Anxiety is complex. Anxiety is simple. Wait, huh?
The thing is… both of these statements are true.
Anxiety is complex in that we all experience different types of anxious thoughts, feelings and behaviors to different degrees and for very different reasons.
However, although the anxiety experienced from person to person varies greatly in many ways, there are many underlying features of anxiety that are similar for anxious people of all sorts.
Generally speaking, there are four main aspects of anxious thinking:
1. High threat likelihood: People with anxiety tend to believe that a bad outcome is more likely to happen than is realistically true.
2. Exaggerated threat severity: People with anxiety tend to imagine that the very worst outcome possible is going to happen.
3. Helplessness assumptions: People with anxiety tend to think that they will not be able to cope or deal with a future difficulty.
4. Underestimate safety: People with anxiety often fail to notice safety aspects of situations.
All of us who experience severe anxiety exhibit these maladaptive thinking patterns to one extent or another. It is what feeds our anxiety.
So how does this all play out? Let’s get artistic and paint a pretty picture.
Natalie has generalized anxiety. She persistently worries about a number of things on any given day. She worries about her finances, worries about her health, worries about offending people, worries about whether she will ever meet someone right for her, worries about whether her appearance is good enough, worries about whether she is doing a good enough job at work. Pick any topic, she has probably worried about it excessively at some point. The problem for Natalie is that the worrying never stops. If one particular concern about something fades away or is no longer a threat, she’ll find something new to worry about.
Today, she is extremely worried about a presentation she has to give at work. She is terrified that she is going to screw the presentation up somehow and humiliate herself in front of all of her colleagues. She believes she is going to do things like stutter, mispronounce words, not know the answer to a colleague’s question or give the wrong information about something. Let’s breakdown Natalie’s thought process about her upcoming presentation.
1. High threat likelihood: People with anxiety tend to believe that a bad outcome is more likely to happen than is realistically true.
Natalie has convinced herself that it is much more likely that she will do something embarrassing and much less likely that she will actually make it through the whole presentation without mispronouncing things, giving the wrong information or not knowing the answer to a question.
2. Exaggerated threat severity: People with anxiety tend to imagine that the very worst outcome possible is going to happen.
Natalie has convinced herself that if she does make any of the above mistakes, her colleagues are all going to snicker, smirk, challenge her or talk behind her back afterwards. Her colleagues will all think she is an idiot and will no longer respect her.
3. Helplessness assumptions: People with anxiety tend to think that they will not be able to cope or deal with a future difficulty.
Natalie assumes that if she were to, for example, not know the answer to a colleague’s question, that she will be helpless to do anything about it and will just stand there, frozen in silence, looking like a deer in headlights.
4. Underestimate safety: People with anxiety often fail to notice safety aspects of situations.
Natalie assumes that in this scenario her colleagues are all cruel people who will criticize and insult her for making even the smallest mistake. She underestimates that many of her coworkers are actually kind people, some of whom she is even friends with.
Can you see how these 4 key aspects of anxious thinking have made Natalie believe that this presentation is going to be a lot worse of a situation than it is likely to be? What this really means is that Natalie is going through a lot of pain and discomfort unnecessarily. She is living through a pretty horrendous scenario that is VERY unlikely to happen: that during her presentation she is going to mutter incoherently, stare at everyone blankly when they ask questions and give a bunch of wrong information on the presentation topic.
So how does Natalie (and how do the rest of us) manage these anxious thinking patterns?
By evaluating and challenging the validity of these thoughts. And by learning to think more realistically about the potential outcomes of feared situations.
1. High threat likelihood- is this realistic?
Natalie assumes she is much more likely to give a bad presentation than a good presentation. Thus, we would ask Natalie to think about her assumption that her presentation is going to go terribly. What is the evidence for this? What is the evidence against this? Has she given a presentation before (either within this job role, a class or in some other context)? How did it turn out? Did any of her previous presentations turn out as badly as she is imagining this situation turning out? Has she ever walked away from giving a presentation and actually felt good about it?
2. Exaggerated threat severity- is this realistic?
Natalie assumes that, in the unlikely event that she does stutter, forget what to say or give the wrong information, the outcome of this will be absolutely horrendous. We would help Natalie walk through this scenario to determine whether it really seems feasible that the outcome would be as bad as she thinks and to think through more realistic outcomes. Would it really be that big of a deal if she mispronounced a word or didn’t know the answer to one of the questions? Is it realistic to think that if that were to happen, she would fall on the floor and start crying or throw her papers in the air and run out of the room? Would it really be that much of a disaster? Instead, perhaps she would simply say, “I actually I am not sure but that is a great question. I will get back to you about that.” And then Natalie would move on and perhaps even still give a great presentation. We would help Natalie to see that this a much more realistic outcome than the one she is imagining happening as a result of her making a mistake.
3. Helplessness assumptions- is this realistic?
Natalie assumes that if she does make a mistake she will be completely helpless to do anything about it. We would help Natalie think about ways she would deal with it if she does make a mistake. Let’s say she mispronounced something or was slightly off about some information at some point during the presentation. And let’s also imagine that one of her colleagues was assy enough to point that out. Would she really stand there frozen and just stare at the person blankly? Likely not. We would help Natalie think through situations in the past that have come up and how she has managed them. What would be a more realistic response that she would have in this situation? She might say, “Thank you for pointing that out,” and then take a minute to clarify it and move on. We would help Natalie realize she is not helpless and would have the skills to manage the situation well in the unlikely event that she made the kind of mistake she is worried about.
4. Underestimate safety- is this realistic?
Natalie assumes that her place of work is filled with a bunch of arrogant jerks who want to see her go down! Even if that were true to some extent (many of us have a colleague like this), she is likely underestimating the general safety in her environment. We would ask her about whether there are people who will be watching her presentation with whom she has a good relationship or who are decent and kind people. We would ask her to reflect on it and determine how realistic is it that all (or many) of these colleagues would snicker, laugh, call her out or talk behind her back if she made a mistake during her presentation. On the contrary, what are some examples she has seen where these people are actually kind and, perhaps, wouldn’t even notice or care if she made a mistake during her presentation? Through all of this, we would come up with a more realistic assessment of her environment and how people would respond to a less-than-perfect presentation.
So what is the take-home message here? People with anxiety are stuck in unhelpful and unrealistic thought patterns. The only way to address this is to interrupt these patterns of thinking. We often just assume our thoughts are valid. We need to challenge these thoughts and learn to think more realistically about our feared situations. With time, effort and practice, our fears can be overcome through this process!
