Cognitive Behavioral Therapy

Summarized using AI

Why we worry about all the wrong things

Hilary Stohs-Krause • November 08, 2022 • Denver, CO

In her talk "Why We Worry About All the Wrong Things," Hilary Stohs-Krause explores the common misconceptions surrounding fear and anxiety in modern humans, addressing how our risk assessment skills often misallocate our worries toward things that are relatively safe while ignoring genuine threats. She begins by discussing the nature of fear, highlighting that humans might be the most fearful species due to our imaginative capabilities that can amplify perceived risks.

Key points discussed include:

- Common Misplaced Fears: Stohs-Krause examines common fears, such as spiders and flying, providing statistics that reveal their relatively low danger compared to activities we engage in daily, like driving. For instance, while spiders kill around seven people annually in the U.S., cows cause 22 fatalities.

- Risk Perception Gap: This concept refers to the disparity between what we worry about and what actually poses a threat. Misplaced fears can lead to emotional and mental energy wastage, poor decision-making, and various health concerns like weakened immune systems and increased anxiety.

- Origins of Fear and Anxiety: Stohs-Krause outlines how fear stems from the brain's amygdala, hippocampus, and prefrontal cortex, emphasizing that fear is an emotional reaction that can sometimes lead to sound decision-making.

- Factors Influencing Risk Overestimation: She identifies several factors, such as lack of personal control and familiarity with danger, that exacerbate our tendency to overestimate risk in certain situations. For instance, people are notably more scared of manmade disasters compared to natural ones, even though the latter can be more damaging.

- Strategies for Reassessing Fears: To combat these misplaced fears, Stohs-Krause suggests reframing our perceptions, recognizing the difference between being scared and recognizing danger, and being prepared for both expected and unexpected challenges. She emphasizes that asking for help and discussing fears can diminish their impact.

- Cognitive Behavioral Tools: The talk also introduces cognitive techniques for reshaping our fears and decision-making processes, including the importance of identifying stressors, recognizing patterns, and re-evaluating decisions based on available information.

In conclusion, Stohs-Krause urges us to accept that perfection can hinder good decision-making, encouraging a perspective that values practical solutions over theoretical ideals. Her insights highlight the necessity for modern individuals to better understand their emotional reactions and to refine their risk assessments in both personal and professional contexts.

Why we worry about all the wrong things
Hilary Stohs-Krause • November 08, 2022 • Denver, CO

Modern humans aren’t great at risk assessment.

We often blithely ignore that which could harm us, and are conversely intimidated by things that are quite safe. This inability to recognize threat has vast implications for many aspects of our lives, including our careers.

In this talk, we’ll explore root causes of fear and anxiety, and discover how we can start to deliberately rewrite our “instincts”. This will allow us to redirect our worry toward what actually matters, and channel it into productive outcomes that make us safer, happier and less stressed, both at work and in our personal lives.

RubyConf 2021

00:00:10.639 Okay, I'm going to go a little quickly because everyone likes lunch, including me. I have a lot I want to talk about.
00:00:14.799 The slides and presentation will be available afterwards, and I really love talking about this. If there's anything you feel like I went too fast on or didn't quite understand, please come talk to me.
00:00:29.599 So, this is why we worry about all the wrong things. I'm Hilary Stohs-Krause, a senior developer and co-owner at 10 Forward Consulting in Madison, Wisconsin, which is a Ruby dev shop.
00:00:37.120 I'm a coding bootcamp grad. Any bootcamp graduates here? Random fun fact: I have a Sindarin elvish tattoo, which everyone thinks is Hebrew, proving that no one knows Hebrew as they do not look the same.
00:00:47.360 A couple of quick disclaimers: I'm not a therapist or a scientist. I just find this really interesting and have done a lot of research. There are two books in particular that were really foundational to this talk that I highly recommend.
00:01:10.240 Today, we will talk about some common misplaced fears, the implications of having stress and anxiety in your life, where fear and anxiety come from, and finally, some strategies we can use to adapt and make our lives better.
00:01:30.479 Some neuroscientists claim that humans are the most fearful creatures on the planet because of our ability to learn, think, and create fear in our minds. I view our imagination as one of our greatest assets, but it can also be one of our greatest liabilities.
00:01:50.479 First, we'll look at some common misplaced fears. At this point, if anyone is really not into spiders, I want you to close your eyes, and I will tell you when you can reopen them. Okay?
00:02:10.120 Look at this little cutie. I found a cute one. How many people here feel any kind of fear or anxiety when they think about or encounter a spider? About half the room, which is what I expected.
00:02:25.440 We all know that this fear isn't something we need to focus on in our daily lives. What percentage of the more than 40,000 species of spider do you think are poisonous or venomous? It’s about 0.00003%. That means there are only 12 poisonous species out of 40,000.
00:02:40.000 So, we’re very safe when it comes to spiders. In fact, in the United States, you’re much more likely to be killed by a cow than a spider. I couldn’t find global numbers on how many cows kill people each year, but in the U.S., cows kill an average of 22 people a year, while spiders kill only seven.
00:03:00.239 Now, let’s talk about fear number two, which is flying. Who here experiences anxiety or stress when thinking about getting on a plane? Not as many people as I would have thought.
00:03:19.680 Generally speaking, flying provides a stress response, if not outright anxiety or fear. But flying is super safe. The impetus for this talk was actually a flight I was on that experienced severe turbulence, the kind where you feel like you’re rising out of your seat and pushing against your seatbelt.
00:03:40.560 People around me were terrified, some crying, others praying. Meanwhile, I was just sitting there trying not to giggle because it felt like being on a roller coaster. I knew that airplanes are super safe, and I just thought it was fun. But everyone looked at me like I was losing my mind.
00:04:06.639 Statistics show that the odds of a flight worldwide resulting in a fatal incident are one in 3.7 million. You could take a flight every day for 241 years before getting into a crash. In the U.S., between February 2009 and February 2019, commercial airlines recorded zero fatalities.
00:04:36.800 Still, we often feel more fear when flying than when walking on the sidewalk, getting in a car, or hopping on a bike. In reality, 1.35 million people die on roadways globally every year, which is about half the estimated number of COVID deaths in 2020—this is every single year.
00:05:03.760 Your chances of dying in a vehicle in the U.S. are one in 107, so, you might be thinking, 'Great, now I'm afraid of cars and cows awesome.' But really, who cares if spiders make me squeamish or if I get nervous on flights?
00:05:36.640 There are harmful impacts of these misplaced fears. I don't call them irrational, as that term is often thrown around. The mechanisms by which we experience fear have very sound logic behind them.
00:06:02.880 One implication is the risk perception gap, which is the difference between what we're spending time worrying about and what actually poses a threat. This leads to wasted emotional, mental, and physical energy and blindsides us from real threats.
00:06:28.480 Misplaced fears also lead to poor decision-making and multiple health concerns, such as a weakened immune system, damage to our hearts, ulcers, decreased fertility, accelerated aging, and premature death.
00:06:55.040 Stress and anxiety also impair the formation of long-term memories, so now you might be feeling anxiety about having anxiety right. Additionally, we often self-select out of opportunities when we don't feel we can make good decisions due to anxiety.
00:07:22.959 When we are in a place of anxiety, we can hold back our teams or self-sabotage. Long-term stress and anxiety impact our ability to act ethically because we become narrowly focused on ourselves.
00:07:50.000 The tension between perfection and completion can also hold us back; we might obsess over 'what ifs' that prevent us from finishing tasks. So, where does anxiety even come from?
00:08:14.560 The process in our brains starts with the amygdala, where we process emotions. Fear is an emotional reaction first and foremost. The amygdala also initiates our physical response to threats; it releases stress hormones, firing up our sympathetic nervous system.
00:08:31.600 Even when we realize something isn’t dangerous, we can have a physical reaction. For example, if we’re walking down the street and someone turns the corner too quickly, we may sweat or increase our heart rate.
00:08:53.200 After that, our brain then references our memory in the hippocampus to contextualize what we find frightening. If we’ve been in an accident before, our brains can trigger a physical reaction when we encounter a similar situation.
00:09:16.160 Finally, the prefrontal cortex processes the complex cognitive behavior and makes decisions based on our fear response. This is our analytical brain at work, which reassures our emotional, reflexive brain.
00:09:42.080 There are three main types of fear: anticipatory fear, biological fear, which is innate, and fear based on lived experiences. For instance, we often develop a fear of something based on a past traumatic event.
00:10:03.200 Additionally, factors can amplify our fears. A professor at the University of Wisconsin-Madison identified three themes in films that people fear most: disturbing visual images, imminent threat, and a lack of control. A lack of control may be one of those innate fears.
00:10:30.639 Other people can also increase our fears. This phenomenon relates to emotional contagion, where we can actually smell fear through sweat and detect when someone is afraid.
00:10:46.080 Moreover, the scarier we feel, the scarier things seem. For example, if you’re watching a documentary on spiders and feel a breeze, you might think a spider is on your neck, but if you’re barbecuing and feel the same breeze, you likely won't think twice.
00:11:07.760 There are specific factors that cause us to overestimate risk. Catastrophic potential, for instance, makes us fear situations that could harm many people rather than just a few. Familiarity plays a significant role as well—if something is unfamiliar, we often associate it with higher risk.
00:11:31.600 This overestimation of risk often happens with man-made problems compared to natural disasters. We are more scared of human-created situations than the world around us. Change in our risk assessment processes is necessary due to these outdated perceptions.
00:12:00.960 For example, evolutionary processes taught us to react instantly to immediate threats, such as potential predators. However, in today's world, we often struggle to evaluate the dangers of abstract threats like climate change.
00:12:27.360 As Sandberg, a computational neuroscientist, points out, modern dangers are incredibly abstract. There’s little immediate benefit to being scared of these threats, unlike the clear survival benefit of fearing a wolf.
00:13:16.480 As such, we might know something could hurt us, but if we don't have an immediate reward from fearing it, we underestimate the risk associated with that situation. To overcome this misfocusing on risk and emotional responses, we can’t blame ourselves for having outsized reactions.
00:13:56.159 When we make decisions that seem sound but lead to bad outcomes, we often reflect on what we did wrong. We are uncomfortable with the impact of luck in our lives, often leading to second-guessing ourselves.
00:14:35.679 In her book, 'Thinking in Bets', the author highlights that the quality of an outcome doesn't equal the quality of a decision. It’s important to reframe what success looks like and focus on what we can control while letting go of what we can’t.
00:15:26.720 To manage our anxiety, we need to work within the limitations of our brains. One effective way to do this is to be prepared. For example, although many expressed concern about natural disasters, only about a quarter have taken action to prepare an emergency kit.
00:16:05.680 This demonstrates that planning doesn’t equate to execution. We should take ownership of what we know and admit what we don’t. In our work lives, we often admit our ignorance, but in personal matters, we can struggle to grant ourselves that same grace.
00:16:47.120 Every decision we make is a prediction, involving both what we know and what we don’t. It’s easy to focus too heavily on one side of that equation. Now, let’s look at some algorithms that might help us with evaluating our thoughts.
00:17:31.840 One method is the optimal stopping rule, which reminds us to wait longer when we have more options available. We often pick too early. The opposite applies when options dwindle—then it’s better to simply choose a decent option than hold out for perfection.
00:18:11.680 The 'Explore-Exploit' concept teaches us to take chances when we have time to explore, while exploiting options when it's beneficial to do so. Similarly, the 'Shift is Better than Perfect' principle encourages choosing an option at random rather than aiming for perfection.
00:18:47.840 The 'Last Recently Used' structure is interesting; items accessed recently are likely to be needed again, similar to how we search through junk drawers for needed items rather than attempting to organize everything immediately.
00:19:16.640 'Constraint Relaxation' is about addressing large problems by breaking them down into manageable chunks. By imagining the perfect solution without constraints, we can map a path towards solutions despite these constraints.
00:19:58.680 Finally, there's 'Information Cascades', where we misinterpret actions as beliefs. We often assume that others know more than us and ignore our doubts based on outward appearances, which can lead to anxiety.
00:20:38.080 Reframing the underlying thought patterns is a crucial strategy in cognitive behavioral therapy. We shift from viewing situations as losses of control to seeing them as growth opportunities.
00:21:06.080 It’s essential to specify what we aim to achieve, identifying specific issues to address. The steps to reshaping those thoughts include identification, awareness of patterns, and reset through practice, which can be difficult but becomes easier over time.
00:21:43.520 Finally, asking for help is crucial when dealing with indecision or anxiety. Sharing fears with others can lessen their weight, provide new perspectives, and help us to think logically instead of emotional.
00:22:21.360 So, remember, perfect is the enemy of good. Accepting solutions that are close enough can help us tackle even the most challenging problems. Thank you for sticking around despite the technical difficulties.
00:23:00.560 I have references available for those interested, but I don't think we have time for questions as everyone wants to go eat, myself included. However, I truly enjoy discussing this topic, so feel free to connect with me through social media or come chat afterward.
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