154 ASSESSMENT AND INTERVENTION STRATEGIES
your supervisors’ office and were thinking that you were “so pathetic” (using your
expression).Jo h n: I find I worry a lot about how I come across to other people and the negative
effects of my “bumbling” conversations with others.
Th e r a p i sT: John, in this situation did you notice any changes in your anxiety level while
you were worrying before or after the interaction with your boss?
Jo h n: Not sure what you mean.
Th e r a p i sT: Did you notice any increases or decreases in your anxious feelings while you
were worrying?
Jo h n: Oh, I definitely felt more anxious. Before the interaction I tried to convince myself
everything would be okay but all I could think about was his anger, and afterward I
again tried to reassure myself that everything would be fine but the more I thought
about it the more convinced I became that he thinks I’m incompetent.
Th e r a p i sT: So one of the negative effects of worry is that it makes you more anxious
rather than less anxious. Do you think worrying about talking to your boss made
you more effective when you actually went and asked him the question?
Jo h n: No, I don’t think worrying about it gave me more confidence or improved the
conversation. All I could think about was getting it over and dealing with the nega-
tive consequences later.
Th e r a p i sT: You’ve mentioned a couple of other ways that worry may have a negative
effect. It sounds like it makes you think about avoiding or escaping as quickly as
possible. Also it doesn’t sound like worry helps you cope with situations or prob-
lems more effectively. Did you notice anything else about your thinking when you
were worrying?
Jo h n: Not sure what you mean.
Th e r a p i sT: Did you notice whether a lot of upsetting thoughts kept popping into your
mind even though you didn’t want them?
Jo h n: Oh, yes. I kept seeing an image of my supervisor’s angry face, I could hear him
shouting at me, and I kept having the thought “He thinks I’m such an idiot.”
Th e r a p i sT: From your description, John, it sounds like worry has a number of negative
effects on your anxiety. It is associated with an increase in anxious feelings; it may
interfere with your ability to deal with situations; it intensifies the urge to escape or
avoid the anxiety; and it increases unwanted distressing thoughts and images. This
is not unusual in anxiety. Our research on worry indicates that it has far- reaching
negative effects that can contribute to the persistence of anxiety. Would you like to
make worry reduction an important goal in your anxiety treatment plan?
Jo h n: Yeah, I definitely think I need to learn how to get a handle on my worry.
Other Cognitive Coping Strategies
In Chapter 3 (see Hypothesis 10) attempts to deliberately suppress unwanted thoughts
and feelings were considered compensatory coping strategies that may contribute to the
persistence of anxiety. In addition the intentional suppression of emotional expression
may have adverse effects on negative emotion, although far fewer studies have investi-