Cognitive Therapy Techniques: 5 Steps to Stop Worrying

If you struggle with persistent anxiety, it is likely that excessive worrying is partly to blame. Although you may sometimes feel worrying is beneficial in that it protects us from being unprepared or caught off guard, for many people it causes more problems than it solves. There are numerous ways cognitive behavioral therapy (CBT) can reduce excessive worry. One way is through evaluating the worry, to determine whether it is productive or unproductive. 
There are several questions you can ask yourself to evaluate your worry. After going through these questions, you’ll probably have a better idea whether the worry is helpful or just background noise that only serves to increase your anxiety:

1. What are you predicting will happen, and what is the likelihood it will actually happen? Identify in detail what you are most concerned will happen. If it’s giving a speech, it may be people laughing at you or heckling you. If you’re worried about a difficult interpersonal situation, you may fear someone will yell at you or reject you in some way. If it’s making a mistake, you may fear being fired. Whatever the situation, consider what it really is that you are most afraid of. Oftentimes just identifying specifically what we fear can help us realize our anxiety may be unfounded. Once you identify the perceived threat, make some evidence-based predictions about how likely this is. How many times has this worst-case scenario actually happened to you before? Would there be steps you could take to reduce the likelihood? Given the situation you fear, is this a plausible outcome (For instance, do you really think people will heckle you at a professional conference?). 

2. What is the worst case scenario, best case scenario, and most likely scenario? Identifying the worst-case scenario is the first step, and it’s described above. Some people though, are already experts at identifying the worst case scenario. In fact, they’re so good at it they forget to consider other possibilities. It is helpful to also consider the best case scenario, which is often equally plausible to the worst-case. Finally, after identifying the extremes, consider what the most likely scenario is. Usually our minds go right to the extremes, when in reality the extremes rarely happen. If you have difficulty identifying the most likely scenario, it may be helpful to find a scenario that has some degree of negative outcome paired with some degree of positive outcome. For instance, “I’ll give the speech and there will probably be some people who are bored and some people who are really interested.”

3. How many times have you made this prediction and it came true? Another way to consider the usefulness of your worry is to actually count how many times the worst case scenario has happened. If you’ve driven on the freeway 100 times in the past year and have never gotten into an accident, those are pretty good odds and indicate maybe your worry is a bit disproportionate. Even if you have been in 1 accident in 100 trips on the freeway, that’s a 1% chance, and your level of worry may have made it feel like it was a 50% chance. 

4. If it did happen, what would you do to cope with it? People generally end their worrisome predictions right at the worst moment. You may find it helpful to think about what would happen next, and what you would do to get through the difficult situation. If you do fail the test, you might be disappointed for the rest of the day, curl up on the couch with a pint of ice cream and watch T.V. Then you’ll probably get back on the horse by finding out what you did wrong and altering your study strategy so you pass the next time. Although failing an important exam is unpleasant, you probably have a lot you could do to deal with it effectively. Consider that too!

5. What are the costs and benefits of worrying about this? Finally, examine how effective it is to worry about this situation. Some degree of worry may be helpful in motivating you to prepare. Too much on the other hand may paralyze you, becoming a self-fulfilling prophecy. And some things, no matter how much you worry about them, you won’t have any control over. In these latter two instances the worry is self-defeating. When you identify a worry as unproductive, you can say to yourself “Thinking about this is of no use to me now. Let it go.” Then immediately refocus your mind on what’s actually going on around you. 

This technique comes from a cognitive behavioral therapy protocol for generalized anxiety. CBT for generalized anxiety has been found to be 70%-80% effective in significantly reducing anxiety symptoms (Durham, 1995). Compare that to 30%, which is the percentage of people with anxiety who benefit from traditional talk therapy. CBT for anxiety behavioral activation should only be employed with the help of a trained cognitive-behavioral therapist. Click here for more information about CBT for Anxiety

 

Durham, R.C. (1995). Comparing treatments for generalized anxiety disorder: Reply. British Journal of Psychiatry, 166, 266-267.

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