4 How to Deal with “What If”

There are several reasons why someone might have the tendency to become anxious in new situations.

One of the primary ones is a self-concept where this person sees him or herself as less competent than others and thus, less able to deal with the unexpected.

A second cause I’d like to focus on here is the habit of doing what is often called negative anticipation, or in more everyday terms, “What-If” thinking.

Behind What If Questions…

This type of thinking is characterized by imagining a host of frightening possibilities.

Having worked for over 20 years with anxiety disorders, it’s common for people who tend to hyperventilate to think, “what if I pass out,” when preparing to go somewhere.

This thought then generates a host of frightening thoughts and images of passing out along with negative consequences that might follow.

When challenging these what if questions, it is important to look at your track record.

How often has this actually happened in the past?

This is often difficult because what if thinking tends to be accompanied by emotional reasoning.

Emotional reasoning is when you use emotions to evaluate the possibility of something happening.

In other words, if it feels like something might happen, a person then thinks that it is likely to happen.

Unfortunately, this feeling is usually being fueled by anxiety and is not based on reality.

When I ask a person who is thinking that they might pass out, “how likely is this?,”

They usually respond that its highly likely.

When I then ask, “how many times have you actually passed out?”

They usually respond, “I’ve never passed out.”

So, based on emotion, it is very likely.

However, based on past experience, it’s very unlikely.

How To Challenge What If Questions In Your Mind

The key point is that “feelings are not facts”.

Sometimes, they come from rational thinking; and sometimes, they come from very distorted and irrational thinking.

You always have to evaluate your feelings with the cognitive or thinking part of your mind.

To summarize, challenging what-if thinking or those what if questions involves four steps:

• First, based on reality, rather than emotional reasoning, how likely is this?
• Second, how bad would it be if this happened?
• Third, what is my plan to prevent this from happening?
• And finally, what is my plan for coping with this if it were to happen?

Let’s continue with the example of a person who is going somewhere and thinks, “I might pass out.”

1. How likely is this? Based on the past, the odds are very low that this will happen because this person has never passed out.

2. How bad would it be? If a person is using emotional reasoning when thinking about this and saying something like, “This would be the worst thing I can think of.”

I usually have them imagine a scale of 1 to 10 with 10 representing having someone you love die or you dying from a wasting disease.

Next, consider that if you passed out due to hyperventilation, which is not very common, you would have time to sit down so you wouldn’t hurt yourself.

You would also regain consciousness fairly quickly as your body readjusted the oxygen and CO₂ levels back to normal.

The main consequence of passing out would be embarrassment.

While embarrassment is unpleasant, it is way down the scale from truly catastrophic things that could happen.

3. What is my plan to prevent this from happening? People often have things they can do to reduce hyperventilation, such as diaphragmatic breathing, having their coping self-statements on a card that they carry, having something to eat, and so on.

4. What would I do if it were to happen? I usually go through the specifics of what a person could do if he or she felt like passing out.

First, you’d want to sit down so you don’t hurt yourself.

Second, you need to have something to say when you’re feeling better in case there are people around such as, “I’m OK, I’ve just been a little weak lately.

Just give me a few minutes and I’ll be fine.”

After thinking through these what-if questions in detail, you then need to compress it into a short coping self-statement you can use to counter them, whenever it comes up.

Often, a person will write this on a card if the thought is a particularly troublesome one.

Here’s an example of what a person wrote for the thought, “I might pass out”:

• I’ve never passed out so it is very unlikely that this will occur – stop your emotional reasoning.
• It would not be the end of the world so stop catastrophizing.
• I know how to do relaxed diaphragmatic breathing and I do better when I chew gum.
• I know what to say and can take care of myself.

You can use this approach for any fearful thought or worry that causes anxiety.

In fact, it is helpful to make a list of the fearful thoughts that you tend to have, and create a card for each one.

This can be especially helpful when embarking on something new.

List the various fear thoughts or what if questions you have.

Then use the above steps to address them.