[2021-10-30] The what-if tree

I came across the analogy of the what-if tree while searching for guidance on dealing with worries related to the illness of a loved one. Clinical psychologist Jade Wu writes in Afraid of a Loved One Dying? How to Keep Yourself Tethered to Now:

The what-if tree has a sturdy trunk with strong roots at the bottom—that’s the present moment. As you climb the what-if tree, with each branching what-if scenario the branches get thinner and your footing gets shakier. At some point, it’s not useful to think that far ahead.

We've all climbed the what-if tree. The more we allow our thoughts to extend into scary possibilities, the higher we climb, and the more vulnerable we feel as the branches get thinner and thinner.

Perhaps we're worrying about a friend who's just learned they have cancer, or a spouse who is dealing with a chronic illness, or a colleague who has lost a loved one, or a child who's making a big life change, such as going off to university, buying a house or moving across the country.

It's understandable that we would be worried in such circumstances, imagining all sorts of what-if scenarios, like different branches extending from a single tree trunk. And if we're already stressed, the worries can be even more intense. "We may be more prone to this type of worry," Wu points out, "if we've experienced an unexpected loss in the past or we're feeling particularly stressed or vulnerable."

So why do we worry? Wu suggests several reasons:
  • Worrying is our brain's way of trying to feel safe and in control.
  • Some of us may believe that worrying helps prevent bad things from happening, consciously or subconsciously telling ourselves: "If I turn this worst-case scenario over in my mind enough times, surely I can head it off, right?"
  • Worrying can give us a feeling that we're doing something proactive, which can distract us from our feelings of fear or sadness.
  • "We may also worry as a way of purposely keeping ourselves in a negative mental state," says Wu. "That way, if the worst really does happen, we’re not taken off guard and we don’t have far to fall."
Wu states that worries are just stories we tell ourselves or merely bits and pieces of dialogue our brain repeats. It’s up to us to decide whether these thoughts represent something true, meaningful or helpful.

Wu acknowledges that it's understandable if frightening thoughts pop into our minds from time to time and that it's okay to turn them over a few times to see whether they're true, meaningful or helpful. We may find that we're reading too much into the situation. She recommends that we ask ourselves: "Are these thoughts based on the facts I have right now ... or are they just thoughts?"

I try to face my health challenges by distinguishing between truths, risks and conjecture. For example, I knew in July 2020 that I had ovarian cancer—it was a hard truth to hear, but there was no point in avoiding that reality. Before my surgery in August 2020, my oncologist discussed the possibility that I would need a bowel dissection and a colostomy—that was a risk that scared me and that I tried to put out of my mind. Worrying that every ache and pain is a sign of cancer recurrence is conjecture—unless a healthcare professional provides evidence that my cancer has recurred, I will believe that I'm okay.

How do we focus on the facts while banishing thoughts based on speculation? Wu advises:

Practice shifting your attention to what’s going on in the here and now, in your body and your surroundings. Name what you can see, hear, feel, and smell in this moment. Follow the rhythm of your breath for a few minutes. This strengthens your mindfulness muscles, making it easier to prevent yourself from going up the what-if tree next time.

Remaining grounded, hugging the sturdy trunk with its strong roots, requires us to be comfortable with the unknown, which can be especially difficult for those of us who came from uncomfortable, unpredictable and uncontrolled circumstances.

Some of us imagine the darkest scenarios by default. We're like the little girl who asks "What if I fall?" But if we're going to go out on a limb and imagine all sorts of negative what-if scenarios, then perhaps we could insist that we also imagine positive what-if scenarios. One branch might lead to cancer recurrence, while another one might lead to cancer remission, and a third might lead to a medical breakthrough.

And while we're out on a branch, worried that we might fall, perhaps we should remember the reply to the little girl's question: "Oh, but darling, What if you fly?"