Dealing With Worry and Rumination
- "Worry is a special form of fear. To create worry, humans
elongate fear with anticipation and memory, expand it in
imagination, and fuel it with emotion. Worry is what humans do with
simple fear once it reaches the cerebral cortex. They make it
complex." "Worry = vulnerability + powerlessness" (Edward
- "Your brain is not your friend." (Steven Hayes)
Our lower brain emotional centers and our verbally driven cerebral
cortex did not evolve to issue warm and fuzzy thoughts-they are
overly sensitive alarm systems!
- Questions to ask yourself: What is the difference between
"good" (adaptive) worry vs. "bad" (maladaptive) worry? How much
worry is a natural part of living versus how often do we needlessly
torment ourselves? How often has your worry actually saved you from
- "Worry gives a small thing a big shadow." (Swedish
- Most worriers are not passively beset by worry. Although they
may not realize it, most actively seek worry. Rumination is
persistent and repetitive thinking that is usually looking backward
and more associated with depression; worry is persistent and
repetitive thinking that is usually looking forward and more
associated with anxious apprehension. (The word "rumination"
describes what a cow does when "chewing its cud" or chewing,
swallowing, regurgitating and then chewing it again-a well chosen
word to describe the ruminative thinking process.)
- The neurophysiology of worry: Primitive emotional centers in
our brain (e.g., the amygdala) react to potential danger by
transmitting an alarm to the area of our brain behind and above our
eyes (the prefrontal cortex). The prefrontal cortex analyzes the
alarm (worrying, essentially) which signals further alarm back to
the amygdala. Picture a vicious cycle of escalating and
self-perpetuating alarm and worry between the amygdala and the
prefrontal cortex and you have a simplified understanding of the
brain's role in worry. Other parts of the brain contribute, too.
For example, the cingulate cortex seems to be overly active among
ruminating worriers and may be dampened by appropriate medication
- Nature versus nurture: Is your "worry quotient" as immutable as
your height or your eye color? Might nature provide the "hardware"
and life experience provide the "software" of worry? Although
nature might impose a range, healthy habits may determine where in
that range someone usually functions. Excessive worry should not be
seen as a "given."
- Neuroticism: A worrier's temperament? Worriers were often
conscientious, inhibited and highly sensitive children
characterized by high and inflexible autonomic reactivity.
(Autonomic reactivity = hyperarousal, hypervigilance, and slowness
to habituate.) Studies of fetus' and infants' heart rates and their
responses to stimuli suggest that the underpinnings for excessive
worry are probably "hardwired." Remind yourself not to hold
yourself responsible for your "wiring" even though you strive to
take responsibility for managing worry more effectively.
- Typical beliefs and assumptions that fuel
worry: (Shearer & Gordon, 2006)
Intolerance for uncertainty: "If I think about
this enough, I should feel a sense of certainty."
Intolerance for discomfort: "If I can just
think this through, I won't have to feel this way."
Inflated sense of responsibility and culpability:
"If bad things happen, it's my fault."
Distorted risk assessment/emotional reasoning:
"If it feels likely, it is likely. If it feels dangerous, it is
Perfectionism--mistakes are unacceptable:
"Mistakes mean I wasn't in control and screwed
Pessimism/presumed incapability: "Bad things
will happen to me and I won't be able to deal with it."
Misconstrued virtue: "Worry shows how deeply I
care about my children."
Overvaluation of the thought process: "Because
I have a thought, it is, therefore, an important thought, and I
must give it my full attention and get it settled. I can anticipate
and avoid discomfort by worrying."
"Meta-worry" or worry about worrying:
"I'm making myself sick. I'm going to bring on an early heart
attack. I'm out of control. I'm weak. If my faith was stronger, I
Implicit magical beliefs: "Worry prevents bad
things from happening. It keeps loved ones safer."
- The limits of reassurance: If reassurance
doesn't work the first time, it's probably not going to work so
don't keep trying to make it work. The temporary relief you feel
when reassured simply sets up your next need for reassurance. Plus,
when you go looking for reassurance enough, you will usually
uncover something new to worry about!
- The limits of worry suppression: What we
resist persists. Often, the more we try to directly suppress worry,
the more we worry.
- Indeed, control of thought content is the problem, not
the solution. "Ironic processes" in our thinking and
behaving seem to leave us inclined to think about that which we are
striving not to think about (see Wegner).
- Worry and religious faith: Your faith or your
prayers may help to dampen worry, but, if not, can leave you
worrying about your faith as well! Aim for meditative prayer and
guidance in coping more effectively rather than supplicatory prayer
asking that your worries be removed. Do not make your worries the
litmus test of your faith.
- Worry and insomnia often become a vicious
circle. When you worry, sleep onset is delayed and when
sleep onset is delayed, you worry about not sleeping. Then, as
another example of ironic processes, the more important it becomes
that you must sleep and the more you strive to make yourself go to
sleep, the less readily you fall asleep. For occasional insomnia,
accept that it's okay if you stay up, it's okay if you "just rest,"
and it's okay if you're tired and not at your best tomorrow.
- "Predictability diminishes worry by increasing our sense of
power, even if the predictions are dire." (Hallowell)
- "The certainty of misery is better than the misery of
uncertainty." (Pogo the cartoon character from the 1960's)
For example, some people who have for many years lived in consuming
fear of cancer only to develop cancer have commented that dealing
with the reality of cancer is actually easier than dealing with the
uncertainty that they might get cancer.
- Worry as manifest in various disorders:
(Shearer & Gordon, 2006)
Strategies for Reducing Chronic Worry or Rumination:
ASDI: Serving the Baltimore Area & Central Maryland