Chapter 13
Secondary Disturbance: Getting Upset About Being Upset

I am always with myself, and it is I who am my tormentor.
--LEO TOLSTOY (1828-1910)

You are offered a million dollars to spend the night in a spooky “haunted” castle. If you’re like most people, you would probably accept this offer with feelings of excited anticipation. You’d correctly rate as close to zero any risk of your experiencing a serious scare, but even if you saw, larger than life, a headless ghost with clanking chains you would very likely think hard about the million dollars and stay put.

But now suppose that, as part of this deal, you are connected to a “fear meter”—an electronic device to measure your heartbeat, perspiration, and other bodily signs of fear. If your level of fear rises above a certain point, as indicated by a needle on the fear meter dial, you lose.

Now, the proposition looks less attractive. If you did accept it, you might start worrying more about what was showing on the fear meter dial than about what the ghosts could do to you. With every creepy creak of a door, your thoughts might instantly turn to the needle on that dial, and you might have the thought, Am I going to lose this bet because I am having a twinge of fear? The knowledge that you could lose the bet because of a high fear reading might cause you to lose the bet. You would be more fearful about your fear than about the ghosts!

Although I have invented a fanciful example to illustrate the point, this is a very common problem of everyday life, a problem called “secondary disturbance.” In fact, the majority of people with emotional problems undergo some kind of secondary disturbance. Yet, it is a problem that most traditional therapists have completely ignored.

An adolescent boy introduced to the girl of his dreams blushes and then feels like a fool because he is blushing. He is embarrassed about being embarrassed.

A busy executive lies awake in bed worrying about deadlines. As he becomes aware that he is not dropping off to sleep, he starts to worry that he is going to be awake all night. This worry then preys on his mind and keeps him awake. He is staying awake because of his fear of staying awake.

A political speech writer who puts herself down at every opportunity, with consequent bouts of depression, begins to think: “What a worthless creep I am; I’m always depressed.” This thought does nothing to cheer her up. She becomes further depressed about being depressed.

Sometimes the secondary disturbance is a different emotion from the primary disturbance. A woman turns down a job because it involves taking a glass elevator to the 30th floor every day, and she experiences fear at the thought of this. She then becomes ashamed of her fear, and potentially depressed about it. She is depressed about her fear of heights.

Notice that such cases are even more unreasonable than the haunted castle example. In that illustration, being afraid could lead to losing a chance of acquiring a million dollars. No such heavy stakes are usually involved in everyday examples of secondary disturbance, but when people observe that they are distraught, they often give themselves a hard time about it. They do this because they place a demand upon themselves. They tell themselves, “I MUST not become distraught. I SHOULD remain cool and in control at all times.”

Fearing Fear Itself

Lynn appeared at my office door, a tall, willowy figure with a bounce in her step, sporting shoulder-length auburn hair. She looked a good ten years younger than her actual age of 43, and wore an infectious smile, highlighted by her large, coal-black sparkling eyes.

Lynn had recently landed a position as managing editor of a national women’s magazine, and with her emerald velvet pants and white trim blouse, she looked every inch the part. Deeply in love with her work, she stated that she worried “too much” about getting fired. Early in our first session, her desperation became apparent.

“I start worrying when a deadline’s approaching. As it nears I get more and more nervous. Then I start blocking, and my project’s almost always late. It becomes obvious that I’m the nutcase of the office. I just GOTTA stop being so uptight,” she concluded.

“You really have two emotional problems, not just one,” I pointed out.

“Two emotional problems?”

“Yes. First you make yourself anxious about the deadline.”

“Yeah, that’s my problem.”

“That’s your initial problem. But when you notice this anxiety, you then make yourself anxious about that,” I explained.

“You mean I’m anxious about being anxious?”

“Precisely.”

“Oh no, that’s awful!” she exclaimed (ready to become anxious about being anxious about being anxious).

“It’s not really awful. But it is two problems. First your anxiety about your practical difficulties—meeting the deadline. And second, your anxiety about your anxiety. But both problems are solvable,” I assured Lynn.

“Really? Really? How can I solve them?”

“Well, you can start by attending to the Secondary Problem, your anxiety about your anxiety. Once you’ve eliminated that, you can then think more clearly about your primary anxiety and surrender that too.”

I sometimes humorously tell my clients that Franklin Delano Roosevelt had a secondary disturbance problem. He said: “The only thing we have to fear is fear itself.” Of course, that was just a figure of speech, but it does illustrate the way people take for granted the false belief that the only way to avoid something is to be worked up emotionally about it.

Free-Floating Folly

Traditional therapists would label Lynn’s secondary problem “free-floating anxiety,” the result of unconscious forces and childhood conflicts, not tied to anything in the present.

This notion, largely popularized by Freudians and post-Freudians, is mistaken. There exists no emotion—anxiety or any other—that is truly “free-floating.” Anxiety is anchored in specific irrational beliefs in relation to specific circumstances. By their use of the term “free-floating,” traditional therapists reveal their failure to understand that feelings are governed by thinking, and that emotional problems are most often the outcome of “musty” or demanding thoughts.

Ego Disturbance vs. Discomfort Disturbance

As we have observed, secondary disturbance arises because the individual is disturbed about being disturbed. The individual thinks: “I MUST not get disturbed. For me to be disturbed is just horrible.” But what is it about the original disturbance that the individual finds so unacceptable? Here we observe two distinct possibilities: ego disturbance and discomfort disturbance.

In ego disturbance the person thinks: “If I get upset, if I become fearful or anxious or depressed, it shows that I am an inadequate or seriously flawed person. It shows that I am no good, worthless, a failure.”

In discomfort disturbance the individual thinks: “If I get upset, or if I become fearful, anxious, or depressed, this is a dreadful, intolerable feeling. I cannot stand to undergo such anguish.”

As you will recall from chapter 1, ego disturbance is “Must” #1 (demand on oneself), while discomfort disturbance is “Must” #3 (demand on the universe).

Lynn’s Ego

The first step in attacking Lynn’s secondary anxiety was to diagnose it as either an ego or a discomfort disturbance.

Lynn was putting herself down for feeling uptight. She was telling herself: “I MUST not be so disturbed, and when I am, this proves that I’m a weak person.” Lynn was able to see that becoming anxious was a human weakness, but paradoxically, she wished to forbid herself to be human and have that weakness. Lynn had an ego disturbance. Here’s one of the Three Minute Exercises she wrote out to combat her underlying “must”:

Lynn’s Three Minute Exercise

  1. (Activating event): I’m making myself very uptight about this deadline.

  2. (irrational Belief): I MUST not make myself uptight. If I do, it proves that I’m a weak person.

  3. (emotional Consequence): Anxiety about my anxiety.

  4. (Disputing): Why MUST I not make myself uptight?

  5. (Effective new thinking): There’s no reason why I MUST not make myself nervous about a deadline. I prefer not to, and it’s unfortunate that I do. Making myself anxious is a human weakness, something that all humans do, and that hardly turns me into a weak person. It would be better for me to fully accept myself, no matter what, even when I’m nervous.

    At worst, I could continue to make myself nervous about deadlines for the rest of my life, and not get such good jobs as I would like. That would prove rather uncomfortable, but would hardly rate as a horror. Even if I always have this problem, there’s no reason why I can’t be fairly happy, if I just accept myself as imperfect. There’s no reason why I couldn’t accomplish tasks when anxious, though not as well as if I were not upset.

    Furthermore, just because I have this problem, it doesn’t follow that I will always have it. I’m an ongoing process and forever changing. So if I conscientiously practice my Three Minute Exercises, why couldn’t I beat it? I damn well could!

    I intend to keep working on this problem until I beat it. Accomplishing this is largely a matter of repetition and reinforcement. Many others make themselves nervous about deadlines, but even if I were the only one with this problem, it would be no more than a royal pain — not awful, terrible, or horrible.

  6. (new Feeling): Concern, rather than anxiety, about the initial anxiety.

Afraid To Ask

Here’s another example of secondary anxiety, taken from my monthly advice column, “Ask Dr. Mike”:

DEAR DR. MIKE: Recently, while chatting with an attractive woman at a party, I decided I wanted to see her again and thought of asking for her phone number. Immediately, my heart started racing, and I couldn’t bring myself to ask for her number. I dragged the conversation on for quite a while, hoping that I would calm down enough to ask for her number. Does this experience mean that I’m afraid of commitment?

--NUMBERLESS

DEAR NUMBERLESS: Probably not. There is a much more simple and probable explanation—and it isn’t a fear of numbers! Rather, you may have a problem usually overlooked by psychotherapists: the fear of momentary anxiety.

While chatting with her, you probably realized that it would feel a little awkward to change conversational gears and request her number (a little discomfort). Perhaps you recognized that she possibly might not be interested, and might therefore be put on the spot (a little more discomfort). Then you guessed that if she did reject you, you might feel disappointed and even faintly humiliated (yet a little more discomfort). Next, you might have projected that you’d be anxious about a little rejection (still more discomfort, and now some anxiety).

Finally, you might have told yourself: “All this discomfort and anxiety will prove AWFUL, TERRIBLE, and HORRIBLE. I CANNOT face it. I MUST avoid it.” And so you missed out on a possible relationship.

The solution begins with recognizing that a change in view results in a change in behavior, so adopt the following hardheaded (but open-hearted) view: “No excuses and no debates. I’m going to ask for her number right now if it’s the last thing I do. If it kills me, it kills me. Since I abhor discomfort and anxiety, I had better face it immediately and thereby create more comfort for myself in the long run.” Then ruthlessly take the plunge.

This strategy will help you keep the immediate discomfort and anxiety in its proper perspective. A delightful, long-term relationship may well follow.

Depression About Anxiety

At first glance, Elmer had a carefree appearance. As he sat down across from me, he whistled through his front teeth while precipitously dangling a matchstick from the right corner of his mouth. Wearing tight, faded jeans and a half-unbuttoned plaid flannel shirt, Elmer’s sleeves were rolled up to reveal brimming muscles. A straw hat and cowboy boots seemed somehow missing.

Elmer’s problem was a fear of crowds and of waiting in line. So he avoided restaurants, movies, theaters, and parties. He also worried about doing badly in his work as a commercial artist.

Elmer felt relaxed only at home with his lover, Chuck, yet he was beginning to feel guilty even with him. Elmer blamed himself because Chuck had chosen to restrict his social life drastically in order to spend all his free time with Elmer.

Because of these pervasive fears, Elmer felt depressed. Only Chuck, who came with Elmer on his first visit to me, knew about his problems.

“I shouldn’t have these silly fears,” he told me. “It embarrasses me to think how weak I am.”

“How does it make you weak to be human and have fears?” I asked.

“It just does. It’s not as if I get afraid once in a while. These fears dominate my life. I’m not strong enough to face them.”

“It sounds as if you think you’re either a strong person or a weak person.”

“Yeah, I guess you could say that. I used to think I was a strong person. But I’m sure a weakie now.”

In Elmer’s head he became a strong person when he dealt fearlessly with problems. Conversely, he thought he had turned into a “weakie” when he was beset by fears, as he often was of late. In reality, of course, Elmer was, like everyone else, a person who at times acts strongly and at other times acts weakly.

Elmer was, like Lynn, putting himself down because of his primary disturbance. By condemning himself for getting disturbed, Elmer was actually decreasing his chances of eliminating his fears. His conviction that he was a weak person set up a self-fulfilling prophecy:

  1. Elmer, like all of us, has anxieties. He predicts they will not diminish (prophecy).

  2. But Elmer incorrectly concludes that this makes him a weak person (self-downing).

  3. As a weak person, he considers himself unable to act strongly and conquer his anxieties (hopelessness).

  4. So he gives up facing his fears (avoidance).

  5. Unaddressed, his fears grow stronger (fulfillment of the prophecy).

Seven Easy Steps

Elmer and Lynn each condemned themselves for having Emotional Problems. They foolishly denigrated themselves for doing something that all humans do easily and naturally—get upset. Their self-condemnation created Secondary Problems worse than the Primary Problem itself.

Do you ever make statements condemning yourself? “What an idiot I am!” “Well, that’s just the sort of blunder you’d expect from a klutz like me!” If you find it natural to condemn yourself in this way for mistakes, you probably also condemn yourself about any fears, anxieties, or gloomy feelings you experience. But this only makes it harder to tackle your Primary Emotional Problem.

Here is a simple approach to dealing with your Secondary Problem:

  1. Specify your upset emotion. Try to identify your Primary Problem. Is it anxiety, depression, guilt, or hostility?

  2. Determine whether there’s a Secondary Problem. Are you upsetting yourself about that initial upsetness?

    A general anxiety or depression that seems to materialize “out of the blue,” not directly related to anything concrete in your life, is a clue. In all probability, it really is related to something specific—your experience of feeling anxious or depressed about some Practical Problem. You are worried that you may get anxious—upset about being upset.

    Feeling overwhelmed, out of control, or as if you’re going crazy is usually a sign that you have a Secondary Problem. You’re feeling “out of control” because you feel unable to control your Primary Emotional Problem, and you think you “must” control it.

    For instance, a client of mine says: “Work is really getting me down. I feel overwhelmed. I just can’t face it.” But what is really the object of her feeling overwhelmed is the foreboding she has when she goes to work in the morning or the panic that arises when she thinks about the pile of papers on her desk.

  3. Identify your “musts.” What are you telling yourself that creates your secondary problem? “I MUST not be anxious, or else I’m an inadequate person.” “I MUST not keep depressing myself about the same situations, because if I do, it makes me a hopeless case.” “I MUST not be nervous and awkward, because if I am, people will notice, and I could not stand that.”

  4. Challenge your “musts.” If your friend believes in Santa Claus, and you tell him “There is no Santa Claus,” you have expressed your opinion, but you have not really challenged or effectively disputed his belief.

    But instead you might say to your friend: “What’s your evidence for the existence of Santa? Give me some facts to support your contention. Prove it to me.” Now you’re pushing him to defend his belief. This encourages him to actively question its truth.

    Use this same challenging approach with yourself: “What’s the evidence I MUST not be anxious? Where is it written that I become a hopelessly weak person because I sometimes act weakly? Prove I CAN’T STAND people thinking I’m nervous.”

  5. Refute your “musts.” Don’t be satisfied with facile answers. Think it through carefully and see if you can come up with evidence to support the “must.” Discover that there’s really no evidence for the demands that underlie your “musty” thinking. A “must” implies that there’s an absolute law of the universe that you “ought” not to be upset. Obviously, there can be no such law, or you wouldn’t be upset.

    Clearly, it’s preferable that you do not upset yourself. It’s desirable to avoid anxiety. But we’re not debating what is preferable or desirable—we’re debating your “must.”

    When you act weakly or irrationally, we cannot conclude that your entire self is weak and irrational. At times, like all humans, you act irrationally and at times you act rationally.

  6. Take risks. You can convince yourself, in action, that you’re not a wholly weak and inadequate person. You can actively court “danger”—seek out situations in which you become upset. Avoidance only helps to reinforce your secondary fears.

    If you get panicky in elevators and are telling yourself you’re inadequate and a loser for this weakness, go out of your way to take an elevator.

    If, like many new parents, you easily become angry at your young children and feel like a loathsome failure because of this, seek out opportunities to be in your children’s company just when they’re at their most difficult.

    If you feel anxious about committing yourself to intimate relationships, plunge into a relationship.

  7. Utilize practice and reinforcement. Go through the steps outlined above many times. Resolutely launch a campaign to accept yourself thoroughly, with all your emotional problems. Have no fear that this will make you complacent about those problems, so that you fail to do anything about them! Quite the contrary, you will find that it is much easier to deal with problems if you don’t get upset about the fact that you have them. The first step to achieving control over your upsets is to abandon the demand to have superhuman control of yourself.

    Convince yourself, by argument and disputation, and also by observation and experiment, that becoming unnecessarily upset is a typical human weakness, and not something to which you can reasonably expect to be granted immunity.

Anne’s Discomfort Anxiety

Anne called me to cancel her first therapy appointment with only thirty minutes notice but with heartfelt apologies. She rescheduled for the following week and again failed to appear. When I did finally meet her, it soon came out that this pattern of unreliability pervaded her entire life.

After some questioning, I found that Anne suffered from acrophobia—fear of heights. She made herself extremely anxious about driving across bridges. Traveling to my office from her home meant crossing a bridge, as did traveling from her home to her office.

On occasional bad days, Anne would set out for work, turn around at the entry to the bridge, and return home. On fairly good days, Anne did make it across the bridge—but it took her an hour to cajole herself to cross. Every morning she allowed herself an hour and twenty minutes to get to work: twenty minutes to drive to work and one hour to get up the nerve to cross the three-quarter-mile bridge.

“I just fall apart when I try to cross that bridge,” she explained.

“What do you mean by ‘fall apart’?” I asked her.

“I start shaking all over. I can’t catch my breath; I feel like jelly. I put it off as long as I can, then I decide I have to face it. So I clench my teeth, shut my eyes, and speed across. It’s absolutely horrible.”

“What aspect is horrible?”

“Those feelings. You have no idea how horrible they are. I feel like I’m going to die. No—it’s worse. I feel as if something even worse than death is going to happen, but I don’t know what. I feel as though I’m going crazy.”

“You put off crossing the bridge as long as possible to avoid these very unpleasant feelings?”

“Yes—those feelings terrify me.”

“I understand that it seems so. But in reality, it’s never feelings that terrify you. It’s always what you tell yourself about those feelings. Such as: ‘Crossing the bridge SHOULDN’T be so unpleasant, I can’t STAND shaking, It’s HORRIBLE to feel like jelly.’ ”

“I don’t understand.”

“In reality, those feelings are extremely unpleasant. But if you were realistic, you’d cross the bridge as soon as possible to get it over with. You wouldn’t agonize and prolong the discomfort.”

“I never thought of it that way.”

“But when you bring in the magical notions: ‘It SHOULDN’T be so unpleasant, it’s AWFUL, and I CAN’T STAND it,’ then you make it feel much worse than it really is. And you extend the unpleasantness for an hour twice a day."

Anne was not suffering from ego disturbance. She did not think she was an unworthy person because she felt panicky crossing over bridges. But she had made herself afraid of those panicky feelings and told herself she could not tolerate them.

Applying Problem Separation to a Secondary Problem

We have learned in earlier chapters that it’s useful to separate a Practical Problem from an associated Emotional Problem: this is the Problem Separation Technique. We can now see that the same approach works for Primary and Secondary Emotional Problems. Just as people often think that their Practical Problem is causing their Primary Emotional Problem (A causing C), so they often think that their Primary Emotional Problem is causing their Secondary Emotional Problem.

To tackle your Secondary Problem, the best approach is to separate it from your Primary Problem. Then fully accept your Primary Problem, your initial disturbed feeling, so that you don’t go on to disturb yourself about your disturbed feeling. Accepting your Primary Problem means that your desire to be rid of that problem is a preference, not a “must.” Since “musts” generate Emotional Problems, feeling that you MUST rid yourself of your Primary Problem is likely to generate a new Emotional Problem—your Secondary Problem. This Secondary Problem tends to get in the way of tackling the Primary Problem.

It may seem paradoxical to accept your Primary disturbance, because you do want to remove that disturbance. But if you run over someone in your car, do you think it would be helpful to reverse the car and run over them again in the opposite direction? No, that would do nothing to heal the original injuries, would add new injuries, and would complicate the first injuries so that they were harder to treat. Having hurt yourself by inflicting your Primary disturbance on yourself, it will not help to inflict an additional disturbance by upsetting yourself about your Primary disturbance.

By accepting your disturbance, I don't mean accepting that there’s nothing you can do about it. But simply accept that you do have that Primary disturbance, and that this is a typical human failing.

You are accepting your problem if:

  • You believe that, although feeling upset is distinctly uncomfortable, it’s an essential aspect of the human condition

  • You see that, although such feelings detract from your enjoyment of life, they do not obliterate all of it

  • You’re aware that such unpleasant feelings tend to wax and wane

  • You recognize that dwelling on them only tends to prolong and intensify them needlessly

  • You know that it’s best to face up to them rather than avoid them.

You are hurting yourself, just as if you were hitting yourself on the head with a hammer, if:

  • You tell yourself you can’t stand feeling anxious or upset

  • You believe that life is terrible because you’re feeling down

  • You tell yourself that life SHOULDN’T be so uncomfortable

  • You regularly avoid situations just because you associate them with some emotional discomfort

Once you have identified your Primary disturbance, classify your Secondary disturbance. Are you upset about being upset? If you are, discover the beliefs that make you disturbed about your Primary disturbance. Are your putting yourself down (ego disturbance) or are you putting the universe down (discomfort disturbance)? Either way, you can challenge and combat your unreasonable beliefs and change them. Then your Secondary disturbance will evaporate, leaving you in a better position to tackle your Primary disturbance.

Tell a friend: PASS IT ON
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Dr. Michael R. Edelstein
Clinical Psychologist, San Francisco
415-673-2848 (24 hours)
DrEdelstein@ThreeMinuteTherapy.com
www.ThreeMinuteTherapy.com