Worry is a common experience, particularly when something feels uncertain, important or outside our control. For some people, however, worrying becomes persistent and begins to take up a significant amount of mental space.
It can feel as though continuing to think about a concern will help prevent something going wrong, prepare for difficulties or provide greater certainty. Yet there is an important distinction between worry and problem solving. Understanding that distinction, alongside the role of uncertainty, beliefs about worry and behaviours such as reassurance seeking, can help explain why worry sometimes becomes difficult to control.
What Is Worry?
Worry is a pattern of thinking focused on possible problems and negative outcomes. It often involves considering different possibilities, anticipating what might happen and asking questions such as “What if something goes wrong?”or “What if I cannot cope?”
Worry can relate to many areas of life, including health, relationships, work, finances or family. The content may change, but the underlying process can remain similar: trying to think through uncertainty in an attempt to feel more prepared or certain.
The distinction between occasional concern and persistent worry is important. Worry becomes more clinically significant when it is excessive, difficult to control or begins to interfere with everyday life.
Persistent and excessive worry is a central feature of Generalised Anxiety Disorder (GAD), where people experience ongoing worry across a range of areas rather than being focused on one particular situation.
The Impact of Persistent Worry
Persistent worry can be mentally exhausting. Rather than resolving a concern, the thinking can continue and generate further questions, possibilities and uncertainty.
Over time, this can affect concentration, sleep, decision making and the ability to be fully present in everyday life. Some people also find themselves spending considerable amounts of time researching, checking, seeking reassurance or mentally reviewing situations in an attempt to feel more certain.
These responses are understandable, particularly when uncertainty feels difficult to tolerate. However, they can inadvertently keep attention focused on the concern and reinforce the idea that greater certainty is needed before you can move forward.
Worry and Problem Solving: What Is the Difference?
Worry can feel productive because it involves thinking carefully about a problem. However, problem solving and worry serve different functions.
Problem solving involves identifying a specific issue, considering what can realistically be changed and deciding what action to take. Once there is no further useful action available, the problem solving process can come to an end.
Worry tends to continue beyond this point. The focus shifts towards possible outcomes and questions that cannot necessarily be answered:
What if I have missed something?
What if it doesn’t work?
What if something unexpected happens?
A useful distinction is therefore whether the thinking is helping you take appropriate action or attempting to eliminate uncertainty.
For example, preparing for an important meeting by considering what you need to communicate and making appropriate preparations is problem solving. Repeatedly imagining everything that could go wrong, reconsidering what you have prepared and trying to guarantee that the meeting will go well is more characteristic of worry.
How Does Uncertainty Affect Worry?
Uncertainty is an unavoidable part of life. We cannot always know how a situation will develop, how another person will respond or whether a particular outcome will occur.
For some people, uncertainty is particularly difficult to tolerate. This is sometimes described clinically as intolerance of uncertainty or difficulty tolerating uncertainty.
When uncertainty feels uncomfortable, there can be a strong urge to resolve it through further thinking, researching, checking or reassurance seeking. These behaviours may provide temporary relief, but they cannot provide complete certainty.
This is one reason worry can become self perpetuating. The more certainty feels necessary, the more compelling it can become to continue thinking or checking.
Beliefs About Worry
Our beliefs about worry can also influence how persistent it becomes.
Someone might believe that worrying helps them prepare, prevents problems, shows that they care or means they are less likely to be caught off guard. These beliefs can make it difficult to step away from worry because stopping can feel as though something important is being overlooked.
CBT explores these beliefs alongside the behaviours that accompany worry, rather than simply trying to replace worrying thoughts with more positive ones.
How Can CBT Help With Persistent Worry?
Cognitive Behavioural Therapy (CBT) is an established psychological treatment for persistent worry and Generalised Anxiety Disorder.
CBT looks at the individual pattern of worry and the factors that maintain it. This may include beliefs about worry, difficulty tolerating uncertainty, reassurance seeking, checking, avoidance and the distinction between genuine problem solving and continued worry.
An important part of treatment can be learning to recognise when there is a practical problem that requires action and when further thinking is unlikely to provide a useful solution.
Therapy can also help develop greater confidence in responding to uncertainty without relying on repeated reassurance, checking or research to feel sufficiently certain.
The aim is not to remove all uncertainty or ensure that difficult things never happen. It is to develop a more flexible response to uncertainty, so that worry is less able to dictate your attention, decisions and behaviour.
Take the Next Step
Persistent worry can become so familiar that it is difficult to identify what is maintaining it. A comprehensive assessment provides an opportunity to look beyond the content of the worry and understand the individual pattern, including the thoughts, beliefs and behaviours involved.
At Sereno Therapy, our experienced clinicians provide personalised, evidence based therapy for anxiety and related difficulties. Where appropriate, CBT can be used to address persistent worry and the factors maintaining it.
If worry is taking up a significant amount of your time or beginning to affect your everyday life, book an Appointment with Sereno Therapy to explore the right therapeutic approach for you.
