Handling stress and balancing life are important ingredients for health and well-being. Stress is unavoidable so it's in our best interest to figure out a way to deal with it. When we are caught up in a stressor sometimes it is hard to gain perspective. If we are anxious, this can lead to catastrophic predictions about what the outcome may be.
Changing thoughts and interrupting projections will cut down on anticipatory anxiety and help with stress management. Create a framework to break down these thoughts and analyze them. Anxiety management and recovery require recognizing anxious catastrophic thinking when it is happening (read here for more details on this).
First, some definitions:
Anticipatory anxiety is all the time wasted dreading, worrying, and panicking over a future event (a projection of an imagined outcome) where every imaginable negative outcome is thought of (catastrophizing). Cognitive restructuring techniques are tools to help break down these thoughts and analyze them using a series of questions. These questions help to identify when a cognitive distortion (a thought that isn’t accurate or based in current reality) is driving your anxiety.
Here is a series of questions you can go through if you find yourself worrying about a stressor, getting caught up catastrophizing the outcome, and living in projected future worries. Answering these questions can help shift your thinking from emotional reactivity to more rational evidence collecting. You will be able to more accurately assess the stressor and determine how to handle it.
You had a friend over for dinner and when they left you told them to text you when they got home. You were worried because it was at night. Later, you realize your friend didn’t text but it is late so you are afraid to call and wake them if they are asleep. But what if they are in trouble? What if they got in an accident and that is why they didn’t call you. What if they have been attacked outside their home and are being killed right now?
Using this example we will go through and apply cognitive restructuring techniques to break down the thoughts:
What is the evidence to support your worries?
Your friend didn’t text you when they got home and they said they would.
Is there another way to look at it?
Your friend was exhausted and forgot. They are now asleep.
What’s the worst that can happen?
Your friend is killed and you could have intervened if you had called the police.
They are asleep in bed.
What is the most realistic outcome?
They are asleep in bed. They are a safe driver and have never been in an accident before. Although an accident or attack could happen, it never has before and they are cautious. The likelihood that this is why they didn’t call is very low.
Is it all or none or is there something in between? A shade of grey?
This is similar to the above answers but continues to break the thoughts down and provide alternative explanations with the most realistic outcomes. Read about black and white thinking and learn techniques for how to interrupt it.
Am I underestimating my ability to cope? What resources do I have to get through this?
If you think back to times negative things have happened you will likely remember that it was unpleasant or painful but that you were able to reach out for help when you need it and gather up resources to recover. What difficult situations have you navigated through in your life? Did you learn something about your strength?
Many times, anxious catastrophic thinking isn’t about a life or death but a concern for an unpleasant outcome. For example:
In all of these situations, it is important to step back and realize that you would be able to cope and your life will continue to go forward. Yes, it would be embarrassing if you had a “bathroom accident” but it's a mere blip on the radar in life and doesn’t deserve the level of life-altering panic and avoidance that it gets.
Am I overvaluing anxious thoughts and feelings and accepting them as fact?
It’s important to realize anxiety thoughts for what they are: thoughts that will pass. Just because we are feeling anxious doesn’t mean it is evidence a certain situation will turn out disastrously.
How have your previous catastrophic predictions turned out?
Generally, catastrophic predictions are incorrect given they are not based on real facts. If you search back to other times you have catastrophized the likelihood is that you haven’t been correct with your prediction. Do you ever feel like the catastrophizing has helped you more than it is hurt you?
It takes practice to train yourself to step out of stressors and rethink them without getting caught up in anxiety and projection. As you go through these exercises this will become more automatic and it will be easier to reduce stress.
While learning cognitive restructuring techniques write out the worry and the answers to the questions. As you practice, it will become a more natural and ingrained process and won't always require writing it out unless you get stuck.
Download a practice worksheet to walk through the questions when you have anticipatory anxiety and catastrophic thinking. If you are prone to catastrophizing, the good news is that you will have plenty of opportunities to practice! (That’s one way to put a positive spin on it, right?)
To manage catastrophizing and anticipatory anxiety download this free PDF. This worksheet will help you learn to shift thoughts and improve anxiety control.
Try these exercises and let me know how it goes. Are there places you get stuck? Have you found a particular technique helpful?
Dr. Melissa Welby is a psychiatrist practicing in CT. She is one of LinkedIn Top Voices and a healthcare blogger.
Get future articles emailed directly by signing up here.
A version of this article was first published here.
Dr. Melissa Welby is a psychiatrist that participates in people’s process of discovery, empowerment, and search for satisfaction and happiness. She treats a variety of illnesses including depression, anxiety & panic attacks, adult ADHD (Attention Deficit / Hyperactivity Disorders), bipolar disorder, OCD (Obsessive-Compulsive Disorder) and borderline personality disorder. She is also the current president of the Connecticut Psychiatric Association.She completed her Internship & Residency at Cambridge Hospital, affiliate of Harvard Medical School, 2000 to 2004. Dr. Melissa Welby is Board Certified in General Psychiatry by the American Board of Psychiatry and Neurology, 2005 to present.