Sunday, April 19, 2015

Book review: "The Worry Cure" by Robert L Leahy

"You should only worry if you don't have this book" a rave review intones from the cover-thankfully I sorted that out!

"The Worry Cure" is a book aimed at helping the reader address excessive worry and anxiety. Although I am prone to checking things a lot (particularly if I unplugged the iron), I'm not really much of a worrier myself. Nonetheless, I couldn't resist getting a bit of insight into how cognitive therapists such as author Robert L. Leahy help people think their way through anxiety and worry.

The book opens with quite a bit of descriptive exposition that is likely to reflect the worrier's cognitive habits back at them. Leahy gets a few fair digs in at unhelpful advice others often give to people riddled with anxiety, and suggests why these tips might not work. He then has the largesse to include a few questionnaires that help the reader to identify what type of worrier they are. It may at first blush seem a bit needless for the reader to answer such questionnaires for their own insight (instead of informing a new clinician of their worry), but as Leahy notes from experience not everyone has great insight into their own thought processes. (Later on he suggests keeping diaries, a handy way to avoid trying to gain insight to your own past thoughts via memory).

Dr Leahy is not short of ideas of how to think differently about life. Although he proposes seven overall steps to fighting anxiety, some chapters come with very long lists of sub-strategies (20 different ways of turning "failure" into opportunity). It would be good to group them together in order to make more of them easier to remember. I was interested to see that some ideas from mindfulness (e.g. awareness of the present moment) get an outing-although this should come as little surprise given that mindfulness-based CBT is a big thing on campus these days.

Strategies to think differently about sources of worry are liberally peppered with clinical anecdotes. Oftentimes the man makes it look too easy. It's only natural to highlight successful cases to show how things can go right (and encourage optimism in the reader), but I can't help but imagine it is a very drawn-out process with many clients. In fairness, Leahy does allude to this in places, and as he notes himself, worry can persist in people because they feel that worrying helps them in some way. A counter-intuitive example would be that worry can help you to avoid intense emotion-by thinking about many ways things can go wrong and how you might avoid it, you don't have to spend time imagining what the worst outcome might be.

The latter portion of the book is dedicated to specific worries-work worries, relationship worries, health worries etc. Leahy applies his 7-step program to these different areas of life, suggesting a broad applicability. In the section on work anxiety, he does have the social awareness to add a preface on the increase in job insecurity over the past few decades.

Will reading this book solve people's anxiety? Like the typical CBT course, there's more to it than the 8 or so hours you spend in the therapist's company. Entrenched anxiety can take a long time to work through, but if you work through the exercises in this book you are likely to know your worry better, and it should hopefully sound like less of a broken record. (Although it will sound like this if using the exposure techniques!)

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