A Surprising Way to Manage Worrying

Source: Stocksnap

Chronic worrying affects millions of North Americans. As us worriers (yes, I include myself in this group) know all too well, worries tend to creep in during the most inopportune times (like when we're trying to fall asleep or relax during yoga). It's perhaps no wonder, then, that worrying is linked to some not-so-great-things like anxiety, depressed mood, and sleep difficulties (McGowan and Behar, 2013).

However, for many people, worrying acts as an important protective factor from things like painful memories or unmet needs they aren't quite ready or able to address. It can also give a sense of control - even over uncontrollable things. Indeed, several clients have shared with me their belief that, if they worry about something enough, it will never happen.

Thus, it's not always helpful, realistic, or effective to try and stop worrying cold turkey.

Enter Stimulus Control (SC) Training for Worry (or, as I like to call it, "Scheduling Worry Time").

SC training is a behavioural approach that was first used in the context of worrying by Borkovec and colleagues (1983). Basically, it involves four fairly simple steps:

1. Identify worrisome thoughts and distinguish these from more pleasant ones.
2. Create a 30-minute "worry period" to occur at the same time and place everyday (note: when I use this technique, I encourage this time not to be right before bed).
3. Delay spontaneous worries until the designated worry period, redirecting attention to the present moment.
4. Use the worry period to both worry and problem solve.

In Borkovec et al.'s study, undergraduate students who reported worrying at least 50% of the time were randomly assigned to a treatment condition (i.e., SC training) or a no-treatment condition. Results showed that those in the treatment condition reported greater reductions in daily percentage of worry and tension compared to those in the no-treatment group.

However, we can't be sure that the study's results were due to SC training, or simply being in treatment of any kind. As such, building upon this work, McGowan and Behar (2013) randomly assigned 53 undergraduate students to either SC training or another condition they called "focused worry" (where participants were instructed not to avoid naturally occurring worry). Both conditions were described to participants as interventions that would help them reduce their worrying.

Results showed that participants in both groups experienced significant decreases in measures of worry, anxiety, negative affect and insomnia. However, this decrease was greater in the SC training condition. The authors concluded that "results provide preliminary support for the use of SC training techniques in larger treatment packages for individuals who experience high levels of worry" (p. 90).

Of course, more than two studies are needed to tease out the effectiveness of this intervention - especially studies with larger, more diverse samples. We also need studies that explore exactly which component of SC training helps decrease worrying and its associated emotions. Is it delaying worry to a certain time? Is it incorporating an aspect of mindfulness?

Importantly, I don't think this intervention is a replacement for therapy that explores the deeper core emotional schemas and/or beliefs beneath the worry. However, I do believe SC training is an effective tool to manage worries in a tangible, solution-focused way.

Anecdotally, many of my clients have shared that this intervention has helped quiet their busy minds. One client told me it reduced her judgment towards worry by helping her to stop fighting against it. Rather, she could work with worry in a different, more helpful, and less invasive way in her life.

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Not a bad outcome I'd say.