Big Worries Vs. Little Worries

Bernie, the caveman, was a worrier. He worried about big things and little things; but some people only worry about the big things. I know a joke about this:  One guy is talking to another at a bar. (Imagine some sort of ethnic accent)

“I worry about the big things. I don’t bother about the small things. I let my wife worry about the small things.”

Another guy (Imagine a bored guy holding a bottle of beer.) “Yeah?”

“Yeah. I worry about global warming, about an earthquake opening up in the center of town, and especially the possibility of an asteroid hitting the earth and wiping out the human race. Like what happened to the dinosaurs.  I let my wife worry about picking the kids up from school, taking them to the doctor and getting enough money to pay the rent.”

It turns out that people often worry about unlikely events and neglect the real dangers in life. They worry about the big things. A lot of people are afraid of flying because they think the airplane may crash, yet they drive around carelessly. They have a sense of being able to control the car, and so they don’t worry. They can’t control the airplane. The fact is, driving a car is about ten times as dangerous, per mile, as flying in an airplane. I already know of one person who drove from New York City to Florida by car rather than risk flying in an airplane. Tragically, she was killed in a car accident on the way back.

Some of the big things people worry about:

1. Events that kill a lot of people at one time. Airplane crashes make the news; the much greater number of people who are killed in automobile accidents or by being shot by a gun do not make the news because they are so common and because only one or two people are killed at a time.

2. Events that happen nearby. I practice in New York. The airplane crash a few years back that happened off Long Island made much more of an impression on my patients (some refused to fly) than crashes in South America or India.

3. Unusual events. Tsunamis, for instance. Or poisonings from canned goods.(They too are publicized widely.)

4. Events that seem to be malicious, like terrorist attacks.  People feel more vulnerable when they think someone is out to get them, even though common accidents are much more dangerous to them. (Making sure the bathroom is safe, by putting non-slip pads in the tub, etc. is a much more advantageous strategy than packing up the car in  case there is a dirty bomb set off in New York City. I had to point out to one patient that the last thing she wanted was to be caught in a traffic jam on the Tappen Zee bridge while a radioactive cloud drifted north.)

There are certain rules that tend to govern why people worry or don’t worry about the things they do. One is familiarity. Someone accustomed to doing something that may or may not be dangerous will stop worrying about that thing, inevitably, if nothing happens. Of course, this is the essential principal in exposure therapy. Someone afraid of traveling on highways will lose that fear sooner or later by driving a lot–unless that person is in an accident. Driving mile after mile without anything happening causes people to become unafraid. Similarly, people continue smoking, which is the single most dangerous thing anyone can do regularly, because they lit up yesterday and the day before and the week and year before that without anything obvious happening! For similar reasons, people neglect to put on their seat belts.  It is hard to determine the real risks of life; but that is what we should all struggle to do.

Bernie, being a typical worrier, worried about all kinds of things. He worried about the saber tooth tiger coming back to the neighborhood. (Think airplane crash. It made a big impression when the tiger ate his neighbor. He worried less about slipping on the rocks, which happened, after all, all the time.) No one thought that was so strange. Of course, the reason I mention Bernie is that he worried about things that were never going to happen! (I had a patient who came to me worried about a heart attack because he had a pain in the left foot.) Bernie worried a lot about getting sick, but he didn’t worry about getting sick because he got caught in the rain. Because he got caught in the rain all the time without anything happening! However,  Bernie’s ability to imagine catastrophe set him apart from ordinary people who just worried a lot.

One day, Bernie was sitting with Charlie on a rock, watching the sunset.

“I hope the sun comes up again tomorrow,” he said gloomily.

“Whattaya mean,” Charlie said. “The sun always comes up.”

“Just because the sun always came up so far, doesn’t mean it’s going to come up tomorrow.”

Actually, David Hume, the philosopher made the same point about 300,000 years later. Of course, everyone remembers David Hume, the philosopher and no one remembers Bernie. BECAUSE DAVID HUME WROTE DOWN HIS IDEA WITH A PENCIL ON A PIECE OF PAPER. Bernie didn’t have anything to write with, and he didn’t know how to write anyway. If he ever saw a piece of paper he would have thought it was a leaf from one of those big trees that grew up river that got bleached, somehow, floating down the river. If he ever saw a pencil he would have thought it was a small spear for hunting mice.