoir of anxiety that our worry has left behind in our unconscious.
The type of conscious cognitive activity that is quickest to yield to control is what we call "self-talk". We all have ongoing internal dialogues about concerns, hopes, plans, decisions and so forth, and we can easily observe what we're saying to ourselves, how we're saying it, when we're saying it and what are our perspectives, intentions and directions. Worry involves a great deal of self-talk. Controlling worry can be easily accomplished by intentionally intervening in that internal dialogue.
Self-directed imagery (picturing scenes on the movie-screens of our imaginations) is also extremely influential in causing and curing worry. It is also a quick route to making change.
Worry and Self-Talk
Remember, self-talk is simply an internal dialogue, conversations we have with ourselves. Usually, when we worry, we have conversations with ourselves about distressing things we anticipate happening. The key word here is "anticipate." The worry is about something that hasn't happened and may or may not happen. Worry is always about something imaginary. Something that doesn't yet exist. Worry, in fact, is the process of becoming distressed about the nonexistent. Put in that perspective, it seems rather silly and useless.
Of course, worry is sometimes about events we imagine happening right now, but hidden from us or at a distance from us, as when we worry about whether or not the kids are at home doing their homework while we're at the office.
And I'm not going to even begin to deal with worry about what someone else is thinking while we're dealing with him, because we don't call that "worry," we call it "paranoia."
But wait, you say, this can't be true. I know the things I worry about are real and have happened already. For example, said one client: "My husband had a heart attack -- that's awfully real -- and I'm damned worried about that." No, she's not worried about the heart attack, she's worried about the consequences of that heart attack and about the event of another heart attack. Events that may or may not occur. She's emotionally distressed about the heart attack, but it's already happened, it is a known quantity. We worry about what we don't know.
Now you may feel the same way when you are distressed about a real event as when you are worried, but worry is a cognitive or intellectual happening that results in feelings. Feelings are real in either case. It's what the feelings are attached to that may or may not be real.
So, to get back to worry and self-talk, when you are worried about something, you are having distressing conversations with yourself about things you imagine might happen or be happening outside your observation. Because you are literally worried about nothing -- these events are in your mind, not in your real, physical environment -- there is nothing you can do about the objects of your worry. You are stuck. You are helpless. You can't do anything about nothing.
But you can intervene in these self-abusive internal dialogues as if you were an outside, objective mediator. You can transform these dialogues into useful and productive activities that allay the fears you feel and break the useless cycle of mental "awful"-izing. Here's how:
First, use thought-stopping. Simply say "Stop" in your mind. Mentally
shout it, if necessary. Whenever you find yourself worrying, stop the dialogue this way immediately. This may sound too easy, but it really works!
Next, replace the worry dialogue with a practical dialogue. The events you are anticipating really might occur and you can't waste your time stuck in the worry cycle. You have to plan your most probably effective responses to the most probable future events. (Or current events at a distance that will affect you in the future.) You have to determine if there is anything you can do right now to prevent or modify those events. Talk to yourself about what probably will happen. What can you do about it now and then.
(And you have to do now what you can do now to prepare for, modify or prevent those events. The only alternative is worry. What would you rather do, worry or take what control of your life that is available?)
Here's an example. The woman whose husband suffered a heart attack worries about how that's going to affect his everyday life -- what will he be able to do, how will his activities be restricted, will he be able to return to work, how will their financial life be changed if he can't go back to work, is he going to have another heart attack and die?
She has to break the harmful, thought-churning internal dialogue, get the facts that are known, project the probabilities, plan strategies for dealing with the probabilities and direct herself in doing everything now that can be done now. She has to discover what is being done and what can be done to promote recovery, both in the hospital and at home. She has to plan and act upon necessary modifications in the couple's lifestyle that will help improve her husband's overall health, fitness and resistance to illness, such as diet, exercise, smoking cessation and stress-reduction.
If her husband can't go back to work for a while, the wife must discover the facts about the disability benefits his company offers, plan their household budget around the new, probably lower, income. She must decide if she needs to modify the hours she spends on her job to accommodate her participation in her husband's recovery program. Or if she needs to take on a second job for their financial needs. In short, she doesn't have time to waste on worry, she has a lot of strategic planning to do and action to take. Right now.
Worry and Imagery
Imagery is the making of mental pictures, it is visual thinking. Whenever we're having an internal dialogue, we're usually making up images of whatever it is we're talking about. So, if you are talking to yourself about a meeting you are going to host, you are making pictures in your head of the meeting room, the participants, the actions and reactions of the participants, yourself, your actions, your reactions. If you are worried about the meeting, the pictures are going to be distressing ones, since worry will be about unpleasant and undesirable happenings.
To continue to use the wife of the heart attack survivor for our example, we can speculate that some of the worried mental videotapes and slide shows she's playing include: picturing her husband as an invalid, continually dependent upon her and demanding of her moral, physical and financial support; seeing the balance in their savings account dwindle despite her working two jobs to support their lifestyle; imagining the "For Sale" sign in front of the home they worked so hard to buy, that they expected to retire to; looking at her husband in his coffin and receiving the condolences of friends and family.
If you have already learned how to intervene in your self-talk, you will have found that the images are forced into change in relation to the new messages you are inserting into your thought system. However, if you consciously choose new images to match the new internal dialogue you are creating for yourself, you can speed up and magnify your results. In fact, if you have trouble changing self-talk, you may find changing the pictures in your head to be an easier and more powerful tool. And, in its turn, that change will cause changes in your self-talk.
When you make pictures in your mind, you are giving yourself experiences as valid to your mind as any external or "real" experience. When you dream, don't you feel happy afterward if you dream something that makes you happy in "real life?" If you watch a drama on TV, don't you feel as angry with the villain character as you would if he were "really" harming someone you know? It doesn't matter whether experiences are external or internal -- your mind does not automatically differentiate. To give yourself the best life experience, you will want the best match between your new self-talk and the new mental pictures that you can get. And you will not only get the best match but you will remember much better if you consciously choose the new pictures.
Here's what to do:
First, when you intervene in your worried self-talk, note the images that go along with the worry. Just as you will choose the new messages to give yourself to counteract the worried, you will want to choose the pictures that best counteract the worried images.
Next, make up pictures that represent what you want to happen that oppose the pictures of what you fear will happen. Example: the worried wife's picture of her husband in his coffin can be counteracted with a picture of him in vibrant health, playing a favorite sport or game.
Or, if you are dealing with a probable outcome that is unpleasant or undesirable, and most probably unavoidable, make pictures of your desired responses to counteract the feared responses.
For example, your beloved mother is in the final stages of cancer and is almost certainly going to die within the week. If you check your thinking, you'll find you are not worrying about her dying. If you are worrying about anything, it will be the consequences of her dying, including how you will feel when she does. If you check your pictures, you will see that you fear how you and others may react. You may also have pictures of what you believe will happen to your mother after she dies, depending upon your religious or philosophical orientation.
In a case like this, you would modify your self-talk to messages about being morally strong enough to get through your grief and make pictures showing yourself reacting bravely and confidently when receiving the news of the death, when telling others about it and when receiving condolences. You would tell yourself about the support system you have and make pictures of yourself receiving the help you need from family and friends. You would tell yourself that while you would miss your mother, your life is separate from hers and complete without her and make pictures of yourself going on with all the good things you do that do not include her.
Most importantly, you would use the time you have before her death to remember all the good things she represents to you and the good things you've shared, talk to yourself and make pictures about these and -- whether or not she is conscious -- relay your self-talk to her and describe your pictures to her; tell her every loving thing you always meant to; ask her forgiveness for trouble you've given her and give her yours for any trouble she's given you.
In short, make your self-talk and your imagery about what you can do now. Then, finally, use your self-talk and imagery to do what you can do now.