Therapists (myself included) are notorious for being particularly nit picky when it comes to the terms that clients use in sessions. I am guilty of asking clients to clarify whether a certain recollection was “a thought or a feeling” and rarely allow clients to get away with describing emotions in vague terminology. However, when someone is struggling with anxiety, it is important to understand the difference between feeling “anxious” vs. “worried.”
Fear, Anxiety, and Worry
Fear is an emotional state in which the body’s alarm system is accidentally triggered by a perceived threat. When a person is in a truly dangerous situation, this alarm system, known as the “fight or flight” response, helps to prepare you to either defend yourself or run away from the threat. The fear experienced is in-line with the danger of the situation. Clinical anxiety occurs when the body’s alarm system is triggered in response to situations which are not actually dangerous. Because the “fight or flight” response is triggered, the brain begins to match the specific trigger (ex: speaking in public) with the same sense of unease and fear experienced when someone’s life is truly in danger.
Unlike fear and anxiety, worry is not a feeling but rather a pattern of thoughts revolving around future events. In many cases, worry is helpful and may involve problem-solving to prevent negative outcomes. For example, worrying about an upcoming trip may motivate you to think about what items you need to buy, or when to leave for the airport. Although worry can be helpful in moderation, for individuals experiencing generalized anxiety disorder (GAD), a condition characterized by pervasive and uncontrollable worry, worry takes on a life of its own. This can lead to constant stress, difficulty staying “in-the-moment”, and physiological symptoms of anxiety, including muscle tension and panic symptoms.
The Worry Dilemma
When worry becomes uncontrollable, it creates a conflict within us. On one hand, worry contributes to high stress levels and excessive overthinking. On the other hand, it provides a sense of control and certainty. I often ask clients dealing with GAD whether they would choose to “switch off” their worry if given the choice to do so. Many are hesitant about switching off their worry, despite the significant distress it causes them. This ambivalence can hinder the treatment process, given that clients may be weary of interventions which can be helpful to decrease worry.
Breaking the Worry Cycle
There is no one-size-fits-all solution to the Worry Dilemma, but exploring the benefits and challenges of worry can guide you towards a solution that works for you. Here are some questions to consider:
- At what point does worry become unhelpful for me? Recognize when worry transitions from “useful problem-solving” to “uncontrollable overthinking.” By becoming aware of this boundary, it can feel safer to work towards accepting uncertainty and giving up control in specific situations.
- What function does my worry serve? Even if worry proves unhelpful in a specific situation, it might be challenging to let go completely. Understanding what function(s) your worry serves can help to guide treatment:
- The illusion of control: In many cases, worry can serve to provide a (false) sense of control, even when there is no such control to be had. If this is relevant for you, then treatment may focus on developing your ability to sit with and accept uncertainty.
- Avoiding painful emotions: The logical nature of worry can serve to keep your focus away from underlying emotions you may be feeling. When this is the case, it may be helpful to explore both where such emotions are coming from, as well as why you may be hesitant to sit with these emotions.
- Perfectionism and self-critique: Perfectionism is a common trait among people experiencing uncontrollable worry. For some individuals, working towards a less “all-or-nothing” thought pattern can help to lessen the pressure to perform perfectly. When perfectionism stems from a self critical nature, treatment may focus on developing a more self-compassionate perspective.
- What would I be able to do if I worried less? Consider the positive experiences and personal growth that could be available if excessive worry didn’t hold you back. Don’t wait to “solve” your worry before making changes to your routine and lifestyle which allow you to live a life which is meaningful and rewarding. By engaging in activities aligned with your values and goals, you can reduce ongoing negative emotions and lead a more fulfilling life.
Excessive worry can lead us to feel stuck in an endless cycle of anxiety and overthinking which can hold us back from enjoying daily life as much as we otherwise could. It is important to understand the function of your worry and what this says about the steps and possibly the style of treatment which may be best suited for your needs.
