How Can I Cope With Uncertainty?

By Dr. Amanda Beaman, C.Psych

Life is inherently uncertain. We’ve all had the experience of wishing we had more certainty, especially when we’re trying to make an important decision.  Will the person we marry be the one forever? Will taking a new job help our career path?  Will our kids succeed in life? This desire for certainty is normal, part of what it means to be human.  Let’s face it though, we can’t possibly know for sure what will happen in any area of our life.  When we’re unable to accept that uncertainty is normal it can perpetuate anxiety.

How Does Uncertainty Relate to Anxiety?

Over the years researchers have discovered a common thread among people who experience higher levels of generalized anxiety (the clinical term for excessive worry).  They found that people who worry more tend to have lower levels of tolerance for uncertainty.  Worrying is often an attempt to gain certainty by asking the self a bunch of “what if” questions.  Unfortunately these questions tend to end up at worst case scenarios (E.g. why did my boss book a meeting with me out of the blue?….what if she wants to fire me?).  Because we can’t get answers to some questions, they continue to play on the mind, in a repetitive fashion.  Often there are positive beliefs about worry in the background that fuel it, such as “if I worry, I’ll be more prepared… get perfect certainty… or prevent a problem”.  Positive beliefs such as these perpetuate the illusion that worrying will help. On the contrary, if we spend time thinking about worst-case scenarios, our body responds with feelings of unease, vigilance, and anxiety. This can further reinforce that there is something to be worried about!! And so the cycle continues.

One way that we might try to get certainty (and reduce anxiety) is by engaging in behaviours such as reassurance seeking- this can come in many forms such as checking, seeking information (i.e. googling), talking to people about worries, seeking expert advice (i.e. doctors).  These behaviours may provide short term relief, but over time they erode one’s tolerance for uncertainty and therefore perpetuate anxiety.  For example, seeking reassurance from a partner that “everything will be ok” works in the moment, but is rarely sufficient to relieve anxiety over the long run, as we all know deep down that our partner can’t be 100% certain that everything will be ok.

The Cycle of Worry: An Example

Let’s review an example of a hypothetical client called Jill, to illustrate the concepts described so far.  Jill is a woman with three children who works in finance.  She does double-duty as a working mom, juggling her children’s school and activities’ schedules with her own busy working life.  Jill is very hard-working and productive, however she has a lot of difficulty accepting uncertainty about her health.  When she notices a minor “symptom”, such as a headache or a bloated stomach, she becomes preoccupied with thinking about what is wrong with her and it derails her ability to manage her busy life.  She worries it is a sign of serious illness and wants certainty right away that it isn’t true.  She ends up calling in sick.   She gets caught up in many futile behaviours, attempts to gain certainty that only fuel her anxiety, such as researching the internet, asking her spouse to reassure her, or going to multiple doctors.  Inevitably these “symptoms” turn out to be nothing, and she wonders why her life gets turned upside down when a minor symptom occurs.

Practice Accepting Uncertainty Leads to Less Discomfort With It

What is always surprising to our clients like Jill is just how much uncertainty they are able to tolerate in the rest of their life! In the case of Jill, she works in the financial markets, she doesn’t know from one day to the next what the markets will do, but somehow she accepts this as part of her job, knowing that she will deal with what comes.  She puts her kids on the bus each morning, and accepts not knowing for sure whether they got to school okay.  There are hundreds of other examples like this.  Why can she accept uncertainty in some areas and not others? There may be many reasons, but it often boils down to positive beliefs about worrying.  For example, perhaps when Jill was a child she had a family member who became seriously ill and this led to entrenched beliefs that one needs to be vigilant to their health to prevent catastrophe.  Or maybe she learned from a parent who was afraid of getting ill, who displayed vigilance to minor sensations in the body.  Importantly, Jill (unknowingly) practices accepting uncertainty with other areas of her life everyday whereas she does not do this with her health, she does the opposite.  Jill can’t change past experiences that may have led to positive beliefs about worrying about her health, however she can practice becoming more accepting of uncertainty, which will change her beliefs, behaviours, and therefore her anxiety. This is where CBT comes in.

How Can We Relate to Uncertainty in a Helpful Way?

The CBT approach endeavors to help clients like Jill learn to relate to uncertainty differently.  This wouldn’t mean becoming careless or indifferent to real problems, but rather, learning to have a more balanced way of thinking and behaving when uncertainty arises.

We might help Jill by working on “worst case scenario” thoughts, by having her evaluate the facts that suggest she is not suffering from a serious illness.  When we feel anxious our thinking becomes skewed and we often dismiss facts that challenge our negative ideas.  Taking stock of the facts that support and do not support our fear can be a very useful exercise in reducing anxiety, and preventing behaviours that fuel it.   A CBT therapist would also help Jill practice behaving as if she had the same ability to accept uncertainties about minor ailments as she did about her job or kids.  This may involve practicing new behaviours or letting go of old ones. For example, not googling or calling the doctor right away because of a minor headache or bloating, just as she wouldn’t google traffic accidents or make her kids stay home from school because of not knowing how their bus ride would turn out.  With time, clients such as Jill learn to trust, as they do in other areas of life, that they can accept not knowing for sure whether their health would be ok for some period of time. As we let go of thoughts and behaviours aimed at gaining perfect certainty, our ability to tolerate uncertainty becomes strengthened.  As tolerance increases over time, anxiety dissipates.

Strengthen Your Uncertainty Muscle

It may be helpful to think about the ability to accept uncertainty as a muscle.  When Jill can resist giving into searching the internet about “symptoms”, it will be uncomfortable initially, but doing it is like she just did 10 “push ups” to strengthen her acceptance muscle.  Because her acceptance muscle for uncertainty about her health is weak, it takes time and repetition to strengthen it.  As she strengthens this muscle by not giving into thoughts and behaviours that weaken it (e.g. staying home and googling symptoms), her anxieties begin to reduce.  She is able to learn that worrying and its associated behaviours have no impact on whether worst fears will or won’t come true.  Since strengthening muscles requires repetition, consistency and effort, it is important for her to practice tolerating uncertainty every day.

Questions that can help you get started:

• Are there areas of your life where you have trouble accepting uncertainty? Your relationship? Health? Job? Safety?
• What facts do you have that support and do not support your worst fear?
• Are there behaviours that you do to try to gain certainty?
• How would you behave differently if you accepted uncertainty in this area?

CBT Tip: practice one new acceptance behaviour each day for one week and see how this changes your attitude toward uncertainty and possibly your anxiety.  Start with a small behaviour change, and each week add a more challenging goal.

Stay tuned for more articles with CBT Tips!!