WHAT CAN HELP WITH WORRYING SO MUCH ABOUT THE WAY I LOOK?

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We live in a society that emphasizes appearance as the means to success and happiness. Given the media's bombardment of perfect-looking images, it is difficult not to compare yourself to television and film figures and magazine covers and come up short. Despite societal influences, however, the way a person looks doesn't produce worry or distress—rather, a person's thoughts about her appearance are the culprit. What are you saying to yourself about how you look? If you tell yourself that you look terrible, it's not surprising that you would feel anxious and depressed. But what's the evidence that you look terrible even if you don't resemble a magazine cover? Where is it getting you to think, “I look terrible”? Resisting unhelpful societal demands to look a certain way and learning to separate your appearance from your worth as a person are very important goals in improving emotional well-being. Growing up, perhaps you learned that self-value was based on having a particular body image. Now is an excellent time to question this old assumption. Inevitably, people get older, and physical changes will occur. If you awfulize these changes and condemn yourself for them, you will feel much worse than if you learn to tolerate the physical differences and accept yourself anyway. Again, using effective, forceful self-talk is key.

Anxiety-Generating Self-Talk

·       I must look perfect or I'm no good.

·       Everyone can see this flaw—how terrible!

·       I can't stand this flaw.

·       I can't be happy until I lose weight.

·       I hate my body!

Anxiety-Reducing Self-Talk

·       Nobody looks perfect all the time, and appearance is not the gauge of my worth.

·       People are far more focused on themselves than on anything about me. I look fine!

·       Even if I don't like this particular body part, I certainly can stand it. There's much more to me than this one feature.

·       If I'd like to lose weight, I can work on this goal, but it doesn't determine my level of happiness. Moreover, putting appearance-based demands on myself just makes me more anxious and interferes with reaching my goals.

·       My body can do an amazing number of activities! Why condemn it because it doesn't look like a movie star's body? I would never judge anyone else as harshly as I'm judging myself.

It is important to note that some people are so focused on perceived physical flaws that it becomes consuming. Body dysmorphic disorder is an increasingly recognized mental disorder in which a person is preoccupied with an imagined or slight deficit in appearance (e.g., “crooked” nose, facial lines, acne scars, thinning hair). Other people might not even notice what the individual is concerned about, but the BDD sufferer believes the flaw is repulsive. As a result, she may engage in compulsive mirror-checking or mirror-avoidance, over-grooming, skin-picking, cosmetic procedures, or reassurance-seeking. In addition to avoiding school, work, and social activities, people with body dysmorphic disorder tend to report high levels of distress and suicidal ideation and attempts. Other appearance-related, highly-distressing clinical conditions include eating disorders, which are prevalent in women and increasing in men. Both cognitive-behavioral therapy and medications (SSRIs) can be effective in treating eating disorders and body dysmorphic disorder. Early diagnosis and intervention are vital in offsetting the harmful effects of these conditions.

Source: The Anxiety Answer Book by: Laurie A. Helgoe, PhD, Laura R. Wilhelm, PhD, Martin J. Kommor, MD

A PART OF ME THINKS MY PARTNER IS CHEATING ON ME. I WORRY ABOUT IT ALL THE TIME. WHAT CAN I DO TO RESOLVE THIS ANXIETY?

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This is where you have to ask yourself if your worry is based on reason and fact or on imagination and fantasy. If you have a basis for your worry, you may allow the feelings to eat away at you rather than face the truth. The most direct way to discover the truth is to look your partner in the eyes and ask. To find out if you're imagining things, ask yourself the following questions, and be honest with yourself:

·       Do I have any evidence?

·       Is my evidence substantial?

·       If I ask my partner if he is having an affair, and he says “no”, will I believe him?

·       Is there any way he could convince me that he isn't having an affair?

·       If I hire a private detective to determine if there is an affair and the detective says “no,” would I believe her?

If your answers show that even though you don't have any evidence, your partner would deny it, and a detective would find no evidence, you would still worry—then your worry may be excessive. In this case, your worry is not based on fact or reason. Some people in this situation can be reassured but only temporarily. Treatment is often necessary because this kind of worry can easily take over your life and destroy your relationship.

If you get therapy, you may discover that there is indeed something you wish were different about your spouse or your relationship. It may be something you can speak with him about. He may or may not be willing to change, but you can have the satisfaction of knowing the truth about your own worries and knowing you took measures to address them.

Source: The Anxiety Answer Book by: Laurie A. Helgoe, PhD, Laura R. Wilhelm, PhD, Martin J. Kommor, MD

MY SON IS A POLICE OFFICER. EVERY DAY, I WORRY I WILL GET A CALL THAT HE IS HURT OR DEAD. HOW CAN I LIVE A HEALTHY LIFE WITH THIS CONSTANT WORRY?

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Anybody with a loved one working in dangerous conditions such as police work or the military would feel concern. The degree of concern, however, depends on how you think about this situation. Keep in mind that it is not really your loved one's work that causes your constant worry. Rather, it is what you tell yourself about his work. If you are saying to yourself, “Today will be the day I get the call that he's been killed,” here's what might be going on in your head:

You are telling yourself something is going to happen at a certain point in time. This type of thinking (self-talk) is called fortune-telling.

You are also jumping to the worst conclusion about what could happen. This is called catastrophizing.

At the same time that you are overestimating the danger and threat of the situation, you are underestimating your own or a loved one's ability to cope.

One of the best ways to deal with constant worrying is to learn to challenge negative predictions and develop more realistic views of situations and coping resources. For example, you might remind yourself that your loved one is doing the job she wants to do, that she is skilled, that she works with competent colleagues, and that she has handled difficult situations well in the past. Also note that there is a difference between possibilities (it could happen) and probabilities (it's likely to happen). You could get a call that your loved one has been hurt or killed, but that's not the most likely outcome. We're better off when we resist turning small negative possibilities into probabilities. Life has no guarantees, but learning and practicing more realistic self-talk can help you better tolerate uncertainties.

Further, it's important to realize that we can't see into the future—you are not God, and no one has a crystal ball. The truest statement we can make about the future is that we don't know what it holds. Therefore, it is best to try to live in the moment. Sometimes our focus on someone else's well-being can be a way of avoiding attending to our own lives. Start focusing on spending your time in ways that feel meaningful and productive—maybe through becoming more engaged in your own work, getting together with friends, or starting something new, like a hobby or volunteering.

Finally, we sometimes worry because we believe that our worry magically protects others. Or, we believe the person we're concerned about not only wants us to be concerned about them, but to worry about them. We think that he will feel better in a dangerous situation if he knows we are constantly worrying about him. These ideas overestimate the effects of worry for any benefit. In fact, these beliefs are akin to believing in magic. We have no evidence that worry benefits anyone, but we do know that it causes the worrier harm. If you want to help your loved one, focus on what you can control. Send a care package, help out, express your love. It's generally better to control those aspects of your life you can actually control than those aspects of your life where the only control is through magic.

Source: The Anxiety Answer Book by: Laurie A. Helgoe, PhD, Laura R. Wilhelm, PhD, Martin J. Kommor, MD

EVERY ONCE IN A WHILE, I HAVE A THOUGHT ABOUT DOING SOMETHING "OUT THERE" LIKE THROWING SOMETHING AT MY NEIGHBOR OR TELLING OFF MY BOSS. DOES THIS MEAN I'M CRAZY?

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Studies have shown that 85-90% of ordinary people experience intrusive thoughts or mental images that they consider distressing or disruptive. Just because negative thoughts come into your mind, that does not make you crazy or abnormal. What distinguishes normal intrusive thoughts from psychotic or delusional thoughts is that the latter involve a break with reality. For example, a psychotic person may believe that the thought originates from a higher authority, such as Jesus Christ, and may even hear the thought as an actual voice (auditory hallucination). The person may then feel that he has no choice but to obey.

It is normal to have thoughts about things you would not actually do. You will become needlessly anxious if you attach great significance to the negative thoughts. If you have a negative and impulsive thought like “I'm going to embarrass my boss in front of everybody,” and then you say to yourself, “Because I have this thought, I'm a horrible person” or “That was terrible of me,” you are going to be a lot more bothered than if you can say to yourself, “It's just a thought, and I know I wouldn't act on it.”

Source: The Anxiety Answer Book by: Laurie A. Helgoe, PhD, Laura R. Wilhelm, PhD, Martin J. Kommor, MD

IS IT NORMAL TO WORRY ABOUT WHAT PEOPLE WILL THINK OF ME?

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In the way that the outdoor temperature is reflected in degrees on a thermometer, it's helpful to think of worry as occurring at different levels instead of as an all-or-nothing emotion. It is completely normal to be concerned about what people think of us. We live in a social world, and interaction with other people is vital. Naturally, we want others to think well of us. Getting along well with others feels good and often helps us reach our social and professional goals.

Yet, focusing on the views of others can make us overly cautious and anxious. Here are some signs that your focus is excessive or unhealthy:

You don't feel good about yourself, and are projecting your negative feelings. For example, you imagine your boss is unhappy with your work rather than admitting that you aren't happy with your performance.

You may be engaging in a thinking mistake known as mind-reading —assuming that you know what a person is thinking about you when you actually have no evidence for your conclusion.

You tell yourself that it's terrible if someone doesn't like you, when maybe it's just inconvenient. Another person's view of you is not a measure of your worth unless you allow it to be.

To shift these tendencies, give yourself credit for your strengths and practice learning to accept your mistakes—we all make them! And keep in mind that most people are more focused on their own priorities and interests than on thinking about you. To illustrate this point, try writing down all the topics that others could be considering or discussing, besides you! You'll find that this list is endless!

Source: The Anxiety Answer Book by: Laurie A. Helgoe, PhD, Laura R. Wilhelm, PhD, Martin J. Kommor, MD

MY MOTHER WORRIED ALL THE TIME, AND I TEND TO WORRY A LOT TOO. DOES THAT MEAN THAT I'M GOING TO BE A WORRIER FOR THE REST OF MY LIFE LIKE SHE IS?

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Worry is based on self-talk. Often when people worry excessively, they overestimate danger in the world and underestimate their ability to cope. Just because your mother worried a lot does not automatically mean you are going to be a worrier for the rest of your life. Worrying can become a habit, but all habits can be changed with hard work. When you start to worry, instead of letting your mind toss around “what if this and what if that?” it is a good idea to flesh out what is most likely to happen. Focus on probabilities (likelihoods) rather than remote possibities. Also, ask yourself, “What's the worst- case scenario and how would I deal with it?”

Perhaps your mother was afraid to drive and never drove her car. This is a behavior that can change if a person is willing to question some of her negative assumptions. Your mother might have said to herself, “I can't drive—I'll crash…What if I totaled the car?…What if I hurt somebody else?…What if I became paralyzed?” If that is what she believed, it makes sense she would feel anxious about driving and probably avoid it. However, it might have been good for her to question, “Why can't I learn to drive a car?” and “Even though car accidents happen, what makes it certain I'm going to have a car accident if I try to drive?” Worrisome thoughts can be identified, evaluated and disputed, but it takes consistent effort. Remember also that life contains hassles, problems, and nuisances, so an absence of any distressing emotion is not going to be realistic. However, if you notice yourself worrying excessively, you might decide you prefer appropriate concern to excessive worry. The difference between worries and concerns depends on your thinking!

Source: The Anxiety Answer Book by: Laurie A. Helgoe, PhD, Laura R. Wilhelm, PhD, Martin J. Kommor, MD

I ALWAYS WORRY ABOUT MY HEALTH. PEOPLE TELL ME I AM A HYPOCHONDRIAC. WHAT CAN I DO ABOUT THIS?

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Hypochondriasis is a disorder where someone fears developing, or believes she already has, a dreaded disease and repeatedly seeks medical attention. She is preoccupied with her health and commonly misinterprets harmless bodily sensations as indicative of serious illness. In her mind, something is really wrong with her, and the doctors keep missing the problem. She continues to pursue appointments with physicians to increase the chance of “getting to the bottom of the matter,” and she hates to be called a hypochondriac. Despite the accumulated evidence suggesting no dangerous illness, the hypochondriac doesn't consider her beliefs to be irrational or unreasonable. Most individuals with hypochondriasis are so focused on the idea of having a severe medical problem that the other matters in their life take a back seat. The vocational, romantic, family, and recreational aspects of their lives are often in shambles, and they don't recognize it.

Whereas patients frequently visit their doctors to feel better, hypochondriasis actually persists because of repeated medical examination and reassurance. People seek temporary relief strategies that ultimately keep them from disconfirming their incorrect, unhelpful, exaggerated illness beliefs. Getting better means learning alternative explanations for bodily sensations and practicing believing more accurate, realistic explanations related to one's health. Additionally, it is essential to decrease the “safety behaviors” (e.g., looking on the internet, reading medical texts, taking blood pressure and temperature) and reassurance-seeking (e.g., visiting a doctor, calling the doctor's nurse) that actually maintain the excessive worry over time.

Source: The Anxiety Answer Book by: Laurie A. Helgoe, PhD, Laura R. Wilhelm, PhD, Martin J. Kommor, MD