I came relatively late to an understanding of anxiety. I lived with it without realizing it, and parented a child with it, doing everything I now know is wrong. It wasn’t until my child became nearly incapacitated by a fear of splinters that I discovered Cognitive-Behavioral Therapy and with it, the need to move towards rather than away from the (safe) things that scare you. With that new understanding, my son got better, my clinical practice got transformed, and I wrote a best-selling book. But still, I realize in retrospect, I didn’t have all the details quite right.
The piece of my thinking that has evolved most significantly in the nearly 20-years since I got on the CBT bandwagon and wrote What to Do When You Worry Too Much has to do with the relationship between a worrier and his/her Worry.
I think of Worry with an upper-case W. A critter of some sort, personified, external. That part, I think I got right. But initially, I conceptualized that externalized Worry as a bully. I encouraged children to talk back to it. Forcefully. GO AWAY, WORRY! I told them to flick it away, stomp on it. But here’s the thing: yelling at Worry doesn’t work. If you are 7 years old (or 17, or 77) and worried that something bad might happen to someone you love, and you think about a mean Worry-bully inside of you, and you tell that Worry-bully to beat it, it’s not as if you are suddenly going to feel better. And that’s why children were coming to me week after week and saying, “Dr. Huebner, I read the book and I tried it. I told my Worry to go away, but it didn’t.” Ah, right. That’s not how feelings work. We can’t just tell them to go away.
After years of struggling with this dilemma – knowing that externalizing Worry was important but recognizing, also, that yelling at it was ineffective – it occurred to me that the problem lay with the bully model. Worry isn’t a bully to stand up to; it’s more like a clueless friend.
Shift, for a moment, to the smoke detector in your house. You probably have one in your kitchen, a small plastic disk you count on to keep you safe. That smoke detector is going to try its hardest to do just that, alerting you to even the merest whiff of smoke. The problem is, the only thing your smoke detector knows is smoke. Not where that smoke is coming from, or what it means. So, it blares its impossible-to-ignore alarm and then it’s up to you – the owner of that alarm – to determine whether there is an emergency or not. A fire or a piece of burnt toast.
The amygdala is the human equivalent of a smoke detector. Worry is its alarm. For many of us, the calibration is somewhat off, and we compound the problem by responding to every pang of Worry as if it’s a 5-alarm fire. We do the equivalent of running from the house without so much as glancing at the toaster. And therein lies the problem. Worry is trying to protect us from something we don’t need protecting from. It’s making a mistake. And like anyone or anything that makes a mistake, yelling at it isn’t the answer. Recognizing its fallibility and correcting it is.
I still teach children to think about Worry as a little creature, separate from them. And then I explain about the alarm in all of our brains, and how it’s tasked with keeping us safe. How it blares at the merest hint of danger to get us to pay attention. But the thing is, the alarm makes mistakes. It goes off when we aren’t in danger at all, or when the likelihood of danger is minuscule. It goes off when we think about a problem we are perfectly capable of handling, making us forget that we are perfectly capable of handling that thing.
Because there are all these “false alarms”, it is important to look for evidence of danger. To check the toaster before running out of the house. That means remembering that your mom has never not shown up after soccer practice, and that even if she is late, your coach will be there to help you. Or that even though throwing up is unpleasant, it eventually ends, and kind grownups do what they need to do to get you home.
I now teach children to talk back to Worry from this perspective. Not to yell at Worry but instead to say, “No thank you, Worry. I’ve got this.” Or “Oh, Worry, it’s just toast.” Meaning a false alarm. Scary but safe.
I do still teach children that there is no need to let Worry call the shots, but instead of recommending that they yell at Worry, I now suggest they say, “You’re not the boss of this.” Or “I get to decide.”
Talking back to Worry is best done firmly but not angrily. Decisively but not argumentatively. There is no need to enter into a debate with Worry. In fact, trying to convince Worry that the bad thing is definitely not going to happen is both unrealistic and counterproductive.
I want children to understand that treating every Worry-alarm like the real deal keeps the problem going. Talking back to Worry helps to re-calibrate the system. Talking back – combined with challenging Worry (also known as exposure) – teaches Worry (and thus the brain) what is scary but safe, or scary but super-unlikely. It helps kids move forward, which is exactly what we want them to do.