Speaking of Psychology - Encore - Waiting, worrying and dealing with uncertainty, with Kate Sweeny, PhD

Episode Date: August 2, 2023

Is there anything more agonizing than being in limbo? Time may seem to slow to a crawl when you’re waiting for high-stakes news like a hiring decision, a biopsy result – or the end of a pandemic. Kate Sweeny, PhD, of the University of California, Riverside, discusses what makes waiting so stressful, how the stress of waiting differs from other types of stress, the relationship between waiting and worrying, and strategies people can use to lessen anxiety and make waiting easier. For transcripts, links and more information, please visit the Speaking of Psychology Homepage. Learn more about your ad choices. Visit megaphone.fm/adchoices

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We hope you enjoy this episode from the archives. Speaking of Psychology, we'll be back with new episodes on August 23rd. Thank you for listening. Is there anything more agonizing than having to wait for something important? You know that feeling of hoping for good news while bracing for the worst? Time seems to crawl in periods of high-stakes uncertainty, such as for a job applicant waiting to find out whether they got their dream job, or a high school senior waiting for word from colleges,

or a patient awaiting biopsy results. And since COVID-19 entered our lives, the whole world has gotten a crash course in waiting and worrying, as we've all hoped for the end of this agonizing pandemic. What makes waiting so stressful? How does the stress of waiting differ from other types of stress? What kinds of waiting periods are the most difficult? Do some people have an easier time waiting than others? And what's the relationship between waiting and worrying?

Is worrying always bad? And if you're in a period of anxious waiting, are there strategies you can use to lessen your anxiety and make the time pass more easily? Welcome to Speaking of Psychology, the flagship podcast of the American Psychological Association that examines the links between psychological science and everyday life. I'm Kim Mills. Our guest today is Dr. Kate Sweeney, a professor of psychology at the University of California Riverside. Dr. Sweeney researches how people cope with acute uncertainty. Her lab has studied people experiencing tense times in their lives, including law school graduates awaiting

news about the bar exam, patients awaiting biopsy results, and voters awaiting the outcome of a presidential election. In recent years, she's become interested in exploring how getting into a state of flow can help people cope with this type of uncertainty. She also studies how doctors can talk to their patients to lessen the patient's anxiety. She has published dozens of peer-reviewed research studies and received APA's 2016 award for Distinguished Scientific Early Career Contributions to Psychology. Thank you for joining us, Dr. Sweeney. Thanks so much for having me. Let's talk about how the stress of waiting differs from other types of stress. For example, you might think that receiving a bad medical diagnosis would be more stressful than waiting for the diagnosis, but that's not necessarily

what you've found. So what makes the experience of waiting particularly stressful? Yeah, that's exactly right. So just as an example, studies find that if you ask women who have gone through, for example, treatment for breast cancer, you know, what was the hardest part of that experience? Many of them will say it was the period of uncertainty that preceded the diagnosis, not the diagnosis, not the treatment, which can be very unpleasant. So there's definitely truth to what you said. What we think, and we have some data now to support this, is that waiting combines two really challenging states of mind, not knowing what's coming, uncertainty, and not being able to do much or anything about it, so a lack of control. And neither of those are comfortable states

for humans to be in. And when you combine them into these waiting periods, it really, kind of boosts waiting into this extra suffering kind of state compared to other kinds of stress, which may be difficult in other ways, but waiting does seem to kind of tap into some existential challenges for humans in that it combines those two really challenging states. And you also study worrying, which is obviously related to stress uncertainty in waiting. You published a paper a few years ago called the surprising upsides of worry that got some media attention. What are the surprising upsides of worrying?

So worry is actually super helpful. That might be hard to imagine if someone is feeling worried. It's not very pleasant. And that's exactly how it's helpful, in fact, is that it draws our attention to something that might befall us in the future. It motivates us through its very unpleasantness to prevent in some way that future bad event. Now, the trouble is when we're waiting, we often can't do anything about the future event. So if you've taken an exam, you've undergone a medical test, you know, there's really nothing

you can do while you're waiting for that news to change your fate. Your fate is sealed. You just don't know it yet. And so worry in that case can get a little stuck. It kind of doesn't help us in the same ways that it does when, say, we're worried about a car accident and so we put on our seatbelt or we're worried about breast cancer so we get a mammogram. Those are very useful moments of worry. During waiting periods, it doesn't quite have that same useful function.

and that is, I think, one of the other things that makes waiting so hard. So it's almost a kind of controlled worry, a worry under the circumstances that is going to protect you. That's right. And it's not to say that worry has no function in, for example, waiting periods. One of the things that worry can prompt us to do is to, for example, plan out, you know, maybe worst-case scenarios and make sure we're ready for them. So it's not exactly prevention. It's not quite the job worry wants to do for us. but it still can be useful to kind of get your ducks in a row, make sure that you're prepared for the worst case. And that can be a little bit comforting. It feels like grabbing back some control from the universe in these moments where we have so little control.

You've talked before about how some of your research started as me search, which is a great term we've heard other guests use on this podcast. What were the situations in your own life that inspired your interest in this topic? I am certainly a worrier by nature, as so many people are. get it from my mom. So we share that in common. So that's been kind of, you know, a lifelong reality. I think, you know, to some extent, everyone has their moments of worry, but mine might be a little more profound than others. There have been, though, also some very specific experiences that I think informed my work on waiting and worry. One that came kind of right around the time that I started to think about these issues was being on the academic job market, which is long and tedious and

stressful process that, you know, begins somewhere around August of the year before you want the job. And in my case, went through about January. And it was one of the most difficult kind of uncertain periods of my life. I feared often that I would be unemployed with a PhD. Of course, thankfully, it worked out and here I am. But that experience was one that I came back to often as I was thinking about how we cope with these experiences of uncertainty and what just makes them so difficult. you looking at worrying during your graduate studies as well, or was it really just the experience of waiting for this, the first job? Yeah, so certainly my research has been in some ways consistent from the early days of graduate school. I came there to work with a professor who was

studying at the time one piece of the waiting experience, and that is bracing for the worst, which is a kind of nitpicky phenomenon that happens while we're waiting where your expectations tend to go from very optimistic at the start or before a waiting period and then plunge into pessimism at the moment of truth when we're convinced we fail the exam or we have cancer or whatever the fear might be. And so I studied that phenomenon, as small as it may be, for quite a long time with a lot of focus. And then as I came into this job at UC Riverside and, again, having had that experience of uncertainty during the job market, I started to kind of broaden out the view and start to think about, yes, we brace for the worst while we're waiting, but what

else are we doing? And what else is going on during those experiences that makes it so difficult? So that was kind of the evolution of my research program. There's a stereotype that women are bigger worriers than men. Is there any truth to that? Is waiting for uncertain news more difficult for some people than for others? And how does personality or other demographic factors figure into worrying? So we actually did publish a paper just a few years ago with some pretty convincing evidence that women report more worried than men. I think that's a pretty important distinction. It may be that for various reasons, be they evolutionary or socialization, kind of how we're raised, that women may, on average, perhaps experience a bit more of that particular kind of negative emotional experience.

But it's a little bit hard to parse that out because it is also the case that women learn from an early age, very, very, very. early age, in fact, research shows that, you know, it's kind of okay to cry and it's okay to be worried and it's okay to be anxious and, you know, little boys may be less so. Certainly that was true. Historically, I would like to think maybe that's changing, but it's a pretty pervasive gender difference in how we raise kids. So I think that, yes, there is quite a bit of evidence, again, that women are at least willing to report more worry than men. It's also the case that personality matters. So people who have an overall tendency towards what psychologists call neuroticism, which is essentially emotional instability combined with a negative

emotional kind of tendency. Unsurprisingly, those folks tend to deal with more worried than folks who are less neurotic or less lower in neuroticism. There are other kinds of individual differences we would refer to them as that matter. One big one is what we call dispositional optimism. And that just means kind of an overall tendency to be bright and cheery and kind of expect the best. And even if it doesn't work out the way you want, it's going to be okay anyway. You know, those annoyingly happy folks that we all know, the higher you are in that tendency, that dispositional optimism, the easier time you have in the face of uncertainty. Now, having said all of that, no one finds all uncertainty to be comfortable.

As I said earlier about worry, it's useful. And so we really can't escape it entirely. And I, you know, anecdotally have yet to find a person who hears about my research and says, I don't know why you'd even study that. It's not that hard for me. So I think it's a fairly universal experience at some level. Does being an optimist, I mean, having a positive outlook on the world protect you from worrying to optimists, worry less than pessimists, or is everybody, you know, we all just worry. Yeah, optimists do worry less than pessimist, on average. Again, there are exceptional moments where, you know, the situation is so extreme that everyone worries. But on average, yeah, optimism being an optimist in that.

that way, that kind of cheery, dispositional way, does, it is protective. In fact, it's, it's one of the rare areas in psychology where it's pretty hard to find a downside to that particular kind of personality trait. You might gamble more aggressively. Like, that's the one finding about dispositional optimism that is, that's negative. But pretty much everything else about it is protective. Now, I want to make a really important distinction, and that is being that type of person doesn't mean that you always think things will go well for you. That's what you. That's what we call unrealistic optimism. And that is more of a kind of situational tendency to, you know, just expect the best when it's not really something you should be expecting. And that has all kinds of

downsides. But that more, you know, kind of general disposition towards optimism and cheerfulness seems to be a pretty good thing if you can have it. Does worrying kind of level off with age? I mean, there are a lot of, you know, negative characteristics that many people have that as you get older and you know, we always talk about how the baby boomers, the older folks are, they feel more comfortable in their skin, basically. I mean, does that happen with worrying as well? We're just sort of, okay, I got this. I've been here before. Yeah, I don't know actually of any really good data on that question, but you might assume so from other research on aging. One of the things, one of my favorite, I guess, findings in psychology, though it's not my area,

really, is that we do generally tend to get happier as we get older, at least from sort of the point of middle age onto later adulthood and older old age. It's maybe counterintuitive, but it's, the evidence is pretty compelling. And there are lots of good reasons why, you know, as you said, you kind of get a better perspective. You're a little bit less concerned about kind of, you know, achievement and making remark on the world and kind of settling in more to a comfortable place in life. That's, you know, not entirely a faithful interpretation of the very complicated research on that topic. But it's very reassuring for me to know that, you know, likely I will get happier as I get older. It's a one thing to look forward to. And, you know,

again, I think worry likely goes along with that. Now, of course, there's huge variability. We probably all know older people who are, you know, beset by a lot of anxiety and worry. And that's a tough, a tough place to be at that age. But on average, it does seem like people tend to, as you said, mellow out kind of as we get older. There's a really old adage, probably a lot of our listeners have never heard it, but it's the kind of thing my grandmother used to say. A watched pot never boils. So does time slow down for everybody who's worrying? I mean, that is kind of what that describes that if you watch the water, it's never going to boil. If you walk away, it will boil. Yep, that's exactly right. Yeah. So in general, we've all, I'm sure, had the experience in lots of contexts where if you're having a good time, time flies. And if you're, you know, experiencing something frustrating or boring or tedious or unpleasant. time seems to crawl along a minute can feel like an hour. And that's the case with waiting and worry as well. So we have found that when people are suffering during a waiting period, they're worried,

they're having a difficult time coping, that it feels like the end of that waiting period will never come. Now, unfortunately, there's a bit of a downward spiral that can occur because it's also the case that when you feel like this waiting period will never end, it can heighten that distress that you're experiencing. So we've worked pretty hard to find good ways to kind of break that cycle. But it's somewhat inevitable, I think, in those moments where you are feeling particularly worried.

So I think that segues us into the concept of flow, right? That's something that you have named and have been looking at. Can you explain what flow is and how it can help people who worry? Yeah. So flow is a concept that's been around in the research literature for, gosh, I forget how old I am, but it's probably more than 50 years at this point. a very long time, longer than I am alive. And Mike Chiksetmi Hai is the kind of father of that concept of flow.

He did studies some really interesting in-depth studies many, many, many decades ago about creative types and the folks who can sit and paint and, you know, forego food and never get up to go to the bathroom and, you know, they'll cramp up and they barely notice it because they're so in the zone in the activity they're doing. And so he really identified that kind of absorbed flow state that, that many of us experience in our everyday lives as well, not just the artists among us.

And so we have picked up that concept and really applied it to this idea of waiting. As we just talked about, one of the difficult things about waiting is the persistence of time passing slowly and not passing as quickly as we would like it to when we are eager to find out some information. And so, you know, what better to do

than to do something that will make time feel like it's flying by. And there are lots of things we can do that might be, you know, a little bit distracting that, you know, get us away from watching that pot as the saying goes. But it is especially useful if you can get into that kind of exquisitely distracting state of flow where, you know, you lose self-consciousness, you are completely out of your head, you are completely in the activity. And in fact, we know that time seems to really just pass by in a moment when we're in that state. In fact, when people ask, like, how do I know what my own flow activities might be? I say, think about the thing you can't do if you need to leave the house anytime soon

because you'll lose track of time and end up being late wherever you're going. And that's a pretty good indicator that that's a flow activity, which is different for everyone. So, yeah, that's a good test and really points to that time perception aspect of flow experiences. It sounds like it almost relates to a meditative state. I mean, is that part of what you advise? people who are worriers that if you can focus in the way that you might mindfully meditate, that that will help? We have studied mindfulness meditation as well in this context, or in this context, excuse me. And it's interesting. Flow and mindfulness are cousins, I would say.

They certainly share a lot in common. They are both a form of focused attention, which might not, again, intuitively seem like something that would be helpful, but it turns out that attention is a really powerful force. And if we're letting it kind of carry away, to worries and ruminations and unpleasant thoughts that's going to hurt us, whereas if we can focus it towards something productive and pleasant, that's probably going to help us in those moments. So they're similar in that sense. They're also similar in the sense that they are beneficial

in lots of ways for reducing stress, for improving our emotional state. How they are different, I think, importantly, is that mindfulness is really about total awareness of your experience in a given moment. And that's really the focus, of most meditations is maybe focus on the breath, but also kind of notice your thoughts passing by, notice feelings that arise, notice sounds in your environment.

Whereas flow is really the opposite in that particular way, where you are so absorbed in an activity. One term that comes up in the flow research is action awareness merging, which just means you and the activity are essentially one. There is like no kind of mental space between you and what you're doing. And that's really different.

You won't notice anything going on around you if you're really in a flow state. And so the way I think about it is I think mindfulness is a really important practice for kind of getting good at managing worry, at reacting to worry in a way that isn't doesn't kind of carry you away and take you down with it. And that's something that's very useful for sure in lots of parts of life. Flow I think of is more of like an in the moment solution. So I'm having a bad worry day. Today is a good day to get into that flow state. It might not help five minutes after you're finished with the activity, but it will be very helpful.

as you're in that moment and your worries shut down for a period of time. What about turning to friends or family for support? Is there any research on whether that's helpful during periods of acute uncertainty? It is. As it is during most times of life, social support is crucially helpful for our well-being and also our health. It's, you know, having people who you know can support you in difficult times predicts longevity, for example, like how long you will live at the same level as something like smoking. So it's hugely important in general, therefore perhaps unsurprisingly, also helpful during the stress of waiting and uncertainty. Maybe the more kind of interesting aspect of that social support during waiting, though, is that I think it's really hard to provide it well. So we need it when we're waiting.

It can be really lonely sometimes, especially if you're waiting for something very personal. But people aren't always great at providing social support in those moments where, you know, nothing is really happening. Like you're waiting for that test result to come back. You know, people might feel like, I don't know, just wait. Like, it's coming. You'll know in a day or two, you know, how this is going to turn out. Why are you thinking about it right now? Well, we've all been there.

We know you can't not think about it. But as a, you know, social support provider, those moments can be really challenging. And we have found, in fact, that in a prolonged waiting period, specifically where law school graduates were waiting for their bar exam results for four long, torturous months, you know, their romantic partners did a pretty good job. supporting them shortly after the exam, you know, when there was stuff to talk about, essentially, and then right before they got their results, in the middle of that four months, they still needed the support. They weren't always doing well, and their romantic partners weren't showing up for them

quite as much as they wanted them to in those moments. That makes sense. So you choose carefully who you're going to confide in and who's going to be your support. Spread them out. So this year has been marked by intense uncertainty and stress for many of us. At one point, we thought the pandemic might be over, but then the Delta variant showed up and breakthrough infections. Is it more stressful to wait through a period of uncertainty without knowing the end date like the pandemic as opposed to something like the bar exam results where there's a date? You know that you're going to get an answer on a certain date. Yeah, that's right. So it's been interesting, actually, for me, just personally as a researcher,

or to think about how my work on waiting applies to this, you know, global and very open-ended kind of uncertainty that we're experiencing. And as you pointed out, not just open-ended, but kind of almost cyclical where we have these periods where things seem to be going well and we think we might be out of it and then we're plunged back into uncertainty again. You know, I think there is a similarity in many ways across different kinds of uncertainty, whether they are those structured sorts of waiting periods that I typically study where the end is known, or at least the end date is known, if not the result, versus, you know, this kind of

situation with COVID and so many other things where it's kind of open-ended. We've, for example, looked at cancer survivors experiences as well, which is a different kind of open-ended uncertainty where it might come back or not, but you really don't know when that might happen. You know, whether it's harder or easier is a little tricky, I think, to be sure about. when we know that a waiting period will end, those last moments, hours, days, weeks, however, kind of it falls within your particular waiting period can be pretty torturous. You know, those final moments of truth, we all have a tendency to, you know, plunge into pessimism, plunge into a worst case scenario thinking to kind of have a difficult time coping.

When there's no clear end, you don't kind of have that ramp up of distress in that same way. but you also don't get that kind of relief and maybe the middle of the waiting period, which is typically an easier time. We have found that waiting has a shape such that the beginning and end is the hardest and the middle tends to be easier. When you're in one of these like endless waiting periods, like we're all in now for the, you know, end of a global pandemic, I don't even know what that will look like. You know, it's really hard to kind of know at what point you should be gearing up for the moment

of truth. Like there just is no moment of truth at this point. Or there are many of them, I guess, maybe. but no one singular end to our uncertainty. So the way that I've at least observed it, again, somewhat anecdotally, not so much in data, is that I think that it creates more of a good day, bad day situation where rather than kind of settling into more of a pattern

where it's hard at the beginning, you calm down a bit, and then it gets hard at the end, we just kind of do a bunch of little cycles of, you know, oh, hey, this is where we are, I'm kind of used to it. I've got my situation settled in a way that's comfortable, and then a week of, oh, no, this is awful and I can't handle this. And, you know, when will my kids get to go back to school? Or when will my job, you know, become in person again?

Or when will I get my job back? And so I think it's unfortunately hard to find real relief for any length of time when the situation is constantly evolving and there's no clear end in sight. So what are you working on now? And what are the next big questions that you want to answer? Yeah, I've been thinking a lot about that. You know, I've been studying this very focused question about like, what is this thing that is waiting? and how do we make it easier for about 10 years now?

And, you know, it's felt like a big question at times. But I think after about a decade, we've answered a lot of the questions that I kind of had at the beginning. There's more to do. But I think we know a lot now about waiting that we didn't know a decade ago. And so I've started to think about where to next. And there's really three big areas that my lab is focusing on now. One is flow, which we've already talked about. And it turns out that the world of flow research is huge and wild and wacky.

That's very interdisciplinary, I guess. It's kind of a nice word for it, which means people from lots of different fields, often not even scientific fields, are interested in it. But that means that it's a mess. I mean, honestly, the research is kind of a mess. And it's really hard to know what we know about flow. And it is this very kind of powerful, compelling experience that, you know, we all have and I think we seek sometimes.

But what exactly it is and what it looks like in the brain and the body, how exactly it benefits us and when we really don't have a lot of good evidence on that. So, you know, I became interested in flow because of waiting and because of its fit as a coping strategy during waiting periods. But now I and my graduate students have fallen down the rabbit hole a little bit and are interested in getting a better handle on what that exactly is. So that's one area. I'm also taking a deeper dive into worry and what exactly it is about worry during waiting periods that is so difficult. And that is work I'm doing with a collaborator at another University of California campus at Merced, Jennifer Howell, who's a long-time

collaborator of mine. And we have some money right now to try to figure out, you know, when is it that worry is hopeful to us and not so disruptive to our lives? And when is it that it really does become a problem for our health and well-being? And that turns out to be, as things will tend to be in psychology, a more complicated question than might appear on the surface. And then the third big question is one that's a big, big collaboration that I'm really excited about thinking about patience, which in some ways I've been studying all along, but more as a virtue. And that's an interesting way to kind of think about patience, not just as like waiting calmly, but as something that we can kind of cultivate, that does have connections to philosophy and theology. And so

a researcher at Baylor University, Sarah Schnichter, is leading this big, big, initiative to bring together researchers from across fields to kind of bring our perspectives on what the heck this thing is called patience, you know, what it looks like, how to get it. And one of, to me, the most interesting questions about patience is, why are we so quick to say we don't have it? So most of us, you know, wouldn't quickly say that we are, you know, cowardly or unkind or ungenerous, but lots of people, myself included, will happily say we're inpatience, which makes it kind of a funny virtue. So those are just some of the things. we're digging into in the coming years.

Wow, that all sounds really fascinating, so we'll have to stay in touch and keep an eye on your research so that we can talk again when you've got some big breakthrough, which I'm sure you'll get to. So thank you so much for joining us today, Dr. Sweeney. This was fun. Thanks so much for having me.

You can read more about Dr. Sweeney's work in the November 2021 issue of APA's magazine Monitor on Psychology. You'll find a link in the show notes on our website at www. www. speakingof psychology.org. You can also find previous episodes of Speaking of Psychology on Apple, Stitcher, Pandora, or wherever you get your favorite podcasts. If you have comments or ideas for future episodes,

you can email us at Speaking of Psychology at APA.org. Speaking of Psychology is produced by Lee Weinerman. Our sound editor is Chris Condihan. Thank you for listening. For the American Psychological Association, I'm Kim Mills.