Worrying occasionally is common and nothing to “worry” about!

1. Worry Controldeveloped by Sandra Haddad and Carol Yoken at the Counseling Center, University of Cincinnati

2. Worrying occasionally is common and nothing to “worry” about! Worrying frequently can interrupt your socializing, studying, working, and other activities.

3. Understanding worry • What is worry? • What are common examples of worry? • Why do people worry? • Is there a difference between useful worry and useless worry? • How can you control worry?

4. Anxiety • Worry is a cognitive, or mental, form of anxiety • According to Aaron Beck, founder of Cognitive Therapy, anxiety serves to maintain our “survival, growth…” • Anxiety is a natural reaction to fear, danger, complex events, and the unpredictability of the future.

5. Common examples of worry • You worry that you are losing a friend. • You worry that you are not doing well in school. • You worry that you might lose your job.

6. What about you? • What are some of the things you worry about? Be specific. ___________________________________ ___________________________________ ___________________________________

7. Why worry? Sometimes, worrying can help. It directs you to focus on how you can “resolve problems and anticipate and prepare for future events” (Sanderson, 1992). For example: You worry that you won’t do well on your exam. • The worry tells you to prepare—read, study, ask questions….

8. Useful worry • “Worry can serve a very adaptive function by helping us to prepare or problem-solve and decide upon ways of coping with upcoming difficult situations….” (Craske et al.)

9. Useful worry vs. useless worry • Worrying is useful when: • You are able to control the worry rather than letting it control you. • It is a signal for you to start problem-solving or searching for a solution. • It gets you thinking about a plan. • It leads to a productive outcome.

10. Worrying is useless when… • You repeat the same worries over and over (ruminating). • It takes up a lot of your time and energy. • You overestimate bad things happening. • You always predict the worst outcome. • It causes physical problems like head or stomach aches, difficulty sleeping or eating.

11. Ways to control worry • Practice thought-stopping • Schedule worry time • Evaluate your worries • Use your worries • Learn ways to relax

12. Thought stopping According to Joseph Wolpe, a behavior therapist, 1. The word “STOP!” distracts you temporarily from whatever thought you might be having. 2. Once you say “STOP!” you can begin to replace your worry thoughts with positive and productive thinking.

13. Say STOP! to replace any worry or negative thought you might be having. (You can say it silently.) • Put it off until your worry appointment (see below). Or… • Replace that negative thought with a more positive one.

14. For example • You are sitting in class, and your teacher assigns a paper. • You begin to worry about the paper. • Tell yourself to STOP! • Put this worry off until your worry appointment, or replace the worry with something constructive.

15. Places I might try thought –stopping are: _____________________________________ _____________________________________ _____________________________________

16. Scheduling worry time What? Scheduling worry? Yes! Set up a worry appointment with yourself.

17. Putting the worry off until your appointment helps you feel more in control…and saves your time for better things. • You’ll probably feel happier if you worry less often.

18. The goal of a worry appointment is to contain your worry to a time and place that you control. • At first, you may have appointments daily. • After a while, you may decrease the frequency or duration of the appointments. • You determine the time you need.

19. Set aside about half an hour – but not before bedtime. • Dedicate this time to worrying ONLY. • If you find yourself worrying beforehand, make a note of the worry and come back to it at your appointment time. • At worry time, let all your worries come back. Look at them. Think about them.

20. I am worried about__________________. • I will make my worry appointment for this matter for ______________________. (day, date, time—from when to when?) • I promise myself I WILL WORRY THEN AND ONLY THEN.

21. Did you forget some worries? Maybe those worries aren’t that important. • Are some worries still nagging at you? Make regular appointments to worry, but also consider your worries.

22. Evaluate your worries • Is your worry realistic? Or are you only seeing the negatives? • Overestimating how awful things may turn out? • Ignoring the evidence to the contrary?

23. My first worry is ___________________. • What’s the very worst that can happen? • What’s the likelihood that the very worst will actually happen? 100%? Not likely!

24. My second worry is about ___________________. • I’m afraid what will happen is _______________ __________________________________________. • The likelihood of this really happening is less than 100%. It’s probably between _________% and ________%.

25. Do I really need to worry so much??!! □ Yes □ No (hint: no)

26. …Add constructive thoughts about the problem This problem is not so big, really. It’s not that unusual, either. With a reasonable plan, it’s totally manageable.

27. …Add constructive thoughts about yourself • I have many abilities to address this problem I can: 1. ___________________________________ 2. ___________________________________ 3. ___________________________________

28. Use your worries • Rather than just worrying about something DO something about it! • When you identify actions to fix the situation (i.e., prepare better for the next exam) then you have turned worry into something positive. You have made a plan to tackle the issue.

29. Write ‘em down • When you find yourself worrying about something, write it down. • When you look at it on paper, it all may become clearer to you, and you stop the circular process of worrying. • You can now look at your concern and work on it.

30. Use your worries—advanced version • If you have more time and dedication, you can make a list of worries and then turn it into goals for effective and productive problem solving. The following two slides are adapted from: Davis, M., Eshelman E.R., McKay, M. The Relaxation and Stress Reduction Workbook. (2000). 5th ed. Raincoast Books.

31. How-to… 1. Make a list of things that worry you. 2. Brainstorm about possible solutions without making any judgment at this point. 3. Evaluate those solutions to see which ones seem possible and impossible. 4. Put a √ mark next to the ones that are possible, and an x next to the ones that feel impossible.

32. 5. Set a deadline for the √ marked items. 6. Once the √ marked items have been tackled, move onto the more difficult ones that you marked with an x. 7. The x marked items might not seem impossible as you originally thought.

33. Relaxation • Relaxation is a good way of dealing with stress in every day life. • “Deep relaxation refers to a distinct physiological state that is the exact opposite of the way your body reacts under stress or during a panic attack” (Bourne). • Deep relaxation can have mental as well as physical effects.

34. Mental effects of relaxation • Reduces anxiety • Prevents stress from building • Improves concentration • Increases self-confidence • Increases awareness of feelings

35. Physical effects of relaxation • Lowers heart rate. • Slows breathing. • Lowers blood pressure. • Lowers muscle tension.

36. Relaxation • Deep breathing. • Progressive muscle relaxation. The following 4 slides are adapted from: Davis, M., Fanning, P., McKay, M. Thoughts and Feelings: Taking Control of Your Moods and Your life. (1997). Raincoast Books.

37. Deep breathing • This may feel funny or unnatural at first, but the more you practice the more you will see results. • Set aside a time and find a quiet place for relaxation.

38. Slow, deep breathing • Place one hand on your abdomen beneath your ribcage. • Inhale slowly through your nose into the bottom most part of your lungs. • Pause for a second, and then exhale for a count of 10 through your nose or your mouth. Exhale fully. Let your body go. • Do this 10 times.

39. Muscle relaxation • Three deep abdominal breaths • For each of the following muscle groups, tighten for 7-10 seconds and then release for 15-20 seconds. • Clench fists. • Tighten biceps (bend arm to shoulder) • Tighten triceps • (hold arms out straight and lock elbows) • Tense forehead (raise eyebrows) • Tense eyes (close eyes tight)

40. 9. Tense jaw (open wide) 10. Tighten back (bend head back gently) 11. Weight of your head on chair/couch 12. Tighten your shoulders (shrugging) 13. Tighten your chest (take a deep breath) 14. Tighten your stomach (suck it in) 15. Tighten your lower back (arc up – leave out if back pain) 16. Tighten your buttocks

41. 17. Tighten your thigh muscles 18. Tighten your calf muscles (pull toes toward you) 19. Tighten your feet (curl toes down) 20. Scan body for tension. If an area is tense repeat cycle for that area. Let the wave of relaxation spread through your head to your toes.

42. Still worried? Relax. It takes time (and practice).

43. References • Beck, A.T., Emery, G., Greenberg, R.L. (1985). Anxiety Disorders and Phobias: A Cognitive Perspective. Basic Books. • Bourne, E.J. (2000). The Anxiety and Phobia Workbook. 3rd ed. New Harbinger Publications Inc. • Craske, M.G., Barlow, D.H., O’Leary, T.A. (1992). Graywind Publications Incorporated. • Davis, M., Eshelman, E.R., McKay, M. (2000). The Relaxation and Stress Reduction Workbook. 5th ed. Raincoast Books.

44. Davis, M., Fanning, P., McKay, M. Thoughts and Feelings: Taking Control of Your Moods and Your life. (1997). Raincoast Books. • University of Idaho Counseling and Testing Center website: http://www.ctc.uidaho.edu/default.aspx?pid=64768 • Why do people worry and how one can overcome it? website: http://drsanderson.com/worry.htm