Managing ‘What-If’ Worries with DBT Skills: A Guide to Practical Strategies for Everyday Anxiety
Managing ‘What-If’ Worries with DBT Skills: A Guide to Practical Strategies for Everyday Anxiety
“What-if” worries are a common and often exhausting part of life. These hypothetical thoughts revolve around potential negative outcomes, leaving us wondering, “What if I make a mistake?” or “What if something bad happens?” While some level of worry can be helpful for preparing and planning, excessive “what-if” thinking can escalate anxiety, pull us away from the present moment, and leave us feeling overwhelmed. Dialectical Behavior Therapy (DBT) offers a structured approach to help manage these anxieties, equipping individuals with tools to remain present and resilient in the face of hypothetical worries.
For individuals considering a DBT program or working with DBT therapists, here’s an overview of how these skills can be applied to manage “what-if” worries and lead a more grounded life.
“What-if” worries are usually hypothetical, often fueled by a desire to feel prepared or in control of the future. Yet, rather than solving actual problems, they tend to amplify anxiety by focusing on imagined scenarios. Unlike cognitive behavioral therapy (CBT), which centers on recognizing and challenging distorted thinking, DBT takes a unique approach by emphasizing mindfulness, emotion regulation, distress tolerance, and interpersonal effectiveness. Cognitive behavioral therapy vs dialectical behavior therapy differs significantly in this regard; where CBT focuses on the accuracy of thoughts, DBT brings attention back to managing emotions in the present moment—a core necessity when dealing with ongoing, “what-if” worries.
Mindfulness is a central component of dialectical behavior therapy, and it’s instrumental in addressing worry. This practice involves cultivating awareness of the present moment, which helps prevent the mind from wandering to “what-if” scenarios. When anxious thoughts arise, mindfulness techniques, like focusing on one’s breath or observing thoughts without judgment, create a “pause” that allows a person to observe their worries without immediately reacting.
Try It: To manage a “what-if” worry, take a moment to notice and label the thought as a “worry” rather than a reality. Then, practice returning your attention to the present, perhaps by focusing on your senses or your breathing. This can weaken the grip of hypothetical concerns and bring a calming sense of grounding.
DBT’s distress tolerance skills teach individuals how to manage intense emotions without letting them drive unhelpful behaviors. For those with borderline personality disorder and dialectical behavioral therapy needs, distress tolerance skills are invaluable for handling powerful surges of anxiety or impulsivity. This skill set can be particularly effective for “what-if” worries that feel overwhelming and urgent.
Try It: The TIP skill—Temperature, Intense Exercise, Paced Breathing, and Progressive Muscle Relaxation—can help when anxiety spikes. For example, you might try splashing your face with cold water or going for a brisk walk, both of which can decrease the immediate intensity of anxious thoughts and break the cycle of worrying.
By improving emotional regulation, we become less vulnerable to stressors that can trigger “what-if” thinking. DBT teaches us to notice and label our emotions, offering choices in how we respond rather than reacting impulsively.
One effective emotional regulation tool is “opposite action.” When faced with intense anxiety, for example, opposite action would suggest doing something calming or engaging, which counters the drive to ruminate on worries. Through these skills, a person can stabilize emotionally, making it easier to disengage from endless worrying.
Try It: If you’re feeling consumed by worry, consider doing something that fosters a positive or relaxed mood—calling a supportive friend, listening to music, or engaging in a hobby you enjoy.
Interpersonal effectiveness skills in DBT are primarily designed to improve communication in relationships, but they can also be helpful for worries tied to social situations or self-esteem. These skills teach assertiveness and clear communication, helping individuals express their needs and reduce social anxieties.
Try It: If you’re anxious about a social interaction or relationship issue, practice using “DEAR MAN” (Describe, Express, Assert, Reinforce, Mindful, Appear confident, Negotiate) to clarify your needs calmly and effectively. This can help reduce anticipatory “what-if” worries related to how others may respond.
Try It: When you catch yourself worrying, take a moment to identify both emotional and rational aspects of the thought. Then ask, “What would my wise mind say about this?” This practice fosters a grounded response that’s both intuitive and balanced.
Creating a pros and cons list around “what-if” thoughts can help you evaluate whether it’s worth the mental energy to continue worrying.
Try It: List the pros and cons of focusing on a “what-if” thought versus staying grounded in the present. This can make it easier to release thoughts that serve little purpose and redirect focus.
Managing “what-if” worries with DBT is an ongoing journey that combines skill practice, patience, and professional support. By incorporating mindfulness, distress tolerance, emotional regulation, and interpersonal skills into everyday life, individuals can find relief from hypothetical anxieties and cultivate greater peace of mind. Creating a personalized plan to practice these skills regularly can make it easier to turn to them when worries arise.
If you or someone you know is struggling with “what-if” worries or more intensive challenges like borderline personality disorder, working with DBT therapists or exploring a DBT program can offer structured, professional support. Additionally, if you’re considering therapy options, searching “dialectical behavior therapy near me” can be a first step in connecting with specialists trained to help individuals manage anxiety and improve their quality of life.
While DBT skills can be transformative, remember that lasting change often involves the guidance of DBT therapists. These professionals provide the support and expertise needed to make lasting shifts in how you manage worry and anxiety. Seeking support from DBT therapists is a proactive choice that empowers you to cultivate resilience and improve overall well-being.