The key element behind this type of anxiety and worry is an intolerance of uncertainty. Over time, our excessive worry becomes persistent, repetitive and uncontrollable. We rush around trying to find solutions, yet we never end up finding any sort of relief.
When we worry, we tend to predict that bad things will happen to themselves or other people. These fears may even be based on real events. We try to figure out one or more solutions to what we fear will happen. However, since the “bad” event still hasn’t actually happened yet, we never end up being able to use our solution. As a result, we still continue to feel uncertain and anxious.
Intolerance of Uncertainty
When we can’t handle uncertainty, we tend to become intolerant of it. This intolerance tends to set us up for developing Generalized Anxiety Disorder (GAD) as well as maintaining the disorder once it starts.
People without GAD may not like uncertainty, but they generally tolerate it. They tend to believe that if bad things happen to them, they’ll be able to cope.
GAD clients have a different perspective! They believe it is unacceptable to have any uncertainty. They fear that experiencing any uncertainty or ambiguity will actually cause more problems. There is even a believe that they would be irresponsible of they don’t try to eliminate any uncertainty.
Beliefs About Worry (Positive & Negative)
Generalized Anxiety Disorder (GAD) clients suffer from dysfunctional beliefs about how worry works. They tend to have extreme views on how helpful or harmful worry is.
People with GAD might feel that worrying ahead of time can prepare them for anything that happens to them (extreme positive belief). Or they might feel that it is dangerous to experience worry and that any worry is uncontrollable (extreme negative belief). It’s the extreme beliefs that are the actual danger themselves, as they add fuel to the fire to make us worry more.
Poor Problem Orientation
Those with General Anxiety Disorder tend to view any problems as threats. They aren’t very confident in their ability to come up with any solutions. This mindset sets them up to always expect a negative outcome when they attempt to solve any problem. As a result, they overcompensate by trying to create a perfect solution.
But, when you combine a Poor Problem Solving Orientation with an Intolerance for Uncertainty, this is what happens:
- You’ll keep trying to come up with a solution that you are certain will work.
- Yet the problem is still in the future, so you won’t be able to implement the solution at the moment.
- The result is that you can’t be certain that your solution will work, so you’ll continue to worry and come up with more solutions without actually choosing one.
Cognitive & Emotional Avoidance
Ironically, worry itself is a way for us to avoid certain things. We don’t want to think of what things will look like if something goes bad. We start to imagine “worst case scenarios” and experience very distressing feelings. As a result, clients with Generalized Anxiety Disorder use worry as a way to avoid these thoughts and emotions.
Cognitive-Behavioral Therapy for GAD
To combat Generalized Anxiety Disorder (GAD), therapists use a specific collection of tools and techniques:
- Worry awareness to identify which worries are productive vs. unhelpful.
- Changing how we respond to worries (cognitive restructuring).
- Evaluating our beliefs about worry to reduce worry across all areas of life.
- Learning how to evaluate, respond and postpone worry using critical thinking and mindfulness.
- Increasing real-life exposures with mild-to-moderate uncertainty.
- Visualizing gradually increasing uncertainty in a controlled setting.