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Change #7 "I must be certain (that there is no risk.)" to "I can tolerate uncertainty."

Most problems with anxiety relate to a fear of uncertainty.

My educated guess is that the brains of about twenty percent of the population have a more difficult time than the average person in tolerating uncertainty regarding risk. This, of course, can put them at a serious disadvantage, since living demands risk. It is no wonder, then, that so many people develop anxiety problems. They worry because their brain is demanding closure on a specific issue. Their mind says, "This is how it must turn out for me to feel secure. And I must feel secure. Do I know for certain it will turn out this way?" It is as though they require a 100% guarantee that they will encounter zero risk. That is simply too much to ask of life. If you intend to go up against one of the most powerful forces of the natural world -- that is, continual change -- you will have a tough time winning. Listen to these expectations of life and you will see what I mean. The person with panic attacks, phobias or social anxieties asks such questions as:

  • "Can I know for certain that I won't have any symptoms?"
  • "Can I know for certain that I won't have to leave?"
  • "Can I know for certain that I won't feel trapped?"
  • "Can I know for certain that this isn't a heart attack?"
  • "Can I know for certain that I won't die on that plane?"
  • "Can I know for certain that I won't cause an embarrassing scene?"
  • "Can I know for certain that people won't stare at me?"
  • "Can I know for certain that I won't have a panic attack?"

If we look at a different anxiety problem -- obsessive-compulsive disorder -- we find the same kinds of questions:

  • "Can I know for certain that this object is clean?"
  • "Can I know for certain that I won't get contaminated if I touch the ground?"
  • "Can I know for certain that my family will be safe?"
  • "Can I know for certain that I didn't run someone over?"
  • "Can I know for certain that I unplugged that iron?"
  • "Can I know for certain that I won't kill my child?"

If it is true that some people's brains cause them to feel a strong yet inappropriate need for certainty, then confronting that problem involves disrupting those demanding thoughts. It involves confronting them consistently and directly everyday to produce the change we want. This is where your new attitude comes in. You must find ways to accept risk and tolerate uncertainty.

Stay with me as I explain how this works, because this stance doesn't seem very attractive at first glance. Whatever outcome you fear, work to find a way to accept that outcome as a possibility. For example, imagine that sometimes when you begin to have panicky symptoms you feel a pain in your chest that runs down one arm. Each time it happens, your first thought is, "This could be a heart attack!" Of course you have had one or more medical evaluations by a specialist. Let's also say that all physicians you consult declare you have a strong heart, take good care of yourself and are not at risk of a heart attack.

Nonetheless, as soon as that pain shoots down your arm, you say, "This time it really could be my heart! How do I know? There's no guarantee that this is only panic. And if it is a heart attack, I need help now!"

Further, let's say that you've been learning to reassure yourself as a way to get some perspective on panic. "Look, guy, you've been to the emergency room twelve times in the last two years. One hundred percent of those visits have been false alarms. You know you suffer from panic attacks, and this is what they feel like, too. Take a few Calming Breaths, relax, wait a few minutes. You'll begin to feel better."

The reassurance lasts all of five seconds. Then you're back in the saddle. "But I don't know. I don't know for certain. If this is a heart attack I could die! Right now! There's always a chance."

It's the same with people's fear of dying on a plane. Commercial flight is the safest mode of transportation we have. On average, about one hundred people die on a plane per year, while 47,000 motorists die on the highways and 8,000 pedestrians die each year. If you are looking for a risk-free environment, don't stay at home; 22,000 people die of accidents a year without even leaving their house!

Even though your odds of dying on a plane are one in 7.5 million, the dialogue goes like this, "There's still a chance I might die. And if I do, that will be the most horrible, terrifying death I can imagine." You reassure, "Planes are safe. You'll be fine. The pilot has gray hair; he has twenty-five years' experience."

"Yes, but how do I know? How can I be certain?"

This is what you do to yourself, in your own unique way. You ask, "how can I be certain someone won't criticize me?", or "how can I be certain I won't have to leave the concert?" You might as well give it up, because you can never satisfy the demand for absolute confidence. No amount of reassurance will ever be enough.

Here, instead, is the attitude to strive for: "I accept the possibility of that (negative event) happening."

For fear of heart attacks: "I accept the possibility that this time could actually be a heart attack. I'm going to respond to it as though it is a panic attack. I accept the risk that I might be wrong."

For fear of dying on a plane: "I accept the possibility that this plane could crash. I'm going to think and feel and act as though this plane is 100% safe. I accept the risk that I might be wrong."

For fear of having to leave an event: "I accept the possibility that I might have to leave the restaurant. I imagine I'd feel embarrassed, but I'm willing to tolerate that now."

By making this decision -- to accept the possibility of a negative outcome -- you circumvent the requirement for absolute certainty of your future comfort and safety. There's always a chance you will have a heart attack, regardless of your health. There's always a chance you could die in a plane crash, regardless of the relative safety of air travel. There's always a chance you will leave the restaurant and become embarrassed.

If you want to lower your chances of panicking and raise your chances of flying comfortably or feeling more at ease at the restaurant, you have work to do. Your job is to lower your risk of problems as much as makes common sense, then accept the remaining risk that is not under your control. You only have two other basic options. You can keep worrying about the risk while you continue with these behaviors. That leads to anxiety and the increased likelihood of panic. Or, you can withdraw from these activities. The world can get by with you never flying again. The world can get by if you never enter another restaurant. There are consequences to these behaviors, of course. (It may take longer to travel to your friends or relatives, and so forth.) But it's your choice.

I encourage you, instead, to practice this idea of accepting uncertainty.

There is an interesting thing about many therapeutic interventions designed to help you control anxiety. Most actually make you more anxious at first. This one -- giving up the requirement for complete confidence in the outcome -- is a good example. For instance, you begin to feel that pain in your chest that shoots down you arm. Now you are saying, "I'm going to apply all my skills as though this is a panic attack. I'm not going to act as though this is a heart attack." Do you think 100% of you is going to agree to this plan? No way! Some part of your mind is still going to feel scared, because, try as you might, some part of you will still be worried about a heart attack..

If worrying, or fearful monitoring, is one of our most common ways to stay in control, then if you practice letting go of your worries, your mind and body will feel out of control. That will make you anxious. This anxiety is the distress of positive experimentation and change. It's a good kind of anxiety. Remember what Goleman said: "A person prevails over anxiety by sacrificing attention." But expect to be uncomfortable at first anyway! Have faith that over time, this anxiety will diminish.

Reading about the next attitude shift will give you a better understanding of the value in accepting uncertainty.