Psychologists who work with anxious and depressed patients often focus on how people jump to consistently negative conclusions. Sometimes a therapist might promote “the power of positive thinking,” encouraging patients to look at the positives and not be “biased” toward the negative. We tend to think that problems are due to overestimating risk and may try to get our patients to engage in less avoidance and instead pursue activities that could be rewarding. These are good ideas—up to a point—but many of the most serious problems people experience are due to underestimating risk.
Here are some examples of behaviors and problems where people continually underestimate risk:
- Obesity: 32% are overweight, 42% are obese
- Alcohol Misuse: 23% engaged in binge drinking in the past month; 10.2% had alcohol abuse disorder, and 9.7% struggled with drug addiction
- Not taking medication: 75% have difficulty taking their prescribed medication
- Not following up with medical exams: 27% don’t get a colonoscopy
- Driving too fast: 54% admitted speeding in the past month, and among young adults, admitted to being distracted by their cell phone while driving
- Unprotected sex: 39% of adolescent boys do not use a condom
- Overspending: 57% of Americans say they live paycheck to paycheck
These are the consequences of the behavioral problems listed above:
- Obesity: heart disease, stroke, hypertension, metabolic syndrome, cancer
- Alcohol Misuse: 178,000,000 people die every year, from cancer, liver disease, cardiovascular problems, increased risk of depression, and suicide
- Not taking medication: stroke, heart attack, diabetes, death
- Not following up with medical exams: cancer (colorectal, breast, cervical), worsening of any disease, or death
- Driving too fast: accidents, injury to self and others, death, fines, criminal charges, loss of license
- Unprotected sex: HIV, gonorrhea, chlamydia, hepatitis, and unwanted pregnancy
- Overspending: increased debt, failure to save, anxiety, frequent domestic conflict, effects on children, and bankruptcy
Productive Worry
I remember participating in an international convention a few years ago where we discussed worry. I had published a popular book, The Worry Cure, and my fellow panel members were all highly respected academics researching worry. I pointed out that worry can sometimes be productive, at which point almost every one of them challenged me. I suggested that if they were right, worry would be the one emotion that has evolved that was never useful. I argued that worry can be productive if it gets you to anticipate a potential hazard that you can prepare for or avoid. It allows you to consider your options and avoid unnecessary risk. They asked me to give examples. I pointed out certain countries whose debt led to a debt crisis (e.g., Argentina, Greece). Or individuals who can afford insurance but don’t purchase it, or people who spend more than they earn, or people who don’t save for the future. I indicated that architects and engineers who design buildings and bridges need to anticipate danger. They employ stress tests to ensure their structures will not collapse. I also suggested that financial investors will anticipate risk to avoid it or hedge against it, and that banks periodically engage in stress tests to ensure they are not overly exposed. Indeed, when I met a prominent hedge fund investor and told him I wrote a book on worry, he told me that he attributes his success to worry. He was trying to avoid unnecessary risk while balancing his strategy to gain profits. Thinking positively is not the same thing as thinking realistically.
The same is true in our everyday life. Sometimes worry can help us avoid unnecessary risk. It links us to our future self and how we can protect that self from unforced errors. Of course, we want to turn worry into problem-solving and then into a plan, and then start changing our behavior accordingly. It’s not easy, because it sometimes feels good to ignore risk. However, sometimes just feeling good for the moment can lead to feeling miserable in the future.