What? Me Worry!?!

What? Me Worry!?!

What? Me Worry!?!

Module 5
Negative Beliefs About Worrying:
“Worrying Is Dangerous”

Introduction 2
Changing Your Belief 2
Challenging Your Belief 3
Worksheet: Challenging Your Belief 5
An Important Word on “Factual Evidence” 6
Module Summary 9

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 What? Me Worry!?!

Introduction
Ask yourself the question: if you believed your worrying couldn’t harm you or wasn’t dangerous
(either mentally or physically), how much would your worrying bother you? Chances are you
wouldn’t feel as bad if you thought your worrying was a harmless mental activity, as opposed
to believing your worrying can hurt you.

Also, if you didn’t see worrying as being such a bad and dangerous thing, then chances are you wouldn’t feel
the need to suppress your worrisome thoughts when they pop into your head. Remember, we have
mentioned before that thought suppression can be really unhelpful, because it backfires and makes you
think even more about whatever you are trying not the think about, hence leading to more worrying. So,
looking at your belief that worrying is dangerous is really important in order to get out of the ‘thought
suppression trap’.

In this module we will look at changing beliefs like:

“Worrying will make me go crazy”
“If I keep worrying I will have a nervous breakdown”
“I’ll get sick if I don’t stop worrying”
“Worrying will damage my body”
“I’ll go nuts if I keep worrying”
“Worrying will make me ill”

Changing Your Belief

Before we start changing your belief that worrying is dangerous and harmful, we need to know how much
you believe it.

How much do you believe your worrying is dangerous/harmful?

(Circle the percentage that best describes the strength of your belief)

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

If you do not think you hold this belief at all, still work through this module just to be sure, but chances are
you can move on quickly from this module to the next.

To change your belief that your worrying is dangerous, you need to do something you
are already familiar with from Module 3. That is, challenge or dispute your belief.
This means dissecting the belief that your worry will cause you physical or mental
harm, 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 dangerous to you. We would encourage you to be curious and open
minded about changing this belief.

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Challenging Your Belief

Below is a list of questions you can ask yourself to challenge whether worrying really is dangerous.
Remember, you are 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 5 you will find a worksheet to
help you do this for yourself.

Evidence For
 What makes you think worrying is dangerous/harmful?
 What’s the evidence for your belief?
 Exactly how does worrying cause mental/physical harm (be specific)?
 Is the evidence for your belief good/solid/reliable?
 Is there another way the evidence for your belief could be viewed?

Evidence Against
 Is there any evidence that goes against your belief?
 How long have you worried for? What specific physical or mental harm has resulted over this time?
 During a worry episode have you ever become ill or gone crazy?
 Are there other explanations or greater risk factors for the illnesses you are concerned worrying will
cause? (e.g., genetics, diet, exercise, lifestyle, smoking, alcohol, etc).
 Can you think of other people/professions that are constantly under intense stress or anxiety, have
they all suffered physical or mental harm? (e.g., students studying for exams, people in stressful jobs –
army officers, police, emergency department staff, etc).
 How can you believe that worrying is both dangerous on the one hand and has many positive benefits
(motivates, prepares, prevents, etc) on the other hand?

EXAMPLE:
Evidence For Evidence Against

I don’t know exactly how it will make me sick, How can something be both dangerous and
but I have heard stress isn’t good for you, so it helpful at the same time?
must be something to do with that. [My beliefs about worrying don’t match up. Maybe I need to re-
[I haven’t got a very strong, specific or scientific argument for think.]
worrying being harmful. Maybe I need to look into it more, and
get the facts.] I have never actually gone crazy or gotten
really sick from worrying.
It just feels like I am going to go crazy, [What I am worried about has never actually happened.]
therefore I must be.
[This isn’t very solid evidence that worrying is going to harm Plenty of people have worry and stress in their
me. It has never actually happened, it is just that it feels so bad lives. While it doesn’t feel great, these people
at the time, so I assume something bad will happen. Just don’t all break down physically or mentally.
because I feel it is true, isn’t really evidence it is true.] [It doesn’t tend to happen to other people, so why should it
happen to me.]
When I worry a lot, I get a cold, so worrying
must be bad for my health. When it comes to my health, making positive
[There have been times when I haven’t worried and have gotten
sick. Also when I have worried a lot and gotten sick, I guess I changes to my diet, exercise and lifestyle
haven’t been sleeping well, eating right or exercising. So I guess might be more important to focus my energy
it might not be the worrying itself that caused it, but how my on.
lifestyle changes when I worry.] [Rather than worrying about worrying.]

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Additional ideas to consider…

Sometimes people think that things like increased heart rate, blood pressure, tension, or adrenalin, which
can often accompany worrying, are the culprit in explaining how worrying might pose a danger. However,
another way to think about these things is that they all occur when we exercise, yet most people would
consider exercise as something that is good for you. Aren’t we told to get our heart pumping 30 minutes a
day? And surely athletes would do a lot more than 30mins? In addition, adrenalin is often used to save
people’s lives during cardiac arrest!

Also, the physical symptoms just mentioned are all part of the ‘fight or flight’ response, which from an
evolutionary perspective is something that protects us. How can something that has helped us survive as a
species also be harmful to us?

The fact that worrying can cause some very real physical sensations in our body (e.g., heart rate increase,
tension, headaches, gastro intestinal symptoms, etc), this is often used by people as evidence of harm and
danger. However, even though these sensations feel unpleasant or distressing, are the sensations actually
dangerous?

People may use the argument that “stress is bad for you”. But, are stress and worry the same thing? Stress
occurs when we perceive the demands placed on us are too much. Worrying is then an unhelpful coping
strategy in response to stress, and we can learn other more helpful ways to handle stress.

Another idea to consider is, if you purposely worried excessively right now would the danger occur? If the
answer is ‘no’, why not? This may suggest there are other factors involved in mental or physical illness, not
just worrying. At the end of the day, mental and physical health is complex, multifaceted, and often not well
understood, and it is unlikely that worrying itself causes direct mental or physical harm.

In conclusion…
The beliefs we hold that worrying is dangerous are often the ‘stickiest’ to challenge. They have built up
gradually over time from things we may have heard from family, friends, the media, etc. If you are having
trouble challenging this belief, don’t despair. Instead consider the following…

Question: What is the consequence of believing that worrying is dangerous?

Answer: It increases my worrying, by giving me something else to worry about, and making me want to
push away my negative thoughts, which just makes them push back harder.

So, the belief that worrying is dangerous is really unhelpful because it causes the very thing you don’t
want…more worry! Knowing this, what could you then do when thoughts about mental or physical harm
from worrying come to mind? Given these thoughts don’t help you, they too can be postponed along with
all your other worries.

One Final Question: If worrying is controllable (via postponement), what’s the danger? If we can control
our worrying by getting good at postponement, any perceived danger is irrelevant.

If any of the above points were helpful in seeing your worry in a less dangerous light, make sure you include
them in the ‘evidence against column’ of your page 5 worksheet.

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Challenging Your Belief

Belief: My worrying is dangerous

Evidence For Evidence Against

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An Important Word on “Factual Evidence”
Some people may check their concerns regarding the impact worrying will have on their mental or physical
health by researching this, particularly on the internet. Spending too much time researching your worries
about your health may be unhelpful, as it can just keep you preoccupied with your worry, and the
information you gather may not always be reputable.

With the wealth of information readily available to us via the media and internet search engines, it is
important for us to remain smart consumers of the information we receive. Unfortunately, not all health
information available in magazines, newspapers and on the internet goes through the same quality control
processes. Some websites, for example, may look quite convincing on the surface, but not actually
represent the best practice and most up to date health-related information. This can be both confusing and
dangerous for us.

It can be confusing when we receive mixed messages about whether or not we need to
make changes to important things such as our diets, medications, or other lifestyle choices. It
can also be confusing when we receive mixed messages about the importance of particular
symptoms, their relevance to serious health problems, and the need to continue to seek help
from health professionals. It can be potentially dangerous when we do make decisions
about our health or changes based on information that is not reliable or factual.

Fortunately, by changing the way we search for and evaluate health information, we can start to reduce any
confusion and risks and begin to take a more helpful and critical stance.

Information seeking
Quite often we can turn the very thing we are thinking about into the phrase we type into an internet
search engine. For example, if we are concerned about the impacts of worrying on our potential for a
heart attack, we may type “worry and heart attacks” and hit Search.

This type of searching can be problematic as it can lead to biased results. That is, you will most likely
• filter in web pages that do talk about there being links between worry and heart attacks, and
• filter out any that do not talk about or debunk such links.
This unhelpful searching can therefore reinforce your worrisome belief that there is a link!!

There are two steps you can take to change the way you gather and filter information from the internet.

Step 1: Practice using more helpful and less biased search phrases to find out what you want to know.
For example,
Instead of: You could try:
“Worry and heart attacks” “What causes heart attacks?” or “Leading causes of heart attacks”

Less helpful More helpful

More biased filtering Less biased filtering

Step 2: Look for ways of filtering in alternative view points. You can do this by typing in mismatching
statements. For example, you could try: “Is coffee bad for you?” and “Is coffee good for you?”
These strategies can lead to you coming up with some very different health information!

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 What? Me Worry!?!
If you are someone who has or is thinking about using the internet to search for health information, take a
moment to think about some alternative ways you could search for that information:
Instead of: I could (also) try:

Evaluating health information

Even with good search strategies we will often come across unhelpful or even conflicting information (e.g.,
one magazine article stating that coffee is good for you whilst another states that coffee is bad for you).

Unfortunately, in this day and age, anyone with access to the internet can send
information around the world and claim it to be factual. Some website or magazine
articles can also appear to contain useful information from reputable sources. So how do
we know what is good information and what is not so good?

Ten questions to ask...

Is this written by a qualified and registered health professional (e.g., GP, Psychologist)?
Does the author represent an established and reputable health organisation (e.g., government
body, university, major hospital)?
Is the author free of commercial interests (i.e., they are not trying to sell you a product or
sensationalise a story to sell a magazine)?
Does the article include multiple pieces of evidence to back up it’s claims (i.e., discusses the results
of several research studies conducted by reputable organisations rather than anecdotal stories or
one-off studies)?
Is enough information provided for you to check the background research for yourself?
Was the background research based on people similar to yourself (e.g., similar age, height/weight,
gender, diagnosis, comorbid problems etc)?
Was the background research based on many people?
Are statistics clearly explained?
Is this information consistent with health information you have read from other reputable sources,
(e.g., other government bodies, universities, major hospitals)?
Is a review date provided so that you can tell the information is up-to-date?

The more ticks you have above, the better your health information is likely to be. However, it is
important to remember that information from the internet and media is one resource only, and
should never alone be used to diagnose a medical or psychological condition, or to make
important changes to your medication, diet, or other lifestyle choices. Your GP or local
health clinic can assist you in understanding the specific risks and benefits of such changes
based on your full personal medical and/or psychological history.

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So the focus of this module has been on challenging your belief that worrying is dangerous, trying to look at
the factual evidence.

In addition, people can experiment with the belief that worrying is dangerous too, just as you did in Module
3. Such an experiment might involve pushing your worrying to the ‘max’. This means trying your hardest
to lose control of your worrying, seeing if you truly can ‘worry yourself sick’. Typically people predict that
trying to push their worrying to the limit will be awful, and that something terrible will happen. Often
people are surprised that nothing bad actually happens when they allow their negative thoughts to come
and don’t suppress them. In fact, sometimes people actually get bored of whatever they are worrying
about. Doing this can take the fear and power out of their worries, and allow people to experience their
worry as harmless. However, this approach is best done very strategically with the guidance of a mental
health professional to gain maximum benefit, and so it is not part of this information package.

Now that you have challenged your belief that worrying is dangerous/harmful:

Rate again how much you believe your worrying is dangerous/harmful?

(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 dangerous 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 may not be enough. You need to practice this strategy until the evidence for your belief is
weak and the evidence against your belief is strong. A good gauge of when you have done enough work on
this belief may be when your belief is relatively weak – say about only 20%.

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Module Summary

• Negative beliefs regarding worrying being dangerous to your mental or physical health make your
worrying worse

• To change these beliefs you can:

 Challenge them – look at the evidence for and against the beliefs.

• In order to change your belief that worrying will cause you harm, you need to persist until:

 The evidence for your belief is weak.

 The evidence against your belief is strong.

• Once you have achieved this ask yourself:

 What does all this say about my worrying?

 Hopefully you can start to entertain the idea that, whilst worrying doesn’t feel good, it may in fact
be harmless.

 You can then start to deal with these old danger beliefs by postponing them if they still arise for
you, and recognise that if worrying is controllable via postponement, then it can’t pose any danger
to you.

 If you are someone who likes to research your worries about your mental or physical health, watch
how much time you spend doing this, and ensure your research is unbiased and from reputable
sources.

Coming up next …
In the next module you will learn how
to change the positive beliefs you hold
about worry.

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About The Modules
CONTRIBUTORS
Dr Lisa Saulsman (MPsych1; PhD2) Dr Helen Correia (MApp Psych1; PhD2)
Centre for Clinical Interventions Centre for Clinical Interventions
Paula Nathan (MPsych1) Dr Rebecca Anderson (MPsych1; PhD2)
Director, Centre for Clinical Interventions Centre for Clinical Interventions
Adjunct Senior Lecturer, School of Psychiatry and Clinical Bruce Campbell (MPsych1)
Neuroscience, The University of Western Australia Centre for Clinical Interventions
Dr Louella Lim (DPsych3)
Centre for Clinical Interventions
1 2 3
Masters of Psychology (Clinical Psychology) Doctor of Philosophy (Clinical Psychology) 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 (2nd 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

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