Overcoming Unwanted Intrusive Thoughts: A CBT-Based Guide to Getting Over Frightening, Obsessive, or Disturbing Thoughts

by Sally M. Winston PsyD

Toxic worry, on the other hand, involves trying to solve an issue where the outcome is uncertain or unknowable and there is no good answer to form an action plan. So you start to “solve” the problem once and can’t seem to come up with any good answer. So the worry returns, and then the entire process continues to repeat. It becomes stuck. Toxic worry starts with a what-if and continues in an endless loop of unsatisfactory “solutions.” Attempts to solve the problem in order to reassure yourself fail. Toxic worry can be about ordinary things like friendships, money, and scheduling—or it can be about highly unlikely things like rare illnesses and catastrophic events. What defines toxic worry is not what the worrying is about, but how the worries behave—they get stuck, repeat, escalate, and preoccupy. They don’t subside and take a back seat when no solution can be found. So you are trying to engage in mental problem solving, but all you come up with are other possible negative outcomes (Borkovec et al. 1983). In other words, no matter what False Comfort might say to Worried Voice, no matter how sensible or reassuring or distracting, Worried Voice has something else to come back with that keeps the what-if questions coming. There are three types of toxic worry: single-topic, multi-topic, and meta-worry (worry about worry). Helpful Fact: Toxic worry is not defined by the worry topic, but how the worry thoughts behave.