CBT for Worry

Therapy for Managing Anxiety in Canary Wharf

Do you worry a lot?
Do other people call you a “worrier”?
Do you find it hard to stop worrying?
When it comes to the future, do you predict that things will turn out badly?
Do you worry about the fact that you worry?
Are you experiencing symptoms like muscle tension, restlessness, difficulty concentrating or sleep problems?

If you answered yes to at least three of the above, you may suffer with Generalized Anxiety Disorder and might benefit from anxiety therapy.

What is Generalized Anxiety Disorder (GAD)?

Generalized Anxiety Disorder is an anxiety disorder characterized by excessive and uncontrollable worry. The worries tend to be about day-to-day events, i.e., the health of your loved ones, your finances, the mess your workmen might leave, arriving late for a meeting, etc. People with GAD can worry about anything.

CBT for worry - woman with head in her hands

What are the Symptoms of Generalized Anxiety Disorder?

Typically, a person with generalized anxiety disorder (the official term for “Worry”) experiences uncontrollable worry, accompanied by restlessness, feeling on edge, sleep disturbance, feeling tired much of the time, difficulty concentrating, irritability, and muscle tension. Most worriers describe constant anxiety and find it hard to stop worrying.

Many people with GAD find it difficult to “switch off”. They describe a racing mind, and an inability to stop worrying. As a result, they are unable to relax, their sleep can suffer, and they don’t enjoy life because they are too busy worrying about day-to-day events.

What are the Symptoms of Generalized Anxiety Disorder?

Typically, a person with generalized anxiety disorder (the official term for “Worry”) experiences uncontrollable worry, accompanied by restlessness, feeling on edge, sleep disturbance, feeling tired much of the time, difficulty concentrating, irritability, and muscle tension. Most worriers describe constant anxiety and find it hard to stop worrying.

Many people with GAD find it difficult to “switch off”. They describe a racing mind, and an inability to stop worrying. As a result, they are unable to relax, their sleep can suffer, and they don’t enjoy life because they are too busy worrying about day-to-day events.

CBT for Worry can help you manage your anxiety better

Doesn’t Everyone Worry?

Everybody worries from time to time. It’s normal to worry at times of stress, i.e., when you are trying to conceive, going for a job interview, thinking of changing jobs, or perhaps leaving your relationship. But there is a difference between “normal” worry, and unhelpful or unproductive worry. Those who suffer with GAD tend to engage in unproductive worry.

Unproductive worry has the following qualities:

Catastrophic thinking: predicting that a negative outcome will occur, and if it does, doubting your ability to cope.
Intolerance of uncertainty: you find it very difficult to accept the unknown and so seek every ounce of reassurance you can that your worst fear will not happen.
Ineffective problem-solving: since most of the events that you worry about are future-oriented, (i.e., they haven’t yet happened), attempting to solve them only leads you to a heightened state of anxiety.
Difficulty accepting risk: unproductive worry leads to attempts to abolish any possibility of future danger, or at least minimize the chances of negative events occurring. These attempts are exhausting, time-consuming and unrealistic because accepting an element of risk and uncertainty is part of life!
Worry about Worry: worriers don’t only worry about day-to- day events, but also about their inability to control their worries. Common worries include:

So When Does Normal Worry Become Unproductive?

Clinically, we consider worry to be a problem when it occurs frequently, when it is long in duration (i.e., it lasts hours or days), and when it causes you a significant amount of distress (you can’t sleep, or you are distracted by your worries to the extent it interferes with your day-to-day tasks).

How Common is GAD and What Causes it?

It is thought that 5% of the population experience GAD. Many sufferers say they have been a worrier for years, and that they worry about everything. Like many anxiety disorders, there are different risk factors involved in the development of Generalized Anxiety Disorder.

Temperament/Biology: it is thought that individuals born with particular temperaments are more likely to develop Generalized Anxiety Disorder. “Children who are behaviourally inhibited are more easily distressed and react quite easily to novel stimuli” (Fox & Frenkel, 2013). We also know that individuals with GAD are often found to have an imbalance of brain chemicals (serotonin, dopamine and norepinephrine) and this could be a contributing factor to developing GAD; an imbalance of these chemicals can affect emotional stability. It’s also thought that in people with GAD, the amygdala has become highly sensitive and thus it reacts with a high stress response.

Genetics: many anxiety disorders are hereditary and GAD is no different. In fact, GAD has a higher genetic component than other anxiety disorders. One twin study found that genes accounted for nearly 40% of the development of GAD in twin males.

Stress: it is thought that individuals exposed to stressful events either during their childhood, or in adulthood, are at a higher risk of developing GAD. Examples of stressful events include the death or illness of a loved one, or going through an illness oneself. Often when we experience an illness, either of our own, or of a loved one, it can trigger worries and anxiety, which sometimes don’t improve, even if/when the illness does.

Traumatic Experiences: abuse in childhood can also put an individual at a greater risk for developing GAD. The experience of abuse can lead to a state of hyper-vigilance (always on the lookout for danger) -a feeling of constantly being on edge, and feeling wired up. This is a normal and natural response to abuse. The problem is when the response carries on, long after the abuse is over.

Why Does Worry Persist?

There are a number of reasons worry persists:

Positive Beliefs About Worry

Individuals who suffer with excessive worry tend to have a number of positive beliefs about worry, including, worry:

Helps me to problem-solve
Prepares me for bad outcomes
Protects me from negative emotions associated with bad outcomes
Shows that I am a loving and caring friend/partner/parent/child
Motivates me (“if I didn’t worry, I wouldn’t get anything done”)

“What-If” Thoughts and Fortune-Telling

Individuals who suffer from GAD typically spend a lot of time predicting the future. They engage in “what-if” thoughts, thinking that if they can anticipate the future this will reduce the uncertainty of what lies ahead.

Some examples of uncertain situations include:

Helps me to problem-solve
Prepares me for bad outcomes
My child has a cold but what if it’s something more serious?
up for promotion but what if I won’t get it?
What if I lose my job and won’t be able to afford my standard of living?
partner and I argue all the time; what if our relationship doesn’t last?
I booked a hotel abroad; what if it looks nothing like it did online?

All of the above examples contain an element of uncertainty or the unknown. Worriers are not great at dealing with the unknown. As a result, people who worry excessively often think about everything that could go wrong in the hopes that this will help them feel more prepared for when it does.

Preventing Catastrophe with Safety Behaviours

In addition to the positive beliefs above, most worriers engage in safety behaviours to protect themselves from bad outcomes. The following are common safety behaviours that worriers engage in:

Conducting excessive research: (whatever your worry, you will research a lot of information to try and “solve” your worry).
Reassurance-seeking: worriers typically ask for reassurance from loved ones/doctors, in order to reduce their anxiety about their particular worry.
Avoidance: many individuals choose to avoid thinking about their worry (covert avoidance), or they avoid triggers to their worry (overt avoidance).
Examples of overt avoidance include:
- avoiding flying if you are afraid the plane will crash
- avoiding weighing your infant child in case you discover they haven’t gained weight
- avoiding checking your bank balance in case you discover you owe money.
Excessive checking:
- you might check emails over and over before hitting “send”
- you might check these emails even after you’ve sent them
- you might send text messages to loved ones checking that they are OK
- you might check your work over and over before submitting it

Safety behaviors keep excessive worry going because they prevent you from learning to tolerate uncertainty.

What is CBT for Generalized Anxiety?

Cognitive Behavioural Therapy for Generalized Anxiety Disorder (CBT for GAD) is an evidence-based, highly effective therapy which has been proven effective in helping individuals like you manage anxiety.

CBT is recommended by the National Institute for Health and Care Excellence (NICE) in the treatment of GAD.

CBT involves a variety of tools and treatment techniques to help you control anxiety, and our work will primarily include helping you to:

Understand the difference between real life problems and worries about the future (the former you can do something about, the latter you cannot).
Apply problem-solving to real-life problems
Increase your tolerance for uncertainty
Identify your positive beliefs about worry (the beliefs that keep worry going)
Reduce your safety behaviours
Design behavioural experiments to test out what happens when you reduce your safety behaviours

Through our work together you will learn how to cope with anxiety and discover that you don’t have to control every possible outcome and situation, and that doing so doesn’t really have any bearing on the outcome.

The Challenges of Treating Generalized Anxiety Disorder

Many of my clients work in banking, in jobs involving risk management. They are expected to forecast the future and reduce risk on a daily basis. This can make overcoming worry a challenge because this is what makes them good at their job! The problem arises when you approach situations outside of work in the same manner as you do your work. In other words, the skills and mental processes that make you great at your job can actually debilitate you in your everyday life. However, it is possible to continue reducing risk in your job, but learning to let go a little outside work.

Do you still have questions or concerns about CBT for Worry?

I have tried to stop worrying in the past and it just didn’t work. What is different about CBT?

CBT differs from other therapies in that the focus is not on the specific worries themselves (content) but rather on the processes that keep the worries going. We are more interested in learning about the function of your worries, i.e., what does worrying do for you? Benefits? Costs? We help you evaluate the usefulness of worry. What we know for certain is that even if we looked at the content of one of your worries, i.e., your worry that you might not get a promotion, and helped you to feel less worried about that, you will probably find something else to worry about within a few hours or days. This is the nature of worry. You solve one worry and another pops up! Sort of like when you try to put out a fire by fanning the flames and more appear!

What is the difference between worry and anxiety?

This is a great question! There are two main differences. Worry occurs in the mind (it’s the “cognitive” part), whereas anxiety occurs in the body (it’s the “physical” part). Excessive and uncontrollable worry can therefore lead to anxiety symptoms. But there’s also another difference between worry and anxiety; worry tends to be future-oriented, i.e., “what-if I don’t get that promotion”, whereas anxiety is what you feel now about something happening imminently, i.e., the butterflies you get in your stomach just before a job interview.

I don’t want anyone to know I’m seeing a CBT therapist for managing anxiety.

I understand your privacy concerns. One way that I protect your anonymity is by booking meetings so they are spaced out. That way, your session will finish before my next client arrives, and you won’t have to worry about running into someone on your way in or out.

The only time I would need to disclose that you are seeing me is if you were an imminent risk to yourself or to others (see FAQS #8 & #9 for more information).

If I attend during the day, won’t I feel worse when I go back to work? I’ll need to be able to concentrate back at the office.

This is an understandable concern, but most of my clients actually feel that they are able to return to work feeling more positive. They feel pleased that they are taking charge and tackling their problems.

Sometimes, however, sessions can feel emotionally draining, especially if we are working on personal issues. And, when this is the case, it is a good idea to leave yourself some time to process the session and prepare yourself mentally before you return to work. Many of my clients find the walk back to their office sufficient time to regroup, but you might prefer to stop off at a nearby coffee shop to give yourself time to reflect and regroup before returning to work. It’s really a matter of personal preference.

What does CBT for Worry cost?

If you’d like to know more about what CBT for Worry costs, please visit my Fees page.

Do you have more general questions about CBT?

If you have more questions about CBT, please visit my FAQ page.

Are you ready to take the first step?

If you are ready to address your tendency to worry and learn how to cope with anxiety better, or if you still have questions about cognitive behavioural therapy for worry at CBT Canary Wharf, please get in touch with me on (020) 7531-1220 to schedule a preliminary phone consultation.

I look forward to hearing from you!