‘This is a wise, practical book full of genuinely useful strategies

for dealing with your worries.’

Dr Stephen Briers, clinical psychologist and broadcaster

‘It's a book which sets realistic goals, has a down-to-earth approach and is

genuinely useful.’

Claudia Hammond, broadcaster, writer and academic psychologist

‘Very simple and very practical.’

Professor Geoff Beattie, University of Manchester and resident Big Brother psychologist

‘This book is a well thought-out combination of cognitive therapy and mindful

techniques. It is a practical book with useful step-by-step exercises. It contains

an excellent analysis of the common causes of worry and methods for

overcoming it.’

Dr Steven Melemis, author of I Want To Change My Life

We all worry about things - some of us even worry about the fact that we are worrying.This practical book will help you to put your fears into perspective and teach you to cope with stressful situations.

Using Cognitive Behavioural Therapy (CBT) exercises to understand the nature and seriousness of your worrying, Kerkhof shows you how to stop the cycle of worrying. By spending 15 minutes, twice a day, you will learn to take control of your repetitive thoughts. By integrating humour into the exercises, Kerkhof encourages you to face and deal with your worries.

Supporting and offering advice to worriers, as well as their family and friends, this book also provides guidance for professionals who work in mental health, especially those who recommend self-help to their clients.

Ad Kerkhof is Professor of Clinical Psychology at the VU University,Amsterdam,The Netherlands. He specializes in worry, depression and suicide. He also has a psychotherapy practice, where he treats clients for persistent forms of worrying, depression and burn-out.

Other contributors: Saida Akhnikh,Anneke Koopman, Maarten van der Linde, Marleen Stam and Elvan Tutkun.

Cover design by René van der Vooren

Adapted for the UK version by Naomi Mitchell

Stop Worrying

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Stop

Worrying

Get your life back on track

with CBT

Ad Kerkhof

In collaboration with

Saida Akhnikh, Anneke Koopman, Maarten van der Linde,

Marleen Stam & Elvan Tutkun

Open University Press

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iv

Open University Press

McGraw-Hill Education

McGraw-Hill House

Shoppenhangers Road

Maidenhead

Berkshire

England

SL6 2QL

email: enquiries@openup.co.uk

world wide web: www.openup.co.uk

and Two Penn Plaza, New York, NY 10121–2289, USA

Piekeren, First edition, by Ad J. F. M. Kerkhof

Original edition copyright 2007 by Boom uitgevers. All rights reserved English language of Piekeren by Ad J. F. M. Kerkhof

First edition copyright 2010 by Open University Press. All rights reserved.

English translation copyright © Anna George, 2010

All rights reserved. Except for the quotation of short passages for the purposes of criticism and review, no part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, without the prior written permission of the publisher or a licence from the Copyright Licensing Agency Limited. Details of such licences (for reprographic reproduction) may be obtained from the Copyright Licensing Agency Ltd of Saffron House, 6–10 Kirby Street, London, EC1N 8TS.

A catalogue record of this book is available from the British Library ISBN-13: 978–0–33–524252–8

ISBN-10: 0–33–524252–9

Library of Congress Cataloging-in-Publication Data

CIP data applied for

Typeset by Refi neCatch Limited, Bungay, Suffolk

Printed in the UK by Bell and Bain Ltd, Glasgow

Fictitious names of companies, products, people, characters and/or data that may be used herein (in case studies or in examples) are not intended to represent any real individual, company, product or event.

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v

Praise for this book

‘CBT requires a measure of self-discipline that can be hard to muster when you’re struggling. The real strength of this book is that it’s structured day by day programme that tells you exactly what to do when.’

‘This is not just a collection of good ideas but a carefully structured programme that should yield real benefi ts for anyone who follows it. Professor Kerkhof offers practical exercises using techniques clinically proven to help in the management of anxiety.’

‘This is a wise, practical book full of genuinely useful strategies for dealing with your worries.’

Dr Stephen Briers, Clinical psychologist and broadcaster

It’s good to see a self-help book which is based on solid,

psychological research. It’s a book which sets realistic goals, has a down-to-earth approach and is genuinely useful. This book is careful not to promise the earth, but if the exercises are followed carefully some people will fi nd it makes a real difference.

Claudia Hammond, Broadcaster and writer

Very simple and very practical.

Professor Geoff Beattie, University of Manchester and resident Big Brother psychologist

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vii

Contents

Foreword xi

Guidance

note

xiii

The CBT approach to worrying xv

Acknowledgements

xix

About the Authors xxi

Part

1

Stop worrying in four weeks 1

What is worry? 3

What can be done about it? 4

At the beginning 5

Week 1

To begin with: how much have you worried over

the past week? 10

Day 1 The

beginning

12

Day 2 Distraction

16

Day 3 Concentration

20

Day 4 Whirling

thoughts

24

Day 5 Talking about worrying 28

Day 6 Relaxation

32

Day 7 I must = I want to 36

How much have you worried over the past week? 40

Week 2

Day 8 Worrying and writing worries down 44

Day 9 Top

3

48

Day 10 Positive future 52

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viii

Day 11 Negative

future 56

Day 12 Probable future 60

Day 13 The next time 64

Day 14 Catch thoughts when relaxed 68

How much have you worried over the past week? 72

A word in the meantime 73

Week 3

Day 15 Writing exercise 76

Day 16 Three-scenarios writing exercise 80

Day 17 Scoring 84

Day 18 Next worry 89

Day 19 Not now but later and looking at things differently 94

Day 20 Writing 98

Day 21 Relaxation 102

How much have you worried over the past week? 106

Week 4

Day 22 Three-column exercise 110

Day 23 Make a decision 118

Day 24 Looking forward 122

Day 25 Catch your thoughts 126

Day 26 A realistic approach 130

Day 27 Free choice 134

Day 28 A positive day 138

How much have you worried over the past week? 142

End of Part 1 144

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Contents

ix

Part

2

Worrying for advanced students 147

Favourite worries 151

1 I am not good enough 151

2 Nobody likes me 153

3 I can’t do that 155

4 I won’t be able to cope 157

5 I am stupid 159

6 I don’t know what I want 160

7 I am a failure 162

8 I hope I’m not going mad 163

Another exercise for readers in the meantime 164

9 Why am I worrying so much? 164

10 When will this stop? 165

11 But that’s just the way I am 167

12 I must stop thinking like this 168

13 It would be better if I wasn’t here any more /I’m a burden to others 170

14 Life won’t get any better/I have no future /Life has no

meaning 171

Treatment of obsessive worrying about suicide 173

Fixed times to think about suicide 173

Worrying in metaphors and with exaggeration 177

Worrying as self-protection and self-torture 178

Final

exercises

179

Conclusion 181

More information about worrying 182

Tips for those providing specialist help 182

References

183

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xi

Foreword

Excessive worrying is a burdensome phenomenon which can

considerably affect the lives of the people who struggle with it.

People with depression or depressive disorders, for example, have to deal with this to a far greater extent than others. In some cases people who worry excessively even go on to develop what may be

referred to as a ‘worry disorder’ which can seriously disrupt their lives. In the United Kingdom around 4.4 per cent of adults suffer from a worry disorder (also referred to as a ‘generalized anxiety disorder’). Exactly how many people suffer from excessive worrying is not known precisely but it must be around several hundred

thousand a year. There is thus no doubt that this is a very

frequently occurring phenomenon.

It is therefore commendable that a book has now appeared for

people who suffer from excessive worrying. One of the most

positive aspects of this book is that it offers a wide range of exercises that people can do themselves to reduce worrying.

People who struggle with worrying can quite satisfactorily tackle worry for themselves. We also know this from a number of

scientifi c studies. This book offers a rich and varied choice of exercises which worriers can do for themselves. If one tackles this seriously, there is a good chance that the worrying will be

considerably reduced.

This book has been written by Professor Ad Kerkhof and his

colleagues. He is not only a highly valued colleague of mine but also an experienced clinician. Professor Kerkhof has many years experience as a psychotherapist and has used this experience to produce this book. And as you will see, the exercises are easy to do but still structured in an effective and balanced way.

As well as being a clinician, Prof. Kerkhof is also an excellent stop worrying.indd xi

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researcher/academic who well knows what research into the

treatment of worrying has produced, as you will see in this book.

This book is based on the principles of cognitive behavioural

therapy which we know is very effective when dealing with

worrying. Moreover, the information is presented in such a way

that people can adapt the exercises to their own needs.

All in all, this is an excellent book which I would very much like to recommend to people who want to get to grips with and change their excessive worrying.

Professor Pim Cuijpers

Amsterdam

Autumn 2007

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xiii

Guidance note

This self-help book contains a number of exercises to do at home.

These are exercises which you can also do anywhere, in the car or while doing the shopping. These exercises will slowly but surely help you to worry less. What you will have to do is to set aside a quarter of an hour twice a day in which you commit to do the

exercises. This is a time investment which you will quickly recoup as you will spend less time worrying. You should also aim to do the exercises at weekends.

In this book of exercises there are one or more exercises for

each day. We advise you to go through this book of exercises step by step and to calmly take the time to try out each exercise. After a while, you will notice which exercises work best for you. And then you can select a number of different exercises. If you fi nd you are at times still worrying after completing this course, then you can of course always continue using the exercises in this book.

Worrying often happens automatically without us necessarily

being aware of it. If you concentrate on this activity, you may notice your worrying thoughts may occur more frequently than you were previously aware of. Then it may also seem that at the start you are worrying more. After some time, however, you should

notice that you are overtaken by worrying thoughts less frequently.

This exercise book will not solve your problems. You will,

however, learn to worry less about your problems. This will free up time for you to work on real solutions.

We wish you every success and perhaps even some fun with

the exercises!

Professor Ad Kerkhof

Saida Akhnikh

Anneke Koopman

Maarten van der Linde

Marleen Stam

Elvan Tutkun

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xv

The Cognitive Behavioural

Therapy approach to worrying

For those clients (and therapists) who want to know how this book works, some scientifi c background material is provided in the next couple of pages. Readers who don’t want to read this now can

proceed immediately to the beginning of the book on page 1.

The Cognitive Behavioural Therapy (CBT) model emphasizes

that emotional states, depression, anger and suicidal thoughts are often maintained and strengthened by exaggerated or biased ways of thinking. In therapy, clients are taught how to improve their thinking habits. In CBT, thinking habits which are frequently

encountered, such as generalization, selective attention,

catastrophizing, are being combated with a multitude of CBT

techniques. Nowadays it is increasingly clear that in order to

benefi t from CBT approaches clients do not even have to see a

therapist face to face. E-mental health approaches (web-based

self-help interventions), bibliotherapy, or e-mail chat therapy can work as well.

Worrying is a stream of often uncontrollable stressful recurrent negative thoughts, mostly anticipating and expecting negative

outcomes in the future, focused on control and avoidance of future danger or failure. Worry is a central element in generalized anxiety, post-traumatic stress and depression (Borkovec et al. 1983;

Borkovec 1994; Borkovec and Sharpless 2004; Chelminski and

Zimmerman 2003; Kerkhof et al. 2000). Worrying and rumination,

closely related but distinct processes (Fresco et al. 2002; Watkins et al., 2005; Hong 2007), are associated with general health

complaints, cardiovascular disease and also with cardiovascular, endocrinological and immunological activation (Brosschot and Van stop worrying.indd xv

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xvi

der Doef 2006; Brosschot et al. 2006). There is an abundance of research linking worrying to neuroticism (Davey and Tallis 1994; Tallis and Eysenck 1994; Muris et al. 2005). Excessive worrying may be one of the accelerators of anxiety and depression, but it may also be conceived of as a product of anxiety and depression.

Even milder forms of excessive worrying are troublesome

and can induce sleeplessness and stress. From a preventive,

public health approach, there are several popular books to help people reduce their unwanted worrying, which will thus also

prevent the development of more serious clinical syndromes

(e.g. Nolen-Hoeksema 2003; Tallis 1990; Sterk and Swaen 2004;

Leahy 2006; Hayes 2005). Readers may fi nd tips and advice on

how to deal with recurrent intrusive thoughts such as rumination or worrying. As yet there are not many experimental studies

focusing exclusively on the psychological treatment of non-clinical worrying. Most of the research into the treatment of worrying has concentrated on patients with General Anxiety Disorder (Ladouceur et al. 2000).

Self-help interventions are effective in reducing mental health problems in the general population (Anderson et al. 2005; Boer et al. 2004; Cuijpers, 1997). A self-help intervention is a structured psychological treatment which the person works through

independently at home. Self-help interventions may be accessible in writing (bibliotherapy), on CD-ROM, on video or DVD, through television programmes, or over the internet (Spek et al. 2006). Self-help interventions may reach people in the general population who are not seeking, or do not yet seek or fi nd professional mental health care.

In a Dutch adult community study, 9 per cent of respondents

reported excessive worry. This means that about 1.1 million Dutch adults are suffering to some degree. Those with excessive worrying reported negative effects on their mental health, more days on sick leave (30 days versus 12 days a year), more GP visits (7 vs 3), higher use of tranquillizers (35 per cent vs 9 per cent) and

antidepressants (22 per cent vs 3 per cent) (Foekema 2001). From stop worrying.indd xvi

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The CBT approach to worrying

xvii

this study it is clear that although excessive worriers do receive more medical care and mental health care, many do not receive

adequate help or treatment and they can fi nd themselves worrying for extended periods of time. Therefore we felt a need to develop a structured self-help approach to provide people in the community with tools to combat initial stages of excessive worrying and in doing so to prevent people having to access mental health care. It was considered worthwhile to develop a short worry reduction

course in writing that would be easy to distribute, through GPs, pharmacies, bookshops, and the internet.

As a general framework for the intervention in this book, we

used the model of worrying of Borkovec (Borkovec and Costello

1993; Borkovec and Newman 1999; Borkovec and Roemer 1995),

and Dugas, Gagnon, Ladouceur and Freeston (1998), focusing on

intolerance of uncertainty, erroneous beliefs about worry, poor problem orientation and cognitive avoidance. We use these CBT

approaches to worrying in combination with problem solving

approaches and some mindfulness approaches (Beck et al. 1979;

Borkovec et al. 1983, Butler 1994; Leahy and Holland 2000, Leahy 2002, 2003, 2006; Broderick 2005, Segal et al. 2002; Hayes 2005; Hazlett-Stevens 2005; Ladouceur et al. 2000; Wells and

Papageorgiou 1995; Wells 2000; Davey and Wells 2006). CBT and

problem solving approaches have proved their effi cacy in the face-to-face treatment of depression and anxiety, and for other mental health problems. This also applies to CBT self-help approaches. In these interventions the application of CBT to worrying has received considerable attention (Ladouceur et al. 2000; Leahy 2002, 2003, 2006; Wells 2000; Davey and Wells 2006). In the mindfulness-based CBT approaches, worrying is one of the targets for

decentring and meditation (Segal et al. 2002).

The general idea of the interventions in this book is that

subjects:

•

learn to regain control over their thoughts;

•

learn to realistically evaluate future threats;

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•

learn to identify and combat automatic thoughts;

•

learn to identify and combat common errors in thinking;

•

correct erroneous beliefs about worrying;

•

learn to use other means of coping with future threats;

•

learn how to deal with uncertainty;

•

learn how to face cognitions instead of avoiding cognitions;

•

learn how to use distraction, relaxation, writing, imagination, and humour as coping mechanisms.

Exercises chosen or developed for this worry reduction intervention are, among others:

• worry

postponement;

•

muscle relaxation exercises;

• writing

exercises;

• monitoring

specifi c worries;

•

using positive forms of worrying;

• meditation/mindfulness-type

exercises;

•

the use of a buddy to communicate about worries.

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xix

Acknowledgements

This self-help book has been produced as the result of a research project where 200 ‘worriers’ read an earlier version. The scientifi c evaluation and the reactions of the ‘worriers’ have led to

adaptations of and improvements to this book. The question list used to measure the weekly level of worry is the Penn State Worry Questionnaire – Past Week (Stöber and Bittencourt 1998). The daily measurement of worrying and sleeping problems is developed by

Chantal Schutz (2002) in her Master’s thesis on worrying.

Most of the exercises in this self-help book are new and have

been especially created for this project. A small number of the exercises are commonly used cognitive behavioural therapy

exercises, such as the relaxation exercises, or mindfulness

exercises, such as the whirling with your thoughts exercise.

The exercise with the 7b’s on pages 130–31 is an adapted

version of the 5b exercise of F. Sterk and S. Swaen, Living with Worry (2004: 83).

The exercise with the three columns on pages 110–15 has

been reprinted with the permission of H. Hermans, Je piekert je suf (2006: 65–6).

I would like to express my gratitude to Anna George for her

faithful translation from the original Dutch text, and my special thanks to Dr Monika Lee at Open University Press for all her

enthusiasm and support.

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xxi

About the authors

Ad Kerkhof is Professor of Clinical Psychology at the VU University Amsterdam. He specializes in worry, depression and suicide. Ad

Kerkhof also has a psychotherapy practice, where he treats clients for persistent forms of worrying, depression, burn-out and suicidal thoughts. He observed that suicides and suicide attempts are often preceded by persistent worrying and lack of sleep. Since then he has considered suicidal thoughts as an expression of excessive and persistent worrying. This offers new starting points for suicide prevention and the psychotherapy treatment of depressed and

suicidal patients. Stop Worrying has also been written in the hope that people who worry and read this book will not reach the stage of contemplating suicide.

Saida Akhnikh, Anneke Koopman, Maarten van der Linde,

Marleen Stam, and Elvan Tutkun were doctoral students in clinical psychology at the VU University of Amsterdam. They carried out

research on the Stop Worrying project which formed the basis of this publication.

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Part 1

Stop

worrying

in four

weeks

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3

What is worry?

Worry is a phenomenon which all of us will have experienced at

least once. Who has not on occasion had a sleepless night when

they have stayed awake tossing and turning with worry? You will primarily worry about diffi cult things. For example, about taking a driving test, a dentist’s appointment, problems at work, problems in a relationship or a critical remark by a friend. You might worry about the future and also about events in the past. You might even worry about the fact that you are worrying.

Of course, it is necessary to consider how to solve or prevent

problems. This only becomes a burden when you can no longer

control your thoughts – when they suddenly come into your head

at inconvenient moments, when the same thoughts keep on

recurring and when you cannot stop them. The majority of worrying thoughts don’t lead to a solution. You fi nish up going round in never-ending circles. You then end up drifting into excessive

worrying due to these thoughts.

In the majority of cases, excessive worrying is completely

unproductive. It costs time and energy. Excessive worrying about the future often goes hand in hand with anxiety. You have a

concern and you always ask: ‘What if . . . ?’ Your muscles tense unnecessarily and in the long term you feel more and more tired and apathetic. Worrying about things which have happened in the past gives rise to feelings of dejection and anger. Worriers often know perfectly well that they cannot change the past but they still remain caught up in negative memories and can no longer

concentrate on school, work or household duties.

Long-term worry can mean that you fi nd it diffi cult to sleep. Or you are so tired that you go out like a light but after a few hours you are wide awake again . . . and worrying. It is night-time

worrying which is often the most troublesome because everything seems worse at night and because the following day you feel even more tired. This can even become so serious that you have no

desire to do anything any more. That is a pity and it moreover

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4

gives you occasion to worry all the more. Once you are caught in this vicious circle, it is hard to fi nd a way out.

We thus return to the original question: ‘What actually is

worry?’ Worry is defi nitely not the same as thinking, it is the uninterrupted never-ending repetition of the same thoughts.

Thinking leads to solutions or recovery. Worrying leads nowhere.

Thinking leads to action, worrying leads to nothing, at the very most it may lead to preparation for action but then one just

freezes, as it were, during these preparations. Thinking leads to relief, worrying does not. Worrying leads to powerlessness.

Thinking leads to the energy to take action. Worrying leads to

tiredness and exhaustion.

Worry is something which many people experience regardless

of their personality. But there are naturally people who never worry and people who often worry. In German, the following words are

used for worrying: Besorgnis or grübeln. From the sound of these words alone it is clear that they don’t mean anything good. But the best foreign term for worrying is in French: torturer l’esprit, torturing of the mind. Our proposal is that we subscribe to

the French viewpoint and that we regard worrying as a form

of self-torture.

What can be done about it?

You can use your own strength to ensure you overcome these

thoughts. This book of exercises should help you to worry less so that you have more time and energy left to deal with your

problems in a different, more focused manner.

What is at the heart of this approach is that you learn as

quickly as possible to recognize your worrying thoughts and to

replace them with something else. This may be other thoughts but it could also be distraction, relaxation, a thought break or just letting thoughts whirl around freely in your head. You could also learn how to worry in a positive manner. This book offers a number of exercises which have been proven to help you to do this – at stop worrying.indd 4

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Stop worrying in four weeks

5

least if you practise them regularly. The most vital requirement is the time to do the exercises and patience, as it will take some time to break the habit of worrying. You are training your thoughts, as it were. Just as with fi tness training, repetition and perseverance are required to get results. The most effective strategy is to do one or more tasks every day and thus work through all the exercises.

After that you can continue to use the exercises which work best for you.

It sometimes helps to write down worrying thoughts, examine

them and consider whether it is perhaps possible to think any

other less anxious or gloomy thoughts. You could, for example,

write your thoughts in a notebook.

Because many of your worrying thoughts play out in your

imagination (for example, what you think the future has in store for you), it is necessary to combat these thoughts with more realistic imaginings. For many exercises you need to fantasize a little, for example, not just about what could go wrong but also what could go right. You should use the power of your imagination in a more realistic direction.

You will also need an old shoebox or rucksack, a good friend,

a notepad or notebook, a pen and a kitchen timer. Make sure you are sleeping on a good mattress as a poor quality mattress can

lead to a lack of sleep and thus to worry.

At the beginning

When you decide to start doing the exercises in this book, it is good to always bear the following points in mind:

1

Even if you are a worrier by nature, you can still benefi t from a considerable reduction in the time you spend worrying.

2 If you imagine that as from tomorrow you will never worry ever again, then you will not succeed. This is unrealistic.

3 If you imagine that once you have reached the end of this book of exercises you will not worry any more, then this can be a

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6

further source of disappointment if you then don’t get to that

stage. This is probably hoping for too much.

4 If through using this book you aim to halve the time spent

worrying, then this is a realistic objective. Who knows, you

may reduce it by more than half which would then be a bonus.

5 If you start to consider your worries during the quarter of an hour set aside for this, known as worry time, and nothing

comes to mind and you don’t succeed in having any worrying

thoughts, then you can go back further and deal with what you

were worrying about yesterday.

6 If that doesn’t work either, there is no need to be concerned.

You can do different exercises, for example, relaxation

exercises which will help you achieve the desired results.

7 The aim is for you to concentrate your worrying within fi xed periods of time, during the worry times.

8 If you notice that during the second week working with the

book you are worrying more than in the fi rst week, then this

too does not matter at all. Worrying is not something which

remains stable every day of the week. It fl uctuates in frequency and intensity. The best approach is to accept these changes as

normal.

9 The objective is that you regularly record in the exercise book how much and how intensely you worry. This recording of your

patterns of worry is one of the most powerful and effective

exercises in the book. The better records you keep of how

frequently you worry, the better the view you will have of the

(lost) time which you spend on this activity and the better you will be able to monitor your progress. Here measurement =

knowledge.

10 If you record your progress regularly in this exercise book, then that will help you to do your exercises regularly.

11 If now and again you have an uncontrollable urge to worry, for example because you feel you need to due to a new situation,

then it is perhaps best to give in on that one occasion. But

don’t do this too often.

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Stop worrying in four weeks

7

12 If you notice that you regress on one or a few occasions and you are once again worrying more than during the past few days, this too is nothing to be concerned about. It is completely natural that now and again you will regress to a greater or lesser extent. It is precisely at these times that you need to follow through with the exercises and you should notice over the whole four-week period that you will on average have made progress.

13 If you dislike some of the worry exercises, fi nd them unpleasant or ineffective, then you can upon your own initiative replace

these with other exercises – exercises which you fi nd work better for you, earlier exercises from this book or exercises which you think up for yourself, which you have read about elsewhere or

which others have told you about.

14 The method described here works and has been proven by

scientifi c research. But it does not work in equal measure for everyone. Some people derive a great deal of benefi t from it,

others less. And there will be a few who will derive no benefi t at all. It cannot be predicted in advance into which category you will fall. You will notice this for yourself.

15 If during the period of the exercises you go on holiday, have to take an exam, have a death or illness in the family and due to

these circumstances you cannot practise the exercises for one or more weeks, this does not have to disrupt your efforts to worry less. After several weeks you can pick up from where you left off, or you can start again from scratch, if you feel this is necessary.

16 Worrying is a serious activity. In order to reduce its effects it is important to relativize your worry. You will gradually learn how to do this through the exercises, with a degree of humour, when you look at your own thought patterns. That means that from time to time you will need to treat the exercises detailed here with

humour. Anti-worrying exercises don’t have to be terribly serious all the time.

17 Don’t forget to tell those close to you about your efforts to worry less. They will be happy to support you.

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stop worrying.indd 8

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9

Week

1

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10

To begin with: how much have you worried over the

past week?

For each of the following statements indicate which is most

applicable to you by circling the appropriate number. This applies to the past week.

never

very

rarely

some-

often

very

almost

rarely

times

often

always

1 If I did not have

6

5

4

3

2

1

0

enough time to do

everything, I did

not worry about it.

1 Week 2 My worries 0 1 2 3 4 5 6

overwhelmed me.

3 I didn’t tend to

6

5

4

3

2

1

0

worry about things.

4 Many

situations

0

1

2

3

4

5

6

made me worry.

5 I knew that I

0

1

2

3

4

5

6

shouldn’t have

worried about

things but I just

couldn’t help it.

6 When I was under

0

1

2

3

4

5

6

pressure, I worried

a lot.

7 I was always

0

1

2

3

4

5

6

worrying about

something.

8 I found it easy to

6

5

4

3

2

1

0

dismiss worrisome

thoughts.

stop worrying.indd 10

15/07/2010 14:44

Week 1

11

never

very

rarely

some-

often

very

almost

rarely

times

often

always

9 As soon as I

0

1

2

3

4

5

6

fi nished one task, I

started to worry

about everything

else that I had to

do.

10 I did not worry

6

5

4

3

2

1

0

about anything.

11 When there was

6

5

4

3

2

1

0

nothing more I

could do about a

concern, I did not

worry about it any

more.

12 I noticed that I had

0

1

2

3

4

5

6

been worrying

about things.

13 Once I started

0

1

2

3

4

5

6

worrying, I couldn’t

stop.

14 I worried all the

0

1

2

3

4

5

6

time.

15 I worried about

0

1

2

3

4

5

6

projects until they

were all done.

Total

➠ Total score for the past week :

stop worrying.indd 11

15/07/2010 14:44

12

Day 1 The beginning

As from today you will not spend all day worrying. Instead you will allocate two fi xed worry times, one worry time in the morning or the afternoon and one in the evening. You will use these times to do your exercises. Try to do the exercises at the same time each day.

Worry time I

Controlled worrying

morning/afternoon

1 Explanation It is important to make worrying as unattractive as Week

possible. So you will no longer go and worry in your warm bed

or in your favourite comfortable armchair but you will sit on an upright chair at a table. Instead of being overcome by the

worrying thoughts, you will now consciously seek them out

and control them in the worry time. If you don’t succeed in

worrying intensely during the worry time, then this doesn’t

matter. Go through the other exercises and then try to worry as much as possible during the following worry time.

a First

fi ll in here which fi xed time slots you have selected.

Time slot 1 ......................................

Time slot 2 ......................................

b For these worry times choose a place where you will not be disturbed. If necessary, lock the door.

c

During this worry time, you will worry as much as possible

about everything you are concerned about. Once the worry

time is up, stop worrying and go and do something else. If you

have not yet fi nished worrying then you can give yourself the

stop worrying.indd 12

15/07/2010 14:44

Week 1 Day 1

13

task of continuing with this during the worry time in the

evening.

In the meantime Sometimes you will worry in the meantime. That is not serious but do try as much as possible to keep these

worrying thoughts for the next worry time. Here is an exercise

which you could do in the meantime if you start to worry: clap

your hands loudly and say to yourself, ‘Not now!’ (and

28

postpone the worrying until the evening).

27

26

Worry time II

25

Positive worrying 1

24

evening

23

22

Explanation Whenever we worry, we are overtaken by negative 21

thoughts and feelings. This does not serve any purpose. If you

20

are worrying, is there any reason why you should not think

19

about a happy time too? We now replace the negative thoughts

18

and feelings with a positive memory.

17

16

a

Just as during the previous worry time, start to worry intensely.

15

But do this for just fi ve minutes.

14

13

b Devote the following ten minutes to a good memory. Ensure you are in a relaxed position. Close your eyes and take a few

12

deep breaths. Go back in your thoughts to an event which

11

made you happy at the time. Think about this as intensely as

10

possible. Look around in your thoughts and pay attention to

9

the small things too. What colours did you see? What kind of

8

noises were there to be heard? Who was there? What did they

7

say? What could you smell at that moment? Go back to this

6

event in your thoughts for ten minutes. We refer to this

5

exercise as positive worrying 1 and we shall use this more

4

frequently: always just think back to a good memory.

3

2

1

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15/07/2010 14:44

14

Day

1

Notes

1

Tick the boxes to indicate which subjects you have worried

about today (you can give several answers).

studies/

fi nances

health

relationships

family/

what others

other

work

friends

think of me

❏

❏

❏

❏

❏

❏

❏

2 Tick a box to indicate how many minutes/hours you have 1 Week worried today.

0–30

30–60

1–2

2–3

3–4

4–5

> 5

minutes

minutes

hours

hours

hours

hours

hours

❏

❏

❏

❏

❏

❏

❏

3 Tick a box to indicate how much effort it took today to stop worrying, on a scale of 1 (almost no effort) to 5 (a great deal of effort).

no effort

almost no

some effort

quite a lot

a great deal

at all

effort

of effort

of effort

❏

❏

❏

❏

❏

stop worrying.indd 14

15/07/2010 14:44

Week 1 Day 1

15

4 How did you sleep last night? Indicate to what extent the following three statements apply to you.

completely

true

neutral

untrue

not true

true

at all

I found it hard to

1

2

3

4

5

get to sleep.

I suffered disturbed

1

2

3

4

5

28

or broken sleep.

27

I awoke too early.

1

2

3

4

5

26

25

24

5 Event Did anything particular happen today which made you 23

start to worry? If so then write down what happened below,

22

using key words.

21

20

.........................................................................................................

19

18

.........................................................................................................

17

.........................................................................................................

16

15

.........................................................................................................

14

.........................................................................................................

13

.........................................................................................................

12

11

.........................................................................................................

10

.........................................................................................................

9

8

.........................................................................................................

7

.........................................................................................................

6

5

4

3

2

1

stop worrying.indd 15

15/07/2010 14:44

16

Day 2 Distraction

Worry time I

Look for distraction

morning/afternoon

Explanation You can get out of the vicious circle of worrying thoughts just by doing something to distract yourself. Worrying often makes us somewhat passive. The best remedy is to look

for contact with others or to stay active and busy.

1 a Begin today with ten minutes worrying. Worry as intensely as Week

possible.

b If you fi nd yourself worrying, you may feel that you cannot stop. One way to stop is to look for some distraction. Today

think about what you could do to distract yourself from these

thoughts. The best remedy is to look for contact with others.

➠ Look for contact with others. Have a chat with a neighbour

or telephone a friend.

➠ Get active, or do some sports practise. For example, go for

a bike ride or a walk, preferably with someone else.

➠ Take a nice shower, let all the worry be washed away.

➠ Read a good book, you will then be in another world.

c

Make a list of distraction activities in your notebook.

In the meantime When you start to worry, look for some

distraction by engaging in the activities you have just listed

(for example, calling on someone, telephoning a friend,

practising a sport).

stop worrying.indd 16

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Week 1 Day 2

17

Worry time II

Positive worrying 2

evening

Explanation We often concentrate on looking at our negative side and qualities. This gives us a feeling of unease and ensures

that all too soon we end up . . . yes you guessed it, worrying!

It is important that we emphasize our positive qualities and

28

skills. You will have more than enough of these.

27

26

a

Start by worrying intensely for fi ve minutes.

25

24

b Then do the second positive worrying exercise. Close your 23

eyes. Take a quality or skill which you are good at or in which 22

you take a pride. This could be anything. You stood up for

21

yourself or someone else once, you are a good spouse, parent,

20

colleague or friend, you are a good cook, you can write or

19

dance well, you are amusing, smart. You then say to yourself: ‘I 18

am good at . . .’ Perhaps you will doubt that you can hold onto 17

this good feeling. So say it again: ‘I am good at . . .’ Now say it 16

to yourself twenty times. Allow yourself to be proud for fi ve

15

minutes.

14

This is what we call positive worrying 2.

13

At night Are you unable to sleep at night due to all that worrying?

12

If so, there are a number of things that could help you. Before 11

going to sleep you could drink a glass of warm milk, read,

10

listen to music. You could also put on something warm, for

9

example, pyjamas or an extra T-shirt. Try out positive worrying.

8

Think about a happy event or a good quality or skill you have.

7

6

5

4

3

2

1

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15/07/2010 14:44

18

Day

2

Notes

1

Tick the boxes to indicate which subjects you have worried

about today (you can give several answers).

studies/

fi nances

health

relationships

family/

what others

other

work

friends

think of me

❏

❏

❏

❏

❏

❏

❏

2 Tick a box to indicate how many minutes/hours you have 1 Week worried today.

0–30

30–60

1–2

2–3

3–4

4–5

> 5

minutes

minutes

hours

hours

hours

hours

hours

❏

❏

❏

❏

❏

❏

❏

3 Tick a box to indicate how much effort it took today to stop worrying, on a scale of 1 (almost no effort) to 5 (a great deal of effort).

no effort

almost no

some effort

quite a lot

a great deal

at all

effort

of effort

of effort

❏

❏

❏

❏

❏

stop worrying.indd 18

15/07/2010 14:44

Week 1 Day 2

19

4 How did you sleep last night? Indicate to what extent the following three statements apply to you.

completely

true

neutral

untrue

not true

true

at all

I found it hard to

1

2

3

4

5

get to sleep.

I suffered disturbed

1

2

3

4

5

28

or broken sleep.

27

I awoke too early.

1

2

3

4

5

26

25

24

5 Event Did anything particular happen today which made you 23

start to worry? If so then write down what happened below,

22

using key words.

21

20

.........................................................................................................

19

18

.........................................................................................................

17

.........................................................................................................

16

15

.........................................................................................................

14

.........................................................................................................

13

.........................................................................................................

12

11

.........................................................................................................

10

.........................................................................................................

9

8

.........................................................................................................

7

.........................................................................................................

6

5

4

3

2

1

stop worrying.indd 19

15/07/2010 14:44

20

Day 3 Concentration

Worry time I

Concentrating on breathing

morning/afternoon

Explanation The aim of this exercise is to learn to breathe with the highest level of concentration.

You are going to relax in this worry time. Go and sit at the

(kitchen) table and relax. Set the kitchen timer for ten minutes.

1 Become conscious of all your movements. Are you moving your

Week

foot? Are you sitting so your body is twisted or are you

relaxed? Is your jaw relaxed? Are your shoulders relaxed? This

exercise sounds very simple but it requires a great deal of

concentration. Now you are going to count your breaths. While

you are counting your breaths, pay attention to how deeply

you are breathing. Pay attention to the point at which

breathing in changes into breathing out. This exercise is about breathing purposefully. You will feel that every time you

breathe in you become a little larger and every time you

breathe out you become a little smaller. Do thoughts come into

your mind or do you have intense feelings and are distracted

by this? Don’t judge yourself because these thoughts occur.

Just let this go. Continue to concentrate on your breathing. Do this ten times and repeat.

In the meantime Try to postpone worrying thoughts until the second worry time. If this does not work, then look for a

distraction or do positive worrying exercise 1 about a happy

memory or positive worrying exercise 2 about one of your

positive qualities.

stop worrying.indd 20

15/07/2010 14:44

Week 1 Day 3

21

Worry time II

Slow concentration

evening

Explanation In this exercise you will carry out an activity on which you will concentrate fully. You will experience how relaxing this can be.

28

This worry time will be spent carrying out an activity with the 27

highest level of concentration. The activity is, for example,

26

going for a walk. Are you good on your feet and is the weather

25

outside good enough? Then go outside and walk for a quarter

24

of an hour. If you normally go running somewhere, then run at

23

a certain rate. You will run more slowly than normal during this 22

exercise. Run at half your normal speed. Go for a nice stroll.

21

Pay attention to the movement of your body. Are your

20

shoulders relaxed? Make sure your jaw is relaxed while running.

19

Notice how your feet touch the ground. If your attention drifts 18

away from your body, then look at the environment. What can

17

you see around you? Do you see trees, clouds or animals? What

16

buildings can you see, which people? What sounds can you

15

hear around you? Note the thoughts which come to you, ‘look’

14

at them and then let them go. You can also carry out this

13

exercise with other activities such as tidying up, washing up,

going cycling, etc. The most important element is that you

12

carry out the activity accurately and at half your normal speed.

11

10

At night Perhaps due to tension you lie there tossing and turning 9

with worry. Try to postpone the worrying thoughts until the

8

following worry time. Use the distraction, positive worrying

7

exercise 1 and positive worrying exercise 2.

6

5

4

3

2

1

stop worrying.indd 21

15/07/2010 14:44

22

Day

3

Notes

1

Tick the boxes to indicate which subjects you have worried

about today (you can give several answers).

studies/

fi nances

health

relationships

family/

what others

other

work

friends

think of me

❏

❏

❏

❏

❏

❏

❏

2 Tick a box to indicate how many minutes/hours you have 1 Week worried today.

0–30

30–60

1–2

2–3

3–4

4–5

> 5

minutes

minutes

hours

hours

hours

hours

hours

❏

❏

❏

❏

❏

❏

❏

3 Tick a box to indicate how much effort it took today to stop worrying, on a scale of 1 (almost no effort) to 5 (a great deal of effort).

no effort

almost no

some effort

quite a lot

a great deal

at all

effort

of effort

of effort

❏

❏

❏

❏

❏

stop worrying.indd 22

15/07/2010 14:44

Week 1 Day 3

23

4 How did you sleep last night? Indicate to what extent the following three statements apply to you.

completely

true

neutral

untrue

not true

true

at all

I found it hard to

1

2

3

4

5

get to sleep.

I suffered disturbed

1

2

3

4

5

28

or broken sleep.

27

I awoke too early.

1

2

3

4

5

26

25

24

5 Event Did anything particular happen today which made you 23

start to worry? If so then write down what happened below,

22

using key words.

21

20

.........................................................................................................

19

18

.........................................................................................................

17

.........................................................................................................

16

15

.........................................................................................................

14

.........................................................................................................

13

.........................................................................................................

12

11

.........................................................................................................

10

.........................................................................................................

9

8

.........................................................................................................

7

.........................................................................................................

6

5

4

3

2

1

stop worrying.indd 23

15/07/2010 14:44

24

Day 4 Whirling thoughts

Worry time I

Whirling exercise

morning/afternoon

Explanation In this exercise you will learn how to distance yourself from your thoughts. You will learn how to relativize

them and how to view them comparatively.

a

Begin with around ten minutes intense worrying.

1 Week b Now we will start with a whirling exercise. Try to empty your mind for the whirling exercise. If thoughts come into your mind, don’t try to prevent this. Thoughts are just thoughts. Accept

everything that comes to mind. Place these thoughts in light

clouds. Let these clouds quietly whirl around in your head

while you concentrate on your breathing. Let the clouds with

thoughts in them move here and there slowly in your head,

from left to right and back again. When you breathe out, you

can quietly blow the clouds away. In this way you can allow the thoughts to come and then go again. We call this whirling.

In the meantime If you have worrying thoughts, then postpone these until the next worry time, clap your hands and say to

yourself, ‘Not now’, or do a positive worrying exercise.

stop worrying.indd 24

15/07/2010 14:44

Week 1 Day 4

25

Worry time II

Continuation of whirling exercise

evening

a

Begin with fi ve minutes worrying.

b We shall take the whirling exercise from the fi rst worry time further. Empty your mind. Try to place the thoughts that come

28

to you in clouds. Think about the fact that these thoughts are

27

not the truth. There are no bad thoughts. You don’t have to

26

think the thoughts. You can also allow them to be what they

25

are. You don’t have to concentrate on these thoughts, you can

24

let them whirl away. You don’t have to fi nish your thoughts.

23

You don’t need to have control over your thoughts. We call this 22

thought whirling too. Carry out this exercise for fi ve minutes.

21

20

At night Put a shoebox or an old rucksack under your bed. Every 19

time you wake up and get a worrying thought, put this in your

18

imagination in the box or the rucksack. Close the box or the

17

rucksack and put it back under the bed. Or write the worrying

16

thought down in a tiny memo and place this in your shoebox.

15

The following morning you can get out your worrying thoughts

14

again during the worry time.

13

12

11

10

9

8

7

6

5

4

3

2

1

stop worrying.indd 25

15/07/2010 14:44

26

Day

4

Notes

1

Tick the boxes to indicate which subjects you have worried

about today (you can give several answers).

studies/

fi nances

health

relationships

family/

what others

other

work

friends

think of me

❏

❏

❏

❏

❏

❏

❏

2 Tick a box to indicate how many minutes/hours you have 1 Week worried today.

0–30

30–60

1–2

2–3

3–4

4–5

> 5

minutes

minutes

hours

hours

hours

hours

hours

❏

❏

❏

❏

❏

❏

❏

3 Tick a box to indicate how much effort it took today to stop worrying, on a scale of 1 (almost no effort) to 5 (a great deal of effort).

no effort

almost no

some effort

quite a lot

a great deal

at all

effort

of effort

of effort

❏

❏

❏

❏

❏

stop worrying.indd 26

15/07/2010 14:44

Week 1 Day 4

27

4 How did you sleep last night? Indicate to what extent the following three statements apply to you.

completely

true

neutral

untrue

not true

true

at all

I found it hard to

1

2

3

4

5

get to sleep.

I suffered disturbed

1

2

3

4

5

28

or broken sleep.

27

I awoke too early.

1

2

3

4

5

26

25

24

5 Event Did anything particular happen today which made you 23

start to worry? If so then write down what happened below,

22

using key words.

21

20

.........................................................................................................

19

18

.........................................................................................................

17

.........................................................................................................

16

15

.........................................................................................................

14

.........................................................................................................

13

.........................................................................................................

12

11

.........................................................................................................

10

.........................................................................................................

9

8

.........................................................................................................

7

.........................................................................................................

6

5

4

3

2

1

stop worrying.indd 27

15/07/2010 14:44

28

Day 5 Talking about worrying

Worry time I

Talking about worrying

morning/afternoon

Explanation Worries have the unpleasant habit of entering your head and not leaving. These thoughts go round in circles and

end up making things seem much worse than they really are.

But you can get relief from this by saying your thoughts out

loud. This is not to resolve your worries but rather to share

1 them and unload them.

Week

a

Begin with around ten minutes intense worrying.

b For the following exercise you will need someone who will listen to you. This can be anyone – a friend, acquaintance or

parent. We shall call him/her X.

Today you will do the following: telephone the chosen

person, talk to him/her or visit him/her. Ask this person if he/

she has time to listen to you. Then recount a number of the

worrying thoughts which are on your mind. Even if they appear

to be insignifi cant, just express them out loud. For example: ‘I am worried about my work.’ You are expressing your worry.

Just ask the person you have chosen to listen and not to offer

solutions or advice. What you are doing here is expressing your worries and not solving them. This exercise is called talking

about worrying. The objective is that in the meanwhile you

now have someone in mind and that you carry out this exercise

today.

In the meantime Carry out the exercise of the fi rst worry time. Get in touch with X.

stop worrying.indd 28

15/07/2010 14:44

Week 1 Day 5

29

Worry time II

Talking about worrying in your imagination

evening

Explanation This exercise is handy for when there is no suitable person available. The principle is the same as that used earlier today.

28

a

Begin with fi ve minutes intense worrying.

27

26

b Did you manage to tell anyone your thoughts today? In the 25

following exercise you will once again talk about your worries.

24

But now we won’t need anyone. You will do the same as in the

23

previous worry time but in your imagination. You will act as

22

though the person with whom you talked in the previous

21

exercise was sitting in front of you. Now once again talk about 20

the worries concerning you. They can be the same as those

19

from this morning or this afternoon but of course they don’t

18

have to be.

17

16

At night While undressing for bed, imagine that your clothes are 15

your worries. Take these off one after the other. Think about

14

your worries. With each piece of clothing you take off

13

consciously lay aside one worry.

12

11

10

9

8

7

6

5

4

3

2

1

stop worrying.indd 29

15/07/2010 14:44

30

Day

5

Notes

1

Tick the boxes to indicate which subjects you have worried

about today (you can give several answers).

studies/

fi nances

health

relationships

family/

what others

other

work

friends

think of me

❏

❏

❏

❏

❏

❏

❏

2 Tick a box to indicate how many minutes/hours you have 1 Week worried today.

0–30

30–60

1–2

2–3

3–4

4–5

> 5

minutes

minutes

hours

hours

hours

hours

hours

❏

❏

❏

❏

❏

❏

❏

3 Tick a box to indicate how much effort it took today to stop worrying, on a scale of 1 (almost no effort) to 5 (a great deal of effort).

no effort

almost no

some effort

quite a lot

a great deal

at all

effort

of effort

of effort

❏

❏

❏

❏

❏

stop worrying.indd 30

15/07/2010 14:44

Week 1 Day 5

31

4 How did you sleep last night? Indicate to what extent the following three statements apply to you.

completely

true

neutral

untrue

not true

true

at all

I found it hard to

1

2

3

4

5

get to sleep.

I suffered disturbed

1

2

3

4

5

28

or broken sleep.

27

I awoke too early.

1

2

3

4

5

26

25

24

5 Event Did anything particular happen today which made you 23

start to worry? If so then write down what happened below,

22

using key words.

21

20

.........................................................................................................

19

18

.........................................................................................................

17

.........................................................................................................

16

15

.........................................................................................................

14

.........................................................................................................

13

.........................................................................................................

12

11

.........................................................................................................

10

.........................................................................................................

9

8

.........................................................................................................

7

.........................................................................................................

6

5

4

3

2

1

stop worrying.indd 31

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32

Day 6 Relaxation

Worry time I

Muscle relaxation (arms)

morning/afternoon

Explanation Worrying every day creates a great deal of tension and stress in your body. So today we are going to do some

relaxation exercises so as to reduce this. Relaxation exercises are used to reduce physical complaints caused by worrying.

They take away the feelings of tension in your body.

1 Week a Begin with ten minutes intense worrying.

b Now we are going to do some relaxation exercises.

Begin with your writing arm. Place your elbow on the arm

of the chair, clench your fi st and then tense your forearm and the biceps/upper arm. But don’t overdo it – the aim is not to

get cramp, it should stay feeling good. Keep the arm tensed for six seconds. Then say to yourself, ‘Relax’ and let your muscles go. Let your muscle relax for about ten seconds. Then repeat

with the other arm.

Tense the muscles for six seconds again. Say to yourself,

‘Relax’ and then relax this arm for about ten seconds.

Repeat this exercise fi ve times.

In the meantime Try the talking in your imagination exercise. Or do the whirling exercise. You could also look for some

distraction.

stop worrying.indd 32

15/07/2010 14:44

Week 1 Day 6

33

Worry time II

Muscle relaxation (legs)

evening

a

Begin with fi ve minutes worrying.

b Go and sit up straight on a chair and raise your right leg.

Stretch your leg out in front of you with the foot turned

28

inwards so that your big toe is pointing at your face. Do this

27

for six seconds. Say to yourself, ‘Relax’ and then put your leg 26

down again. Then do the same with the left leg. Repeat fi ve

25

times.

24

23

At night Try the relaxation exercises when lying in bed. Or do a 22

whirling exercise or a positive worrying exercise.

21

20

19

18

17

16

15

14

13

12

11

10

9

8

7

6

5

4

3

2

1

stop worrying.indd 33

15/07/2010 14:44

34

Day

6

Notes

1

Tick the boxes to indicate which subjects you have worried

about today (you can give several answers).

studies/

fi nances

health

relationships

family/

what others

other

work

friends

think of me

❏

❏

❏

❏

❏

❏

❏

2 Tick a box to indicate how many minutes/hours you have 1 Week worried today.

0–30

30–60

1–2

2–3

3–4

4–5

> 5

minutes

minutes

hours

hours

hours

hours

hours

❏

❏

❏

❏

❏

❏

❏

3 Tick a box to indicate how much effort it took today to stop worrying, on a scale of 1 (almost no effort) to 5 (a great deal of effort).

no effort

almost no

some effort

quite a lot

a great deal

at all

effort

of effort

of effort

❏

❏

❏

❏

❏

stop worrying.indd 34

15/07/2010 14:44

Week 1 Day 6

35

4 How did you sleep last night? Indicate to what extent the following three statements apply to you.

completely

true

neutral

untrue

not true

true

at all

I found it hard to

1

2

3

4

5

get to sleep.

I suffered disturbed

1

2

3

4

5

28

or broken sleep.

27

I awoke too early.

1

2

3

4

5

26

25

24

5 Event Did anything particular happen today which made you 23

start to worry? If so then write down what happened below,

22

using key words.

21

20

.........................................................................................................

19

18

.........................................................................................................

17

.........................................................................................................

16

15

.........................................................................................................

14

.........................................................................................................

13

.........................................................................................................

12

11

.........................................................................................................

10

.........................................................................................................

9

8

.........................................................................................................

7

.........................................................................................................

6

5

4

3

2

1

stop worrying.indd 35

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36

Day 7 I must = I want to

Worry time I

I must = I want to

morning/afternoon

a

Begin with fi ve minutes intense worrying.

b When you go through what you have wanted to do in the day ahead, are you perhaps inclined to set yourself tasks such as:

‘I still have to . . . And after that I must . . .’? These self-1 imposed obligations are enough to give you a headache. For

Week

this reason you have to tell yourself that you don’t have to do certain things but that you want to do them. Think about the things you must do today and then tell yourself that you don’t have to do them but that you want to do them. You are going to do the following exercise. Every time you use the words

must or have to in your thoughts today replace it straightaway with the words ‘ I want’ . For example, you should replace ‘I must go to training today’ with ‘No, I don’t have to go to training at all but I want to go to training because I want to stay fi t and healthy.’

In the meantime Try to put off worrying thoughts until the next worry time. If this does not work, then look for some

distraction or do one of the relaxation exercises.

stop worrying.indd 36

15/07/2010 14:44

Week 1 Day 7

37

Worry time II

Breathing from the stomach

evening

Explanation Breathing from the stomach kills two birds with one stone. First, the tension caused by worry will be reduced.

Second, concentrating on breathing will distract you.

28

a

Begin with ten minutes intense worrying.

27

26

b A good exercise to relax you is to pay attention to your 25

breathing. The following exercise will teach you to relax by

24

making better use of your breathing.

23

Go and sit or lie as comfortably as possible in a comfy

22

chair or on the sofa. Place one or two hands on your stomach.

21

You can also close your eyes if you like. Breathe in deeply

20

through your nose. Try to feel the movement of your stomach.

19

Don’t hold your breath, just breathe out quietly.

18

Try to breathe out for longer than you breathe in. What is

17

important is that you are breathing in a quiet and relaxed

16

manner. Don’t do this for longer than a few minutes.

15

14

At night You may be tossing and turning with worry all the more 13

due to the tension you are feeling. Try to postpone your

worries until the next worry time. Use the distraction, positive 12

worrying exercise 1 or positive worrying exercise 2.

11

10

9

8

7

6

5

4

3

2

1

stop worrying.indd 37

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38

Day

7

Notes

1

Tick the boxes to indicate which subjects you have worried

about today (you can give several answers).

studies/

fi nances

health

relationships

family/

what others

other

work

friends

think of me

❏

❏

❏

❏

❏

❏

❏

2 Tick a box to indicate how many minutes/hours you have 1 Week worried today.

0–30

30–60

1–2

2–3

3–4

4–5

> 5

minutes

minutes

hours

hours

hours

hours

hours

❏

❏

❏

❏

❏

❏

❏

3 Tick a box to indicate how much effort it took today to stop worrying, on a scale of 1 (almost no effort) to 5 (a great deal of effort).

no effort

almost no

some effort

quite a lot

a great deal

at all

effort

of effort

of effort

❏

❏

❏

❏

❏

stop worrying.indd 38

15/07/2010 14:44

Week 1 Day 7

39

4 How did you sleep last night? Indicate to what extent the following three statements apply to you.

completely

true

neutral

untrue

not true

true

at all

I found it hard to

1

2

3

4

5

get to sleep.

I suffered disturbed

1

2

3

4

5

28

or broken sleep.

27

I awoke too early.

1

2

3

4

5

26

25

24

5 Event Did anything particular happen today which made you 23

start to worry? If so then write down what happened below,

22

using key words.

21

20

.........................................................................................................

19

18

.........................................................................................................

17

.........................................................................................................

16

15

.........................................................................................................

14

.........................................................................................................

13

.........................................................................................................

12

11

.........................................................................................................

10

.........................................................................................................

9

8

.........................................................................................................

7

.........................................................................................................

6

5

4

3

2

1

stop worrying.indd 39

15/07/2010 14:44

40

How much have you worried over the past week?

For each of the following statements indicate which is most

applicable to you by circling the appropriate number. This applies to the past week.

never

very

rarely

some-

often

very

almost

rarely

times

often

always

1 If I did not have

6

5

4

3

2

1

0

enough time to do

everything, I did

not worry about it.

2 My worries

0

1

2

3

4

5

6

1 Week overwhelmed me.

3 I didn’t tend to

6

5

4

3

2

1

0

worry about things.

4 Many

situations

0

1

2

3

4

5

6

made me worry.

5 I knew that I

0

1

2

3

4

5

6

shouldn’t have

worried about

things but I just

couldn’t help it.

6 When I was under

0

1

2

3

4

5

6

pressure, I worried

a lot.

7 I was always

0

1

2

3

4

5

6

worrying about

something.

8 I found it easy to

6

5

4

3

2

1

0

dismiss worrisome

thoughts.

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15/07/2010 14:44

Week 1 Day 7

41

never

very

rarely

some-

often

very

almost

rarely

times

often

always

9 As soon as I

0

1

2

3

4

5

6

fi nished one task, I

started to worry

about everything

else that I had to

do.

28

10 I did not worry

6

5

4

3

2

1

0

27

about anything.

26

11 When there was

6

5

4

3

2

1

0

25

nothing more I

24

could do about a

concern, I did not

23

worry about it any

22

more.

21

12 I noticed that I had

0

1

2

3

4

5

6

20

been worrying

about things.

19

18

13 Once I started

0

1

2

3

4

5

6

worrying, I couldn’t

17

stop.

16

14 I worried all the

0

1

2

3

4

5

6

15

time.

14

15 I worried about

0

1

2

3

4

5

6

13

projects until they

12

were all done.

11

Total

10

9

8

➠ Total score for the fi rst week :

7

6

5

4

3

2

1

stop worrying.indd 41

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stop worrying.indd 42

15/07/2010 14:44

43

Week

2

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44

Day 8 Worrying and writing worries down

Worry time I

Writing down worries

morning/afternoon

a

Begin with fi ve minutes intense worrying.

b Now get out your pen and paper/notebook and spend ten minutes writing down your worries. For example: ‘When I go to

a party I am afraid that people won’t like me.’

2 Week In the meantime Whenever you start worrying, write down your worries in your notebook, using key words. Postpone worrying

thoughts until the next worry time.

stop worrying.indd 44

15/07/2010 14:44

Week 2 Day 8

45

Worry time II

Positive worrying, exercise 1

evening

a

Begin with fi ve minutes intense worrying.

b We shall spend the next fi ve minutes on a fantasy exercise.

You’re going to write this time too so get out your pen and

28

notebook. Sit in a relaxed position. Close your eyes and take a 27

couple of deep breaths. Go back in your thoughts to an event

26

which at the time made you happy. Think about this as hard as

25

you can. Look around you in your thoughts and pay attention

24

to the small things.

23

What colours did you see? What kind of noises were there

22

to be heard? Who was there? What did they say? What could

21

you smell at that moment? Go back to this event in your

20

thoughts for fi ve minutes. Now write about this event.

19

18

At night If necessary, open the old shoebox/rucksack. You should 17

still have the old shoebox/rucksack under the bed. Every time

16

you are awake and worrying put these worries in your

15

imagination into the box or the rucksack and put it back under

14

the bed. Then you can get out your worries again the following

13

morning.

12

11

10

9

8

7

6

5

4

3

2

1

stop worrying.indd 45

15/07/2010 14:44

46

Day

8

Notes

1

Tick the boxes to indicate which subjects you have worried

about today (you can give several answers).

studies/

fi nances

health

relationships

family/

what others

other

work

friends

think of me

❏

❏

❏

❏

❏

❏

❏

2 Tick a box to indicate how many minutes/hours you have 2 Week worried today.

0–30

30–60

1–2

2–3

3–4

4–5

> 5

minutes

minutes

hours

hours

hours

hours

hours

❏

❏

❏

❏

❏

❏

❏

3 Tick a box to indicate how much effort it took today to stop worrying, on a scale of 1 (almost no effort) to 5 (a great deal of effort).

no effort

almost no

some effort

quite a lot

a great deal

at all

effort

of effort

of effort

❏

❏

❏

❏

❏

stop worrying.indd 46

15/07/2010 14:44

Week 2 Day 8

47

4 How did you sleep last night? Indicate to what extent the following three statements apply to you.

completely

true

neutral

untrue

not true

true

at all

I found it hard to

1

2

3

4

5

get to sleep.

I suffered disturbed

1

2

3

4

5

28

or broken sleep.

27

I awoke too early.

1

2

3

4

5

26

25

24

5 Event Did anything particular happen today which made you 23

start to worry? If so then write down what happened below,

22

using key words.

21

20

.........................................................................................................

19

18

.........................................................................................................

17

.........................................................................................................

16

15

.........................................................................................................

14

.........................................................................................................

13

.........................................................................................................

12

11

.........................................................................................................

10

.........................................................................................................

9

8

.........................................................................................................

7

.........................................................................................................

6

5

4

3

2

1

stop worrying.indd 47

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48

Day 9 Top 3

Worry time I

Top 3

morning/afternoon

a

Begin again with around ten minutes intense worrying.

b Now go through the things you worry about frequently. Write down your top 3 worries on paper, putting the thing you worry

about most frequently in the number 1 position.

2 Week c Note down this top 3 on the next page of this book.

In the meantime Try to postpone worrying thoughts until the next worry time. If this does not work then look for distraction or

do one of the exercises which you have done up to now.

Worry time II

Positive worrying, exercise 2

evening

a

Begin with around fi ve minutes intense worrying.

b Now close your eyes. Think about something that you are good at. This can be anything. You stood up for yourself or someone

else once, you are a good spouse, parent, colleague or friend,

you are a good cook, you can write or dance well, you are

amusing, smart. You are proud and you should then say to

yourself: ‘I am good at . . . and I am proud of that.’ Perhaps

you will doubt that you can hold onto this good feeling. So say it again: ‘I am good at . . .’ Now say it to yourself twenty times.

Allow yourself to be proud for fi ve minutes.

stop worrying.indd 48

15/07/2010 14:44

Week 2 Day 9

49

Sometimes you may not be able to worry intensely during

the worry slot but this is nothing to be concerned about. Go

through the other exercises as usual. Then try to worry

intensely during the following worry time.

At night Try to do the relaxation exercises when you are in bed.

Top 3 worries

28

27

1

.........................................................................................................

26

25

.........................................................................................................

24

.........................................................................................................

23

22

2 .........................................................................................................

21

.........................................................................................................

20

19

.........................................................................................................

18

17

3 .........................................................................................................

16

.........................................................................................................

15

14

.........................................................................................................

13

12

11

10

9

8

7

6

5

4

3

2

1

stop worrying.indd 49

15/07/2010 14:44

50

Day

9

Notes

1

Tick the boxes to indicate which subjects you have worried

about today (you can give several answers).

studies/

fi nances

health

relationships

family/

what others

other

work

friends

think of me

❏

❏

❏

❏

❏

❏

❏

2 Tick a box to indicate how many minutes/hours you have 2 Week worried today.

0–30

30–60

1–2

2–3

3–4

4–5

> 5

minutes

minutes

hours

hours

hours

hours

hours

❏

❏

❏

❏

❏

❏

❏

3 Tick a box to indicate how much effort it took today to stop worrying, on a scale of 1 (almost no effort) to 5 (a great deal of effort).

no effort

almost no

some effort

quite a lot

a great deal

at all

effort

of effort

of effort

❏

❏

❏

❏

❏

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15/07/2010 14:44

Week 2 Day 9

51

4 How did you sleep last night? Indicate to what extent the following three statements apply to you.

completely

true

neutral

untrue

not true

true

at all

I found it hard to

1

2

3

4

5

get to sleep.

I suffered disturbed

1

2

3

4

5

28

or broken sleep.

27

I awoke too early.

1

2

3

4

5

26

25

24

5 Event Did anything particular happen today which made you 23

start to worry? If so then write down what happened below,

22

using key words.

21

20

.........................................................................................................

19

18

.........................................................................................................

17

.........................................................................................................

16

15

.........................................................................................................

14

.........................................................................................................

13

.........................................................................................................

12

11

.........................................................................................................

10

.........................................................................................................

9

8

.........................................................................................................

7

.........................................................................................................

6

5

4

3

2

1

stop worrying.indd 51

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52

Day 10 Positive future

Worry time I

Positive future alternative

morning/afternoon

a

Begin with around ten minutes intense worrying.

b Now look at your most signifi cant worries like a fi lm. Next write down an extremely positive alternative to these thoughts. Try

to make the situation exactly as you want it. Use your

2 imagination and try to make it as lifelike as possible. You can Week

exaggerate, however odd your ideas may seem. For example:

‘Tomorrow (next week) when I am at the party people will

compliment me on my good taste in clothes. They will say I

look amazing. Everyone will want to talk to me and they will

think I have something interesting to say. I feel completely at home. The atmosphere is really good.’

In the meantime Have you been worrying a lot over the day? Clap your hands and say to yourself, ‘Not now!’ Try to keep your

worries for the following worry time.

stop worrying.indd 52

15/07/2010 14:44

Week 2 Day 10

53

Worry time II

Your choice

evening

Here choose the exercise which you have found most helpful

up to now.

At night While undressing for bed, imagine that your clothes are 28

your worries. Take these off one after the other. Think about

27

your worries. With each piece of clothing you take off

26

consciously lay aside one worry. The following day you can put

25

them on again.

24

23

22

21

20

19

18

17

16

15

14

13

12

11

10

9

8

7

6

5

4

3

2

1

stop worrying.indd 53

15/07/2010 14:44

54

Day

10

Notes

1

Tick the boxes to indicate which subjects you have worried

about today (you can give several answers).

studies/

fi nances

health

relationships

family/

what others

other

work

friends

think of me

❏

❏

❏

❏

❏

❏

❏

2 Tick a box to indicate how many minutes/hours you have 2 Week worried today.

0–30

30–60

1–2

2–3

3–4

4–5

> 5

minutes

minutes

hours

hours

hours

hours

hours

❏

❏

❏

❏

❏

❏

❏

3 Tick a box to indicate how much effort it took today to stop worrying, on a scale of 1 (almost no effort) to 5 (a great deal of effort).

no effort

almost no

some effort

quite a lot

a great deal

at all

effort

of effort

of effort

❏

❏

❏

❏

❏

stop worrying.indd 54

15/07/2010 14:44

Week 2 Day 10

55

4 How did you sleep last night? Indicate to what extent the following three statements apply to you.

completely

true

neutral

untrue

not true

true

at all

I found it hard to

1

2

3

4

5

get to sleep.

I suffered disturbed

1

2

3

4

5

28

or broken sleep.

27

I awoke too early.

1

2

3

4

5

26

25

24

5 Event Did anything particular happen today which made you 23

start to worry? If so then write down what happened below,

22

using key words.

21

20

.........................................................................................................

19

18

.........................................................................................................

17

.........................................................................................................

16

15

.........................................................................................................

14

.........................................................................................................

13

.........................................................................................................

12

11

.........................................................................................................

10

.........................................................................................................

9

8

.........................................................................................................

7

.........................................................................................................

6

5

4

3

2

1

stop worrying.indd 55

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56

Day 11 Negative future

Worry time I

Negative future alternative

morning/afternoon

a

Begin again with around ten minutes intense worrying.

b This exercise is the same as exercise b for day 10. But this time you will change your positive story into a negative one. Get out your pen and paper and write it down in as much detail as

2 possible. What is the worst that can happen tomorrow (or next Week

week)? Feel free to exaggerate here too. For example: ‘I will go to the party and the people I meet there will not like me!

Worse still, they will think I am a joke. They will not say a

single word to me. People will act as though I am not there.

When I want to say something I will be mocked or snapped at.

They will be laughing at me behind my back.’

In the meantime If you start worrying, then postpone this until the next worry time, look for some distraction or do the

whirling exercise.

stop worrying.indd 56

15/07/2010 14:44

Week 2 Day 11

57

Worry time II

Whirling exercise

evening

a

Begin again with around fi ve minute intense worrying.

b Empty your mind for the following exercise. If thoughts come into your mind, don’t try and prevent this. Thoughts are just

28

thoughts. Accept everything that comes to mind. Place these

27

thoughts in light clouds. Let these clouds quietly whirl around 26

in your head while you concentrate on your breathing. Let the

25

clouds with thoughts in them move here and there slowly in

24

your head, from left to right and back again. When you breathe

23

out you can quietly blow the clouds away. In this way you can

22

allow the thoughts to come and then go again.

21

20

At night Are you unable to sleep at night due to worrying? There 19

are a number of things that could help you. Before going to

18

sleep you could drink a glass of warm milk, read or listen to

17

music. This will distract you from your worries. Put on

16

something warm, for example pyjamas or an extra T-shirt.

15

14

13

12

11

10

9

8

7

6

5

4

3

2

1

stop worrying.indd 57

15/07/2010 14:44

58

Day

11

Notes

1

Tick the boxes to indicate which subjects you have worried

about today (you can give several answers).

studies/

fi nances

health

relationships

family/

what others

other

work

friends

think of me

❏

❏

❏

❏

❏

❏

❏

2 Tick a box to indicate how many minutes/hours you have 2 Week worried today.

0–30

30–60

1–2

2–3

3–4

4–5

> 5

minutes

minutes

hours

hours

hours

hours

hours

❏

❏

❏

❏

❏

❏

❏

3 Tick a box to indicate how much effort it took today to stop worrying, on a scale of 1 (almost no effort) to 5 (a great deal of effort).

no effort

almost no

some effort

quite a lot

a great deal

at all

effort

of effort

of effort

❏

❏

❏

❏

❏

stop worrying.indd 58

15/07/2010 14:44

Week 2 Day 11

59

4 How did you sleep last night? Indicate to what extent the following three statements apply to you.

completely

true

neutral

untrue

not true

true

at all

I found it hard to

1

2

3

4

5

get to sleep.

I suffered disturbed

1

2

3

4

5

28

or broken sleep.

27

I awoke too early.

1

2

3

4

5

26

25

24

5 Event Did anything particular happen today which made you 23

start to worry? If so then write down what happened below,

22

using key words.

21

20

.........................................................................................................

19

18

.........................................................................................................

17

.........................................................................................................

16

15

.........................................................................................................

14

.........................................................................................................

13

.........................................................................................................

12

11

.........................................................................................................

10

.........................................................................................................

9

8

.........................................................................................................

7

.........................................................................................................

6

5

4

3

2

1

stop worrying.indd 59

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60

Day 12 Probable future

Worry time I

Probable future alternative

morning/afternoon

Explanation When you worry about what the future may hold, do you have a realistic picture of it? Or is this picture of the future overshadowed by negative thoughts and feelings? This exercise

will help you to put your thoughts in perspective, relax and

learn to view the future positively.

2 Week a Begin again with around ten minutes intense worrying.

b We shall go further with future expectations. Over the last couple of days you have written down the most positive and

the most negative scenarios for a day in the near future. There is still one more expectation of the future. Now write down the future scenario which is mid-way between the worst case and

best case scenarios. This is probably the most realistic

scenario.

In the meantime Try to postpone worrying thoughts until the next worry time. If this does not work, then look for some

distraction or do one of the exercises which you have done up

to now.

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Week 2 Day 12

61

Worry time II

Whirling exercise

evening

a

Begin with around fi ve minutes worrying. Worry as intensely as possible.

b We shall go further with a whirling exercise. Let the thoughts 28

come. Thoughts are not reality. There are no bad thoughts. You

27

don’t have to think the thoughts. You can let them be what

26

they are. You don’t have to concentrate on the thoughts, you

25

can let them whirl away too. You don’t have to fi nish your

24

thoughts. You don’t need to control your thoughts. Put them in

23

little clouds. We call this thought whirling.

22

21

At night You may be tossing and turning with worry all the more 20

due to the tension you are feeling. Try to postpone your

19

worries until the next worry time. Think about the ‘I must = I

18

want to’ exercise!

17

16

15

14

13

12

11

10

9

8

7

6

5

4

3

2

1

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62

Day

12

Notes

1

Tick the boxes to indicate which subjects you have worried

about today (you can give several answers).

studies/

fi nances

health

relationships

family/

what others

other

work

friends

think of me

❏

❏

❏

❏

❏

❏

❏

2 Tick a box to indicate how many minutes/hours you have 2 Week worried today.

0–30

30–60

1–2

2–3

3–4

4–5

> 5

minutes

minutes

hours

hours

hours

hours

hours

❏

❏

❏

❏

❏

❏

❏

3 Tick a box to indicate how much effort it took today to stop worrying, on a scale of 1 (almost no effort) to 5 (a great deal of effort).

no effort

almost no

some effort

quite a lot

a great deal

at all

effort

of effort

of effort

❏

❏

❏

❏

❏

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Week 2 Day 12

63

4 How did you sleep last night? Indicate to what extent the following three statements apply to you.

completely

true

neutral

untrue

not true

true

at all

I found it hard to

1

2

3

4

5

get to sleep.

I suffered disturbed

1

2

3

4

5

28

or broken sleep.

27

I awoke too early.

1

2

3

4

5

26

25

24

5 Event Did anything particular happen today which made you 23

start to worry? If so then write down what happened below,

22

using key words.

21

20

.........................................................................................................

19

18

.........................................................................................................

17

.........................................................................................................

16

15

.........................................................................................................

14

.........................................................................................................

13

.........................................................................................................

12

11

.........................................................................................................

10

.........................................................................................................

9

8

.........................................................................................................

7

.........................................................................................................

6

5

4

3

2

1

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64

Day 13 The next time

Worry time I

The next time

morning/afternoon

Explanation We often waste a lot of time and energy brooding over past events, blaming ourselves for not handling things

better. In this exercise you will learn how to react next time so that you are less affected by worry. So instead of brooding

about what has happened you can come to a solution: you will

be thinking constructively.

2 Week a Begin now with around fi ve minutes intense worrying.

b The exercise deals with the choices you have made which you were dissatisfi ed with afterwards. In most cases worrying

about the past involves the question ‘why?’. For example, ‘Why

didn’t I say no to that request?’ These why questions can be

very exhausting. Can you recall being in a situation like this?

Get a pen and paper and write down how you want to

react in a similar situation in the future.

In the meantime When you are worrying a lot, write down your worries in the form of keywords. Then work on these in the

next worry time.

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Week 2 Day 13

65

Worry time II

Breathing from the stomach

evening

a

Begin with around ten minutes intense worrying.

b Now we are going to do a breathing exercise. Paying attention to your breathing is a good way to relax. The following exercise 28

will teach you to relax by making better use of your breathing.

27

Go and sit or lie as comfortably as possible in a comfy

26

chair or on the sofa. Place one or two hands on your stomach.

25

You can also close your eyes if you like. Breathe in deeply

24

through your nose. Try to feel the movement of your stomach.

23

Don’t hold your breath, just breathe out quietly. Try to breathe 22

out for longer than you breathe in. What is important is that

21

you are breathing in a quiet and relaxed manner. Don’t do this

20

for longer than a few minutes.

19

18

At night Try the breathing from the stomach exercise once at 17

night too.

16

15

14

13

12

11

10

9

8

7

6

5

4

3

2

1

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66

Day

13

Notes

1

Tick the boxes to indicate which subjects you have worried

about today (you can give several answers).

studies/

fi nances

health

relationships

family/

what others

other

work

friends

think of me

❏

❏

❏

❏

❏

❏

❏

2 Tick a box to indicate how many minutes/hours you have 2 Week worried today.

0–30

30–60

1–2

2–3

3–4

4–5

> 5

minutes

minutes

hours

hours

hours

hours

hours

❏

❏

❏

❏

❏

❏

❏

3 Tick a box to indicate how much effort it took today to stop worrying, on a scale of 1 (almost no effort) to 5 (a great deal of effort).

no effort

almost no

some effort

quite a lot

a great deal

at all

effort

of effort

of effort

❏

❏

❏

❏

❏

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Week 2 Day 13

67

4 How did you sleep last night? Indicate to what extent the following three statements apply to you.

completely

true

neutral

untrue

not true

true

at all

I found it hard to

1

2

3

4

5

get to sleep.

I suffered disturbed

1

2

3

4

5

28

or broken sleep.

27

I awoke too early.

1

2

3

4

5

26

25

24

5 Event Did anything particular happen today which made you 23

start to worry? If so then write down what happened below,

22

using key words.

21

20

.........................................................................................................

19

18

.........................................................................................................

17

.........................................................................................................

16

15

.........................................................................................................

14

.........................................................................................................

13

.........................................................................................................

12

11

.........................................................................................................

10

.........................................................................................................

9

8

.........................................................................................................

7

.........................................................................................................

6

5

4

3

2

1

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68

Day 14 Catch thoughts when relaxed

Worry time I

Catching mice

morning/afternoon

Try to relax. Imagine that you are a cat out hunting for mice.

You are lying next to a mouse hole in the skirting board,

waiting for any mouse that may poke his head out so that you

can then pounce on him. You are the cat. As soon as a mouse

looks out, jump on the mouse and catch him with your paws.

2 Now replace the mouse in your thoughts with a worry: as soon

Week

as another worry pokes its head out you will jump on this

mouse and catch it with your paws. You can decide for yourself

what to do with this thought afterwards. In this way you will

teach yourself to be on the alert for those moments when a

(known) worry appears. As soon as you become conscious that

a worry has popped into your mind, then jump on this worry,

grab it by the scruff of its neck and try to render it harmless.

You can render the mouse harmless by, for example, shutting it

in a box and then going on the lookout for new mice.

In the meantime Do one of the whirling exercises. Let your thoughts go and think: ‘I don’t have to, I want to!’

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Week 2 Day 14

69

Worry time II

Muscle relaxation (arms)

evening

a

Begin with around fi ve minutes intense worrying.

b Now we are going to do some relaxation exercises.

28

➠ Begin with your writing arm. Place your elbow on the arm

27

of the chair, clench your fi st and then tense your forearm

26

and the biceps/upper arm. But don’t overdo it – the aim

25

is not to get cramp, it should stay feeling good. Keep the

24

arm tensed for six seconds. Then say to yourself, ‘Relax’

23

and let your muscles go. Let your muscle relax for about

22

ten seconds. Then repeat with the other arm. Tense the

21

muscles for six seconds again. Say to yourself, ‘Relax’ and

20

then relax this arm for about ten seconds. Repeat this

19

exercise fi ve times.

18

17

➠ Then repeat with the other arm. Tense the muscles for six

16

seconds again. Say to yourself, ‘Relax’ and then relax this

15

arm for about ten seconds.

14

13

Repeat this exercise fi ve times.

12

At night Try the muscle relaxation exercises when you are in bed.

11

10

9

8

7

6

5

4

3

2

1

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70

Day

14

Notes

1

Tick the boxes to indicate which subjects you have worried

about today (you can give several answers).

studies/

fi nances

health

relationships

family/

what others

other

work

friends

think of me

❏

❏

❏

❏

❏

❏

❏

2 Tick a box to indicate how many minutes/hours you have 2 Week worried today.

0–30

30–60

1–2

2–3

3–4

4–5

> 5

minutes

minutes

hours

hours

hours

hours

hours

❏

❏

❏

❏

❏

❏

❏

3 Tick a box to indicate how much effort it took today to stop worrying, on a scale of 1 (almost no effort) to 5 (a great deal of effort).

no effort

almost no

some effort

quite a lot

a great deal

at all

effort

of effort

of effort

❏

❏

❏

❏

❏

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Week 2 Day 14

71

4 How did you sleep last night? Indicate to what extent the following three statements apply to you.

completely

true

neutral

untrue

not true

true

at all

I found it hard to

1

2

3

4

5

get to sleep.

I suffered disturbed

1

2

3

4

5

28

or broken sleep.

27

I awoke too early.

1

2

3

4

5

26

25

24

5 Event Did anything particular happen today which made you 23

start to worry? If so then write down what happened below,

22

using key words.

21

20

.........................................................................................................

19

18

.........................................................................................................

17

.........................................................................................................

16

15

.........................................................................................................

14

.........................................................................................................

13

.........................................................................................................

12

11

.........................................................................................................

10

.........................................................................................................

9

8

.........................................................................................................

7

.........................................................................................................

6

5

4

3

2

1

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72

How much have you worried over the past week?

For each of the following statements indicate which is most

applicable to you by circling the appropriate number. This applies to the past week.

never

very

rarely

some-

often

very

almost

rarely

times

often

always

1 If I did not have

6

5

4

3

2

1

0

enough time to do

everything, I did

not worry about it.

2 My worries

0

1

2

3

4

5

6

2 Week overwhelmed me.

3 I didn’t tend to

6

5

4

3

2

1

0

worry about things.

4 Many

situations

0

1

2

3

4

5

6

made me worry.

5 I knew that I

0

1

2

3

4

5

6

shouldn’t have

worried about

things but I just

couldn’t help it.

6 When I was under

0

1

2

3

4

5

6

pressure, I worried

a lot.

7 I was always

0

1

2

3

4

5

6

worrying about

something.

8 I found it easy to

6

5

4

3

2

1

0

dismiss worrisome

thoughts.

9 As soon as I

0

1

2

3

4

5

6

fi nished one task, I

started to worry

about everything

else that I had to

do.

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Week 2 Day 14

73

never

very

rarely

some-

often

very

almost

rarely

times

often

always

10 I did not worry

6

5

4

3

2

1

0

about anything.

11 When there was

6

5

4

3

2

1

0

nothing more I

could do about a

concern, I did not

28

worry about it any

27

more.

26

12 I noticed that I had

0

1

2

3

4

5

6

25

been worrying

24

about things.

23

13 Once I started

0

1

2

3

4

5

6

worrying, I couldn’t

22

stop.

21

14 I worried all the

0

1

2

3

4

5

6

20

time.

19

15 I worried about

0

1

2

3

4

5

6

18

projects until they

17

were all done.

16

Total

15

14

13

➠ Total score for the second week :

12

11

10

A word in the meantime

9

8

Worry is a reaction to a threat. People and animals react in much 7

the same way to a threat. One option is to fi ght. The other option 6

is fl ight. Worrying is not really either of the two. Excessive 5

worrying is getting stuck at the preparation stage. No decision is 4

made. All options are chewed over again and again. No solutions arise from this. You are not fl eeing or fi ghting – it’s as though 3

you’ve frozen.

2

1

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74

Postponement It is important for you to learn how to postpone

your worrying, otherwise you will be inclined to give in to it. These worrying thoughts will then take all your attention and

concentration. If you just worry during the worry time, then it’s easier to fi nd solutions to your problems outside this time.

Writing exercises In the coming two weeks we are going to

concentrate on your thinking habits. We are going to tackle those worries with a number of writing exercises. You have everything you need to practise this to hand. It does not matter what you

write, what matters is that you write something. You can write

what you want. Spelling, grammar and sentence structure are not 2 important. Writing exercises call for imagination. Worries are Week

always fantasies – negative fantasies about how it will all go

wrong. But you can also use fantasy to imagine how fantastically well things can go! We are now going to combat negative fantasies (worries) with positive and realistic fantasies.

What are you worrying about? You could be worrying about an

event in the future. You might think of a number of possible

scenarios for how things could turn out and what the best thing is for you to do. You could also be worrying about the past. Perhaps you wanted something to have turned out differently, or wish you had reacted differently in the situation. If you are in an uncertain situation, it can sometimes be diffi cult to actually come to a decision. You keep on having doubts and asking yourself what

would be the right choice.

But what does worrying actually achieve? By worrying you

probably just end up feeling more tense, with more doubts and no solutions or decisions. Perhaps you will benefi t more if you worry less in similar situations.

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75

Week

3

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76

Day 15 Writing exercise

Worry time I

Worry intensely

morning/afternoon

Explanation We all know that feeling well – you worry and feel anxious. This can be relieved by writing down your worries so

that you get your thoughts in order. By putting your feelings

into writing you can free yourself of worry.

3 a Begin with fi ve minutes intense worrying.

Week

b Then get out your pen and paper, or use a notebook. Write down your worries and feelings in as much detail as possible.

If nothing comes to mind, then you can also use yesterday’s

worries.

In the meantime If you worry during the day you can choose from one of the following exercises to reduce this: positive worrying, whirling exercise, clouds or look for some distraction.

Worry time II

Core thoughts

evening

a

Begin with ten minutes intense worrying.

b Then look at what you have written this morning or this afternoon. This can help you rank your thoughts in order of

importance.

Some worries can look unimportant when you read them

back but some may just refl ect core thoughts. Core thoughts

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Week 3 Day 15

77

are the thoughts which always keep coming back to trouble

you whenever you worry.

c

Write down at least three core thoughts below on this page of

the book.

At night When you lie in bed and think about what you have got planned for the next day? When you think for example what

28

do you have to do? Change the meaning: ‘ I must . . .’ to ‘ I 27

want . . .’ When you have done that then you can in your 26

imagination, try to put the worries into the shoebox or the

25

rucksack under the bed where they will then stay . . . Let them 24

stay there until the next day. Then the following morning you

23

can bring out your anxieties and look at them again.

22

21

Core thoughts

20

19

1

.........................................................................................................

18

.........................................................................................................

17

16

.........................................................................................................

15

14

2 .........................................................................................................

13

.........................................................................................................

12

.........................................................................................................

11

10

3 .........................................................................................................

9

8

.........................................................................................................

7

.........................................................................................................

6

5

4

3

2

1

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78

Day

15

Notes

1

Tick the boxes to indicate which subjects you have worried

about today (you can give several answers).

studies/

fi nances

health

relationships

family/

what others

other

work

friends

think of me

❏

❏

❏

❏

❏

❏

❏

2 Tick a box to indicate how many minutes/hours you have 3 Week worried today.

0–30

30–60

1–2

2–3

3–4

4–5

> 5

minutes

minutes

hours

hours

hours

hours

hours

❏

❏

❏

❏

❏

❏

❏

3 Tick a box to indicate how much effort it took today to stop worrying, on a scale of 1 (almost no effort) to 5 (a great deal of effort).

no effort

almost no

some effort

quite a lot

a great deal

at all

effort

of effort

of effort

❏

❏

❏

❏

❏

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Week 3 Day 15

79

4 How did you sleep last night? Indicate to what extent the following three statements apply to you.

completely

true

neutral

untrue

not true

true

at all

I found it hard to

1

2

3

4

5

get to sleep.

I suffered disturbed

1

2

3

4

5

28

or broken sleep.

27

I awoke too early.

1

2

3

4

5

26

25

24

5 Event Did anything particular happen today which made you 23

start to worry? If so then write down what happened below,

22

using key words.

21

20

.........................................................................................................

19

18

.........................................................................................................

17

.........................................................................................................

16

15

.........................................................................................................

14

.........................................................................................................

13

.........................................................................................................

12

11

.........................................................................................................

10

.........................................................................................................

9

8

.........................................................................................................

7

.........................................................................................................

6

5

4

3

2

1

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80

Day 16 Three-scenarios writing exercise

Worry time I

Fantasy

morning/afternoon

Step

1 You have already done this exercise on days 10–12.

You are going to do it once again but this time more quickly.

This exercise is handy for when you get anxious about future

events.

Write down the most important worries of the moment in a

3 notebook. For example: ‘I am afraid I am not going to manage

Week

on my salary and that I won’t be able to pay my bills any more’

or ‘I can’t go to my parents to ask for money again, they’ll just throw me out’.

Step

2 Look at this worry like a fi lm. Now write the future in the style of a really disastrous scenario. What is the worst that can happen? Use your imagination and exaggerate. For

example: ‘If I go home and ask my parents for money again,

then they won’t want to give me any more, because I have

spent so much. And then I won’t be able to go on holiday with

my friends. They will then talk to me about my spending

patterns and reduce what they pay me each month to help out.

I am afraid that they will stop supporting me fi nancially

altogether and that I must get a job. And without the education I have missed out on I will never be able to fi nd an interesting career. So I shall have to make do with stacking shelves at the supermarket for the rest of my life. My parents will be so angry at my request that they will throw me out.’

In the meantime There is one more exercise you can do in the meantime when you worry. Clap your hands and say to

yourself. ‘Not now!’

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Week 3 Day 16

81

Worry time II

Future scenario

evening

Step

3 Now write a future scenario which is as positive as

possible. Try to make the situation exactly as you want it. Use your imagination and try to make it as lifelike as you can. You can exaggerate, however odd your ideas may seem. It is after

28

all fantasy and not reality.

27

For example: ‘When I go home to ask my parents for

26

money to go on holiday, they will be completely happy about

25

this. They say they prefer I ask them for money rather than

24

having to go and earn it at the supermarket. They say they

23

prefer I spend my time studying rather than working on extra

22

jobs. In addition they say that they are pleased they are able

21

to support me. They say that I should never be too

20

embarrassed to call upon them for help.’

19

18

Step

4 Now that you have written down a positive scenario

17

and a negative scenario you should now write a scenario that

16

is mid-way between step 2 and step 3. This is probably the

15

most realistic scenario.

14

13

At night Try to postpone your worries until the next worry time.

Look for some distraction or try to do positive worrying 1 (day 12

1) about a good memory or positive worrying 2 (day 2) about a

11

good quality.

10

9

8

7

6

5

4

3

2

1

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82

Day

16

Notes

1

Tick the boxes to indicate which subjects you have worried

about today (you can give several answers).

studies/

fi nances

health

relationships

family/

what others

other

work

friends

think of me

❏

❏

❏

❏

❏

❏

❏

2 Tick a box to indicate how many minutes/hours you have 3 Week worried today.

0–30

30–60

1–2

2–3

3–4

4–5

> 5

minutes

minutes

hours

hours

hours

hours

hours

❏

❏

❏

❏

❏

❏

❏

3 Tick a box to indicate how much effort it took today to stop worrying, on a scale of 1 (almost no effort) to 5 (a great deal of effort).

no effort

almost no

some effort

quite a lot

a great deal

at all

effort

of effort

of effort

❏

❏

❏

❏

❏

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Week 3 Day 16

83

4 How did you sleep last night? Indicate to what extent the following three statements apply to you.

completely

true

neutral

untrue

not true

true

at all

I found it hard to

1

2

3

4

5

get to sleep.

I suffered disturbed

1

2

3

4

5

28

or broken sleep.

27

I awoke too early.

1

2

3

4

5

26

25

24

5 Event Did anything particular happen today which made you 23

start to worry? If so then write down what happened below,

22

using key words.

21

20

.........................................................................................................

19

18

.........................................................................................................

17

.........................................................................................................

16

15

.........................................................................................................

14

.........................................................................................................

13

.........................................................................................................

12

11

.........................................................................................................

10

.........................................................................................................

9

8

.........................................................................................................

7

.........................................................................................................

6

5

4

3

2

1

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84

Day 17 Scoring

Worry time I

Scoring task

morning/afternoon

Explanation How often do you have your tiresome worrying thoughts now? Worries often go through your head unnoticed.

This exercise will teach you to be aware of the extent to which you worry. You may be a bit shocked at the results. But just

bear in mind that you can only tackle your behaviour in terms

3 of worrying if you are aware of it.

Week

a

Begin with fi ve minutes intense worrying.

b Today’s exercise is scoring. Write down now which worry is most signifi cant at this point in time. Which worry is going

through your head most? Which worry always keeps recurring?

You will need a notebook and a pen or pencil for this exercise.

Keep this with you during the day, in your bag or on your desk, for example. Every time you notice you are having this worry

again make a short line in the notebook. You will score your

worry until the second worry time.

c

We will come back to this scoring exercise in the second worry

time.

In the meantime Try to postpone your worries until the next worry time. If this does not work then look for a distraction but

remember to continue scoring.

stop worrying.indd 84

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Week 3 Day 17

85

Worry time II

Purposeful worrying?

evening

a

Begin with fi ve minutes intense worrying.

b Your task for today was to score one of your worries. Now count the number of lines on the page. How frequently did you

28

have this worry?

27

Now ask yourself what you gained from this worry. What

26

did you get out of it? Did it give you any relief or did this

25

thought just end up making you feel more tense? Did it make

24

you any wiser? Did you come to any conclusions?

23

Then divide the number of lines you have written down by

22

two. If you have had this worry in total 32 times, for example, 21

32 divided by 2 is 16. Tomorrow’s task is to halve the number

20

of time you have this worry: try to have this worry not more

19

than 16 times instead of 32 times.

18

17

At night If you can’t sleep, try the whirling exercise again, or one 16

of the other fantasy exercises from this book – choose the one

15

which works best for you.

14

At the top of the following page, write your top 3 worries

13

for the last day in key words. Choose one of these three

worries and score this one until the next worry time tomorrow.

12

As with today’s exercise make a short line every time you have

11

this worry again.

10

9

8

7

6

5

4

3

2

1

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86

Worries

1

.........................................................................................................

.........................................................................................................

.........................................................................................................

2 .........................................................................................................

.........................................................................................................

.........................................................................................................

3 3 .........................................................................................................

Week

.........................................................................................................

.........................................................................................................

stop worrying.indd 86

15/07/2010 14:44

Week 3 Day 17

87

Day

17

Notes

1

Tick the boxes to indicate which subjects you have worried

about today (you can give several answers).

studies/

fi nances

health

relationships

family/

what others

other

work

friends

think of me

28

❏

❏

❏

❏

❏

❏

❏

27

26

25

24

2 Tick a box to indicate how many minutes/hours you have worried today.

23

22

0–30

30–60

1–2

2–3

3–4

4–5

> 5

21

minutes

minutes

hours

hours

hours

hours

hours

20

❏

❏

❏

❏

❏

❏

❏

19

18

17

16

3 Tick a box to indicate how much effort it took today to stop worrying, on a scale of 1 (almost no effort) to 5 (a great deal 15

of effort).

14

13

no effort

almost no

some effort

quite a lot

a great deal

12

at all

effort

of effort

of effort

11

❏

❏

❏

❏

❏

10

9

8

7

6

5

4

3

2

1

stop worrying.indd 87

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88

4 How did you sleep last night? Indicate to what extent the following three statements apply to you.

completely

true

neutral

untrue

not true

true

at all

I found it hard to

1

2

3

4

5

get to sleep.

I suffered disturbed

1

2

3

4

5

or broken sleep.

I awoke too early.

1

2

3

4

5

3 Week 5 Event Did anything particular happen today which made you start to worry? If so then write down what happened below,

using key words.

.........................................................................................................

.........................................................................................................

.........................................................................................................

.........................................................................................................

.........................................................................................................

.........................................................................................................

.........................................................................................................

.........................................................................................................

.........................................................................................................

.........................................................................................................

stop worrying.indd 88

15/07/2010 14:44

Week 3 Day 18

89

Day 18 Next worry

Worry time I

Next please!

morning/afternoon

Explanation If you are troubled about something then you will be 28

inclined to continually replay certain thought scenarios. The

27

result is a constantly recurring stream of thoughts which feed

26

one another. You can try the following technique to break this

25

vicious circle (if possible use a kitchen timer).

24

23

a

Begin with fi ve minutes intense worrying.

22

21

b Now try to make a summary of your worries. Formulate each 20

worry in detail, set the kitchen timer for one minute,

19

concentrate for one minute on the fi rst worry, then say to

18

yourself, ‘Next please!’ and then continue with the next worry

17

which is bothering you. After one minute, again say ‘Next

16

please!’ to yourself. Continue with this until no more worries

15

are left. Write down the content of each worry in several key

14

words. It will surprise you how quickly you reach the point by

13

which you can’t think of any more worries.

12

Below write the key words for all ‘Next please! thoughts’.

11

10

9

Next please!

8

7

6

5

4

3

2

1

stop worrying.indd 89

15/07/2010 14:44

90

Next please!

Next please!

3 Week Next please!

Next please!

In the meantime If you begin to worry during the day, use the

‘Next please!’ method.

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15/07/2010 14:44

Week 3 Day 18

91

Worry time II

Gentle breathing exercises

evening

a

Begin with fi ve minutes intense worrying.

b Go and lie or sit in a comfortable position.

28

1

Shut your eyes and become aware of your breathing. Let

27

your breathing continue at its natural rate.

26

2 Breathe in through your nose and out through your mouth.

25

Breathe deeply from your abdomen. Put your hands on

24

your stomach.

23

3 Concentrate on your breathing. You should fi nd that

22

focusing on your breathing makes you feel calm.

21

4 Begin to count. Every time you breathe in count one, and

20

every time you breathe out count one. When you get to

19

ten, start again.

18

5 You should notice that thoughts come into your head,

17

thoughts about yesterday, about today and the future.

16

Calmly let the thoughts be what they are, observe them,

15

and then set them free. Observe them and then pay no

14

more attention to them. Put the thoughts in little clouds

13

and then let the clouds drift away.

6 Continue to concentrate on your breathing and on counting

12

your breaths. If you get distracted then start counting your

11

breaths again.

10

9

At night Try putting your worries into your rucksack or shoebox 8

under your bed where they will then stay until the next day.

7

Then the following morning you can bring them out and look

6

at them again.

5

4

3

2

1

stop worrying.indd 91

15/07/2010 14:44

92

Day

18

Notes

1

Tick the boxes to indicate which subjects you have worried

about today (you can give several answers).

studies/

fi nances

health

relationships

family/

what others

other

work

friends

think of me

❏

❏

❏

❏

❏

❏

❏

2 Tick a box to indicate how many minutes/hours you have 3 Week worried today.

0–30

30–60

1–2

2–3

3–4

4–5

> 5

minutes

minutes

hours

hours

hours

hours

hours

❏

❏

❏

❏

❏

❏

❏

3 Tick a box to indicate how much effort it took today to stop worrying, on a scale of 1 (almost no effort) to 5 (a great deal of effort).

no effort

almost no

some effort

quite a lot

a great deal

at all

effort

of effort

of effort

❏

❏

❏

❏

❏

stop worrying.indd 92

15/07/2010 14:44

Week 3 Day 18

93

4 How did you sleep last night? Indicate to what extent the following three statements apply to you.

completely

true

neutral

untrue

not true

true

at all

I found it hard to

1

2

3

4

5

get to sleep.

I suffered disturbed

1

2

3

4

5

28

or broken sleep.

27

I awoke too early.

1

2

3

4

5

26

25

24

5 Event Did anything particular happen today which made you 23

start to worry? If so then write down what happened below,

22

using key words.

21

20

.........................................................................................................

19

18

.........................................................................................................

17

.........................................................................................................

16

15

.........................................................................................................

14

.........................................................................................................

13

.........................................................................................................

12

11

.........................................................................................................

10

.........................................................................................................

9

8

.........................................................................................................

7

.........................................................................................................

6

5

4

3

2

1

stop worrying.indd 93

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94

Day 19 Not now but later and looking at things

differently

Worry time I

Stop

morning/afternoon

Explanation The not now but later method is focused on worries which, among other things, make it diffi cult to sleep. It is

useful for dealing with regularly recurring thoughts which are

irrational or disturbing. Sometimes they may make you

3 anxious, as with the recurring thought that someone is walking Week

around your house during the night.

a

Begin with fi ve minutes intense worrying.

b We will now start the thought stop exercise. With your eyes closed you will express the constantly recurring thought in

detail. During this account suddenly call out to yourself ‘Not

now but later’ and postpone thinking this thought.

c

Repeat this fi ve times.

In the meantime The thoughts will doubtless return and you can postpone them again using the procedure you have learned.

You can perhaps intensify the effect by looking for some

distraction after the not now but later technique.

stop worrying.indd 94

15/07/2010 14:44

Week 3 Day 19

95

Worry time II

Looking at things another way

evening

a

Take a piece of paper and write down everything you like

about yourself. Don’t stop until you have written at least three things, the more the better.

28

b If you fi nd this exercise diffi cult, then look at it from someone 27

else’s point of view. How would your friends describe your

26

positive qualities? Once you have written down a number of

25

good points about yourself, then think about how you would

24

feel if at a party you were introduced to someone who had all

23

these positive qualities. There is a very good chance that you

22

will like this person, isn’t there? Keep this sheet of paper with 21

you for a week and look at it several times a day to remind

20

yourself that you too have positive qualities. Look at it

19

whenever you start to worry.

18

17

At night When undressing for bed, imagine that your clothes are 16

your worries. Take these off one after the other. Think about

15

your worries. With each piece of clothing you take off

14

consciously lay aside one worry.

13

12

11

10

9

8

7

6

5

4

3

2

1

stop worrying.indd 95

15/07/2010 14:44

96

Day

19

Notes

1

Tick the boxes to indicate which subjects you have worried

about today (you can give several answers).

studies/

fi nances

health

relationships

family/

what others

other

work

friends

think of me

❏

❏

❏

❏

❏

❏

❏

2 Tick a box to indicate how many minutes/hours you have 3 Week worried today.

0–30

30–60

1–2

2–3

3–4

4–5

> 5

minutes

minutes

hours

hours

hours

hours

hours

❏

❏

❏

❏

❏

❏

❏

3 Tick a box to indicate how much effort it took today to stop worrying, on a scale of 1 (almost no effort) to 5 (a great deal of effort).

no effort

almost no

some effort

quite a lot

a great deal

at all

effort

of effort

of effort

❏

❏

❏

❏

❏

stop worrying.indd 96

15/07/2010 14:44

Week 3 Day 19

97

4 How did you sleep last night? Indicate to what extent the following three statements apply to you.

completely

true

neutral

untrue

not true

true

at all

I found it hard to

1

2

3

4

5

get to sleep.

I suffered disturbed

1

2

3

4

5

28

or broken sleep.

27

I awoke too early.

1

2

3

4

5

26

25

24

5 Event Did anything particular happen today which made you 23

start to worry? If so then write down what happened below,

22

using key words.

21

20

.........................................................................................................

19

18

.........................................................................................................

17

.........................................................................................................

16

15

.........................................................................................................

14

.........................................................................................................

13

.........................................................................................................

12

11

.........................................................................................................

10

.........................................................................................................

9

8

.........................................................................................................

7

.........................................................................................................

6

5

4

3

2

1

stop worrying.indd 97

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98

Day 20 Writing

Worry time I

Writing exercise

morning/afternoon

a

Begin with fi ve minutes intense worrying.

b Get your pen and paper. Take an unpleasant incident from the past and think about it. Describe the event as fully as possible in the present tense as though it was happening now. Write

3 down exactly what you are saying, and what the other person

Week

or people are saying. What are you thinking and feeling at the

time? It is important to write down the details you remember

about the situation, even if they do not seem relevant. For

example, what you can smell, hear or see at the place it

happened (colours, objects, sounds). What season is it? How is

the weather?

In the meantime If you worry in the meantime, you could consider trying one of the fantasy or relaxation exercises. Or if you are short of time, you could do the thought stop exercise again.

stop worrying.indd 98

15/07/2010 14:44

Week 3 Day 20

99

Worry time II

Continuation of writing exercise

evening

a

Begin with fi ve minutes intense worrying.

b Now that you have described this event in the fi rst worry time, write down what you found out about yourself in the situation.

28

Then write down what you will do the next time in the same

27

situation. Ask yourself to what extent the situation could have 26

turned out differently, and how much control you really had

25

over the situation. Try to accept the errors you made and to

24

learn from them. Come to a conclusion for yourself. What have

23

you learned? How can you ensure that the ‘errors’ you made

22

don’t happen again the next time? What could you do in the

21

future?

20

19

c

You have now fi nished this exercise, you cannot do anything

18

more. You are now well prepared.

17

16

At night If you worry, change the phrase ‘ I must . . .’ into ‘I 15

want . . .’

14

13

12

11

10

9

8

7

6

5

4

3

2

1

stop worrying.indd 99

15/07/2010 14:44

100

Day

20

Notes

1

Tick the boxes to indicate which subjects you have worried

about today (you can give several answers).

studies/

fi nances

health

relationships

family/

what others

other

work

friends

think of me

❏

❏

❏

❏

❏

❏

❏

2 Tick a box to indicate how many minutes/hours you have 3 Week worried today.

0–30

30–60

1–2

2–3

3–4

4–5

> 5

minutes

minutes

hours

hours

hours

hours

hours

❏

❏

❏

❏

❏

❏

❏

3 Tick a box to indicate how much effort it took today to stop worrying, on a scale of 1 (almost no effort) to 5 (a great deal of effort).

no effort

almost no

some effort

quite a lot

a great deal

at all

effort

of effort

of effort

❏

❏

❏

❏

❏

stop worrying.indd 100

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Week 3 Day 20

101

4 How did you sleep last night? Indicate to what extent the following three statements apply to you.

completely

true

neutral

untrue

not true

true

at all

I found it hard to

1

2

3

4

5

get to sleep.

I suffered disturbed

1

2

3

4

5

28

or broken sleep.

27

I awoke too early.

1

2

3

4

5

26

25

24

5 Event Did anything particular happen today which made you 23

start to worry? If so then write down what happened below,

22

using key words.

21

20

.........................................................................................................

19

18

.........................................................................................................

17

.........................................................................................................

16

15

.........................................................................................................

14

.........................................................................................................

13

.........................................................................................................

12

11

.........................................................................................................

10

.........................................................................................................

9

8

.........................................................................................................

7

.........................................................................................................

6

5

4

3

2

1

stop worrying.indd 101

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102

Day 21 Relaxation

Worry time 1

Whirling exercise

morning/afternoon

a

Begin with fi ve minutes intense worrying.

b Empty your mind for the following exercise. If thoughts come into your mind don’t try to prevent this. Thoughts are just

thoughts. Accept everything that comes to mind. Place these

3 thoughts in light clouds. Let these clouds quietly whirl around Week

in your head while you concentrate on your breathing. When

you breathe out, you can quietly blow the clouds away. In this

way you can allow the thoughts to come and then go again.

In the meantime Try to do the talking in your imagination exercise (day 5). Or do the whirling exercise once more in the meantime.

stop worrying.indd 102

15/07/2010 14:44

Week 3 Day 21

103

Worry time II

Relaxation

evening

a

Begin again with fi ve minutes intense worrying.

28

b Afterwards go and sit or lie as comfortably as possible in a 27

soft chair or on the bed.

26

25

1

Close your eyes and breathe deeply through your nose a

24

few times.

23

2 Feel your limbs become warm, heavy and relaxed.

22

3 Imagine that you are lying quietly on a warm beach or that

21

you are bobbing around in a boat.

20

4 Hold onto this image by thinking about the details, for

19

example, that you are enjoying the warm weather, it is not

18

too hot and not too cold. You are having a refreshing drink

17

and lying quietly.

16

5 Do this for fi ve minutes.

15

14

At night Imagine that you are having a fantastic time lying on the 13

beach. You are feeling really relaxed and enjoying feeling the

warmth of the sun’s rays. Relax completely and feel your body

12

become heavier. Feel how your body is making an imprint in

11

the sand.

10

9

8

7

6

5

4

3

2

1

stop worrying.indd 103

15/07/2010 14:44

104

Day

21

Notes

1

Tick the boxes to indicate which subjects you have worried

about today (you can give several answers).

studies/

fi nances

health

relationships

family/

what others

other

work

friends

think of me

❏

❏

❏

❏

❏

❏

❏

2 Tick a box to indicate how many minutes/hours you have 3 Week worried today.

0–30

30–60

1–2

2–3

3–4

4–5

> 5

minutes

minutes

hours

hours

hours

hours

hours

❏

❏

❏

❏

❏

❏

❏

3 Tick a box to indicate how much effort it took today to stop worrying, on a scale of 1 (almost no effort) to 5 (a great deal of effort).

no effort

almost no

some effort

quite a lot

a great deal

at all

effort

of effort

of effort

❏

❏

❏

❏

❏

stop worrying.indd 104

15/07/2010 14:44

Week 3 Day 21

105

4 How did you sleep last night? Indicate to what extent the following three statements apply to you.

completely

true

neutral

untrue

not true

true

at all

I found it hard to

1

2

3

4

5

get to sleep.

I suffered disturbed

1

2

3

4

5

28

or broken sleep.

27

I awoke too early.

1

2

3

4

5

26

25

24

5 Event Did anything particular happen today which made you 23

start to worry? If so then write down what happened below,

22

using key words.

21

20

.........................................................................................................

19

18

.........................................................................................................

17

.........................................................................................................

16

15

.........................................................................................................

14

.........................................................................................................

13

.........................................................................................................

12

11

.........................................................................................................

10

.........................................................................................................

9

8

.........................................................................................................

7

.........................................................................................................

6

5

4

3

2

1

stop worrying.indd 105

15/07/2010 14:44

106

How much have you worried over the past week?

For each of the following statements indicate which is most

applicable to you by circling the appropriate number. This applies to the past week.

never

very

rarely

some-

often

very

almost

rarely

times

often

always

1 If I did not have

6

5

4

3

2

1

0

enough time to do

everything, I did

not worry about it.

2 My worries

0

1

2

3

4

5

6

3 Week overwhelmed me.

3 I didn’t tend to

6

5

4

3

2

1

0

worry about things.

4 Many

situations

0

1

2

3

4

5

6

made me worry.

5 I knew that I

0

1

2

3

4

5

6

shouldn’t have

worried about

things but I just

couldn’t help it.

6 When I was under

0

1

2

3

4

5

6

pressure, I worried

a lot.

7 I was always

0

1

2

3

4

5

6

worrying about

something.

8 I found it easy to

6

5

4

3

2

1

0

dismiss worrisome

thoughts.

stop worrying.indd 106

15/07/2010 14:44

Week 3 Day 21

107

never

very

rarely

some-

often

very

almost

rarely

times

often

always

9 As soon as I

0

1

2

3

4

5

6

fi nished one task, I

started to worry

about everything

else that I had to

do.

28

10 I did not worry

6

5

4

3

2

1

0

27

about anything.

26

11 When there was

6

5

4

3

2

1

0

25

nothing more I

24

could do about a

concern, I did not

23

worry about it any

22

more.

21

12 I noticed that I had

0

1

2

3

4

5

6

20

been worrying

about things.

19

18

13 Once I started

0

1

2

3

4

5

6

worrying, I couldn’t

17

stop.

16

14 I worried all the

0

1

2

3

4

5

6

15

time.

14

15 I worried about

0

1

2

3

4

5

6

13

projects until they

12

were all done.

11

Total

10

9

8

➠ Total score for the third week :

7

6

5

4

3

2

1

stop worrying.indd 107

15/07/2010 14:44

stop worrying.indd 108

15/07/2010 14:44

109

Week

4

stop worrying.indd 109

15/07/2010 14:44

110

Day 22 Three-column exercise

Worry time I

Thinking habits

morning/afternoon

Explanation On pages 114–15 there are three empty columns. The aim is to replace your negative thoughts with positive

thoughts. On pages 112 and 113 there is an example of how to

do the three-column exercise.

4 Step 1 Write down three worries in the fi rst column.

Week

Step

2 Which thinking habits do you have with which worries?

Choose from the following alternatives:

1

Generalization: Drawing general conclusions from a limited number of experiences.

2 Black and white thinking: You just think in extremes: something is always all good or all bad.

3 Thought reading: Assuming that you know exactly what other people are thinking in a certain situation.

4 Limited perception: You take a (negative) detail from a specifi c incident and focus your thoughts exclusively on

this.

5 Emotional thinking: You take your feelings as proof for a certain thought being correct.

6 Negative thinking: With negative thinking you turn neutral or even positive experiences into negative ones.

In the meantime Try to postpone worrying until the next worry time. If this does not work, look for some distraction or do one of the relaxation exercises. You could also choose to phone

your chosen person X and tell them your worries.

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15/07/2010 14:44

Week 4 Day 22

111

Worry time II

Other habits

evening

Step

3

In the fi rst worry time you have seen that some

thinking habits work against you. These thinking habits can be

changed into realistic ways of thinking. During this worry time change all the worries from the fi rst column into more realistic 28

thoughts. This means your task is this: complete column 3 with

27

more realistic thoughts.

26

25

At night Try the exercise from yesterday night again. You are lying 24

on the beach. You are feeling incredibly relaxed and enjoying

23

feeling the warmth of the sun’s rays. Relax completely and feel 22

your body become heavier. Feel how your body is making an

21

imprint in the sand.

20

19

18

17

16

15

14

13

12

11

10

9

8

7

6

5

4

3

2

1

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112

Example of three-column exercise

Worry

Thinking habit

Realistic thought

Men can’t be

generalization

Some men can’t be trusted but

trusted

this is certainly not always the

case

All they did was

limited

There was criticism but there

criticize me

perception

were also other reactions

I feel stupid so I am

emotional

The fact that I feel inadequate

stupid

thinking

in this situation does not mean

that I am always inadequate

4 Week I can’t do anything black and white I can do some things better thinking

than others

They must be

thought reading

I don’t know what they think of

thinking: ‘he’s a

me

right mug’

She compliments me

negative

Perhaps the compliment was

but she doesn’t

thinking and

genuine

mean it

reading

thoughts

If it’s not right, then

black and white

Most things are not 100% right

it must be wrong

thinking

or wrong

I never do anything

generalization

Some things go better for me

good

and limited

than others. I am not perfect

perception

If they don’t think

black and white

Other things are possible. I have

I’m nice then they

thinking

my good points and bad points.

must dislike me

Who doesn’t?

He has decided he

thought reading

I don’t know what he is

is going to make me

planning

look a fool

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Week 4 Day 22

113

Worry

Thinking habit

Realistic thought

They were not

black and white

Perhaps it was not what they

happy with the

thinking and

wanted. I can only ask them

present, so they

thought reading

won’t think it means

anything

28

Nothing goes well

limited

Sometimes things go well for

for me

perception

me and sometimes not, the

27

same as for everyone else

26

25

24

23

22

21

20

19

18

17

16

15

14

13

12

11

10

9

8

7

6

5

4

3

2

1

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114

Step 1

Step 2

Worries

Thinking Habits

4 Week

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15/07/2010 14:44

Week 4 Day 22

115

Step 3

Realistic thoughts

28

27

26

25

24

23

22

21

20

19

18

17

16

15

14

13

12

11

10

9

8

7

6

5

4

3

2

1

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116

Day

22

Notes

1

Tick the boxes to indicate which subjects you have worried

about today (you can give several answers).

studies/

fi nances

health

relationships

family/

what others

other

work

friends

think of me

❏

❏

❏

❏

❏

❏

❏

2 Tick a box to indicate how many minutes/hours you have 4 Week worried today.

0–30

30–60

1–2

2–3

3–4

4–5

> 5

minutes

minutes

hours

hours

hours

hours

hours

❏

❏

❏

❏

❏

❏

❏

3 Tick a box to indicate how much effort it took today to stop worrying, on a scale of 1 (almost no effort) to 5 (a great deal of effort).

no effort

almost no

some effort

quite a lot

a great deal

at all

effort

of effort

of effort

❏

❏

❏

❏

❏

stop worrying.indd 116

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Week 4 Day 22

117

4 How did you sleep last night? Indicate to what extent the following three statements apply to you.

completely

true

neutral

untrue

not true

true

at all

I found it hard to

1

2

3

4

5

get to sleep.

I suffered disturbed

1

2

3

4

5

28

or broken sleep.

27

I awoke too early.

1

2

3

4

5

26

25

24

5 Event Did anything particular happen today which made you 23

start to worry? If so then write down what happened below,

22

using key words.

21

20

.........................................................................................................

19

18

.........................................................................................................

17

.........................................................................................................

16

15

.........................................................................................................

14

.........................................................................................................

13

.........................................................................................................

12

11

.........................................................................................................

10

.........................................................................................................

9

8

.........................................................................................................

7

.........................................................................................................

6

5

4

3

2

1

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118

Day 23 Make a decision

Worry time I

Make a decision

morning/afternoon

a

Begin with fi ve minutes intense worrying.

b Explanation Perhaps you will recognize this situation: You want to make a decision about something but you never do

because you worry too much. You keep going round in circles

4 about this decision, you are indecisive and this makes you

Week

passive. This results in the decision being postponed and you

are stuck there worrying.

You can use the following plan, which is in stages, to help

you come to a decision. It is a good idea to write down your

answers to the question, so that you have an overview and a

plan. Get out some paper or a notebook and do the following

exercise.

Step 1 What is the choice you have to make?

Example: Where should we go on holiday this year?

Step

2 What doubts do you have?

Example: Should we go to the same camping site as last year?

Was it nice for the children? Shall we take the car on holiday or should we book an all-inclusive holiday? Won’t that be far too

expensive?

Step

3 Go and get some information to reduce your doubts.

Options: A trip to the travel agent. Ask family and friends what they are going to do.

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Week 4 Day 23

119

In the meantime Step 4 Collect information (You can use the rest of the day to get this information, so that in the second worry time you can make a decision. Possible examples: Compare the

different options such as price, play facilities for the children, for example. You can ask what is included in the price, what

unforeseen expenses are to be expected. Ask other people

how and where they are arranging their holidays.

28

Worry time II

27

Deadline

26

evening

25

24

Step 5 Weigh up the options against the information.

23

22

Step

6

Set a deadline. Decide for yourself how much time you

21

want to spend on this decision. Do you want to think about it

20

for another two weeks? Then set a deadline for two weeks

19

time, note it in your diary, and make a decision within these

18

two weeks.

17

16

Step

7 Evaluate your decision, not yourself.

15

Every decision involves advantages and disadvantages and

14

often you only get to know about them afterwards. It is not the 13

case that there is only one right answer. A perfect decision

does not exist, it is possible you will regret your decision later, 12

but you can learn from this. It is possible that both alternatives 11

are attractive and you have no regrets. Perhaps you can still

10

cancel or change it. Also, you have taken a risk and life is not 9

without its risks. Perhaps all the alternatives were equally as 8

attractive or advantageous. It may also be the case that you

7

are perfectly satisfi ed with your decision.

6

5

At night If you start to worry, change the phrase: ‘ I must . . .’ into 4

‘I want . . .’

3

2

1

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120

Day

23

Notes

1

Tick the boxes to indicate which subjects you have worried

about today (you can give several answers).

studies/

fi nances

health

relationships

family/

what others

other

work

friends

think of me

❏

❏

❏

❏

❏

❏

❏

2 Tick a box to indicate how many minutes/hours you have 4 Week worried today.

0–30

30–60

1–2

2–3

3–4

4–5

> 5

minutes

minutes

hours

hours

hours

hours

hours

❏

❏

❏

❏

❏

❏

❏

3 Tick a box to indicate how much effort it took today to stop worrying, on a scale of 1 (almost no effort) to 5 (a great deal of effort).

no effort

almost no

some effort

quite a lot

a great deal

at all

effort

of effort

of effort

❏

❏

❏

❏

❏

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Week 4 Day 23

121

4 How did you sleep last night? Indicate to what extent the following three statements apply to you.

completely

true

neutral

untrue

not true

true

at all

I found it hard to

1

2

3

4

5

get to sleep.

I suffered disturbed

1

2

3

4

5

28

or broken sleep.

27

I awoke too early.

1

2

3

4

5

26

25

24

5 Event Did anything particular happen today which made you 23

start to worry? If so then write down what happened below,

22

using key words.

21

20

.........................................................................................................

19

18

.........................................................................................................

17

.........................................................................................................

16

15

.........................................................................................................

14

.........................................................................................................

13

.........................................................................................................

12

11

.........................................................................................................

10

.........................................................................................................

9

8

.........................................................................................................

7

.........................................................................................................

6

5

4

3

2

1

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122

Day 24 Looking forward

Worry time I

Imagine that . . .

morning/afternoon

Explanation What life will be like within a certain period of time is a question which many people ask themselves. People can

spend hours worrying about events they are very afraid of.

This exercise is useful for people who are afraid that

something bad is going to happen which they will not be able

4 to cope with. At an earlier stage you wrote down some

Week

concerns in keywords on paper. We are now asking you to use

one of your concerns for this exercise.

a

Begin with fi ve minutes intense worrying.

b Imagine what your life would be like if this concern became a reality tomorrow. The thing you are really afraid of is

happening. Perhaps in the fi rst instance this thought will be

quite stressful in itself. But describe this situation in as much detail as possible. Whatever happens, describe it as though it

is happening now. What are you feeling? What are your

thoughts? In what sort of environment is this taking place? And what consequences does this have for you? Don’t worry about

spelling. Just write something.

Example: ‘I have not passed my exams, which I worked

really hard for.’ You very much blame yourself for this: ‘I am

not capable’ or ‘I am too stupid’ or ‘I am never going to fi nish this’. This is just one example of a negative event which can

occur. How do you see your life in a year’s time?

In the meantime Read the exercise for the next worry time and think about it today.

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Week 4 Day 24

123

Worry time II

What next?

evening

a

Begin with fi ve minutes intense worrying.

b Afterwards you are going to describe what your life will be like one year after the imaginary outcome of your worry. Imagine

28

what your life will be like one year after the event you have

27

feared. Describe how you feel one year later, and what your

26

thoughts are. Try to think about the future logically: perhaps

25

the future is bleak but this situation may not be

24

insurmountable. New chances will have come up for you over

23

this year. Write down too what pleasurable activities you could 22

also have been involved in after this situation occurred. Your

21

future is not a disaster but a situation which can be overcome.

20

19

At night Try to postpone your worries until the next worry time.

18

Use the distraction exercise, or positive worrying about a good 17

memory you have or one of your good qualities.

16

15

14

13

12

11

10

9

8

7

6

5

4

3

2

1

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124

Day

24

Notes

1

Tick the boxes to indicate which subjects you have worried

about today (you can give several answers).

studies/

fi nances

health

relationships

family/

what others

other

work

friends

think of me

❏

❏

❏

❏

❏

❏

❏

2 Tick a box to indicate how many minutes/hours you have 4 Week worried today.

0–30

30–60

1–2

2–3

3–4

4–5

> 5

minutes

minutes

hours

hours

hours

hours

hours

❏

❏

❏

❏

❏

❏

❏

3 Tick a box to indicate how much effort it took today to stop worrying, on a scale of 1 (almost no effort) to 5 (a great deal of effort).

no effort

almost no

some effort

quite a lot

a great deal

at all

effort

of effort

of effort

❏

❏

❏

❏

❏

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Week 4 Day 24

125

4 How did you sleep last night? Indicate to what extent the following three statements apply to you.

completely

true

neutral

untrue

not true

true

at all

I found it hard to

1

2

3

4

5

get to sleep.

I suffered disturbed

1

2

3

4

5

28

or broken sleep.

27

I awoke too early.

1

2

3

4

5

26

25

24

5 Event Did anything particular happen today which made you 23

start to worry? If so then write down what happened below,

22

using key words.

21

20

.........................................................................................................

19

18

.........................................................................................................

17

.........................................................................................................

16

15

.........................................................................................................

14

.........................................................................................................

13

.........................................................................................................

12

11

.........................................................................................................

10

.........................................................................................................

9

8

.........................................................................................................

7

.........................................................................................................

6

5

4

3

2

1

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126

Day 25 Catch your thoughts

Worry time I

Thought catching

morning/afternoon

a

Begin with fi ve in minutes intense worrying.

b Today every time you have a worry, say it out loud to yourself.

Before saying the worry, put the words ‘I think’ in front of it.

For example, ‘I think that I don’t spend enough time with my

4 children and I am perhaps too busy with my career.’ Note these Week

thoughts down on a sheet of paper. Do this straightaway as

otherwise you may forget them. Note the situation in which

these thoughts occurred. Also note how upsetting you found

them on a scale of 0 to 10.

In the meantime When you worry, imagine you are on a short holiday. For half an hour let yourself enjoy that lovely, carefree holiday feeling. Do something nice, buy a newspaper, for

example, and enjoy a half-hour holiday.

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Week 4 Day 25

127

Worry time II

Putting your thoughts in context

evening

a

Begin with fi ve minutes intense worrying.

b In this worry time we are going to take a closer look at the thoughts you have had today. Choose the thought which has

28

occurred most frequently or which you have found the most

27

upsetting. Answer the following questions on paper or in your

26

notebook:

25

24

1

What does this thought say about me?

23

2 What does this thought say about my world, my friends

22

and my family?

21

3 What is the worst thing about this situation, these

20

thoughts and this feeling? Why is it so bad?

19

4 What is it that makes the thought so distracting and why

18

do I fi nd it so troubling?

17

16

At night Imagine that you are once again having a fantastic time 15

lying on the beach. You are feeling really relaxed and enjoying 14

feeling the warmth of the sun’s rays. Relax completely and feel 13

your body become heavier. Feel how your body is making an

imprint in the sand.

12

11

10

9

8

7

6

5

4

3

2

1

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128

Day

25

Notes

1

Tick the boxes to indicate which subjects you have worried

about today (you can give several answers).

studies/

fi nances

health

relationships

family/

what others

other

work

friends

think of me

❏

❏

❏

❏

❏

❏

❏

2 Tick a box to indicate how many minutes/hours you have 4 Week worried today.

0–30

30–60

1–2

2–3

3–4

4–5

> 5

minutes

minutes

hours

hours

hours

hours

hours

❏

❏

❏

❏

❏

❏

❏

3 Tick a box to indicate how much effort it took today to stop worrying, on a scale of 1 (almost no effort) to 5 (a great deal of effort).

no effort

almost no

some effort

quite a lot

a great deal

at all

effort

of effort

of effort

❏

❏

❏

❏

❏

stop worrying.indd 128

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Week 4 Day 25

129

4 How did you sleep last night? Indicate to what extent the following three statements apply to you.

completely

true

neutral

untrue

not true

true

at all

I found it hard to

1

2

3

4

5

get to sleep.

I suffered disturbed

1

2

3

4

5

28

or broken sleep.

27

I awoke too early.

1

2

3

4

5

26

25

24

5 Event Did anything particular happen today which made you 23

start to worry? If so then write down what happened below,

22

using key words.

21

20

.........................................................................................................

19

18

.........................................................................................................

17

.........................................................................................................

16

15

.........................................................................................................

14

.........................................................................................................

13

.........................................................................................................

12

11

.........................................................................................................

10

.........................................................................................................

9

8

.........................................................................................................

7

.........................................................................................................

6

5

4

3

2

1

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130

Day 26 A realistic approach

Worry time I

A realistic approach

morning/afternoon

Explanation In the exercise we are going to look for realistic thoughts. The thought pattern you have fallen into cannot be

unlearned all at once. Every time you must replace your

thoughts with realistic thoughts. It will be a while before this becomes second nature. Take your time.

4 Answer the questions below, using the results from the

Week

three-column exercise.

a

Begin with fi ve minutes intense worrying.

b1 Describe the problem:

What is worrying you? Describe the situation.

In what direction are your thoughts taking you?

Where do things go wrong?

What is the underlying need/disaster/theme of your thoughts?

b2 Give evidence for your worries:

What evidence is there for the validity of your worries?

What evidence is there for the non-validity of your worries?

b3 State your aims:

What would you like to be different and better? Think about

this and give your imagination free rein.

b4 Think of realistic alternatives:

What is the worst that can happen?

What would be the most positive solution for you?

What would be the most realistic solution?

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Week 4 Day 26

131

In the meantime Try the talking in your imagination exercise from day 5 again. You could also telephone someone and tell them

your worries. Make sure they don’t react but just listen.

Worry time II

A realistic approach (continuation)

evening

28

27

b5 Look at the following consequences:

26

Imagine that you are going to actually put the most realistic

25

solution of b4 into practice and think about what it will mean

24

for you.

23

What are the positive and negative consequences of this

22

solution in the short and the long term?

21

20

b6 Put this new realistic approach into practice:

19

Make it a habit to have a realistic outlook. Act in accordance

18

with this realistic outlook.

17

16

b7 Assess the results, give yourself the time to take ownership of 15

these new realistic thoughts. After a while you will see that

14

this will become automatic.

13

At night Try the muscle relaxation exercise once more when you 12

are in bed.

11

10

9

8

7

6

5

4

3

2

1

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132

Day

26

Notes

1

Tick the boxes to indicate which subjects you have worried

about today (you can give several answers).

studies/

fi nances

health

relationships

family/

what others

other

work

friends

think of me

❏

❏

❏

❏

❏

❏

❏

2 Tick a box to indicate how many minutes/hours you have 4 Week worried today.

0–30

30–60

1–2

2–3

3–4

4–5

> 5

minutes

minutes

hours

hours

hours

hours

hours

❏

❏

❏

❏

❏

❏

❏

3 Tick a box to indicate how much effort it took today to stop worrying, on a scale of 1 (almost no effort) to 5 (a great deal of effort).

no effort

almost no

some effort

quite a lot

a great deal

at all

effort

of effort

of effort

❏

❏

❏

❏

❏

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Week 4 Day 26

133

4 How did you sleep last night? Indicate to what extent the following three statements apply to you.

completely

true

neutral

untrue

not true

true

at all

I found it hard to

1

2

3

4

5

get to sleep.

I suffered disturbed

1

2

3

4

5

28

or broken sleep.

27

I awoke too early.

1

2

3

4

5

26

25

24

5 Event Did anything particular happen today which made you 23

start to worry? If so then write down what happened below,

22

using key words.

21

20

.........................................................................................................

19

18

.........................................................................................................

17

.........................................................................................................

16

15

.........................................................................................................

14

.........................................................................................................

13

.........................................................................................................

12

11

.........................................................................................................

10

.........................................................................................................

9

8

.........................................................................................................

7

.........................................................................................................

6

5

4

3

2

1

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134

Day 27 Free choice

Worry time I

Choose for yourself

morning/afternoon

a

Begin with fi ve minutes intense worrying.

b You have done a lot of exercises over the past few weeks. You will have found some exercises more benefi cial/useful to do

than others. This is why we are going to let you choose for

4 yourself which exercise you want to do today.

Week

Now choose the exercise from the fi rst two weeks from

which you feel you have benefi tted the most, and do this now.

In the meantime Try to postpone your worries until the next worry time. If that does not work, do the positive worrying 1 exercise about a good memory you have or positive worrying 2 exercise

about one of your good qualities.

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Week 4 Day 27

135

Worry time II

Choose for yourself

evening

a

Begin with fi ve minutes intense worrying.

b Now choose the exercise from the last two weeks from which you feel you have benefi tted the most, and do this now.

28

27

At night If you are worrying about what you have got planned 26

change the phrase: ‘ I must . . .’ into ‘I want . . .’

25

24

23

22

21

20

19

18

17

16

15

14

13

12

11

10

9

8

7

6

5

4

3

2

1

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136

Day

27

Notes

1

Tick the boxes to indicate which subjects you have worried

about today (you can give several answers).

studies/

fi nances

health

relationships

family/

what others

other

work

friends

think of me

❏

❏

❏

❏

❏

❏

❏

2 Tick a box to indicate how many minutes/hours you have 4 Week worried today.

0–30

30–60

1–2

2–3

3–4

4–5

> 5

minutes

minutes

hours

hours

hours

hours

hours

❏

❏

❏

❏

❏

❏

❏

3 Tick a box to indicate how much effort it took today to stop worrying, on a scale of 1 (almost no effort) to 5 (a great deal of effort).

no effort

almost no

some effort

quite a lot

a great deal

at all

effort

of effort

of effort

❏

❏

❏

❏

❏

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Week 4 Day 27

137

4 How did you sleep last night? Indicate to what extent the following three statements apply to you.

completely

true

neutral

untrue

not true

true

at all

I found it hard to

1

2

3

4

5

get to sleep.

I suffered disturbed

1

2

3

4

5

28

or broken sleep.

27

I awoke too early.

1

2

3

4

5

26

25

24

5 Event Did anything particular happen today which made you 23

start to worry? If so then write down what happened below,

22

using key words.

21

20

.........................................................................................................

19

18

.........................................................................................................

17

.........................................................................................................

16

15

.........................................................................................................

14

.........................................................................................................

13

.........................................................................................................

12

11

.........................................................................................................

10

.........................................................................................................

9

8

.........................................................................................................

7

.........................................................................................................

6

5

4

3

2

1

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138

Day 28 A positive day

Worry time I

Positive thinking exercise

morning/afternoon

a

Begin with fi ve minutes intense worrying.

b Go and sit down quietly. Acknowledge your anxiety and your worries, gather them up and let them be. Now you are not

going to concentrate on the things you are dissatisfi ed with or 4 which you worry about but on something you are proud of.

Week

Shut your eyes. Take time to let something come to mind, a

positive quality, a special achievement, something which

makes you proud of yourself, something you have done.

When you have found this quality, think about your

achievement and then tell (yourself ) quietly in one sentence

that you are proud of yourself.

.................... (your name) when you .................... you did a fantastic job, I am proud of you!

.................... (your name) your .................... is a great quality you have, I am proud of you!

Then repeat this phrase ten times in your head and say it in

your mind with ever increasing conviction and enthusiasm.

Finally you can even shout it out (in your mind). In this way

you will see that positive thoughts have a strength which will

make you feel good again. Accept that you have good qualities

as well as bad qualities, the same as everyone else.

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139

In the meantime There is an exercise which you can do again in the meantime if you start to worry: clap your hands and say to

yourself, ‘Not now but later!’ You could also even take a half-

hour holiday.

Worry time II

Positive worrying

28

evening

27

26

a

Begin with fi ve minutes intense worrying.

25

24

b Write a positive account of yourself but try to be realistic. Write 23

about your personality, your good and bad points, your life and 22

your future. Write about what is important to you. Are these

21

things achievable? What are your wishes for the coming weeks

20

or months? Are they realistic, are they also what you really

19

want and not infl uenced by others? Set targets which are as

18

small as possible. Are you on your way to achieving your goal?

17

If not, then you must put this goal to one side and make your

16

goals attainable.

15

14

At night If you worry, do the thought whirling exercise.

13

12

11

10

9

8

7

6

5

4

3

2

1

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Day

28

Notes

1

Tick the boxes to indicate which subjects you have worried

about today (you can give several answers).

studies/

fi nances

health

relationships

family/

what others

other

work

friends

think of me

❏

❏

❏

❏

❏

❏

❏

2 Tick a box to indicate how many minutes/hours you have 4 Week worried today.

0–30

30–60

1–2

2–3

3–4

4–5

> 5

minutes

minutes

hours

hours

hours

hours

hours

❏

❏

❏

❏

❏

❏

❏

3 Tick a box to indicate how much effort it took today to stop worrying, on a scale of 1 (almost no effort) to 5 (a great deal of effort).

no effort

almost no

some effort

quite a lot

a great deal

at all

effort

of effort

of effort

❏

❏

❏

❏

❏

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4 How did you sleep last night? Indicate to what extent the following three statements apply to you.

completely

true

neutral

untrue

not true

true

at all

I found it hard to

1

2

3

4

5

get to sleep.

I suffered disturbed

1

2

3

4

5

28

or broken sleep.

27

I awoke too early.

1

2

3

4

5

26

25

24

5 Event Did anything particular happen today which made you 23

start to worry? If so then write down what happened below,

22

using key words.

21

20

.........................................................................................................

19

18

.........................................................................................................

17

.........................................................................................................

16

15

.........................................................................................................

14

.........................................................................................................

13

.........................................................................................................

12

11

.........................................................................................................

10

.........................................................................................................

9

8

.........................................................................................................

7

.........................................................................................................

6

5

4

3

2

1

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142

How much have you worried over the past week?

For each of the following statements indicate which is most

applicable to you by circling the appropriate number. This applies to the past week.

never

very

rarely

some-

often

very

almost

rarely

times

often

always

1 If I did not have

6

5

4

3

2

1

0

enough time to do

everything, I did

not worry about it.

2 My worries

0

1

2

3

4

5

6

4 Week overwhelmed me.

3 I didn’t tend to

6

5

4

3

2

1

0

worry about things.

4 Many

situations

0

1

2

3

4

5

6

made me worry.

5 I knew that I

0

1

2

3

4

5

6

shouldn’t have

worried about

things but I just

couldn’t help it.

6 When I was under

0

1

2

3

4

5

6

pressure, I worried

a lot.

7 I was always

0

1

2

3

4

5

6

worrying about

something.

8 I found it easy to

6

5

4

3

2

1

0

dismiss worrisome

thoughts.

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143

never

very

rarely

some-

often

very

almost

rarely

times

often

always

9 As soon as I

0

1

2

3

4

5

6

fi nished one task, I

started to worry

about everything

else that I had to

do.

28

10 I did not worry

6

5

4

3

2

1

0

27

about anything.

26

11 When there was

6

5

4

3

2

1

0

25

nothing more I

24

could do about a

concern, I did not

23

worry about it any

22

more.

21

12 I noticed that I had

0

1

2

3

4

5

6

20

been worrying

about things.

19

18

13 Once I started

0

1

2

3

4

5

6

worrying, I couldn’t

17

stop.

16

14 I worried all the

0

1

2

3

4

5

6

15

time.

14

15 I worried about

0

1

2

3

4

5

6

13

projects until they

12

were all done.

11

Total

10

9

8

➠ Total score for the fourth week :

7

6

5

4

3

2

1

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End of Part 1

The aim of this book is to teach you how to reduce your worrying and how to have more control over your thoughts. You have

learned a number of exercises to help you to do this. If by doing the exercises you have succeeded in reducing your worrying, then it is advisable to continue with them. It is best for you to decide for yourself which exercises you want to continue with and which exercises you have found most helpful in achieving this.

Worriers do not let go of their worrying thoughts easily and

this is because they are anxious that they will lose control of a problem. They feel that they are solving the problem with this way 4 of thinking. Up to a point that may be so, if you do fi nd a solution Week

or end up taking action, but excessive worrying will not solve your problems. It is important that you realize this.

Positive emotions broaden our outlook on things and make us

more creative when thinking about solutions to our problems. It is important in our daily lives that we regularly create situations in which we have the possibility of experiencing positive emotions.

These can take any form as long as they make you feel good.

Meditation, for example, or a walk in the wood, a hobby, drinking a cup of coffee, etc. Don’t wait until you start worrying again

because then it is often diffi cult for that reason to motivate yourself to go and do anything. The advice is to use positive

emotions on a daily basis. Just the fact that you regularly do

something which is good for you can help you to feel better. This in turn will increase your feeling of being in control.

How much less am I worrying now?

In the following table you can note down your total scores from the worry questionnaires that you completed at the end of each week.

This will give you an insight into the progress you have made with your behaviour in terms of worrying. Are you worrying less now?

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Score

Total score on the worry list at the beginning

Total score on the worry list at the end of week 1

Total score on the worry list at the end of week 2

Total score on the worry list at the end of week 3

28

27

Total score on the worry list at the end of week 4

26

25

24

If your score on the last worry list is less than half that of the score 23

you had at the beginning, then we congratulate you on the result 22

you have achieved. If your score is between 25 and 50 per cent

21

lower than it was at the beginning, then we advise that you

20

continue with the exercises. If your score is a reduction of less than 19

25 per cent or it has remained the same or it has even increased, 18

then it would be advisable for you to discuss with your GP whether 17

treatment with a psychologist, psychotherapist or psychiatrist is 16

necessary. It is not advisable to wait too long before seeking

15

professional help because excessive worrying will not, in the

14

majority of cases, decrease by itself.

13

12

11

10

9

8

7

6

5

4

3

2

1

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Part 2

Worrying

for

advanced

students

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Some worries are very persistent. This is because in the majority of cases we don’t notice these worries creeping up on us. Then we

grow so accustomed to these self-invented ‘cobwebs’ blowing

around our heads that we don’t notice them. These thoughts have become automatic. Sometimes we believe our own little fabrication to be the truth. Sometimes we exaggerate. Our own thoughts often make us suffer a great deal. The inability to sleep is the best indication that we are worrying (although the inability to sleep is not always necessarily an indication of worrying).

Worries have the habit of making their existence obvious. ‘You

see I’m stupid, you see I can’t do anything, you see that I’m not good enough, that I can’t get my words out etc. etc.’ For

convenience we will refer to this as the ‘you seeism-complex’. If you practise this a lot, then you are always right. Except you are not really right, because in the majority of cases it is simply not true.

What is diffi cult is that many thoughts taken in isolation do not have to become worries but they become worries when memorized

by constant repetition. If someone moves from the city centre into a house in a newly built suburb and complains that ‘I feel as

though I am buried alive here’, by which he means that he doesn’t have many visitors and he misses the former sense of social

cohesion, then there is nothing wrong in expressing this. It is a metaphor with a slight degree of exaggeration. However, if some weeks later this phrase still continuously crops up in a person’s thoughts (that is to say, several dozen times a day), then we are dealing with a worry.

The difference between normal thoughts and worries lies

mainly in their high frequency, duration and our lack of control over them. Thoughts about a problem which go through one’s head for several days and which result in a decision are not worries.

Thoughts about a problem which occupy you for several weeks

without a solution then being found probably are worries. A feature of worries is that they always come back, including at times when you don’t want them to, and no solution or decision follows, nor stop worrying.indd 149

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any relief, which leads to fatigue. Worries often cause emotional exhaustion due to the lack of sleep and hopelessness which

eventually results. You feel as though you are being kicked around like a football by your uncontrollable thoughts.

Another feature of worrying is that it takes up a great deal of time. Real worriers can all too easily spend many hours a day

thinking of nothing other than their worries. We should not brush this aside lightly. People who worry can sometimes lose ten hours a day on their worries. And some will spend fi fteen hours a day or more worrying. Some people claim to spend all their waking hours worrying and there are even people who claim that they lie

worrying during the night in their sleep and in their dreams.

Research in the meantime has shown that the brain activity that takes place during worrying also usually continues in some people when they are asleep.

Another feature of the worrying of those who do it persistently is that in the majority of cases they worry about a limited number of subjects. In most cases they worry about one or two subjects and in some cases three. But the subjects themselves are endlessly repeated in many variations.

This part is especially intended for people who are persistent

worriers. Some commonly occurring worries are dealt with in

stages and a commentary is provided. Possible alternatives for

these worries are given. You may notice that you easily recognize the worries other people have, but that it is diffi cult to recognize your own worries. This is just the way we are made as people. You can easily see how little sense there is in some of the worries other people have and you may think yourself lucky that you do

not share these worries. Your own worries, however, seem sensible and necessary. This book will help you to question the logic of some of your favourite worries.

In this book you have already learned how to spot, write

down and challenge your worries. In this part we are going to go further with these persistent worries. We will look at their content but we will also take the form of the worry, into consideration stop worrying.indd 150

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such as frequency, intensity, duration, repetition, degree of

reality, etc.

After some time you may notice that exactly what you are

worrying about is really not that important. It is much more

important to notice that you are worrying and that this is not

getting you anywhere. You waste a lot of time worrying. And it

does not solve your problems in any way. As soon as you realize this, you can start to blow these webs of worry away.

For some people worrying is closely linked with their level of

anxiety and depression. Even when that is the case, by tackling your worrying you can to some degree reduce your level of anxiety or depression. It is important that you do not set your hopes too high, but this applies to all other readers too.

Some persistent worriers feel so powerless in the face of their own thoughts that they just don’t want to think any longer.

Sometimes people take too many pills or drink too much alcohol

so as to blot out their thoughts, stop them or eliminate them

entirely. Some people experience suicidal thoughts as a result of endless worrying. Suicidal thoughts therefore can be regarded as an extreme form of worrying. This book is also intended for

readers who sometimes just want to stop these thoughts

altogether.

Favourite worries

1 I am not good enough

Perhaps the most popular worry is: ‘I am not good enough.’ If you think or say this repeatedly then you will probably end up being trapped in very frequent fi ts of worry. Now you might imagine that you lack self-confi dence and that this is why you end up saying these things. But perhaps it would be better to view the sequence in another way, that is to say, if you keep on saying this type of thing then you will end up lacking confi dence. Or you will end up believing that you are not a good mother, or that you have

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shortcomings as a husband or wife, or as a teacher or that you

cannot do DIY properly. These statements are made in the spirit of all or nothing. The whole person is degraded and not just what has been achieved. A signifi cant feature of these and similar thoughts is that they can become self-fulfi lling, that is to say that if you think you are not good enough, then you are going to behave

accordingly like a man or a woman who is insecure about

themselves, and there will be a good chance that this will lead to a reduced level of achievement, which means that you will have more reason to think of yourself as not good enough (you see). In the end, others will see this too. This is what is referred to as a self-fulfi lling prophecy, a prophecy that becomes true on its own. This is a recurring feature of many worries.

The challenge

What is striking is that worriers accept the statement: ‘I am not good enough’ as the truth without stopping to examine how much

truth there really is in this statement. Because what does ‘not good enough’ really mean? Many worriers set themselves very high

standards. Sometimes they are too perfectionist. And if they only fulfi l 90 per cent of their own requirements they feel they have not performed adequately. Compare this with the high jumper who has set himself the target of being able to jump 2 metres in height.

After many years training he can only just clear 1.98 metres. He might think that he had at least almost achieved his target. In that case he would not be a worrier. A real worrier would view this

achievement as not good enough. And perhaps not just his

performance but possibly also his whole person. Because he

maintains that he should have trained harder, should have been

more ambitious, been a stronger character, etc. And so the

maximum achievement is devalued in the eyes of a worrier to an

achievement which was not good enough, performed by an athlete

who was not good enough as a person. But what is ‘good’ really?

Even the term ‘good’ is rather vague. What does one understand

by a ‘good’ mother, a ‘good’ spouse, a ‘good’ researcher?

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The evaluation of behaviour fi tting to the role of mothers,

spouses or researchers does not have much to do with the term

‘good’. Much more specifi c qualifi cations are required for these, which are themselves also somewhat subjective. In short, the term

‘good’ is almost always a subjective standard, and everyone

understands something different by it. And why should you

want to go along with what someone else fi nds good? What is

important is that you should fi rst clearly defi ne your own norms and standards of performance. And when things do not go well,

it therefore makes no sense to ask yourself whether or not

you can measure up to unclear criteria. Moreover, if you want

to be perfect as a mother then your children will probably have no life.

Alternative

It is important, if you feel the need for this, to create a suitable alternative for yourself (and write this down). An alternative for this phrase could be: ‘I have many roles and do many activities, and in the case of each of these roles I can ask myself whether I may

want to grow further. If I enjoy cooking then I can get more

training, or I can take courses in DIY, and in my role as a mother I can ask for tips from other mothers, etc. Let me try to be a normal housewife and mother, a good-enough mother, a mother who does

what she likes to do with the children’ (and the same for fathers or people who want to do DIY). An alternative for people who go out to work could be: ‘If I assume that I am not yet fulfi lling the requirements of my employer in terms of my work then I can get

more qualifi cations. Let me use my superior’s judgement rather than judging myself initially.’

2 Nobody likes me

This is a popular worry. This worry too can be self-fulfi lling: If you think this for long enough and you believe it, then this statement will to a certain extent become true, because you will behave like stop worrying.indd 153

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154

an insecure person who is wanting to be liked but who is not

always liked (you see).

Watch out for the all or nothing attitude. Nobody likes me, that is to say there is not one person who likes me. The meaning of this thought is of course also the conviction that my personality is so bad that nobody can like me. And that all social situations will end in the same way: with rejection.

The challenge

This statement is, in general, not true. If you believe this statement to be true, then you have not grasped the fact that in reality you are liked, just not by everyone, and not by everyone whom you

would want to like you. If you repeat a statement of this kind to yourself, then you will become reconciled to the problem of getting people to like you. And then you will be very different indeed to people who set little store by the judgements of others. In short, people who fear rejection often come across as very likeable when you encounter them in everyday life. It is just that in the long term people can sometimes get tired of the exaggerated friendliness

with which these worriers pester the people they know. You may

also interpret all clear signs of liking or warmth around you

incorrectly: ‘They are just saying they like me but really they think I’m nothing’, thus not believing the reassurances to the contrary.

Also being liked is not everything. This is because there are

several ways in which we can be liked. These may be a superfi cial fi rst impression or a substantial impression which has been built up over several years. The fi rst impression is important if a good second impression follows on from it. Some charmers can make an excellent fi rst impression only to then use this charm to swindle people. Some very likeable people turn out to be tyrants in their private lives and some grumpy people who do not seem very

likeable can turn out in private to be extraordinarily helpful and deserving. When people like you, in the majority of cases this is because your behaviour or appearance is of help to them, or makes them think of someone dear to them. Your behaviour suits their

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agenda. In short; to be liked is something which is just registered momentarily, and does not say everything about you by a long

way. It is better if you can focus on people you like yourself. And then just wait to see if the feeling is mutual.

Alternative

If you have these types of thoughts frequently then perhaps think about the following statement (you can write your own alternative in a notebook): ‘There is no single person in the world who is liked by everyone (except for some fi lm stars but they have no life).

There are some people who have great social skills and who are

liked by many people. There are a lot of people who have quite

normal skills in terms of how they interact with others and who are liked by some people but not by others. This is because everyone has their good and bad points and sometimes that says more

about other people than about me. It is just a matter of chance whether I am liked and by whom I am liked. In addition, people can make of me what they will – I don’t have much infl uence over that.

However nice I am is no guarantee that the people will like me. It is much more important for me to like other people. If I take stock of who I like and focus on them, then I increase the chance that the positive impression is mutual.’

3 I can’t do that

This thought may be true. For example, you cannot fl y, therefore you can’t do that. But people often use this statement both

appropriately and inappropriately. In particular if you repeat it often then it can turn into a worry which will mean that you do not start to do the things you really want to do. ‘That is too diffi cult for me’ is a variant of this. Or ‘I won’t succeed in doing that’.

Remember that we are dealing with predictions here: ‘If I tackle this or that then I won’t succeed at it, that is too diffi cult for me, or it will turn out that I can’t do it.’ Success is excluded in advance.

Then you are going to end up looking for obstacles everywhere

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and you will end up not doing the diffi cult task. ‘I wouldn’t dare do that’ is a statement from the same category.

The challenge

Again, sometimes this prediction may be correct but in many cases it won’t. Take, for example, changing a burst tyre on a car or a punctured tyre on a bike. Some people will say immediately that they can’t do this but what they really mean is that they don’t know how to do it at present. But with some explanations and

practice, it should be the case that practically every person can learn to repair a puncture on a bike or how to replace a burst tyre.

Or when someone asks you to make a short speech at the wedding

of a good friend. You then react straightaway by saying ‘I can’t do that’ and you always do this whenever anyone asks you to do

anything diffi cult – this can then turn into a worry, which here too will once again end up coming true. Because if you always think or say: ‘I can’t do that’ then in the long term, you will end up not learning very much. What many people also mean when they say; ‘I can’t do that’ is: ‘That is really diffi cult.’ But often if you just try something you will end up succeeding. It is therefore better to think: ‘That is diffi cult but not impossible.’ This is because most things can be learned. If you don’t know how to replace a water tap, or how to change a spark plug, or how to commence legal

proceedings to fi ght a ruling concerning seeing the children after a divorce, then it does not help to say that you can’t do this. You can always start by asking for some information or help fi rst, and then it may well turn out that the task in question is not beyond your capabilities.

It always helps to look at the word that from the statement ‘I can’t do that’ a little more closely and to break it down. Because if the word that stands for fi tting a radiator, then this task can be broken down as follows: [1] look for information in books or on the Internet; [2] ask a friend with practical skills how it should be done; [3] look into what materials you will need; [4] look into what tools you will need; [5] check how expensive it would be to pay a stop worrying.indd 156

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professional; [6] see if a friend with practical skills would support you; [7] follow a course in fi tting radiators at a local college of further education, and [8] check how much time and money you

have available. In the time that you will have spent taking these steps the fi tting of the radiator has come a little closer.

In short, some things are diffi cult but not impossible.

Alternative

Always try to make it clear what you mean by that (cook a tasty meal? Write a letter?) and bear in mind that ‘perhaps some things are diffi cult and at present you do not have suffi cient knowledge and skills, but that many things can be learned and many things can be achieved by taking them one step at a time’. In brief: ‘It is diffi cult but not impossible.’ The suggestion here is that every time you fi nd yourself trapped by the thought: ‘I can’t do that’ replace this thought with: ‘I don’t know if I can do that yet, I shall go and learn how to do it fi rst and then try it.’ The statement: ‘That is too diffi cult for me’ could be replaced by: ‘That is too diffi cult for me now but if I want to learn about it then I can go and start on it’.

The statement: ‘I wouldn’t dare’ can be replaced by: ‘I do fi nd it a bit scary but perhaps I could be daring and do it if I am well-prepared.’

4 I won’t be able to cope

‘I won’t be able to cope’ is the expression people use when they imagine a future event which is bound to be linked with negative emotions. For example, if you have a fear of fl ying and you are planning to travel by plane then this could prompt you to think about the unbearable panic you might experience. Or you might

anticipate a moment of panic when you have to get in a lift and you are afraid of lifts. Equally, you might be afraid of going

through life alone after a divorce. If you regularly think: ‘I won’t be able to cope’ then that can lead to a suffocating attitude to life built around avoidance, which is based on nothing other than

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continuous worrying about the intolerable anxiety which you

believe you will feel in the future. That means you are feeling anxious about future anxiety.

The challenge

To be precise, what you are afraid of is your own intolerable

anxiety which you think you will suffer when something bad

happens. You are afraid of not being able to tolerate the panic you will feel in the future, the distress, the loneliness. In reality most people (and probably you too) can cope quite adequately with

anxiety, distress, loneliness, dejection, etc. If next week you get into a panic when you faint in a crowded shop, then this type of panic can be tolerated quite well. If you let the feeling of panic pass and you just wait half an hour, then the panic will in the majority of cases subside and you will in fact have survived the panic attack. In fact nothing happened, you just had a panic attack which is of course inconvenient but not disastrous. In reality you are not going to have a heart attack, nor will your hair suddenly turn grey, your loved ones will not leave you in the lurch and

bystanders will, for the most part, offer well-meaning sympathy. In short, almost everyone will survive a panic attack. That does not mean it is pleasant but in reality you will be able to cope with it.

You too can cope with feelings of anxiety.

The problem is that if you try to escape the panic then the

avoidance tactics often cause more damage than the anxiety itself.

Take the following case. A woman was in her car on the way to

work when she saw a small spider hanging from her rear view

mirror. Because she was afraid of spiders she tried to kill it by hitting it with a newspaper but in so doing she ended up crashing her car into a lamppost. The moral of the story: it is much better to accept your anxiety than to use all these avoidance tactics. Then there was a man who was so anxious about losing his partner to

another man that he panicked about it and then spied on his wife to such an extent that she did in fact end up leaving him. In short: expressing your anxiety is often less harmful than all those

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attempts to escape it. Moreover, escaping your anxiety does not work: the more frequently you run away from your anxiety the

stronger these feelings will become.

The best remedy is to accept your feelings of anxiety, to tolerate them and not try to escape them. Then these feelings of anxiety will die down.

Alternative

Why not try one of the following phrases?: ‘If I feel anxious or get into a panic, then I will be able to cope.’ ‘It is just inconvenient but I don’t need to run away from my anxieties.’ ‘If I do end up on my own after the divorce, then I will be able to cope with that in the end. It will be very diffi cult but I will survive it.’ ‘When I am scared by my anxiety, then I will go and sit down quietly and wait until the anxiety passes.’ ‘I accept that I am scared and I will wait until the anxiety just dies down.’

5 I am stupid

The statement ‘I am stupid’ and similar statements such as: ‘I don’t know a lot, other people know a lot more, I can’t remember anything, they’ll think I am really stupid’, etc. are very common.

People who say these things about themselves lack self-

confi dence and are perhaps beginning to suffer from depression. That is the best way to make yourself feel useless. It is also a good example of the you seeism complex: ‘You see, my husband always

knows much more about everything.’ It is incredible that some people carry on saying these things against themselves for decades and then end up believing them to be true.

The challenge

It is striking that people who think of themselves as stupid often do not know exactly what they mean by the term ‘stupid’. When asked they struggle to give a defi nition of or criteria for what they understand by the terms ‘stupid’. Because ‘stupid’ is not the same as stop worrying.indd 159

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not intelligent. There are plenty of intelligent people (because they have done A levels or gone to college or university) who call

themselves stupid. And even people with a low IQ or with a mental handicap are not stupid, just limited in their abilities.

Stupid is a term which is used to indicate that someone should

have known better, should have given something more

consideration, or someone who has done something stupid through laziness or thoughtlessness. Stupidity is thus a subjective

judgement at the core of which is the idea that you could have

done something better if you had thought about it more. But

worriers don’t use or no longer use the term in that sense. They objectively believe that for once and for all they are completely unintelligent.

Alternative

Try to write an alternative defi nition for this thought in your notebook or use one of the following phrases: ‘I do make mistakes now and again just like everyone does, and from time to time it happens that when I think about a situation I realize I should have thought harder about it, but I am not stupid. Everyone sometimes has thought processes which are not very clever but that doesn’t mean I am not intelligent. I am usually as clever as most people with my level of education, and sometimes even more clever and

sometimes not as clever. And even if I have a low IQ (which has not yet been proven), I can’t do anything about it and I should not get upset about it.’

6 I don’t know what I want

It is not rare for worriers to tell themselves they do not know what they want. And then they say this as though it was self-evident.

Real worriers have said this to themselves so many times that their whole lives are lived on this basis. The effect is that people

become crippled by their inability to make choices, and they end up becoming passive and apathetic. This statement often goes

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together with: ‘I can’t choose.’ And even more extreme: the

statement about not knowing what you want is used as an

explanation for the feeling that you are unable to make a choice.

Some people can no longer even choose between tomato and

vegetable soup in a restaurant, at which point they then decide to eliminate the need to make such a choice for ever by not going out for a meal again.

The challenge

In general, this statement is not true at all. Worriers often know what they want, but they don’t dare to voice this, or they have wishes and preferences but they think they don’t have good

enough arguments for these preferences. If you question them

more closely, worriers have the same preferences (for example

music, holiday destinations) as other people but when it comes to important decisions they act as though they do not want to trust in their own preferences. First of all, what may be referred to as an in-depth analysis has to be carried out of all the pros and cons before you are able to make a choice. But of course decisions are not made like that. The best decisions are not those where you

have thought about it extensively overnight but the decisions

where you go with your (spontaneous) preference. Moreover, if you do make a wrong decision then you can always go back on it or

change it at a later stage. And if you can choose between attractive alternatives then you can never make the wrong decision.

Alternative

Just try one of the following statements: ‘Mostly I know what I like and what I don’t like, and usually I succeed in making a

decision I am happy with. But sometimes it is hard to choose. I try as hard as I can to take my own advice about what I have up to

now found really always suits me best. This means I don’t have to over-analyse. I may usually do and have what I like.’ ‘My life does not depend on which choice I make. Perhaps later it will turn out that the chosen alternative was not the best one but then a little stop worrying.indd 161

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bad luck is normal. I’ll just let myself make a choice, by tossing a coin if I have to, and just see what happens.’

7 I am a failure

If you say this to yourself ten times a day, then in the end you will start to think really negatively about yourself. The following are in the same category: ‘I have never succeeded at anything’ or

‘Nothing ever works out for me’ Or ‘I’ve never fi nished anything well’. Note how generalized this judgement is: a failure. Sometime people even add to this: a complete failure.

The challenge

This is a good example of ‘all or nothing’ thinking: ‘If I did not succeed in doing what I wanted to, then that means I am a

complete failure. It does not matter if anything did get fi nished or achieved, the required standard was not good enough and I am

therefore a complete failure.’ Persistent worriers believe this completely and regard it as the truth. Less persistent worriers know that this is nonsense but in spite of this they cannot get the thought out of their head and it continues to preoccupy them.

Furthermore, this thought is complete rubbish. A person can never be a complete failure: if only due to the fact that it would not be possible for a complete failure to be even born. The fact that the person in question is still alive, breathing, can see, can read and write indicates that at least a number of functions are succeeding.

A failure is an action or an undertaking which has not succeeded but this cannot be applied to a person as a whole.

Alternative

It is therefore better to pass judgement in terms of specifi c actions, such as for example: ‘I did not manage to lose weight, I did not manage to pass my driving test the fi rst time, but on the other hand I did manage to fi nd a new home within three months’ or: ‘If I do not achieve some aims that does not mean to say I am a failure stop worrying.indd 162

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as a person: I have just not managed to do some of the things I wanted to do. I am going to try again or I’ll try and do something else.’

8 I hope I’m not going mad

Some worriers get even more panicked by the idea that they will not be able to stop worrying. And then they start to imagine that they will go completely mad (not just 65 per cent but the full 100).

‘I hope I’m not going mad’ (or ‘I hope I’m not going to die, or get a serious illness’). They often add to this: ‘I mustn’t think about it.’

Those who recognize themselves here will doubtless say this is a realistic thought. But it isn’t.

The challenge

You won’t suddenly go mad just by thinking. Also, what do you

understand by mad? Do you mean disturbed, psychotic, out of

touch with reality in the psychiatric sense? Do you also picture this being followed by admission to a psychiatric hospital? It is perhaps not impossible that you could drive yourself mad by

worrying, but it will take a very long time for this to happen. Most worriers reach pension age without anything like this ever

happening. But you could become depressed or anxious or even

suicidal by worrying. This is why it is important to deal with your worrying appropriately.

Alternative

‘If I carry on worrying a lot, then I will become depressed or

anxious, or both. But there is a greater chance that I will just continue to worry as usual and not go mad. I have remained

reasonably normal up until now. If I carry on worrying it does not mean that I will then go mad. It is better for me to consider the possibility and take some precautions: I shall try little by little to examine my worries and think of some better alternatives to

them.’

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Another exercise for readers in the meantime

Below are listed a few more of the most popular worries. For a few of the worries below try to write a challenge and an alternative, in the style of the above examples. Be prepared to sit down and think of reasonable alternatives. By practising these thoughts you can teach yourself to approach your own favourite subjects for worrying.

➠ I am fat, stupid, ugly and/or unattractive (you choose).

➠ I have no self-confi dence.

➠ I can’t stand up for myself.

➠ I can never sleep.

➠ I am of no value to society.

9 Why am I worrying so much?

A favourite occupation of many worriers is to continually ask

themselves why they are worrying so much and so often. In the

long term this preoccupation can become so overwhelming that

they start to worry about the fact that they are worrying. Worriers can end up spending quite a lot of time on this worry. What is

striking about those who spend a lot of time on this is that they are often not interested in the most obvious answer: you worry

because you are afraid of a future negative event or a negative emotion, and you think incorrectly that by worrying you will have control over the future. The more people worry, the more they are unable to come to any decisions.

The challenge

It is not at all important to know why you are worrying. It is much more important to accept that you are worrying. The drive to fi nd out why you are worrying could keep you busy for several years

without you making much progress on this. Have you accepted that you are afraid of the future? Why are you afraid of the future?

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things are going to happen that you don’t want to happen. Or

perhaps you are afraid that you yourself or the events in your life are not under your control. Maybe you are afraid that you will not be able to express yourself, that you may make a mistake or that you will make some other blunder. If you examine such anxieties more closely, then you will see that these are not at all necessary.

For the most part people deal with setbacks much better than they may have previously thought possible. Mostly people can also

cope much better than they think with the accompanying emotions.

Therefore you do not have to be quite so terrifi ed about your

future emotions. Also people are often much better able to do

diffi cult things (such as giving a speech) than they think. By continually worrying about things in advance you will not improve your future performance, but what you will do is waste a lot of time on unnecessary anxiety.

Alternative

‘As soon as I say to myself that it is important to know why I

worry so much then I will remind myself that it is not at all

important to know this or to spend much time dwelling on it. What is more important is how I can stop it. Moreover I do know deep down why I worry: because I am afraid of the future, that is to say I am afraid of what I imagine the future to be. I am therefore afraid of my own thoughts, fantasies and imaginings. My future just

exists in my own thoughts. In reality my future could be quite

different from what I imagine. This means that it does not make sense to be so afraid of a future which will perhaps be quite

different to the one which I now fear.’

10 When will this stop?

A time-consuming preoccupation is ‘brooding’ over the question as to when the worrying will fi nally stop. Brooding is continually dwelling on the fact that you are worrying, that you are depressed, or that you are unhappy.

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‘How long am I going to carry on feeling so bad?’ This sort of

complaining type of question is rhetorical in character: just one answer is possible and in the imagination of the worrier it is this:

‘There will never be an end to this.’ Brooding is a form of

complaining which is intended to arouse sympathy and at the start this may well actually happen. But after a time this sympathy will wear thin as it will become clear that the person complaining is in fact doing nothing about the cause of the complaint. Because when people complain they are not actually doing anything. Except

getting sympathy.

The challenge

If you really want to know how long it will be before the worrying will stop then the answer is quite simple: It will go on for as long as necessary. It will go on for as long as it takes to recover from it.

A broken leg will take at least six weeks to heal if it is not a complicated break. It takes at least six weeks to recover from

excessive worrying, as long as this excessive worrying is not

complicated by depression or an anxiety disorder. Otherwise it will take longer. Moreover it is also dependent on the way in which you make this healing process happen. If you do all the exercises in this book seriously and try them out one by one then you will

recover more quickly than if you were to think that they were not suitable for you. When you come to realize that excessive worrying is a temporary problem that you can work on by doing the

appropriate exercises or having therapy, then recovery will be

quicker than if you think that the fact you worry is just one of your character traits.

Alternative

‘It will take as long as it takes to recover. If I work on my recovery seriously then it will take me six weeks. Perhaps it may take

longer. If I don’t do anything about it then it will defi nitely take longer. Let me try as quickly as possible to change my worrying into a purposeful way of working towards my future.’

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11 But that’s just the way I am

’I can’t change, it’s just the way I am.’ This is the way worriers who have given up on any attempts to stop worrying think. It is as

though they think they have to change their whole personality in order to change their worry habits.

The challenge

This is a good time to discuss this. Some people never worry,

others worry a great deal. It is as though worry is a fi xed

personality trait. Research has shown that what is defi nite is that people with certain personality traits are more susceptible to

excessive worrying. It has been proven that neurotic people are more liable to worry. Neuroticism is an associated character trait which consists of the inclination to react with anxiety, dejection, insecurity, black and white thinking, perfectionism and fear of failure to events in life. It is stressed that this is sometimes a hereditary biological factor. But it is important to note that within the large group of people with a neurotic personality by no means all of them will worry endlessly. Neuroticism cannot be changed but worrying as a form of expression is defi nitely something that can be changed, either as a result of self-help or therapy. In short, even if you are inclined to be neurotic you can still make changes to your worrying.

Alternative

‘I do not have to change in every way if I want to stop worrying.

Worrying only relates to a small part of my personality and it’s just a bad habit. I can change it if I want to. I have also had periods in my life when I have not worried or when I have worried less, so why should it not be like that again? And when I think that I have always been a worrier, then this means that even I was able to

push my worries away. At least for half the time.’

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12 I must stop thinking like this

If you have done everything to stop worrying and it hasn’t

worked, then you can go as far as saying that you have developed a strong desire to stop these thoughts. If you haven’t slept for a few days or longer and your thoughts keep going round your

head then it is only human to despair and to wonder if you will ever be free of them. Some people succeed in doing this more

or less temporarily by drinking a lot of alcohol. Some people try to infl uence their thoughts by taking cannabis or other

consciousness-altering drugs. For the most part, dulling or

stopping your thoughts does not work and the remedy is worse

than the problem. Once the drugs have come out of your system

your thoughts will seem worse than before. A handful of sleeping pills can help you to switch off from your thoughts for a while but it is guaranteed they will return and the following day you will still be crippled by worry. Bear in mind that you can make things worse by saying: ‘I must stop these thoughts, I can’t bear them any longer. If I have to think them for another fi ve minutes then I will go completely mad’ or similar things. If you have got to this stage then you have become depressed and

possibly also suicidal. By this we mean that you want to rid

yourself of these thoughts so much that you are even considering ending your life.

The challenge

If you continuously repeat; ‘I want to stop these thoughts’ then there will come a point when you can think no thoughts other than these. All other thoughts are pushed out by this one prevailing thought. You are then forced into thinking of ways to stop your thoughts and each of these ways just leads to more problems. You may possibly feel so bad that on impulse you will want to do

something drastic to stop these terrible thoughts. You may want to hurt yourself, scratch yourself or harm yourself in another way, take pills, or make attempts to end your life.

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All these remedies are worse than the problem. In fact the

solution lies elsewhere: fi rst accept your thoughts for what they are. You can in reality tolerate your thoughts and you don’t have to stop them at this point. Bear in mind: they are just thoughts. When you think about wanting to stop these thoughts, what you need to do is to accept that you have these thoughts and that they are a sign that all is not well with you. But you can still live perfectly well with these thoughts. If you just go and sit down and accept you have these thoughts, then you will see that in fact nothing happens at all. Then you can examine your thoughts one by one

and try, preferably with someone you trust or a psychologist, to challenge your thoughts one by one and to look for better

alternatives (see below). Bear in mind that it is very hard to change all your thoughts in one go. But if you start with some of the main thoughts (such as: ‘I have no more future, life will never be happy again’) and fi nd better alternatives for them then you will have taken a step in the right direction.

Alternative

‘I accept that at the moment I have thoughts which I feel are

terrible. I want to stop having them but that won’t happen all at once. I am going to try and examine some of my thoughts and look for some better alternatives. If necessary I shall seek help with this from a person I trust, my GP, a telephone helpline or a

psychologist. I accept that the thoughts I have mean that not all is well with me. I am perhaps getting depressed by this. If that is the case then my thoughts are coloured by this depression and they

are very black and white. This means I can no longer make good

judgements about my future. Every time I think: “I must stop these thoughts because they have become intolerable”, then I will say to myself: “I want to stop these thoughts and I am going to work on this, but I can in fact tolerate them.”’

Every time you are on the point of doing something like

swallowing pills or other things to shut out the thoughts say to yourself: ‘ Not now, but later. I am fi rst going to seek help with stop worrying.indd 169

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examining my thoughts one by one, challenging them and

improving on them.’

13 It would be better if I wasn’t here any more/I’m a burden to others

At a given moment you could get so desperate with worry that you think it would be much better for yourself and for others if you were no longer there. Perhaps you have thoughts like: ‘My friends and family are just fed up with me’ or ‘I’m just a burden to my children’ or ‘Why would they want anything to do with me, I’m just moody and depressed and I’m a burden to my loved ones, so it

would be better if I was out of the way.’

Thoughts of this type are obviously very common in people

who make suicide attempts and people who are depressed. But

these are worries which don’t add up. What is almost never true is the thought that nobody would care if you were to commit suicide.

Some worriers who are depressed will say: ‘If I’m not around any more, then nobody will be upset, nobody cares about me and they won’t even miss me. They’ll get over their grief really quickly.’ If you recognize these thoughts or others like them, you need to

realize you are suffering from severe depression and that this

statement is completely wrong. You have become locked into your own way of thinking which bears no relation to reality. The reality is quite different: those who are close to you in the future could suffer long-term trauma due to your suicide and they may grieve for many years. Even if you believe this is nothing to do with you, it is still true.

The challenge

We know in general that these thoughts don’t add up. In the

majority of cases, your committing suicide is the last thing they want.

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your worries and that perhaps you can be rather wearisome with

your depressive outlook on life but they would much rather you

were still there with them. Given the choice, most family members will say that they would rather be stuck with you still sitting there even though you can be a bit of a pain sometimes. Or they will say that the extent of the burden you may put on them is really

actually manageable, and that you should not blame yourself for being depressed and that they would want to support anyone who

is sick. What is most important, however, is to be aware that if you were to commit suicide then your loved ones would grieve a great deal and your suicide would be a far greater burden. Moreover,

your suicide would cause much more distress to your loved ones

than you may now be causing them with your worrying and

depression. In short: you would do much better by staying around rather than leaving them.

Alternative

‘Other people may defi nitely fi nd my worrying and my depressive outlook on life tiresome to deal with. But the same could be said if I had a broken leg or if I have had to be cared for by my loved ones because of long-term illness. They are probably happy that they are able to help me out if I am sick. I will try to be as little trouble to my loved ones as possible by working towards a quick recovery and also by changing my worry habits. If I were to commit suicide, then I really will place a great burden on my loved ones, and I don’t want to do that. If I do not feel that my loved ones would grieve if I were to die, then I am aware that I am seriously depressed and that this thought is not true. I will try to be less depressive in my outlook.’

14 Life won’t get any better/I have no future/Life has no

meaning

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won’t get any better’ or: ‘I have no future any more.’ For those who recognize these thoughts, it is important to check how frequently you repeat them to yourself in the space of a day. If you repeat them to yourself more than ten times a day then you are well on the way to suffering from depression or you already are. Depressed people can repeat the same thoughts in an endless litany,

sometimes with not much variation on the theme. The question is, what is the effect exactly of such endless repetition? Why would you repeat the same thoughts to yourself ten times or more? Does it make life more meaningful? The core of the problem here is that the more frequently you say this thought to yourself the truer it will seem and the more you will continue to believe in it. But such thoughts are not true.

The challenge

The question about the meaning of life is a typical ‘all or nothing’

question: Does life have any meaning or not? It is 100 per cent or 0

per cent. Often worriers cannot see any middle ground where life may have meaning 40 per cent of the time and no meaning 60 per

cent of the time. But if you ask what people how exactly they are defi ning the meaning of life you will not get an exact defi nition.

This is in fact impossible anyway as the meaning of life is a catch-all expression: it can include everything but there is nothing to accurately describe what the meaning of life covers. People who never think about the meaning of life also have great diffi culty in defi ning it. The question about the meaning of life is rhetorical: the answer can only be negative. In short: asking a question about the meaning of life in itself has no meaning. The question about

whether you have any future is from the same stable. It is also a rhetorical question which you are better off not asking.

Of course you will have both good and bad experiences in the

future. You will not know now whether parts of your life will be better in the future. You will see that for yourself.

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Alternative

‘It is better if I do not ask how much meaning my life has. That is because this is a question which has no answer. I will try and get as much satisfaction as possible from the small things I do. I don’t know how my future will turn out. There will doubtless be happier and less happy times in my life. I cannot predict the future.

I will try as hard as I can to achieve my aims. I do not know to what extent I will succeed in this but I will see this clearly for myself.’

Treatment of obsessive worrying about suicide

Elements from cognitive treatment of worrying may be applied

in the treatment of suicidal thoughts. The most important aspect of this is that worry is concentrated into fi xed periods during the day.

Fixed times to think about suicide

Mrs. A came for treatment via a series of healthcare professionals, because for years she had been thinking of nothing other than

suicide. In reality she did not want to commit suicide at all but her thoughts tortured her to such an extent that she did not see any other way out. She is currently seriously depressed. She has been diagnosed with a borderline personality disorder but at the

moment she is more of a depressive. In the past she has made

several suicide attempts. Her referral states that she has obsessive compulsive disorder with obsessive worrying about suicide. She

continually imagines in her head how she is going to jump off a roof, or jump in front of a train, slash her wrists or take an

overdose. These imaginings are repeated continuously without a

break. Mrs. A, who is aged 33, is experiencing intense self-loathing.

She hates herself. This relates to the different negative experiences she has had throughout her upbringing. She predominantly repeats the following thoughts:

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•

I don’t want to take this any longer.

•

I can’t enjoy anything any more.

•

I just can’t bear to think about it.

•

When I am no longer here, I won’t be a burden to anyone any

more.

•

I can’t stand it any longer.

•

I don’t see the point of anything any more.

•

I can’t imagine that anyone can possibly like me.

Admittedly she repeats each of these thoughts more than 500

times a day. She becomes completely exhausted by this. She tries to stop these thoughts but the harder she tries to stop them the more intensely they recur each time. The following instructions have been provided in order to help her to bring these thoughts under control to some extent:

Instructions

Dear Mrs. A. Perhaps you could try the following. Instead of stopping your thoughts, it is perhaps better not to stop them but just to postpone them until specifi c times. When you try to stop these thoughts, they always come back. They come back in the same way the thought of a pink elephant will when you least want it to. That is to say, if I promise to give you a thousand euros if you don’t think about a pink elephant for the next fi ve minutes, then there is a very good chance that you won’t be able to manage it.

Then you may well notice that the thought about the pink elephant keeps on coming back into your mind. This is the same with

everything you may try to stop or to forbid yourself from doing.

Therefore I am suggesting to you that you do think about suicide now but in a good way. That is to say: not all day long but at fi xed times. What I suggest you do is to set aside a number of hours a day to think about suicide, and nothing else, and then use this time to do so. If you are able to think about suicide for an hour three times a day, and think about it rather less in between these times, stop worrying.indd 174

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then you will perhaps in total spend several hours less thinking about suicide. Then you will have more free time to spend on other things. The trick is that if you give yourself permission to think about suicide in the next worry time, you will then feel the need to think about suicide less in the time between the worry times. You can then think with peace of mind about the fact that tomorrow morning you can think about suicide again or this evening after dinner. Then you can accommodate your need to think about

suicide but you won’t have to spend the whole day doing it.

I would suggest that you go and sit down for an hour; at a

table with a notepad to hand. Make sure that you won’t be

disturbed, that your mobile is switched off and that you can devote yourself fully to thinking about suicide. Take a kitchen timer with you and set it for an hour and stop thinking about suicide when this goes off. If you feel that you have still not quite fi nished then resolve to continue with this train of thought in the next worry time.

If I have understood you correctly, you are spending around eighteen hours a day thinking about suicide, about how you

imagine committing suicide and on thoughts such as: I can’t stand it any longer, I can’t imagine how anyone could possibly like me, etc. If you can now concentrate these thoughts into one hour three times a day, then the result would be that you gain fi fteen hours a day to spend doing something else other than think. Because to be honest, I don’t think it really matters whether you now spend eighteen hours a day or three hours a day thinking about suicide.

Is three hours a day not ample time in which to think about suicide? And in the other fi fteen hours of the day am I to assume that you are always coming up with more new and creative

thoughts about suicide?

When you practise this exercise, you will then teach yourself that you can start to think about suicide and that you can then stop and postpone your thoughts until another time. Then you are no longer being pushed around by your thoughts but you will have regained some control over them.

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The aim is that you think about suicide less in the meantime.

This will not be easy to start with but just try it. You can also try to write down the thoughts that come into your head by noting down keywords associated with them on a sheet of paper, which you can then keep until the following worry time. If you do have to go off in the meantime and think intensely about suicide, then this is nothing to be concerned about. Just try to postpone your thoughts to the following worry time.

If when you are ready to sit down and worry about suicide and you fi nd no suicidal thoughts come to mind, which is quite possible, then try to pick up the thread of the thoughts you had during the previous worry time, or the thoughts you had yesterday.

In most cases you will be able to pick up the thread again quickly.

If you wake up at night and start thinking about suicide, then here too try to write down the thoughts on a notepad in terms of keywords associated with them. Put this note into a shoe box under your bed. The next morning, during your worry time, take all your notes out of the shoe box and you can then use them to consider the thoughts you had.

If you ask yourself what you should go and do between worry times – well, that is entirely up to you. You could perhaps read a book or do a Sudoku puzzle, phone or visit friends or people you know, or else just do nothing and watch TV. You are free to decide.

At the start perhaps you will have to get used to the free time you will have by thinking less about suicide. It is a good idea to arrange things to do with other people in order to fi ll the time together.

When you fi nd you are getting on well with this exercise, you can shorten the worry times to half an hour or a quarter of an hour. You will then gradually become less weighed down by

obsessive thoughts of suicide and these thoughts will occur more of your own free will. The objective is thus not to stop you thinking any suicidal thoughts at all but we just hope that you will fi nd them less of a burden in this way.’

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In this way Mrs. A has been given instructions on how to reduce the distress caused by her obsessive thoughts about suicide. Some weeks later it appeared that Mrs. A has succeeded in concentrating her thoughts on suicide into several moments a day. Because she did not like being ordered to go and think about suicide she, on her own initiative, reduced the worry times to three sessions of a quarter of an hour each per day. When she felt inclined to think about suicide in the meantime she said to herself: Not now but later’. Her permanent carer noticed that she became more active again, attended her activities and that she was much more

cheerful. And she talked noticeably less about suicide.

Of course it is not always like this. In contrast to this success story there are also cases where progress is slower and not as

good. But this is one of the possible options which can be tried in cases of chronic and obsessive suicidal thoughts.

Does this sound familiar?

If you the reader recognize elements from the above account,

would you like to try out these instructions for yourself?

Worrying in metaphors and with exaggeration

Many worries are in the form of metaphors. For example the

thought: ‘I am buried alive here in this suburb’. The man who said this of course was not buried but he worded it as though he was.

That is a metaphor. He was thus expressing how serious he found the situation, namely very serious. And all metaphors are

characterized by slight or more than slight exaggeration. The man was not in fact buried at all but very much alive. But because he let this thought run through his head all day, he ended up feeling down in the dumps (another metaphor). There are many sayings

which when repeatedly used can turn into worries. For example:

‘They treated me like an idiot’ or ‘I’ll be nothing more than a cabbage in the nursing home.’ The metaphor is clear but it is of stop worrying.indd 177

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course just a manner of speaking. There are no actual cabbages

sitting in nursing homes, and only a few people there can no

longer communicate much with anyone around them. The word

cabbage is used by way of exaggeration.

Real worriers will, without even noticing, start to believe in

their exaggerations and accept them as the truth: ‘When I have to go into a nursing home I’ll end up turning into a cabbage.’ That seems a dreadful picture of the future, but it is of course an

exaggeration and a fantasy.

Many worriers are characterized by the fact that they no longer use these exaggerated metaphors fi guratively but literally, and they end up believing them. For example, the chairman of a technical commission of a volleyball club was not asked to continue by the board once his two-year term was up. He felt he had been treated so unfairly that he referred to it as follows: ‘They’ve demoted me.’

And he was unable to sleep for weeks due to the unfair treatment he felt he had received. It took a lot of persuasion to convince this man that the word ‘demoted’ had quite different associations,

which were not at all appropriate to his situation. Once he

understood how much he had over-exaggerated the situation by

referring to it in this way, he could sleep soundly again. What had happened to him was really not that unfair. The moral of this story is that it is not uncommon for worriers to exaggerate greatly and that they then go on to believe in their own exaggerations.

Worrying as self-protection and self-torture

Now we have come to the end of the book, it is logical to once

again take some time to look at the function of worrying. Why do people worry so much and so often? What, in the psychological

sense, is the explanation for this phenomenon? It is the author’s opinion that at best worrying may be understood as an

unsuccessful form of self-protection. Worriers try to infl uence their future, they try to prevent possibly harmful events or

situations. In doing this they are actually busy protecting

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themselves against future disaster. Worrying can therefore be

described as a form of self-protection. People prepare for fi ght or fl ight, but the worrier does neither – he just freezes. Somehow in the process of self-protection, worriers get into a state and get caught in a net of repetitive thoughts of the ‘all or nothing’ type.

They end up exaggerating things with metaphors and fi nally come to a complete standstill. This standstill is then experienced as torture because they feel powerless, without options and without hope. The thoughts just keep coming again and again, and in the end they become a form of self-punishment. This is why excessive worrying is both a form of self-protection and self-torture. Normal worrying can be regarded as self-protection but excessive worrying, on the other hand, is self-protection which has overshot the mark by a long way. This is when it becomes self-torture. We recommend that those who want to be freed from this torture read this book from cover to cover again and above all do the exercises.

Final exercises

For readers who want to do some more exercises to enable them to stop worrying here are a few last tips:

1 Divide by two

If you cling onto persistent worries, you will frequently get very negative feelings which go with the frequently exaggerated ideas.

If you complain that you are being ‘buried alive’ then you will end up feeling down in the dumps. If you complain about being

demoted then you will not feel good about this. If you think that life has no meaning then you will start to feel dejected. In order to bring these feelings back into proportion, you can try to divide your feelings and thoughts by two. Just try to divide the feeling of having been treated unfairly by two, so that you still have half of the unpleasant sensation and ask yourself whether half of the

intensity of feeling would not be enough in terms of what has

happened to you. I would advise our chairman: try to fi nd another stop worrying.indd 179

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word that has half the impact of ‘demoted’. For example: ‘The

board saw reasons why my contribution would no longer be

required.

If you feel that life has no meaning, then try to divide this

feeling by two: ‘The good part of my life does have meaning, but the other half doesn’t (here you could regard the less good half as the half you spend worrying). If you complain about being ‘buried alive’ divide this by two as well: ‘I am not yet buried, I’ve only got one foot in the grave’.

Another piece of advice would be to divide your worry time in

half. If you spend on average six hours a day worrying, then divide this by two and try not to worry for more than three hours a day.

Remember that in three hours you cannot worry as much as you

can in six, but if you take a thorough approach to it, you will fi nd three hours is more than enough.

2 So what?

The last exercise we will discuss is the ‘So what?’ exercise. This can be really helpful. What this involves is that for every anxiety that you have about whatever may go wrong in the future, you

then ask the question: ‘So what?’ (or if you want you can replace

‘So what?’ with ‘Oh yes?’). And after asking a succession of ‘So what?’ questions, then imagine what your situation may be one

year after the event you fear. For example: ‘I am afraid that I won’t pass my preliminary exams.’ ‘So what?’ ‘Then I maybe won’t

complete my studies.’ ‘So what?’ ‘Then I will be a disappointment to my parents.’ ‘Oh yes?’ ‘That is very upsetting for them.’ ‘So what?’ ‘Then I shall have to study something else or get a job.’ ‘So what?’ ‘How will you feel about things in a year’s time?’ ‘Perhaps I will regret that I did not study hard enough. But in the meantime I will have found a way forward which perhaps gives me more

satisfaction than the studies which did not really engage me.’

Or another example: ‘I am afraid that my wife will leave me.’

‘So what?’ ‘I won’t be able to cope with that.’ ‘So what?’ ‘Then I’ll go mad.’ ‘Oh yes?’ ‘That is a disaster.’ ‘So what?’ ‘Then I will take stop worrying.indd 180

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to drink.’ ‘What then?’ ‘Then I’ll drink myself to death.’ ‘Oh yes?’ By the time you end up asking these questions you will yourself come to understand that you are loading exaggeration upon

exaggeration. What will your situation probably be in a year’s time?

Perhaps you can then say: ‘Within a year the worst should be over and I may perhaps have the prospect of a new relationship with a nice woman.’ But you can never know anything for sure.

The exercise is intended to help you really examine the

consequences of your anxiety closely. What could go wrong if

everything that you feared became a reality? In the majority of cases the feared future event may have unpleasant consequences

but in the long term even in the most undesirable situations you should be able to see possible options for coping with life in the future and you may also encounter new challenges which could in the end make your life better.

Conclusion

Worrying is a form of self-protection which can fi nd its expression in self-torture. The moral here is that you can protect yourself much better by not worrying excessively. If you don’t succeed in reducing your worrying and you have used all the exercises in this book seriously, then it is time to seek specialist help. Your GP can refer you to a psychologist, psychotherapist or psychiatrist. All these specialists are able to give you additional help to reduce your worrying. Don’t wait too long before seeking professional

help, because if you carry on worrying to the same extent, then you will waste a lot of time, you will not solve your problems and that is often an unpleasant situation to be in. It is common for persistent worriers to be able to solve their problems with worry within six weeks with specialist help. But it can take longer. Our advice is not to wait too long before seeking help.

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More information about worrying

Would you like some more information about worrying? Here are

some sources recommended by the author:

Books

Butler, G. and Hope, T. (2007) Manage your Mind, 2nd edn. Oxford: Oxford University Press.

Leahy, R.L. (2003) Cognitive Therapy Techniques. New York: Guilford Press.

Leahy, R.L. (2006) The Worry Cure. London: Piatkus.

Nolen Hoeksema, S. (2005) The Worry Princess. Archipel.

Tips for those providing specialist help

The exercises in this book are excellent for use at the start of psychotherapy treatment for depressive, burn-out or anxiety

disorders. Clients who feel as though they are being kicked around like a football by their own thoughts and emotions will be able to benefi t very quickly from these exercises. If clients have to wait for a period of time between being referred for help and their

consultation or between their consultation and the start of their treatment, they can in the meantime start to work on their recovery with the help of this book. Previous research concerning people who worry has shown that those who reduce their worrying also

see a reduction in anxiety or depression. Research has not yet

been carried out into whether this applies in equal measure to in-patients and out-patients. In the case of therapy provided within the practice of the author, reductions in depression and anxiety have regularly been noted after active use of these anti-worry

exercises.

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‘This is a wise, practical book full of genuinely useful strategies

for dealing with your worries.’

Dr Stephen Briers, clinical psychologist and broadcaster

‘It's a book which sets realistic goals, has a down-to-earth approach and is

genuinely useful.’

Claudia Hammond, broadcaster, writer and academic psychologist

‘Very simple and very practical.’

Professor Geoff Beattie, University of Manchester and resident Big Brother psychologist

‘This book is a well thought-out combination of cognitive therapy and mindful

techniques. It is a practical book with useful step-by-step exercises. It contains

an excellent analysis of the common causes of worry and methods for

overcoming it.’

Dr Steven Melemis, author of I Want To Change My Life

We all worry about things - some of us even worry about the fact that we are worrying.This practical book will help you to put your fears into perspective and teach you to cope with stressful situations.

Using Cognitive Behavioural Therapy (CBT) exercises to understand the nature and seriousness of your worrying, Kerkhof shows you how to stop the cycle of worrying. By spending 15 minutes, twice a day, you will learn to take control of your repetitive thoughts. By integrating humour into the exercises, Kerkhof encourages you to face and deal with your worries.

Supporting and offering advice to worriers, as well as their family and friends, this book also provides guidance for professionals who work in mental health, especially those who recommend self-help to their clients.

Ad Kerkhof is Professor of Clinical Psychology at the VU University,Amsterdam,The Netherlands. He specializes in worry, depression and suicide. He also has a psychotherapy practice, where he treats clients for persistent forms of worrying, depression and burn-out.

Other contributors: Saida Akhnikh,Anneke Koopman, Maarten van der Linde, Marleen Stam and Elvan Tutkun.

Cover design by René van der Vooren

Adapted for the UK version by Naomi Mitchell

Document Outline

- Half title page

- Title page

- Copyright page

- Contents

- Foreword

- Guidance note

- The Cognitive Behavioural Therapy approach to worrying

- Acknowledgements

- About the Authors

- Part 1 Stop worrying in four weeks

- What is worry?

- What can be done about it?

- At the beginning

- Week 1

- To begin with: how much have you worried over the past week?

- Day 1 The beginning

- Day 2 Distraction

- Day 3 Concentration

- Day 4 Whirling thoughts

- Day 5 Talking about worrying

- Day 6 Relaxation

- Day 7 I must = I want to

- How much have you worried over the past week?

- Week 2

- Day 8 Worrying and writing worries down

- Day 9 Top 3

- Day 10 Positive future

- Day 11 Negative future

- Day 12 Probable future

- Day 13 The next time

- Day 14 Catch thoughts when relaxed

- How much have you worried over the past week?

- A word in the meantime

- Week 3

- Day 15 Writing exercise

- Day 16 Three-scenarios writing exercise

- Day 17 Scoring

- Day 18 Next worry

- Day 19 Not now but later and looking at things differently

- Day 20 Writing

- Day 21 Relaxation

- How much have you worried over the past week?

- Week 4

- Day 22 Three-column exercise

- Day 23 Make a decision

- Day 24 Looking forward

- Day 25 Catch your thoughts

- Day 26 A realistic approach

- Day 27 Free choice

- Day 28 A positive day

- How much have you worried over the past week?

- End of Part 1

- Part 2 Worrying for advanced students

- Favourite worries

- 1 I am not good enough

- 2 Nobody likes me

- 3 I can’t do that

- 4 I won’t be able to cope

- 5 I am stupid

- 6 I don’t know what I want

- 7 I am a failure

- 8 I hope I’m not going mad

- Another exercise for readers in the meantime

- 9 Why am I worrying so much?

- 10 When will this stop?

- 11 But that’s just the way I am

- 12 I must stop thinking like this

- 13 It would be better if I wasn’t here any more/I’m a burden to others

- 14 Life won’t get any better/I have no future/Life has no meaning

- Treatment of obsessive worrying about suicide

- Fixed times to think about suicide

- Worrying in metaphors and with exaggeration

- Worrying as self-protection and self-torture

- Final exercises

- Conclusion

- More information about worrying

- Tips for those providing specialist help

- References

Table of Contents

Half title page

Title page

Copyright page

Contents

Foreword

Guidance note

The Cognitive Behavioural Therapy approach to worrying

Acknowledgements

About the Authors

Part 1 Stop worrying in four weeks

What is worry?

What can be done about it?

At the beginning

Week 1

To begin with: how much have you worried over the past week?

Day 1 The beginning

Day 2 Distraction

Day 3 Concentration

Day 4 Whirling thoughts

Day 5 Talking about worrying

Day 6 Relaxation

Day 7 I must = I want to

How much have you worried over the past week?

Week 2

Day 8 Worrying and writing worries down

Day 9 Top 3

Day 10 Positive future

Day 11 Negative future

Day 12 Probable future

Day 13 The next time

Day 14 Catch thoughts when relaxed

A word in the meantime

Week 3

Day 15 Writing exercise

Day 16 Three-scenarios writing exercise

Day 17 Scoring

Day 18 Next worry

Day 19 Not now but later and looking at things differently

Day 20 Writing

Day 21 Relaxation

Week 4

Day 22 Three-column exercise

Day 23 Make a decision

Day 24 Looking forward

Day 25 Catch your thoughts

Day 26 A realistic approach

Day 27 Free choice

Day 28 A positive day

End of Part 1

Part 2 Worrying for advanced students