posted 17th May 2020
Avoidance of uncertainty: generalised anxiety explained: Learn why your anxiety may be about fear of the unknown and what to do about it. One of the first things I explain to my anxious patients when they come in for therapy is that avoidance maintains anxiety; anything you do to avoid or escape anxiety triggers in the short-term gives you more anxiety in response to those triggers in the long-term.
This is easy to see when the fear is of something physical like flying, contamination with germs, or social situations. But many anxiety sufferers are not doing any wholesale avoidance of any major physical situations. Often what they are avoiding is simply uncertainty, the unknown. The behavior they use to avoid uncertainty is the act of worrying.
For most people, even those without a diagnosable anxiety disorder, uncertainty can trigger anxiety. Because uncertainty is not an overt, physical object or situation, we can't literally run away from it like we can from a dog or a social situation. So what our brains tell us to do to get away from uncertainty is to try and eliminate it by mentally analyzing the situation we are uncertain about. That's what worry behavior is.
For instance, let's say you're afraid you're going to lose your job. You feel uncertain about whether you will lose your job, and that uncertainty triggers anxiety. Your mind is saying, "This uncertainty is dangerous—we must get away from it! The way to do that is to eliminate the uncertainty by analyzing it until you are certain whether you're going to lose your job or not! And until you do that, you can't move on with your day." Now, of course, when we put it like that, it sounds ridiculous. No one can predict the future and it's impossible to know for certain whether you're going to lose your job or not. But when you are anxious about something, you still try to get certain about it anyway! You try to analyze in your head whether you are going to lose your job or not.
Sometimes when you do this, you will come to a potentially reassuring answer about all the logical reasons why you are probably not going to lose your job. When you come up with that answer, it alleviates the anxiety, but only very briefly. This is the short-term avoidance of uncertainty.
But it is only reassuring for a moment because your mind can always come back and say, "Well sure, but how do you KNOW you're not going to lose your job?" But because the very nature of the situation is that it's uncertain, you don't KNOW you won't lose your job. So now you're right back where you started with uncertainty triggering anxiety again. You'll probably go right back to trying to analyze it again to try and convince yourself that you can be certain you won't lose your job.
If this worry process becomes so frequent that it seems like it is happening all the time, we call it Generalised Anxiety Disorder (GAD). The main characteristic of GAD is excessive worry about any of a number of different topics. People with GAD overvalue worry behavior: they believe that worrying is necessary, important, useful, responsible, and safe. They believe that it can prevent bad things from happening. They commonly think things like, "If I don't worry about losing my job, I'll miss some key thing I can do that would prevent it from happening." And, "If I worry about losing my job, at least I'll see it coming and be prepared."
The solution to fear of uncertainty is to purposely leave worry questions unanswered, unresolved, and uncertain. This type of anxiety gets better by tolerating and accepting uncertainty, ignoring worry thoughts rather than attending to them, and moving on with what you are actually doing in the present moment in spite of uncertainty.
To GAD sufferers, this often feels like sticking your head in the sand and letting yourself be purposely oblivious to things that could hurt you. But that's actually what works; if you tolerate uncertainty rather than trying to eliminate it, your brain eventually learns all of the following: Uncertainty is not dangerous; it is tolerable; Worry behavior is utterly pointless. It does not stop bad things from happening; Worry behavior causes you more suffering right now and does not save you from any suffering; Uncertainty does not require your attention.
When your brain naturally learns these lessons from seeing that you are unharmed by foregoing worry and returning to the present moment, it stops giving you anxiety in response to uncertainty. That's how generalised anxiety and fear of uncertainty get better.
Helping patients understand how to do this and implement it successfully is how I spend a lot of my time during therapy sessions with patients with generalized anxiety, but I can offer a quick way to understand it here: Imagine that you are operating a spotlight. The spotlight is your attention, what you choose to pay attention to right now.
You can choose to point the spotlight at uncertainty by doing worry behavior and mental analysis. In the above example, that would mean spending your time trying to figure out whether you are going to lose your job and what you should do about it. Or you can choose to put the spotlight on whatever it is you are actually doing in the present moment. That could be anything: eating, talking to a friend, driving, watching TV, etc.
Typically, when we worry, we feel like we can't put the spotlight on what we are doing in the present moment and move on with our day until we have put the spotlight on the worry first and resolved it. But that doesn't work—the worry just goes on forever because again, you can't actually have certainty about what you are worried about. You can't resolve it.
The healthier thing to do is ignore the uncertainty and put the spotlight on what you are doing in the present. This doesn't mean the worry thoughts won't be there, you just won't be attending to them. Even though that's scary—and easier said than done at first—your brain will learn from it and the anxiety will naturally subside over time if you stick with it.
