MMN 043: Why Worry? Generalized Anxiety Disorder – with Dave Carbonell

On this episode of the Make a Mental Note podcast, Dave Carbonell, a licensed psychologist, discusses the nature of worry and how people can cope more effectively with this form of anxiety. Give it a listen and find out why this episode is worthy of a mental note!

Dave Carbonell interview (click on Dave’s name to listen to interview)

Mental Notes:

* Generalized Anxiety Disorder (GAD) – people who have a lot of trouble with worry.

* Worry stems from irrationawl thoughts.

* People with GAD spend a lot of time trying to get their irrational thoughts to “behave”/to not be so bothersome, which leads to them withdrawing into their own minds and away from activities and people that are around them.

* They exert a lot of energy thinking about and trying to get rid of irrational thoughts.

* People with GAD do a lot of “what if” thinking and try to argue with these thoughts to shut them off. However, they discover that “the harder I try, the worse it gets.”

* Why do people worry? People are predisposed to worry, but some have a greater sensitivity to it than others. People with GAD probably began with a greater tendency toward worrisome thinking than the average person.

* People with GAD worry about a variety of things – thus the name “Generalized” Anxiety Disorder. The topics about which people worry seem to threaten their integrity – their character, intelligence, physical survival, reputation, etc.

* What is it that sustains anxiety/worry? People try to change their worrisome/irrational thoughts and try to have happy thoughts, but by doing this and arguing with them they are inadvertently maintaining the problem.

* People with GAD vacillate with regard to being very aware of the silliness of their thoughts and being unaware of how or the extent to which they are creating them problems.

* Worries can compound. “If this happens, then this will happen. And if that happens, then this could happen…,” etc., etc.

* Thought stopping and arguing with thoughts is counterproductive with people with chronic anxiety disorders like GAD.

* Acceptance & Commitment Therapy approach to dealing with worry – Working with the thought and treating the worrisome thought as just another symptom of anxiety that’s not to be corrected/eliminated, but to be lived with agreeably will allow the thoughts to have less and less power going forward. Getting the client to treat the worrisome thoughts like a comedian would treat a heckler is the idea.

* People with GAD ascribe some importance and prediction to irrational thoughts and don’t recognize them in the moment as being another way of being nervous – like having sweaty palms. When people are in situations that results in nervousness they don’t look at their sweaty palms and think, “Oh my gosh, I’m going to dehydrate! All of my bodily fluids are going to leave me!” They understand and are reminded that the sweaty palms are an indication that they’re nervous. But when they have a worrisome or anxious thought they tend to treat it as a prediction of something bad that’s going to happen instead of – like the sweaty hands – an indication that they’re simply feeling nervous. The trick is to help clients understand and accept the worrisome/anxious thought as being equivalent to sweaty palms.

* Exposure therapy – Having clients try little experiments can help people with GAD. “Let’s take that thought – ‘What if I go crazy or what if I have a heart attack?’ – and have you repeat it 25 times and I’ll keep track as you do so.” Following the experiment, clients can be asked, “How did the emotional impact of the 25th repetition compare to the emotional impact of the 1st repetition?” Most clients report that it the thought lost its power to bother them.

* Evidence of client improvement includes less preoccupation with worrisome thoughts, increased amount of involvement in the world around them (e.g., hobbies, friends, activities) and better sleep.

* People with GAD oftentimes feel so ashamed about the types of things they worry about and the amount of time they worry that they do not confide in others as to how big of a problem it is and keep it a secret. The more they hide it the more they convince themselves that they’re the only ones with this type of peculiar problem and they continue feeling miserable.

* Word of wisdom to deal with anxiety/improve mental wellness: The “opposites” approach might be helpful: “Since my gut instinct in a moment of high anxiety is usually dead wrong then I should do the opposite of my gut instinct.”

Mental Notes Takeaway:

* Generalized Anxiety Disorder is a chronic condition characterized by excessive worry about events that are very unlikely to happen and that can be made worse by fighting it. A better approach is to learn how to be an observer of worry – similar to how a person might observe – say – dark clouds moving swiftly through the sky during a thunderstorm and accepting that the clouds, rain, thunder and lighting are there – even though the person might not be thrilled about them – but know that all of this bad weather will go away in time and so to just “go with the flow” while it’s happening.

Check It Out:

* Dave Carbonell’s website:

* Dave’s books:

* The Worry Trick (

* Panic Attacks Workbook (



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(615) 403-5227

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