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Anxiety and Stress

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Worry & Metacognitive Skills

It is common for cognitive strategies to assess whether or not the content of thoughts are valid and realistic. However, it is also important to understand the underlying maladaptive cognitive processes. One strategy for disputing the thought, "I am worthless" is to search for counter-evidence. However, the metacognitive strategy would be to explore, "What is the point in evaluating your worth?"

Worry and rumination are frequently employed as coping strategies in reaction to a distressing thought. The purpose of worry is to solve a perceived problem or avoid an imagined danger. However, if we only focus on the content of worry, we might overlook the underlying beliefs about worry and the factors that maintain it.

Positive beliefs about Worry: Worry helps me be prepared. Worrying helps me solve problems. Worry keeps me in control of the situation.

Persistent positive and negative beliefs about worry (That worry is helpful, is uncontrollable, or is dangerous) lead to the development of chronic and excessive worry about worry. This is a pattern where worry is used as a rigid, unhelpful coping strategy (reassurance seeking, avoidance, information searching, distraction, and thought suppression) combined with negative beliefs about worry.

Negative Beliefs about Worry: I have no control over the worry. My worries have taken control of my life. I have lost control of my thoughts. My worry is uncontrollable. If my worry continues, I'll lose my mind and go crazy.

Vicious cycle of anxiety:

Unhelpful coping strategies are deceptive because they temporarily result in relief and decreased anxiety, which increases the likelihood that they will be used again. However, they don't have long-term benefit. They prevent people from learning that they can cope with worry, responding in helpful ways to minimize worry, and learning that the predicted negative consequences of worry won't happen. Some unhelpful coping strategies can produce immediate negative consequences. For example, thought suppression, trying not to think about thoughts that cause worry, is frequently believed to be an effective way to control worry. However, it inevitably fails which results in more worry and reinforces the negative belief that the worry cannot be controlled or managed. This creates a vicious cycle of anxiety where an individual tries the best they can to alleviate their anxiety through strategies that ultimately lead to more long-term distress.

Metacognitive Skills:

Discover your beliefs about worry: (Pay attention to these on your thought monitoring handout. It is important to know your positive and negative beliefs about worry before you get started.)

  • What are advantages and disadvantages to worry? Does the worrying make you feel better and could you stop worrying if you wanted to? How does your worry stop once it starts? What function does your worry serve?

Detached Mindfulness: a state of awareness of internal events, without responding to them with sustained evaluation, attempts to control or suppress them, or respond to them behaviorally

  • "Have you ever decided not to worry in response to a triggering thought? Have you ever tried to hold in mind a trigger and just leave it alone? Have you ever seen your negative thoughts as merely events passing through your mind? For the next two minutes, think about clouds and allow the thought to exist in its own space in your mind. I'd like you to just watch the thought and do nothing to control it or influence it in any way. Just watch the clouds. You may notice that they are moving, but don't make them move. You may notice the thought fades, but don't make it fade. You may notice other thoughts but they should not be of your deliberate making. Just watch the thought in a detached way." Think about your most recent worry. What was the triggering thought? Bring the worry trigger into your mind. Allow the trigger to be in your mind but do nothing with it. Don't push it away, and don't try to reason with it and work it out. It's only a thought.

Worry Postponement:

  • Identify triggering thoughts and postpone worry through detached mindfulness. "There's a worrisome thought. However, I don't need to dwell on this now. I'm going to leave it alone and deal with it later." Later that day, set aside a time to worry about that thought. Limit yourself to 10 minutes of worry. This isn't thought suppression. It is about realizing that an anxious thought has occurred and choosing not to engage your thinking and reasoning process.

Worry Mismatch Strategy:

  • To challenge beliefs about the utility of worry and illustrate how it does not often match reality. Create two columns. The first is a "Worry Script" column that illustrates the sequences of worrisome thoughts about the situation. Add additional items by asking yourself, "What if that happens?" Create a second "Reality Script" column that includes what actually happened. Can be completed for events that already happened as an example or upcoming/frequently avoided situations.

Worry Modulation Experiment:

  • If worry really is helpful then increases and decreases should have measurable benefits. Operationalize what benefits to performance you want to see (e.g. better test grade, faster completion of homework) and purposefully increase and postpone worry on different days and measure outcomes.