Tips and Techniques

1. Caffeine: A surprisingly subtle stressor
2. Sleep: Don't leave home without it
3. How to stop unwanted thoughts
4. Do you have trouble making decisions?
5. More ideas for making decisions
6. What did you expect? (Managing your expectations)
7. Be careful what you say
8. Long distance worrying
9. The art of reframing
10. Attitude is everything
11. Reframing: The upside of a "crisis"
12. If you can't "optimize", then "neutralize"
13. Reframing other people's behaviour
14. Dealing with difficult people
15. Stop giving power to other people
16. Stop giving power to abusive people
17. How I learned to meditate
18. Relaxation techniques
19. The importance of social support
20. Social support: Why and how?
21. Communication aggravation
22. Communication aggravation (part two)
23. The power of permission
24. Good health - It's your choice

Take me back to the Resource Centre index

I saw a patient this morning with a very common problem. She had wakened twice in the night worrying about problems at work. And while some of the issues were current, many were more general and related to things that won't happen for a long time, if at all.

Worrying is both a cause and a symptom of stress. It's also a terrible drain on time and energy. Some worrying is normal and inevitable - such as when your teenager is still out two hours after curfew. But some people worry weeks or months in advance. This is a real time-waster - especially since most of the things we worry about never come to pass. I call this "long distance worrying." One of my patients calls it "borrowing trouble from the future." It's almost as if people are trying to get a head start so they can be miserable for as long as possible. It reminds me of the guy who receives a telegram that says: "START WORRYING - DETAILS TO FOLLOW."

Some people believe that worrying wards off trouble. One of my patients calls it "preventive worrying." His philosophy is that if he worries about something, then it's not going to happen. Since it's impossible to prove a negative, this can be a difficult notion to dispel. It's like the story of the guy who's snapping his fingers all the time and somebody asks him, "Why are you doing that?"

"To keep the elephants away."

"There are no elephants within 5000 miles of here."

"See, it works!"

During the 1990s, a lot of worrying was about the possibility of job loss either through downsizing, restructuring or merger. People became hypervigilant to every nuance in the workplace. Any directive or off-hand remark was seen as a potential tip-off about some change in company policy. I learned to take a different approach to these matters. Whenever there were rumors of new government policy regarding doctors, I chose to take a "wait and see" approach and not get caught up in speculation and "what ifs." It saved me considerable aggravation.

I've developed a philosophy for dealing with fears and unknowns about the future: "Don't worry about things until you know you have something to worry about." And there's a corollary: "If there is something to worry about, you'll have all the time in the world to worry about it then. You don't have to start early." These mottos have served me and many of my patients very well over time.

What's the alternative?

My antidote for worrying is not to ignore everything and bury your head in the sand. That kind of denial can be irresponsible or even dangerous. However, there is a middle ground between complacency and worry: "Concern." This is another distinction in language that relates to my column last week.

On a spectrum it looks like this:

Here's how I define the difference between worry and concern:

WORRY	CONCERN
Involves emotion	Involves the mind
Fear, fretting, anxiety	Caring about, interest in
Problem-oriented (reactive)	Solution-oriented (proactive)
Stressful, draining	Appropriate, constructive
Hurtful	Helpful

In one of my seminars a man put it this way: "Worry is what I choke on; Concern is what I chew on." So, the alternative to worry is not blanking out your mind to matters of importance, but developing a more constructive and organized approach.

There's an exercise that I've been using called "Creative Worrying". It can be done when you're fretting about a particular issue. For example, if you're worrying about something at bedtime, you might try this exercise before you crawl into bed. Sit down with a pen and paper and answer these four questions in writing:

1. What's the worst thing that can happen? What's my greatest fear?

2. How likely is it to happen? What is the likelihood of this actually occurring?

3. If it does happen, what would I do to handle it? What measures would I take to deal with the problem?

4. What can I do to either prevent it from happening or to prepare for it?

Once you've answered these questions, you now have a game plan to implement if the worst really does occur. File it away and go to bed. There's nothing more that you can do right now. Further worry will add absolutely nothing.

And just to keep things in perspective, remember the words of the French philosopher, Montaigne: "My life has been a series of catastrophes - most of which never happened." If you're a chronic worrier, review your track record and see that most of the things you worried about didn't happen after all. Also notice that, even when certain things did happen, you usually dealt with them and landed on your feet. That's a helpful reality check.

All material copyrighted, David B. Posen M.D.