“But what if…?” 7 tips on how to manage your worry and exit the worry cycle. - ONLINE TELEHEALTH THERAPY APPOINTMENTS FOR ILLINOIS RESIDENTS | Verdandi Anxiety Clinic & Consulting

Posted by Ellen Jorstad-Stein, Ph.D. on October 12, 2017April 17, 2020

Thoughts happen automatically, so from time to time, we all experience thoughts about what may happen in the future. These “what if” thoughts can be about anything, which means the “what if” thoughts of one person will differ from the “what if” thoughts of the person next to them.

“What if” thoughts can be helpful, but the “what if” thoughts need to stay within a certain level to stay adaptive. They become problematic for a person when they occur often, the person has a sense of the thoughts being difficult to control, and their occurrence affect that person’s life and satisfaction with life by causing interference with relationships, school or work, or other areas of importance to the person. All together, these experiences make up what we know as worry. Because of the variety of “what if” thoughts and worries, they may shift from one topic to another. Adults may have unhelpful “what if” thoughts or worries about their work (“What if I get fired?”), own health or the health of family (“What if the stomach pain is cancer?”), finances (“What if I can’t pay my mortgage?”), world events (“What if there will be World War III soon?”), the future (“What if I lose everyone and die alone?”), or other circumstances of life. Other “what if” thoughts or worries may be related to anxiety, such as “what if I make a fool of myself at the party?”, “what if I forgot to lock the front door before I left?”, “what if I panic in the stadium?”, “what if I hit someone with my car?”, or “what if I touch the handrail and get sick and die?”. The tips below may help you if you find that your “what ifs” are problematic.

“Most things I worry about never happen anyway.”

– Tom Petty

Learn about your thoughts.

Recording your thoughts on paper is an objective way to get a sense of the types of thoughts you are having. It can give you a greater sense of control rather than feeling like a passive bystander or trying to make the thoughts go away by suppressing them. Thought suppression make the suppressed thoughts bounce back later with greater force.

You can take this a step further and use this information to check in about which emotions you were feeling when you were having a specific thought and what you were doing when this occurred. This technique can teach you how to respond emotionally and behaviorally to your thoughts more helpful way. For example, you are on a flight that left late from the gate and have a connection to reach the final destination of your journey. During the descent for arrival you look at your watch and notice that you are arriving late. You notice that you are thinking “what if I don’t make the connecting flight and do not get to my destination today?” Next you notice that you are feeling anxious and that your muscles are tense. You are looking around to see how many people will be disembarking before you and begin to sweat. You realize that it is your thoughts about not making your connecting flight that are triggering your anxiety. You consider alternative ways of thinking about the situation to address your anxiety: “Flights are delayed everyday – it is not the end of the world”, “I may be able to get on a later flight”, or “I’ll deal with it when it happens.”

It can be helpful to carry reminder to do this check in. The reminder can be anything from a little card you carry with you to a reminder that is set on your phone.

Take helpful action.

“What ifs” and other worries can bring on feelings of being out of control and helpless. Actions that are helpful will begin to do something about the problem at hand in a productive way. Try replacing ‘what if…?” with “how can I…?” For example, if you are worrying about an upcoming job interview and thinking that you will not know what to say, it can be helpful to start thinking “how can I prepare for the job interview?” Coming up with ideas on your own or with the help of family and friends on how to prepare for the interview and follow through with at least one of the ideas is a helpful and productive action.

Keep pen and paper by your bed.

Anxiety and worries can interfere with your sleep and make it hard to fall asleep or stay asleep. If you find that the “what ifs” or other worries are running through your mind when it is time to sleep and that worrying is waking you up from your sleep, you may find it helpful to write down a list of things to do the next day or write down you worry so you can learn more about your thoughts or take helpful action the next day. Be old school and use pen and paper – your phone’s light emitting screen will not be your friend when you are trying to get precious hours of sleep.

Set aside time to worry.

If you find that the “what ifs” or worrying occurs any time and is hard to control, you can try a time management technique. Allow yourself to worry during a specific time during the day by scheduling your daily worry time for 15-30 minutes in the morning or afternoon. Avoid scheduling worry times at bedtime. Set aside this time in your calendar every day for a week. Write down your worries during the worry time. At the end of the week, looks for patterns to your worry from the past week to learn more about your thoughts and take helpful action. Consider scheduling worry time for a second week. If you find yourself worrying outside of your worry time, acknowledge that the worry is there and tell yourself to let go of the worry until your worry time.

Do things that make you feel good.

If your mood is negative, you may be worrying more or thinking more “what ifs”. In addition to anxiety, some examples of negative moods include sadness, anger, tiredness, pain, shame, or guilt. If you find yourself worrying in a negative state of mind, change what you are doing to an activity that usually gives you enjoyment or joy. This can include anything from listening to your favorite music, reading a book, talking with a friend, writing in a journal, taking a shower or having a bath, going for a walk, practicing meditation or relaxation skills, or trying a number of other activities. The key is to do something you enjoy.

Learn to accept that uncertainty is the only other thing in life in addition to taxes and death that is certain.

One thing that I am certain about is that uncertainty is sticking around. Openness and willingness to experience uncertainty, and anxiety too, is important in developing an acceptance of uncertainty being ever present. Practicing mindfulness mediation is helpful in increasing acceptance of uncomfortable thoughts and feelings that come and go. Over time, mindful practice will also help you get better at staying in the present moment rather than in a hypothetical future. Practicing relaxation techniques, like diaphragmatic breathing or progressive muscle relaxation, and using them to get through anxiety-provoking situations can be helpful to increase tolerance of anxiety.

Begin to see a therapist.

If you find that you have problems taking on your problematic “what ifs” or other worries on your own, it is time to consider scheduling an appointment with a licensed therapist. Scheduling an appointment with someone who specializes in cognitive behavioral therapy (CBT) for the anxiety disorders is recommended. CBT is a collaborative type of talking therapy that focuses on moving thoughts and behavior in a helpful direction in and out of session. Its effectiveness is supported by a large number of research studies. Mindfulness-based and Acceptance and Commitment Therapy strategies may be integrated with CBT.