Taming the “What-if” Monster

One of the main reasons it is so difficult to stay positive is that our brain was designed to protect us. Sometimes, it does too good a job measuring the threats we face. The brain is always trying to stay ahead of dangers, so we don’t get “eaten” so to speak. It acts as a giant filter to make split second decisions about what is threatening and what is harmless. In a sense the default setting for our brain is negative, so we don’t get surprised. We can hang on to unpleasant past events and we can certainly “catastrophize” about the future. It is really easy to paint horrible pictures in our minds.

There are at least four ways to confront the “What-If Monster”. First, identify a particular worry. Ask yourself if there is any specific step(s) you can take to reduce the worry then take the action and enact your plan. For example: I had a patient overhear some staff talking about a patient not getting well enough to go home. She thought she was sicker than she was. After counseling her, she decided to check with her doctor. She got the communication straightened out, calmed down and was discharged on schedule. You feel a new ache or pain and worry that your cancer has returned. It is normal to worry about recurrence, but if you worry excessively when there is no indication or test results to warrant it, you get stressed and waste energy needlessly. Ask your doctor about your latest test results or whether your symptom warrants further testing. If there is nothing you can do, then consciously work on acceptance by reminding yourself that at this point in time you are in remission.

A second way is to limit your worry time. It may sound artificial, but decide how much or long you need to worry about that particular concern. I had a patient who worried about her cancer for five minutes after she first woke up. Then she was able to let it go for the rest of the day. To paraphrase Kurt Vonnegut, worry if you must, but realize that worrying is about as helpful as chewing gum to solve a quadratic equation.

A third strategy is to carefully listen to what you are saying to yourself and make sure it is accurate. We tend to believe what we tell ourselves even if it is not true. An example: You feel a new ache or pain and are convinced that your cancer has returned. It is normal to worry about recurrence, but if you worry excessively when there is no indication or test results to warrant it, you get stressed and waste energy needlessly. Ask your doctor about your latest test results or whether your symptom warrants further testing. If there is nothing you can do, then consciously work on acceptance by reminding yourself that at this point in time you are in remission. Examine the objective evidence so you can determine how possible the worry is likely to actually happen. If you cannot convince yourself to say something positive, at least stop repeating the negative over and over, especially if it is not even true!

Lastly, remember to stay more mindful and enjoy the present fully. We cannot do much (if anything) about the past, so we need to let it go. The future hasn’t happened yet (and possibly won’t happen the way we convince ourselves), so all we really have is the gift of the present moment. If we can savor the present moment, we can be safe and peaceful. The hard part is stringing those moments together. All we can do sometimes is to breathe slowly and drink deeply from each moment.

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