Oct. 24, 2024

How well do you cope with uncertainty?

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Cass responds to a listener question about how to live with uncertainty. She discusses the psychological concept of 'Intolerance of Uncertainty', its impact on mental health, particularly anxiety and worry, and explains how worry serves as a mental behaviour that provides an illusion of control but ultimately detracts from present joy. Cass emphasises the importance of understanding the physiological aspects of anxiety and offers practical strategies for managing uncertainty and worry, including mindfulness, breathing techniques, and cognitive tools.Take the IU Scale here: https://www.phenxtoolkit.org/protocols/view/650701Connect with Cass:www.crappytohappypod.comhello@crappytohappypod.com
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Transcript

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This is Crappita Happy and I am your host Castunn.

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I'm a clinical and coaching psychologist. I'm mindfulness meditation teacher

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and of course author of the Crappita Happy books. In

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this show, I bring you conversations with interesting, inspiring, intelligent

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people who are experts in their field and who have

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something of value to share that will help you feel

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less crappy and more happy. Welcome to another solo episode

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of Crappita Happy. I have recently returned from a lovely

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little trip to Portugal with the family, so I apologize.

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I haven't been around for the last couple of weeks.

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Wasn't my intention to be away for so long. I've

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just been busy catching up since I came back from

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my mini break. Portugal was lovely, did rain, just my luck,

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an area of the world that apparently never rains rained

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two out of the five days that we were there,

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but regardless, it was very nice to visit somewhere different

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and just be away with the family. But I am

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back and this week I've got something special. I've had

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a listener send me a voice note sharing a problem

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which you are about to hear, and it is all

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about dealing with uncertainty, which I know is a very

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very common problem. I am about to play that for you,

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but before I do, just a reminder. You are also

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most welcome to send me a voice note. You can

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DM me on Instagram, you can record a voice note

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on your phone and email it to me. I'm always

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happy to hear from you, or as you know, you

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can go to cast done dot com Forward Slash podcast

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and you can just type it if that feels more

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comfortable to you. But for now, let's hear from our listener.

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Hey, Cas, I just wanted to hear your thoughts on

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the topic living with uncertainty. Recently, we've been given news

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that we need to vacate our home. My partner's dealing

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with it fine, he says, Let's just park it right now.

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We don't need to leave until a certain date, which

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is another six months away. There's plenty of time to

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figure it out. Whereas I'm already day one, day two,

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cannot sleep at night, just stressing about that. I need

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to fix it now, otherwise I'm going to feel this,

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I'm going to have sleepless nights and not going to

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be able to, you know, really enjoy the present. Until

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I know what that end result will be. I just, yeah,

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I need help with being able to sit in that

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uncomfortable feeling and or know what to say to myself

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to just get on with the day and be okay

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and not sit in such a yucky feeling and have

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that effect everything that's else that's going on in my life.

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Basically, when I first heard this audio, when I listened

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to that, I thought, Okay, so this sounds to me

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like a really classic case of intolerance of uncertainty. And

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the first time I heard that expression was when I

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was actually doing my masters in clinical psychology and we

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were in clinic under supervision, and I had a client

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who was experiencing really significant worry, like she was worrying

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all day every day about various things. It was really

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debilitating for her. And so what we would do in

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this clinic is we would bring our cases to supervision,

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a group supervision, and we had a supervising psychologist and

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a supervising psychiatrist who would give their feedback on our case.

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We would talk about the formulation, conceptualization, what do we

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think was going on here, what did we think was

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the best treatment. And this woman had worry, which I

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associate with anxiety, and we had whole chapters in our

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textbooks about how to deal with worry and how to

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help people to manage their worry. And I remember at

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the time, the supervising psychiatrist who was in the room.

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He just said, Oh my god, this is just classic

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intolerance of uncertainty. Go and read about intolerance of uncertainty,

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and so I did, and ever since then I can

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spot this a mile away. And the thing is, the

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thing about intolerance of uncertainty is that we all, to

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varying degrees, have trouble tolerating uncertainty or unpredictability, ambiguity, things

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that we can't plan a predict or control, but that

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our level of a tolerance exists on a spectrum. Some

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people have a very high tolerance, a high capacity to

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cope with uncertainty, unpredictability, with not knowing what's going to happen,

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and so they're therefore less likely to be stressed or

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worried about too many things, whereas other people, for various reasons,

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have a really low level of tolerance for uncertainty. So

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these people are more prone to anxiety, even to depression.

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They're more likely to worry and I'll talk about that

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in a minute. But there is now a whole lot

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of research that's been done. This term was kind of

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first put forward in the nineteen nineties. There's now a scale.

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You can actually do a test online to measure your

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level of intolerance for uncertainty. You probably already know within

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yourself around about where you are on that spectrum. I

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think we all do have that understanding of ourself. But

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if you don't, then then go ahead and do the assessment,

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or maybe even just start to think to yourself right now, like, well,

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how do I manage when I can't plan or predict

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or control outcomes or I can't be sure of an outcome,

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or I can't be sure what's going to happen. I

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can't be sure what the outcome is going to be

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in any given situation, and what does that lead me

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to do? So, if you are a person who is

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intolerant of uncertainty, you probably do worry a lot. And

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I want to talk about this particularly because worry is

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a mental behavior. It is a constant being in your

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head thinking about all of the worst case scenarios and

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what could go wrong. We know that we know that

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that's what worry is, but we don't often think about

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what is the function of worry. The function of worry,

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It is a mental behavior, the function of which is

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to give you the illusion of control. It is giving

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you the illusion that you were doing something to mitigate

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potentially bad outcomes or bad things happening. You think in

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your mind that if you worry enough, if you think

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enough about all of the things that could potentially go wrong,

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or all the things that might happen, or all the

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potential outcomes or likelihoods, then you can plan for that,

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and you can be prepared for that, and that gives

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you this false sense of being in control. Therefore, it

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reduces your feeling of uncertainty, which you find really uncomfortable. Now,

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the truth of the matter is that worrying actually never

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solves anything, or worry does, and if you're a person

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who is a chronic warrior, you will know this. All

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worry does is just suck all of the joy that

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is available to you in the present moment by anticipating

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all of these things that may or may not and

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likely will not happen in the future. But that is

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the function of worry, and so it is a mental

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behavior that arises in response to a feeling of uncertainty

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and an inability to be able to sit with that

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uncertainty and to be okay with not knowing. So the

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other part of this, I guess, is that there is

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this tendency to overestimate the likelihood that there is going

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to be a negative outcome or that something bad will happen,

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and that's also associated with anxiety. As we know, anxiety

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is often about overestimating the size of the threat, overestimating

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the likelihood of something bad happening, and underestimating your capacity

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to deal with that if it does happen. So that's

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really important. It's a cognitive distortion, it's a mental distortion.

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Is your brain overestimating the threat or overestimating the probability

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of the threat, underestimating your capacity to be able to

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deal with it, and that gap creates this anxiety. Remember,

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fear is what happens in response to a very real danger,

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something very real in your world that is happening, that

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is frightening. You have a fear response. Anxiety is an

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imagined threat that evokes that fear response in your body.

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The physiological sensation of fear, the fight or flight response, essentially,

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but in relation to something that's not actually happening, that

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you are just imagining is happening or that might happen.

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So intolerance of uncertainty, we know that it is linked

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with as you would imagine, generalized anxiety disorder, things like OCD, panic,

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and as I said, even depression, because it really sucks

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the life out of you. It really impacts your mood.

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If you're a person who is intolerant of uncertainty, some

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of the things that you might do, for example, are

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ask for a lot of people's opinions before you make

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a decision, do a lot of reassurance seeking that you've

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done the right thing or that you're making the right decision.

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You know, always looking for somebody to confirm for you

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that this is the right thing or that you've made

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the right decision. Because you lack the capacity to be

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able to trust in yourself and that feel that worry

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that you have potentially made the wrong decision, the uncertainty,

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feel so uncomfortable that you go looking to create certainty,

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create the illusion of certainty by getting other people's opinions.

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You might do a whole lot of information gathering. You

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might be a researcher. You might research things to within

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an inch of their life. Like you know, you do

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so much research before you make any decision, book a holiday.

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And you know this is not always bad. This is

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some of these behaviors are not necessarily bad in and

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of themselves. You always have to weigh it up against,

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you know, the benefit of doing that versus what it's

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actually costing you in terms of time, energy, mental resources,

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and the impact it's having on your mood. Obviously, it

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might be that you worry a lot about potential negative

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things happening, you know, potential disasters, really impacting your ability

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to just enjoy the day, enjoy the moment because you

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are in your head all the time, off imagining some

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disastrous future and all of these things that may potentially happen. Now,

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the thing about worry is that it can feel really

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justified because some of these things might happen. You know,

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something might go wrong, So it feels like it's rational.

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It feels like it is sensible to consider all of

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these things that might go wrong. That's the tricky thing

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about it. That's how it can really suck you in.

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But what it does is, you know, like I said,

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it's about really being realistic and rational about the level

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of possibility, you know, basing your decisions on probability, not

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just some remote possibility. It's that disproportionate response to a tiny,

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tiny possibility that something might go wrong or something negative

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might happen. In tolerance of uncertainty is also you know,

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this needing to plan and predict and control for outcomes

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and to have kind of iron clad guarantees. It can

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be so debilitating and so restrictive because it can stop

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you from moving forward on anything in life. It can

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stop you making a decision about taking a job, or

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buying a house, or buying a handbag, or choosing dinner.

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You know, if you're a person who can never decide

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what you want off the menu because you're so afraid

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that you're going to choose the wrong thing. You know,

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that's just a tiny, tiny example, but it's that, but

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apply it to you know, some pretty big life decisions

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as well, and it can really keep you stuck because

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you are so afraid of making the wrong decision that

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you don't make any decision at all, and therefore you're

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just spinning your wheels feeling frustrated all the time. Because

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you can never get a guaranteed, iron clad you know,

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be one hundred percent certain that the decision that you

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make is going to be one hundred percent the right

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one and there will be no negative consequences in the

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future for the things that you do. It can lead

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to you questioning everything. You're questioning relationships, questioning the career, questioning,

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you're parenting, questioning all sorts of things in life, just

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second guessing yourself all the time because you really lack

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the capacity to sit in ambiguity, to sit in not

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knowing for certain the outcome of something or the truth

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of a situation, and sometimes you're just not going to know.

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So you understand that when people have a really high,

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sorry a very low tolerance for uncertainty, how this can

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really significantly impact people's lives when it manifests as going

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to check, so, oh, I'm not really certain if I

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turn the iron off, and I'm not comfortable to just

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trust that I probably did, because I do it most

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days when I leave the house. Therefore, I turn my

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car around and drive home and check that I turned

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the iron off. That's OCD you start doing that compulsively, checking,

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rechecking you've locked the doors, checking rechecking, rechecking, rechecking, that

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you've turned the stove off, turn the light off, locked

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the door, put the bins out. I don't know, but

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you know, but particularly with OCD, it's particularly things that

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have a potential for danger, like fire. That's why it's

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often things like hair straighteners, irons, ovens, stovetops, because there's

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this fear that if that is unattended to, that if

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you're wrong on this occasion and that you didn't turn

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it off, that something catastrophic will happen, that you've burned

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the house down. So going back to my caller, I

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know that was quite a long winded kind of tangent,

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but I wanted to really put this in context. This

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is not just a oh God, I don't know where

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I'm going to be living in six months and I'm

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struggling with that, like this impacts many many other areas

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of your life. And I know for sure that my

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caller will relate to this, that she will have this

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experience and other aspects of her life just by the

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nature of what she shared in this voice note, I

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know that this is not an isolated incident for her.

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This will be something that pops up in a lot

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of different areas. So this is why it's really important

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to actually look at this as a broader you know,

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this is not just oh okay, So in this situation,

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how about you apply XYZX strategy in terms of what

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you're going to do in six months when you need

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to find someone to live, and what you can start

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doing now to feel better about that. This is about

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getting to the root of the issue, which is in

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tolerance of uncertainty and looking at well, how do you

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manage that, how do you find ways to be able

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to sit more comfortably with uncertainty, because otherwise we solve

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this problem and it's like a whack a mole, you know,

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it's just going to keep on popping up in all

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different areas of life.

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So what do you do?

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What do you do? It's a tough one, It is

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really tough. But so I think some of the important

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things to remember are that worry is a function of

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the mind. Anxiety lives in the body. So anxiety is

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something that is produced like it's a physiological reaction in

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your body. It's elevated heart rate, it is higher blood pressure,

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sweaty palms, dry mouth, it is a flooding of cortisol

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and adrenaline in your body when you go into that

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fight or flight response. It's a physiological state that you're

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in which is often created by the story that's in

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your mind. But when we're looking to address this, it

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can be helpful to look at these as separate, like

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look at the worry that we need to address, but

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then also look at how do we manage our physiology.

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Remembering also the idea that story follows state. Story, as in,

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the story that you're creating in your mind often is

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a product of your physiological state. So if you have

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a shallow breathe, if you typically live in a slightly elevated,

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aroused kind of state, you've a little hypervigilant all the time,

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You're a little on guard all the time, and that

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tends to be your default state. Then when your body

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is in that state and there's all of your biochemistry

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is aligned with that, like I said, the cortisol, the

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adrenaline's flooding around your body. What that happens is it

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puts your brain. It sends a signal to your brain

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that there is something to be on the lookout for,

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that there is danger, and it will start creating stories

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and looking for things to worry about. So when I

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say worry is a function of the mind, anxiety lives

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in the body. This thing's obviously completely interconnected, and they

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create a self reinforcing kind of loop. But in terms

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of strategies thinking about what potentially might happen in the

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future and feeling out of control, the person who called in,

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the key issue here is that I can't physically do anything.

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I can't go out tomorrow and find a place to live.

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I can't just go out. I can't just give notice now.

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I mean she could, and I suspect that that is

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what she wants to do because she just wants an

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answer right now. I want to know where I'm going

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to be living. I'll leave early if I have to.

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That's what I need to do to get myself back

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into feeling safe and stable and having a sense of

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certainty again. But if that's not possible, then in the

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absence of being able to physically do something, then this

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is why the worry is happening, because that is a

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mental behavior that is taking the place of being able

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to physically do something. But it's giving her the illusion

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that she's doing something, you know, like she's thinking about it,

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ruminating about it all of the time because she just

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feels like she needs to be doing something to alleviate

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this sense of uncertainty and this ambiguity about what the

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future holds. So right now, in this moment, there is

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no problem. Right now, in this moment, she has a

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place to live, and her family has a place to live.

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It can be really difficult, but it's really important to

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try as much as possible to rain our mind back

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in when it's off in the future trying to imagine

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possibilities or to think of solutions, or to take you

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out of the present moment off into the future. To

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try as much as possible to really rain that back

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in and bring your mind back into your body, which

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is always in the present. Your body is always here,

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right here in this present moment. Your body can't be

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anywhere else in another time. So if you bring your

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mind back into your body by concentrating on your feet

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on the floor, pressing into the ground, hands in your lap,

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rub your hands together, you know, bring your attention, your

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awareness into your physical sensations in your body. Take a

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few deep breaths, be in your body in the present.

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That is a great way to just interrupt that pattern

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and to get you backgrounded in the present and just

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remind yourself that in this moment, nothing is wrong. It's

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very power of now Eckattle. If you've ever read that book,

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he talks about this a lot in that book, about

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how whatever you are stressing about, it's likely not happening

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right now. No matter how bad things are right now,

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in this moment, you're quite likely physically safe, and if not,

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then you'll deal with it at the time you need

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to deal with. Whatever you need to deal with, you

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will deal with it in the moment, so you don't

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need to worry about that right now. And it's really simple,

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but it can be really useful just to try to

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remember and remind yourself that right now everything is actually okay.

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The other thing I just mentioned was the breath. I

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said breathe into your body and breathing, as I've discussed

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many times and this show, is a calming response. It

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connects you and it calms down your physiology. So when

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your body is in that sympathetic state, when you're in

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that hyper aroused state, taking some slow, deep breaths and

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calming down your physiology can also be really useful. Remember

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these are all connected, so if you're feeling stressed and anxious,

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you are likely to be elevated. Your physiology is elevated,

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and that's feeding into the stories in your mind. So

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but calming down and coming into that parasympathetic state using

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your breath is the simplest tool. But there are other

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things that you can do to help to put you

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into that more calm and relaxed state being. You know,

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with your kids or pets, if you enjoy your kids

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and pets, not if you desperately need a break from

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them and they're just causing you stress. But walking in nature,

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walking in grass, listening to music that puts you into

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a more positive mood, breathing in essential oils that help

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to connect you to the present moment but also feel calming,

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to your physiology, to your nervous system. Just think about

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all of your senses. What can you listen to, what

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can you smell, what can you taste? Touch? And what

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can you see in your environment that helps you to

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feel more present, connected and positive When it comes to

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managing worry. You know one useful strategy that we learned

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in our clinical training CBT one oh one dear, just

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to postpone worry. Just to tell your mind that you'll

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think about that later. If you find yourself going down

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that path of worrying about a whole lot of things

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causing you to feel stressed, it's causing you to feel anxious,

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and it's impacting your mood, it's impacting your ability just

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to be present, just to enjoy the moment. And sometimes

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just telling yourself, I mean allocating time to worry, allocating

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time to think about that, and almost scheduling it. That way,

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you can tell your brain now is not the time.

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We're going to worry about that later, and it's like

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your brain gets the message, Oh, okay, she's not ignoring me,

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she's not dismissing me. We're is going to deal with

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this later. It's like when you write a to do list,

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you know, writing it to do list is one of

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the things that people do who have an intolerance of uncertainty.

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They're so afraid they're going to forget something that they

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just write lists and lists and lists and lists. So

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therefore you you would know the power of writing a

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list or writing something down and getting out of your

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head but telling your brain, we're going to park this,

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We're going to deal with it later. Then that can

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be really useful. You know, five o'clock this afternoon, five

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from five till five point fifteen, that's when I can

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you know, worry as much as I like about that.

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But you know, when that time does come, if you

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are still feeling compelled to worry about that, if it's

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still feeling very present and feeling like it needs your attention,

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then try to think about how rational it is, like

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