Therapy in LA

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June 2013

CATASTROPHIC THINKING: ANXIETY, ANTICIPATION AND ALLIGATORS

Susan Harper Slate, Ph.D.

Some years ago I was vacationing in Telluride. Our condo overlooked a trail with a bridge running over a stream. The path led into the small town. Looking down at the path, we watched a large brown bear lumbering on all fours across the bridge, headed into town. He turned the corner, and while we could no longer see him, we knew just about where he was because of the screams, gasps, and yelling from people just a few blocks away from us. No doubt the locals knew what to do, but we tourists certainly did not. Fast forward some years and I was in a gift store and came across a series of books called “Worst Case Scenario”. These are books—and there were a few different versions—that would explain an intense encounter and what steps you should take to deal with it. The thing that made these books funny is that the situations are very rare and unusual, but the answers about how to deal with the situation are legitimate. I remember reading what to do if you encounter an alligator. These two memories in tandem begin to explain some of the difficulties of anticipation: I know what to do if I ever encounter an alligator, but not a brown bear (and will probably never have to deal with either scenario.)

Anticipating life’s events and how to prepare for them can be very adaptive. College students who begin to study for finals a few weeks before the tests generally do better than students who cram a night or two before. Every financial advisor recommends creating a retirement plan many years before retirement is likely. Yet any good healthy, adaptive habit can be overused and develop into a maladaptive trait, thereby robbing someone of enjoyment in life.

As I work with a client who is coming to psychotherapy for anxiety, it is important to understand the source of the anxiety. The client may be encountering a situation they have never faced before or one that they feel is very problematic for them. With deeper exploration, I want to understand if the person’s anxiety has “a life of it’s own”—in other words, do they often respond with anxiety to life’s challenges? One client discovered a “mood app” for her phone and was able to register her emotions throughout the day, thereby discovering that she spent almost half of any given day with some uncomfortable level of anxiety. Her anxiety was taking over.

As people anticipate interactions with others or managing busy schedules, it is not uncommon to focus on the problem side of these scenarios. If it seems easy or routine, people don’t tend to overthink these situations. So it may be a “half-step” between someone who often thinks about future plans and starting to “catastrophize” these situations. This is where someone has gone beyond the usual and is seeing the unusual: in other words, what do I do if I encounter an alligator? Of course if you live in the everglades of Florida, it would be adaptive to know this, but not in Los Angeles. Therein lies the difference.

As many people know from experience, if one continues to do something over and over, you develop a habit. We are all capable of developing both good and bad habits. Brain pathways—thoughts linked together—are forged. And thoughts occur in conjunction with feelings, and feelings come with related physical reactions. These pathways, while difficult to change, are not impossible. A current phrase used to describe the “difficult but not impossible” aspect of changing brain pathways is to refer to the “neuroplasticity of the brain.”

Another feature of developing a brain pathway is the saying that what is “fired together is wired together.” This attempts to explain how two various events or thoughts could become intertwined. As an example, one of my clients was told some devastating family news as a child. The next morning she and her family flew across the country. She had never been afraid of flying before, but this experience created a connection. So whether a brain pathway develops over time with continuity or through a one-time trauma, it is not set in concrete. These ways of thinking/feeling/physical reactions can be changed with work and determination.

An example of catastrophic thinking (a brain pathway for some people) might be illustrated by this fictional account. Imagine you are working for a demanding, overly critical and inconsistent boss. (For some of you, this may not be difficult to picture.) He has given you a special project to finish on top of your regular heavy workload. His instructions are complicated and confusing. As you approach the day he wants the project done, you are feeling more and more anxious. It isn’t just the work. You begin to have more and more imaginary conversations and confrontations with your boss. Sometimes these scenarios are of him getting upset with you, sometimes you imagine losing control and yelling at him. Regardless, you haven’t even turned the project in yet! Anxiety and frustration have increased, your sleep has been disturbed, you are complaining more and more to friends, and you are generally feeling miserable.

It is not that you are foolish for feeling this way, nor that everything will turn out okay. Instead, there is a lot of energy, time and distress spent on scenarios that may or may not come to fruition. Plenty of different conclusions could occur. However, one’s field of perception has narrowed to the disastrous, the tragic and the most problematic. Attempting to continually deal with the worst is tedious and painful.

Some people have fears about letting go of worrying. Clients over the years have said that it comforts them to think of the worst possibility. One admitted that he thought that if he could come up with the situation, it would ensure that it would never happen. (This is what psychologists call magical thinking, meaning that the thoughts have magical powers.) Others have felt that thinking of all the scenarios has prepared them for dealing with possibilities. They think it gives them a “head start” on solving the problem. Still others feel that the idea of something happening without them first knowing about it is like “having the rug pulled out from underneath them.” For these people, the worrying has given them some sense of control. Consider, though, the cost of this sense of control. Continuous anxiety and stress has a marked effect upon one’s health, relationships, and sense of self, not to mention how it interferes with one’s happiness.

In the 1980’s, I worked at Loyola Marymount University in the Counseling Services. One morning a colleague ran in my office to announce that a crisis had occurred, that I would probably be called upon to help, to clear my calendar and ran out saying he didn’t have time to discuss it and would be back later. I could feel the adrenaline and surge of energy. I cleared my calendar and then pulled out a copy of the manual on Emergency Procedures. (Here’s the funny part: I had written the manual). As I began going through the scenarios (potential suicide, homicide, psychotic break?) it occurred to me that I had nothing to go on and I thought: I will deal with this if this comes up. I stopped reading the manual, began calming down and did paperwork until I was needed.

I didn’t know at that time how important those words would become, but they have stayed as one of the most cherished philosophies for my life. One client said that if he were to say the same thing, it would indicate a level of competence and self-esteem that he didn’t have about his abilities. Ironically, many of the people who anticipate, plan, and worry are very competent individuals. While it initially felt uncomfortable, he stopped preparing for every eventuality, and didn’t rehearse every scenario. As he did this, he developed a new sense of self, as someone who can handle whatever comes his way.

Changing catastrophic thinking starts with awareness (as so many psychological dynamics do.) You have to work to hear your “narrating voice”—the one that is evaluating and commenting about how you are doing, what’s going on your life, etc. Often this voice hums along quietly, so it may require “turning up the volume”. For example, if you are a student and in a difficult class for you, you may be saying something like the following: “Everyone else is getting this. Wow, look at Jack—he knew the answer right away. I never was any good at this, and I am going to bomb at the final. I can’t even follow what Mr. Smith is saying right now. I am in big trouble.”

As you develop this awareness, you can begin changing it. Perhaps a hundred times a day you may need to divert your attention from planning imaginary scenarios or critical judgments to going back to the task at hand, to being in the moment. Being in the moment helps us to listen, take in information, and learn. Here is another way to approach the same critical voice: “Wow, I am having a difficult time learning this and it looks like others are doing fine. But I don’t really know how it is for them. I’m going to listen as well as I can, and make an appointment with Mr. Smith to go over these concepts.”

Another approach to changing this maladaptive pathway would be the following: “Oh, here you are again, Catastrophic Thinking! I might find some use for you sometimes, but not right now. Right now I want to get back to right now.” As you approach change, it helps if you are firm and consistent but also kind with yourself. You didn’t develop this trait over night and you won’t change it over night either. Further, as a society, living in the moment is not easy for Western thinkers. We tend to be future-oriented. Lots of approaches help to change this including psychotherapy, meditation, yoga and mindfulness training.

It is very freeing to live life on its terms. Dealing with “what is” versus the “what if’s,” allows us more freedom and energy. If you’re planning a trip to the Florida Everglades, study up on escaping from alligators. But otherwise, learn to live and fully engage in the present moment, whatever challenges and joys there may be.

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Dr. Susan Harper Slate is a Clinical Psychologist in practice in Brentwood. She is a member of the Independent Psychotherapy Network. Dr. Slate can be reached at (310) 472-5333 or shslate@aol.com.