Prescribed or scheduled worry is an exercise that we have used with good results with many patients over the years. In its simplest form, scheduled anxiety or worry means that you set aside a block of time each day or each week to sit down and really face the things you are worrying about. People who try this on a consistent basis find that they worry less overall because if something worrisome comes to mind they can just tell it to “make an appointment” and consider the anxiety-producing item or problem at a time they choose.
Useful exercises are not perfect, and several difficulties with this approach have been reported by patients trying it out. Recently, a patient, let’s call her Jean, reported using the scheduled worry approach with some success for practical problems. Even if they seem huge, or insurmountable, most things she was worrying about have practical steps she can take to mitigate their overwhelm. For example, she has recently had a bad response to dental anesthesia when having work done on her teeth, and now worries that it could get worse. A practical step is to discuss this issue with her dentist beforehand, because the dentist may have suggestions she has not thought of.
So far, so good. But Jean also has things in her life that don’t lend themselves well to taking practical steps. Her husband’s long-term health problems have a lot of uncertainty built in, and she cannot easily let go of a sense of generalized, underlying anxiety after the scheduled worry session is over. For this scenario, a slightly different approach may help.
The worry session itself may be set at different times of the day or week, not necessarily at a time when the worries regularly build up. A morning person might find a scheduled worry session helpful at the beginning of the day, to prepare for an assault of worry as the day begins. If the worries are mostly work-related, the worry session should be scheduled during the work day, not brought home to disturb personal time. In Jean’s case, we suggested scheduling a worry session before another, transitional activity, for example, after dinner, before turning on the TV. Or set it up so there is a specific reward that turns the mind away from the completed worry session and on to something more positive.
Scheduled anxiety is a form of mindfulness practice, one in which we turn towards our lives instead of away. Being mindful of the problems in our lives, noting their boundaries, their specificity and their finite nature puts them in their place, in a life that consists of more than just constant worry. For worries that seem too big, too ongoing, too hot to handle, mindfulness leads to acceptance. Acceptance doesn’t mean that you tell yourself that the bad things in your life are really OK, it means that you agree that life has problems and you have the strength and skills to deal with them. For Jean, taking a mindfulness approach means being present for her husband in his own health care journey, and being able to address today’s need without being incapacitated by not knowing what tomorrow’s need is going to be.
Planned worry is a discipline: you might not always be ready to do the job at the time you planned to do it, but over the long haul, it can become a regular, and useful part of the daily routine. See below for some other resources from MoodSurfing about planned worry:
Facing Fear Through Prescribed Worry