Interview with Alejandro García Alamán: the fear of uncertainty

This expert psychologist in anxiety talks to us about how the fear of not knowing what will happen appears.

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

It can, for example, appear as anxiety about the transition from university to the world of work. Or it may arise just at the moment when a couple relationship in which we have been for years ends, and we feel the need to adapt to totally new habits alone. It may even facilitate the onset of diagnosable psychological disorders, such as phobias or OCD.

To better understand the nature of the fear of uncertainty, we spoke with Alejandro García Alamán, Director of the Barcelona psychology center Hylé Consulta de Psicología.

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 makes things worse. For this reason, we asked this psychologist a series of questions to provide him with the main keys to understand 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 point of view, it would fall into the field of anxiety disorders, like any overflowing fear. In people who suffer for not knowing what will happen and always put themselves in the worst case, for example, we could speak of a generalized anxiety disorder.

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

In practice, how does it differ from other forms of fear?

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

Since we do not know what we are referring to, we fill it with our own predictions. They are usually catastrophic, since most people have a strong negative bias, an evolutionary inheritance that sometimes plays tricks on us.

When we do not know what we are going to find, we try to put a face to it, so to speak, and that face is usually that of our worst concern. At the beginning of the therapy nobody knows what they are afraid of, they only know that they are afraid.

In what way is it embodied in common experiences in people's lives? Could you give some examples?

Above all, in paralysis or blockages when deciding on a course of action. Someone who doesn't know what he will do with his life, simply stops. And becomes distressed. Also those who see so many options that they don't know which one to choose.

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

This is why we have such a hard time deciding issues that we consider crucial, even if 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 gates to the field, because we cannot foresee any external situation.

It is believed that human intelligence exists 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, absolutely. In fact, it is an evolutionary behavior: fear warns you of possible threats and it is a common practice to prevent what might happen. It prepares us for some eventualities and reassures us to have a plan.

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

But this prevention is often 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 seek psychotherapy?

In general, when the person shows very high levels of anxiety, which translate into physiological symptoms (having suffered an anxiety attack, or somatizations due to stress) and a high emotional suffering, where fear and also to some extent sadness predominate. All accompanied by the obsessive thoughts typical of the point at which you turn over an issue without finding a solution. This is the moment when they usually appear in psychotherapy.

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

In the first moment the most worrying thing for the person in therapy is the symptomatology, so we work on techniques to reduce it. But we cannot stay only in this part; in parallel we analyze the context of this anxiety, which, being of a more existential type, is complicated 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 am afraid of. There comes a whole part of clarification. Putting concrete words to that "I don't know".

And of course, working to reinforce the person's control over his or her own life; as the sense of capacity and autonomy increases, decisions are made and the recovery process is on track.

Perhaps you could elaborate on some of the techniques used in psychotherapy to treat these cases.

If the physical symptoms cause a lot of discomfort, we use relaxation or mindfulness techniques, we look for calming routines or places, and so on. As for obsessive ideas, we use patterns of detention, 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 disregard them. Also the acceptance that one cannot anticipate everything.

There is an important part of differentiating what are the real responsibilities of the person, what is in his hand and what is not. Here we use various clarification exercises. Finally, we explore what are the real desires and needs of the person - because they are often contaminated by external criteria or social acceptance - and based on this, and the particular context, we use decision-making techniques.

Finally... 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 very varied, but I especially like to work with students who are either about to start or are finishing their studies. These are moments of great anxiety in which they try to guess an impossible future. Who is able to predict which studies will have a good job opportunity four years from now, or whether they will be liked or not?

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

In the end she managed 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 I remember most fondly and proudly.