Worries are a normal feature of human existence. Whether it is an upcoming presentation or a romantic date, we all have our concerns about the future, and in many cases, this type of worry is actually helpful1. For instance, worrying about that upcoming date may encourage you to buy a new outfit or clean your place of residence, both of which may help you impress your potential partner. In anxiety disorders, though, worrying can be taken to a pathological extreme2. For these individuals, worries are often intrusive and uncontrollable and can produce a significant amount of distress. Consequently, research scientists and clinicians alike are always on the hunt for easily implemented forms of treatment that can help alleviate such worries.
Focusing on the Negative
One aspect of pathological worry that is particularly distressing for sufferers is that these individuals tend to imagine only negative outcomes to future scenarios3. Returning to the romantic date example, an individual with healthy amounts of worry might imagine that their date will think their new outfit is ugly, but they will also imagine that their date might find it attractive and fashionable. In this way, their fear is balanced by a positive possibility. However, an individual with pathological worry will imagine only the negative outcome. In this scenario, the individual can become fixated on the imagined negative outcome and fail to realize that there are positive possibilities as well.
Positive Thoughts as Way to Treat Worry?
Recently, a team of researchers led by Dr. Claire Eagleson of King’s College London wanted to know whether pathological worriers could be trained to imagine positive outcomes to their worries rather than fixate on negative possibilities4. To investigate this question, the researchers recruited individuals with Generalized Anxiety Disorder (GAD) and trained them to respond to worries by imagining positive outcomes to the situations that spurred their fears. Participants were asked to identify a situation they were currently worried about, imagine how that event could have a positive outcome, and record this positive outcome in a journal. A separate group of participants were asked to simply imagine something positive that was completely unrelated to the initial worry and record this positive imagery in their journal. The researchers then sent participants home with these journals so that they could record themselves practicing.
After four weeks, the participants came back into the lab, and they were evaluated to see if their anxiety had improved. The results revealed that, on average, participants reported a significant decrease in their worry and experience of anxiety-related symptoms over the course of the study. They also reported an increase in their feelings of optimism. Intriguingly, the participants who imagined unrelated positive events reported the same improvements in worries and anxiety as well as the same increase in optimism. Thus, this intervention seemed to help even after a very short period of time.
What this Means for Treatment
This study is encouraging in that the simple act of imagining positive events, either related to the initial fear or not, served to counteract the negative effects of worry. These findings suggest that simply redirecting worried thoughts to positive imagery of any kind can lead to improvements in the overall experience of anxiety. Crucially, given that even individuals imagining unrelated positive events saw improvements, this work suggests that it might not be necessary to challenge or change the worries themselves. Instead, the simple act of distracting the mind with a positive image may be sufficient. Though further research is needed, this work opens the door to new avenues of treatments that are easy for individuals to implement in any number of situations.
If you were interested in this article, you might also want to read: What Is Rumination?
1. Davey, G. C. (1993). A comparison of three worry questionnaires. Behaviour research and therapy, 31(1), 51-56.
2. Chelminski, I., & Zimmerman, M. (2003). Pathological worry in depressed and anxious patients. Journal of Anxiety Disorders, 17(5), 533-546.
3. Hirsch, C. R., & Mathews, A. (2012). A cognitive model of pathological worry. Behaviour research and therapy, 50(10), 636-646.
4. Eagleson, C., Hayes, S., Mathews, A., Perman, G., & Hirsch, C. R. (2016). The power of positive thinking: Pathological worry is reduced by thought replacement in Generalized Anxiety Disorder. Behaviour research and therapy, 78, 13-18.
Sam Hunley holds a doctorate in cognitive psychology from Emory University. He pursued his Bachelor's degree in psychology from Furman University and a master's from Emory. Sam's research, alongside Dr. Stella Lourenco, focuses on human perception of the space surrounding the body, exploring the impact of anxiety and phobias on this perception. Together, they contribute to Anxiety.org articles. Post-graduation, Sam became a Presidential Management Fellow.