New book on managing worry, anxiety and fear

Dec 3 2010

Americans' danger detectors are cranked up way too high these days, but we don't have to be held hostage by our anxiety, according to a new book on coping with stress by a Northwestern Medicine psychologist.

The book, by Northwestern's Mark Reinecke, is titled "Little Ways to Keep Calm and Carry On: Twenty Lessons for Managing Worry, Anxiety and Fear." He offers an easy to understand strategy, based on recent psychological research and cognitive behavioral therapy, to reduce anxiety and live a happier, less fretful life.

"We live in an age of anxiety, whether it's economic worries or potential terrorist threats, or how you are going to care for your aging mother," says Reinecke, head of psychology at Northwestern University Feinberg School of Medicine and Northwestern Memorial Hospital. "There are a whole range of things that come at us as a society that make us feel more anxious than at any time in our recent history."

One chapter in his book discusses the realistic assessment of whether a bad thing will happen. "You should prepare for the most likely scenario, not the worst case, because it is statistically very unlikely," advises Reinecke, also professor of psychiatry and behavioral sciences at Feinberg. "You should ask what is the probability of a bad event happening, how will you cope, are you able to protect yourself?"

He suggests whitewater rafting as a metaphor for effective coping. "When you are thrown from the boat, you cover your head, protect what's important and go with the flow," Reinecke says. "You let the current take you to a calm eddy on the side of the river."

Anxiety is a natural and adaptive emotion from an evolutionary perspective. It protects us from perceived threats, he notes. It leads to neurochemical and cognitive changes, which prepare us for fight or flight.

"The problem occurs when the sensitivity of our perceptual threat detector system gets cranked up too high," Reinecke says. "We perceive many things as threats that are really not threats at all."

We tend to overestimate the likelihood of bad things happening and underestimate our ability to cope. "When you do those two things, the estimation of how much danger you are in goes up proportionately," Reinecke says. "We go to the worst-case scenario immediately. We awful-ize."

In the book, Reinecke discusses productive versus unproductive worrying, how to cope with recurring intrusive negative thoughts (which he likens to the flying monkeys in "The Wizard of Oz"), how to control your anxiety, accepting an uncertain future, changing dysfunctional thoughts and strategies to relax. All of these skills can be learned, he notes. They are effective for daily life as well as for dealing with serious illness.

"You don't want to avoid the things you fear; you want to think about how to effectively manage them," Reinecke says. "The more you effectively cope with a situation, the more confidence you have. Then, when a threat arises in the future, you know you can manage it."

Security doesn't reside outside of us, like an insurance policy. Rather, Reinecke says, security resides within us. "No matter the problem life brings us, we know we can manage and cope."

SOURCE Northwestern University Feinberg School of Medicine