Book Review: ‘Things Might Go Terribly, Horribly Wrong: A Guide to Life Liberated from Anxiety’

“If suffering is ubiquitous in life,” write authors Kelly G. Wilson, Ph.D. and Troy Dufrene, “then withdrawal from and avoidance of suffering is accordingly the withdrawal from and avoidance of life.” Their book, Things Might Go Terribly, Horribly Wrong, as you may guess from the title, is about dealing with anxiety.

However, Wilson and Dufrene do not claim to teach you how to stomp down your anxious thoughts, because life’s joys would be stomped down as well. Instead, Things Might Go Terribly, Horribly Wrong guides its readers to a new way of looking at anxiety.  Wilson and Dufrene write: “…our goal will be to help you find a way to live a rich and meaningful life in the presence of whatever your mind throws your way, including anxiety.”

The past and the future create more anxiety than the present

We suffer when things go wrong, but we suffer even more knowing things could go wrong. The authors titled their book Things Might Go Terribly, Horribly Wrong for a reason. The ambiguity of the future, what might happen, creates more anxiety than any actual threat in the present.  If something bad actually happens, we are usually equipped to deal with the problem, as terrible as it may be. However, humans don’t fare well with uncertainty. Anticipating problems creates a level of stress and anxiety that can put a stranglehold on our daily functioning. Worry is our attempt to control an unknown future; anxiety, the authors write, is our attempt to neutralize ambiguity. It is an ineffective strategy, but how do we deal with unbidden thoughts that something might go terribly, horribly wrong?

Acceptance and Commitment Therapy (ACT): A behavior analysis approach

The slender volume is written in a conversational and sometime humorous tone, making it an easy read, yet it deals with some profound ideas. The authors draw from literature to demonstrate how writers, poets and philosophers throughout the ages support the concept of ACT, the Acceptance and Commitment Therapy developed by Wilson. Throughout the book, readers are given simple exercises to explain the six core processes at the heart of ACT and help the reader develop “psychological flexibility.”

Increase your psychological flexibility

Just as you stretch your muscles to develop flexibility, you can stretch your psychological processes to expand your ability to be aware of and adapt to psychological demands. With psychological flexibility, you have a greater repertoire of responses to the events of daily life. Things Might Go Terribly, Horribly Wrong provides exercises designed to increase this flexibility by building on the six interrelated psychological processes that form the foundation of ACT.

The six process areas of ACT

These are core principles that, once embraced, will help you break out of an inhibiting, anxiety- riddled mindset.

1. Contact with the present moment — focus and mindfulness are the buzz words here. Whenever we dwell on the past or worry about the future, we are not in the present. This is not to say we should get so caught up smelling the roses along the way that we forget to show up for work. Psychological flexibility is the ability to find a balance, and the authors offer exercises and anecdotes to help develop this skill.

2. Defusion — Cognitive Behavioral Therapy (CBT) tells us that many of our problems stem from distorted thinking. For example, you may believe you are not good with math, which leads you to believe you will fail your math class. The imminent failure makes you anxious and depressed.  CBT says you should question the first assumption, “I’m bad at math.” But what if you really have a difficult time grasping math concepts?

You have fused two ideas — “I’m bad at Math” and “I will fail the class.” Defusion is the process of undoing this fusion and recognizing that, while you have deficiencies in math skills, you have options other than failure (hire a tutor, practice underlying math principles via internet videos, etc.).

3. Acceptance — Accept what is, the good and the bad. It won’t always be fun, but acceptance is liberation; it allows you to move on. For example, if you lost your job, spending time bemoaning your situation, ruminating over the past (why me?) or worrying you will never find another job, won’t help. Accept your job has ended and take it as an opportunity to explore new career options.

4. Values — Ideally, your actions will be reflections of your values. What is important to you? Your spirituality? Being a good partner and parent? Keeping physically fit? Adhering to your values may cause some difficulties. If being a good parent is a core value, and you believe you must attend all of your child’s weekend soccer games even though you have housework to do and errands to run, you will be in conflict. The authors prompt you to ask this question, “If you could decide to live out your thoughts or your values, which would you choose?”

5. Committed actions — All these processes work together, and dedicating yourself to committed actions will help you live a values-driven life. View commitment, the authors exhort, in the present, rather than as a distant goal. If health is a value, rather than setting a goal in the unknowable future — “I will lose 20 pounds by summer” — commit to making healthy food choices on a daily basis.

6. Self-as-context — You create your own sense of self. Who you are evolves. Your identity is not static. Too often, we lock ourselves into an outdated self-image. You may have been socially awkward in high school, but as an adult, you exist in a different context. You may tell yourself stories about who you are, “I’m the sort of person who doesn’t travel.” You don’t have to accept this as gospel. Embrace the possibility of a vacation at some exotic port.

Things Might Go Terribly, Horribly Wrong concludes with the assurance that “things still might go terribly, horribly wrong.” You can only avoid pain by avoiding life, including its joys. Rather than withdrawing from possible misfortune, the authors offer a way to open up and embrace life, good and bad, without letting bad experiences, or fear of them, take over.