Help Clients Get a Handle on Their Worries

Margaret WehrenbergMaybe you think you’re a Class A worrier. But there are worriers, and then there are Worriers.

Anxiety and worry aren’t all bad. “We live in a worrisome world,” Margaret Wehrenberg told a continuing education workshop for clinical psychology field supervisors at AUNE February 18. “It’s uncontrolled anxiety and needless worry that keep you from living your life in the present and can ruin your life.”

Wehrenberg is a clinical psychologist and nationally recognized speaker on clinical psychotherapy. She is the author of The Anxious Brain, The 10 Best Ever Anxiety Management Techniques and The 10 Best Ever Depression Management Techniques.

“Anxiety is a condition looking for content. The brain says there’s something wrong, and you go looking for it,” she said. “People with general anxiety disorder (GAD) will search the world for something wrong so they can figure it out and resolve it. But if something is really wrong, you don’t have to go looking for it.”

Improper functioning of neurotransmitters such as serotonin can predispose some people to GAD. They may be tense and high-strung, hypervigilant for bad news or have a hard time suppressing negative thoughts and have poor impulse control. They are often Type-A overachievers. They do more than required. “Their brains go a million miles an hour; they’re exhausted,” Wehrenberg said. “But other people often see them as controlling.”

Those with anxiety disorder often chase perfection to fend off anxiety. They may not even begin activities that they can’t do perfectly. The solution, said Wehrenberg, is to help them discern the difference between “good enough” and “perfect.”

“Good enough is usually good enough,” Wehrenberg said. Movement toward a goal is probably more important than immediate perfect completion, which is impossible and therefore produces anxiety.

But you can help clients learn to talk themselves out of unproductive worry. Suppressing worrying thoughts can be healthy, Wehrenberg said. “We don’t want life leaking out all over the place †it limits our ability to get things done.”

One cognitive technique for silencing anxious thoughts: Practice mindful awareness to move attention away from worries. “Clients need to know that they don’t have to pay attention to inner sensations but can shift their awareness outward,” she said.

Replacing anxious thoughts with calmer ones can also work. But be prepared. “Every day, have two pleasant things to think about and write them on a Post-it note, because you need it right in your face,” Wehrenberg said.

Wehrenberg suggested other techniques to use with the chronic worrier:

- Ask yourself: What outcome do I want? Is the activity I’m undertaking to achieve that result essential, helpful or inconsequential? And how important is what I have to give up to do that activity?

- Clear your mind by putting worries in an imaginary container. Then close the lid and put it away.

- Be aware of using magical worry to ward off bad things. This is the “If-I-worry-about-it,-it-won’t-happen” fantasy. If it is an important worry, set up a specific time to worry about it.

- Change your lifestyle. Too much caffeine, alcohol and energy drinks; not enough sleep, good nutrition, and exercise; and tension from constant technology, all factor into chronic anxiety. “If you can do just two things for good brain health, it’s sleep and exercise,” Wehrenberg said.

- Identify the problem and make a plan to deal with it. But replanning your plan is worry in disguise. Know when, and when not, to evaluate your plan.

- Do the worst first. The longer you put off doing those worrisome tasks, the more you’re going to worry.

- Transfer worry to someone who can help with the problem.

- Pay attention out loud by talking to yourself about what you are doing. “If you’re anxious, you’re preoccupied and not paying attention,” Wehrenberg said. That’s when you lose the car keys and forget to turn off the iron. Or did you? Better go back and check.