Category: Worry

This transcription was auto-generated by YouTube. I’ve only added minimal editing, so I apologize for any errors, run-on sentences, etc.

Cognitive distortions are exaggerated and negatively biased thought patterns that lead us to perceive reality inaccurately. They’re a way our minds have of convincing ourselves to believe things that aren’t really true. They show up all the time in our automatic negative thoughts, and they’re significant because our thoughts have such a big influence over how we feel and how we act. And when we treat these cognitive distortions as if they were facts, we end up feeling and acting based on faulty assumptions, usually in ways that contribute to things like depression, anxiety, low self-esteem, anger, and countless other issues.

As we learn to identify cognitive disorders in our thought patterns, we become better at recognizing when and how our minds are leading us astray, which helps us see the ways in which our thoughts aren’t accurate; and makes it easier to reframe our thoughts and think about things in ways that are less likely to have a negative impact on our mood or mental health, and can help us start feeling better. So now let’s look at some of the most common types of cognitive distortions.

When we engage in all or nothing thinking we see things as black or white with no shades of gray in between. Something or someone is either all good or all bad. If we don’t do everything right we’re a complete failure. One bad thing happens and our whole day is ruined. Someone makes a mistake or disappoints us and they’re irredeemable.

All or nothing thinking is a hallmark of perfectionism. It leads to unrealistic standards for ourselves and others, which can negatively affect our motivation and set ourselves up for failure and disappointment. If you find yourself engaging in all or nothing thinking, try to start recognizing and acknowledging to yourself that things are rarely simply black or white, and start looking for the shades of grey in between.

Overgeneralization is when we see a single negative event as a never-ending pattern of failure or defeat. You’re making dinner and you burn something and you think, i always ruin everything, i never do anything right. You’re in a rush to get somewhere and hit a red light and think, nothing ever goes my way.

Overgeneralizations are often stated in terms of always, never or nothing. If you find yourself overgeneralizing, look for exceptions, and try replacing words like always never or nothing with words like sometimes or some things. And this can help you see that one negative event doesn’t define everything, and helps make your thinking less negatively biased and more accurately reflect reality.

Mental filter refers to filtering out positives and dwelling on negatives. A mental filter is like one drop of ink that discolors a whole glass of clear water: that single drop of something negative colors everything. We pick one negative detail and dwell on it exclusively.

You get lots of positive feedback from your boss with one suggestion about how you could improve, and your takeaway is that you’re no good at your job, and you dwell on that one comment all day. You make a YouTube video that gets twenty positive comments and one person says how much they hate it, and you’re so discouraged you never want to make another video again. If you find yourself operating with a mental filter, learn to start asking yourself if there are any positives or even neutral things about the situation you’re overlooking, and then adjust your filter to let those aspects through as well.

Discounting the positive is similar to a mental filter, but instead of filtering out anything positive, we dismiss it and tell ourselves it doesn’t really count. We get a compliment or some praise and tell ourselves, well that doesn’t really count they’re just trying to be nice to me. Or we succeed at something, but it doesn’t really count because we tell ourselves anyone could do that, i just got lucky.

If you find yourself discounting the positive, take a moment to ask yourself, why doesn’t that count, what reasons do i have to just dismiss that? And most of the time we won’t be able to come up with a good answer. Which makes it harder to discount everything positive. And we can start giving ourselves at least a little credit when things go well. And there’s an exercise called three good things that i talk about in my video on depression that can help you stop discounting the positive, and you’ll find a time stamp link to that exercise in the description and pinned comment.

Jumping to conclusions involves interpreting things negatively without any facts to support our conclusions. When we mind read we make assumptions about what someone’s thinking based on their behavior without confirming with them what they’re actually thinking. If our partner is being quieter than usual we assume it’s because they’re upset with us. If we text a friend and they don’t reply fast enough we assume it’s because we’re not important to them or they don’t like us anymore.

We make these assumptions about what’s going through other people’s minds based on no conclusive evidence, it’s just our interpretation of their behavior, usually mixed in with projecting our own emotions into the situation. We’re feeling insecure about a relationship or friendship, and so we assume that their behavior confirms what we’re feeling and that they’re upset with us.

With fortune telling we predict the future, and that things are going to go badly, without any real evidence to back up the prediction. Again these predictions say more about how we’re feeling ourselves than they do about the actual reality of the situation. Fortune telling is a hallmark of the worrying that comes with anxiety or the hopelessness of depression.

If we find ourselves jumping to conclusions the best thing we can do is to simply ask ourselves, what are the facts of this situation what actual evidence do we have to support this conclusion? Is there any way to interpret the evidence to support alternate conclusions? Or is there any evidence we’re overlooking that suggests a different conclusion? And the goal isn’t to try to predict the right conclusion, but to recognize that there are lots of possible outcomes and we just don’t have enough information yet to know which one is going to come true. And so any conclusion we draw is going to involve jumping to conclusions.

With magnification and minimization we give greater weight to our perceived weaknesses and failures and to the strengths and success of others; and we give less weight to our own perceived strengths and success. It’s like looking through binoculars from each end. We look at our weaknesses and failures through the magnifying side of the binoculars, making them seem bigger and more significant than they actually are.

And then we reverse the binoculars when looking at our own positive attributes and successes, making them seem smaller and less significant than they actually are. And if you find yourself engaging in magnification or minimization, try imagining a friend or loved one in your shoes and see how you’d regard their qualities or results, and then see if you can’t be as generous to yourself in your assessment as you would be to someone else that you care about.

Catastrophizing is related to jumping to conclusions and magnification, and it’s typically what we do when we worry. We’re predicting the future and jumping to the worst possible conclusion no matter how unlikely it is. And we’re magnifying the consequences of this outcome and imagining it’ll be unbearable.

Catastrophizing often unfolds as a series of what-ifs: what if i made a mistake what if my boss finds out? What if i get fired what if i can’t find another job? What if i can’t pay my rent? And if you find yourself catastrophizing try asking yourself the following questions: you’ve already been asking yourself what’s the worst case scenario. So make sure to also ask yourself what’s the best case scenario? And then what’s the most likely scenario? And this helps you get a more balanced perspective and can help prevent you from automatically jumping to the worst possible conclusion.

And then ask yourself, if the worst case scenario did happen, how would i be able to cope with it? How have i coped with similar situations in the past? And this can help limit magnification of the consequences that so often goes along with catastrophization.

When we use emotional reasoning, we think the way we feel reflects reality. So we view ourselves and our situations based on how we feel, rather than on any external evidence. I feel this way therefore it must be true.

If we feel like an idiot that means we are idiots. If we feel anxious we know something bad is about to happen. If we feel depressed and hopeless we convince ourselves this means there is no hope. Or we feel angry so that means we must be being treated unfairly.

But the world doesn’t revolve around how we feel, and if we find ourselves engaging in emotional reasoning, we need to remind ourselves that just because we feel a certain way about something, doesn’t make it true and not to confuse feelings with facts.

The type of should statements we’re referring to here are the arbitrary rules we set for ourselves and others when we tell ourselves that things should be a certain way. I should make everyone happy. I shouldn’t make any mistakes. People should always be on time. When we use should statements we create unrealistic expectations for ourselves and others. When the should statements are directed towards ourselves we set ourselves up for guilt disappointment and frustration, and when we apply should statements to others we can feel let down disappointed or angry.

Often we try using should statements for motivation: i should go to the gym more often; i should stop eating junk food. But presenting these as shoulds can drain our motivation when we fail at something we think we should do, because we feel so bad about it. And should statements can make us rebel, because nobody likes to be told what they should and shouldn’t do, even if we’re the ones telling ourselves what we should do.

If you find yourself engaging in should statements, try rephrasing them with less judgmental terms like I’d like to, or I’ll do my best, or it would be nice if. That way we’re still acknowledging to ourselves what we’d like to do, or how we’d like other people to act, but we don’t have to feel guilty if we don’t, or as angry when people don’t behave the way we think they should.

Labeling is a form of all or nothing thinking and overgeneralization where we judge and label ourselves or someone else, usually in a very negative way, based on a single event or behavior, or attribute that doesn’t really define who we or they are. We knock our coffee off the table and it spills and we label ourselves an idiot. We try to make plans with friends and no one’s available and we label ourselves a loser. When someone has to reschedule a meeting and we label them a selfish jerk. Or they make a mistake at work and we label them useless.

When we use labels we don’t take context into account we don’t consider anything beyond what’s in front of us at this moment. We’re just reflexively assigning a negative label and using it to define the totality of ourselves or someone else. When we apply these labels to ourselves it hurts our confidence and self-esteem and can leave us feeling depressed. And when we apply them to other people it increases hostility and leaves little room for communication. The antidote to labeling is to recognize that one act isn’t defining: just because i made a mistake doesn’t make me an idiot; if someone disappoints us it doesn’t automatically make them a selfish jerk.

Personalization involves holding ourselves personally responsible for a situation that’s not entirely under our control. We take total responsibility for an external event that occurs and ignore any other important factors. As a consequence we end up completely blaming ourselves when something goes wrong, even when we may be only partially responsible, or not responsible at all for the results. Our kid gets sick and we blame ourselves for letting them sleep over at their friend’s house. We’re late for dinner because our partner isn’t ready on time, and we blame ourselves for not making sure they left work earlier.

Or instead of personalization, we can blame other people for things that aren’t totally their fault while overlooking our own contributions to the situation. If you’d reminded me about dinner tonight i would have been ready on time. If you weren’t always working all the time i never would have cheated on you. If you find yourself engaging in personalization and blame, take a moment to ask yourself if there are any other factors you’re overlooking that contributed to the outcome. And recognize that just because you have some responsibility for how something turned out, you’re almost never going to be in a position where you’re 100 to blame.

And if you have trouble accepting that it’s not entirely your fault, you can try using a responsibility pie, where you write down all of the factors that may have contributed to a situation, and then make a pie chart assigning a share of responsibility to each of these factors to help illustrate how you’re not fully responsible for the way things turned out.

And for some more tips on how to combat cognitive distortions check out my video on cognitive restructuring and reframing your thoughts and please like and subscribe and check out my other videos for more tips on how to manage negative thinking.

Do you frequently worry about your health, preoccupied with having or acquiring a serious illness, or constantly checking for signs that something’s wrong? Worrying about every body sensation and symptom and obsessively researching them online or frequently visiting doctors? Or maybe you avoid doctors altogether out of fear of getting a serious diagnosis. While it’s natural to be concerned about our health sometimes, if we have health anxiety or illness anxiety disorder, these concerns can become debilitating and disruptive to daily life. So let’s look at what health anxiety involves and how we can manage it.

First, there’s a trigger which could be an uncomfortable body sensation or any sort of symptom, which we then misinterpret as a sign of a serious health issue, and this makes us anxious. The trigger could be some health-related news or something we read online, and this leads to anxiety. Once our anxiety kicks in, there are a few paths we can go down.

We can start over-monitoring our symptoms, looking for any sign that there might be something wrong, frequently checking our symptoms for any changes, and being on the lookout for any new symptoms that might arise.

Health anxiety can also lead to excessive reassurance seeking, checking with external sources to evaluate our health, which can involve frequent visits to the doctor or obsessively researching our health online. These behaviors sometimes offer temporary relief but often leave us even more anxious, and this hypervigilance about our health means we’re always going to find something new to trigger our anxiety.

Sometimes we respond to health anxiety with avoidance, either avoiding situations due to fear of getting sick or avoiding health professionals out of fear of getting a bad diagnosis, which can offer some temporary relief but may end up ignoring legitimate health concerns. This temporary relief can offer some short-term comfort, but it does nothing to alleviate anxiety long-term, and so our health anxiety will keep getting triggered.

We can reduce health anxiety by making changes to various parts of this cycle. With health anxiety, we typically respond to triggers by imagining the worst-case scenario. Our headache is a brain tumor or aneurysm, stomach pain is bowel disease or cancer, if we feel dizzy we worry it’s a neurological disorder, and any mole or rash is skin cancer. The list of possible symptoms and self-diagnosis is endless. So we need to replace these catastrophic thoughts with more realistic interpretations.

People get headaches for all sorts of reasons, and they’re usually harmless and go away on their own. Mild stomach or chest discomfort is likely due to something I ate, or stress, or anxiety, or maybe I strained a muscle. Modifying our thoughts about our symptoms from catastrophic worst-case scenarios to more likely explanations can help ease our anxiety.

This often helps relieve our symptoms because if we have a headache or stomach ache or any uncomfortable sensations in our bodies and start getting really anxious about it, our anxiety can make these physical sensations stronger, whereas calming our anxiety helps calm these sensations as well. Learning to modify our anxious thoughts can be challenging, and I have some videos that can help.

There’s nothing wrong with occasionally monitoring symptoms or checking for new ones, but with health anxiety, these behaviors can become excessive and go far beyond what’s necessary to evaluate or catch health issues. One way to start reducing monitoring and checking is to schedule a health check-in in the evenings. During this time, we take a moment to assess how we’ve been feeling overall. We can note any new symptoms experienced during the day or any significant changes from the previous day. There’s no need to spend more than a few minutes on this.

We don’t want to engage in a prolonged checking session, just aim for a general awareness of how our health has been throughout the day. If we’re keeping a wellness journal, we can briefly note any significant symptoms and the context in which they occurred, and if something needs to be checked out, we can make a note to contact our doctors. If we’re already checking less frequently than this, it’s certainly not necessary to do this every day to maintain our health. This is just a strategy to reduce excessive checking and symptom monitoring throughout the day.

Then if we do start worrying about our health during the day or a symptom arises unexpectedly, unless it’s something that requires immediate medical attention, we simply acknowledge it. We can write down the worry or symptom if we think it’s important, briefly modify any catastrophic thoughts, “something’s wrong with my heart, it’s probably just anxiety or indigestion,” then rather than fixating on it or seeking reassurance right away, we just set it aside for now and postpone thinking about it until our health check-in later in the day. Then we redirect our attention back to our current task because continuing to think or worry about our health right now isn’t going to be productive, and it’s not going to accomplish anything except make us anxious.

Knowing we have time set aside later to reflect on our health makes it easier to not get caught up in minor sensations or symptoms we might experience throughout the day. This teaches us that our health anxiety isn’t uncontrollable, and we have the ability to focus our attention where we want it instead of constantly being carried away by worries about our health. If you do experience sudden, severe, or debilitating symptoms such as intense pain, a high fever, or difficulty breathing that isn’t related to a panic attack, it’s important to seek immediate medical attention.

We can try responding to health concerns and perceived symptoms with mindfulness. It’s completely natural to experience a range of body sensations throughout the day: general aches and pains, muscle tightness or tension, or tingling, digestive processes, and so on. Often, uncomfortable body sensations arise out of our emotions and have nothing to do with our physical health. I have a video that looks at this in detail.

Most of these sensations don’t require our attention. We don’t need to do anything about them. So when we notice the sensation in our bodies, we simply acknowledge it, “I’m starting to get a headache, there’s some tightness in my throat, there’s a funny feeling in my stomach,” and then as best we can, we gently shift our attention away from the sensation and back to whatever we’re doing.

Anytime a new sensation arises, we just use the same process of noticing and acknowledging it, maybe even reassuring ourselves with a phrase like, “This is just a natural body sensation, and it’s completely normal for feelings like this to come and go throughout the day,” and then we gently shift our attention away from the sensation and back to what we were doing. We might want to breathe with the sensation for a few minutes, which can help ease tension and calm emotions, using our breath to bring our awareness to the sensation as we breathe in and then allowing it to soften and relax as we breathe out.

If we start having thoughts about our body sensations like, “Oh no, there’s something wrong with me, what if I have cancer?” rather than getting caught up in these thoughts, we can respond to them mindfully and simply acknowledge them, “I’m having the thought there’s something wrong with me, I’m worrying what if I have cancer,” and then as best we can, we let these thoughts go and redirect our attention back to whatever we’re doing. We can add the qualifier “just,” “This is just a thought, this is just a worry,” which can help make it easier to let the thoughts go. I have a number of videos with various mindfulness strategies that can help us manage anxiety.

If we do get fixated on a body sensation and have trouble letting it go, we can try to distract ourselves by switching tasks, going for a walk, exercising, or engaging in any activity that requires our full attention. Grounding exercises that focus on the external environment can also help divert our focus away from internal sensations, such as naming five things we can see, four things we can touch, three things we can hear, two things we can smell, and one thing we can taste.

Now let’s look at reassurance seeking. If we have health anxiety, one of the most counterproductive things we can do is engage in online health research regarding our symptoms. If we look up every body sensation or symptom we’re experiencing, we’re going to find it could potentially be a symptom of any number of serious diagnoses. Also, we’re likely not qualified to make sense of the information we find and be able to distinguish between something that’s harmless or might indicate an underlying health issue. So this sort of checking doesn’t reduce our anxiety, it increases it by giving us lots of different health issues to worry about. Even if we do learn something that eases our mind for a moment, checking and reassurance seeking offers at best very time-limited relief. Once this time runs out, anxiety returns, and we feel the need to check again.

Of course, there are times when checking with a health professional is warranted, but it’s easy to go overboard. If we frequently seek medical advice for symptoms that turn out to be insignificant or get second and third opinions that tell us the same thing, we should talk to our health care providers about how often we should be consulting them. Instead of constantly seeking reassurance, we need to learn to reassure ourselves, which we can practice with a couple of strategies we’ve talked about already: modifying our catastrophic thoughts with more realistic interpretations and practicing mindfulness. We can reassure ourselves that a lot of the sensations we experience in our bodies are related to emotions: “This tightness in my throat is because I’m sad, this feeling in my stomach is anxiety, why am I so hot? It’s just my anger.”

Another key component in managing health anxiety is building up a tolerance for uncertainty. It’s impossible to have complete certainty about our health, and that can be stressful. Seeking constant reassurance or excessively monitoring symptoms doesn’t resolve the uncertainty, so instead, we need to learn to manage the uncertainty of not knowing whether a symptom is serious or not a big deal. The uncertainty associated with waiting for information from an upcoming doctor’s appointment, for test results, and so on. This practice of accepting uncertainty can reduce the compulsive need to seek reassurance and monitor symptoms excessively. I have a video that looks at ways to build up our tolerance for uncertainty that I’ll link to in the description.

Finally, avoidance, which is often accompanied by safety behaviors, actions taken to feel safer or to prevent feared outcomes. For example, we might frequently wash our hands, avoid touching door knobs, or carry medical supplies or instruments like a thermometer or blood pressure monitor at all times. We can reduce avoidance and safety behaviors through exposure, which involves intentionally placing ourselves in situations that make us anxious in order to learn that our feared outcomes are less likely than we predict, that we can handle these situations even if things don’t go the way we want, and that the anxiety we experience is manageable even if it’s uncomfortable. As a result, these situations start causing us less anxiety, we’re less compelled to avoid them, and we can resist engaging in safety behaviors. I have videos that describe how to practice exposure and exposure and response prevention, which is designed for OCD but can be helpful with managing safety behaviors and excessive checking in the context of health anxiety.

By changing the way we interpret our symptoms, reducing our symptom monitoring, checking, and reassurance seeking, and no longer practicing avoidance, we can start to relieve our health anxiety while also weakening or even breaking the connections that keep the cycle of health anxiety going.

Do you ever have a thought pop into your head and you just can’t stop thinking about it? OCD consists of persistent and distressing intrusive thoughts, images, or urges referred to as obsessions. These obsessions trigger intense anxiety or discomfort, which lead people to engage in repetitive behaviors or mental rituals called compulsions in an attempt to cope with or alleviate the distress.

In this video, we’re going to look at four main types of OCD and the best ways to treat them, focusing on obsessions.

Contamination-based OCD is characterized by obsessions about germs or contaminants leading to illness and compulsions like obsessive handwashing, sanitizing surfaces, and avoiding touching objects out of fear of getting sick or making someone else sick.

Responsibility for harm-based OCD is characterized by obsessions about being responsible for accidentally causing harm, such as leaving the stove on and burning down the house or accidentally hitting a pedestrian while driving. Compulsions involve constant checking and rechecking to try to prevent harm or ensure that no harm was done.

Symmetry, ordering, and arranging OCD is characterized by feelings of discomfort or dissatisfaction associated with the perception that things aren’t ordered or arranged symmetrically or that they just don’t feel right. Compulsive behaviors may involve meticulously arranging items until they achieve a sense of symmetry or perceived perfection or feel just right. Unlike other types of OCD, there often isn’t fear or anxiety about negative consequences of things not being arranged just right, just a strong uncomfortable feeling of incompleteness that needs to be resolved.

Taboo or forbidden or unacceptable thoughts OCD is characterized by obsessions regarding thoughts related to harm and aggression, sexuality, morality, or religion, such as “What if I push someone into traffic?” not accidentally like with a responsibility for harm-based obsession, but “What if I push them intentionally?” or “Am I a sinner?” The compulsion often involves avoiding situations that could trigger these thoughts, or compulsions may be mental rituals such as neutralizing thoughts by replacing bad thoughts with good ones, repeating prayers or affirmations, or excessively analyzing thoughts and behaviors looking for reassurance.

OCD in which compulsions don’t entail overt actions and behaviors but consist of covert mental acts and rituals is commonly known as pure O OCD for purely obsessional. While this technically still involves obsessions and compulsions, the compulsions are primarily internal cognitive processes, though there are almost always these at least subtle overt compulsive behaviors as well.

Treatment for OCD involves cognitive therapy to help reduce obsessions, which is what we’re going to focus on in this video, and a type of behavioral therapy known as ERP (exposure and response or ritual prevention) that helps reduce compulsions and compulsive behavior. I’ll talk about this in another video that I’ll link to in the description once it’s out.

Everyone experiences intrusive, unwanted thoughts throughout the course of our everyday lives. There’s nothing special about these thoughts, and just having them doesn’t automatically lead to OCD. People without OCD have the same types of intrusive thoughts as people with OCD. What matters is how we interpret these thoughts, and there are six types of beliefs that are associated with OCD. So, we’re going to look at these beliefs and some strategies to counter them, which can reduce obsessive thinking and will help with exposure and response prevention for compulsive behaviors that we’ll be learning in the next video.

One of these beliefs involves assigning excessive importance to our thoughts. We believe that merely having a certain thought implies that it’s meaningful and potentially dangerous. “I wouldn’t be thinking about this if it weren’t important. There must be some truth to it, or I wouldn’t be thinking it. Or if I’m having this thought, that must mean I want it to happen.” But just having a thought doesn’t imply significance or importance.

We have thousands of thoughts every day, and most of these thoughts come and go without us really noticing them. They’re just like background sounds in our minds while we’re focused on other things. But with obsessive thinking, sometimes what might be just a fleeting thought to someone else captures our attention because we find it personally significant and believe it reflects our true character, intentions, or future actions. For example, we have a thought of harming a loved one and then worry excessively that we’re a potential danger to that person, so we start to obsess over it. Or a thought might have an emotional pull; it triggers anxiety, and our anxiety leads us to perceive the thought as important and a sign of threat or danger. This is an example of emotional reasoning, but our emotional reaction to a thought is subjective; it’s not evidence of any objective threat. My anxiety is not evidence that I probably did.

One way we can give undue importance to our thoughts is what’s known as thought-action fusion (TAF) likelihood bias. We perceive that just thinking about something makes it more likely to happen. But having the thought “What if I accidentally harm my child?” doesn’t increase the likelihood that I will harm my child, and we can test this out. See how often your phone battery dies this week and then, every day next week, think about forgetting to charge your phone so it dies and see if your phone battery is more likely to die this week than it did in the previous week when you weren’t thinking about it.

With TAF moral bias, we believe that thinking about something bad is morally equivalent to actually doing something bad. So, let’s explore the strength of our TAF moral bias. Imagine a person who has intentionally driven their car onto a sidewalk trying to harm pedestrians. On a scale from 1 to 10, rate how morally reprehensible you find this. Now, imagine another person who has entertained the thought of driving their car onto a sidewalk but has never actually acted on this thought and rate this person on the same moral scale. If we find these two scenarios morally equivalent or close to equivalent, that reflects TAF moral bias. So, if we do find them morally equivalent, we can seek the opinion of friends and family about these scenarios, which will likely reveal that most people don’t regard bad thoughts as remotely equivalent to bad actions. And this can help loosen our TAF moral bias.

If we wonder why would we even have these bad thoughts if we weren’t bad people and didn’t want to do this at least on some level, well, everyone has thoughts pop into our heads about things we find immoral but would never actually act on. And that doesn’t make us bad people; that’s just how our minds work. And over-importance of thoughts is correlated with the belief that we need to control our thoughts and prevent ourselves from having these personally significant thoughts that we regard as dangerous. And this belief is particularly strong in taboo forbidden or unacceptable thoughts OCD. But no matter how hard we try, we just can’t control our thoughts in a way that allows us to prevent ourselves from ever having certain kinds of thoughts.

But learning to be mindful of our thoughts can help reduce obsessive thinking. Mindfulness involves being aware of the thoughts that enter our minds and simply observing them without judgment, allowing them to be there until they naturally pass away, similar to how we might respond to a sound we hear in the background. We just notice the sound and then let it fade away, and this is naturally what happens with intrusive thoughts if we don’t get caught up in them and start obsessing over them. They just come and go, much like background sounds. We can also use cognitive diffusion, which is a mindfulness technique that helps us get some distance from our intrusive thoughts so that we can let them go. I have videos that describe these strategies in detail that I’ll link to in the description.

OCD is also associated with a sense of inflated responsibility, the belief that we have the power to bring about or prevent negative outcomes, accompanied by feeling a strong responsibility to protect ourselves and others from harm. If there’s any chance we could prevent something bad from happening, we must do so at any cost. This can lead to compulsive checking. For example, someone with contamination-related OCD might fear that touching a doorknob or shaking hands will spread germs and cause people to get sick, leading to compulsive handwashing rituals.

One way to counter such beliefs is with what’s called a “responsibility pie,” which involves breaking down the feared scenario and systematically dissecting all of the possible contributing factors. It’s possible someone will get sick, and if so, sure, we might not have perfectly decontaminated our hands before shaking their hands. But the person could have been exposed to germs elsewhere in the office, or perhaps their kids caught a bug at school that they passed on. And even if they did contract something from shaking our hands, if they had practiced good hygiene and washed their hands afterwards, the risk of illness would have been diminished. Then, by assigning a percentage of possible responsibility to each factor and representing it on a pie chart, we gain a more accurate perspective and see that we’re not close to being fully responsible for preventing others from getting sick, which can reduce our need to engage in compulsive behaviors.

People with OCD also tend to overestimate threats, seeing situations as more dangerous than they actually are and exaggerating the likelihood and severity of harm, especially in situations that aren’t inherently dangerous. This belief is characteristic of contamination-based OCD as well as accidental harm-based OCD, where we overestimate the likelihood that we did leave the door unlocked and the severity of the consequences if that were actually true.

We can challenge these beliefs through cognitive restructuring, which involves changing or modifying a negatively biased thought with a thought that’s more accurate and better reflects reality. Here are some questions we can ask ourselves that can help us come up with a more balanced perspective that reduces the amount of anxiety we feel:

• What am I worrying or predicting will happen?
• How likely is it that what I’m worrying about will happen?
• What evidence do I have that it will happen?
• What evidence do I have that it may not happen?
• What are some other possible scenarios, other outcomes, other ways things might turn out?
• Looking at all of this information, what’s the most likely thing to happen?

I have a number of videos that go into cognitive restructuring in more detail.

OCD is also associated with an intolerance of uncertainty and the need to do everything possible to try to remove any and all doubt. Perfectionistic beliefs are also common with OCD, the tendency to think that there’s a perfect solution for every problem and that doing things perfectly without any mistake is not just achievable but also necessary. Even small mistakes are believed to have serious consequences.

So, how can we become more accepting of uncertainty and reduce our need for perfection? First, it’s important to recognize that in most aspects of life, absolute certainty and perfection are unattainable goals. We need to work on shifting our focus from aiming for certainty or perfection to tolerating a state of “good enough” and balancing our desire for certainty or perfection with the practical reality that absolute certainty or perfection is never entirely achievable.

In general, if we look at the benefits versus costs of seeking absolute certainty or perfection, we’ll often find that there are some short-term benefits, but these come at the expense of significant long-term costs. For example, we may get some temporary relief from anxiety and discomfort, and the illusion of control and attention to detail can lead to higher quality results. However, in the long term, we also experience increased anxiety and stress, and it’s very time-consuming and can damage relationships, lead to procrastination, and result in missed opportunities.

We can use cognitive restructuring to challenge our beliefs about the need for certainty or perfection, which we talked about in reference to assessing threats and danger more accurately. I describe strategies to do this in a number of other videos. Mindfulness can help us accept uncertainty and imperfections as we simply become aware of our thoughts, urges, or feelings regarding certainty or perfection and just acknowledge them, allowing them to be here without acting on them. We can try labeling these thoughts and urges and then gently letting them go. If they stick around, we allow them to be here but in the background of our awareness as we shift the focus of our attention to whatever we’re doing in the present or just something neutral like our breath. These mindfulness skills take some practice, but they’re things anyone can learn to develop.

Learning to reduce obsessive thinking is an important first step in managing OCD. In the next video, we’ll build upon this and look at exposure and response prevention, which targets compulsive behaviors and is regarded as the most effective treatment for OCD. You’ll find that video along with all the videos I mentioned here together on my website, so please check that out. Please hit the like button and subscribe to my channel. If you’d like to support my channel and help me make more videos like this, I really appreciate it. Please check out the donation links in the description.

Clark, D. A. (2020). Cognitive-Behavioral Therapy for OCD and Its Subtypes (2nd ed.). The Guilford Press.

Cognitive assessment of obsessive-compulsive disorder. Obsessive Compulsive Cognitions Working Group. (1997). Behaviour research and therapy, 35(7), 667–681. https://doi.org/10.1016/s0005-7967(97)00017-x

Do you ever get anxious not knowing what the future holds, worrying about all the what-ifs? Well, what if the key to reducing your worry and anxiety isn’t trying to plan for all possibilities or control what happens in the future, but learning to live with and accept uncertainty? Uncertainty is an unavoidable part of life, from everyday decisions to major events, whether it’s waiting for medical tests, facing career challenges, dating and relationships, dealing with unpredictable situations, and so on. Uncertainty influences many aspects of our lives, but a lot of people have difficulty tolerating uncertainty and the unknown and find it incredibly stressful and uncomfortable and can go to great lengths to avoid uncertainty even if it means sacrificing opportunities or happiness.

Intolerance of uncertainty, or fear or dread of the unknown, can be like a magnifying glass focused on negative possibilities, magnifying even minor uncertainties and making them feel overwhelming. Intolerance of uncertainty can lead to things like health anxiety, chronic stress, general anxiety disorder, and OCD. Learning to tolerate anxiety involves accepting the inherent unpredictability of life and developing strategies to live with the discomfort it can bring. This doesn’t mean we ignore risks or stop planning for the future, but that we learn to handle the unknowns in a healthier, more balanced way.

So how do we do this? First, we can challenge our beliefs regarding our need to avoid uncertainty by asking: what are the benefits of striving for certainty in life, and what are the costs? Well, there are often some short-term benefits. We may get some temporary relief from anxiety and discomfort and feel more in control, but in the long term, not learning to tolerate uncertainty leads to increased anxiety and stress.

Efforts to eliminate uncertainty and gain control over the unknown are very time-consuming. Constant reassurance seeking can put a strain on relationships, limits adaptability and openness to new experiences and opportunities, and makes it harder to cope with unexpected changes and challenges. Since we can never get rid of all uncertainty, ultimately, our attempts to do so are futile.

Common behaviors related to intolerance of uncertainty include seeking excessive reassurance from others, like repeatedly asking friends or family for advice or comfort whenever we start to feel anxious, or consulting a doctor or the internet every time we notice a possible health symptom, excessive list-making and planning, writing out scripts for phone calls or conversations, triple and quadruple checking for mistakes or to make sure that loved ones are okay.

These behaviors can be helpful or even important in moderation, but when they become excessive, not only can they consume us, they make us less equipped to cope with uncertainty since we never give ourselves a chance to learn to manage it better and more prone to anxiety in the future.

So we want to stop engaging in these types of behaviors, but the goal isn’t to just tolerate our anxiety over uncertainty through force of will. Willpower alone isn’t effective because eventually, we’ll usually give in and resort back to our old behaviors to try to get some relief. Instead, we want to approach things from a mindset that anxiety is a natural human emotion. It can feel really unpleasant or even distressing, but it’s tolerable, as is the discomfort that arises from uncertainty. We want to give ourselves the opportunity to learn that we don’t need to rely on these behaviors in order to tolerate anxiety and discomfort and that we’re able to function in our daily lives despite feeling anxious.

When our anxiety starts to rise, instead of trying to fight it off by resorting to our habitual behaviors, we respond to it mindfully. We start by acknowledging and accepting that we’re feeling anxious in this moment: I’m feeling anxious right now and that’s okay. It’s uncomfortable, but it’s not dangerous. It can’t hurt me, and I’m willing to experience it now in order to learn to manage anxiety better and improve my quality of life. Fighting it doesn’t even help; it can make my anxiety even stronger.

Responding to anxiety in this way often calms our anxiety at least a little. If we’re feeling really anxious or starting to panic, we can calm our anxiety with our breath, slowing down our breathing by breathing in through our nostrils for a count of two, pausing, and then breathing out through pursed or puckered lips for a count of four, and just continuing with this until we start to feel better. Allowing ourselves to experience uncertainty can be challenging, and learning emotion regulation and distress tolerance skills can help.

Now let’s look at our thoughts. If we have difficulty tolerating uncertainty when faced with the unknown, we often imagine and expect worst-case scenarios, the outcomes we fear the most, which increases anxiety and makes us worry even more.

To reassure ourselves, we can ask: Am I worrying about the worst possible outcome, and then, how likely is that to happen? Not very. What are some other possible scenarios, outcomes, or ways things might turn out? I’m pretty nervous and I make a few mistakes, but it’s good enough. Everything goes fine and I worried over nothing. What’s the most likely thing to happen? I do get pretty nervous and make a few mistakes, but everything’s fine. If that were to happen, how could I cope? It’s not a big deal. I’m my own harshest critic and others won’t even notice some of my mistakes. I definitely won’t lose my job.

Sometimes analyzing our anxious thoughts like this just feeds into our worrying and can make us even more anxious. Instead, we can try just letting go of our worries, which can be difficult to do on its own. So we can start by labeling our anxious thoughts as worrying, catastrophizing, worst-case scenario, which helps us focus on the nature of these thoughts rather than their content. This gives us some perspective, which makes the thoughts easier to let go. We can add the qualifier “just”: I’m just worrying. I’m just imagining worst-case scenarios, which creates some distance between ourselves and our worries and makes them easier to let go.

We can also use a technique called postponing worry, where we just write down our worries and then set them aside for now and postpone thinking about them until a scheduled worry period later in the day, by which point often our worries don’t seem that important anymore, and so we don’t need to worry about them. If they are important, we can deal with them now on our own terms and not just because a worry popped into our heads because we were feeling anxious. I have videos that go into these techniques in more detail.

Learning to tolerate uncertainty not only reduces anxiety, it also boosts our resilience and allows us to adapt more effectively to unpredictable situations, which helps us become more confident and flexible in the face of change. As a result, we’re willing to take more calculated risks and become more open to new opportunities and experiences.

This transcription was auto-generated by YouTube and formatted by ChatGPT.

Are you an overthinker? Excessively analyzing and evaluating things, sometimes to the point of becoming obsessive? When we overthink, we tend to focus on the negative aspects of a situation and can experience a sense of dread or anxiety. We might worry about something that’s coming up or hypothetical scenarios that may or may not happen. Or dwell with regret on our mistakes or anger about something that’s happened. Or stress about how we’re going to be able to manage everything we’ve got going on right now.

Or we might overthink what we say or do in social situations and then afterwards replay interactions we’ve had over and over in our heads. We can overthink personal issues such as relationships or health problems. And it’s really common to overthink decisions.

So why do we overthink, and what can we do about it? Often, overthinking arises out of fear of the unknown. We attempt to think through every possible outcome and scenario as we try to gain some control over a situation, hoping that eventually, we’ll figure out a way to resolve it that avoids any possible negative consequences. If we find ourselves doing this, we can ask ourselves, “Is this something I have control over?” And if it is, then we ask ourselves, “Is there anything I can do about this now?” And if there is, then rather than continuing to think about it, we take some action.

Engaging in productive action is an effective way to break free from overthinking, especially when it stems from feeling stuck or powerless in a situation. Shifting our focus towards taking action can help us feel more in control, lower our anxiety, and reduce the time we spend worrying, ruminating, and overthinking.

But often, there’s no action to take because our overthinking is an attempt to control the uncontrollable or to answer questions that just don’t have any answers, at least not with the information available to us right now. And so, these aren’t things we can act on, but we’re just so uncomfortable with the uncertainty, we keep trying to think our way out of it.

So setting boundaries and limits is crucial. Rather than allowing ourselves to constantly worry and overthink throughout the day, we set aside a specific time to spend 20 to 30 minutes looking at these situations and our thoughts and feelings about them. And we use this time for structured problem-solving or reflecting about a difficult situation, or maybe journaling or talking to a friend about what’s going on, or engaging in whatever activities help us explore our thoughts and feelings. And then once our 20 to 30 minutes are up, we allow ourselves to stop thinking about this because thinking about it any longer is likely to become unproductive and just lead us back into overthinking. So instead, we let go of these thoughts and move on to something else, which is easier said than done. But we’ll learn some strategies to help us do this in a moment.

Setting boundaries is also crucial if our overthinking stems from perfectionism and we get stuck agonizing over the smallest details. We can limit the time we give ourselves to find the best way to do something and set limits on our expectations. And resist falling into all-or-nothing thinking, recognizing that we can strive for a very high level but still be satisfied with the result that is good enough.

And if our overthinking is triggered by decisions, in addition to setting a time limit on how long we’re going to give ourselves to think about the decision, we can try to limit the number of decisions we have to make or limit the options or choices we give ourselves.

And then, regardless of the source of our overthinking, once we’ve reached whatever limit we’ve set for ourselves, rather than continuing to engage with our thoughts or trying to forcibly push them away, we can practice being mindful of our thoughts, which involves simply noticing our thoughts as they arise, and acknowledging them, and choosing whether or not we want to continue thinking about them right now. And if we don’t, rather than allowing them to pull our minds away from what we want to be doing or thinking about, which is often the first step in overthinking, we can simply let them go.

A common metaphor is to just allow our thoughts to come and go through our minds like clouds passing through the sky. They float into our minds, and we notice them, and then they float away.

Another mindfulness strategy is to label our thoughts. And as each thought passes into our minds, labeling it as thinking, or worrying, or obsessing, and so on. And this labeling helps create some distance between ourselves and our thoughts, reducing our tendency to get caught up in them. And using the qualifier “just” can also help give us some distance from our thoughts and put them into perspective, reminding ourselves, “I’m just thinking,” “I’m just imagining,” “I’m just having the thought I can’t deal with this,” or “This is just a thought and not a fact.” And when we create this distance between ourselves and our thoughts, it’s less likely we get pulled into a cycle of overthinking, and it becomes more possible to let these thoughts go.

Mindfulness is also a great way to prevent overthinking from getting started in the first place. We often become caught up in our thoughts without even noticing we’re doing it. But if we can become more aware of our thoughts as we’re having them, then we can choose how we engage with them and consciously decide whether or not this is a line of thinking we want to go down right now. And if our thoughts are unrelated to what we’re doing at the time, like worrying about our relationship while trying to get work done, then probably not.

And the 10-second rule can help whenever we notice overthinking starting to take hold. We pause for 10 seconds and take a slow, deep breath. And then, during this pause, remind ourselves that we have a choice in how we engage with our thoughts. And instead of getting carried away by worries or frustration, we can simply ask ourselves if dwelling on this issue right now is helpful or if there are better ways to approach it, like taking action if there’s anything we can do about it right now, or engaging in some sort of structured problem-solving. We’re just giving ourselves permission to not think about it now, letting the thought go, and refocusing our minds on whatever we want to be doing or thinking about.

We can also try modifying our negative thoughts. When we overthink, we often magnify problems and imagine worst-case scenarios. And these types of thoughts can be difficult to just let go. So it can be helpful to take a step back and try to objectively evaluate the situation. Ask ourselves if our thoughts are based on evidence or if they’re simply assumptions or fears. And then consider alternative perspectives and try to challenge negative or unhelpful thoughts that may not be completely accurate. And once our thoughts become less negative, less worrisome, or anxiety-provoking, there’s more chance we’ll be able to let them go.

But this can be a double-edged sword because it involves thinking about our thoughts. It can feed into more overthinking. So anytime we notice that we’ve slipped from trying to modify our negative thinking back to overthinking, we need to take a break, set some boundaries, postpone thinking about it until later, and come back to it with a clearer mind.

So sometimes we might prefer to take a few minutes to just write down our thoughts or worries without trying to change or modify them. And just this act of writing can help get our thoughts out of our heads and clear our minds a bit. And then, once we look at what we’ve written down, sometimes it can all seem a bit ridiculous, which can help make it easier for us to let go of thinking about this for now. Talking to a friend about what’s been going on and what we’ve been thinking about can have a similar effect.

And finally, distraction is often the first thing we try when we find ourselves overthinking. And sometimes it works. The more engaging the distraction, the more likely it is to help. Something like watching TV or scrolling through our phones often won’t be interesting or compelling enough to hold our attention, and our minds will keep wandering back to whatever we’ve been thinking about.

Doing something with our friends or something a little physical, like going for a walk, can help get us out of our heads a bit. But still, it’s often not enough to keep our minds from wandering back to whatever we’ve been thinking about. And many people find that strenuous exercise is the only thing that helps clear their minds. But even if distraction does work, often once the distraction ends, we resume our overthinking almost immediately. So distraction can be hit or miss.

But we don’t need to be discouraged if it doesn’t work because there are lots of other strategies we can try. And whatever strategies we use, the key is to implement them as soon as we’ve noticed we’ve started to overthink because that’s when they’re going to be most effective. And let me know in the comments how you manage overthinking.

This transcription was auto-generated by YouTube. I’ve only added minimal editing, so I apologize for any errors, run-on sentences, etc.

In this video we’re going to learn how to reduce anxiety and worry with a worksheet from cognitive behavioral therapy called a worry record. I’ve made a few videos about worry recently where we’ve looked at the difference between productive and unproductive worry; and how we can turn productive worrying into problem solving; and how to just let our unproductive worries go or postpone our worry and use a worry period later in the day. And then when we do look at our worries, a worry record is a great tool to find different ways of looking at situations that are causing us anxiety and as a result experience less anxiety and have less reason to worry.

If you’ve seen my other videos you’ve probably heard me talk about the close relationship between our thoughts and our feelings. When we feel anxious we tend to have anxious thoughts and worry a lot. And these thoughts and worries feed back into our anxiety, making us even more anxious; which leads to even more worrying, and so on. But if we’re able to change the thoughts that we’re having about the situation that’s making us anxious, we can decrease the amount of anxiety we’re feeling.

And then as we decrease our levels of anxiety our thoughts will naturally become less anxious, and we’ll start to worry les; which leads to a further reduction in anxiety; which leaves our thoughts less anxious; and reduces how much we worry.

Now when we’re anxious and worrying our thoughts tend to follow a certain pattern. First, we worry that something bad or unpleasant is going to happen. And this can take the form of predicting a negative outcome like, i’m not going to be able to get everything done on time; i’m going to let everyone down.

Or i think they’re mad at me, they probably don’t like me anymore. Or instead of an actual prediction our worries can take the form of a what if statement. What if i can’t get everything done on time? What if i let everyone down? What if they’re mad at me? What if they don’t like me anymore?

And second, we overestimate the likelihood that this bad outcome will occur. I’m sure i’ll never be able to get this done on time. I know i’m going to let everyone down. They must be mad at me.

And then we overestimate just how bad things will be: i’m going to get fired; they’re going to break up with me. And we underestimate our ability to cope with that negative outcome if it does arise: i don’t know what i’m going to do; i’m not going to be able to deal with it.

So the worry record is a type of thought record that focuses specifically on anxious thoughts and worry, and helps us challenge these worries and: either modify them so that they’re more accurate and less negatively and catastrophically biased; or we replace these worried thoughts with new thoughts that more accurately reflect the reality of our situations. And in both cases these modified or new thoughts lead to a reduction in our anxiety because of this close connection between our thoughts and how we feel.

So now let’s look at how the worry record helps us do this. So in part one of the worry record we start off by describing the situation we’re anxious or worried about. So for example an important project we have at work. And then we write down our feelings and emotions, describing them with single words like anxious, worried, nervous.

And we also write down any physiological symptoms or physical sensations we’re experiencing, because these can be such a big part of anxiety. So maybe there’s some tightness in our throats and our stomachs feel really tense. And then we rate the intensity of these emotions and sensations on a scale from zero to a hundred.

And then we write down what we’re worried about, what we’re thinking or saying to ourselves, or just whatever’s going through our minds. It’s too much work, i’m never going to get it all done. Or i’m going to have to rush everything and do a really bad job.

And then we write down what we predict is going to happen. I’m not going to get it all done. Or if i do it’s not going to be very good and i’m going to let everyone down and i’m going to get in trouble with my boss. And then we rate how likely we think it is this prediction will come true on a scale from zero to a hundred percent.

And so these last couple of sections relate to our tendency to overestimate the likelihood that something bad will happen, and also overestimate how bad it will be. And so as the worksheet continues we’ll generate more accurate estimations in both of these areas. And then in part two we challenge and modify our worries and predictions.

So we start by writing down all of the evidence that supports our prediction and all of the evidence that doesn’t support our prediction. So maybe the evidence for is something like: i do have so much work to do; i don’t have very much time; i know that when i’m anxious i’m not able to work as effectively as i usually do so i can’t even get as much work done as normal; when i’m rushed i never do my best quality work; and i know how important this project is for my boss and my colleagues.

And then the evidence that doesn’t support our prediction could be things: like i’ve never missed a deadline before; no one’s ever complained about the quality of my work; i often feel stressed at first but i always manage to make it work in the end; even if i didn’t do as good a job as i could it’s still probably going to be good enough; and even if i do let people down i’ve worked here long enough with good enough results that i’m not going to get fired over this one thing.

And if we get stuck trying to come up with evidence that doesn’t support our predictions we’re stuck on any of the questions coming up at the bottom of the worksheet there are series of prompt questions we can use to help us with our responses.

And now we ask ourselves what’s the worst that could happen. Well the worst case scenario is probably, i could lose my job over this. And then we ask ourselves if the worst case did happen, what could we do to help ourselves cope. And this helps address our tendency to underestimate our ability to cope if something bad were to happen. Well i guess i could live off my savings for a while while i look for another job, and if i run out of money i could even live with my parents for a while until i’m working again. And obviously these aren’t great options—nobody wants to be unemployed or have to move back in with their parents—but remember we’re looking at the worst case scenario here, which probably isn’t going to happen. But even if it does, at least there are some things we can do, even if none of them are ideal. And just knowing this can help reduce our anxiety a little bit.

And then we ask ourselves what’s the best that could happen. And this question is important because when we’re feeling anxious and worrying we have such a tendency to fixate on only the worst case scenario, which is going to leave us feeling as anxious as possible. So we need to remind ourselves that the worst case scenario isn’t the only scenario. And in the best case scenario probably nothing that bad happens. And then we’re going to look at the most likely scenario.

So maybe the best case scenario is, i get everything done on time and it turns out pretty well. And maybe the most likely scenario is, i’m really stressed for a few days and struggle to finish on time, but in the end i do get everything done, and even though it’s not my best work it’s perfectly fine.

And then we ask ourselves what are the consequences of continuing to worry about this. Well worrying makes me feel like i’m doing something, but really i’d be much better off spending my time actually working on the project rather than worrying about it. And the more i worry, the more difficult it is for me to focus when i’m trying to work, the more stressed i get, and the harder it is for me to get to sleep at night. And when i’m stressed and tired i can’t get as much work done and the quality of my work suffers.

So now based on our answers from the last section we come up with modified and alternative ways of viewing the situation and predicting what’s going to happen that don’t cause us so much anxiety and give us less reason to worry. If i’m able to focus on work and not worry so much i probably will be able to get it all done. And i might have to work late or even on the weekend or ask for some help, but one way or another i’m gonna get it finished.

And then we write down our new prediction about what we think will happen, which could be the most likely scenario we identified above, or it could be something slightly different like, i’m going to be really stressed and struggle to finish on time, but in the end it’ll get done even if it’s not my best work. And we rate the likelihood that our new prediction will come true on a scale from zero to a hundred percent.

And then we ask ourselves how much do i believe my original prediction now, and we re-rate how likely we think it is that prediction will come true. And then we go back and re-rate the intensity of the emotions and physiological symptoms and physical sensations that we identified in the first part, and write down any new emotions or physical sensations we’re feeling now.

And now with these new ways of thinking about the situation a new prediction about what will happen that’s not so catastrophic, our levels of anxiety will decrease and we’ll have less reason to worry. And you can download a worry record worksheet from my site selfhelptons.com where you’ll also find my complete self-help course for anxiety.

Now let’s go through another example. So let’s say the situation is, we got in an argument with our partners this morning and they haven’t been responding to our texts or calls all day. And we’re feeling anxious and sad and impatient, and we notice some tightness in our chests.

So what am i worrying about thinking or saying to myself? What if they keep ignoring me? What if they’re really mad at me? What if we get into a big fight over this? What if they want to break up with me? And then we write down what we predict is going to happen. We’re going to have a big fight about this tonight and maybe we’re even gonna break up. And then we rate how much we believe this prediction.

And now in part two we look for the evidence that supports and that doesn’t support our prediction. They were upset this morning they haven’t answered my texts all day. They’ve seemed kind of distant lately and we’ve been arguing a lot. This is exactly how my last relationship ended.

And now we look at the evidence against our prediction. I can’t read their mind and so i don’t know what they’re thinking. Maybe they’re just too busy to respond right now. And i know they don’t like arguing over text so maybe they’re just waiting until we can talk about this in person. This relationship is so much different than my last one, there’s no point trying to compare the two. We’ve had plenty of arguments before and we’ve always worked things out.

And what’s the worst that could happen? Well the worst that could happen is that we break up. And if the worst did happen how would i be able to cope with it? I’ve had relationships end in the past and i’ve always gotten over it. I’ve got some close friends that would be there for me and i’d be miserable for a while but eventually i’d be okay. And again this isn’t great but remember we’re looking at the absolute worst case scenario, which is probably not going to happen. But even if it does at least we know that we’ve been in similar situations before and found a way to manage.

And now what’s the best thing that could happen? They’re just busy right now and they’ll text or call us back as soon as they have time. And what’s the most likely thing that could happen? Well we’ll talk about things tonight and probably even argue over them, and in the end we’ll resolve things and make up like we always do. And what are the consequences of continuing to worry about this? Well it’s just going to make me feel bad all day. I’m going to have trouble focusing on anything else. And i’m going to be in a bad mood when we do talk about things.

So what’s a more balanced or alternative way of thinking about this situation? I don’t know why they’re not responding to me. Maybe they’re just busy or maybe they’re just waiting until they get home so we can talk in person. And even if we do end up in a big argument, we’ll probably work things out and make up just like we always do.

And then we ask ourselves, what am i now predicting will happen? We’ll talk things over tonight and maybe we’ll even fight a bit, but in the end we’ll figure things out and it’ll be okay. And we rate how much we believe this new prediction. And we go back and re-rate how likely we think it is our original prediction comes true. And then we re-rate the intensity of the emotions and physical symptoms we identified in part one, and write down any new emotions or physical sensations we’re experiencing now.

So whenever we’re not able to problem solve what we’re worried about, or just let our unproductive worries go, the worry record is a great tool to help change our anxious thoughts, which then reduces our anxiety, and gives us less to worry about.

One of the basic premises of cognitive behavioral therapy is that our thoughts have a powerful influence on our moods and how we feel. If we can change our thoughts – change the way we’re thinking about situations or circumstances we find ourselves in – then we can change the way we feel. So if we’re feeling anxious and having a lot of anxious thoughts, if we can change or modify the nature of these thoughts to make them less anxious, then our levels of anxiety will decrease. In cognitive behavioral therapy, we change or modify our thoughts with a technique called cognitive restructuring. In this video, we’re going to learn how to use cognitive restructuring to modify our anxious thoughts in ways that help make us less anxious.

When we have anxious thoughts, we tend to overestimate the likelihood that something bad will happen and overestimate how bad things will be, and underestimate our abilities to cope with bad things if they do occur. Sometimes it’s just one of these, and sometimes it’s two or all three.

My boss wants to meet with me this afternoon. She must be disappointed with my work. I’m probably gonna get fired, and then I’m never gonna be able to find a new job.

My partner was supposed to be home an hour ago. They’re not answering my texts. Something must have happened to them. What if they were in an accident? What if they’re really hurt?

I have to go to Sam’s birthday thing this weekend. It’s going to be really uncomfortable. I’m not going to know anyone there. I’m not going to have anything to say to anyone. Everyone’s going to think I’m some kind of weirdo. I’m just going to embarrass myself.

Oh no, what’s this feeling in my chest? What if there’s something wrong with me? I’m having a heart attack. I’m starting to have trouble breathing. I think I’m dying.

When we have these types of thoughts, they make us anxious. If we’re already feeling anxious, we tend to have more of these thoughts, which make us even more anxious, leading to even more anxious thoughts that increase our anxiety, creating a vicious cycle. The more anxious we are, the more anxious thoughts we have, and the more anxious thoughts we have, the more anxious we feel, and so on. But if we’re able to change our thoughts with cognitive restructuring to make them less anxious, then we reverse this cycle. As our thoughts become less anxious, our levels of anxiety begin to decrease, which leads to us having fewer anxious thoughts, which reduces our anxiety even more, and so on.

When we have these types of thoughts, they make us anxious. If we’re already feeling anxious, we tend to have more of these thoughts, which make us even more anxious, leading to even more anxious thoughts that increase our anxiety, creating a vicious cycle. The more anxious we are, the more anxious thoughts we have, and the more anxious thoughts we have, the more anxious we feel, and so on.

But if we’re able to change our thoughts with cognitive restructuring to make them less anxious, then we reverse this cycle. As our thoughts become less anxious…

So, how does cognitive restructuring work? How do we change these thoughts to make them less anxious? We can’t just change our thoughts because we decide we want to. If we try to do this and engage in some sort of positive thinking, for example, if we’re having the thought, “This is going to be terrible,” and we tell ourselves, “No, you can’t think that, it’s making you anxious, you need to change that thought to ‘This is going to be great’ or even ‘Everything’s going to be fine,” the problem is we don’t believe that this is going to be great or that everything is going to be fine.

And since we don’t really believe these thoughts, they’re not going to affect the way we feel, they’re not going to make us any less anxious. If anything, this type of positive thinking only makes us feel worse because we’re trying to force ourselves to believe things that we don’t really think are true. So the key to cognitive restructuring is to replace or modify our existing thoughts with thoughts that are less anxiety-provoking but that we can believe. Let’s learn how to do this.

So, first, we start with a thought we’re having that’s associated with our anxiety. Then we’re going to assess how accurate that thought is. We want to see how well that thought fits the facts of the situations or circumstances we find ourselves in that we’re feeling anxious about. And then if we discover that our thought isn’t that accurate, it doesn’t fit the facts that well, then we change that thought to make it more accurate so that it fits the facts better.

And instead of just trying to come up with a new thought off the top of our heads to replace this anxious thought with, there are a series of questions we can use as prompts to help us come up with new less anxious thoughts or ways of looking at things. You can pause the video and read over them now if you like, or you can download a copy of these questions from my website from the link in the description. But we’re also going to go through them now with some examples. And it can help to actually write down our answers because that gets us out of our heads a bit, and sometimes it’s easier to see things from a different perspective when we’re looking at them on paper rather than trying to sort it all out in our heads.

So, we have a presentation coming up that we’re feeling anxious about. So we ask ourselves, what’s going through my mind? What am I thinking? I hate speaking in front of people. I’m no good at it. It’s going to be terrible. And what am I worrying will happen? I’m going to embarrass myself and let people down. What am I predicting will happen? I’m not going to be prepared enough, and I’m going to forget what I want to say. And then what’s the worst-case scenario? I’ll completely freeze and make a fool of myself, and people will think I’m stupid, my boss will be disappointed, and it’s going to hurt my career.

What evidence do I have that this worst-case scenario will come true? I’m always uncomfortable when I speak in public. I never do as well as I think I should.

What evidence do I have that the worst-case scenario may not come true? Even if it hasn’t always been perfect, it’s always gone okay when I’ve given a presentation, and I’ve always managed to get through it. How likely is it that the worst-case scenario will come true? It’s not very likely.

If the worst-case scenario did happen, what could I do to help me cope with it? If I start to freeze and figure out what I’m supposed to say, I can drink some water to help calm myself down and gather myself, and then I can start reading off my notes for a bit until I get back on track. What are some other possible scenarios, other outcomes, other ways things might turn out? It could go fine, and no one will notice that I’m nervous, and I might stumble a bit, but I’ll get through it. And what’s the most likely thing to happen? Well, I’ll be nervous beforehand, and when I first start speaking, but once I’ve been going for a while, I’ll settle down, and I’ll do okay, even if it’s not perfect.

So if that most likely case scenario were to happen, how could I cope? Well, there’s not much to cope with, and that actually isn’t so bad.

Have I ever been in a similar situation? How did that turn out? How was I able to cope then? Well, I always feel really nervous when I know I’m going to have to do a presentation. I never feel like I’m prepared enough, and I usually make a few mistakes or forget something, but nothing bad has ever really happened, and I’ve always gotten through it.

And what have I learned from past situations that can help me deal with what I’m going through now? Well, I’ll be uncomfortable when I first start talking, but then I’ll calm down, and things will go okay. Even though I never feel prepared, I usually prepare really well, and so if I get stuck, I can always refer to my notes until I get back on track.

What advice would I give to a friend or loved one who is in a similar situation, or what advice might a friend or loved one give to me? Just prepare as much as you can and know that you’re probably going to be nervous at first, but a lot of people get nervous speaking in front of people. If you stumble over a few words or speak too fast or forget something, people will understand, and once you start talking, you’ll start to feel less anxious, and it’ll probably go okay. And you’ve never completely messed up a presentation in the past, so there’s no reason to think you will now.

So is there another way of thinking about the situation that’s more accurate or fits the facts better? I’ll probably be really nervous at first and feel unprepared, but once I start talking and settle into the presentation, I’ll start feeling less anxious, and the presentation is going to be fine.

We started off thinking, “This presentation is going to go terribly. I’m really going to mess it up,” and this perspective causes us a lot of anxiety. But then after some cognitive restructuring, we’re able to come up with a way of looking at things that’s more accurate and fits the facts better and helps us feel less anxious.

We don’t have to use all of these questions, just whichever ones seem most relevant or helpful for the situation. So let’s look at a couple more examples.

I’m feeling anxious about going to my friend’s birthday party on the weekend. What am I worrying will happen? Well, that I won’t know anyone there. What am I predicting will happen? I’ll be too uncomfortable to talk to anyone, and the worst-case scenario is I’ll just stand in a corner by myself looking stupid, or I’ll try talking to people, but I won’t have anything to say, and I’ll just embarrass myself.

And how likely is this worst-case scenario? Well, I probably won’t embarrass myself, but there’s a good chance I spend a lot of time avoiding people I don’t know, just staring at my phone.

And what evidence do I have that this worst-case scenario will come true? Well, when I’m around a group of people I don’t know, I’m usually very uncomfortable and quiet and keep to myself.

And what evidence do I have that it won’t come true? Well, I usually find at least one person I know that I can talk to, and even if I don’t, there’s usually someone friendly who comes over and starts talking to me.

And that’s also the most likely scenario. I’ll know someone there, but even if I don’t, someone will start talking to me, and as long as they’re outgoing enough, I usually don’t have a problem holding up my end of the conversation. And then once I’ve talked to one person, I start feeling less anxious, and I start enjoying myself.

And if the worst-case scenario does come true, how could I cope? Well, I can stick around for a while feeling uncomfortable and then go home, and at least Sam will know that I showed up, and that’ll mean a lot to them.

We started off thinking, “I’m not going to know anyone. I’m not going to have anything to say to anyone. I’m just going to look stupid or embarrass myself,” which causes us a lot of anxiety. But then after some cognitive restructuring, we end up with a more accurate perspective that fits the facts better, something like, “I felt this way about going to parties before and still had a good time, but I might be uncomfortable and not have much to say to anyone, and if that happens, I can just go home,” and this new perspective and new way of thinking about the situation reduce the amount of anxiety we’re experiencing.

Or finally, I notice an uncomfortable feeling in my chest, and I start worrying. I think I’m having a heart attack. The worst-case scenario is I’m having a heart attack, and I’m about to die. And obviously, as soon as we start thinking about this worst-case scenario, it causes us a lot of anxiety. But how likely is that worst-case scenario? Well, I’m pretty young, and I’ve never had any problems with my heart before, so it’s probably very unlikely that I’m having a heart attack.

What evidence do I have that the worst-case scenario will come true? Well, I feel horrible right now, and I’m not sure why my heart is pounding like this.

So what are some other possible scenarios? It feels like a heart attack because my anxiety has set off the fight-or-flight response, and that’s caused my heart to start racing, and it’s probably just a panic attack.

What have I learned from past situations like this? Well, I’ve had a lot of panic attacks in the past, and they often feel like a heart attack at first, but they always turn out to be just a panic attack.

And if this most likely scenario is true, what can I do to help me cope with it? If I can slow down my breathing, I’m usually able to prevent a full-blown panic attack, but even if I can’t, once the panic attack passes, I’m going to be okay.

So I’m not having a heart attack, I’m having a panic attack, and I have some tools that can help me cope with it, and even if they don’t work, I know that once the panic attack passes, I’m going to be okay.

So with the help of some cognitive restructuring, we’re able to change our initial thought that’s causing us so much anxiety, “I’m having a heart attack and I’m gonna die,” to a new, more accurate thought, “This is a panic attack and it feels really scary and uncomfortable, but it’s not gonna kill me and I’m gonna be okay once it passes,” and this new way of looking at things reduces our anxiety, which also makes it less likely that things do escalate into a full-blown panic attack.

So in each of these examples, we took our initial thoughts about a situation that were causing us a lot of anxiety and modified them with cognitive restructuring into a more accurate way of looking at things that reduces our anxiety.