Stop worrying

Everyone worries some of the time. We worry about medical problems, about paying bills, about our loved ones, and about our jobs. Worrying isn't all bad. It motivates us to problem-solve...to get things done. But worries, which psychologists call obsessions, are driven by anxiety and can become destructive. Some people worry all the time. In extreme cases worrying can lead to panic attacks with bodily symptoms suich as rapid heart, trouble breathing, and trembling.

Historians, novelists and poets have referred to the period between 1914 (the beginning of World War I in Europe) and 1950 as "the age of anxiety." This theme influenced the writings of Marcel Proust, James Joyce, D. H. Lawrence, and W. H. Auden. In 1950, Rollo May, an existential psychologist, published "The Meaning of Anxiety," based on his doctoral dissertation, a seminal volume that led to numerous scientific studies of the biological and psychological componenets of anxiety and worrying. In July, 1955, the cover of the 24th issue of Mad Magazine depicted the cartoon image of a big eared, gap-toothed man named Alfred E. Newman. The picture was titled "What, me worry?" It became the iconic image of the magazine, appearing in miniature on every subsequent cover. Representing both denial and stupidity, the message appeared to be that only stupid people don't worry.

Obsessions are frequently accompanied by compulsions--repetitive, stereotyped behaviors that serve to reduce anxiety, but only temporarily. Compulsions include such behaviors as hand washing, organizing, excessive cleaning and tidying, saving, and hoarding. These actions, which become ritualized, are intended to reduce the intensity of the bad thought. They may become so severe as to interfere with activities of daily living. Persons labeled as having obsessive-compulsive personalities appear to organize their lives around obsessive worrying and compulsive behaviors. The father of psychoanalysis, Sigmund Freud, attributed such conditions to overly severe toilet training in young children; hence the slang term "anal personality." What follows are suggestions for self-help to alleviate obsessions and compulsions. They should not substitute for help from a trained professional when needed. Many cognitive behavior therapists would suggest similar approaches.

Your first impulse would likely be to fight the obsession. An early approach often suggested to patients, called thought-stopping, advised the worrier to say "Stop!" Sometimes a rubberband worn around the wrist was to be snapped to reinforce the command. Don't bother doing this. It doesn't work. Rather than trying to overpower the worry, it is more effective to accept that it exists but to diminish its emotional impact. Rather than expecting immediate relief by the strategies suggested here, it is more realistic to take a longer perspectivce and hope for gradual improvement. The worrier needs to minimize the significance of the worry. It is merely a thought and often an irrational or over-exaggerated one at that. A useful technique is to postpone worrying by setting aside a certain time of day to worry. During this time the individual is advised to give in to the worry and let it take its course. THe worrying can be accompanied by an attempt to devise some realistic solution to the problem. At all other times he need not worry. A man might say to himself: "I'll worry about it after supper." At first it may be possible only to delay worrying for a few minutes. Later the time can be increased in small increments. Similarly, worry times can be longer at first and gradually shortened. During the woirry time it is helpful to address the thought in a different way than usual. Writing the worry has proven effective. Even singing it may work. These changes may provide a sense of control over the worry, replacing feelings of helplessness. Worries can gradually be accepted as temporary or momentary problems, well within the range of normal experience. Developing a visual image that contradicts or is opposite to the worry may help. A student worrying about failing an exam, even though she has studied for it, may imagiune receiving an A and making the honor roll. Additionally, relaxation techniques such as progressive muscle relaxation, diaphragmatic breathing, meditation, and yoga can reduce the anxiety supporting the obsessions.

The best way to overcome compulsions involves elicitation of the impulse to perform the behavior and suppression or delay of the behavior. A seventeen year old girl had a persistent and intense fear of germs. The fear was most often aroused when she had to open a door by turning the doorknob. There were numerous occasions when she had no choice but to do so. As soon as she touched the doorklnob she had a strong urge to wash her hands. Howerver, this usually was not possible. Instead, she developed the expedient of wiping her hands on her pants legs. She did this rapidly and inobtrusively so that it would not be noticed by others. However, her germ worry persisted. The technique that helped her overcome the compulsive hand wiping was to encourage her to touch the doorknob but delay the wiping motiuon as long as possible, At first she could delay only by a few seconds. This time was gradually increased until she found she no longer needed to wipe her hands at all. The technique of eliiciting the anxiety and withholding the behavior is the method of choice in behavioral treatment of compulsions. Treating her worries about germs was also used.

These self-help strategies are not meant to cure obsessive-compulsive disorder or obsessive-compulsive personalities. Nevertheless, they have proven helpful in teaching such persons to cope on a daily basis.