Is “Intolerance of Uncertainty” Making You Anxious?

July 22, 2016Health And Wellness

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“It ain’t no use putting up your umbrella till it rains!” – Alice Caldwell Rice

Worry, stress, anxiety…we all experience these at some point in our lives. It is hard not to: on a daily basis, we are inundated with bad news about crime, the declining economy, high unemployment, accidents, and natural disasters. We have bills to pay, medical issues to manage, pressures at work, and families to care for.

We also have an unlimited amount of resources at our disposal. A quick internet search and a few clicks later, and we are searching through page after page of information about whatever concern is plaguing our thoughts. In fact, there is now a term for researching health concerns online: “cyberchondria.”

While it isn’t necessarily a good idea to shut out the external world and become oblivious to possible dangers, balance is important.

Knowledge is power…if you use it correctly. Obsessing over every little thing that could possibly go wrong is not healthy and is not beneficial.

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All of us have concerns…daily life is never “perfect” and there will always be bumps along the journey. It is normal to worry – it is human nature to ponder what could go wrong and imagine possible scenarios. This has advantages – thinking about pros and cons and potential outcomes helps us make sound decisions and avoid problems.

But when this kind of worry becomes intrusive, obsessive, inappropriate, or out of control, it moves from serving as a protective mechanism to being a mental health issue. If you find yourself obsessing over “what if…” type questions, it is possible you are uncomfortable with the unknown.

In cognitive-behavioral therapy, this is referred to as “intolerance of uncertainty.” It plays a significant role in the tendency to worry, particularly in people who suffer from generalized anxiety disorder (GAD).

People who are intolerant of uncertainty misjudge the likelihood of a negative event occurring. They have a tendency to overestimate risks and the negative consequences that may result from the situation.

The more you are intolerant of uncertainty, the more you ask those “what if…” type questions, and the more you overestimate risks and negative consequences, the more youworry.

Concordia University provides an example of what intolerance to uncertainty might look like:

Allison and Brenda are both referred for an abdominal ultrasound because of recurring abdominal pain. Allison asks her doctor about the possible cause of her pain and the medical procedure and then makes an appointment. During the next few days, she thinks about the procedure and starts to feel anxious. She tells herself, however, that the procedure will help determine the cause of her pain. She continues with her daily activities and doesn’t think too much about the procedure.

Brenda, on the other hand, asks her doctor plenty of questions. She wants to be reassured and told that she does not have cancer. Over the next few days, she thinks often about the procedure, imagining that she will be told she has cancer, that she will have to undergo difficult treatments, that she might die, and that her children will grow up without a mother. To calm herself, she looks for information on the Internet and asks her husband for reassurance about her condition. Despite everything she is told, she continues to feel anxious and has difficulty sleeping.

This example shows how two people can react differently to an uncertain situation. Allison is more tolerant of uncertainty – she doesn’t dramatize the situation and waits for answers. Brenda, however, is quite intolerant of uncertainty – she immediately imagines the worst case scenario, searches for reassurance, and experiences many symptoms of anxiety.

There are various ways intolerance of uncertainty manifests:

avoiding certain activities or people
creating roadblocks
procrastinating
controlling situations; not delegating tasks to others
being non-committal: leaving an “out” to escape a situation or relationship
over-informing: seeking out more and more information about a concern
trouble making and sticking to decisions
seeking reassurance from others
repeatedly checking things: double-checking emails or that doors are locked, for example
overprotectiveness of loved ones
exaggerated optimism or rationalization

Do any of these tactics actually help reduce worry?

Experts say no, and in fact, they may make the problem worse:

It is well known that engaging in checking behaviors leads to the belief that there may be serious consequences to not checking. The search for certainty quickly decreases tolerance of uncertainty and contributes to the maintenance of worry. In addition, the search for certainty is futile as uncertainty is a part of life. Since it is impossible to be 100% certain of anything, the search for certainty will lead you to worry.

In cognitive-behavioral therapy, behavior experiments are used to help people increase tolerance of uncertainty by having the patient deliberately do “uncertain” things, like shopping in unfamiliar stores, meeting new people, and breaking routines. This “exposure” serves to let the patient see if things are actually as bad as they fear they will be.

Instead of trying to increase certainty, the focus shifts to increasing tolerance of uncertainty.

This doesn’t mean you should disregard all responsibilities, throw caution to the wind, and simply let things happen: it means learning how to recognize your reactions to uncertainty so you can put them in perspective and worry less. An example would be going to the doctor if you develop a symptom that concerns you, but NOT launching into full-blown cyberchondria and obsessive thoughts over it.

Experts suggest asking yourself the following questions when you suspect you are experiencing intolerance of uncertainty:

Why do I react this way in this situation?
Have I done something I should not have done?
Did I not do something I should have done?

This self-assessment can help you determine how you react to the uncertainties of life.

To practice tolerating uncertainty, researchers at Concordia suggest the following:

First choose one of the manifestations of intolerance of uncertainty and describe the action you have chosen to fight it with. From this moment on, this action will be your new behavior in response to this reaction of intolerance of uncertainty. Next, identify the discomfort and thoughts during and after the action. You will find that the discomfort decreases as you practice the new behavior. Choose a new action each week. The ultimate goal is to become a detective skilled at identifying your reactions to uncertainty and to choose to act as though you were already tolerant of uncertainty. This exercise will help you reduce your worrying.

It is normal to feel anxious when you are forming new behaviors, but that anxiety should disappear in time, with consistent practice. Working with a cognitive-behavioral therapist can help, too.

“If a problem is fixable, if a situation is such that you can do something about it, then there is no need to worry. If it’s not fixable, then there is no help in worrying. There is no benefit in worrying whatsoever.” – Dalai Lama

Image: Pixabay