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Your Better Mental Wellbeing Podcast
Every Friday, GP and mental wellbeing expert Dr Neera Dholakia, and software developer and neuroscience researcher Soen Trueman, will help you discover how you can manage stress and build resilience through discussion and practical exercises, so that you can live a healthy, productive and meaningful life.
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Episode 6: Taming your Worries in Today's World

Do you spend time worrying about things, wishing that you weren't worrying or feeling anxious? Finding helpful ways to manage your worries will reduce your stress and give you time back to focus on things meaningful to you.

That's what we are talking about today on Episode 6:Taming your Worries in Today's World .

We're your hosts: Dr. Neera Dholakia and Soen Trueman, and we're joined by Ben Cronin who is an experienced high intensity cognitive behavioural therapist working in an NHS Talking Therapy service in Surrey and Kent for With You. We explore the science behind worry and anxiety. We provide insights into the benefits and drawbacks of worry and discuss common worries and concerns. We also discuss lots of practical tips to cope better and manage worries effectively.

Your Better Mental Wellbeing is a weekly podcast helping you to manage stress and build resilience with easy evidence-based tools.

Dr Neera Dholakia is a GP for Boots Online Doctor and the NHS. She is an expert in mental wellbeing and has extensive experience designing mental health services whilst working for NHS England, Healthy London Partnership and mental health trusts. As well as promoting self-care, she also works to improve mental wellbeing in the workplace.

Soen Trueman is a full stack developer with Boots Online Doctor, specialising in graphics design, user experience, and user behaviour. Soen’s interests in behavioural analysis extends to psychology and further to neuroscience, which he is currently studying at Harvard University.

Links to this week's discussion:

02:47 Common themes of worry

04:06 The purpose of worry including the impact of social media

06:51 Rumination and the role of worrying about past events

09:49 Differentiating between helpful and unhelpful worry

11:40 Coping with your worst case scenario

15:43 Practical techniques to deal with worry: cost-benefit analysis, worry postponement, 2 minute rule, spot-stop-switch

Key takeaways:

-Worrying can be a helpful process but it's important to identify when it is not.

-We often compare ourselves, judge ourselves and worry we are not good enough

-Some easy techniques to cope with worry or worry better include: saying 'so what if', postponing worrying or worrying for 2 minutes and spot-stop-switch 'choo-choo'.

Join us next week for an Impactful 10 guided session on Being Present and Becoming Mindful.

Find out more:

Ben Cronin is a Cognitive Behavioural Psychotherapist providing mental health support for individuals, couples and families. He works for WithYou treating people with mild to moderate depression and anxiety disorders.

WithYou provides free, confidential counselling and cognitive behavioural therapy (CBT) in Surrey and Kent. They also have an online chat service. For more information, visit https://www.wearewithyou.org.uk

For transcripts visit our website: https://yourbettermentalwellbeing.show

For great health, lifestyle and wellbeing information visit: https://onlinedoctor.boots.com

The information in this podcast is not intended to replace your own GP or other doctor’s professional medical advice.

00:00/22:26
Read Full Episode Transcript
Neera

Do you spend time worrying about things, wishing that you weren't worrying or feeling anxious? Finding helpful ways to manage your worries will reduce your stress and give you time back to focus on things meaningful to you.

That's what we're going to talk about today on Your Better Mental Wellbeing. Helping you to manage stress and build resilience with easy evidence based tools. Hello, and a very warm welcome to you. You're listening to Episode 6, Taming Your Worries in Today's World.

I'm Dr. Neera Dholakia. I'm a GP for Boots Online Doctor and the NHS and my expertise is in mental health and wellbeing. I'm really pleased to be hosting the show, focusing on improving your mental wellbeing.

Soen

And I'm Soen Trueman. I'm a software developer for Boots Online Doctor and a neuroscience researcher. I'm going to help you understand the science of mental health and wellbeing.

Neera

Today, we're joined by Ben Cronin, who is a high intensity cognitive behavioural therapist.

He works in an NHS talking therapy service in Surrey for an organisation called We Are With You, which specialises in mental health treatment. So thank you for joining us today, Ben.

Ben: Thanks so much for having me on.

Neera

Just before we get into it, I wanted to let you know that Boots Online Doctor has lots of great information on lifestyle and wellbeing. You'll find this on the website at onlinedoctor.boots.com.

Today we're going to be talking about worry and anxiety. Why we worry and what we worry about, how we can reduce our worries or stop worrying, and if we do worry, how we can worry better and cope. So before I start worrying about getting this podcast out on time, let's get straight into it.

Soen, I know you worry about many things, but what would be something you worry about a lot?

Soen

I would say really about my health because I think my health is so unpredictable and that puts a lot of strain on my relationships with other people because sometimes I just can't go to the things that we were planning or, you know, I have to change plans at last minute so people don't think you're reliable. So, yeah. I'd say that was definitely one of my big worries that I have.

So Ben, what about you? What do you think your big worries are?

Ben: Oh, I worry about lots of different things. At the moment I've got a birthday coming up shortly, which is nice. A nice kind of reminder that getting older makes me worry about my body, about my health. Also, my wife kindly pointed out that my ear hair is getting longer, and she's right. It's blossoming at a quite a rate at the moment. It looks like some kind of coronal mass ejection. Anyway, I think I might be getting some ear and nose hair trimmers for my birthday.

Soen

It's that time of your life. And so... Age and ageing. I think it's probably quite a common concern a lot of people have. What do you hear back from other people about their anxieties? What do you think are common themes?

Ben: There certainly are lots of common themes that come up for people, lots of worries. Certainly lots of concerns about relationships. Other people, how they may be interpreted, understood by others, certain worries that people have about safety for themselves. And, uh, quite a lot of concerns about what if I get it wrong? What if I embarrass myself as well? It's a huge one that comes up for people.

Public speaking is often one of the things that comes up as, you know, creating a lot of worry. In fact, I remember reading a piece of research that said that the most anxious thing that people are afraid of is public speaking. Number two was death. People in general are more scared of giving a speech at a wedding than they are of death.

Neera

And Ben, do you think that's come to the fore because of us being online a lot as well with people having to actually speak directly into a camera, for example?

Ben: Definitely, I think there's a lot of, you know, impact of that on our lives. The fact that so much of our lives is now broadcasted. We're always often being recorded and watched. And that leaves us open then potentially to judgments of other people. These worries that come up for us about it.

Neera

And we often, a bit like stress, think of worry as being unhelpful. So, let's talk about why we feel anxious and why we actually worry. What is the benefit in that?

Ben: If we think about the fact that 200, 000 years ago, human beings were just evolving. And we were living in very uncertain times, where around us there could have been marauding tribes, there could have been saber-toothed tigers, there could have been lots of threats to our life. And our brain evolved in this environment essentially to keep us safe. So we're constantly on the lookout for what a particular threat could be. We have evolved it to be a helpful part of our functioning indeed. In fact, if we didn't have any anxiety at all, we might be inclined to walk out into a road without having looked left and right. And then we get squished. So we do need to have a certain level of anxiety.

Also, we have to remember that we are social creatures. So we grew up in tribes. So it was very important for us to be accepted, to be part of the tribe. If we were ever kind of kicked out of it or the possibility we could be ostracised, separated from the tribe, would result in death essentially. So we have evolved abilities to look out for practical threats in our lives, but also these social threats as well.

I mentioned social media earlier. There is this now direct comparison that not only to our tribe, this small group of people that we live with, but to any number of other human beings. This constant comparison with other human beings that we are constantly ranking and judging ourselves against. If anything, it makes perfect sense that so many of us are feeling anxious and are very prone to worry.

Neera

Ben, what's the difference between worrying and anxiety? We use those words almost interchangeably, but there is a difference, isn't there?

Ben: There is, absolutely. The anxiety, it's similar to the stress response. It's a physiological response, more an emotional response to a perceived threat. Worry, we would probably categorise that more as a cognitive process. So that's something that happens in the prefrontal cortex at the front of the brain, that gives us the ability to think in words or often images as well. And worrying is this way of trying to predict in the future what is going to happen, essentially making a plan.

The difficulty is sometimes that we might maybe engage in this process a little bit too much and it becomes excessive. That's potentially when worry becomes something that's a little bit more unhelpful.

Neera

So what you're saying is that worry is a process. So the process of worrying and the thinking behind it. And anxiety is the feeling or the response to stress. So the kind of emotional side of it.

Ben: Yes, very much so.

Soen

In Episode Two, Managing Stressful Moments, we go into detail about our body's stress reaction, our response to it, and ways in which we can cope better to reduce that stress and anxiety.

Neera

Okay, what about when we seem to worry about something that's happened in the past? I'm thinking about a conversation I had with a friend which ended badly and we've not spoken since. I go over and over it in my mind thinking of the different ways it could have played out if I'd responded differently.

Ben: It's a similar process to worry where we're trying to get this answer. We're trying to resolve a situation. And it can be really helpful, similar to worry, but this is obviously focused in the past, where we're going over and over events, trying to find a lesson to be learned from it, to maybe not do it again in the future, or maybe we're trying to correct the past in some way. We tend to call this process rumination. And it keeps us locked in this cycle of going over and over again, and once again, similar to worrying, if we maybe do that a bit excessively, that can then have unhelpful consequences for us.

I think it's really helpful to be able to refocus, come back to the moment a lot of the time, especially when maybe we're devoting a lot of time thinking about it until we really kind of lose track of any perspective of things and what's going on around us. And instead of engaging with those things that are important to us. So maybe living in more of a valued direction, something that's going to be really encouraging and something meaningful to us. Spending all of this time worrying, which then takes us out of that, means we're not living our lives, not being present.

Soen

You know, Neera and I both discuss this a lot about actually refocusing yourself to be in the here and now is really powerful and how that unhelpful behaviours really detract you from that.

Neera

I know sometimes we worry as a reaction to not having certainty. So a classic example is worrying about medical test results or exam results. We have this intolerance of uncertainty.

Ben: So this basically means this fear of the unknown, essentially this inability to sit with that, that not knowing and that being really scary, really anxiety provoking to not know how things are. So potentially one thing that we can do to help give us a bit more kind of certainty potentially is to worry. However, even by worrying, that's not going to give us that certainty.

Soen

Absolutely.

Ben: Try and worry about a million possible opportunities and what's going to happen. Is that going to guarantee we know what's going to happen? Sadly not.

Neera

So what you're saying is that we often use worry as a way to help us feel better about something that we are not sure about or something that we are not able to be certain about. And so we find that by worrying, we're doing something. So that helps us feel better.

Ben: Exactly, Neera. That kind of active kind of belief around worry. That we think that worry is going to be helping us in some kind of way, and because we believe it's going to be helping us, that maybe we're more inclined to do it, and what we can notice by worrying more is that we're actually then more likely to feel anxious.

There's a quote by Bombeck which says that, you know, worrying is like a rocking chair. It gives you something to do, but doesn't get you anywhere.

Soen

I like that, that's a very good quote.

Neera

And so how can we tell the difference between worrying that's helpful and worrying that's unhelpful?

Ben: Well, there's a simple question that if we are worrying about a particular situation, if we ask ourselves, can I do something about this? That then gives us two potential answers. One of them is, yes, that means that I can do something about this. Great. Brilliant. Go and do something about it, for then you'll be able to focus on things that are going to be more life enhancing. If we answer that question, can I do something about this, and the answer is no, then potentially it's what we would refer to as a hypothetical worry. It's about something that hasn't happened, might never happen. What happens if my train's late? Well, it's not happened yet, so we can't do anything about it. But if my train's late, I'll be late for the meeting, and if I'm late for the meeting, then I might lose my job, and if I lose my job, I might lose my house. Well, that's alright, none of those things have happened yet, so we can't do anything about them. They are all hypothetical worries.

I often like to compare this to the hungry hamster. You imagine a hamster in a cage. On one side of the cage is a piece of cheese. To get to that piece of cheese, it can go through a maze. Solve the maze, I've got some cheese, fantastic. Potentially the other option on the other side of the cage was a wheel. The hamster could easily have got on the wheel and just gone round and round and round. It would have just got more tired, more stressed, and then gone, ah, can't do this anymore. That's how we can tell the difference between what's going to be a helpful worry and what's not.

By asking the question, can I do something about this?

Neera

For the first six months of my son's life, I constantly worried about if he was still alive when he was asleep, and I would check his breathing multiple times. Initially, it was something helpful as I did all the things in the safer sleeping advice, but then after that it became unhelpful and I had to learn to let go by accepting the likelihood that he would remain alive.

Soen

I think that's something lots of new parents go through.

Neera

Yes, I think so.

Ben, you mentioned at the start that many people have public speaking as their top worry. So for example, imagine that you are having to give a presentation tomorrow and you're going through it in your head and you're worried that you'll start to speak and nothing will come out. What can you do to think through your worst case scenario and how you could cope with this?

Ben: It's a good question because one of the central features or cognitive feature around anxiety is often double pronged. We often tend to overestimate the downside of something, how dangerous and how bad and how serious the outcome could be. At the same time, we also underestimate our ability to cope with it. I suppose it's just trying to be realistic. So we have this understanding around what is the worst case scenario we think is going to happen, and in that moment we think we're not going to be able to cope at all. Well let's maybe ask ourselves in that moment, realistically, what do we think is actually going to happen?

Is there any evidence for this at all? Indeed, is there any kind of evidence in the past that maybe we have coped?

Soen

I often think, if a friend came to me with this issue, what would I say to them, and then use that to figure out what to do?

Ben: Absolutely, and the thing that can help in that moment to help us get through it, and as you've done in a previous episode, breathing exercises are a really important way of engaging the parasympathetic nervous system to help.

And in those moments, it can often be a temptation afterwards to maybe engage in what we talked about earlier, rumination. After that situation, after the meeting has finished, we may have the temptation to be going through it with a fine tooth comb, looking over our performance and judging ourselves in that moment. Maybe when that happens, instead of doing that, we can give ourselves a bit of compassion in that moment and recognize that it was really difficult. It was overwhelming. And this is just what happens sometimes to all of us.

Soen

If you have ever been on a meeting with me, you'll realise that I have a very specific technique of dealing with anxiety. It's to do something stupid straight away. If you tell a joke or get people on your side straight away, that just eases everybody's anxieties down.

Neera

You mentioned this idea of not being good enough. It seems to be a common theme that people worry about.

Soen

Life is imperfect in the best of times, especially with the advent of social media is that people try and live this perfect life and that's not what life is. You're seeing a little edited snapshot of their life. So why worry and stress about what somebody else is doing when you could be living your own truth, finding your own path.

Ben: And what we've noticed in terms of the cognitive research is that these worries, they can start off usually with something innocuous, typically with a sentence such as 'what if'. What if something happens? And then that can move into the next stage. So what if? And then what if that gets bigger? And what if that gets bigger? And they snowball. They can really pick up pace. Maybe from worrying about why did I chastise a child about a small incident to then them really ballooning up into huge worries about Oh my goodness, what does this say about me as a person? What if I'm not a good enough parent? We call these worry chains, where they then kind of build from one link into the next link into the next link. And before we realise it, we're just completely tied up in worry, completely bound up. Ultimately ending up with the biggest kind of worries. What does this say about me?

Neera

The one technique I was taught in relation to the what if question was to put a 'so' at the beginning of it. So I would ask myself, 'so what if'? And I find that really helps actually when I'm thinking too far into the future and worrying about things that haven't happened yet. It's just to put some perspective on it. So what if I didn't make that meeting? So what if I only gave my son spaghetti bolognese from a packet for his dinner? And actually then it starts to feel okay. Because, generally speaking, the consequence of my what if is actually something I can deal with.

Ben: Sounds like you can really take the sting out of some of those worrisome thoughts by simply putting so in the front.

Neera

Ben, we've already touched on a couple of tools that we can use, but are there some specific techniques that will really help us to cope with worry and ensure that we are dealing with it in the most effective way?

Ben: There are definitely some things that we can do. I've got three possible little techniques just for people to try. But before I come to them, just maybe something to do, uh, in terms of better understanding worry itself. Sometimes we call this metacognition. It's a very simple activity of sitting down and doing a cost benefit analysis. So getting a piece of paper and a pen, putting a line down the middle, one side writing all of the benefits of worry. What are the real kind of benefits you get out of worrying? How does it help your life? How does it enrich you? And then on the other side. What does it cost? What is worry? Taking away from your life means you don't get to engage in fully and maybe understanding and learning that actually, worry itself it's maybe costing us more than it is benefiting.

Soen

For sure. And actually just getting those things out of your head onto paper, what your concerns, your anxieties, your worries are, it helps massively.

Ben: I think you're absolutely right. So that idea of taking, uh, and reflecting on ideas and it brings back one of the central features of how to deal with worrying is paying attention to what's going on in the moment for us. What we often refer to as mindfulness.

Neera

And join us in our next Impactful 10 episode, which is focusing on mindfulness.

Okay, so we have looked at doing a cost benefit analysis and also writing those worries down and getting them out of your head. What do we do after that?

Ben: So the three techniques I wanted to introduce today, the first one is called worry postponement. If we're still finding it really hard to stop worrying, if we still notice that we're spending quite a lot of time doing it, then what we can do is dedicate a portion of the day specifically for worrying. Be that half an hour, maybe that 45 minutes, that hour, however long you want it to be, that is worry time. So whenever you find yourself worrying in the day before that, you're maybe noticing that you're in the middle of writing an email and you're worrying about something else. Ah, catch that worry, put it on your worry list, and then re engage with what it is you're actually doing. So that when you come to that particular time, later in the day or the next morning, you can say, great, these are my worries. I'm now going to sit here for an hour and I'm going to worry about these. And the idea is that you just worry about that in that specific worry time.

Soen

That's really interesting actually, because I love procrastinating.

Ben: Procrastination is a really big symptom of worry and anxiety. The idea of, I can't deal with that right now, I'll just do it later, so yeah. Having that specific, dedicated worry time means that I'm not going to worry about this right now. Let's just do that later and then, in the meantime, I'm going to do what actually matters to me, what's actually important.

Soen

And some people have a specific chair or area they go to for their worry time.

Ben: Yes. The second technique I want to introduce is something called the two minute rule. So when we notice that we're worrying, set a little timer for two minutes and click start. And worry for those two minutes about whatever's going through your mind at that time, that whole process of worry. At the end of the two minutes, you ask yourself three questions. The first question, have I got any new information? Second question, is my problem solved? The third question is, is my anxiety reducing? If you can answer yes to two of those questions, great, carry on. Keep doing what you're doing because what you're doing is problem solving. You're actually using that cognitive process to come to a solution to rectify the situation, whatever it might be. If you can't answer yes to two of those questions, stop doing it. Once again, shift your focus of attention onto something that's going to be more meaningful, something that really matters to you in that moment.

The third and final technique I wanted to introduce was something, it's a very short, pithy little activity. It's spot, stop, and switch. And this is a way of identifying when we are worrying. Choosing to stop in that moment and switching it. Similar to lots of the other techniques discussed, but choosing how to stop in the moment.

Because once we've noticed that we're worrying, we're worrying about a particular topic, we can then do something about it to break out of that worry. I like to think of it as being on a train. You're just chugging along on that worry and it is taking you wherever it takes you. Oh no, and you want to get off that train. You've noticed that you're on it, so it's like, nope, I'm off this train. Do you know what I'm going to do? Out loud, I'm going to make the sound of a train. Choo choo! I'm no longer going to be on this train and I'm going to get up and I'm going to go and do something else. I'm going to switch my attention to something else. That's something I like doing.

Soen

That's really interesting. It's very much like a tapping technique that I was taught, you know, as soon as you realise your brain is running away, you know, you tap different places on your hands and things. But I've never had somebody say choo choo out loud.

Ben: Give it a go, because next time you're on the train and maybe you're worrying there, it's out loud, go choo choo.

Neera

I like that idea. I can visualise the train and actually I think I'm more somebody who would pull the emergency cord rather than choo choo, but you know, each to their own. But that really works in terms of drawing attention to the thought and the worry that you've got to stop it, and then you can think about something else, either a different worry or something that is more helpful for you.

Ben, thank you so much for joining us today to talk about worries and anxieties. It's certainly been revealing what our own worries and anxieties are, but also what we can do about them. You've given us some excellent straightforward techniques. We can turn what if into so what if. We can do a cost benefit analysis to understand our worries. And then we have worry postponement, two minute rule, and finally spot, stop, and switch to help us cope with our worries better.

So this week I'm going to think about what I read about other people online, and how I can consider the way that I compare myself with them, and think about not worrying about that as much.

Soen

Uh, this week I'm going to try and stop predicting the future, you know, you're never sure what is going to happen, so this week I'm going to try and live more in the moment.

Neera

And Ben, any final words of wisdom for us?

Ben: Maybe look at things differently. Maybe start questioning things and just interrogating it a little bit to see what's actually going on, what's actually the realistic story.

Neera

Thank you so much for listening to this episode of Your Better Mental Wellbeing.

Soen

If you liked the episode and think it would be useful for someone else, please follow and share. For more information and transcripts, please visit our website at yourbettermentalwellbeing.show

Neera

Join us next week for our next Impactful 10 episode, Being Present and Becoming Mindful. And remember to live your values, accept yourself and let go.

About This Podcast
Your Hosts
Dr Neera Dholakia
Dr Neera is a GP and Clinical Lead for our Depression and Anxiety service. A safeguarding and mental health expert, she helps ensure services are both efficient and safe. As well as promoting self-care, she works to improve mental wellbeing in the workplace.
Soen Trueman
Soen is a full stack developer with Boots Online Doctor, specialising in graphics design, user experience, and user behaviour. Soen’s interests in behavioural analysis extends to psychology and further to neuroscience, which he is currently studying at Harvard University.
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The information in this podcast is not intended to replace your own GP or other doctor's professional medical advice.
Music credits: Main theme by AudioCoffee, Impactful 10 by Dream-Protocol, Jingle by Serge Quadrado Music