Overcoming Fear and Anxiety: What's the Worst that Could Happen?

Andrew McNaughton, LCSW, CADC

When we fall victim to our anxieties, we frequently neglect to identify the source of our fear. This hinders our ability to put any consequences into rational perspective. This is a blog on how to identify the source of our anxieties, and how to manage our thoughts and feelings by using Rational Emotive Behavioral Therapy (REBT).

What is REBT?

Here is a quick refresher on REBT (though you can also see my previous blog that goes into further detail on this time-tested and evidence based practice): REBT is a thought and behavior change modality that teaches us that our beliefs about perceived, inferred, or actual real world events dictate our emotional or behavioral response using the ABC tool.

(A) is the Activating Event, (B) is our Belief about the Activating Event, and (C) is the Consequence, whether it be emotional, behavioral, or both. Our (A) does not make us feel or do (C), but through our (B) about (A), we make ourselves feel or do (C).

When our Consequence is unproductive and maladaptive, it is because of our Belief is irrational, and we are disturbing ourselves by catastrophizing or giving into our discomfort anxiety, also referred to as Low Frustration Tolerance (LFT).

Detecting Our Anxiety

It can be fairly simple to recognize that we are making ourselves anxious by identifying our common anxiety symptoms. Physical symptoms can include sweating, tightening of the chest, feeling pressure in our heads, and increased heart rate, while cognitive symptoms frequently present themselves when we engage in our anxiety narrative, which I refer to as playing the “What if?” game, and occurs when we allow our racing thoughts to determine that all possible outcomes will absolutely lead to the worst case scenarios. When we make ourselves feel these symptoms, we are acting out of anxiety and fear.

What Am I Afraid of?

I will briefly present a common scenario that may result in anxiety and fear, and how we can identify and dispute our irrational beliefs about the scenario. Let’s say I am tasked with giving a presentation about a mental health topic to a large group of colleagues, and I feel anxious and fearful about doing it. What am I afraid of? Let’s map it out using the ABCs of REBT:

• Activating Event = Giving a presentation to colleagues
• Belief = If it is not perfect, I cannot stand it and it will be terrible
• Consequence = Anxiety and fear

My Belief that I will suffer intolerable and catastrophic professional embarrassment that could end my career if my presentation is lousy will not hold up to the scrutiny. Using my rational Disputations (D), I ask myself, “What is the worst that could happen?” That I give a lousy presentation and am not asked back by this group of colleagues. This would feel bad and I would be disappointed in my efforts. This outcome is undesirable and uncomfortable, yet still manageable since it is not truly intolerable or catastrophic. If there is even the possibility of catastrophe, it is an extremely unlikely to be a direct consequence of my next action or decision. I can always choose to think and act rationally. I can even use it to motivate myself to do better in the future to significantly reduce the likelihood of a truly catastrophic outcome, such as losing my job and damaging my professional reputation. I have successfully identified the worst case scenarios, and while undesirable, I do not benefit from making myself anxious and fearful about them.

If you would like to learn how to use REBT to manage your fears and discomfort anxiety, please contact me for a free phone consultation and to set up an appointment at Symmetry Counseling Chicago.