MODULE 1: REFACTORING FEAR – ANTECEDENTS

01  Overture

02  The Function of Anxiety

03  The Structure of Anxiety

04  Decoding Fear

05  Disarming Fear

06  Dismantling Fear

07  Fear Exposure

08  Case Study Acrophobia

MODULE 2: UNPLUGGING PANIC – AROUSAL

09  The Physiology of Anxiety

10  Decoding Panic

11  Disarming Panic

12  Dismantling Panic

13  Case Study: Job Interview Panic

MODULE 3: REWIRING WORRY – APPRAISAL

14  Targets of Worry

15  Decoding Worry|

16  Disarming Worry

17  Dismantling Worry

18  Restructuring Utility

19  Restructuring Security

20  Restructuring Sovereignty

21  Restructuring Adequacy

22  Restructuring Catastrophe

23  Case Study: Social Anxiety

MODULE 4: DEBUGGING BEHAVIORS – ACTION

24  Avoidance Behaviors

25  Decoding Behaviors

26  Disarming Behaviors

27  Dismantling Behaviors

28  Overwhelm, Overwork, and Stress

29  Case Study: Putting It All Together

30  Aftermath

LESSON 15 – DECODING WORRY

TRANSCRIPT

Now it’s time to get into the actual worry mechanism. It operates in very similar ways to panic anxiety, but there are some crucial differences. So go ahead and take a look at the first diagram in this lesson to see how we demonstrate the worry algorithm:

Now in the fear module, we were primarily interested in that grey node – the external antecedent or trigger associated with our fears. In the panic module, we were mainly looking at the pink node, arousal – the physiological sensations at play in anxiety. With worry, we’re going to be closely examining the blue node – the appraisal. Of course, all of these nodes have a role in all types of anxiety. But we can often identify the variation of anxiety based on the dominant node that is perpetuating it. And with worry, we show the blue one before the pink to indicate that this is worry and is thought-dominant.

You can follow along with this section through the diagrams. So there is still an antecedent, or trigger, in worry. Sometimes this is a thought that pops into our head. Other times, it is an actual physical trigger, like catching a glimpse of our briefcase. Do people still use briefcases? If you do, seeing it might immediately activate your concerns and a flood of worry thoughts start pouring in.

Before long, you start to feel those anxious feelings in response to the thoughts.

Now like we said before, anxiety is cyclical, and worry is no exception. Worry is the same kind of vicious cycle that keeps you going around in circles instead of forming plans and taking action. If it were useful, it would trigger you to form a plan, act according to it, and then terminate on its own, not resulting in anxiety. But worry gets you caught up in a loop. You have a “what if” thought, which increases your physical arousal and feelings of anxiety.

But what happens next is interesting. These feelings trigger more thoughts, this time thoughts that attempt to comfort you and lower those feelings of arousal. So after you have the thought “what if I never meet someone and end up alone,” the feelings of anxiety get triggered, and then you have a thought like “no that’s silly, I’ll find someone.” This lowers the feelings of anxiety. And then you have another concern, or even the same one from before. This cycle can go on over and over and never seem to end.

Before long, you identify this cycle and the problem it poses. You start worrying about your worrying. “Do I worry too much? No, it’s fine. Am I losing my mind? No this is normal.” You can see how problematic and paralyzing these loops can become. But let’s dig a little deeper into what is going on here. We are going to call the first part of worry “the obsession.” This is the “what if” question that gets your heart beating and your mind racing. We’ll call the second component of worry “the compulsion.” This is the part that soothes you, lowers your anxiety, and tells you everything is going to be okay.

You worry, you negatively evaluate that worry and attempt to eliminate it, and then you worry some more. These two parts of worry are a lot like first fear and second fear in the panic section. And once again, we’re going to find that the first part, the obsession, only becomes an actual obsession when you add fuel to the fire. But this whole cycle eventually terminates when you take that avoidance behavior, like reaching for the wine bottle and having a few drinks, which of course perpetuates the worry cycle into the future.

Now some of you may notice something interesting about these two concepts: they make worry sound a lot like obsessive-compulsive disorder, or OCD. That’s because worry is thought by many experts to be of the same fundamental nature as OCD. And it’s not so hard to see why. When you think of someone with OCD, you may think of someone with germophobic tendencies, who has to check the oven a million times before leaving the house, or who has to do strange routines throughout the day to cope.

People with OCD have these unusual requirements because they have recurring worry thoughts, or obsessions, pop into their minds in response to certain triggers. And then they take actions, or compulsions, to try and comfort or soothe themselves and make the worry go away. Then the obsession comes back, and once again they try to soothe their discomfort with the compulsive habit. This cycle can continue for quite a long time, resulting in seemingly absurd repetition of acts like checking the stove or washing their hands.

In OCD, the compulsion that provides comfort can often be a behavioral habit. But it doesn’t have to be. And when we look at those with generalized anxiety disorder, or even the milder version we might call “worry warts” we find a highly similar mental pattern, the key difference being that the compulsion is another thought instead of a behavior. The worry thought triggers a negative feeling, and being uncomfortable with these, you quickly activate the cognitive compulsion to cut off those bad feelings. Then of course the worry thought comes back and so on.

It is crucial to understand the nature of compulsions. Whether we are looking at OCD-like behaviors or reassurance worry thoughts, we are essentially looking at avoidance. Resistance. Though it may not always be as obvious, these compulsions are a way of avoiding real possibilities, risks, and uncertainties in our lives.

It may seem strange, but worriers are worriers, not because they are constantly confronting reality, but because they are constantly avoiding confronting it. The person terrified of losing their job is avoiding the real possibility of risk, resisting nature, and attempting to fight the wave. And we’re going to find that this is one of the keys to putting an end to these useless and repetitive worries.

Believe it or not, imagining bad things happening does not make you a worrier. Imagining bad things happening can actually be a useful tool, as we’ll discuss when we get to Stoic negative visualization. It is the bad “what if” thought, followed by the compulsive comforting thought that creates the cycle of worry. Those who are willing to consider the possibility of losing their job, even the worst-case scenario, and embrace the possibility and uncertainty without needing to reassure themselves are the healthy ones. But old habits die hard, and just trying to stop this tendency will only make it worse.

Now before we get into the effective steps for eliminating worry, I want to talk about some of the ineffective or even counterproductive methods people try for getting rid of their worries. There is a good chance you have tried some of these with little success.

Telling yourself to just relax. Just like we discussed in previous modules, paradoxical effort will counteract your goal to relax. Similarly, telling yourself that your worrying is unhealthy or problematic and you must stop will only add to your worries. Repeatedly assuring yourself that everything will be okay. Again, this is a form of reassurance, avoidance, and resistance.

Trying to distract yourself, push the worry thoughts away, or replace them with happy, positive thoughts. These suppression methods only backfire and reinforce the worry thoughts. When it comes to thought suppression, don’t even think about it. That was a joke. But really, this is not an effective strategy.

Attempting to use meditation, exercise, prayer, or even deep diaphragmatic breathing in the moment to fight the worries. Though these can be healthy habits, using them to escape your worry thoughts will just constitute another kind of avoidance compulsion that will strengthen the worries. And trying to numb the worries with unhealthy habits like drugs, alcohol, and overeating will both strengthen the worries and potentially harm your health (we’ll deal with some of these behaviors in the last module). Any other safety behaviors, coping mechanisms, or emotional support partners will likely have the same effect for reasons you can probably guess by now.

Lastly, and this is a tough one, trying to use information and logic alone to fight the thoughts is unlikely to help. Digging into your past to try to find out why you’re so worried, collecting as much information on the actual risks as you can, or trying to analyze the worries from any other angle will simply give the worries more legitimacy in your mind. Though it can be good to be aware of the actual risks and probabilities relevant to your worries, going over them repeatedly is just another compulsion.

We’re going to dig into some of the core beliefs that perpetuate worry in later lessons, but it is important to understand that it is generally not the content of the worry thoughts that needs changing. It’s your relationship to the thoughts. Our goal will be to reduce the power of the worry thoughts. We’re not solving the problems posed by anxious worry, but learning how to disregard them, which ironically frees up our mind for actual problem-solving and action.

You may have picked up on the patterns from previous modules and be saying “Ahhh so we need to use paradoxical intention, thought defusion, and learn to embrace our fears and worry thoughts instead of resisting them.” And you’re right! But much like in the other modules, there is a science to doing this correctly for this particular type of anxiety, and you’ll want to follow the steps in the next few lessons to make sure you maximize your success.

EXERCISE

So like all other decoding lessons, it’s time to start logging our worry algorithms. But this can be particularly difficult with worries, because they have a tendency to sneak into our minds without warning. You will need to pay close attention any time you’re feeling worried and start writing down the thoughts and feelings you’re experiencing. Try to identify the “obsession” thoughts that escalate your anxiety and the “compulsion” thoughts that attempt to soothe you. You can post some of your worry algorithms in the comments, today and over the next week or so as you notice more of them. And I’ll see you tomorrow, as we start diving into the process of rewiring those worries.

KEY TAKEAWAYS

  • Appraisal is the dominant node in worry, because it is primarily a cognitive process.
  • Worry is a feedback loop that involves increasing and then lowering your anxiety.
  • Obsessions, or “what if” thoughts elevate anxiety. Compulsions, or mental reassurances lower it back down and continue the cycle.
  • Worriers are worriers, not because they are constantly confronting reality, but because they are constantly avoiding confronting it.
  • Any method that attempts to fight, push away, or avoid the worry thoughts will cause them to come back stronger.