Notice and challenge meta-worry: the fear of worry itself

Examine the belief that worry is uncontrollable or will cause harm — the worry about worrying.

Why it works

Meta-cognition about worry predicts GAD severity more robustly than worry content alone. The belief that "I can’t control my worry" and "worrying will damage me" perpetuates the worry cycle independently of what is being worried about. Challenging these meta-beliefs removes a maintenance factor that operates above the level of any specific fear content.

How to do it

1. Notice thoughts about your worry itself: "I can’t stop this," "worrying this much will make me ill."
2. Examine the evidence for these beliefs the same way you would examine any worry: "What actually happened the last time I worried intensely?"
3. Test the belief that worry is uncontrollable by completing the stimulus-control practice above.

Evidence

Meta-cognitive therapy (Wells) and the meta-cognitive model of GAD have strong observational support for the role of negative meta-beliefs about worry in maintaining GAD, with RCT evidence for meta-cognitive interventions targeting them. (rct)

Meta-cognitive therapy is a related but distinct approach from Borkovec's worry exposure; this practice draws on both traditions and reflects their overlap in targeting meta-worry.

Sources

• Wells & Carter (1999), preliminary tests of a cognitive model of generalized anxiety disorder, Behaviour Research and Therapy

Common mistake

Treating meta-worries (about worry) with the same avoidance as object-level worries, which allows them to operate silently as hidden maintenance drivers.