WORRYING: STRATEGIES TO CHECK IT

These historically were meant to refer to behavioural measures (rather than medication) people took to quell anxiety. When identifying behaviours that helped someone deal with anxiety, the first obvious question is: What worked for you in the past? For example, if going for a run helped deal with stress in the past than exercise is likely to help in the future.
The best antidote to worrying about something is doing something about it. All of us face anxiety from time-to-time in certain contexts. Perhaps the anxiety is a positive thing telling us “don’t go there” (Dubord, 2011). After all, not all anxiety is pathologic. You can imagine that a anxiety at times in our cavemen ancestors probably kept them alive at times. For example, perhaps you get worried every time you are set to hand out with Angie. Maybe Angie is not a positive relationship in which you should invest time. Maybe you should spend that time doing something else productive or rewarding, like spending time with someone else who doesn’t cause you that anxiety.

Do you find yourself saying “I’ll do it when I feel like doing it?” Sometimes there are things in life we have to do that are not as enjoyable, the scut work that goes with the territory of the roles we fulfill. Here are some strategies to get you rolling so that you have more time left for things that are beneficial.

1. Eliminate distractions: This fits into a previous article written where we outline the 4 Ps: Prioritize, Plan, Pace, Place. If your phone keeps chiming while you are trying to get a task done, and you can’t help but entertaining it, it may be a good idea to put it on silent or keep it across the room until a scheduled break.

2. Just do it: Anyone can do anything for just 20 minutes. If you are having a tough time doing something you ought to be doing (e.g., exercise), why don’t you try setting a timer and going to the basement and doing nothing else but exercise until the timer sounds? Even if you don’t exercise at what you believe your potential to be, you have taken a step in creating a new habit of devoting 20 minutes per day to exercise. As results and fruit come from this habit, you may feel encouraged to dedicate more time to it or put more pep in your step while you are doing it.

3. Commit: If the strategy above won’t work for you, you can make it challenging to back out once you start. For example, if you can’t reliably workout at home on your own, you could always go to the gym. Then you’ll have to workout as you’ve paid the admission fee and have already invested the time in driving over there.

4. Schedule a post-task reward: If you keep imposing task after task on yourself, you may not get away with it. That is, you may start to resent your life and what you are doing to yourself. Why don’t you reward yourself with a “treat” for not procrastinating and taking-care-of-business? Perhaps a mani-pedi, a massage, or hiring the kid next door to shovel your driveway.

1. Your time: A good practice is to sit down for 30 minutes one day a week to make a schedule of things that must get done, things that would be nice if they were to get done and things that can be put off.

2. Your environment: This is an old philosophy in many cultures – Feng Shui, Vastu. Perhaps the time you are spending cleaning and dusting the knickknacks (or even otherwise) you have in your place aren’t worth the joy they bring. At a practical level, getting rid of stuff or organizing your stuff can save you time and free up the things you have on your mind.

Other than it feeling so good to check something of you list, lists can be useful in many areas. Most commonly, people use “To do” lists so that they don’t forget things. But journaling your thoughts, emotions, perceptions is also a helpful exercise in those that find rumination hard to check. Just try to resist re-reading your lists over and over again, or then this strategy is a burden rather than an aid. Learn more on how to organize yourself by reading our article “Executive Functioning

 

This is a common lesson to be learned by the more perfectionist crowd. Sometimes the solution you want to exist doesn’t. Thomas Sowell (Professor at Standford University) said “There are no solutions – only trade-offs.”

You may have to make concessions.

The most common issue we see in those that set down the road to recovery for their concussion is trying not to fall too far behind in work or school, and that attitude sucks them into a challenging situation where they have to rehabilitate themselves – which requires time, mindful effort and relaxation (think vacation-like relaxation for those just starting out on this road) – and keep up at work. All of this equates to them trying keeping up with their former selves!

Time management is a big topic. An occupational therapist can help with this. Read over Covey’s Time management matrix. Try increasing Q2 activities and cutting out Q3 and Q4 activities. (Covey, 2013)

1. Think about asking for help: This can be hired or help from friends/family. This can be help with driving, groceries, lawn work, shovelling the driveway, finances, meal preparation, etc. If you can arrange things so you have an hour or two extra a day just to relax and perhaps do your exercises if you haven’t done them already that day, that will be a good practice. This is a good practice even for those without concussions.

2. Think about challenging what really matters to you: Maybe you can let somethings slide. Perhaps having the perfect yard is not that important to you and you can have simpler plants in your garden this year.

3. Think about investing in processes that will save you time in the long-run: For example, perhaps the meals you made were quite elaborate before this injury. Perhaps you can invest in a new cookbook with fast and healthy recipes. This way, you will learn a new way of cooking that will see you still eating tasty and nutritious food, but also saving time for R&R. Maybe you do like guacamole and didn’t know it?

This has been discussed in many previous articles: nutritional strategies, return-to-athletics, therapeutic activities, sleep quality improvement strategies, mindfulness, relaxation strategies, biofeedback, etc. Improving your lifestyle will not only improve your health but it will also improve your enthusiasm for all that life has to offer.
This is something many of our patients have had to face. This is a strategy that was popular decades ago but somehow fell by the wayside. A recent medical article brings our focus back to it (Speed et al., 2017) For example, we have had patients who were to return to work with medical accommodations accepted by their HR departments just to see their managers assign the very tasks for which they received medical exemption. For many of these patients, their first instincts is to just do what their managers ask only to face the consequences of worsening symptoms, irritability and strained relationships at home. Learning to assert yourself in a way that you’re comfortable with is worth rehearsing so you can adequately deal with these instances. Instances like this, practically speaking, turn out to be the rule rather than the exception in most of our concussion patients.
Thinking about something is not helpful and just wastes energy and emotions. Thinking something through is useful to prepare yourself. If you have a tough time staying on the thinking-something-through side of the fence, consider strategies to help. A couple of options would be to: 1. Journal your thoughts so it symbolizes they are not going anywhere. A spin off from the first option is to write down your worries and then shred them to commemorate releasing yourself of them. 2. Schedule 20-30 min “thinking-something-through time”.
If you are religious or spiritual, this has been found to be helpful
If you’re tired about thinking about the same thing but seem to be compulsively drawn to repeating the same thought, try replacing it with another thought or activity, preferably something “mindless”.

Some common ones are

  • it won’t last forever
  • I’m too old for this (if you’re older than 29-years old)
  • I’m too young for that (if you’re under 29-years old)
This is a spin off of the old adage, “if you can’t beat ‘em, join ‘em”. If you are spending a lot of energy thinking about what you don’t want to happen from happening, try the reverse, let the worst-case scenario play out in your mind’s eye.
  • What’s the worst thing that can happen?
    • What do you know about yourself that tells you that you can handle it if the worst happens?
  • What’s the best thing that can happen?
  • What’s the most likely thing that can happen?
For this, mindfulness techniques are instrumental. If I tell you to not think about purple puppies, how successful are you?

Covey, Stephen R.; The 7 Habits of Highly Effective People: Powerful Lessons in Personal Change – Simon & Schuster; Anniversary edition (Nov. 19 2013)

Dubord, Greg. (2011). Part 6. The CUE question. Canadian family physician Médecin de famille canadien. 57. 573.

Speed, Brittany & L. Goldstein, Brandon & R. Goldfried, Marvin. (2017). Assertiveness Training: A Forgotten Evidence-Based Treatment. Clinical Psychology: Science and Practice. 25. 10.1111/cpsp.12216.

Research & writing: Dr. Taher Chugh

Last update: March 2019