CivilPsych Services

Individuals, Arkansas and Missouri

Worry and anxiety

Anxiety is not something that happens to you out of nowhere. It is the feeling that follows a prediction, usually a prediction that something will go badly and you won't be able to handle it.

Written by Dr. Heath, Ph.D. Neuropsychology, Ph.D. Forensic Psychology. 40+ years of cognitive behavioral work. Reviewed November 2026.

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What's really going on

What people say"I have anxiety." The word gets used as if it were a thing living inside you, running the show.
What's usually happeningA specific thought, a cognition, fires first: this will go wrong, they will think less of me, I can't handle it. The racing heart and the knot in the stomach are exhaust from that engine. Worry isn't too much thinking. It is under-thinking: hard on the worst case and light on the facts and on what you would actually do. Change the prediction and the body follows.

What you might notice

  • You rehearse conversations and outcomes that haven't happened.
  • You put off calls, mail or decisions because you predict they will go badly.
  • You avoid places or people, and the avoiding makes the next time harder.
  • Your sleep, appetite or concentration drop whenever you predict something will go badly.
  • Reassurance helps for an hour, then the worry comes back.

How we work on it

The same method every time: find the thought, test it, practice a better one.

  1. Find the predictionWe pin down the exact thought that shows up right before the worry. Most people have never said it out loud.
  2. Check it against the factsHow often has the thing you predict actually happened? What did you do when something hard did happen?
  3. Write a more accurate oneNot a cheerful thought. An accurate one you can believe.
  4. Field-test itCognitive Field Testing: you take one small step you have been avoiding and check the prediction against what actually happens. The test is of the thought, not of your nerve.

Questions

Is anxiety a chemical imbalance?

The chemistry in your body is real, and it follows what you are thinking. When the prediction changes, the chemistry changes with it.

Will I have to talk about my childhood?

Only if it helps explain a thought you are still running today. The work is about what you think now and what you do next.

Can I keep taking my medication?

Yes. Decisions about medication stay between you and your prescriber. Therapy works alongside it.

Am I overthinking?

No one thinks too much. The brain runs thousands of thoughts a day. Worry is thinking in the wrong direction, and direction can be changed.

Next

Call (870) 219-6312 Other ways to reach me

If you are in crisis or thinking about harming yourself, call or text 988, or call 911.