#11 The most surprising tool to help you worry less - Overcoming Worry & Anxiety | Dr. Rami Nader
Вставка
- Опубліковано 13 чер 2024
- If you worry a lot about things that haven’t happened yet (and may never happen), then chances are that one of the ways you deal with the worries is to try and avoid thinking about them as much as possible. However, as I discussed in the last video, all this does is cause the worries to come up over and over again. So instead of trying not to think about the worries, I encourage my clients to use a tool called cognitive exposure. Essentially, cognitive exposure is intentionally thinking about the worry, all the way to its most upsetting and distressing end, repeatedly as a way of draining the emotion and distress out of the worry thought. By doing the cognitive exposure, you are giving the worry its “airtime” in concentrated ways and, thereby, making the worry less scary and frightening. If the worry no longer brings a high level of emotion or distress, then there will be less need to try and avoid or suppress the worry and, in turn, the worry will not come up as much. This video discusses how to do cognitive exposure by writing out a “worry script” and reviewing it multiple times a day for one or two weeks, monitoring levels of anxiety and distress while you do this. Cognitive exposure is quite a challenging tool, as it tends to bring up a lot of distress, but ultimately, it works and helping a person worry less about these type of worry topics.
For more information about excessive worry and Generalized Anxiety Disorder, see my long form video: tinyurl.com/y4yqthap
#GAD #Worry #CBT
Videos in the worry management series:
Overcoming Worry 1: Defining Worry: 3 features of worry and 2 types of worry - tinyurl.com/y2ox4z9n
Overcoming Worry 2: Understanding a model of worry and worry awareness training - tinyurl.com/y5awco8l
Overcoming Worry & Anxiety 3: The Role of Intolerance of Uncertainty in Worry - tinyurl.com/y6ohak2y
Overcoming Worry & Anxiety 4: Manifestations of Intolerance of Uncertainty - • #4 Manifestations of I...
Overcoming Worry & Anxiety 5: Two Ways to Build Tolerance for Uncertainty - • #5 Two Ways to Build T...
Overcoming Worry & Anxiety 6: Five Myths about Worry - • #6 Five Myths about Wo...
Overcoming Worry & Anxiety 7: Challenging Worry Myths - • #7 Challenging Worry M...
Overcoming Worry & Anxiety 8: What do you do when you hate dealing with problems? - • #8 What do you do when...
Overcoming Worry & Anxiety 9: Problem-Solving Skills to Defeat Worry - • #9 Problem-Solving Ski...
Overcoming Worry & Anxiety 10: Why we worry about things that haven’t happened - • #10 Why we worry about...
Overcoming Worry & Anxiety 11: The most surprising tool to help you worry less - • #11 The most surprisin...
Overcoming Worry & Anxiety 12 - A Worry Management Recipe - • #12 A Worry Management...
Overcoming Worry & Anxiety 13 - Dealing with Complex Worries - • #13 What are Complex W...
Overcoming Worry & Anxiety 14 - Maintaining Progress and Preventing Worry Relapse - • #14 How You Can PREVEN...
For more information about Dr. Rami Nader, visit: tinyurl.com/y3eu5dfw
For more information about Dr. Michel Dugas' work on Generalized Anxiety Disorder and an excellent workbook, visit: tinyurl.com/yxf78mnt
DISCLAIMER: The videos provided here on this UA-cam Channel are for informational use only. The video content provided is not intended to be a substitute for professional advice, diagnosis, or treatment. These videos do not establish a psychologist/client relationship. Always seek the advice of your doctor or mental health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read or seen on this channel. Dr. Rami Nader assumes no duty to correct or update the video content nor to resolve or clarify any inconsistent information that may be a part of the video content. Reliance on any content is solely at the viewer’s risk. Dr. Rami Nader hereby disclaims any and all liability to any party for any direct, indirect, implied, punitive, special, incidental or other consequential damages arising directly or indirectly from any use of the said video content, which is provided as is, and without warranties.
7544
Thank you sir!...I wish all people with the problem could find this channel
Thanks for this Dr. Nader. I reluctantly completed the exercise and wrote my 'horror story'. As I wrote, I realized how unlikely it was that my fear would come true based on the facts. Even in the details, I thought "this sounds very far fetched" which made me worry even less. This is a brilliant technique and has really helped. Thanks for sharing!
I'm so pleased to hear that it worked for you! So great to hear.
I have to really work on this as I am not experiencing as much PTSD symptoms but now having horrible things that may happen, like my kids and family members dying, constantly texting and calling them. This is so triggering to even think about much less write it in detail. This has left me in the past and future, NOT in the present at all.
Thank you for this! When I look up tips and tricks to stop the worrying I see the same technique “plan a time slot every day to have these worries” I feel it is counter productive.
I would agree with you about that. This type of cognitive exposure is different than the "worrying time" approach because cognitive exposure requires a person to think about the most upsetting parts of the worry that they usually do not allow themselves to think about.
Thank you!! Love your videos! I guess this video is what they mean when they say to “play with the stressful thought” so to speak. It’s brilliant!
Hi Sam - glad you found the video useful. It is quite a counterintuitive approach, but once you understand it, it makes a lot of sense. Thanks for supporting the channel.
Writing down my worst fears, I'm reminded, is also a technique recommended by "The Crappy Childhood Fairy," Anna Runkle, who teaches on childhood PTSD here on UA-cam. I watch her videos to help me cope better with my own CPTSD. Your advice here reminds me that I've done a lot of self-therapeutic writing, and got out of the habit. Now, given that fire season here in the Pacific Northwest is going full-blast, and that my beloved mate died two years ago of Alzheimer's, as did my own father, my best friend ever is dying of cancer, and the political situation here in the U.S. is batshit, I am currently terrified of fire, dementia, cancer, and menacing dictatorship. If worry produced heat, I'd think my head's on fire! You've reminded me I need to get back into my daily writing, which did indeed calm and comfort me. I've been off it so long I've actually worried myself into adrenal fatigue. Thank you for your videos.
Love your videos, clear, helpfull and Short , thank you :)
You are welcome, as always. Thanks for watching and supporting this channel!
Thanks so much for these videos, you make the information so clear and they help a lot
You are welcome. I'm glad you are finding them helpful. Hearing feedback like this is very encouraging and the whole reason I wanted to post these videos.
EXCELLENT VIDEO & it really works!!
JUST LIKE ALL YOUR other VIDEOS THEY help me so much to maintaining my selfcare along with meditation & Journal writing. Please keep making your videos!!
Thank you so much for your positive and encouraging comments. This is exactly why I wanted to do these videos, so I am pleased you find them helpful. I don't plan to stop making videos any time soon!
I found these videos extremely helpful to get a deeper understanding for Duga's cognitive model. Thanks a lot!
Thanks so much for your encouraging comment. I'm glad you found the videos helpful. I'm a huge advocate of Dugas' model, so I'm pleased to get the information out as broadly as possible.
This was the best thing I heard since I started watching anyone or anything to do with OCD ty very much!
You're very welcome. Glad you found it helpful!
Your videos are the only ones that have resonated with me and I've seen quite a few. You are helping me come to terms with my anxiety and depression ......Thankyou
Hi Andy - thank you for the kind words. I'm very pleased that you have found the videos helpful and wish you all the best in your efforts to feel better.
your videos are the best.. I am binge watching all of them to save myself from going deep in depression.
Thank you for saying that. I hope you're able to use some of these skills to feel better.
Thanks for the video. Will try to apply this to my situation. I lost my job and the thought of losing financial security always popping out in my head.
Good luck. Let me know how it goes.
Ja
thank you. i really learned a lot from this channel.
You're very welcome, glad you have found the videos helpful.
These videos are so helpful and thought-provoking that I need to stop every now and then to take notes and review articles about the topic, took me an hour to finish this vid. haha. Thanks a lot, and please keep posting. Selamlar
Thank you for your kind and encouraging comment. I am very pleased you are finding the videos helpful. This is exactly why I started doing these videos. I'm planning to keep posting videos every week, so please keep watching and share with anyone you think might find them helpful. Thanks!
@@DrRamiNader I sure will Dr. Nader, thanks 😊
Thank you
You're very welcome.
Helpful. Thanks..
Glad you found it useful.
10:30 a really scary thought and I have a lot of them. They just go on and on. Thank you so much for this tool!
You are welcome Paloma. I hope it's helpful for your type 2 worries.
@@DrRamiNader I do everything to understand that thoughts aren't facts/reality and your information is truly helpful. Thanks a lot!
I feel like being exposed to the "worry", isnt going to help me at all. This is my personal opinion. It may work for others. I dont think giving my worry "air time" will lessen its impact on me. I feel like im gonna be so sad if i write it down and its horrible and ill get more depressed. Im talking about worries that are tragic. It will probably make me fear that issue more and more. The horror movie example was good, however the only problem I find, is that in the horror movie you know the ending. You watch it over and over and you know how it will end. When it comes to worrying you dont know how the story will end. I tend to make up a bunch of scenarios in my head about the worry and how it may end. So if I fear losing a loved one, my mind will think whether I will lose them to a car accident? Cancer? Sports accident? They get murdered? Etc... in the movie example we know how the movie will end. In the worry thoughts we dont know how or IF the incident will even happen. It leaves us uncertain, whereas in the movie when we get to our 3rd or 4th time watching it we know what to expect. You also said its helpful to write out a script of the worry. So lets say I fear my loved one dying and I write out the scenario. Reading it over and over doesnt do anything for me. In fact it makes the worry even more real to me because every day I am reading it and thinking about it. I am ruminating on it. I feel like the worry will maybe even come true if I write it down on paper and put it out into the universe. Of course this is superstitious, I know. But the question we find ourselves coming back to is: WHAT IF this worry does manifest and happen? I know we have to deal with it if it ever happens. But my GOAL is to not be ROBBED of the present moments joy and fear the unknown that may never happen. Its like I'm sacrificing todays happiness for tomrrows worry that may never happen. I am missing out on todays joy for next weeks worry. Its like getting invited to a party and being Miserable at that party and not enjoying the moment because you fear that next week you are going to fail the exam at your University so you miss out on today's pleasure for tomorrow's worry. Is there any evidence that shows that writing a script and thinking about the worry and giving it air time truly helps us "deal with it" better or helps us "cope" with it? Another thing I was thinking about when you said to think about the worry until the very end, is the new worries that arise after the worry does happen. So for example lets say I fear losing my job (a type 2 worry) then I start thinking of intra-intra-worries that are inside of the worry and come after the worry may happen. So ill say what if i lose my job? Then after i lose my job, ill lose my home, then become homeless, then blah blah. So our mind takes the worry even further and conjectures more worries that are related to the initial type 2 worry. So your type 2 worry (losing the job) ends up giving birth to other worries that are deeper into the future. I call the type 2 worry the mom and the subsequent worries the offspring or "baby". Do you really think writing the script for your deepest darkest worry will even help? I feel conflicted on whether it even helps. And what do you do if the script comes true? Sorry my response was long but I want to make sure you hear other perspectives also.
Thank you for your thorough and thoughtful reply. I know this idea of cognitive exposure seems strange, frightening and counterintuitive, but there is a lot of research to show that it works and it targets cognitive avoidance, which we know drives these type 2 worries. This is the same process that we use in treating people with PTSD, except the trauma script in PTSD is something awful that has actually happened, as opposed to something awful that hasn't happened in Type 2 worries. These worries want their air time and will get their air time, either intermittently on an ongoing basis, or through this cognitive exposure. The idea isn't to use cognitive exposure for just any type 2 worries, but the type 2 worries that are particularly problematic and recurring. But I also understand your reluctance to want to do it and point out that it is just one tool that you can use for these type 2 worries. If you don't feel that cognitive exposure would work for you, you can still use tolerating uncertainty skills and challenging beliefs about the usefulness of the type 2 worries, as I discussed in earlier videos. Cognitive exposure is just an additional skill for those that want to use it or feel that they could benefit from it.
This exactly why this method won’t work for me either. The exact same reasons. Crazy that someone else thinks like me 😳
Not an expert but it seems like you gotta get your brain to actually accept the possibility of these bad things happening no idea how severe your worrying is but for some reason I used to have this worry and fear about my mother dying, she's not some sickly person just a random fear. What actually got me over that fear is my dad dying I know sounds crazy but, losing a parent at a young age and being able to get through it actually made me lose my fear of my mom dying. And I apply that to other things I'm worried about like say losing a job and being poor I actually will really sit there and consciously think about the thing and work at accepting the possibility of this outcome.
Recognizing that you can cope when bad things do actually happen can help a lot with worry and always trying to prevent bad things from happening.
I resisted this kind of exposure SO MUCH, which basically means I should do it. Did it the first time today before watching this video. I had the same reservations and reasons as jessie. And I thunk what JD mentioned is also plays a huge part.. I wouldn’t even allow the idea that it “could” happen, but that made the worries even worse. Let’s see.. nothing “worked” so far for me, so I’ll give it a try. What’s the worst thing that can happen? (haha)
Thank you sir!....plz make video on depression and anxiety when both are corelated...means something that is the reason of depression and also causes type 2 worry...
Thanks ,so it's all about letting that anxiety come , sitting with it , not doing anything to prevent it
Hi Doctor Rami, I made my worry script in 30-45 min, I thought the idea was to create a worry script for 30-45 min, and not to do in 5 min then repeat the same thing over and over again.
Good morning sir 🎉🎉
thanks. So this technique of cognitive expression can go well too with somatic expression? (something I've been exploring, given the realization that my anxiety and depression seem to express in my body - as physical symptoms or emotional charges - and a desire to understand how to be with and accept them)
Hi Dr Rami, Thank you for this video very useful! May I ask what happened to the 'putting it all together' video? The final one in this series? I can't find it and I started to watch it a few weeks back.
Thank you.
Hi Colin, you can find all 14 videos in the series here: Generalized Anxiety Disorder and Worry: ua-cam.com/play/PLG_XiSJeP3s3uiRj-4CNEUn2qoK3mLAzD.html. The video you asked about is labeled #12. Hope that helps.
@@DrRamiNader Thanks so much for your prompt response!
Your videos are really helpful.can you please make a video on how to be emotionally stable in all the situation..I become anxious whenever my baby falls sick. Thank you
There's no way to guarantee that a person will not experience emotional states like anxiety and depression in certain circumstances. The key is to be able to manage those symptoms, which is what these videos are aimed at explaining. Hope that helps.
Hi Rami, thanks for this video..Did you know the thumbnail for this video contains a typo? Congitive Vs cognitive. Anyway, just thought you might want to know
Woops - thanks for catching that. I'll see about correcting it!
I'm always afraid that I will have a stomach sickness at home or bathroom problems if I leave the house. It's been 20 years since I've had food poisoning and I know that if it DOES happen again, it's not as bad as the torture of constantly worrying about it. I've had abdominal pain for about two years now, but the doctors and GI doctor can't find anything physically wrong with me. The GI doc says I have IBS (there is no physical proof of this), but I have nothing wrong with regularity or going at the "wrong times". So every time I feel this pain (which is always), I think, "Ok, well this is it. I'm going to get sick" but I never do. I am also suspect of any food I eat. I'm going to try this and see what happens. Thanks!
I wish you all the best. Hope it helps.
Does this really work with the clinically depressed? 😬
Great regards from dr Heera Lal dayma MBBS dausa raj india 🎉🎉🎉🎉🎉❤
How do you deal with type 1 worries though if it completely overwhelms you and you get nervous and stuff
By challenging negative problem orientation and using problem solving skills. You can find out more here:
ua-cam.com/video/CwnlOXtnn58/v-deo.htmlsi=jmxFz4EUW-Z_1hvH
ua-cam.com/video/hyWDgTiVVfY/v-deo.htmlsi=-jSD6vGK49QbLrnY
I identified a lot with yout cancer script as am a cancer phobic and a hypochondriac, I'll try doing that exercise, but doesn't it look like the myth that worry prepares me to the worst happening? Thank you
The difference is that cognitive exposure is different than worrying, because a person allows themselves to think about the worst parts of the worry that they typically don't allow themselves to think about. So the purpose of doing the cognitive exposure isn't to prepare a person for the worst, it's to allow a person to become more comfortable with the thought of the worst thing happening.
Does this work if you feel the worry may partially be true or will come true?
It depends on how realistic or likely the negative event will happen in the immediate future. If it's highly likely to happen, then it seems like more of a type 1 worry (worry about an actual problem). This could also be a complex, or mixed worry, which I discuss in more detail in this video: ua-cam.com/video/rXeISzGK71Q/v-deo.html
It seemed like My head became more tensed after doing it for a couple of days is that normal?
It's normal for anxiety to increase a bit at first when doing this type of exposure. With repeated exposure to a worry script, that anxiety comes down over time.
My worry is fear of when my mom dies because I’ve always been so close to her what to do how I will cope in life without her and also my worry is what do I do in the future if I ever am not financially able to support myself and my family do you think this will work for what I got I’m trying to find out what my worry solution is so I can pick the right therapy These thoughts come out of nowhere over and over and over and over again I try to forget about them but they keep coming back and the crazy part is they come on their own when I’m feeling good and I just freeze is the best way I can explain it frozen in fear of what if what if ok thank you
The what ifs you describe are very common fears and worries people have. I hope some of the worry management videos can help give you a bit of a different perspective on these worries.
sir, if these worries often come in the middle of some important work that I am doing. In that case, these worries become sources of distraction. So how do I manage them in that case.
That's a difficult question to answer. In a situation like the one you described, you may want to try challenging worry beliefs, as discussed in earlier videos. However, the key idea is that worry management skills aren't something you do at singular moments in time. These are skills to practice and over time, they will help bring down overall levels of worry. It would be like asking, "How do I become physically stronger in a given moment to lift something heavy?" You can't, but the way to become physically stronger is to work out, and over time you will be able to lift the heavy object. I hope that makes sense.
@@DrRamiNader thank you sir
You are welcome.
BRILLIANT ANSWER 👏👏
Is there a difference between an obsessive intrusive thought and this type of worry?
Yes, in OCD, the intrusive thoughts are often ego-dystonic, which means they are nonsensical, repugnant or go against how the person views or understands themselves. Whereas in GAD, the intrusive worries tend to be ego-syntonic, which means that they can make sense to the person, even if the worries are excessive.
@@DrRamiNader thank you for that differentiation, makes sense even though I struggle with OCD and GAD so it gets to separate easily
Stressed out just thinking about writing that script good suggestion but I don't even know if I can do it
That's a common sentiment about this type of imaginal exposure. No lie, it's very challenging and uncomfortable.
@@DrRamiNader I thought from the videos that I watched yesterday ,which is when I first discovered your channel ,that first of all you had a very soothing voice and cadence and it was sort of like ASMR cuz I was so stressed but as soon as the suggestion to write it out came up I just clammed right up. But it really does all come down to facing one's fears.. facing the winds because with each storm we get through the stronger we become right ... what doesn't kill us makes us stronger well you know what I mean. Thankyou Dr. Nader👍
@@michelekurlan2580 Hi Michele - you're welcome. I wish you all the best with your efforts.
@@DrRamiNader all the best to you too thanks again I'll be watching.
No really when we think repeatedly about worry thoughts it causes pressure feels bad ,.
I have watched the videos and I like them. But my worry that I have that I really really don’t want to go through writing down is my son going through what the children in Ukraine are going through by the Russian soldiers. I absolutely flip out. I start crying and screaming and I’ll be at work! So I have no choice but to suppress it. Help!
Hi Amanda - sorry you are having such a difficult time with this worry. Unfortunately, I can't provide specific advice to individuals online. I wish you the best and hopefully this worry settles soon.
@@DrRamiNader Oh yes, of course. I understand. These videos are very helpful. Thank you.
No way isnt that like ruminating thought just brings on more anxiety.
It would seem like it would and, in the short term, it does bring on more. But that's the case with all forms of exposure. Avoidance (either behavioral or cognitive) works very well in the short term, but maintains anxiety in the long term. Exposure brings on anxiety in the short term, but reduced anxiety in the long term. And cognitive exposure is different than rumination, because a person is intentionally thinking the worry all the way through to the most upsetting parts in a systematic and controlled way. Rumination is just dwelling on certain parts of the worry and trying to suppress the parts that are too upsetting to think about.
I am a believer in cognitive therapy, but disagree with this particular approach.. As you said, worry is just a thought. The proper way to stop the worry is to dismiss the thought, just let it go. To keep thinking about the worry over and over only serves to instill the worry deeper into your mind. I appreciate much of you advice, but must disagree on this one.
Thank you for your thoughtful comment and I think you make some excellent points. The challenge is what should a person do if they cannot dismiss the worry and let it go? We know that this is the problem that people have with type II worries - they can't stop thinking about it and worrying about it. Any attempts to suppress the worry actually serve to increase the frequency of the worry (see my video on cognitive avoidance in type II worries: ua-cam.com/video/n2u3jpGl81Q/v-deo.html ). These worries want their "air time" and they are going to get that air time. So the point of cognitive exposure isn't to worry about the worry, but to process the emotion out of the worry through repeated exposure to the thought. Cognitive exposure is a much different process than worrying, because it is structured and requires the individual to think the worry through all the way to the parts of the worry that the person does not want to think about. This is certainly not an easy process, but it works to help with worries that a person cannot dismiss or let go of.
Have a distressing thought? say thank you brain, but that's not helpful, I think I'll look for another