Living With Uncertainty
The following is a list of ideas which you might find helpful. Some are my own thoughts, while others (where indicated) are derived from Kevin Meares and Mark Freeston, Overcoming Worry: A Self-Help Guide Using Cognitive Behavioural Techniques, or Rob Willson and David Veale Overcoming Health Anxiety: A Self-Help Guide Using Cognitive Behavioural Techniques.
1. Everything in life is uncertain. According to Pliny the Elder, ‘the only certainty is that there is nothing certain’ (Meares and Freeston, 166). If we seek certainty, we are bound to be disappointed. Therefore, it is not worth spending a great deal of time seeking certainty. We should, of course, take reasonable precautions to avoid an unpleasant outcome. So, what we need to find out is what constitutes ‘reasonable precautions’.
2. When we have taken reasonable precautions and there is nothing to be gained by further thought or action, there is no point in thinking about the uncertainty. It is better to concentrate on living as meaningfully as we can manage in the present.
3. Without uncertainty, there would be little point in many of life’s activities – e.g. there would be no point in taking an exam if everyone was guaranteed to pass.
4. Even if we can never be completely sure that a bad thing won’t happen, it might be better not to know about the bad things which do happen. So uncertainty can be a good thing.
5. A certain amount of worry might lead to action. But worry beyond this is a waste of time and energy.
6. Worry can lead us to assume the worst-case scenario. Mostly, this does not happen. So, when worrying, remember that other things you have worried about did not happen. Even if one or more of the things you worried about did happen, remember that most of them didn’t – which means that you spent a lot of time worrying needlessly.
7. Even if your time on earth is limited – and that is true for all of us – do you really want to spend most of it making yourself miserable by worrying about things which might not happen?
8. Opinions vary regarding whether worry can make you ill. Even if there is no direct correlation, if it takes up time and energy which would otherwise be spent in looking after yourself more effectively, then perhaps it can make you ill. But you have the power to choose to look after yourself better and thus, if you are worrying about your health, to make your worry less likely to become reality.
9. If it’s not possible – or perhaps sensible – not to worry at all about important things, on the grounds that worry can lead to positive action – e.g. worry about an exam might make someone work more systematically – limit your worrying to a set period each day. This might include thinking about what to do with the worry, how one might cope in a worst-case scenario, etc. But then devote the rest of the day to other things.
10. The rationale for worry is to reduce the uncertainty by assuming the worst. Assuming the best seems like tempting fate. But if you assume the best and the worst happens, at least you will have had a better time before it did. If you assume the worst and the best happens, you will have been miserable worrying for nothing. If you assume the worst and the worst happens, you will still have been miserable for longer.
11. What we are thinking about influences what we notice. So, if you have just bought a certain make of car, you may notice many others. This isn’t because there are more of them – it’s just that you now notice them. So if you are preoccupied with worrying about something, you are more likely to think that you have encountered whatever it is that you are worrying about (Willson and Veale, 115). Meares and Freeston (187) suggest that someone who is worried about spiders is constantly on the lookout for spiders, and then thinks that things which are not spiders – such as a knotted piece of wool blowing across a floor – are spiders. This is known as hypervigilance. Hypervigilance helps us detect threats quickly, but also makes things which are not threats seem threatening.
12. Someone who is hypervigilant will always find something to worry about, as nothing is certain. Even if nothing much is uncertain, one can still worry that the uncertainty is coming (Meares and Freeston, 188). This stops one enjoying the present. So excessive worrying can make the situation seem worse.
13. Asking for reassurance too many times can backfire. Worriers often ask those closest to them, which can cause irritation, leading to a dismissive or hurtful response which can lead to more worry (Meares and Freeston, 200).
14. Human beings have evolved to be able to deal with uncertainty by considering what might happen if …. And what could be done to prevent it, or deal with it. So to worry is to be human. But worrying excessively is attempting to be superhuman – to try to be able to anticipate every possible bad event and work out how to prevent it or what to do in every scenario (Mears and Freeston, 50-51). Excessive worry can lead to many years of needless distress, preoccupation and interference in one’s life (Willson and Veale, 101).
15. The way we think, feel and behave are linked, so by changing the way we think we can change the way we feel (Willson and Veale, xi). Human beings, like animals, ‘can train themselves to think and behave in a particular way’ (Willson and Veale, 41).
16. A thought is just a thought; it might not represent reality (Willson and Veale, 6).
17. Distance yourself from your thoughts by imagining that they are cars passing on a road that you are watching from the pavement (Willson and Veale, 97). They are just thoughts and may or may not represent reality.
18. Continually thinking about a problem makes you feel worse if you cannot find a satisfactory answer to your questions, and you might generate new unanswerable questions (Willson and Veale, 8).
19. When you worry about your health, you focus much more on physical sensations and feelings and disregard negative test results. This makes you more aware of how you feel and more likely to assume that your thoughts represent reality (Willson and Veale, 8).
20. The more you seek reassurance, the worse the preoccupation with the worry (Willson and Veale, 46).
21. Types of faulty thinking include:
a. Catastrophizing – e.g. lumps under the skin must be cancer
b. All-or-nothing – e.g. either I have no disease or I am ill and will soon die a painful death
c. Over-generalizing – e.g. because I’ve worried for years I will never be able to stop worrying
d. Fortune-telling – e.g. I know I’ll never get over this
e. Mind-reading – e.g. the doctor didn’t look me in the eye because he knows that I have a serious illness
f. Mental filtering – e.g. paying a disproportionate amount of attention to the small amount of evidence which supports the worry
g. Disqualifying the positive – e.g. the doctor said I was fine but he may not have been concentrating, there’s no point in enjoying life if you’ll die one day
h. Labelling – e.g. my health is poor
i. Emotional reasoning – e.g. listening to negative gut feelings instead of looking at the objective facts
j. Personalizing – e.g. the newsagent looked at me in a certain way because he knows I’m ill
k. Demands – e.g. I must know if there is anything wrong so that I can do something about it
l. Low frustration tolerance – e.g. I can’t stand it, when it is possible to tolerate it (Willson and Veale, 73-75).
22. ‘[Y]ou can experience unpleasant thoughts and feelings and still do what’s important for your life, despite their presence. If you keep doing this, they will slowly fade away’ (Willson and Veale, 79).
23. In most cases, we can only really deal with a worrying event – e.g. a serious illness – if and when it happens. Worrying just makes us anxious and makes it more difficult to get on with things which are important in the present (Willson and Veale, 113).
24. If you keep going over the same worries, this will increase the stress you experience in your mind and body. Focus instead on something else which rests the brain and helps you to appreciate the world (Willson and Veale, 117). You can train yourself to focus more on tasks and your surroundings and less on yourself (Willson and Veale, 122).
25. Even if you are ill, you don’t have to spend hours worrying every day (Willson and Veale, 169).
26. Remember that setbacks are a normal part of recovery (Willson and Veale, 228).
January 2014, Elizabeth Burns
London: Robinson, 2008.
 London: Robinson, 2009.