What? Me Worry!?!
What? Me Worry!?!
Module 3
Negative Beliefs About Worrying:
“Worrying Is Uncontrollable”
Introduction
2
Changing Your Belief
2
Challenging Your Belief
3
Worksheet: Challenging Your Belief
4
Experimenting With Your Belief
5
Worksheet: Postponement Experiment
8
Module Summary
About the Modules
9
10
What? Me Worry!?!
The information provided in the document is for information purposes only. Please refer to
the full disclaimer and copyright statements available at www.cci.health.gov.au regarding the
information on this website before making use of such information.
Page 1
Psychotherapy Research Training
C
C
I
entre for
linical
nterventions
Module 3: Negative Beliefs About Worrying – “Uncontrollable
What? Me Worry!?!
Introduction
Ask yourself this question: if you believed you had control over your worrying, how much would your worrying
bother you? Chances are you wouldn’t feel as bad if you thought you have a choice about whether you
worried, as opposed to thinking that your worry controls you. So in this module we will look at changing
your beliefs that:
“I have no control over my worrying”
“Once I start worrying I can’t stop”
“My worrying is uncontrollable”
“My worrying will never end”
“My worrying controls me”
“I can’t do anything to stop my worrying”
Changing Your Belief
Before we start changing your belief that worrying is uncontrollable, we need to know how much you
believe it. How convinced are you that your worrying is beyond your control? Do you believe it fully and
whole-heartedly? Do you mostly believe it? Half the time? Occasionally? Or maybe this is not a belief you
even hold? Even if you think you do not hold this belief, we encourage you to still work through this
module to be sure it is not a belief that is lurking at the back of your mind without you realising. Chances
are, you can move on quickly from this module to the next.
How much do you believe that your worrying is uncontrollable?
(Circle the percentage that best describes the strength of your belief)
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
To change your belief that your worrying is uncontrollable, you need to do two things.
Firstly, you need to challenge or dispute your belief. That means taking apart the belief
that you can’t control your worrying, by evaluating if it really is accurate and true, and
examining what evidence you base your belief on. In this way you will be like a
detective, trying to get to the facts of whether worrying really is uncontrollable.
Secondly, you need to experiment with your belief. That means doing things to see if worrying really is
uncontrollable. If you are able to do things that show your belief isn’t true that in fact you can control
your worrying it is going to be hard to hold on to your belief. In this way you will be like a scientist with
a prediction that worrying is uncontrollable, which needs to be tested.
Page 2
Psychotherapy Research Training
C
C
I
entre for
linical
nterventions
Module 3: Negative Beliefs About Worrying – “Uncontrollable
What? Me Worry!?!
Challenging Your Belief
Below is a list of questions you can ask yourself to challenge whether your belief that worrying is
uncontrollable is really true. By using these questions you will become a detective, examining the evidence
for and against your belief. An example is given below of how to use these questions to challenge your
belief, and on page 4 you will find a worksheet to help you do this for yourself.
Evidence For
What makes you think worrying is uncontrollable?
What’s the evidence for your belief?
Is the evidence for your belief good/solid/reliable?
Is there another way you could view the evidence for your belief?
Evidence Against
Is there any evidence that goes against your belief?
Has your worrying ever been disrupted/interrupted? Can distraction work in the short term? What
does this tell you about uncontrollability?
Does your worrying stop eventually? How can this be if it is uncontrollable? Shouldn’t it just go on
forever if it can’t be controlled?
Can you manipulate your worrying (i.e., increase or decrease it)? Would this be possible if it was
completely uncontrollable?
Does taking action ever work to stop your worrying? What does this tell you about whether it is
controllable?
What strategies have you tried to control your worrying? Are they mostly forms of suppression, which
only increase worrying?
Have you ever tried to properly postpone your worrying (that is, not suppress it, but instead allow
yourself to have a worrisome thought, and decide not to worry about it at that particular moment)? If
you have done this, what does this tell you about your worrying being uncontrollable? If you haven’t
done this, how do you truly know your worrying is uncontrollable?
Is it possible that it is controllable, you just don’t know how yet?
EXAMPLE:
Belief: “My worrying is uncontrollable”
Evidence For Evidence Against
When I tell myself not to think about
something, I still keep worrying, so it must
be uncontrollable.
[I guess what I am really doing is suppressing my thoughts,
which just makes them come back worse. It is possible that
the strategy I am using is wrong, rather than my worrying
actually being uncontrollable.]
It just feels uncontrollable, therefore it must
be.
[This isn’t very solid evidence that my worrying is beyond my
control. Just because I feel it is true, isn’t really evidence that
it actually is true.]
Things do happen during my day that
naturally interrupt my worrying.
[My worrying can’t be uncontrollable if something can interrupt
it. If it were uncontrollable it would keep going regardless.]
There have been times when I haven’t worried,
because I have been too busy doing something
else.
[My worrying can’t be uncontrollable if being busy can stop it
from happening.]
I have only ever tried to suppress my worrying,
but never tried to postpone it.
[I don’t truly know if it is uncontrollable if I haven’t used the
right strategy to try and control it.]
My worrying does eventually stop, either when
I have run out of steam, or feel I have worried
all I can and I am prepared.
[My worrying can’t be uncontrollable if it doesn’t actually go on
forever.]
Page 3
Psychotherapy Research Training
C
C
I
entre for
linical
nterventions
Module 3: Negative Beliefs About Worrying – “Uncontrollable
What? Me Worry!?!
Challenging Your Belief
Belief: My worrying is uncontrollable
Evidence For Evidence Against
Page 4
Psychotherapy Research Training
C
C
I
entre for
linical
nterventions
Module 3: Negative Beliefs About Worrying – “Uncontrollable
What? Me Worry!?!
Experimenting With Your Belief
Now it’s time to do a bit of experimenting with your belief that worrying is uncontrollable.
Like any good scientist, if you have a prediction about something, the best thing to do is to
conduct an experiment to see if it is true.
You will have noticed in the previous example for challenging your belief that a distinction
was made between suppressing thoughts, and postponing worrying.
As mentioned in Module 2, we tend to do one of two things when a “what if” thought pops into our head.
We either pull it closer, meaning we listen to it, and spend lots of time and attention thinking about it. Or
we push it away, try to suppress it, get rid of it, stop thinking about it. As we know, suppression just does
not work, and the thought we are trying to push away tends to pop back with even more fury. So, both
pushing away and pulling close our negative thoughts just leads to more negative thinking, making it seem
like our worrying is uncontrollable.
Now, perhaps worrying is controllable, but you just haven’t been using the right strategies yet!! One way to
test this out is to postpone your worries until later. Postponement involves neither pushing nor pulling.
Postponing is “putting to the side” or “parking” the negative thought for now.
Postponing negative thoughts means that it is perfectly OK and natural for an
initial “what if” negative thought to pop into your mind (e.g., “What if I fail my
exam?”), but you make a decision not to ‘chase’ the thought any further at that
particular time.
Not chasing the negative thought further means that you don’t try to anticipate the
worst or run scenarios and solutions related to your initial thought through your
head over and over again (e.g., “It will be a disaster, I will be a failure, I will get
kicked out of uni, I won’t be able to find a job, maybe I should pull out of my
course,” etc).
Instead, you postpone thinking about your worry until a later time. This will help
contain your worrying to one part of the day, rather than carrying it with you 24/7.
Most importantly postponing allows us to experiment with our worrying to see if it really is uncontrollable.
After all, if we can interrupt and postpone our worries until later, then they can’t be beyond our control.
How to postpone
1. Set a thinking time
- Nominate a set time, length of time, and place, to do all your thinking about worrisome things.
- Try and keep your thinking time the same everyday (e.g., 6pm, 15mins, dining room). If it does
need to be changed on a certain day, just make sure you have a clear idea when it will be
rescheduled.
- Try not to set your thinking time before bed.
2. Postpone
- When you notice yourself worrying about something during the day, say something to yourself like
“it’s OK to have that thought, but I don’t need to chase it any further right now”. Notice these
words are all about being very accepting of the initial thought.
- List the topic of your worrisome thought briefly (in a couple of words only). This will mean
initially carrying a small notebook with you to do this. Later when you are good at the skill you
could mentally note it down.
- Decide to think about it later and save your thoughts for your thinking time.
- Bring your attention back to the present task at hand and reassure yourself that you will deal
with the negative thoughts later (Note., regularly practicing attention training exercises from
Module 4 will help you with being able to do this).
Page 5
Psychotherapy Research Training
C
C
I
entre for
linical
nterventions
Module 3: Negative Beliefs About Worrying – “Uncontrollable
What? Me Worry!?!
- If the thought pops back again (which it likely will), this is not a sign that postponement hasn’t
worked, after all we can’t control what pops into our head. What we are postponing is the further
thinking, spiralling, chasing or snowballing of those thoughts, otherwise known as worrying. So
when a thought pops back, write it down or put a tick next to it if it is already in your notebook,
and repeat the above postponement steps.
3. When you get to your thinking time
- Only think about the things you’ve listed if you feel you must.
- You don’t have to think about them if they no longer bother you, or if they no longer seem
relevant to you. You could just cross them off your list to signify that they
are no longer important.
- If you do need to spend time thinking about them, only do this for the set
amount of time specified and try to do this in a productive way on paper.
- If the issue that is bothering you is something solvable, then do some
problem solving on paper (e.g., what is the problem, what are my options
for dealing with this, what plan could I put in place to take some action
you will find out more about this in Module 7).
- If the issue is something you recognise you may be overreacting to, try to
think about it in a more helpful, balanced, realistic way (e.g., what would be a more helpful way to
think about this?, what would I say to a friend who was thinking the same way?, etcyou will find out
more about this in Module 8)
- If the issue is not something you can take action with or think about differently, either think about
it on paper, or use your mindfulness meditation practice (from Module 4) to help with accepting
and letting go of these thoughts, or continue to postpone it for now.
- Finally, it is often good to follow your thinking time with some activity that you know lifts your
mood (e.g., certain music, book or TV show, a walk, time with pets, chatting to a friend, etc).
Common postponement pitfalls
It is important to do postponement properly, formally and thoroughly initially to be able to really test if
your worrying is controllable. As with any experiment, if it isn’t done properly, we can’t really make any
new discoveries. The following are the most common ways that postponement is not done properly.
Watch out for these so that they don’t contaminate your experiment.
Suppressing or non-accepting attitude.
Make sure the things you say to yourself in your mind when you
decide to postpone are very accepting of those initial negative thoughts (e.g., “postpone”, “catch you later”,
“see you at 4pm”, “park it for now”, etc). Getting angry with yourself or saying things like “stop it” or “push it
away”, are signs that you are trying to suppress the thoughts, rather than accept them and postpone further
thinking for now.
Giving up when the thoughts pop back
. A thought may only pop up once, but it could pop up 10 times or
100 times. It doesn’t matter. Having to repeatedly postpone the same thought doesn’t mean
postponement hasn’t worked. Remember we aren’t changing what pops into our head, but we are
changing how we respond. Expect and accept that thoughts will pop back.
No Rationalising
. Rationalising or thinking logically when a negative thought pops up may seem like a helpful
thing to do, but if it truly was helpful, this strategy would have put your worries to rest a long time ago.
Rationalising in the moment when a thought pops up, is ultimately a way of pulling it close, giving the
thoughts time, energy, and attention. It could also be a covert form of suppression, trying to ‘logic the
worry away’. Any rational thinking is fine in your designated thinking time, but avoid using it in the moment
to respond to a negative thought that has popped up. Instead acknowledge and accept the thought, and
immediately disengage from further thinking till your thinking time.
Avoiding thinking time
. Some people avoid thinking time because they anticipate it will be unpleasant. This
is likely because of danger beliefswhich we will address later. Try to commit to thinking time and stick
to the time limit. And remember you don’t have to think about things that are no longer important. For
those that do still seem important, try to engage in helpful and constructive thinking.
Page 6
Psychotherapy Research Training
C
C
I
entre for
linical
nterventions
Module 3: Negative Beliefs About Worrying – “Uncontrollable
What? Me Worry!?!
Before you start the experiment, complete the worksheet on page 8 in as much detail as you can and then
continue filling it out as you go along.
Instructions for completing the worksheet:
First, write down the details of your thinking time (start time, time limit, and place). Then, write down
what you think will happen when you try to postpone your worrying. Particularly, how controllable do you
think your worrying will be? After that, rate how confident you are of your ability to postpone your
worrying (between 0 and 10).
Now just give the experiment a go and see what happens.
For each of the next 7 days, fill in the day and the date, and record what actually happened during the day
(e.g., did you manage to stop chasing worrisome thoughts and to postpone worrying? and what happened
at thinking time?). Rate how controllable worrying seemed.
Then, compare what you predicted would happen with what actually happened on those 7 days. Typically
people predict that they won’t be able to postpone their worrying, and that their worrying will be out of
control when they try this new strategy. Often people are surprised that they are actually able to
postpone their worrying, and experience a greater sense of control. Also, people often find that when they
come to their thinking time they don’t feel the need to worry, because most of their worries no longer
seem that important. This begs the question of how important they were in the first place.
What did you find?
While postponing worrying is used here as an experiment to tackle your belief about worrying being
uncontrollable, it is also just a really good strategy for dealing with worries so they don’t interfere with
your day-to-day life. So, try to continue with the postponing worrying activity indefinitely. A later
experiment recommended in this information package may require that you stop the postponing worrying
experiment for a certain period of time. But unless another experiment gets in the way of you postponing
your worrying, treat this technique as your new way of dealing with worrying generally, and use it for as
long as worrying is still a problem for you.
Now that you have challenged and experimented with your belief that worrying is uncontrollable:
Rate again how much you believe your worrying is uncontrollable?
(Circle the percentage that best describes the strength of your belief)
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
If there is some weakening (however small) of your belief that your worrying is uncontrollable compared to
what it was at the start of this module, congratulate yourself. If there’s no change yet, that’s okay.
Remember, changing your beliefs takes time and persistence. Just going over the evidence for and against
your belief once or experimenting with your belief once may not be enough. These are ongoing strategies
you can practice until the evidence for your belief is weak, the evidence against your belief is strong, and
you are successfully able to postpone worrying. We would aim for a 0% belief that worrying is
uncontrollable, so keep using the strategies in this module to help you get there.
Page 7
Psychotherapy Research Training
C
C
I
entre for
linical
nterventions
Module 3: Negative Beliefs About Worrying – “Uncontrollable
What? Me Worry!?!
Postponement Experiment
My Thinking Time:
Start Time:
Time Limit:
Place:
Prediction (What do you think will happen if you postpone worrying? Particularly, how controllable
will worrying be?
)
How confident are you of your ability to postpone worrying?
0 1 2 3 4 5 6 7 8 9 10
I cannot postpone
worrying
at all
I am moderately
confident I can postpone
worrying
I am extremely confident
I can postpone
worrying
Day:
Date:
day day day day day day day
What
happened?
Did you
postpone
worrying?
What
happened at
thinking
time? Did
the thoughts
still seem
important?
How
controllable
did worrying
seem? (0%
to 100%)
Compare prediction with what happened. What did you learn about worrying and how controllable it is?
Page 8
Psychotherapy Research Training
C
C
I
entre for
linical
nterventions
Module 3: Negative Beliefs About Worrying – “Uncontrollable
What? Me Worry!?!
Module Summary
Negative beliefs regarding worrying being uncontrollable make your worrying worse
To change these beliefs you can:
Challenge them look at the evidence for and against the beliefs
Experiment with them set up a postpone worrying experiment to see if worrying really is
uncontrollable
In order to change your belief that worrying is beyond your control, you need to persist with both
techniques until:
The evidence for your belief is weak
The evidence against your belief is strong
You are successfully able to postpone worrying
Once you have achieved these three things ask yourself:
What does all this say about my worrying?
It should show you that your worrying is in fact controllable.
This doesn’t mean we can control what thoughts enter your mind and capture our attention in the first
place, but we can control how we respond once we realise worrisome thoughts have entered our
mind. We have a choice whether we engage with the thoughts, and how we engage with them.
Postponement allows us to put our worries ‘to the side’ for later, rather than pushing them away or
pulling them close.
Coming up next
In the next module you will learn how
to retrain your attention, to be able
to notice when it is caught in worrying
and refocus it on the present task at
hand.
Page 9
Psychotherapy Research Training
C
C
I
entre for
linical
nterventions
Module 3: Negative Beliefs About Worrying – “Uncontrollable
What? Me Worry!?!
About The Modules
CONTRIBUTORS
Dr Lisa Saulsman (MPsych
1
; PhD
2
)
Centre for Clinical Interventions
Dr Helen Correia (MApp Psych
1
; PhD
2
)
Centre for Clinical Interventions
Paula Nathan (MPsych
1
)
Director, Centre for Clinical Interventions
Dr Rebecca Anderson (MPsych
1
; PhD
2
)
Centre for Clinical Interventions
Adjunct Senior Lecturer, School of Psychiatry and Clinical
Neuroscience, The University of Western Australia
Dr Louella Lim (DPsych
3
)
Centre for Clinical Interventions
Bruce Campbell (MPsych
1
)
Centre for Clinical Interventions
1
Masters of Psychology (Clinical Psychology)
2
Doctor of Philosophy (Clinical Psychology)
3
Doctor of Psychology (Clinical)
Some of the materials in the modules of this information package were taken from:
Saulsman, L., Anderson, R., Campbell, B., & Swan, A. (2015). Working with Worry and Rumination: A
Metacognitive Group Treatment Programme for Repetitive Negative Thinking. Perth, Western Australia:
Centre for Clinical Interventions.
BACKGROUND
The concepts and strategies in the modules have been developed from evidence based psychological
practice, primarily Metacognitive Therapy (MCT). MCT is a type of psychotherapy developed by Professor
Adrian Well’s at the University of Manchester. MCT is an extension of Cognitive-Behaviour Therapy
(CBT) and is based on the theory that repetitive negative thinking, such as chronic worry in generalised
anxiety, is a result of problematic metacognitions (i.e., beliefs about thinking) and behaviours. There is good
scientific evidence to support that targeting metacognitions and behaviours in therapy can help many people
to overcome generalised anxiety. Examples of this evidence are reported in:
McEvoy, P. M., Erceg-Hurn, D. M., Anderson, R. A., Campbell, B. N. C., Swan, A., Saulsman, L. M., Summers,
M., & Nathan, P. R. (2015). Group metacognitive therapy for repetitive negative thinking in primary and
non-primary generalized anxiety disorder: an effectiveness trial. Journal of Affective Disorders, 175, 124-
132.
REFERENCES
These are some of the professional references used to create the modules in this information package.
Barlow, D.H. (2002). Anxiety and Its Disorders: The Nature and Treatment of Anxiety and Panic (2
nd
ed.).
London: Guilford Press.
Heimberg, R.G., Turk, C.L., & Mennin, D.S. (2004). Generalized Anxiety Disorder: Advances in Research and
Practice. New York: Guilford Press.
Wells, A. (1997). Cognitive Therapy of Anxiety Disorders: A Practice Manual and Conceptual Guide. Chichester,
UK: John Wiley & Sons Ltd.
Wells, A. (2008). Metacognitive Therapy for Anxiety and Depression. New York: Guilford Press.
“WHAT? ME WORRY!?!”
This module forms part of:
Saulsman, L., Nathan, P., Lim, L., Correia, H., Anderson, R., & Campbell, B. (2015). What? Me Worry!?!
Mastering Your Worries. Perth, Western Australia: Centre for Clinical Interventions.
We would like to thank Mandy Nathan, Psychologist, Oxfordshire, England, for the suggestion of a "worry puss" for
the theme character of this Information Package
ISBN: 0-9751985-9-9 Created: June, 2015
Page 10
Psychotherapy Research Training
C
C
I
entre for
linical
nterventions
Module 3: Negative Beliefs About Worrying – “Uncontrollable