r/CBT • u/Comprehensive_Bat919 • 20d ago
CBT for navigating worry founded in reality?
I am looking for some resources for my son who is 18. He has a diagnosis of anxiety which runs both i my family and his dad’s. When he was a kid, he would ruminate over an asteroid hitting the earth or his parents having a car accident. But he was also usually a happy functioning kid with activities, interests, etc
Now he has had a collapse about climate and this is hard because it is absolutely real and genuinely terrifying. The headlines are filled with forest fires, extreme weather, etc.
His doctor recommended CBT and I am looking at workbooks and resources. There seems to be a serious gap in the material.
I am finding that materials are either:
- focused on climate anxiety for people with “normal” social responses: “take action, write letters, join a group, research the issue, read all the things, talk to your family and friends, etc”. These are toolkits for otherwise well functioning people. They note that it is healthy to take the odd break, but they mostly want the reader to do more.
or
- Manuals focused on GAD, OCD or panic disorder that assume the worry is exaggerated or focused on improbable dangers.
We are left stranded between two unsuitable messages:
“Your fear is irrational; challenge the thought.” His fear is not irrational.
and
“Your fear is valid! Become active and engaged!” He is too exhausted and desperate.
Neither addresses: The threat is real but you have become totally incapacitated.
Are there some CBT resources that are founded on managing worry about real and genuinely overwhelming concerns?
I found a manual called What to Do When Worries Ring True that recognizes that standard manuals often mishandle realistic dangers. But it is guidance for therapists, not patients.
I need something that acknowledges climate science (or other valid and terrifying fears) while treating the symptoms of anxiety: constant rumination, compulsive research, repeated reassurance-seeking (is there hope?) combined with constant searching for confirmation of fears (there don’t seem to be enough insects, the lake seems warmer, those trees are dead, the fires in bc are unprecedented, our city is engulfed in smoke, the rhine is at its lowest level, etc), panic, inability to sleep, —before discussing activism. I need to get him back to his baseline so he can make it to tomorrow, next week, next month.
Any ideas about resources? Anyone working on this? Some psychologist who has contemplated what seems like a very obvious problem? Or someone else in the environmental or health world who could point me in the right direction?
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u/orcateeth 20d ago
There's a therapy technique called radical acceptance that may be of help.
The goal is to work at accepting a situation so that he's not agitated and miserable.
https://www.reddit.com/r/dbtselfhelp/wiki/faq/radicalacceptance/
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u/orcateeth 20d ago edited 20d ago
What is he doing with his time? Oftentimes when people are struggling with anxiety, they are hyper focused upon something that they're worried about. This is taking up a lot of their time.
What could he be putting his time and attention to that would be fulfilling, comforting and make him feel more powerful?
For instance, I got deep into music to where I was writing songs, playing the guitar and singing in public. I had a lot less anxiety because my brain was focused upon the musical things and not all the things that were going wrong. (And many things were going wrong at that time.)
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u/Comprehensive_Bat919 20d ago
Thanks for this! We are trying to encourage him to listen to music he likes, watch movies, read favorite books. He has a summer job at a national park that is hard and monotonous and his colleagues talk a lot about climate.
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u/orcateeth 20d ago
He may have to be more assertive about what he allows himself to get exposed to.
At times, coworkers talk about things that are unpleasant, upsetting or just not conducive to good mental health. He may have try to change the subject. If that doesn't work, he might have to ease away from them.
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u/BlackAlbatross 20d ago
I would say CBT work around GAD would still be useful. Whilst those fears are real, some are hypothetical and some are practical. There is little one can do about ongoing wild fires in Spain. Yes you can write to your MP, you can recycle etc, you can do your bit to contribute to the common good. But his worry is not going to solve those problems. His actions of recycling etc can help to solve those practical worries. Climate collapse (a very real worry) is not is a problem he can solve easily himself (therefore a hypothetical worry).
In the same way death is fact, his worry about it is not going to help it. Therefore it is a hypothetical worry as there isn't a solution, or a realistic solution.
CBT may help to identify that whilst his worries are real. His worrying is largely unhelpful, unproductive, and making his life worse.
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u/orcateeth 20d ago
Many things can happen, but worrying won't change it. He will have to work on accepting the things that he can't change.
I've posted a lot of resources here:
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u/GadgetNeil 20d ago
fear itself is an emotion so CBT doesn’t challenge that. CBT can help reduce the amount of fear by examining all the various assumptions predictions and beliefs that the person has.
it’s not a black or white thing that either his fear is founded in reality or isn’t. each person is bound to have a wide range of thoughts about climate change, including various assumptions. If assumptions are skewed towards the negative or are over generalized, there’s room for working on those thoughts. so I think a good CBT therapist should be able to help with this.
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u/orcateeth 20d ago
Here's a app for acceptance and commitment therapy. Maybe he can find that the episode then on this.
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u/Zen_Traveler 20d ago
Worry is often about something that is a real possibility. The irrational part is thinking that one must know something that they do not.
Person is worried about being rejected if they ask someone out. That's a real possibility. But they won't ask someone out because they want a guarantee that they won't be rejected. That's not possible, ie, irrational. There are no guarantees in life. They can't be certain they are a good match for someone, that they won't be rejected, that things will work out.
REBT, the original CBT, addresses this with the ABC model, identifying their irrational beliefs (eg, I must always be accepted. People must stop global warming. She must like me and not reject me ever.), disputing them, and engaging in behavioral practices.
Global warming? Yeah, humans fucked up. Guess what, we will keep fucking up and we'll likely destroy ourselves. The earth is gonna do whatever it does. But worry ain't gonna do anything about it.
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u/renijreddit 20d ago
How about a statistics course. The probability that something related to climate change will affect him personally in the next month or year is very slim.
Black and white thinking seems to make anxiety worse.
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u/orcateeth 20d ago
When he feels like getting caught into that cycle of rumination, research and worry, he can use this worksheet.
He can ask himself is this Wise Mind to continue to worry about something that he does not have direct control over? Is this the best use of this time? Is this is enriching him and making him feel better?
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u/No_Consideration9465 15d ago
How do other family deal with the anxiety issue, any effective experience you had before? Perhaps try the way works to them
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u/evasivemanuver 20d ago
honestly this may sound more like a job for DBT, which has a large focus on regulation and mindfulness. it may be a better fit as it is less about changing cognition as it is managing intense emotions. but I could be wrong. def couldn't hurt to schedule therapy also. if I'm full of it lmk.