The Worry Trick

by David A Carbonell

  If you catch yourself in the act of offering a fake excuse, simply interrupt yourself and pause, then say something like, “No, I take that back. It’s just that sometimes I get antsy in a place like that, especially when I have a lot on my mind like I do now, and I get too restless to enjoy myself. How about we just do something quick and easy?”

  This has the virtue of maintaining your social connection with this friend and taking care of your needs. And it opens the door a bit for you to acknowledge a bit of worry that you experience, so you can get a realistic reaction from a friend, rather than the blaming, shaming, secretive reaction you experience when you make excuses.

  Getting Support From Another Key Person

  There’s another person in your life from whom you can probably get more support in your effort to reshape your relationship with chronic worry.

  It’s you.

  You might be different from most of the clients I’ve worked with. But what I notice about people struggling with chronic worry is that they tend to be so self-critical with themselves that it makes their job harder. They condemn themselves for being worried, as if it were literally their fault, some kind of crime, rather than an unfortunate problem they wrestle with. They tend to be pretty stingy with praising themselves for their efforts, and all too free with the blame and shame.

  While they often complain about how their friends and family “don’t get it,” they regularly think things to themselves that are far more unhelpful than even their worst enemy would say.

  It’s not because they don’t know how to be supportive and compassionate. These are usually people who are very capable of understanding someone else’s problems and offering support, or at least a neutral ear, without criticism.

  They just don’t give themselves this kind of support. When clients come in and share with me some of the critical self-statements they hear in their internal world, it’s surprising how persistently negative they are.

  They know how to be supportive with others, but don’t use this ability with themselves, in their own internal dialogue. Why not?

  I think it’s because there aren’t any witnesses in there! It happens so automatically they often don’t even notice the critical thoughts. They just feel the effect, in terms of feeling demoralized.

  Does this sound like something you do? Maybe it would be helpful to keep track of your critical internal monologue for a week or so, just to see what it’s like. Keep track, on a pad of paper or a digital device, of how often you find yourself saying harsh and blameful things to yourself in the privacy of your internal world. No need to argue with it, just to observe, and maybe to pause and say, “Oh well—there I go again!”

  Thinking It Over

  What does it mean if you’re motivated to keep your worry a secret? It’s often a good indication that there’s something exaggerated and unrealistic about that worry. That’s a helpful reminder, and if you start looking at the urge to secrecy in that light, it will probably help you respond to your worries in more effective ways.

  Keeping your worries secret comes at a price, often a significant one, with serious negative effects of the secrecy. Try the suggestions in this chapter for experimenting with self-disclosure, a little at a time, and judge it by its results, not by your anticipatory fears.

  Chapter 13

  Specialized Worries: Sleep and Illness

  In this chapter, I’ll look at two specific content areas of worry: sleep and health. Actually, the worries are about feared failures in these areas: worries about failing to sleep, or insomnia; and worries about disease when the worrier doesn’t seem to have a disease.

  These worries often become closely tied with very specific responses, so I’ll describe the responses, explain how they make the problem worse, and offer some specific new responses that will help you unravel the problem. You can skip this chapter if you’re not bothered by either of these worries. You might still find it useful, though, for the way it describes how people’s behaviors change to fit in with the worries.

  Worries About Sleep

  Jay was going through a stressful time. He had recently accepted a new position, a job he thought of as the chance of a lifetime. He accepted the job even though he had some concerns about juggling the new workload with his role as a new father. Work was actually going well for the first six months.

  Then one night he had trouble sleeping. There was no obvious reason, but he woke up around 2 a.m. feeling anxious. His heart was beating faster than usual, and he felt apprehensive. He thought he had experienced an unpleasant dream, but couldn’t remember any details. He lay there for a while, trying to get back to sleep without success. He got up to use the bathroom, had a drink of cool water, checked his e-mail, and then returned to bed, hoping for sleep. He got none. He found himself resenting his wife for the peaceful sleep she seemed to be enjoying, and even the sound of her breathing seemed sufficient to keep him awake. Periodically, he’d look at the clock and calculate how much sleep he could get if he fell asleep right away. This aggravated him and made him less sleepy. Finally, around 5 a.m., he drifted off for a little while, but soon awoke to the sound of his son crying.

  Jay went to work feeling a little tired, but the day passed without trouble. However, shortly before leaving the office, he found himself having the thought, I hope I don’t have trouble sleeping again tonight. The thought bothered him. He could feel his heart beat a little faster, and his breathing got short for a few moments. His thoughts turned to the question What if I can’t sleep tonight? and he envisioned himself mishandling work tasks because he was so sleep deprived.

  Driving home, he found himself wondering what he could do to improve his chances for good sleep. He hit upon a few ideas: he’d have a mug of hot chocolate before bed; he’d skip watching his favorite crime show that night, which was sometimes kind of intense, and read something tame instead; and he’d go to bed early.

  Jay worried about sleep throughout the evening, as if he were preparing for a physical challenge. He went to bed an hour earlier than usual, but it didn’t help him fall asleep earlier. He just lay there, feeling tense. Concerned, he got up and sat in the living room, watching a talk show and hoping to fall asleep. He fell asleep there, waking a couple of hours later with the TV still on and wondered if he should “risk” going back to the bedroom, or stay where he was. He tried going back to bed, but after a few minutes of anxiety there, he returned to the living room and slept until morning.

  He felt apprehensive about going to work and had thoughts about not being alert enough to handle his responsibilities. He drank an extra cup of coffee and tried to get some reassurance from his wife. She pointed out, accurately, that he had gone with a lot less sleep during the first few weeks after the baby was born, but that fact didn’t really calm him. Before he left the house, Jay reviewed his schedule to see if there were any meetings or other activities he could cancel. He didn’t see any, but looking at his schedule reminded him of the end of the day, and he wondered again, What if I can’t sleep tonight?

  Jay “got through” his workday without incident, but felt on edge, and he tried to think of more strategies to get better sleep. He stopped at the gym on the way home for a good workout, hoping to tire himself. He asked his wife to avoid any mention of negative topics, and hoped his son wouldn’t wake him early. He had a glass of warm milk that night, having read that chocolate might hamper sleep, and went to bed early, putting a hand towel over his eyes for extra darkness, and ear plugs in his ears for extra quiet. He tried not to think about waking up at 2 a.m. again. It took him longer than usual to fall asleep, but eventually he did.

  Then he woke up at 2 a.m. and went downstairs to sleep on the sofa. Over the next few days, he started sleeping on the sofa instead of the bed, because he found it easier to drift into sleep there, watching TV and not focusing on trying to sleep. Whenever he went upstairs to go back to the bedroom, he worried about failing to fall asleep, and failed to fall asleep. He switched out the glass
of warm milk for a glass of cold beer for about a week, until his wife persuaded him to go see his doctor. The doctor gave him a prescription for some sleeping tablets. He used those for a week or so, but didn’t like how groggy he felt in the morning, and since the doctor had cautioned him that the pills were only for short-term use, he discontinued taking them.

  Jay’s experience with sleep worry is typical of what many people experience. They have a night of troubled or interrupted sleep, often for no apparent reason. They worry about it repeating. They try to head it off with a variety of tactics. These tactics treat sleep as if it were a struggle or an accomplishment. They actually make sleep more difficult, build worry about sleep. Worry about sleep is often a classic example of the Rule of Opposites. It so often leads people to respond in ways that make sleep more difficult even as they hope and wish for it to come easily.

  Sleep: Let it Happen, or Make it Happen?

  Let’s start with some basics. What do we do to fall asleep?

  Sleep is one of those activities that we allow to happen, rather than make happen. How do we do that? We create a space that’s quiet, comfortable, and dark, with no distractions or features that encourage waking activity. We show up and lie down, prepared to “let go” of daily concerns and activities, and we give that process a little time to occur.

  “Trying to sleep” is a contradiction, because sleep is an activity that doesn’t respond well to effort. Think of one of your favorite meals. How likely are you, when served this meal, to scrutinize what you do with teeth and tongue? How likely are you to urge yourself to get more flavor and enjoyment from that meal, and judge how well you are doing at getting that flavor and enjoyment? Probably not so likely! Instead, you sit down at an appropriate place, with the appropriate utensils, have your beverage of choice, put the food in your mouth, and allow the experience to unfold. Even though it’s the same dish, it’s probably a slightly different experience each time, but you don’t score it like an Olympic event unless you’re a judge on Iron Chef.

  Many of our daily activities are the type requiring effort, in which effort is rewarded. The more persistently I teach my dog to stay off the sofa, the better she’ll behave, at least as far as the sofa’s concerned. The more regular effort I put into my workout, the better my physique and muscle tone, and so on.

  Sleep isn’t like that. The activity of sleep is more like simple relaxation, enjoying the flavor of your food, or having an orgasm. You arrange the right conditions, go through a few simple steps, and enjoy what comes your way. You don’t struggle to create the experience because struggle and enjoyment of these activities are mutually exclusive.

  Setting Up Your Bedroom for Restful Sleep

  What are the right conditions? This is what sleep psychologists call “sleep hygiene.” It doesn’t mean having clean sheets, although that’s always a plus. It means creating a good environment, and routine, that’s conducive to sleep. This means reserving your bed and bedroom for sleep, also for sex, but nothing else. This may be a big adjustment for people who are “plugged in” 24/7.

  No TV in the bedroom, get it out of there. Turn off your devices—your phone, your notebooks and other devices—and leave them in the living room. If you have to have something in your bedroom to divert you, one book is sufficient.

  Take your clock and turn it to face the wall. When people are having trouble sleeping, they often check the time, then find themselves calculating how much sleep they can get if they fall asleep right away, as if sleep were some kind of timed exercise. That’s not conducive to sleep! Still wearing a wristwatch? Leave it on the bureau where you can’t reach or see it. And, if you’ve been using your phone for an alarm clock, it’ll probably be better to get yourself a traditional alarm clock. Even if you have your phone on mute, it probably still flashes and can get your attention that way.

  Sleep is for letting go of the outside world, and it will help to structure your bedroom accordingly.

  Creating a Before-Bed Routine

  How about getting ready for sleep? Here are a couple of guidelines. Disconnect from the Internet and your cell phone for at least thirty minutes before going to bed. Do something a little more traditional and low key, like reading (no murder mysteries!) or watching TV in another room. Pick a program that’s not really engrossing or stimulating—talk shows are designed for this—and one that won’t interfere with your scheduled bedtime.

  Let go of the evening snacks. If you’re sensitive to caffeine, limit any caffeinated beverages to early in the day. Go to bed at a time that will allow you to have the amount of sleep you think you need. Don’t go to bed extra early hoping to increase your chances of getting enough sleep. That will likely ensure extra time of tossing and turning.

  It would probably be good to spend a few minutes with a simple relaxation exercise before going to bed, or right upon getting into bed, like the belly breathing and meditation exercises in chapter 10. As with any relaxation technique, the key is to simply go through the steps and allow whatever happens to happen. Maybe you’ll relax a little, maybe you’ll relax a lot. Just take what comes your way. Don’t strive to relax yourself!

  Avoid napping during the day. When you sleep during the day, it often leads to less sleep at night, and you want to get back into the automatic habit of sleeping comfortably at night. So, even though it might seem like a good way to compensate for lost sleep, it probably just leads to more lost sleep. Get on a regular bedtime schedule and stick to it.

  How soon will you or I fall asleep tonight? We just don’t know exactly. The main point is to create the right conditions for sleep and allow whatever happens to happen.

  Worry About Sleep is Just…Worry

  Worry about sleep usually takes the form of this thought: What if I don’t get enough sleep? The overwhelming majority of times, the answer to this question is that you will get sleepy. It’s a self-correcting problem! It’s not like the problem of, for example, dehydration. If I don’t get enough water, I have to specifically correct that deficit; my body will not generate water on its own, and I have to find it and ingest it. When I get sleepy, my body will induce sleep. My main task with respect to sleep is to stay out of my own way and allow sleep to occur, rather than to make it occur.

  Your best response to worries about troubled sleep will include handling worry about sleep separately from handling sleep. Handle worries about sleep the same way you handle any other comment from Uncle Argument. Treat it as worry, don’t get fooled into taking the content very seriously, and humor the worries. Handle the activity of sleep in accordance with the sleep hygiene suggestions above.

  What to do if you find it hard to fall asleep? Don’t lie there for hours, trying to fall asleep. Give it a reasonable amount of time, perhaps half an hour. If you’re unable to fall asleep within that time, I suggest you get up and engage in a brief period of activity.

  What kind of activity? If you have a history of being able to relax yourself to sleep, perhaps with a book, then do that. But if you have a history of trying to relax yourself and failing, then don’t do that again. Instead, take twenty minutes and work on some uncomfortable, boring chore, like scrubbing a floor or a bathtub. You just had the cleaning lady in today? Doesn’t matter! The point of this task isn’t to spruce up your place, it’s to make sleep more inviting. If you get up and watch a TV show you like, or start a good book, it’s likely to postpone sleep because you’re doing something that’s more interesting than sleep. Do a task that’s less interesting for twenty minutes or so, then go back to bed. If you’re still up in twenty or thirty minutes, repeat the process as needed.

  Sometimes people fall into an unfortunate pattern of waking at the same time each night. It’s usually a particularly unwanted time, like 2 a.m. This seems to occur because, after it happens once or twice, the person starts to worry—What if I wake up at 2 a.m. again?—and sure enough, like a self-fulfilling prophecy, they do. They get caught up in a vicious cycle of anticipatory worry about early wakening, f
ollowed by early wakening, followed by more worry, and on and on and on.

  This is a classic example of chronic worry, in which worry about the possibility and uncertainty of early wakening leads to precisely the outcome you don’t want. Here’s a remedy I’ve found useful. It’s not for the faint-hearted, because it has that classic aspect of medicine—helpful medicines always taste bad—but don’t let that dissuade you.

  When I work with clients who have this problem of habitual waking at 2 a.m., I usually suggest they set their alarm clock for 2. Then quickly, before they storm out of my office, I explain that it’s the doubt and uncertainty about whether or not they will wake at 2 a.m. that feeds and breeds all the worry that actually wakes them, and creates the habitual early wakening. When they set the alarm in this manner, they no longer have any doubt about it. They’re going to wake at 2 a.m.

  This changes the problem. Before, they worried about whether or not they would wake up at 2 a.m. Now they know they will, and when they do, they can decide how to respond. Maybe they’ll respond the same way they do every other time they wake early, but this is not what usually happens, and if it does, they’re no worse off than before. What often does happen is that the person wakes in response to the alarm; wonders why the alarm has gone off; remembers that I asked them to set it that way; has a few choice thoughts for me, then turns it off and goes back to sleep. Sometimes people even find they wake a few minutes before the alarm, turn it off, and go back to sleep.