Individuals with Generalized Anxiety Disorder (GAD) worry frequently and intensely most days, about common life situations (for example, relationships, finances, and routine activities like paying bills, meeting deadlines). Relative to non-anxious people, individuals with GAD tend to have a poorer understanding of their emotions, feel their negative emotions more intensely, and have a lot of difficulty disengaging from their worrying. When people with GAD over-identify with their thoughts and negative emotions, they fuse their experiences of anxiety with those thoughts and emotions; as a result, the thoughts and bad feelings can become triggers for more anxiety. Not surprisingly, people with GAD spend a lot of time trying to avoid their negative thoughts and emotions. Yet, avoidance is ineffective because it maintains worry and anxiety. One way to disrupt this cycle might be through a technique called decentering. Decentering involves observing one’s thoughts and feelings as separate events. The key is to recognize that there is no such thing as a negative or positive thought; instead, people use their beliefs and emotions as a guide to assign meaning to their thoughts. For example, someone with GAD might feel anxious when thinking about a romantic relationship and in turn believe that their relationship is troubled and heading for disaster. However, this is not a helpful interpretation because a negative feeling is not always a signal for something bad to happen. With decentering, one learns that thoughts and emotions are not necessarily reflections of reality. Hence, one does not need to be so drawn into their thoughts and unpleasant feelings. Instead, it is helpful to sit back and notice, without judgement or reaction. Scientists have recently started to investigate whether training the ability to decenter is an effective treatment technique for GAD.
In a study published in 2015, researchers from the University of Massachusetts Boston and Suffolk University analyzed data from 64 individuals diagnosed with GAD who participated in a randomized clinical trial. The researchers investigated the effectiveness of two therapies in relation to decentering. Thirty-one individuals participated in Acceptance-based Behavioural Therapy (ABBT) and 33 individuals participated in Applied Relaxation (AR) therapy. In ABBT, participants identified their negative thoughts and learned to accept and separate the thoughts from their anxiety. In AR, participants engaged in breathing exercises and progressive muscle relaxation. All participants completed weekly, 90-minute therapy sessions for eight-to-sixteen weeks. Every 4 weeks, participants completed questionnaires to assess changes in the tendency to worry and the ability to decenter. A statistical technique was used to determine if changes in decentering affected changes in worry. The results showed that participants in ABBT and AR experienced an increase in decentering across follow-up visits, and that this increase predicted lower worry. That is, participants in both groups were less likely to worry as they learned to separate their thoughts from their negative feelings.
This research suggests that by observing negative thoughts and feelings with less reactivity, individuals with GAD can break the association between thoughts and anxious consequences. This means that in the future, a thought or negative emotion is much less likely to lead to worry and anxiety. This study highlights an important point: regardless of the type of therapy, decentering may be a critical component involved in reducing worry and anxiety. Although more research is needed to confirm the efficacy of decentering for all clients with GAD, the findings seem to suggest that training the ability to decenter is a key ingredient in worry management.