How To Cope With “What If…?” Thoughts

If you struggle with anxiety, then you are familiar with racing thoughts that trigger anxious feelings.  Often these thoughts are characterized by “what if . . . ?” scenarios. For example: “What if that car flips over and hits my car?”, “What if everyone starts laughing at me in this meeting?”, “What if I am attacked by a shark in the ocean?”. 

When one struggles with chronic anxiety, thoughts jump from one anxiety laden scenario to the next. These thoughts are future oriented and trigger discomfort.

As is a common behavioral response when faced with anxiety, one will likely retreat from the thought because of the uncomfortable emotional experience it causes, only to return to the same thought moments later. The worst-case scenario cognitive behavioral therapy intervention is a thought intervention that works to expose and habituate one to the anxiety triggered by “what if . . . ?” thoughts and assist in deliberately challenging distorted thinking.

STEP-BY-STEP CBT INTERVENTION FOR “WHAT IF…?” THOUGHTS

1. Identify the worst case scenarios in a triggering situation (e.g. an upcoming conversation, driving, a new activity). Make a list of the worst possible outcomes. 
2. Order this list from least likely to most likely to occur.
3. Assign a percentage, from 0-100, to each scenario based on the probability that the scenario would occur. Use your experience of such events and knowledge of the world to assist you. 
4. If there is a 50% probability or higher that the scenario will occur, devise a contingency plan. If that scenario should happen, how would you manage it? Make sure to include a self-care component as an add on.
5. Take a look at your list, see if you can identify which thoughts are a product of your anxiety and which thoughts are legitimate concerns. The anxious thoughts are those not very likely to occur. Do the anxious thoughts deserve the mental resources you have been allocating to them? In other words, if a scenario only has a 10% chance of occurring, should one spend their time worrying about it? When this “what if . . . ?” thought arises, remind yourself that this triggering situation makes you anxious but scenario x is not likely to occur.
   
   This exercise is a great method of managing “what if . . . ?” thoughts. However, if you find this exercise difficult to do on your own or find little relief, consider talking to a licensed mental health professional specializing in Cognitive Behavioral Therapy (CBT) for more assistance with this specific type of intervention. Anxiety is a treatable mental health diagnosis. You do not have to suffer. You can experience relief. 
   

Adaobi Anyeji, Phd
Founder and CEO
The Blue Clinic
Specializing in the treatment of worry, sadness, anxiety, depression
Downtown Los Angeles Psychology Practice