Sir Winston Churchill, who battled plenty of demons, once said, “When I look back on all these worries, I remember the story of the old man who said on his deathbed that he had a lot of trouble in his life, most of which had never happened.”
Unfortunately that advice wouldn’t have been able to stop me from praying rosary after rosary when I was in fourth grade to avert going to hell, nor does it quiet the annoying noise and chatter inside my brain today on any given hour. But the fact that a great leader battled the worry war does provide me some consolation.
It doesn’t matter whether you are a chronic worrier without an official diagnosis or battling severe obsessive compulsive disorder (OCD) – a neurobehavioral disorder that involves repetitive unwanted thoughts and rituals — the steps to overcome faulty beliefs and develop healthy patterns of thinking are the same.
Worrying about facing the inferno as a ten year old and fretting about whether or not I’ll provide enough income to keep my kids in private school stems from the same brain abnormality that Jeffrey M. Schwartz, M.D. describes in his book, “Brain Lock.” When we worry the use of energy is consistently higher than normal in the orbital cortex – the underside of the front of the brain. It’s working overtime, heating up – which is exactly what is the PET scans show. Too many “what if’s” and your orbital cortex as shown in a PET scan will light up in beautiful neon colors, like the walls of my daughter’s bedroom. However, with repeated cognitive behavioral exercises, you can cool it down return your PET scan to the boring black and white.
In their book, “The OCD Workbook,” Bruce M. Hyman, Ph.D., and Cherry Pedrick, RN, explain the ABCDs of faulty beliefs. It’s a four-step cycle of insanity:
A = Activity Event and Intrusive Thought, Image or Urge. (What if I didn’t lock the door? What if I upset her? I know I upset her.)
B = Faulty Belief About the Intrusive Thought. (If I don’t say the rosary, I’m going to hell. If I made a mistake in my presentation, I will get fired.)
C = Emotional Consequences: Anxiety, Doubt, and Worry. (I am a horrible person for upsetting her. I keep making mistakes … I will never be able to keep a job. I hate myself.)
D = Neutralizing Ritual or Avoidance. (I need to say the rosary to insure I’m not going to hell. I should avoid my friend who I upset and my boss so that he can’t tell me I’m fired.)
Those might seem extreme for the casual worrier, but the small seed of anxiety doesn’t stay small for long in a person with an overactive orbital cortex.
Hyman and Pedrick also catalog some typical cognitive errors of worriers and persons with OCD:
- Overestimating Risk, Harm, and Danger
- Overcontrol and Perfectionism
- Black-and-White or All-or-Nothing Thinking
- Persistent Doubting
- Magical Thinking
- Superstitious Thinking
- Intolerance of Uncertainty
- Pessimistic Bias
- What-If Thinking
- Intolerance of Anxiety
- Extraordinary Cause and Effect
One of the best approaches to manage a case of the worries and/or OCD is the Four-Step Self-Treatment Method by Schwartz, explained in “Brain Lock.”
Step 1: Relabel
In this step you squeeze a bit of distance between the thought and you. By relabeling the bugger as “MOT” (my obsessive thought) or something like that, you take back control and prevent yourself from being tricked by the message. Because I’ve always suffered from OCD, I remind myself that the illogical thought about which I’m fretting is my illness talking, that I’m not actually going insane.
Step 2: Reattribute
Here is where you remember the PET scan that would look like your brain. By considering that colorful picture, you take the problem from your emotional center to your physiological being. This helps me immensely because I feel less attached to it and less a failure for being able to tame and keep it under control. Just like an arthritis that is flaring up, I consider my poor, over-worked orbital cortex, and I put some ice of it and remember to be gentle with myself.
Step 3: Refocus
If it’s at all possible, turn your attention to some other activity that can distract you from the anxiety. Says Schwartz: “By refusing to take the obsessions and compulsions at face value—by keeping in mind that they are not what they say they are, that they are false messages—you can learn to ignore or to work around them by Refocusing your attention on another behavior and doing something useful and positive.”
Step 4: Revalue
This involves calling out the unwanted thoughts and giving yourself a pep talk on why you want to do everything you can to free yourself from the prison of obsessive thinking. You are basically devaluing the worrying as soon as it tries to intrude.
Published originally on PsychCentral.com.