NYC-Feature Story

Worried Sick
Talking to a therapist helped me learn to deal with my anxiety

By Megan Cohen

I think too much. Not just about really troubling things, but about everything. It takes me 10-15 minutes to figure what to order off a menu, for example. There've been times when I've been up late doing a project and I can't get to sleep because I'm so worried about how I'll feel when the alarm clock wakes me up. I always thought it was a little weird, but I didn't realize how bad my problem was until last year, in 10th grade.

That year, I had two good friends at school-one from 9th grade and a new girl who'd just transferred there in 10th. As I started to get close to the new girl, I became obsessively worried that she'd become closer with my other friend than she was with me, and then they'd exclude me. I was afraid I'd lose two of the people I cared most about.

Sure enough, they did start to bond, probably because they were annoyed at my constant worrying about the issue. Soon they began to hang out without telling me.

Killing My Friendship

Our school lunches became filled with awkward silences in which I felt completely isolated. These silences grew into crushing moments that another friend called "silences of death."

My paranoia didn't stop there. Since I was always thinking about them being such good friends, I began to devalue my other friendships. Sure, my other friendships were fun, but how deep were they? Had we ever cried together? Really delved into our histories? I began to create a mental checklist. Nobody passed.

In the end I was left with the one thing I'd been most afraid of: losing two friends. That's when I realized that my over-thinking was dragging me down. I wanted to know what I could do about my problem. My NYC editor suggested I talk to an expert, so I called Jayme Albin, a cognitive behavioral therapist.

Feeling From Thoughts

I found out that cognitive behavioral therapy is a type of counseling that focuses on how our thinking influences how we feel and what we do. We all have immediate thoughts when we react to a situation, and these thoughts are based on how we see the world-our "core belief system." The way we see things is based mainly on genetics and our past experiences, including how we were raised.

For example, let's say you get a 75 on a test. A reasonable reaction might be, "I didn't study hard enough for this test, but if I study harder for the next one I'll do better." But if you've grown up creating a core belief that, "If things aren't 100% perfect, I'm a failure," your immediate thought when you look at your grade might be, "I'm an idiot and I'll never get into college." That can cause anxiety.

Albin explained that my over-thinking is actually a form of anxiety. Anxiety can be useful in small amounts.

"It helps us focus, study harder, etc. It does serve a purpose," Albin said. "It becomes a problem when it starts interfering with everyday life."

Learning to React Differently

But you can't magically get rid of the core beliefs that cause anxiety. "You can't just say, 'Don't be anxious.' That's not helpful," said Albin.

It's hard to change your core belief system because it's so deeply ingrained in you, but you can change the way you think.

That's where cognitive behavioral therapy comes in, according to Albin. "Cognitive behavioral therapy challenges the automatic thoughts in a given situation," she said. The therapist helps you rethink the situation so that you have a more reasonable reaction to it.

So when you're feeling anxious, you can learn to think your way out of it by telling yourself that the thoughts causing your anxiety are irrational. Then you try to rethink the situation in a more rational way, until eventually that way of thinking just starts coming naturally.

Diary of Worries

Cognitive behavioral therapy usually lasts about 12-18 weeks. By the time you leave therapy you should be so used to thinking yourself through tricky situations that you can sort of act as your own therapist. So, though I'd only met with Albin once and not for the usual 12 weeks, I decided to try just that.

Albin suggested I start by keeping a thought diary for a few weeks. I was supposed to write down every time I was over-thinking or feeling anxious. Then I had to identify and write down the immediate thought that had made me feel that way. If I was feeling worried about my friends being close, maybe my initial thought had been, "They're going to exclude me today." I also had to come up with alternative thoughts to the irrational ones I usually have when I over-think.

If I were in therapy, my therapist and I would then sit down and look at my behavioral pattern. "We'd look to uncover what your tendencies are, like being a perfectionist," said Albin.

Once we saw how I reacted in certain situations, we would talk about how I could've reacted differently. I'd be able to start changing my thoughts and, eventually, my behavior.

'Left or Right?'

For three weeks I wrote in the diary every time I found myself thinking about something too long. In my first entry I wrote, "Today I couldn't even decide what I wanted for lunch, let alone who to eat it with. An everything bagel with butter or a plain bagel with tuna? Or maybe pizza?"

I was frustrated with my indecisiveness, but I didn't use the reasoning process Albin had suggested. It seemed stupid for something as small as picking out lunch. I figured it would take more energy to chart out my thoughts than to just make a decision.

But writing down my thoughts over the three weeks made me realize how often I can't make the most trivial decisions, like whether to turn right or left on a street corner. I started to realize how much energy indecision takes from me. I also started to realize why I over-think sometimes.

A Big Breakthrough

One night about a week into my diary experiment, I "yelled" at a friend online, telling him he ignored me and thought he was superior to me. Even as I was accusing him, I didn't know why I was doing it.

I finally asked myself what I was doing, and realized that I was stressed and worried about another friend of mine. My anger had nothing to do with the person I'd yelled at. I told him to forget about everything I'd said, that I hadn't meant to take it out on him. I wrote in my diary that night, "This feels like a crucial point of progress and something I definitely would've overlooked before."

I've Made My Decision

Now I can tell when I'm about to obsess over a situation and I'm starting to understand why I do it. When I'm upset, I try to block out what's really upsetting me by upsetting myself over something less important.

And I'm still not sure why I over-think decisions like what I want to eat for lunch. Maybe I'm afraid of making the wrong choice and having nobody to blame for it but myself, even if it's just lunch. Now I realize that I just need to let it go and decide.

A couple of weeks ago, my notoriously anxious middle-aged cousin came to visit my family. It's hard to spend time with her because she's always worrying that things that are going just fine will fall apart, like she'll suddenly lose her job one day. She creates an unbearable uneasiness around her. She gave me a glimpse into what I could become if I don't stop this now.

I think I'm getting better already. At least I've decided one thing: I don't like that I over-think. It took me a really long time to figure that out, but I've finally gotten here. Now I just need to notice when I'm doing it, and then rethink the situation more rationally. This is one decision I'll be sure to stick to.

For more information go to: The NYU Child Study Center: www.aboutourkids.org/aboutour/articles/about_anxiety.html

For help with anxiety, contact The Door at 212-941-9090.