What do people worry about? Well, whether or not you have an anxiety disorder, they are actually pretty similar. In fact the five most common worries relate to:
- Illness, injury and health
- Interpersonal relationships, family and home
- Work or school
What makes people with anxiety disorders different is their apparent lack of control over worries. People with a generalized anxiety disorder (GAD) for example, do seem to focus more on illness and poor health - their own and others. People without an anxiety disorder seem able to refocus their thoughts and effectively switch off from worrying while they attend to other issues.
The most obvious question then is why the difference? What turns some people into uncontrollable worriers? Psychologists think there are two possible reasons. The first is that worry can actually provide a way of avoiding other forms of thinking associated with negative feelings. The person worries, this worry prevents access to fear in memory and averts negative feelings, so worry becomes rewarding and encourages more worrying. Another possibility is that people who worry uncontrollably try too hard to control their worrying. Thought suppression refers to act of trying not to think about things. Perversely this causes a rebound effect in which the person worries even more.
If we examine the features of uncontrollable worry a couple of things stand out. The first is the manner in which such people tend to assume a ‘what if’ style of thinking that becomes more and more progressive and negative the more they worry. For example, if the person stands near to someone who coughs a string of worrying thoughts might develop. ‘What if I catch a cold? I’ll have to stay off work. I might lose my job. No job, no food, no accommodation. I’ll be on the streets in a fortnight,’ and so on. This catastrophic form of thinking is very typical.
A second feature of uncontrollable worry is its level of persistence. To explain this we need to focus on the mood of the worrier, which is likely to be negative. Negative moods tend to relate to a lack of belief that a problem has, or can be solved. This may partly explain why worry persists. In 1995, the psychologist Adrian Wells, put forward the concept of ‘meta-worry’. Meta-worry involves themes such as ‘my worry is really out of control’, and ‘no other person worries the way I worry’. In other words the person worries about worrying and this, claims Wells, is what distinguishes people with GAD from everyone else.
One key observation is that many of the features that characterize worrying are also present in the obsessive thinking component of OCD. This suggests that certain mental processes may have the same structural basis common to anxiety disorders.
Field, A (2003) Clinical Psychology. Crucial. Learning Matters Ltd. Exeter.