What-if thoughts aren’t necessarily problematic. They become problematic when they’re chronic, and we experience a lack of control, said L. Kevin Chapman, Ph.D. Chapman is a psychologist and associate professor in clinical psychology at the University of Louisville, where he studies and treats anxiety disorders.

What-if thoughts also become problematic when they cause distress or interfere with a person’s ability to function, said Simon A. Rego, PsyD, director of psychology training and the CBT Training Program at Montefiore Medical Center/Albert Einstein College of Medicine in New York.

In his practice Chapman commonly helps clients traverse what-if thoughts. “[They] are among the most pervasive type of thoughts that I encounter…[They’re] endemic to anxiety and worry.”

What-if thoughts come in myriad shapes and sizes. “There are probably as many different what-if thoughts as there are people I’ve seen in my work,” Rego said.

For instance, he said, common what-if cognitions involve the home (“What if I can’t make my mortgage?”); work (“What if I lose my job?”); finances (“What if I can’t pay for daycare?”); relationships (“What if my partner is cheating on me?”); health (“What if that spot on my skin is cancer?”); and the future (“What if I end up alone?”).

Some what-if thoughts also concern anxiety itself. Chapman shared these examples:

  • “What if I have a panic attack in the movie theater?”
  • “What if I get sick and die as a result of touching the dirty countertop?”
  • “What if I lose control while I’m on the interstate?”
  • “What if I pass out in school?”

How do these thoughts develop?

“One theory I like from evolutionary psychology suggests that these what-if thoughts actually are adaptive — as long as they are kept at a certain level,” Rego said.

What-if thoughts can prepare us for potentially threatening or dangerous situations. They may help us focus on a specific action, such as finishing a work report on time, he said.

Chronic what-if thoughts stem from a “learned cognitive style,” which develops over time, Chapman said. Parents may unintentionally model these thoughts in early life, he said. Also, “negative events that occur throughout our lives compel many of us to view personally salient situations as ‘unpredictable and uncontrollable.’”

If your what-if thoughts have become problematic, here are five expert tips on stopping or minimizing the cycle.

1. Record your thoughts.

“[O]bjectively recording one’s thoughts on paper teaches one to have a sense of control rather than being a passive victim,” Chapman said. This also helps you realize the types of what-if thoughts that are running through your head, he said.

2. Take productive action.

When what-if thoughts are swirling in your head, you can feel powerless and helpless. Taking productive action helps. “A productive action is any action that helps make progress on a problem issue,” Rego said.

He shared this example: If your rent is $500 a month, but your income is $400, you’ll probably think many what-ifs about not being able to make your rent or getting evicted.

Taking productive action can include doing something to reduce your rent, such as renegotiating your lease or moving, or boosting your income, such as working more hours or getting another job, he said.

3. Conduct a three-point check.

“We tend to feel anxious and depressed based on past experiences with similar situations or future expectations,” Chapman said. The key is to understand the emotions in the context they’re occurring, which he said is a “gamechanger,” and do a three-point check:

  • What am I thinking?
  • What am I feeling?
  • What am I doing?

“This teaches us how to alter our emotional and behavioral responses based on what we are thinking in the present.”

Chapman gave the following example: A woman becomes anxious while she’s alone in her room. She notices that she’s thinking about not being invited to a party. She’s feeling anxious and lonely and has tension in her muscles. She’s currently biting her nails and pacing.

She realizes that it’s her thoughts about the party that are triggering her anxiety. She addresses these thoughts by revising them: “I don’t have to go to a party to feel worthwhile,” “I was sick when they sent the invites,” or “we are still friends.”

To remind yourself to do this check, carry a card or another cue (such as a bracelet), or keep a reminder on your smartphone, he said.

4. Learn to tolerate anxiety and uncertainty.

According to Rego, experiencing occasional anxiety is normal. Instead of trying to push your anxiety away, he suggested embracing it by practicing mindfulness and acceptance strategies.

Relaxation techniques, such as diaphragmatic breathing and progressive muscle relaxation, also help to bolster your tolerance for anxiety, he added.

5. See a therapist.

If you’re having a hard time navigating what-if thoughts on your own, consider working with a therapist. For instance, Rego suggested finding a therapist who specializes in cognitive behavioral therapy (CBT), “a type of talk therapy that has a great deal of research support.”

Further Reading

Rego suggested the following tools for readers:

  • The apps MoodKit and Mindshift for dealing with problematic thoughts.
  • Things Might Go Terribly Horribly Wrong by Kelly Wilson.
  • The Worry Cure by Robert Leahy.