Managing Worry in Uncertain Times: Tools for Distinguishing and Coping with Real vs. Hypothetical Concerns

Dr. Tracey Marks addresses a listener's question regarding the ineffectiveness of traditional CBT techniques like avoiding catastrophizing during periods of genuine crisis and uncertainty. She acknowledges that while catastrophizing is a distorted thinking pattern, current global events can indeed feel like a real catastrophe, necessitating alternative coping strategies. The core of her approach involves distinguishing between helpful and unhelpful worry, further broken down into "real problem worries" (actionable, current issues) and "hypothetical worries" (future, uncertain, often uncontrollable scenarios).

The primary tool introduced is the "Worry Decision Tree," developed by Drs. Gillian Butler and Tony Hope. This structured approach guides individuals through a series of questions to identify the nature of their worry: "What am I worrying about? Is it a problem I can do something about?" If actionable, the tree prompts listing options, identifying immediate steps, and then letting go of the worry. If action is not immediately possible, it advises planning for future action. Crucially, if a problem is determined to be entirely beyond one's control, the recommendation is to consciously let go of the worry and redirect focus.

For managing persistent hypothetical worries, Dr. Marks advocates for setting aside a dedicated "worry time"—a formal, scheduled appointment (e.g., 30 minutes) to actively engage with and write down these concerns. This structured approach, she explains, helps contain intrusive thoughts, often reducing their perceived criticality and distress when deferred. Keeping a worry journal during this time allows for tracking worries and observing which ones resolve or persist, fostering a sense of control and perspective.

Complementing these strategies are mindfulness and gratitude practices. Mindfulness, through techniques like deep breathing, a five-senses environmental survey, or focusing on the sensation of breathing, helps pull the mind into the present moment, away from future threats or past pains associated with worry. Gratitude practice, either by reflecting on a pre-written list of blessings (a "gratitude jar") or by daily reflection on specific positive experiences, helps shift focus towards positive feelings and tangible connections, serving as an effective counter-balance to anxiety and a way to de-escalate after worry time.

"People with generalized anxiety and depression are usually taught in CBT, which is cognitive behavior therapy, not to engage in catastrophizing."

"Helpful worry is thinking ahead, anticipating problems and trying to solve them."

"Unhelpful worry is fretting about the things that you can't change or things that may or may not come to pass."

"Real problem worries are about problems that are currently affecting you."

"Hypothetical worries are about things that are not true at the moment, but might happen in the future."

"You set aside worry time, you can start with 30 minutes and this will be dedicated time to just let it rip and make it a formal process."

"Chances are when you defer the worry and contain it to a certain time, it won't seem as critical or distressing."

"Remember, worry is about focusing on a future threat or a past pain, and being mindful pulls you into the present."

"And this helps you connect to the positive feelings in a personal and tangible way, and there are several ways to do this."

"If you determine that this is a problem that you can't do anything about, then you let go of the worry and focus on something else that's important to you."