2. We think we need to worry. (But we don't.)
What factors turn an emerging worry into a distressing activity that you can’t seem to disengage from?I’ve written previously about the general factors that contribute to pathological worrying—both in this blog and elsewhere. But now I’d like to concentrate on some of the factors that combine to turn an emerging worry into a perseverative worry from which you feel you can’t disengage, and which causes more and more distress as the worry bout continues.
This is a common experience for individuals with a diagnosis of generalized anxiety disorder, and for individuals with high levels of stress and anxiety generally. But from time to time, we all experience a worry that just won’t go away and becomes uncontrollable or debilitating. Many of you will be familiar with the experience of waking unexpectedly in the middle of the night as a minor worry pops into your head. Then you find yourself unable to stop catastrophizing it for the next couple of hours and it ends up feeling worse than when you started worrying.
So when you start worrying about something, let’s look at the activated factors that contribute to that specific bout of concern becoming stressful and seemingly uncontrollable. It’s an interesting mix of psychological influences acting in the here and now to determine the way you think about a worry:
1. Attentional and Interpretational Biases.
Many people develop a bias toward automatically attending to events or information that might be threatening or challenging, so that thoughts about these events are automatically triggered and enter conscious awareness immediately. This has two effects:
First, it means that you're likely to interpret any ambiguous information as threatening. For example, if you spot your partner frowning, they could be frowning because they’ve got a difficult job to do at work. But if your brain has automatically tuned into seeing this frown as potentially threatening or challenging to you, you're more likely to interpret it as your partner being annoyed with you and you’ll start to worry about the implications of this—even though you have no hard evidence that this is actually the case.
Second, if you have an automatic attentional bias to threats, this can cause a seemingly uncontrollable cascade of automatic negative intrusive thoughts about the worry. This is very much like the continual “What if…?” questioning style of chronic worriers in which the individual continually bombards themselves with potential negative scenarios associated with the worry.
2. Beliefs about the Usefulness of Worry.
Once your brain has identified a potential worry, the beliefs that you’ve developed about the purpose of worry will begin to kick in—again quite automatically. Many people who are habitual worriers have developed very ingrained beliefs about worry being a necessary thing to do in order to prevent bad things happening. This will kick start the perseverative process by which the worry takes over your information processing capacities in order to ensure that you fully and properly process it.
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3. Goal-Directed Worry Rules.Most worriers worry for a purpose. It’s usually either to neutralize or to solve a problem, so the worry has to continue until the worrier meets this goal. To do this, many of us deploy an implicit set of “goal-directed” rules when we start worrying, and these rules determine when we should stop worrying. But deciding when we’ve achieved our worry aims is not that simple, because some people are never satisfied that they’ve solved the problem (they keep generating “What if…?” scenarios); some people have very low confidence in their ability to solve problems and so can't accept that they ever have; and others simply use their anxious or negative mood when worrying as evidence that they haven’t solved it—and so continue to worry.
4. Negative Mood.
Most people who find their worrying problematic tend to worry while in a negative mood—when they’re anxious, depressed, stressed, or even just tired—and we know that a negative mood will exacerbate all of the processes we’ve mentioned so far. It will increase attentional biases to threat; it will facilitate your use of goal-directed rules for worrying that will increase worry perseveration; and it will provide information that you may interpret as your not having achieved your worry goals, so you should continue to worry. In addition, negative mood increases the probability that you'll try to systematically process information about your worry. Systematic information processing is a deliberate and effortful information processing style in which the individual scrutinizes all useful information for relevance and importance: You can see what a time-consuming process this will be, requiring you to focus on the worry to the detriment of all other issues that might require your attention.
Let’s put these four factors together and see what happens: When combined, they make a toxic recipe for uncontrollable, perseverative worrying. Imagine this sequence of events:
- First, automatic attentional biases project a potential threat into consciousness; if this threat is ambiguous, then it's quite likely that interpretational biases will ensure that you accept it as a genuine threat.
- Second, once accepted as a threat or challenge, the individual’s beliefs in the importance of worrying to resolve the problem will activate. The stronger these beliefs, the more likely they'll trigger automatically. This in turn will activate the deployment of “goal-directed rules” to ensure that worrying doesn’t stop until the problem's solved.
- Thirdly, concurrent negative mood will make it more likely that (1) attentional biases to threat will remain (ensuring that further negative intrusive thoughts about the worry will occur); (2) information about the worry will process systematically, in detail and in a conscious, effortful fashion; and (3) the individual will find it hard to believe they have solved or neutralized the worry because they're still in a negative mood.
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