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Worry & “What If” Questions

Anxiety, What If Questions, & Worry

Answering "What If...?" questions is an anxiety-related avoidance behavior that involves overpreparation.

Anxiety, Worry, & What If Questions


If you have anxiety, it’s likely that you wrestle with worry and “what if” questions. Many what if questions are easily recognizable and start with the obvious, “What if…?” Others are more subtle and begin with phrases like “How am I ever going to…?”

By definition, what if questions prompt us to solve problems that haven’t actually happened yet. The possibilities are truly endless. These worries may involve fears about current situations or about situations set far in the future.

What if questions are often difficult to resist because by answering them, we often feel that we become more mentally “prepared” or “ready” to deal with life’s uncertainties. In fact, many individuals feel stressed out if they ignore their worries. They think that because what ifs involve potentially dangerous situations, it’s irresponsible or reckless to ignore these worries. By answering what ifs, they hope to have a better degree of control if and when these situations actually arise.

Many individuals with anxiety disorders like obsessive-compulsive disorder (OCD) or generalized anxiety disorder (GAD) struggle with what if questions and other worries for hours each day.

How often does this “mental preparation” actually pay off for people with anxiety?

Almost never.

That’s because mental reassurance (a type of mental ritual) is capable of providing only transient relief. We may feel prepared for a few seconds, minutes, or hours, but the feeling eventually wears off and then we feel compelled to re-board the what if train.

Because life involves infinite possibilities and our current situation is constantly changing, the scope of potential what if questions is limitless. You could literally spend the rest of your life preparing for every possible contingency in the hopes that you would be in a better position to deal with it (if and when it actually happens).

However, you can never be fully prepared.  Perfect preparation is only a mirage.

Providing specific answers to your anxiety’s what-if questions is like trying to fill a colander with water. You can spend time doing it, but it’s never going to get you anywhere. Moreover, you’ve wasted a lot of water in the process.

Similarly, there are consequences to answering what ifs.

What are the consequences of answering what if worries?
  • Answering what if questions substitutes thoughts for action. Because only action can create lasting change, answering what ifs is an avoidance behavior.
  • Time spent answering what ifs is time wasted. How would you rather spend your time? Rehashing answers to (likely) irrelevant questions, or doing something that will actually help you recover from your anxiety disorder?
  • What ifs multiply when you engage with them. The more you answer what ifs, the more what ifs will pop up to take their places (think about the paintbrushes in the Sorcerer’s Apprentice).
  • You never learn to trust yourself.  Over-preparation reinforces the idea that you won’t be capable of dealing with stressors when they spontaneously arise.  As such, in the long run, answering what ifs increases feelings of helplessness and dread.

Worry and what if questions do not actually prepare you to deal more effectively with situations; they just temporarily make you feel better.  The only real consequence of exhaustive preparation is that you miss out on experiencing the current moment. Instead, you’re living in (and engaging with) a fantasy.

Time is finite.

The most unfortunate consequence of catering to what-ifs is that you end up spending your life preparing for disasters that may never materialize.  Moreover, the sacrifices you make to “feel prepared” never actually work. You never feel adequately ready…in fact, you likely feel even more out of control.

How to Deal with What If Questions & Worry


The best way to deal with what-if’s is to acknowledge them but resist efforts to mentally solve them.  The reason this is helpful is because it’s based on acceptance of uncertainty.

When you feel an urge to answer a what if, avoid coming up with potential solutions and work on accepting that you’ll cope with the situation when it actually arises.  It’s also helpful to develop a script like the following (note: this script was written to help deal with symptoms of sensorimotor OCD):

“Thank you, OCD, for pointing out that I might have these symptoms forever. It’s certainly possible. I guess I’ll just have to deal with that when it happens. In the meantime, if I have to live with these symptoms, I might as well work on becoming less frightened/annoyed by them.”

That’s it.  If the script feels too abrupt, that’s good.  It’s supposed to be brief so that it doesn’t sideline you from your life.

Write out your script on a coping card and review it when needed.  You could also make an audio recording of your script and load it on your iphone/ipod, smartphone, computer, or car stereo.

If you find yourself asking, “What if I write the wrong script and it doesn’t work?” reread the above section “How to Deal with What If Questions & Worry.”

Questions? Comments? Struggling with anxiety related to what ifs and life’s other worries? Sound off below.




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16 Comments

  1. Such a helpful post!! “By definition, what if questions prompt us to solve problems that haven’t actually happened yet.” That is such a great reminder. It’s so easy to forget that circumstances can and will change and the problem may never materialize.

    I like the use of the script. Do you think such a script could not only keep us from asking what ifs but also help us break through avoidance? How can we move from thinking to action?

    Also, how can those of us with OCD deal with the advice to “Hope for the best, prepare for the worst”? For example, we’re told to prepare for natural disasters, terrorist attackes, etc. I interviewed a meteorologist today (I’m a newspaper reporter for a weekly newspaper) about how to respond to tornado watches and warnings. How can we tell when we’ve gone too far with the “How am I ever going to . . . ” questions?

    Thank you for writing about this.

    • Thanks, Tina. I think scripts can be useful for many different purposes. They can help support response prevention, healthy coping, motivation, and a variety of other pro-recovery factors. The main purpose of that particular script was to replace avoidance with action. The last part (“I might as well work on becoming less frightened/annoyed by them”) was used to support exposure and non-avoidance of triggers.

      I think that in some cases, preparing for low probability events can be helpful. You bring up some good examples: fire drills, natural disasters, etc. I think it’s good to teach yourself and your kids how to handle emergency situations. However, even these preparatory behaviors can become dysfunctional when they’re providing mostly reassurance and not teaching new skills. But, of course, it’s not black or white. It can be hard to tell sometimes.

      One good clue is if you’re replaying the same what-if’s again and again. Even if the original intention of answering the what-if question was functional, at some point it becomes redundant and unhelpful.

  2. Hi, I think that I suffer from some sort of a mixture of Pure-O, GAD  and depression. The thing is that I’ve tried to do erp for hundreds of hours yet I don’t feel any decline in my anxiety. And I don’t think that I use any avoidance strategies/rituals since nothing really brings me relief. What can it be that I’m doing wrong? Do you have any advice for me ?

    Thank you for your time and for great articles
    Best regards 
    A troubled sufferer 

    • Your best bet is to consult directly with an OCD therapist. There are simply too many complex variables to take into account. Best wishes in your recovery!

  3. Hi doctor!
    Would you treat my OCD by skype? I live in another country, and need help at this moment with my OCD. How much would you charge? Thanks for your attention!
    Henrique

    • Hi Henrique,

      Unfortunately, we can’t provide treatment services internationally. I would suggest contacting IOCDF for provider recommendations in your country.

      Wishing you the best!

  4. Greetings from Tampa, Dr. Seay. I appreciate the information that you’ve provided.

    I have a quick question regarding social anxiety, generalized anxiety and OCD and/or Pure O.

    I have been diagnosed with SAD/GAD and MDD. My trap is obsessional thinking. The ‘what-ifs,’ the rumination, crazy thoughts, constant negative thinking. I am having a difficult time trying to understand the relationship between the obsessional thinking and the SAD/GAD. Does one cause the other? Do they go hand-in-hand?

    It all seems so closely related in my experience, yet… it seems ‘medically’ there’s a distinction.

    In my attempt to work through all of this with my therapist, I get side-railed trying to determine the cause and effect, which came first, what do I tackle first, is the obsessional thinking perpetuating the GAD, is the anxiety causing the depression, are my isolating behaviors a result of obsessing or GAD/SAD, etc. Makes my mind spin, but I feel I need a point of reference to at least start making progress.

    Your insights are appreciated. I understand the work should continue with my therapist, but thought I’d get your perspective.

    Thanks!

    • Hi Mas,

      Diagnoses are simply constructs. In other words, diagnoses are labels that we use to organize our knowledge and to facilitate communication about clusters of symptoms that tend to co-occur. Sometimes our diagnostic system is good at imposing order; other times it fails miserably. As such, I would be less concerned about categorizing or organizing your symptoms properly and be more concerned about identifying the functions your symptoms serve and then targeting treatment accordingly. You don’t need to figure out the whole system before taking action to resolve the problem. In some cases, attempts to figure out are merely well-intentioned avoidance strategies.

      Good luck!

  5. Thank you very much for this article. I liked the script and will try to use it. It’s so silly to worry about stuff that hasn’t happened yet. I worry about being not able to sleep as I struggled with this as kid for a few days, and am afraid it will come back. (Being afraid of having no feeling being lifeless like with what happens when you sleep). I still don’t know why this freaks me out so much, and will talk to my counselor about it. It’s just when I’m laying in bed I like being awake and it creeps me out for some reason.

    I guess I worry cause my sensorimotor ocd bothered me a few weeks when I was really young, and it came back. But you can’t do “what ifs” like this cause you’ll eventually drive yourself crazy. And I haven’t actually not been able to fall asleep a single day. The me from a few years ago would of allowed this to really bother me. But I honestly can’t worry about something that hasn’t even happened. You’ll drive yourself insane with thoughts like that.

    Thank you for the articles they are great and very helpful.

  6. Dr Seay, this is a very helpful article about these what if questions…
    I spent my time, wondering…what if i have hit someone with my car? there was a tv programm some years ago, where those accidents were reported, in case someone knew something about car accidents… i did the horrible thing and i called a family, where their son was hit some years ago with a car that i used to have some years ago…i explained to the mother of the person that was hit, that i suffer from ocd..she was kind to me, i dont really remember details…but the what if question, doesn’t leave me to live a happy life…

    Thank you again for your great article..

    many greetings from Greece!

    Maria

    • Glad the article was helpful. Living with uncertainty and unresolved questions can be challenging. Just as I mentioned in the article, one helpful strategy can involve learning to let the question remain unanswered. A therapist can help guide you in this process.

      • Thank you Dr Seay, this is a great advice! I hope that for all of us who suffer harm symptoms, our soul will somehow relax and find some peace…the only thing i need…is to feel peace in my soul…to relax..to be carefree…!

        thank you again for being here for all of us and support us!

        Maria

    • Maria my advice and is only my advice is to know the positive aspect of your OCD is you have heightened awareness meaning that small things or irregularity etc you notice more than anyone. The worry that you’d hit someone in my opinion would never happen because of these heighten senses I think if you hit a squirrel you would know because your instincts are very strong (and one of a few good things about having anxiety or ocd). So in cases where people “accidentally” hit someone and didnt know I bet they didnt have anxiety or ocd and there may have been other variables. Were they drinking? drugs? etc? So I hope that helps you rest assure…you sound like a very caring person. Work on dbt to control negative thinking above all

  7. Your site has been a lifesaver for me. Scrupulosity and OCD have eaten away my self-confidence and ability to function. Religion is nearly a demon in itself now. Spirituality is useful, but not when accessed through religious sources. I now believe atheism or being religion-agnostic is the best way of life for OCD sufferers. It takes a big crushing emotional burden away. Shame is the sharpest weapon in OCD’s collection, which it uses ruthlessly and endlessly. Kill shame and suddenly you feel life is worth living, almost as if a heavy yoke has been lifted from the mind. I would say shame is as potent inwards as hatred is potent outwards.

    Thank you for the brilliant articles. Out of 10 that read, I guess that maybe 1 gathers the courage to reply on such a sensitive topic.

    You are reaching and helping many more broken people than the replies indicate. You have my heartfelt gratitude.

  8. Great post!

    So does that mean we tend to repeat our solutions to what if questions over and over in our head?

  9. Greetings from San Antonio, TX. I am suffering from the what-if nightmare and trying to get out of it. I am seeing a doctor, but perhaps your input can assist me. My what ifs all revolve around one specific concern and then of course, I have tried to solve scenarios but it never ends and so I now trying to convince myself that solving what ifs is not solving anything, no matter how realistic a what if can be (although realistic gets unrealistic quickly when I indulge a realistic what if). The fears that keep coming back are whether or not the thing can hurt me, what if I can’t solve/run out of ways to solve it/and what if I can’t get help solving it/can’t get used to something. I am trying to ignore these thoughts. I did find your article helpful in confirming that what ifs are unsolvable due to the fact that they never seem to end. Any input would be nice. Thanks.

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