When Worry Takes Over: Helping Kids with "What If" Thinking

What if I fail the test? What if the plane crashes? What if you don't pick me up? What if I throw up? What if everyone laughs at me?

For some children, "what if" thinking takes over. One worry leads to another, spiraling into worst-case scenarios. Here's how to help.

Understanding "What If" Thinking

"What if" thoughts are the brain's attempt to prepare for danger. In small doses, anticipating problems is useful. But for anxious children, this mechanism goes into overdrive.

The pattern: 1. A worry appears ("What if I fail the test?") 2. The brain generates a scary scenario 3. Anxiety increases 4. The brain generates another "what if" to prepare for that 5. Anxiety increases more 6. The spiral continues

The child isn't choosing to think this way. Their brain is trying to protect them—just in an unhelpful way.

What Doesn't Work

Answering Every "What If"

If your child asks "What if the house catches fire?" and you explain all your fire safety measures, they might feel better briefly. But then: "What if we can't get out in time? What if the dog gets trapped?"

Answering "what if" questions tends to generate more questions. The anxiety isn't actually about fire safety knowledge—it's about intolerance of uncertainty.

Dismissing the Worry

"That won't happen" or "Don't worry about it" doesn't help. They can't turn off the thoughts, and dismissal makes them feel unheard.

Getting Frustrated

Your frustration is understandable. But showing it adds shame to anxiety, which doesn't help.

What Does Work

Acknowledge Without Engaging

"I hear that you're worried about a lot of things happening." This validates that the worry is real without diving into each scenario.

You're responding to the feeling, not the content.

Name the Pattern

"Your brain is doing that thing again—coming up with a lot of 'what ifs.' That's just your worry brain working overtime."

Naming the pattern creates distance. It's not reality—it's the worry brain.

Teach "Catch, Check, Change"

**Catch:** Notice the "what if" thought. "I'm having a 'what if' thought right now."

**Check:** Is this thought helpful? Is it likely? Is it based on evidence?

**Change:** Replace with a more realistic thought or coping statement.

Example: - Catch: "What if I throw up at school?" - Check: "Have I thrown up at school before? How often do kids actually throw up at school? Is my body telling me I'm sick right now?" - Change: "I don't throw up at school. I'm just nervous. If I ever did feel sick, I could go to the nurse."

Play "Best, Worst, Most Likely"

For each worry, ask: - What's the best thing that could happen? - What's the worst thing that could happen? - What's the most likely thing that could happen?

This expands thinking beyond worst-case scenarios.

Set a "Worry Time"

Designate 10-15 minutes as "worry time." When "what if" thoughts come up outside that window, your child can write them down and save them for worry time.

During worry time, you can discuss the worries (briefly) or your child can discover that by the time worry time arrives, many concerns have faded.

This contains the worry rather than letting it take over all day.

Practice Tolerating Uncertainty

At the heart of "what if" thinking is intolerance of uncertainty. Your child wants to know for sure that bad things won't happen. But certainty isn't possible.

Help them practice sitting with "I don't know":

"Will I get picked for the team?" → "I don't know. Let's see what happens."

"What if no one talks to me?" → "Maybe someone will, maybe not. You'll handle it either way."

This is uncomfortable at first. But tolerating uncertainty is a skill that builds with practice.

Redirect to the Present

"What if" thinking is future-focused. Redirect to right now:

"Right now, are you okay?" "What's happening at this moment?" "Let's focus on today."

For the Big Spirals

If your child is in a full anxiety spiral, cognitive strategies may not work. The thinking brain is overwhelmed.

Go back to basics: - Calm the body first (breathing, movement, grounding) - Offer your calm presence - Don't try to logic them out of it mid-spiral - Wait for the intensity to pass, then talk

Building Long-Term Resilience

Repeated practice with these strategies helps anxious brains learn new patterns. It takes time. Your patient, consistent support is the most important factor.