COPING WITH HYPOTHETICAL WORRY
Tshidi M Wyllie
PhD Candidate - UNICAF University
15 January 2021
ABSTRACT
Worrying is a normal social phenomenon, it is something that well all experience from time
to time in our human existence. However some people have a positive view and attitude to
worrying whilst other perceives it negatively. Those who perceive it in a positive light see it a
helpful tool that motivates them to “fight”; engage, prepare and perform better for example;
there are those who believe that it helps them to feel more in control and alert sand achieve
better results e.g when preparing for a job interview, for a tournament or engaging in a
challenging new project etc. Whilst those with negative perspective towards worry, consider
it to be debilitating and thus become even more worried about being worried.
That being the case, COVID19 has taken worry, anxiety, stress and mental health issues to
another dimension as globally more and more people are experiencing uncertainty and
therefore struggle to cope with the current situation. As new information emerge and statistics
of death tolls and new infections keep rising as well as reports of mutations of the virus
strains, large number of people seems to be experiencing hypothetical worry. This article is
an attempt to empower young people in Botswana with evidence based Cognitive Behaviour
Therapy (CBT) coping strategies to psychologically survive the COVID19 era and beyond.
COPING WITH HYPOTHETICAL WORRY
1.0 Introduction
What is Worry?
Worry is a a normal human phenomenon; it is a normal
mental process that we all
experience from time to time, however, sometimes worry can become overwhelming enough
to impact our daily functioning and cause inability
to manage
our day to day activities.
KnaussKnauss,
& Schofield,2009).
Research shows that 1 out of 5 people battle with worry (Barlow, 2002;
D.H.2002;
C., &
Schofield, M.J.2009).
Its normal in life to experience a certain level of worry, but when its prolonged and excessive
it can complicate lives and sometimes can lead to Generalised Anxiety Disorder (GAD) and
to stress , which will eventually impact on our immune system; Viz; worry becomes a
problem when its:
 Intrusive
 Uncontrollable
 Persistent
 Excessive
To the point where someone becomes restless, have difficulty sleeping , problems
concentrating, consistently on edge, physically tense and avoiding situations.
Thoughts affect our emotions, and our emotions impact on our physical wellbeing and on
our Behaviour.
1
Vicious cycle: We can
call this the vicious cycle.
When you feel anxious
and imagine the worst
scenarios,
you
may
experience
unpleasant
physical symptoms, and
then you might try to
avoid certain situations.
As you worry more,
anxiety will increase your
stress
levels.
When
stressed,
you
might
become
even
more
anxious and worried about
being stressed and fearful.
Ultimately, your fears will
exacerbate
hypothetical
worry and anxiety which
can perpetuate itself, then
you may continue to be
even more worried about
being anxious and worried
and thus it becomes a
viscous cycle.
(Anxiety Canada, 2021; Talkplus,2020)
2.0 Hypothetical
Hypothetical worries are often about the future and situations that haven’t happened yet, it’s
thoughts about what might happen. It concern things that we do not currently have control
over and therefore we cannot do anything about. Its fears, concerns and anxiety about what
might happen, what might go wrong which has not happened and may not even happen. It’s
actually an attempt to solve in our mind problems that haven’t occurred yet. It can be
described as a negative self-talk activity, where we ‘talk to ourselves' repetitively in our mind
about possible future negative events that might happen of which we are afraid. We mentally
discuss the event with ourselves over and over again and think about what would happen
et al.,2015).
should the event occur (Saulsman,L.,
Nathan, P., Lim, L., Correia, H., Anderson, R., &
Campbell, B. 2015).
Hypothetical worry is in fact a type of repetitive negative thinking. It’s negative in the sense
that it becomes a spiral cycle of thinking about the same stuff over and over and they flood
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our mind to the extent where some people have trouble disengaging from these repetitive
negative thoughts. Major cause of hypothetical worry is uncertainty; therefore people with
low tolerance to uncertainty tend to prone to hypothetical worry, and especially those with
GAD.
Hypothetical worries often start as “what if…”, for example; “What if…I lose my job, what if
I get retrenched, what if I catch covid19, what if I die from COVID19, what if my parents die
of COVID19 etc…. it might be helpful if you change the what if to “How can I…” e.g “how
can I protect myself and my family from COVID19? How can I maintain social distancing?
How can I help my family adhere to COVID19 protocols?, How can empower myself? etc.
2.1 WORRY TRIGGERS:
Seeing certain images, hearing certain information, being in a certain situation etc Its
important to pay attention to things that trigger the “what if, what if” episode. For example
what were you doing at the time the thought popped up in your mind, within what you were
engaged in what could have triggered the worry? However, sometimes the thoughts may just
crop up. Remember; the “what if is not really a problem; it is how we respond to it which
may become a problem (Anxiety Canada,2021;The Wellness Society,2020; ) .
3.0 THE DANGERS OF EXCESSIVE HYPOTHETICAL WORRY
Psychosomatic ailments:











Exhaustion
Fatigue
Panic attacks
Headaches
Poor sleeping patterns
Stomach discomfort e.g constipation or diarrhoea due to fear accompanying the worry
Loss of appetite
Anxiety
stress
High blood pressure
Suppressed immune system
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4.0 COPING STRATEGIES
The following are evidence based strategies for addressing hypothetical worrying and
anxiety. It’s not one size fits all, what works for some may not necessarily work for you. But
the strategies shared here have been proven to work.
1.THE 3 STEP STRATEGY
- identify & acknowledge the
worry/have awareness of it
and the related emotions.
.
- write down: What do I think is
going to happen?”
- Is there anything you can do
about it?
- What is making me think this way?
- What emotion am I feeling?
Worry
- What has triggered this worry?
- Set aside
sufficient time each
day for worry time,
when you will not
be interrupted or
distracted
1. Down
Write it/
Journal
Then process, ask
yourself:
- Did the thing you
were worrying
about happen?
- So has worrying
changed anything?
2. Refocus
3. Worry
Time
To Refocus: Pay attention to
whatever task you were doing when
the worry came into your mind. In
Refocusing from worry one you can
use your 5 senses by concentrating
on your Sight, Smell, hearing, touch
and taste can help to ground you to
the present.
- How has the
worrying worked
out for you so far?
- What can you do
differently?
- Some people use music and pay
attention to the melody, rhythm,
lyrics, beat, and harmony, what
rhymes etc.
,
(University of Exeter, 2019;University of Washington,2017;Anxiety Canada,,20202021;
Talkplus,2020)
4
Worry script/Journaling is like a journal, where you write about your worry, you actually
make a list of what you are afraid will happen, what surrounds your fears. Worry Script helps
you to experience the negative emotions associated with your fears and worries head-on
rather than avoid them; instead of suppressing your fears and worries you confront them.
Research shows that confronting fears reduces anxiety and ultimately worry. As you process
them you may experience some discomfort but do not give up as with time, if you stick to the
routine and have your worry time daily, you’ll start experiencing a reduction on the intensity
of the hypothetical worry. Then you could gradually reduce the time. But stick to the same
time of the day. Preferably after day’s work, but not too close to your bed time.
2. ESTABLISH YOUR CIRCLE OF INFLUENCE
If you’re prone to hypothetical worry; the ‘what if’ thoughts, you may find it helpful to pay
attention to noticing these thoughts and then redirecting your attention to things within your
control. Research shows that shifting focus to things that people can control has the ability to
help in lowing anxiety and stress levels and can lead to significant lasting difference in
mental wellbeing, health, and performance. Therefore it is crucial to:
i). Make a list of those things you have control over.
ii). Note down those things you cannot control; those outside your circle/sphere of influence.
#Remember: You cannot stop hypothetical worrying from happening, but you can control
your response, that way you will reduce the possibility of you worrying about being worried
all the time (Andrews et al,.,2003; Heimberg et al,., 2004).
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Your control/outside your control table
WITHIN MY CONTROL
OUTSIDE MY CONTROL
• Following the latest information and advice
• My information diet
• Relaxation
• Eating well
• Seeking and offering support
• Focusing on what’s important to me
• Voting and activism
• Building resilience
•My routine
• Exercising
• Cultivating connection
• Your behaviour/actions
• Your mistakes
• Your opinions
• Your ideas
• Consequences of your actions
• Your words
• My social distancing
• Flights and holidays being cancelled
• Traffic
• Schools opening or closing
• Public transport
• Other people’s health
• The government’s actions
• The state of the healthcare system
•Other people’s decisions
• Aging
• The weather
• The news
• Other people’s actions/behaviour
• other people’s mistakes
• other people’s opinions
• Other people’s ideas
• Consequences of other people’s actions
• Other people’s words
• other people’s social distancing
Epictetus - “Ask yourself: Does this appearance (of events) concern the things that are within
my own control or those that are not? If it concerns anything outside your control, train
yourself not to worry about it.” (The Wellness Society, 2020).
Source: teasearch3d.com
“Freedom and happiness are won by disregarding things that lie beyond our control.”
(Epictetus).
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2.1. MY RESPONSIBILITY
What things are your responsibility and which are not? It’s equally important to establish
your responsibility versus things that are not your responsibility as an effort not to worry
about everything; this will reduce hypothetical worry, anxiety and stress. Living in the
COVID19 era has affected us all and we each have a role to play; especially in safe guarding
your health and mental wellbeing but there are certain things that may not be your
responsibility. Taking on other people’s issues may increase hypothetical worry. Yes we do
need support system, but it does not have to be to the point where you end up owning other
people’s issues. Therefore it’s important to process:
 What things are within your circle of influence and/or are your responsibility
 Is there something you can do about them? = switch to problem solving if you can
do something about them because it means you are probably experiencing Practical
worry; which is situational and based on what maybe going on in your life right now
which you may find solution to.
 If it’s something outside your circle of influence and/or your control or not your
responsibility, then you are probably experiencing hypothetical Worry and therefore
all these strategies may help you to process and cope better.
Source: https://data.whicdn.com/images/325714214/original.jpg
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3. EMBRACING UNCERTAINTY
“It’s not what happens to you, but how you react to it that matters. When something happens,
the only thing in your power is your attitude toward it; you can either accept it or resent it.”
(Epictetus).
According to The Wellness Society (2020) It’s critical to develop tolerance to uncertainty in
order to reduce hypothetical worrying and anxiety. People who experience anxiety have been
shown to have low tolerance for uncertainty (Dugas et al,.,1998; Blais et al,.,1998; Knauss,&
C., & Schofield,(2009)
M.J. (2009).
It’s worth being reminded that uncertainty is an unavoidable
.
part of life, and the sooner one can develop an awareness of it and become more accepting
and comfortable with it, the better. As the opposite could have negative impact and
subsequently create mental torture.
Literature reveals that Christians and other religious believes easily embrace uncertainty and
change as the essence part of life and therefore they tend to cope better with uncertainty.
Many people find reading the bible or other religious books related to hope very helpful; e.g
faith in the scriptures
and meditating on the scriptures has been proven to helps in changing
mindset and reducing anxiety; As a man thinketh in
sohis
is he”
(Proverbs
23:7). 23:7).
heart,
so is he (Proverbs
4. THOUGHT CHALLENGING TECHNIQUES
Research shows that Cognitive Behaviour Therapy (CBT) is scientifically proven to
significantly bring change and is seen as a powerful approach and/or tool/strategy in
“Thought challenging”. Though simple, its yet a powerful technique for reducing anxiety. As
mentioned earlier, anxiety is best described as the unhelpful thinking patterns people
experience when their mind fixates on threat, uncertainty and negativity. Thought challenging
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helps by broadening focus to include the bigger picture (Borkovec et al, 2004; Barlow, 1988;
Barlow, 2002;Baldwin
D.H.2002, Baldwin
& Polkinghorn, 2005).
& Polkinghorn,2005).
Below are two thought challenging techniques one can engage in and continue applying them
until they find what works best for them. It’s not one size fits all, what works for one and for
a certain condition may not work for the other person. But generally CBT has been proven to
work in addressing hypothetical worry and other anxiety disorders.
4.1 THE ABCDE TECHNIQUE
Attention – When you feel distressed, stop what you’re doing and pay attention to your inner
dialogue. What is your mind telling you, what discussions are you having inside your head?
Believe – At times you need to pause and chose not to automatically believe your thoughts,
without testing, probing, challenging and/or confronting your thoughts because; Sometimes
your thoughts can mislead you due to perceptions and other factors..
Challenge – Defuse anxiety by broadening your focus; in other words; what could be the
underlying issues?
Is the thought fact or an opinion? Could it be due to stress or certain
incident? What might you think if you were feeling calmer and not so stressed about the
situation?
Discount – Acknowledge that you are worried and that you now realise that anxiety has been
and is continuing to dominate your thinking and if it persistent seek help e.g go for
counselling, and if it leads to panic attacks and shortness of breath visit your physician.
Though pharmacotherapy is a powerful intervention and verty appropriate for mental
conditions, many a times underlying emotional issues have to be addressed rather than focus
on treating the symptoms with drugs, So a combination for certain situations may help
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Explore options – Ask yourself, what would be helpful to focus on right now? What
options do I have available to me which I could focus on rather than on my worry, which
creates anxiety and more worry about being anxious?
5. THE THINK TECHNIQUE
Ask yourself:
Is it true – Is this thought true? , is it authentic and/or 100% true? If not, what are the facts,
and what is opinion, could this just be an opinion? Where is it coming from? What could
have triggered it?
Is it Kind – Is the thought kind to me? If not, what would be a kinder thought right now?
Is it Inspiring to me – Is this thought bringing inspiration to me; does it inspire me or is it
having negative effect on me?
Is it Helpful – Is paying attention to the thought useful to me and others or is it having
negative effects?
Is it Necessary – Is it crucial that i concentrate on this thought right now or could I shelf it;
script it for later to address it during my “worry time”? Is it really necessary for me to act on
it now or is it interfering with what I am supposed to be doing at the moment? (Andrews,etG.,
al.,2003).
Creamer, M., Crino, R., Hunt, C., Lampe, L., & Page, A.2003).
“You have power over your mind, not outside events. Realize this and you will find
Strength.”(Marcus Aurelius)
“our life is what our thoughts make it.” (Marcus Aurelius)
“Men are disturbed not by things, but by the view which they take of them.” (Epictetus).
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6. THOUGHT CHALLENGING TIPS
The other effective technique for challenging your thoughts is Journaling/ Writing.
Journaling is a positive thought challenging process, it is better than trying to confront your
thoughts in your head over and over (ruminating), journaling brings positive results in
reducing worry, anxiety and stress.
It may not be easy at first; but with time one can get used to confronting and processing
negative repetitive thoughts through this technique; it’s appropriate when feeling distressed
and overwhelmed; i.e.; when autostress and/or the emotional brain has hijacked the cognitive
brain and rational functioning.
Another strategy that may help though its short term, is trying to defuse the emotions with a
mental distraction such as chess, or any physical distraction that requires the use of your mind
as well as physical distraction activity such as swimming, art, walk, exercising, gardening,
baking/cooking, reading etc and returning to thought challenging once you’re feeling calmer
(Knauss,&Schofield,2009;
C., & Schofield,
M.J. et2009;
Heimberg, R.G., Turk, C.L., & Mennin, D.S. 2004;
Heimberg
al.,2004;Barlow,2002).
Barlow, D.H. 2002)
5.0 CONCLUSION
Consequently, it’s not about the “what if “which is a challenge, it is how were respond
following the “what if” thought which can be a problem. Worrying is unavoidable and its part
of human survival. It becomes a challenge with detrimental mental health consequences to
human existence when it’s intrusive, persistent, uncontrollable and excessive to the point of
interfering with our day to day life. As Epictetus quotes: “Don’t demand or expect that events
happen as you would wish them do. Accept events as they actually happen. That way, peace
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is possible.” and according to Marcus Aurelius; “Don’t let your reflection on the whole
sweep of life crush you. Don’t fill your mind with all the bad things that might still happen.
Stay focused on the present situation and ask yourself why it’s so unbearable and can’t be
survived.” Embracing the uncertainties brought by COVID19 requires a proactive approach
to addressing our mental health issues and ensuring that create an emotional equilibrium right
now and beyond COVID19.
REFERENCES
Andrews, G., Creamer, M., Crino, R., Hunt, C., Lampe, L., & Page, A. (2003). The treatment
of anxiety disorders Clinical guides and patient manuals. Cambridge: University Press
Anxiety Canada (Accessed 25Jan,2021) Strategies for
https://anxietycanada.com/sites/default/files/adult_hmgad.pdf
GAD.
Retrieved
from,
Anxiety Review Panel. Evans, M.., Bradwejn, J., & Dunn, L.(2000) .Guidelines for the
Treatment of Anxiety Disorders in Primary Care. Toronto: Queen’s Printer of Ontario.
Baldwin, D. S., & Polkinghorn, C. (2005). Evidence-based pharmacotherapy of generalized
anxiety disorder. International Journal of Neuropsychopharmacology, 8, 293-302.
Barlow, D.H. (2002). Anxiety and Its Disorders: The Nature and Treatment of Anxiety and
Panic (2nd ed.). London: Guilford Press.
Borkovec, T. D.,Alcaine, O. M., & Behar, E. (2004). Avoidance theory of worry and
Generalized Anxiety Disorder. In R. G. Heimberg, C. L Turk, & C. S. Mennin (Eds.),
generalized anxiety disorder: Advances in research and practice (pp. 77-108). New York:
Guilford.
12
University of Washington(2017) CBT+ Worry-GAD Handout 2017. Retrieved from
https://depts.washington.edu/uwhatc/PDF/TF%20CBT/pages/5%20CBT%20for%20Anxiety/
CBT%20Strategies%20for%20Worry.A%20Guide%20for%20Therapists.pdf
Heimberg, R.G., Turk, C.L., & Mennin, D.S. (2004).Generalized Anxiety Disorder:
Advances in Research and Practice. New York: Guilford Press.
Knauss,C., & Schofield, M.J. (2009). A Resource for Counsellors and Psychotherapists
working with clients suffering from anxiety. Melbourne: PACFA.
Maier W, Buller R, Philipp M, Heuser I. (1988) The Hamilton Anxiety Scale: reliability,
validity and sensitivity to change in anxiety and depressive disorders. J Affect
Disord;14(1):61–8.
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.
Talkplus (Accessed 25 Jan, 2021) Worry Management. Retrieved from https:// www
.talkplus.org.uk/downloads folder/Worry_management.pdf
Talkplus (Accessed 25 Jan,2021) Anxiety Information and Advice. Retrieved from
https://www.talkplus.org.uk/wpcontent/uploads/2020/05/TalkPlus_Information_on_Anxiety.
pdf
Teacearch3d.com (2017) My Circle of Control Poster . Retrieved from
https://teasearch3d.com/linhuk/occupational-therapist-my-circle-of-control-poster/
The Wellness Society (Accessed 12Dec, 2020) Coronavirus Anxiety Workbook. A tool to
help you build Resilience during difficult times. JAMMA INTERNATIONAL. Retrieved
from www.thewellnesssociety.org
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University of Exeter (2019) Managing your worries. A Cognitive Behavioural Therapy
evidence based approach to help you overcome your Generalised Anxiety Disorder. )
CEDAR; Psychology Department
Weheartit.com (2014) This ins nit my responsibility/This is my responsibility. Retrieved from
https://data.whicdn.com/images/325714214/original.jpg
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.
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