Uncertainty

Uncertainty is unavoidable in daily life.

Not being able to tolerate uncertainty is a sure path to increased worry and anxiety. Learning how to better accept and cope with uncertainty is possible with practice. Strategies that can help are outlined below.

What is Intolerance of Uncertainty?

“Uncertainty” has been a frequently used and much felt word the past few years. Parents, children, and teens had to manage many unknowns and often experienced a loss of control related to plans for school, work, health, and safety. Having to tolerate or accept what might happen in the future reached a new meaning for many people.

The concept of Intolerance of Uncertainty or “IU” is receiving more attention as it relates to anxiety. In fact, research has found a strong connection between IU and both anxiety and worry in children and adolescents (https://doi.org/10.1016/j.jad.2017.07.035).

Anxiety Canada’s handout How to Tolerate Uncertainty outlines behaviors people do when they have difficulty with uncertainty :

• Seeking excessive reassurance from others
• List-making
• Double checking
• Refusing to delegate tasks to others
• Procrastination/avoidance
• Distraction

How to be more comfortable with “not knowing”

The unknown can be desirable for immediate events like the end to a good book or exciting movie. It can also cause considerable worry and stress when an anticipated outcome could be negative. This can be true for situations we think we have control over and those where we feel that we have absolutely no control. When the possibility of the (highly unlikely) outcome is terrible, it is sometimes difficult to focus on the 99% probability. (This is particularly true if you have experienced a negative life event that is rare). However, because we can very rarely be 100% certain about future events, it is helpful to learn to be okay with some uncertainty, even when a potential outcome would be difficult.

Increasing your ability to tolerate uncertainty can occur the following two ways:

• Changing how you think
• Changing what you do

Change how you think.

Changing how you think about unknown/future possible events is important when thoughts are unhelpful, excessively negative, and unlikely. Cognitive Behavioral Therapy is an approach that helps people understand the connection between thoughts, feelings, and behaviors. Change or modify one to change another. Think different to feel different. Act different to think about yourself or a situation differently.

Catastrophizing is a common “thinking error” or thinking pattern associated with anxiety. This is thinking about or imagining the “worst case scenario” or highly unlikely negative outcome. One good check is to ask yourself: Do I predict bad things when I’m uncertain?

Try asking and answering these questions to challenge persistent worry:

• Anxiety increases when thoughts turn and get stuck on what if? For every What if? come up with three alternative “What else might happen”? reasonable responses.

• Is this worry realistic? What is the probability of what I predict happening? Is this feared outcome likely? If so, can I handle it?

• Imagine and identify What is the Best, Worst and Most Likely outcome? Could good things be just as likely to happen as the anticipated bad?

• What is in my control?

Worry can be helpful when it prompts us to think about and plan. It can provide motivation to take action to try to make sure behaviors are safe or outcomes we want are more likely to happen (studying for a test we want to pass). “By worrying, we are trying to figure out all the possible ways things could go wrong so we can be more certain of the outcome.” (https://www.anxietycanada.com/articles/tool-4-make-uncertainty-your-friend/)

Worry can be an effort to try to reduce feeling of uncertainty and make things more predictable. It is a problem attention to a possible future event or outcome that affects your ability to be present, enjoy or participate in life activities and when there is little control. Identify what you can control and what is outside of your control. If something is in your control, make a plan, and then act on it. When it is not, practice coaching yourself with helpful statement to let go of the worry.

Change what you do.

If you change your behaviors around uncertainty this will help change your feelings and thoughts about it. Act as if you can tolerate uncertainty. See Anxiety Canada’s article on uncertainty for an example of ranking by difficulty behaviors that help manage uncertainty and coming up with a progressively more difficult list of activities that require uncertainty to do. This practice or gradually facing uncertainty without the managing behaviors can increases confidence. Think about the outcome, how you felt, what you did to cope if the outcome was not positive.

Ask yourself the following questions:

• Did things turn out ok even though I was not 100% certain?
• If things did not turn out ok, what happened?
• What did I do to cope with the negative outcome?
• What does this tell me about my ability to cope with negative outcomes in the future?

Practice mindfulness:

Focus on what is happening right now. Not avoiding, but intentionally being aware of the present moment, without judgment. This will increase your ability to handle discomfort of unknown and uncertainty. See How Mindfulness Can Help.

As hard as it is, learning to be able to accept some uncertainty in life is important for reducing excessive worry and managing anxiety. It starts with acknowledging this tendency and increasing awareness of what is happening to be able to use the strategies outlined above. If worry or anxiety has become overwhelming and is negatively interfering with your daily life, please reach out to a physician or therapist to find support.

Resources:

• Returning to a new normal 12 tips for handing uncertainty:
  • https://www.anxietycanada.com/articles/returning-to-a-new-normal-12-tips-for-handling-uncertainty/
• How Uncertainty Fuels Anxiety:
  • https://www.theatlantic.com/health/archive/2015/03/how-uncertainty-fuels-anxiety/388066/
• Coping Tips for Uncertain Times:
  • https://health.choc.org/6-coping-tips-for-uncertain-times/