Cognitive Behavioral Therapy

Summarized using AI

Why we Worry About all the Wrong Things

Hilary Stohs-Krause • April 24, 2020 • Couch Edition (online)

In her talk "Why We Worry About All the Wrong Things," Hilary Stohs-Krause delves into the complex relationship between modern human risk assessment and misplaced fears. She highlights how humans tend to overestimate risks while underestimating the actual dangers around us, causing unnecessary stress and affecting decision-making. Stohs-Krause begins by establishing that fear is a rational emotion but often misplaced, leading to what she refers to as 'misplaced fears.'

Key Points Discussed:
- Common Misplaced Fears:
- Examples include a fear of spiders despite only 12 out of 40,000 species being harmful, and a fear of flying despite low accident rates on commercial flights. In fact, one is more likely to die in a car accident than in an airline crash.

  • Implications of Misplaced Fears:

    • The gap between perceived and actual risk results in wasted emotional and physical energy, hindering effective decision-making and leading to poor health outcomes including stress-related ailments. Stohs-Krause emphasizes that misplaced worries can significantly impact career decisions, where individuals might avoid opportunities due to unfounded anxieties.
  • Origin of Fear and Decision-Making:

    • Fear originates in the brain, specifically in the amygdala that processes emotions. Misplaced fear often leads to an instinctive, reflexive response before the rational part of the brain (the prefrontal cortex) weighs in.
  • Addressing Fear:

    • Stohs-Krause suggests strategies for better risk assessment, such as acknowledging the role of luck in decision outcomes and reframing fear into a tool for growth. She advocates for cognitive-behavioral techniques, highlighting the importance of identifying and understanding personal fears, thereby reframing them into manageable challenges.
  • Social Influence on Fear:

    • Emotional contagion shows that fear can spread among individuals, indicating that being mindful of such influences is crucial for managing one's emotional state.
  • Concrete Strategies for Improvement:

    • Techniques like optimal stopping (knowing when to settle for an option), constraint relaxation (solving complex problems step-by-step), and information cascades (understanding the motivations behind behaviors) are discussed.
  • Reframing Perspectives:

    • Cognitive behavioral therapy principles encourage looking at fear as an opportunity rather than a setback, helping to build resilience against anxiety.

In conclusion, Stohs-Krause encourages the audience to recognize their fears, differentiate them from actual threats, and make informed decisions based on rational assessments rather than gut reactions. She emphasizes that managing fear and anxiety is possible through thoughtful strategies and awareness.

Why we Worry About all the Wrong Things
Hilary Stohs-Krause • April 24, 2020 • Couch Edition (online)

Why we Worry About all the Wrong Things by Hilary Stohs-Krause

"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.

Do you want to be less stressed? Make better decisions? Learn strategies for identifying (and dealing with!) unnecessary worry? Let's explore the root causes of fear and anxiety together, and discover how we can start to deliberately rewrite our instincts."

__________

"Hilary Stohs-Krause is currently based in Madison, WI, where she's co-owner and software developer at Ten Forward Consulting. She came to tech by way of childhood website-building (a ""Buffy the Vampire Slayer"" fansite, to be exact).

She volunteers regularly with several tech and community organizations, and co-runs Madison Women in Tech, a local group with more than 2,000 members. She loves sci-fi/fantasy, board games and bourbon barrel-aged stouts. She tweets at @hilarysk."

RailsConf 2020 CE

00:00:09.110 Today, I'm going to talk about why we worry about all the wrong things. I'm Hilary Stohs-Krause, and I work at a tech shop in Madison, Wisconsin. I graduated from a coding bootcamp, and I have a Cinder in Elvish tattoo for anyone who's a Lord of the Rings fan.
00:00:15.449 Before I dive too deep into the content, I want to note that this talk touches on mental health topics, including anxiety and depression. There will also be some images of common fears. I want to make sure that’s clear right at the beginning. Additionally, I am not a therapist or a scientist; I just find this topic fascinating and have done a lot of research.
00:00:39.570 On that note, I heavily reference two books in this presentation: "Algorithms to Live By: The Computer Science of Human Decisions" and "Thinking in Bets: Making Smarter Decisions When You Don't Have All the Facts." I think this quote aptly summarizes much of what we’ll discuss today: some neuroscientists claim that humans are the most fearful creatures on the planet due to our ability to learn, think, and create fear in our minds.
00:01:03.329 To start, we are going to look at some common misplaced fears. I want to clarify that I don't particularly like the phrase 'irrational fears.' We will discuss this further throughout the presentation, but in reality, being afraid is a rational emotion; it's just often misplaced. For instance, let’s discuss two examples of misplaced fear.
00:01:41.909 First, consider spiders. I wanted to find a picture of a cute spider to avoid traumatizing everyone too early in the presentation, but even with this fuzzy creature, how many of us feel any fear or tension when we encounter or think about spiders? Probably a lot of us, to a greater or lesser degree. However, what percentage of the 40,000 spider species do you think are poisonous or venomous? It’s not very many—only about 12 species can actually cause us legitimate harm.
00:02:09.530 Next, what do you think about how many of those 12 species are found in the United States? Not many! We have this universal distaste for spiders, despite how incredibly unlikely they are to harm us. In fact, you are more likely to be killed by cows than by spiders. Spiders kill, on average, only seven people a year, while cows kill around 20. So this is something to think about.
00:03:07.210 Our second example is flying. Who experiences any fear or anxiety about flying? Many people do. However, only one in 5.4 million flights has any kind of major accident on average. In the last decade, there has been only one commercial airline flight in the U.S. that had at least one fatality—impressive, right? There was a stretch of nine years without a single commercial flight having any fatalities in the United States.
00:03:39.280 In fact, an average passenger could take a flight every single day for 241 years before experiencing an accident with one fatality on board. Mind-blowing, isn’t it? Yet, you’re much more likely to be killed driving to the airport. Over 38,000 people died in car crashes in the U.S. in just 2019, while there was only one flight-related death in the past decade. Your chance of dying in a vehicle accident is one in 103. How many of us feel a similar sense of anxiety about getting into our cars?
00:04:24.100 So, we see these misplaced fears leading to unnecessary anxiety and worry. But why does it matter? It has significant implications for our lives. First, let’s discuss the risk perception gap. This refers to the gap between the things we think could happen and what is actually happening. This gap can be enormous and leads to wasted emotional, mental, and physical energy.
00:05:00.900 If we are worrying about things unnecessarily, we are spending a lot of our cognition and emotion on things that we don’t need to. That’s a waste! It also means we are blindsided by actual threats. If we focus too much on something we think might be a threat, we can miss what is really happening around us. This can lead to poor decision-making. If our choices are based on perceived threats instead of actual ones, we miss a huge part of the puzzle.
00:05:54.450 There are health concerns tied to this as well, such as a weakened immune system, damage to our hearts, ulcers, and decreased fertility—all of which stem from long-term stress and anxiety. These symptoms can accumulate over time, leading to accelerated aging and even premature death. It's also important to recognize that excessive worry can impair the formation of long-term memories. Think about cases where people have experienced deep trauma; they often struggle to recall details or context surrounding the event.
00:06:59.090 There are workplace implications too. Self-selecting out of opportunities can be significant. If there's an open position at your job or a new project looking for volunteers and you're worried about your skills or possible office politics, you might decide, 'No, that’s for someone else.' You might be a great fit, but if we can’t differentiate between real and perceived threats, it becomes really challenging to make accurate decisions.
00:07:28.949 Relatedly, holding back your team might occur if you experience the same fears and concerns. This not only affects you but your entire office. Another interesting aspect is that when we feel stress and anxiety, those emotions can interrupt processes that help us act ethically. When we talk about fight or flight responses, it makes sense. In those moments, our primary concern is survival. Just think about a time when you've had to react quickly, like in a car accident; your heart rate skyrockets, blood pressure rises, and it’s hard to think clearly or make thoughtful decisions.
00:08:29.980 When we fixate on perfection, we often overlook what we can realistically achieve. Instead of feeling confident in our work, we worry that everything has to be perfect. This unnecessary worry can significantly impact our lives. So, what can we do about it? Let's examine the sources of where fear and anxiety come from, which begins in our brains.
00:09:14.800 First, we have the amygdala, which processes our emotions. Fear is predominantly an emotional reaction. The amygdala also initiates our physical reactions by releasing stress hormones and activating our sympathetic nervous system. This is why we can experience sweaty palms or rapid heart rates, even if we later realize there’s no real danger. Following that, we reach the hippocampus, our memory center, which helps contextualize our fears.
00:10:10.720 Have we encountered this fear before? Is it a new experience? This is similar to my earlier point about long-term fear impairing our ability to form memories, since the memory center is linked to our fear response. Finally, after we have this emotional reaction and recall our memories, we reach our prefrontal cortex. This area is responsible for complex cognitive behavior and decision-making, but this happens after all the emotional processes are already engaged.
00:10:58.170 It’s crucial to understand that our default response is to feel fear. Our thinking circuitry then has to reassure the emotional areas that we're actually safe. This discrepancy is vital because many of the decisions we make are rooted in fear rather than solid reasoning. Let's explore the three primary types of fear: anticipatory fear, biological fear, and fear derived from lived experiences.
00:11:38.470 Anticipatory fears are about fearing things that could happen, while biological fears feel instinctual and shared among most individuals. For example, consider the lingering fears some people feel after experiencing a car accident. This fear can last for years. Next, some factors can amplify our fears. Fear is not static—it can fluctuate based on various influences.
00:12:05.700 Professor Joanne Cantor from the University of Wisconsin-Madison studied themes that elicit greater fear. She had participants watch scary movies and recorded their reactions. Three particular themes stood out: disturbing visual images, imminent threats, and a lack of control. The last point was intriguing as I hadn’t considered that factor being as impactful.
00:12:37.980 Moreover, other people can amplify our fears in what's known as emotional contagion or cultural cognition. I came across three studies related to this phenomenon. The first involved participants wearing t-shirts while engaged in active activities, such as running on a treadmill and skydiving. The others were then able to smell those shirts, which increased their anxiety levels significantly, especially for the shirts worn during skydiving. It turns out that others' emotional responses can influence our own.
00:13:12.240 In another study, dental students performed procedures on mannequins while wearing shirts from individuals who had been under stress. They performed significantly worse when wearing the stress-related shirts. This shows how pervasive the influence of others' emotions can be—like how dentists can pick up on their patients' anxieties. The third study involved men wearing t-shirts while watching scary movies and then having women smell those shirts. The women reacted instinctively, showing a fearful expression in response to the scent of fear.
00:14:01.500 We can transmit fear to each other, which is why the environment around us often shapes how we feel. Additionally, if we are already scared, we are prone to become more scared in the face of other stressors. For example, if you're watching a documentary about spiders and touch a loose thread on your sweater, your reaction is heightened compared to if you were watching something benign, like a kitten documentary.
00:14:55.010 If you're flying and feeling nervous when turbulence hits, even with reassurances from the pilot, the feeling of anxiety can still increase. This applies to instances such as being called into your boss's office, which can heighten your anxiety, even if you know you're doing fine—a situation where a little rephrasing of expectations could really help alleviate that discomfort.
00:15:39.100 So, what factors lead us to overestimate risk? We previously discussed the risk perception gap, but there are components contributing to these exaggerations. For example, people are often more fearful after catastrophic events, as seen with heightened anxiety following 9/11 for terrorist attacks instead of chronic issues like lead poisoning, which harms far fewer people per year.
00:16:05.230 Familiarity with risks also plays a role; when something unexpected occurs, we tend to perceive a higher risk level. Knowing about a historical death toll related to an event can elevate fear, especially if the topic has received attention from experts. Additionally, lack of control significantly raises fear; for instance, in the case of a pandemic, people can follow guidelines but still get sick.
00:16:39.909 Moreover, feelings of victim identity can increase fear levels. If a friend, neighbor, or family member suffers, we empathize, making us more conscious of risks. It’s also interesting to note that people perceive man-made threats as more dangerous than natural disasters because we know the cause behind the former. Concrete fears are far easier to recognize than abstract ones.
00:17:21.180 Another factor to consider is that vague rewards do not translate into emotions similar to direct survival scenarios. Fear relating to climate change is abstract; while the threat is real, it does not motivate a response as immediate as a wolf bearing down on its prey. People often redirect their fears toward clear and present dangers rather than more nuanced threats that have become increasingly complex in our society.
00:18:04.210 This gap in our judgment is pertinent, but it highlights that we have strategies to manage it. What can we do to adapt? Here are several tools to help decrease fear and improve risk assessments. First, let’s think about what we should be afraid of. It's okay to have fears; they signify that our brains and bodies are functioning properly. The important point is that we don't have to let fear dictate our decisions.
00:18:50.440 Recognizing how fear impacts us allows us to exert more control over our decisions. Acknowledging that luck plays a role in life can lessen the burden of feeling responsible for every outcome, as we can make the best decisions based on available information, yet outcomes can still vary due to countless unpredictable factors.
00:19:31.489 Additionally, let’s focus on the reflexive versus deliberative mind. We make thousands of decisions daily, often instinctively. In critical situations, it’s essential to rely on reflexive decision-making. Yet, to adapt to our existing brain framework, we must work within its limitations. It’s about recognizing when to utilize that deliberative aspect and counterbalance instinctive reactions.
00:20:12.630 Being prepared is a significant factor, though planning should not be confused with doing. Surveys suggest that while many Americans acknowledge the value of preparedness, only a fraction actually takes action to gather supplies. It’s about ownership over what we know and don’t know.
00:20:53.080 When we train our brains to recognize where anxiety may be overriding our knowledge, we can also accept that gaps in experience exist. Innovations can arise when we understand that taking manageable steps contributes to effective decision-making.
00:21:28.360 Let’s consider algorithms that relate to better decision-making and risk management. These algorithms can streamline decision processes by allowing for optimal stopping, where we learn to identify when something is good enough. In job applications, for instance, hiring managers often avoid selecting the first applicant just because they fit the criteria.
00:22:02.790 Similarly, we should prioritize patience when seeking solutions, as waiting often leads to better outcomes. When we're addressing challenges, we need to know when it’s acceptable to pursue less-than-perfect solutions. For example, if we identify a better than average solution, we should take it even if it isn't 'the best'.
00:22:39.320 Optimize between exploring new options and exploiting something familiar, seeking opportunities that align with our long-term trajectory. Another approach involves allowing ourselves to make random choices, sticking with them until they are no longer effective, which often proves better than chance.
00:23:00.588 As it turns out, keeping some level of messiness—like having junk drawers or piles—can be functional. Not reinventing the wheel each time can lead to efficiency. It’s akin to how libraries organize books; the most desired ones are centrally located because they are sought after the most often.
00:23:35.090 The process of constraint relaxation can also assist problem-solving by dissecting complex issues and adding constraints incrementally back in. This parallels how we might take a large project and break it down into manageable tasks.
00:24:03.960 Information cascades offer another vital avenue for understanding human behavior; they emphasize that examining not just action but the motivations behind them leads to more informed and effective solutions. Recognizing this principle can enhance our approach to user engagement and product design.
00:24:51.340 Another valuable aspect of cognitive behavioral therapy (CBT) relates to reframing problems as opportunities for growth. By shifting perspectives, we can change how we feel about challenges and make them feel less daunting. This adjustment might seem trivial, but research reinforces the impact of language and thought patterns on mental health.
00:25:34.890 Additionally, specificity in our concerns allows us to cultivate control. Instead of allowing general anxiety to overwhelm us, identifying specific, manageable aspects enables clearer actions and reduces our feelings of helplessness. There are four main steps in the CBT process to help cultivate this mindset.
00:26:22.520 Identifying the source of our fear is crucial. Understanding what drives our anxiety helps in addressing it effectively. Once we recognize these triggers, we can begin exploring why we feel this way and evaluating the associated patterns that contribute to our distress.
00:27:13.620 Recognizing and reframing our mental patterns is vital and requires commitment. With sustained effort, we can supplant long-standing behavior patterns with healthier responses over time. This journey allows us to gradually build resilience against anxiety-inducing processes.
00:27:54.030 Additionally, asking for help can be tremendously beneficial. As mentioned earlier, emotional contagion means that positive emotions can also spread. Sharing our fears often lightens the burden and fosters connection, allowing us to gain valuable perspectives from others who have faced similar challenges.
00:28:35.430 Engaging with community helps prevent isolation and shifts thoughts from reactive fear-based responses towards analytical deliberations. Expecting to experience varying emotions alongside cognitive resolutions demonstrates how our social environments shape our response to fears.
00:29:17.760 In conclusion, we are capable of managing the complexity surrounding fear and anxiety. Acknowledging the nuances of how we experience risk allows us to engage with life more fully and authentically. Fortunately, techniques can enable us to recalibrate perceptions, so we can effectively confront fears.
00:30:02.570 I’m grateful to all of you for listening today. If you have any questions or comments, I would love to hear what you think about this topic! I’m on Twitter, and I can also be reached via email. Below, I have provided my citations and slides for anyone who wants to delve deeper into this subject.
00:30:27.410 Thank you, RailsConf, for hosting this virtual conference. I appreciate the effort you put into keeping this event alive and making it accessible for us to connect despite not being physically present.
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