Stop Trying to Fix Anxiety by Reducing Uncertainty

“Anxiety is the combination of uncertainty plus our lack of trust in our ability to handle it” 

                  - Becky Kennedy, PhD Clinical Psychologist aka “Dr Becky”

TL:DR Instead of trying to reduce uncertainty or control/fix the emotions of others, cultivate trust in your ability to be present, empathetic and to allow others to have their emotions. Confused? You gotta read on…

You know how sometimes you come across an idea, a concept, a sentence and it just hits you? And then you remember that you KNOW you have heard it/read it/thought it before. Well…here I am again.

So when I heard Dr Becky say the above sentence on a podcast episode I was listening too, I had to stop and write it down, because we need to talk about this.

Where she went next was to say that we often focus on reducing uncertainty; in other words, trying to regain or maintain control of the situation, which is generally not possible. 

Think of this in the context of your anxiety about one of your difficult patients. Do you get to fully control the situation? Of course not. 

Think of this in the context of parenting, or wrestling your pet. Do you get to fully know what will happen before it happens? Of course not.

Friends, is this what you try to do to reduce uncertainty? ✋ Ask me how I know….

Ok then. If we’ve been trying to reduce uncertainty (deep dives into obscure illnesses, getting a new certification so you can “feel confident,” not closing your notes when you don’t know what’s going on) and that’s not working, what should we be doing instead?

Instead, she tells us to focus on the second part, which is cultivating our self-trust and reminding ourselves that we are capable of handling the situation. 🤯

 What does that look like? Here’s a hypothetical situation: We see Ms Jones on our schedule tomorrow, again, for her headaches. And immediately, we are in dread-mode.

Let’s say we’re anxious because Ms Jones is always unhappy, complaining about her daughter, her medication, her visit with “that inept Neurologist you sent me too!” I’m probably anxious because a.) I don’t know what she’ll be upset about this time, b.) I believe that her being upset isn’t ok (and it’s my fault), c.) I think that her being upset means something about me as a physician (trigger the “I’m not good enough” script…). If I’m trying to reduce uncertainty/maintain control, I’m putting a lot of pressure on being able to change her feelings, which will probably lead to me spending more time, overworking, and giving the impression to her and to myself that her happiness is my job. We’re never going to win this one.

What if, instead of the usual, I remind myself “Ms Jones is often really unhappy when she comes in, and that has been hard for me. However, I know that I can handle it. I’ve never not survived her visit. I’m sure she will be upset/disappointed/worried/frustrated that she still has headaches. We’ve talked about it many times before. I’m not responsible for her feelings or her life stressors. I’m responsible for being present, compassionate, and providing medical care.” This is me leaning into my confidence that I can handle the visit with her, and focusing on the parts that I control. Wow.

Let’s stop trying to control the uncontrollable; we don’t control other people’s thoughts, emotions, genetics and habits. Do we have the responsibility to be compassionate, curious, supportive? Yes. Is it our job to assess symptoms, risks, diagnose and offer treatment? Yes. But just like I can’t prevent all of my kid’s tantrums, I can’t prevent my patients from having illness and distress and feelings. So let’s not try.

Instead, believe in your own capability. Believe in your ability to handle other people being upset/worried/frustrated about their health, and to try to help them navigate the medical concerns. Believe in your ability to allow other people to have their feelings, without being responsible for fixing them.

My friends, trust in yourself. Trust in your goodness. Trust in your desire to help. Trust that you will use your knowledge and skills and do the best you can in any situation with what you have.

Want to hear more? Listen to Dr Becky on The Daily Stoic podcast, episode from December 15, 2023, link here. Or catch the YouTube version here.