A Case Study In Worry
A CASE STUDY IN WORRY
To a point worry is helpful and is a useful prompt to refine our thinking, such as checking your passport and PCR test on your way to the airport. However, too much can be unhelpful if it is continuous and is accompanied by catastrophic thinking about our action or inaction.
Here is the case of Mr Worry:
“Poor Mr Worry.
Whatever happened, he worried about it.
If it rained, he worried that his roof was going to leak.
If it didn’t rain, he worried that all the plants in his garden were going to die.
If he set out Shopping, he worried that the shops would be shut when he got there.
And when the shops weren’t shut when he got there, he worried that he was spending too much money shopping.
And when he got home with his shopping, he worried that he’d left something behind, or that something had fallen out of his basket on the way home.
And when he got home, and discovered that he hadn’t left anything behind, and that nothing had fallen out of his basket on the way home, he worried that he’d bought too much.
And then he worried about where to put it all.
Life was one long worry for poor Mr Worry.”
Maybe you’ll have read or seen ‘Mr Worry’ from the Mr Men children’s book series by Roger Hargreaves, the TV version beautifully narrated by Arthur Lowe.
Mr Worry is living his life in his head and not really enjoying it all that much. For example, Mr Worry is lonely. He worries about everyone else, but he doesn’t spend time with them.
In the story Mr Worry meets a helpful sort of wizard who listens and encourages Mr Worry to write down all his worries. The wizard looks at the content of the list and tells him not to worry about them, that he’ll take care of them. Mr Worry is very relieved. But he wakes up a few days later and he’s worried. Why? Because he has nothing to worry about! The wizard and Mr Worry haven’t addressed the process of worry and haven’t developed a formulation of what is maintaining the worry and so haven’t developed helpful alternative strategies. The wizard is a well-meaning but unhelpful kind of wizard.
People who worry a lot may also find themselves on edge, they are tired, they find it hard to concentrate, their mind goes blank, they are irritable, they find it hard to relax, are tense, there is sleep disrupted, they find it hard to make decisions, they are always expecting the worst, they move from one worry to another, feel out of control, are unproductive and inefficient with time, are low on confidence, muddled, and overwhelmed. These are all signs of worrying too much. We all worry, but we usually save it for the big things in life. Worrying and subsequent anxiety can be undermining, exhausting, and can lead to depression which can seem to come out of the blue.
Worry is an anxiety process across many different anxiety problems, the most common of which is in Generalised Anxiety Disorder (Generalized Anxiety Disorder (GAD) DSM-5 300.02 (F41.1). GAD affects about one in 20 of us. Thinking often involves a stream of ‘What ifs’ and typically in GAD there is no resolution because it is circular thinking, which perhaps why Mr Worry woke up worrying that he wasn’t worrying. The wizard didn’t show him alternative helpful strategies to worry.
Worry is like a rocking chair, you can talk about it forever, but often it won’t get you anywhere unless the process of worry is addressed. Perhaps Mr Worry has only one problem, and that is that he worries too much!
Fortunately, there is a very effective empirically sound psychological treatment available in evidence-based Cognitive Behavioural Therapy. Duration is usually last between 6-20 sessions. Typically for GAD between 8-12 sessions.