Am I Uncertainty-Intolerant? Part 2: How to Treat Uncertainty-Intolerance

In the part 1 of this blog, we discussed intolerance of uncertainty, and how it presents and works within anxiety. Now let’s discuss how to manage and change this intolerance of uncertainty. 

Chances are that if you identify with being intolerant of uncertainty, that over time you have developed habits in your life that either help you avoid uncertain situations, or strive to achieve as much certainty as possible. But these methods are not effective, since uncertainty is an unavoidable part of life. Awareness and acknowledgement of the problem is not enough to change our relationship with uncertainty; Action is required to truly change those deep-rooted beliefs and thoughts about uncertainty mentioned in part 1. This action is reflected through the Cognitive-Behavioural Therapy technique of Behavioural Experiments, and/or exposures (Hebert & Dugas, 2019).

For example, take the common parenting/coaching technique used on young children who were afraid of getting hit by the ball in baseball, where the parent intentionally throws the ball at the child. Once the child has faced their fear of getting hit with the ball, they have objective evidence that helps them learn: 1) whether the feared outcome was as bad as they anticipated, and 2) whether they could cope with the feared outcome. This is how action helps us gather evidence to re-evaluate our beliefs and assumptions, and form new, more adaptive ones.

If I were tolerant of uncertainty, how would I act?

This question forms the basis of behavioural experiments and exposures directly targeting intolerance of uncertainty. But behavioural experiments are developed in a more intentional and systematic way than unpredictably being hit by a baseball and finding out that it wasn’t that bad afterwards. Behavioural experiments take exposure exercises one step further by not only requiring you to face situations that involve uncertainty (i.e., eating at a new restaurant), but facing uncertain situations in order to test specific beliefs about uncertainty (i.e., “Uncertainty will lead to disappointment and regret.”) (Hebert & Dugas, 2019).

Working with a CBT therapist will help you practice behavioural experiments that are effective and therapeutic, via empirically supported treatment. They will help you identify unhelpful or negative beliefs about uncertainty that drive your intolerance and symptoms of anxiety, develop a list of uncertain situations you either avoid altogether or seek out certainty around, and successfully conduct behavioural experiments or exposures that directly target and challenge your specific beliefs about uncertainty. 

Reference:

 Hebert, E. A., & Dugas, M. J. (2019). Behavioral experiments for intolerance of uncertainty: Challenging the unknown in the treatment of generalized anxiety disorder. Cognitive and Behavioral Practice26(2), 421-436.

Erin Tatarnic, R.P. is a registered psychotherapist at the Centre for Interpersonal Relationships (CFIR). She provides psychotherapy to individual adults experiencing a range of mental health difficulties including anxiety and anxiety-related disorders, obsessive-compulsive concerns, depression, relationship difficulties, and coping with neurodiversity differences. Erin works from a client-centred approach using a cognitive-behavioural framework (CBT), while also integrating therapeutic techniques from emotion-focused therapy (EFT) and mindfulness-based cognitive therapy.

Am I Uncertainty-Intolerant? Part One

Yes, you read that right. Not gluten-, not dairy-, but an Intolerance of Uncertainty, which is a key driver within anxiety (Koerner & Dugas, 2006). When one has a medical allergy, they experience very strong physical reactions when exposed to even a small trace of the substance they’re allergic to. Intolerance of uncertainty is like a psychological allergy, where even a miniscule amount of uncertainty in a situation, creates negative and uncomfortable effects, such as excessive worrying and physical symptoms of anxiety. No matter how unlikely an outcome is, such as being in a plane crash, unless one can achieve 100% certainty of the outcome, it will be worried about. This intolerance of uncertainty can go as far as those with anxiety even preferring a negative outcome to their problem, over an uncertain one (Hello, self-sabotage!). 

So what are some telltale signs that you have an intolerance of uncertainty?

No, not hives, anaphylactic shock, or swelling. Some of the most common ways those with anxiety may act in the face of uncertainty include:

  • Avoiding doing uncertain things altogether
    • Avoiding investing in therapy because it’s uncertain what the outcome will be or how the experience will feel
  • Making up obstacles or excuses to not do things
    •  “I know exercise would be good for me, but what if I end up injuring myself?”
  • Procrastinating
    • Avoiding asking a friend for a favour because you’re uncertain of how they’ll respond
  • Having difficulty delegating tasks or trusting others
    • Doing all the chores yourself because you can’t be certain that your partner will do it “right”
  • Seeking excessive information before making decisions or acting
    • Researching several different options of blenders from several different stores before buying one 
  • Seeking reassurance from others
    • Asking multiple people in your life for advice or reassurance about the same problem, or asking them to decide for you

Intolerance of uncertainty is due to unhelpful beliefs held about uncertainty: That it is dangerous, that we cannot cope with it, and that it must be avoided at all costs (Koerner & Dugas, 2006). However, operating under those beliefs only strengthens the adverse reaction to uncertainty, shrinks your comfort zone, and exhausts you from constantly trying to achieve certainty in a world where it’s impossible to not come across uncertainty in some way or another. Read on for part 2 of how to face uncertainty if you identify as uncertainty-intolerant.

Reference:

 Koerner, N., & Dugas, M. J. (2006). A cognitive model of generalized anxiety disorder: The role of intolerance of uncertainty. Worry and its psychological disorders: Theory, assessment and treatment, 201-216.Erin Tatarnic, R.P. is a registered psychotherapist at the Centre for Interpersonal Relationships (CFIR). She provides psychotherapy to individual adults experiencing a range of mental health difficulties including anxiety and anxiety-related disorders, obsessive-compulsive concerns, depression, relationship difficulties, and coping with neurodiversity differences. Erin works from a client-centred approach using a cognitive-behavioural framework (CBT), while also integrating therapeutic techniques from emotion-focused therapy (EFT) and mindfulness-based cognitive therapy.