Worrying about worrying
It is 3am and you are awake, again, running through tomorrow’s meeting, your child’s school report and a slightly odd text from a friend. Then a second layer arrives. “Why can’t I stop this? I’m going to be exhausted. This can’t be good for me. What if I’m losing it?” The second layer is often worse than the first.
The Manchester psychologist Adrian Wells built an entire approach, metacognitive therapy, on that second layer. He distinguished between ordinary worry about events and worry about the worry itself, such as the belief that your worrying is uncontrollable or dangerous. In his model, it is the second kind that turns everyday worry into generalised anxiety.
Wells also noticed something paradoxical. Most chronic worriers hold positive beliefs about worry too: that it helps them prepare, keeps them safe, or shows they care. So they keep choosing it, while simultaneously believing they can’t control it. Trying to push the worry away then tends to produce more of it, in the same way that being told not to think of a white bear guarantees you will.
The treatment that follows from this is different from arguing with the content of each worry. Instead, it targets the thinking style itself: the drawn-out worry, the rumination and the constant checking for threat. People learn that they can notice a worry and postpone it, and discover through experience that the worry is far more controllable than it feels at 3am. In a trial in Copenhagen involving 174 people with depression, Wells’s university reported that 74% recovered with metacognitive therapy, compared with 52% with standard CBT.
If your mind won’t switch off, the problem may not be what you worry about but how you relate to worrying itself. Wells’s ideas inform how I work with overthinking, and it is very workable in therapy. Read more about anxiety therapy, or get in touch.