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 is "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 probably 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 plaing 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 imagese 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 it 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 probably
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 worring 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.
(c) 1990, C.S. Clarke, Ph.D.