APPLE: Tolerating Uncertainty

APPLE is CBT and ACT based strategy to help us respond to unhelpful thoughts and feelings - to help us tolerate uncertainty (and therefore reduce anxiety)

APPLE - this page as PDF

APPLE - a mindful response to thoughts - webpage

When we are anxious, we tend to over-estimate the danger, and the odds, of bad things happening, and we under-estimate our ability to cope if or when those bad things happen.

Even if the odds are really small that a bad thing will happen, that tiny chance is enough to really upset us. We call it "intolerance of uncertainty". We might think things like "I just can't cope with not knowing", "I have to be 100% certain", "uncertain events are almost always bad", so "I must prepare for each uncertain event".

The thoughts make us feel anxious, so we try to reduce the uncertainty by worrying about it - by planning and preparing for the possible negative future event. However, although we think worry helps us feel better and helps us feel more in control, it doesn't reduce the risk of the possible negative event happening. Sometimes we even think it would be better if the bad thing happened right now, because that would be better than living with the uncertainty.

We might try to increase certainty by planning and preparing for each worst case scenario, by seeking reassurance from others, by checking and looking things up on the internet, by avoiding certain things, putting things off or making excuses, or we might try to keep busy so that we don't think about the uncertain future.

However, worrying doesn't affect the future outcome, we cannot prevent all bad things from happening and life remains uncertain. By worrying about what MIGHT happen, how does that affect us right now? Worrying seems like the best thing to do, but it only makes us feel worse and makes us less able to cope with real life.

We can deal with uncertainty in two main ways. We can challenge our need for certainty by looking at the advantages and disadvantages of needing to be certain and how it affects us. We can explore other areas of our lives in which we do tolerate uncertainty, or look at how other people deal with uncertainty, such as friends or characters in television programmes.

The other way is to learn to tolerate uncertainty - to reduce our need for certainty. And we can do this, using the acronym: APPLE

Tolerating Uncertainty with APPLE

ACKNOWLEDGE - Notice and acknowledge the uncertainty as it comes to mind.

PAUSE - Don't react as you normally do. Don't react at all. Just pause, and breathe.

PULL BACK - Tell yourself this is just the anxiety or depression talking, and this thought or feeling is only a thought or feeling. Don't believe everything you think! Thoughts are not statements of fact.

LET GO - Let go of the thought or feeling. It will pass. You don't have to respond to them. You might imagine them floating away in a bubble or cloud.

EXPLORE - Explore the present moment, because right now, in this moment, all is well. Notice your breathing, and the sensations of breathing. Notice the ground beneath you. Look around and notice what you see, what you hear, what you can touch, what you can smell. Right NOW. Then, SHIFT YOUR FOCUS OF ATTENTION to something else - on what you need to do, on what you were doing before you noticed the worry, or do something else - mindfully, with your full attention.