Interview with Alejandro García Alamán: the fear of uncertainty

Fear of uncertainty is one of the most frequent psychological problems in psychotherapy consultations, and can take various forms.

It can, for example, appear as anxiety before going from university to the world of work. Or it can arise just at the moment when a relationship we've been in for years ends, and we feel the need to adapt to totally new solo habits. It is even possible that it facilitates the appearance of diagnosable psychological disorders, such as phobias or OCD.

To better understand what the nature of the fear of uncertainty consists of, we spoke with Alejandro García Alamán, Director of the Barcelona Psychology Center Hylé Psychology Consultation.

Interview with Alejandro García Alamán: the fear of uncertainty

Alejandro has spent many years offering therapy to patients with all kinds of psychological problems, and among these cases anxiety is a very common factor.

The state of tension and alertness generated by not knowing what is going to happen in the short or long term can completely disrupt our well-being, and often not understanding the nature of this fear of uncertainty worsens the things. For this reason, we ask this psychologist a series of questions so that he can contribute

the main keys to understanding this anxiety disorder.

From the point of view of psychology applied to therapy... what is the fear of uncertainty? How can we define it?

Well, from a more clinical perspective, it would enter the field of anxiety disorders, like any overflowing fear. In people who suffer from not knowing what will happen and always put themselves in the worst case, for example, one could speak of a generalized anxiety disorder.

But since it is not easy to identify the origin, as in phobias, it is difficult to put a label on it. And in fact, what we call uncertainty is quite broad: fear of not knowing what to do with one's life, either due to a lack of options, or by excess (the famous existential anxiety that freedom of choice generates), or the fear of what we do not know or what we cannot check.

In practice, how is it different from other forms of fear?

I would say that it differs in that particularity that it is not a fear of something concrete, but rather that it does not have a defined form or object.

Since we don't know what we mean, we fill it in with our own predictions. Which are usually catastrophic, since most people have a strong negative bias, an evolutionary inheritance that sometimes plays tricks on us.

When we don't know what we are going to find, we try to put a face on it, so to speak, and that face is usually our worst concern. At the beginning of the therapy, no one knows what they are afraid of, they only know that they are afraid.

How is it reflected in common experiences in people's lives? Could you put some examples?

Above all, in paralysis or blocks when deciding a course. Someone who doesn't know what he's going to do with his life simply stops. And he is distressed. Also those who see so many options that they do not know which one to choose.

The problem with uncertainty is that it can paralyze us and leave us in a state of helplessness and powerlessness. We all know exactly what we will lose by making a decision, but we can only guess what we will gain.

That's why we have such a hard time deciding questions that we consider crucial, even though they seem like the obvious choice. Then there is the obsessive variant, which is the person who chooses to try to control everything as a solution to living in uncertainty. But that is putting doors on the field, because we cannot foresee any external situation.

Human intelligence is believed to exist as a response to the need to adapt to the changing environment. Taking this into account, couldn't the fear of uncertainty be something natural, which motivates us to adapt to what may come?

Yes, totally. In fact, it is an evolutionary behavior: fear warns you of possible threats and preventing what may happen is a common practice. It prepares us for some eventualities and reassures us to have a plan.

Human beings need regularities, routines that help us order life. It is the first thing we are taught; young children love to watch the same movie dozens of times, because they can predict what will happen and that gives them confidence. There is no more comforting phrase than “I was right”.

But this prevention is usually focused on hypothetical negative events, because it is combined with another evolutionary mechanism, the negativity bias. And of course, it can reach distressing levels.

At what point can it be established that the fear of uncertainty is so intense that it is a reason to go to psychotherapy?

In general, when the person shows very high levels of anxiety, which translate into physiological symptoms (that they have suffered an attack of anxiety, or somatizations due to stress) and high emotional suffering, where fear predominates and also to a certain extent sadness. All accompanied by the typical obsessive thoughts of the point where you think about a subject without finding a solution. This is the time when they usually appear in psychotherapy.

And once in therapy, how does the recovery and improvement process unfold?

At first, the most worrying thing for the person undergoing therapy is the symptomatology, so techniques are worked on to reduce it. But we cannot stay only in this part; In parallel, the context of this anxiety is analyzed, which, being of a more existential type, is difficult to identify.

Normally there are many "I don't know" in the first sessions: I don't know what to do with my life, I don't know what I want, I don't know what could happen, I don't know what I'm afraid of. Here comes a whole part of clarification. Put concrete words to that “I don't know”.

And of course, working to reinforce the control that the person has over their own life; As the sense of capacity and autonomy increases, decisions are made and the recovery process is underway.

Perhaps you could explain to us some techniques used in psychotherapy to treat these cases.

If the physical symptoms cause a lot of discomfort, we use relaxation techniques or mindfulness, we look for routines or calming places, etc. Regarding obsessive ideas, arrest patterns, generation of other possible alternatives and we also analyze the biases and fantasies in the person's beliefs. When you know what your favorite distortions are, you learn to ignore them. Also the acceptance that not everything can be anticipated.

There is an important part of differentiating what are the real responsibilities of the person, what is in her hand and what is not. Here we use various clarifying exercises. Finally, we explore what the person's real desires and needs are – because they are often contaminated by other people's criteria or what is socially accepted - and based on this, and from the particular context, we use decision-making techniques decisions.

To finish… Do you remember any specific case of a patient who has come to Hylé Psicología for this reason for consultation and whose recovery makes you feel especially proud?

Well, there are quite a few, and they are very varied, but above all I really like working with students who are either going to start their studies or are finishing them. These are moments of great anxiety in which you try to guess an impossible future. Who is capable of predicting which studies will have a good job opportunity four years from now, or if they will like it or not?

In any case, I remember the case of a girl who had so much talent and ability to dedicate herself to any activity that she proposed, that she did not know how to decide how to lead her life. Moreover, in very different areas from each other. She came very distressed in a tremendous state of confusion, very influenced by other people's opinions.

In the end, she was able to decide what she really wanted, rule out other options, and commit to a realistic plan. But above all, she learned to trust her own judgment. It is one of the cases that I remember with more affection and pride.