Chronic worry, sometimes warranting a diagnosis of Generalized Anxiety Disorder (GAD), is associated with a variety of difficulties and health problems, including social problems, decreased job performance, high blood pressure, increased risk of heart disease and heart attack.
Anxiety sounds like a pretty bad thing, and nobody reports that living under constant stress is fun. Yet, some people remain very attached to their states of worry and anxiety and don't want to stop worrying. Newman, Llera, et. al (2015) describe this ambivalence:
Individuals with GAD often report that they have a “love-hate” relationship with worry. On the one hand, these individuals view worry as helpful to them with respect to problem-solving, motivation, preparation for possible catastrophic outcomes, and even as a way to feel emotionally protected in the case of such outcomes. On the other hand, as noted above, chronic worry leads to a number of significant physical, mental, and health-related problems.
Newman and Llera focus on the latter comments to try to find out why chronic worry sometimes feels helpful for people. Worrying, a generally negative state, it turns out can be felt as protective. Stressing about failing an exam or getting a traffic ticket keeps the body in a constant state of negative emotions. If something bad ends up happening, the individual experiences only a minor amount of further disappointment. By contrast, going from neutral or happy to upset can be a very dramatic change. If I'm hypersensitive to negative emotions, then if things do end up going wrong it might just be easier to tolerate disappointment if I wasn't happy in the first place.
If things turn out ok, though, the individual experiences the benefits associated with a sense of relief. Hooray, the worried about event did not happen and I can feel better now. Even more so, if things turn out really well, then the individual might find great pleasure in the contrast of moving from sad to happy.
Whereas worry decreased the likelihood of experiencing a negative emotional contrast, worry increased the likelihood of experiencing a positive emotional contrast when participants viewed a subsequent humorous clip. In other words, if people worry about a negative event, and that event does not happen or something good actually happens, they will experience a positive shift from negative to neutral emotions (relief). Given that worry increases the likelihood of experiencing a positive contrast, it is likely that people with GAD enjoy this experience and, as noted, it creates a vicious cycle whereby chronic worry is negatively reinforced.
What does all of this mean for treating chronic worry, or GAD? The article provides a case example illustrating possible therapeutic approaches. At the start of treatment, "Peter" (a pseudonym) dislikes anxiety, but doesn't want to give it up:
Peter has described feeling that it is unwise not to expect the worst outcome, and that although he might worry too much, “it’s a lot better than getting yanked around.” Peter complains that his wife “always wants me to wear rose-colored glasses and look on the bright side,” but that this feels foolish to him.
CBT, or Cognitive Behavioral Therapy, is a proven therapy for addressing anxiety and the thought patterns that lead to excessive worry, but it does not work for everyone. Other approaches suggested in this article include acceptance.
Therapists could focus on teaching strategies that involve letting go of control over emotions, and learning to accept and tolerate emotional vulnerability. It may also be helpful to desensitize them to their phobic reaction . . . . Peter’s therapist collaboratively helped him examine the pros and cons of worry as a way to avoid contrasts, validating his sense that maintaining a negative mood is one way to avoid such contrasts, but also giving him opportunities to articulate how this choice has the consequence of significantly impairing his quality of life. . . . She introduced the metaphor of emotions feeling like waves and said that for some individuals, emotions feel like stormy seas. Peter gradually become open to the idea that he could learn how to allow himself to let go of his negative/defensive stance and to ride out the waves of his emotions.Bottom line, anxiety and worry are with us because they have some adaptive qualities. Problems occur, however, when stress begins to impact career, marriage, friends, and physical health. For the anxious person, anxiety may be performing a protective function for the individual. It may make sense for the therapist and client to address both the helpful and hurtful aspects of anxiety while also desensitizing the patient to the difficult transitions from neutral or positive emotions to negative states.