The Opposite of Worry

Episodic future thinking in GAD.

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  • Will my partner break up with me?
  • Will my parent’s health take a turn for the worse while I’m away?
  • Will I make new friends easily at college?
  • Will I be able to support myself financially if I retire from my job next year?

These are the kinds of questions that many people routinely ask themselves. However, when caught in the anxiety cycle, these questions do not leave you poised for pragmatic problem-solving.

Instead, they quickly morph into negative “what ifs” …

  • What if my partner breaks up with me?
  • What if my parent’s health declines?
  • What if it’s impossible to make friends at school?
  • What if I cannot live within my means during retirement?

It has been well-established in scientific studies comparing non-anxious to anxious people that anxious individuals tend to think predominantly about negative future events, to generate reasons why these events will “definitely” happen, and to imagine that they will recur in the future. This is especially true in people suffering from generalized anxiety disorder (GAD), a condition defined by persistent, uncontrollable worry about the future.

Worry is a cognitive characteristic of GAD, meaning it represents a thinking style (and one that features many cognitive distortions). Worry may actually help people with GAD initially inasmuch as it allows them to avoid the physical sensations that might come along with facing a fear head-on; however, over time the worry intensifies and is no longer serving a helpful function.

Studies of worry have shown that people experience less imagery when worrying, and that talking about a worrisome event is less distressing than visually picturing it. Worry thoughts tend to be broader in scope, less concrete or specific. Worrying also impedes the processing of the full range of emotions that we are wired to feel.

While people with GAD seem to excel at worrying, other important (and potentially counteracting) cognitive processes may be more challenging. An example of this is a thought style called ‘episodic future thinking.’ This type of future-oriented thinking is essentially the opposite of worry – it has to do with problem-solving by both imagining and planning for the future. It’s a common and adaptive process that non-anxious people do a lot of. It is distinct from worry in that it relies on specific imagery and concrete details, and in that it allows more readily for positive outcomes.

There is some evidence to suggest that episodic future thinking is less vivid or flexible in people with GAD as compared to healthy controls. And importantly, this is especially true if the hypothetical future event is positive. Essentially, folks with GAD are not only quicker to imagine the worst-case scenario (and more apt to evaluate it is as more plausible), they are imagining it more thoroughly than they might be able to imagine the best-case scenario.

Understanding how worry and its opposite, episodic future thinking, work in GAD has potentially important treatment implications. For example, a well-validated psychotherapeutic treatment for GAD – cognitive behavioral therapy – typically involves helping patients to test the likelihood of a worst-case scenario occurring and to imagine how they would cope in the event that it did come to fruition. However, within the context of this treatment approach, there is less attention paid to enhancing the practice of positive imagery.

This powerful tool ought not to be neglected. Positive imagery – picturing the best-case scenario – can help people with GAD to reconnect with positive emotions, encourage them to devote cognitive resources in a direction diametrically opposed to worry, and facilitate improvements in imagining specific, concrete positive (or even neutral) outcomes. 

Reference

Wu JQ, Szpunar KK, Godovich SA, Schacter DL. (2015) Episodic future thinking in generalized anxiety disorder. J Anxiety Dis, 36:1-8. 

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