Uncertainty and Anxiety - Two Sides of the Same Coin

Uncertainty is a part of life.

As Benjamin Franklin once wrote “nothing can be certain, except death and taxes”

Like uncertainty, anxiety is also a part of life. Anxiety is an emotion that evolved to help keep us safe. It can also motivate us to behave in ways that help us achieve important goals, like studying for an exam. Whilst anxiety is normal and helpful in some situations, it can become problematic when experienced in excess.

As a highly specialist clinical psychologist, I have spent thousands of hours working with people suffering from significant difficulties with anxiety. During this work, it has become increasingly apparent to me that people’s ability to tolerate uncertainty is key to understanding the persistence of their anxiety problem. Research supports this idea and has identified a low tolerance for uncertainty as a factor involved in the development and maintenance of some anxiety disorders (Boswell at al., 2013).

So how might having a low tolerance for uncertainty contribute to anxiety problems? In my view, uncertainty and anxiety are like two sides of the same coin. Humans have the capacity to experience a range of emotions of which anxiety is one. Each of our emotions evolved for different reasons and whether we experience an emotion depends on the perceptions we make or how we think about things. Anxiety occurs when we think there could be a chance of, and therefore feel uncertain about, something unwanted happening. In this sense, feeling uncertain can be thought of as a necessary condition for anxiety. People who feel able to tolerate uncertainty may still feel anxious when they feel uncertain about something unwanted happening, but they are much better at bearing these feelings and continuing in life despite them compared to people with a low tolerance for uncertainty. This is important because people with a low tolerance of uncertainty often end up engaging in ways of coping aimed at feeling sure and less anxious about what they fear. This can prove very unhelpful for them over time.

Common behaviours in this respect include avoiding things that cause uncertainty, seeking reassurance from others, overthinking things, researching things over and over, and frequently checking one’s actions. These behaviours sometimes help reduce uncertainty and anxiety, but as it's rarely possible to feel sure about most things in life the effect is usually short-lived. The person then repeats these behaviours to try to feel sure and less anxious again. Because these behaviours require attention and effort, when repeated again and again they can start to significantly interfere in the person’s life and make their anxiety problem worse by increasing their preoccupation with what they fear and preventing them from understanding the validity of certain beliefs at the centre of their anxiety.

The good news is there are things we can do or change to improve our ability to tolerate uncertainty, especially regarding unwanted or feared events. Principles from Cognitive Behaviour Therapy (CBT) can be used to help with this. CBT suggests that our thinking, behaviours, and emotions are all interconnected; change one and the others change too. There are specific changes we can make to our thinking and behaviour to improve our tolerance for uncertainty.

Change your thinking about uncertainty

It is important to be realistic in how we think about things. If our expectations about something are unrealistic, they tend to get broken more often than not and when this happens difficult feelings can become more likely. As uncertainty is a part of life, it could be more helpful to think about it as something that is normal and expected rather than something that should not happen and must be gotten rid of. Be careful not to reason purely from it too. Feelings and emotions help us to understand our situation, however they are also unreliable because they depend in large part on the perceptions we make which may not always be the most accurate. Feeling uncertain does not mean anything bad is going to happen. Coming away from catastrophizing about the future is also important in this regard. Catastrophizing is when we fixate on the worst possible outcome and treat this as the most likely thing to happen. It is a very common but unhelpful way of thinking about the future that people engage in when they feel uncertain and anxious. If you notice yourself reasoning from your uncertainty or catastrophizing, pause and take a moment to consider the facts of the situation and practise treating your thoughts and feelings as just that rather than anything more.

Test and build your confidence in your ability to cope with uncertainty by acting ‘as if’

Changing how we think about uncertainty is important because it can increase our willingness to begin allowing more of it in our lives. If we are more willing to allow uncertainty we are more likely to begin putting ourselves in situations that make us feel uncertain and stop unhelpful ways of coping aimed at getting rid of this feeling. This is important because it is difficult to improve our tolerance of something without exposure to it, but also because it creates opportunities to test key beliefs about the likelihood of unwanted events and our ability to cope with feeling uncertain about this, or even the occurrence of the event itself. In my clinical experience, people with anxiety problems often significantly overestimate the likelihood of unwanted events and doubt their ability to cope with difficult feelings or actual unwanted events. Helping people understand the truth of these beliefs is fundamental to helping them overcome their anxiety problem. Acting ‘as if’ we can tolerate uncertainty is a common strategy in CBT used to this end. It involves deliberately putting yourself in situations that make you feel uncertain and anxious about what you fear, whilst refraining from your usual ways of coping to feel sure and less anxious. Whilst this can feel like a daunting task, it can be done with the help of a friend or therapist and in a graded way where you face situations you are more comfortable with first. As your confidence grows, more difficult situations may feel easier to address. Recording your experiences as you go can also help with this.

Foster motivation by reflecting on and putting what’s most important first

Our values reflect what is most important to us in life. They are often likened to directions on a compass and are different from goals. Unlike goals, you never complete or reach a value and there is always more we can do to move in the direction of our values. Having an awareness of our values and making a concerted effort to live according to them is thought to be beneficial for mental wellbeing. They can also be used to motivate us to change unhelpful ways of coping with uncertainty and practice tolerating rather than avoiding this feeling. If you are not aware of your values, take a moment to consider what’s most important to you, the type of person that you want to be, and what a more meaningful life might look like. Your answers might provide some insight into what your values are. When you understand this better, ask yourself if your current ways of coping with uncertainty move you in the direction of or away from how you want your life to be. If you decide certain ways of coping are not aligned with your values, could it be worth changing them and allowing more certainty in your life to move it in a more meaningful direction?

By Dr Ashley Brewer, Clinical Psychologist at HelloSelf.

References

Boswell, J.F., Thompson-Hollands, J., Farchione, T.J., & Barlow, D.H. (2013). Intolerance of uncertainty: A common factor in the treatment of emotional disorders. Clinical Psychology, 69 (6), 630-645.