Anxiety Is Not Worry (And Why It Matters)
When clients begin working with me, many aren’t aware of the difference between anxious feelings and worried thoughts. Anxiety and worry are related, but they aren’t the same. Understanding the similarities and differences between anxiety and worry is an important part of overcoming OCD. So, in this post, we’ll review:
What is anxiety?
What is worry?
How are they related?
How are they different?
Why abstaining from worry is part of overcoming OCD
What is Anxiety?
Anxiety is a physiological and emotional response that arises when we believe that something we care about might be in danger. Danger can come from outside and from inside.
Examples of the danger coming from outside are related to questions such as:
What if I’m contaminated by a deadly germ?
What if there’s an intruder in my house?
What if I’m at the location of a mass shooting?
What if I hit a pedestrian without realizing it?
What if I’m struck by a meteorite?
Examples of danger coming from the inside are related to questions such as:
What if I can’t stop having this thought and it ruins my day?
What if I can’t stop having this feeling and it ruins my day?
What if I lose control?
What if I do (or have done) something terrible?
What if I’m actually a bad person?
Anxiety hurts. But anxiety isn’t bad. We’d be lost without it. Anxiety is our body perceiving the possibility of threat (from outside or from inside) and providing us energy and motivation to help keep us safe.
Anxiety’s job is to keep us safe and it does this in many ways. One of the ways anxiety keeps us safe is by changing our bodies. Anxiety activates our body’s threat-response system, including the sympathetic nervous system and hypothalamic–pituitary–adrenal axis. This includes triggering the release of adrenaline, noradrenaline, and cortisol. These chemicals prepare our body for action by increasing heart rate and blood pressure, speeding breathing, tensing muscles, and diverting blood away from digestion toward large muscles.
Another way our anxiety keeps us safe is by increasing vigilance and focus. Increased vigilance and focus includes turning attention toward potential threats and increasing readiness to respond. This increased awareness of danger promotes faster detection of danger and quicker decision-making, giving us better chances to stay safe.
Anxiety Helps Keep Us Safe From Tigers
Imagine you and I were living in pre-historic times in the jungle. We need to gather berries. But the area with the best berry bushes is roamed by hungry tigers. It would make a lot of sense that, when we walk toward the berry bushes, our bodies are prepared for action and that we’re extremely focused on our surroundings.
Now, imagine that, as a result of our vigilance and focus, we see a tiger far in the distance, crouching behind a tree. What do we do then? We’ll feel increased anxiety. But what should we do?
What we choose to do is related to our anxiety but it’s not the same as our anxiety. Our anxiety will give us energy to run, but it won’t choose the direction we run. Our anxiety will help alert us to danger, but it won’t craft our strategy for managing the danger.
Do we stay perfectly still? Or fight? Or Run? Or climb a tree? Or yell for help? What’s the best choice? Anxiety can’t provide the answer.
What is Worry?
If anxiety can’t provide the answer, what can?
Worry.
Worry is motivated by anxiety but worry isn’t the same as anxiety. Anxiety is a physiological, emotional response to the perception of threat. Worry is an abstract process of thought. Worry is problem-solving, trouble-shooting, planning.
Worrying isn’t bad. It’s extremely important. Worry allows us to imagine problems that might arise. It allows us to think ahead, exploring, identifying, and calculating how we’ll solve those problems. Worrying gives us more time and better chances to take steps to protect from danger.
If Andy was told by a co-worker that there may be mass layoffs, Andy will probably feel anxious. Being the smart, strategic person that he is, Andy may begin worrying about what he can do to protect his job or find a new job. Andy’s worrying might include him asking himself questions such as:
How can I make myself more valuable to the company?
How can I make sure that my supervisor is happy with my performance?
If I lost my job here, what other jobs might be available?
When Anxiety and Worry Become A Problem
We’ve reviewed what anxiety and worry are and that, even though they’re unpleasant, they’re important. However, within OCD, anxiety and worry transform into big problems instead of valuable tools.
Most people with OCD know that the scary stories they’re afraid of are unlikely. But unlikely doesn’t mean impossible. And, even if the scary story doesn’t actually happen, getting stuck with unwanted, uncontrollable, distracting, and painful thoughts and feelings happens all the time. And getting stuck with unwanted, uncontrollable, distracting, and painful internal experiences really hurts, really distracts, even if the terrible event doesn’t ever happen.
That’s why it makes so much sense that those of us with OCD start to become anxious about our anxiety. We start to worry about our worry.
Since we believe our anxiety and our worry are threats, we start to be on the lookout for our anxiety and our worry (just like we’d be on the lookout for tigers). Because we’re on the lookout for anxiety and worry, we notice them more frequently.
When we notice them, we think, “Oh no, not this again. If this is here then…” and we tell ourselves a scary story. Then we feel more anxious and worry more. And the cycle continues (and grows).
Why abstaining from worry is part of overcoming OCD
Overcoming OCD includes changing our relationship with our anxiety and our thoughts. One of the ways we change our relationship with our anxiety and our thoughts is by allowing them to be present without fighting them, without controlling them, without trying to make them go away. To really allow our anxiety to be present, and to really feel it, means we can’t run away from it or push it away.
But worrying does just that: Worrying distances us from our anxious feelings. This is why one of the most important parts of exposure and response prevention (ERP) treatment is abstaining from worrying.
Abstaining from worrying is not the same thing as trying to stop thoughts. You can’t stop thoughts and trying to stop thoughts makes things worse. Instead, abstaining from worrying is recognizing there’s a difference between being aware of a thought and participating in a thought.
Being aware of a thought is, for example, being aware that:
I’m having the thought that I might lose my job
Participating in a thought is, for example, exploring and tracing thoughts such as:
When my supervisor said that, was that an indicator that she might be dissatisfied with my performance?
And would Lucy be laid off before me?
I do more work than Lucy, so I think she’d probably get cut before me.
And, weren’t our profits good last quarter?
Does that mean the layoffs might not happen?
Even if I did get laid off, didn’t Mike say there’s another job open at his company?
Could I get that job?
When we abstain from worrying, we’ll feel the anxiety more fully. We’ll notice that we don’t have full control over what thoughts we’re aware of, even if we do have control over what thoughts we participate in.
Practicing feeling feelings and being aware of thoughts without controlling feelings or thoughts helps us see that:
We can tolerate the feelings and thoughts (even though they hurt and are distracting)
The feelings and thoughts will go away all on their own without us trying to control them
As we get more practice, as we see for ourselves that we can continue living our lives even when we have unwanted, uncontrollable, distracting, and painful internal experiences, we start to become less and less concerned by our unwanted feelings and thoughts. As we become less and less concerned by our unwanted feelings and thoughts, we begin to be less bothered by them. Then we begin to notice them less. Eventually, we don’t notice them much at all (and, even when we do, they barely hurt). Then we feel free to stop worrying and continue living.