Uncertainty and Its Discontents

We hear it now as a truism: These are uncertain times.

Uncertainty gets attached to big events climate change and war, both existent and future, but its most depleting manifestations may be those in our daily lives, or what we call “everyday worries.”

These after all are the means by which we reinforce and habituate our responses to the larger worries.^[1]Our phones of course cause a major exacerbation of this anxiety. Their appeal lies in their ability to give us some seeming relief (via an answered email or text, or the familiarity of a game or … Continue reading

Our lives are rife with uncertainty. What will I wear? Does my boss like me or will I be fired? Will my lover stay faithful? Will my children be happy and healthful? Will I have enough money? Will my life return to normal?

There are some core worries: Will I soon die—and what then?

And then there are the seemingly trite worries that loom absurdly large in us: What does that person think about me?

We can brood endlessly on these thoughts, often to the detriment of our mental health.

The neurotic need to know

All of these questions badger us for answers, for a sense of knowing.

But our quest for knowledge on these matters is often a neurosis. I call it simply the “neurotic need to know.”

This has many manifestations, from the know-it-all^[2]This type of person is defended against the feeling of not knowing, or even the perception by others of his not knowing. to the person who “simply wants an answer” to one who compulsively checks the phone for an expected reply.

Knowing is like an itch, an addiction. We believe that knowing and its attendant sense of certainty will alter our consciousness and alleviate suffering.

And this feeling of certainty (however fleeting) convinces us that the worrying was effective in warding off the threat. We take the same approach with the next threat: We worry and then seek rapid certainty. And so the pattern is reinforced.

Knowing provides us with insufficient relief. It’s merely a short-term avoidance.

The common thread in all of this is an intolerance for uncertainty.

And that intolerance is perhaps our greatest Achilles’ heel, fueling us with high doses of anxiety.

So how do we break the cycle of our maladaptive response to uncertainty?

Adaptive response to uncertainty

One of my favorite quotes for this purpose is “Don’t just do something, stand there!”

That’s right, our most effective strategy in dealing with uncertainty is often to do nothing. Rather than react, become present in the moment. Focus on whatever task you are doing (driving a car, writing something, talking or, even better, listening to a friend, looking at something, reading, walking, cooking) and become present with that task in that moment.

What you discover is manifold:

• The perceived future is not an immediate threat.
• Whatever the uncertainty is it therefore does not require immediate attention.
• Uncertainty may be uncomfortable but it is profoundly tolerable.

One of the most powerful tools for training ourselves to tolerate uncertainty is meditation. By focusing on our breath and returning to it whenever a distracting or anxiety-inducing thought comes up we train our parasympathetic response.

We still get to have all of our thoughts and feelings but remarkably we’ve altered our response to those thoughts and feelings.

Another very powerful means by which to cope with uncertainty is therapy. It has the advantage of being an interpersonal modality and thus expanding the range of our tolerance for uncertainty.

Therapy and its role

Therapy, like life, is rife with uncertainty.

For the patient: Is therapy going to work? Am I with the right therapist? Is this worth it? Will the therapist understand me? Can the therapist love all (even the hidden) parts of me? Is the therapist committed to me? Am I capable of change? Can I make it through the next week without my therapist? Can I tell the therapist that?

For the therapist: Am I good enough? Am I effective enough? Does the patient feel improvement? Is the patient capable of insight and change? Can I go at the patient’s pace rather than mine? Is the patient committed to this process?

Working with all of this uncertainty is an essential part of effective therapy. A good therapist can model not only how to deal with uncertainty, but can also contain it as presented by the patient in the therapy setting.

In other words, properly managed therapy becomes the place where uncertainty—both within the therapist and the patient—is fully tolerated. When the therapist accepts and mindfully manages intra- and inter-personal and situational uncertainties in the clinical setting then the patient has an exemplary pathway with which to do the same.

Tolerance for uncertainty is not merely intellectually understood; it is experienced.

Rapid advice from the therapist is a surefire move away from this. It is a quick fix, an impulsive and often impersonal^[3]Advice is given by the therapist rather than cultivated by the patient and is thus a form of imposition of one’s ideas onto another. Something authentically specific to the patient is more … Continue reading and panicked way out of the uncertainty conundrum.

Nothing is resolved, except for an instant the uncomfortable feelings that come up around uncertainty. What seems needed the next time, of course, is more of the same.

Therapy has no doubt provided my patients with great clarity, allowing them to navigate and resolve some of their lives’ greatest uncertainties. But first we both had to sit with and relate to those uncertainties.^[4]The space between sessions also has a vital role to play, as it provides the patient with instances of slightly prolonged uncertainty, that is, without an immediate response from the therapist. The … Continue reading

In life uncertainty invariably lurks, and lurks again.

Therapy then is less about resolving every instance of uncertainty than it is about teaching us how to live happily with it.