DR. Rizaldy R. Ferrer, PHD

Licensed Psychologist | Online psychological services available across participating PSYPACT states

Tag: Cognitive Reframing

Living with Anxiety: Turning the Mind’s What If Into a What Now

Anxiety is a universal human experience. It’s not just the 30% of people who will meet criteria for an anxiety disorder in their lifetime (Bandelow & Michaelis, 2015). It’s the friend who can’t sleep before a big meeting, the parent who mentally runs through a dozen worst-case scenarios before their child even leaves the driveway, or the student who rewrites a text message three times before pressing send.

Our brains evolved to anticipate. This remarkable ability to look ahead has kept humans alive for millennia—it’s why early hunter-gatherers carried tools before they needed them and why we pack an umbrella when the forecast calls for rain. But the same foresight that allows us to prepare can also trap us in mental simulations of disaster, living in the tension of problems that haven’t happened yet—and may never happen at all.

From Story to Narrative—and Back Again

I hear the same underlying struggles in my recent therapy sessions with patients. One worries that a partner’s habits might shape their child’s future in harmful ways. Another lay awake imagining a tragic bike accident before their child even left the house.

Both situations were rooted in what I call the difference between story and narrative:

  • The story is what is actually happening right now.
  • The narrative is the version of events our mind constructs, often based on fear, assumption, or incomplete information.

When we mistake the narrative for the story, we start responding emotionally to a movie in our head rather than the facts in front of us. That’s where anxiety thrives.

What Science Says About Why We Worry

Modern research tells us anxiety is shaped by multiple forces—biological, cognitive, and environmental.

  • Trait vs. state anxiety (Spielberger, 1983) explains why some people tend to feel anxious across many situations, while others experience it only under specific stressors.
  • Reinforcement sensitivity theory (Gray & McNaughton, 2000) describes how an overactive “behavioral inhibition system” makes us extra alert to potential threats.
  • The tripartite model (Clark & Watson, 1991) helps explain why anxiety often overlaps with depression, highlighting shared features like negative mood and unique features like physiological arousal.
  • Recent neuroscience adds another layer: stress can actually alter gene expression through epigenetic mechanisms, potentially making us more sensitive to anxiety triggers over time (Zannas & West, 2014).

What these theories have in common is the recognition that anxiety isn’t just “in your head”—it’s a complex interaction between brain, body, and lived experience.

Worrying vs. Planning: A Crucial Distinction

Here’s the important part: worrying is never a requirement for effective action.

  • Worrying is imagining the future as if it’s already gone wrong, then reacting to that imagined outcome.
  • Planning is choosing an action in the present, without demanding that the future turn out a certain way.

Both are future-oriented, but only planning moves you forward. Worry burns energy; planning invests it.

What Works: From Therapy Room to Daily Life

In those sessions, the shift came from turning worry into intention. The process looked like this:

  1. Catch it early — Recognize, “This is worry.” Naming it interrupts the spiral.
  2. Anchor in the present — Ask, “What needs my attention right now?”
  3. Plan without prediction — Choose one next step without adding “and it must work out this way.”
  4. Use external supports — Reminders, notes, or scheduled check-ins to keep you aligned with action rather than rumination.
  5. Reframe the narrative — Replace “This will go badly” with “I’ll handle whatever comes.”

These strategies echo what research shows works best for anxiety: cognitive-behavioral methods to challenge distorted thoughts (Beck & Clark, 1997), mindfulness to stay in the present (Hofmann et al., 2010), and acceptance-based approaches that allow worry to exist without letting it steer the wheel (Hayes et al., 2006).

Try This Today

If you find yourself caught in “what if” thinking:

  • Pause and label it: “This is a narrative, not the story.”
  • Shift to a “what now” mindset: “What’s the smallest action I can take in the next 10 minutes?”
  • Ground yourself in sensory details—the sound of a kettle, the texture of your desk, the feel of your feet on the floor.
  • Close the loop by acting on your plan, no matter how small.

Final Thought

The challenge is not to silence our worries completely but to respond skillfully, using it as a prompt to plan instead of a trap and a downward spiral. When we can move from “what if” to “what now,” we reclaim the energy that worry steals and put it toward a present moment that we actually want to live in.

Read more from Rizaldy R. Ferrer, Ph.D.

References

Bandelow, B., & Michaelis, S. (2015). Epidemiology of anxiety disorders in the 21st century. Dialogues in Clinical Neuroscience, 17(3), 327–335.

Beck, A. T., & Clark, D. A. (1997). An information processing model of anxiety: Automatic and strategic processes. Behaviour Research and Therapy, 35(1), 49–58.

Clark, L. A., & Watson, D. (1991). Tripartite model of anxiety and depression. Journal of Abnormal Psychology, 100(3), 316–336.

Gray, J. A., & McNaughton, N. (2000). The neuropsychology of anxiety: An enquiry into the functions of the septo-hippocampal system. Oxford University Press.

Hayes, S. C., Strosahl, K. D., & Wilson, K. G. (2006). Acceptance and Commitment Therapy: An experiential approach to behavior change. Guilford Press.

Hofmann, S. G., Sawyer, A. T., Witt, A. A., & Oh, D. (2010). The effect of mindfulness-based therapy on anxiety and depression: A meta-analytic review. Journal of Consulting and Clinical Psychology, 78(2), 169–183.

Spielberger, C. D. (1983). Manual for the State-Trait Anxiety Inventory. Consulting Psychologists Press.

Zannas, A. S., & West, A. E. (2014). Epigenetics and the regulation of stress vulnerability and resilience. Neuroscience, 264, 157–170.

“Hmm” vs. “Ugh”

Life throws curveballs—missed deadlines, unexpected weather, or even just a bad day. Our reactions to these moments can significantly impact our mental health. Most of us are familiar with the instinctive “ugh,” a reaction rooted in frustration, dismay, or rejection. But what if we replaced “ugh” with “hmm”? This small shift, from resistance to curiosity, can make a big difference in how we navigate life’s challenges.

The Science Behind “Ugh”

“Ugh” is more than just an expression—it’s a manifestation of emotional reactivity. According to Beck’s (1976) cognitive theory, such reactions may arise from distorted thinking. When things don’t go our way, our brains tend to catastrophize or overgeneralize. For instance, spilling coffee might spark an “ugh” followed by the thought, “This ruins my whole day.” This automatic negativity can increase stress and anxiety, trapping us in a cycle of frustration.

Additionally, “ugh” often reflects misperceptions. Imagine planning a beach day, only to encounter rain. The initial “ugh” assumes the trip is ruined. However, this reaction misses the potential for alternative enjoyable activities, such as visiting a local café or spending quality time indoors. By sticking to the “ugh” response, we limit our ability to adapt and find joy in the unexpected.

Why “Hmm” Matters

In contrast, “hmm” embodies curiosity and openness, encouraging us to pause, reflect, and explore. This shift can transform how we experience challenges.

  1. Reduces Negative Judgments. When we respond with “hmm,” we suspend judgment and consider alternative perspectives. Carl Rogers (1951) emphasized the importance of this openness for emotional wellbeing. Instead of thinking, “Ugh, my coworker is so rude,” curiosity might lead us to wonder, “Hmm, what might be going on with them today?”
  2. Encourages Mindfulness. Mindfulness involves staying present and observing experiences without judgment (Kabat-Zinn, 1990). Saying “hmm” instead of “ugh” keeps us grounded, reducing stress and fostering emotional regulation.
  3. Promotes Problem-Solving. The “ugh” mindset focuses on obstacles, while “hmm” seeks solutions. Research on emotion regulation by Gross (1998) shows that reframing situations leads to better outcomes. For example, when a plan falls apart, “hmm, how else can I make this work?” encourages creative thinking.
  4. Fosters Emotional Resilience. A curious approach helps us process emotions more effectively. Asking, “Hmm, why do I feel this way?” can provide insights, reducing the urge to suppress or avoid uncomfortable feelings.

How to Shift from “Ugh” to “Hmm”

Changing your default reaction takes practice, but it’s worth the effort. Here’s how to start:

  1. Notice the “Ugh”
    Pay attention to moments when you react with frustration or dismay. Simply recognizing the “ugh” is a step toward change.
  2. Pause and Reflect
    Instead of jumping to conclusions, take a deep breath and ask yourself a question beginning with “hmm.” For example:

    • “Hmm, what can I learn from this?”
    • “Hmm, how can I approach this differently?”
  1. Reframe the Situation
    Curiosity opens the door to new possibilities. Focus on what you can explore or adapt in the moment rather than dwelling on what went wrong.

Switching from “ugh” to “hmm” is a simple yet powerful tool for improving mental health. Curiosity helps us navigate life with openness and creativity, turning challenges into opportunities for growth. So, the next time life throws you a curveball, pause. Trade the “ugh” for a thoughtful “hmm,” and see how it transforms your perspective.

Read more from Rizaldy R. Ferrer, Ph.D.

References

  • Beck, A. T. (1976). Cognitive therapy and the emotional disorders. International Universities Press.
  • Gross, J. J. (1998). The emerging field of emotion regulation: An integrative review. Review of General Psychology, 2(3), 271–299.
  • Kabat-Zinn, J. (1990). Full catastrophe living: Using the wisdom of your body and mind to face stress, pain, and illness. Delacorte Press.
  • Rogers, C. R. (1951). Client-centered therapy: Its current practice, implications, and theory. Houghton Mifflin.

Pain is Inevitable, but Suffering is a Choice

We inevitably encounter painful experiences in life—breakups, humiliation, rejection, failure, and various stressors that challenge our mental and emotional well-being. These events can be understood as emotional or psychological pain, similar to the way physical injuries or diseases cause pain or discomfort to our bodies. Just as physical pain is a natural response to injury, emotional pain is a response to the mental and emotional “injuries” we face. However, while physical pain tends to subside with time or treatment, emotional pain may linger, even after the original cause has passed.

The key distinction I argue in this philosophy is the difference between pain and suffering. Pain is the initial emotional response to life’s inevitable hardships. It is unavoidable, much like the pain of a physical injury. But suffering—the prolonged and often deepened emotional distress we experience long after the event—is something we contribute to and, to a degree, choose.

Let’s consider physical pain as a metaphor. When you suffer an injury, the body’s natural healing processes often take over. A cut heals, a bruise fades, and with proper care, most physical wounds resolve. While the pain of the injury can be intense, it is typically temporary. Likewise, emotional pain from rejection, failure, or humiliation also has a natural course. Initially, it hurts, but in many cases, it, too, can fade over time, especially when we allow ourselves to process it healthily.

However, unlike physical pain, emotional pain can evolve into something more persistent—suffering. Suffering is what happens when we continue to hold on to the pain through the narratives we create in our minds. These narratives often revolve around self-blame, shame, and negative self-evaluation. We begin to revisit the painful experience repeatedly, analyzing it, assigning personal fault, and questioning our self-worth. Over time, this pattern transforms the pain into suffering.

The original emotional pain—the rejection, the failure—has ended. What sustains the suffering now is not the event itself, but the stories we tell ourselves about that event. For example, after a rejection, we might internalize the belief, “I’m not good enough” or “I’ll always fail.” This self-blame and shame become a feedback loop, feeding the suffering and allowing it to persist far beyond the original pain.

Below is an excerpt of the therapy session I had to illustrate one example of how I applied this philosophy.

Brandi: I kind of lose control when things get off track. Over the weekend, my friend was celebrating her 30th birthday. I wasn’t going to go because of my upcoming surgery, but then I changed my mind. I wanted to be there for her since I heard she was upset that people were dropping out. So I went, even though I was worried about getting sick. And indeed, I believe I caught COVID from being there. I was really kicking myself for it—blaming myself. I should’ve been more careful since I knew surgery was coming up. But my first instinct was to take care of others. I didn’t think about isolating or protecting myself.

Dr. Ferrer: Many people, including you, go to that place of self-blame. The difference is, for you, it’s harder to get out of that loop. Pain is inevitable, but suffering is a choice. The pain there, of course, is the disappointment that your surgery is canceled because you need to be well to undergo the procedure. However, you stay in the suffering longer than necessary. That is, creating a narrative that shames you.

Brandi: Yeah, it’s like a Buddhist principle. I get stuck in it, even though I know logically there’s nothing I can do about it now. It already happened. There’s another surgery date, but I keep wallowing in the “I should’ve done this differently” mindset.

Dr. Ferrer: Think about how you treat your own kids when they’re in pain. Do you immediately tell them, “See, I told you so.” Of course not. There’s no difference in how you should treat yourself. You can give that same care to yourself, but instead, you revert to shame and blame. Pain is already that feeling let down when you realize that taking care of your friend by being present in her celebration may have caused you to catch a virus. It is something you cannot change anymore. But by responding to that pain with the negative narrative is that suffering you are choosing.

Brandi: It’s easy to tell myself I’m a failure. I beat myself up. I forgot to take care of myself when I should’ve. It’s simply hard to just stay in pain and not suffering. I was crying hard that Monday, and my partner didn’t know how to help. I think she was trying by keeping her distance because I was irritable, which is also a trigger for her. I was upset with myself, feeling like a failure for not thinking about protecting myself before the surgery.

Dr. Ferrer: And that’s where the spiral starts.

Brandi: Exactly. Then my daughter came downstairs and saw me crying. She was supposed to watch a movie, but my partner told her I wasn’t up for it. She got upset. I felt like I had to pull myself together because she needed me. So, I went to the bathroom, blew my nose, and told myself, “You have to get up. She’s a kid, she needs help.”

I took a walk with the dog, trying to comfort myself. But it felt like a battle—the mental loop was still there.

Dr. Ferrer: I hear you. And yet, you found a way to comfort yourself. That’s important. You recognized you needed to carry on, even though you were still in pain. In a way, you dealt with the pain but chose not to suffer by doing your best.

Brandi: Yeah, I told my partner what was going on in my head. I explained that when things like this happen, I spiral and beat myself up. But even though I was still struggling, I could see the loop and work through it.

Dr. Ferrer: You’re recognizing it now, which is a big step. The fact that you didn’t get stuck in the negative loop as long as you used to previously is progress. You’re shortening the duration of those spirals.

Brandi: Yeah, I can see that. It took a while, but I managed to pull myself out of it faster than I would’ve in the past. The next day, I called the surgeon’s office, and they postponed the surgery for 30 days. I felt nervous, but I answered the call, which felt like a victory in itself.

In essence, while pain is an inevitable part of life, suffering is something we often create and sustain through our own narratives of self-blame and shame. The distinction lies in our response: while pain arises naturally from difficult experiences, suffering is the result of holding on to and feeding that pain with negative thoughts. By recognizing this, we can choose to let go of the stories that perpetuate suffering and allow ourselves to heal emotionally, just as our bodies naturally heal from physical wounds. Ultimately, though we cannot avoid pain, we can decide whether or not to suffer.

Read more from Rizaldy R. Ferrer, Ph.D.

Disclaimer:
The information provided in this newsletter is not intended to be a substitute for professional medical or mental health advice. If you are experiencing any mental health issues, please seek professional help. The author of this blog is not liable for any damages or injuries that may result from the use of the information provided here.

When applicable, the names, gender identification, location and/or other identifiable characteristics have been modified to maintain privacy and confidentiality; whilst, still maintaining the integrity of their stories and narratives.

I’m Active, Not Busy!

Over 10 years ago, during a therapy session with a 12-year-old patient, I started the conversation by asking, “How are you? Have you been busy?” He paused for a moment and then replied, “No, active.” His response struck me, and it since changed the way I think about the words I choose to describe my intentions and how I go about my day.

I realized that using the word “busy” often leaves me feeling stressed and anxious, as though I’m running around without purpose—like a chicken with its head cut off. When I reflect on how people usually say they’re “busy,” it often seems to carry a sense of being overwhelmed or not in control of life’s demands. Some even wear “busy” as a badge of honor, as if juggling too many things is normal, even though they don’t actually enjoy the feeling.

This experience inspired me to continue to explore how the words we use everyday matter in the way we think and their impact on our feelings and actions. In my work as a practicing psychologist, I pay attention to individuals’ experiences associated with “feeling busy,” and suggest trying to use “active” to gain more control over their behaviors. In this article, I also explore the cultural and common idea of being “busy” in today’s world, looking at research that shows how the words we use shape our behavior, thinking, and wellbeing.

The word “busy” seems to be a common answer to the question, “How are you?” For many, being “busy” has become a way of life, almost a standard response that suggests a sense of productivity and purpose. But is this really the case? The word “busy” often implies that we are overwhelmed and constantly reacting to endless demands. It suggests a lack of control over our time and energy, and it can carry a heavy sense of stress.

The Problem with “Busy”

When people describe themselves as “busy,” they might actually be conveying that their lives feel chaotic and unmanageable. Research shows that this perception of busyness is often linked to increased stress and burnout. A study by Gordon et al. (2019) found that the language we use to talk about our daily lives, like saying we’re “busy,” is directly related to how much stress we experience. People tend to feel less in control when they frame their day-to-day tasks as overwhelming and unmanageable.

In contrast, I argue that when we think of ourselves as “active,” there’s a shift in how we approach our tasks. Being “active” suggests intention and purpose—it implies that we are engaged in our activities by choice, rather than feeling trapped by them. This shift in perspective can make a significant difference in how we experience our daily lives.

Words Shape Our Reality

The idea that language shapes how we think, and feel has long been studied in the field of psychology. According to the Sapir-Whorf Hypothesis (Whorf, 1956), the words we use influence our perception of reality. For instance, a study conducted by Boroditsky (2001) demonstrated that people who speak different languages perceive time differently based on how their language structures the concept of time. This finding shows that our words don’t just reflect our thoughts; they actively shape them.

When we repeatedly use the word “busy,” it can reinforce feelings of stress and anxiety, making it more challenging to find calm in our everyday activities. On the other hand, using a word like “active” can encourage a mindset that focuses on purposeful action and engagement, helping us feel more in control and less overwhelmed.

Changing Language, Changing Behavior

Research has also shown that changing our language can lead to changes in our behavior. Carol Dweck (2006), in her study of mindsets, found that students who used language focused on growth and learning were more resilient and willing to embrace challenges. They developed what she termed a “growth mindset,” which significantly improved their problem-solving skills and adaptability.

Applying this idea to our daily lives, when we choose to describe ourselves as “active” instead of “busy,” we might find that we approach challenges with more intention and clarity. The simple act of changing our language can help us shift from feeling overwhelmed to feeling engaged and purposeful.

The Impact on Wellbeing

Our choice of words also has a profound impact on our overall wellbeing. Studies have shown that people who regularly describe their lives as “busy” are more likely to experience negative emotions, such as anxiety and stress (Matthews & Wells, 2020). In contrast, those who describe their activities as “active” or “engaged” tend to report higher levels of satisfaction and a greater sense of accomplishment.

Killingsworth and Gilbert (2010) conducted a study revealing that people are happiest when they are fully present in their activities, regardless of how many tasks they have. This finding aligns with the idea that being “active” promotes mindfulness and focus, while being “busy” can lead to distraction and a sense of losing control over one’s life.

Conclusion

Choosing to be “active” rather than “busy” is more than just a shift in language—it’s a shift in mindset. This change can help us regain control of our lives, turning what feels like chaos into a series of purposeful actions. By reframing our tasks as part of a chosen engagement rather than overwhelming demands, we create a more balanced, intentional approach to our daily activities.

Read more from Rizaldy R. Ferrer, Ph.D.

References

Boroditsky, L. (2001). Does Language Shape Thought? Mandarin and English Speakers’ Conceptions of Time. Cognitive Psychology, 43(1), 1-22.

Dweck, C. S. (2006). Mindset: The New Psychology of Success. Random House.

Gordon, C., Montgomery, A., & Napier, S. (2019). The Language of Stress: How Words Relate to Mental Health. Journal of Applied Linguistics, 15(2), 210-227.

Killingsworth, M. A., & Gilbert, D. T. (2010). A Wandering Mind Is an Unhappy Mind. Science, 330(6006), 932.

Matthews, G., & Wells, A. (2020). Stress and Language: The Role of Everyday Expressions in Mental Health. Health Psychology Review, 14(3), 456-478.

Whorf, B. L. (1956). Language, Thought, and Reality: Selected Writings of Benjamin Lee Whorf. MIT Press.

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