Two simple questions that can curb social anxiety
Learn how asking ‘What’s the worst that could happen?’ and ‘And then what?’ can help calm social anxiety – and try it this week.
The story behind the two questions
According to Health, a personal essay describes how a therapist’s two‑question prompt – “What’s the worst thing that could happen?” followed by “And then what?” – helped the writer move from avoiding social events to graduating with a first‑class degree. The writer recounts using the pair of questions during university introductions, dates, job interviews and even a move from the UK to Australia.
How the questions work – a brief look at the psychology
The brain’s anxiety response often runs a mental simulation of future disaster. Cognitive‑behavioural theory calls this catastrophic thinking: the mind leaps to the most dreadful outcome and then assumes that outcome will derail the whole day, week or life. The first question, “What’s the worst that could happen?”, forces the mind to articulate that imagined catastrophe instead of letting it lurk as a vague dread.
The second question, “And then what?”, adds a temporal buffer. It asks the person to picture the immediate aftermath of the worst scenario. In most cases the answer is a simple, low‑stakes action – going home, changing into pyjamas, watching a film. By visualising that the worst outcome is survivable and short‑lived, the brain’s alarm system is dialled down. The technique mirrors the CBT strategy of downward‑arrow questioning, where a client is guided from a broad fear to the most concrete, often harmless, consequence.
What the evidence says about similar techniques
Research on CBT for social anxiety consistently shows that cognitive restructuring – challenging and re‑framing unhelpful thoughts – reduces symptom severity. A meta‑analysis of CBT trials (without quoting exact numbers) notes that asking patients to generate realistic worst‑case scenarios and then evaluate the likelihood and impact can lower anxiety scores more than exposure alone. The two‑question method is a stripped‑down version of that process.
Another line of evidence comes from acceptance‑and‑commitment therapy (ACT), which trains people to notice thoughts without elaborating on them. Studies suggest that simply naming a feared outcome and then observing it pass without catastrophe reduces avoidance behaviour. The writer’s experience aligns with these findings: the questions create a mental “pause” that interrupts the automatic spiral.
Alternatives and how they compare
| Approach | Core idea | Typical effort required | Known benefits | Main limitations |
|---|---|---|---|---|
| Two‑question technique | Identify worst outcome, then imagine the next step | 1‑2 minutes before a feared event | Quick, portable, no paperwork | Relies on self‑discipline; may feel simplistic for severe cases |
| Full CBT thought record | Write down situation, automatic thought, evidence for/against, alternative thought | 10‑15 minutes, usually with therapist guidance | Structured, evidence‑based, tracks progress over time | Requires therapist time, can feel academic |
| Medication (e.g., SSRIs) | Pharmacological reduction of serotonin re‑uptake to dampen anxiety | Daily pill, medical prescription | Helpful for chronic, high‑level anxiety; works alongside therapy | Possible side‑effects, takes weeks to act, not a stand‑alone solution |
| Mindfulness meditation | Observe thoughts without judgment, return focus to breath | 5‑20 minutes daily | Improves overall stress resilience | Benefits accrue over weeks; may not address specific catastrophic thoughts |
The table highlights that the two‑question method sits at the low‑effort end of the spectrum. It does not replace formal therapy but can act as a bridge between therapist sessions or a first‑step for someone hesitant to seek help.
Potential pitfalls or unanswered questions
The source does not discuss situations where the worst‑case scenario is genuinely harmful – for example, a fear of losing a job after a failed interview that could have financial repercussions. In such cases, simply accepting “go home and watch TV” may under‑prepare a person for necessary practical steps (e.g., updating a CV, seeking financial advice). Moreover, the technique assumes the individual can generate a realistic “next step”. For people whose anxiety is entangled with rumination, the second question may trigger a new loop of “what if the next step also fails?”. Research on CBT notes that some clients need additional scaffolding, such as behavioural experiments, to cement the new belief.
Another open question is long‑term efficacy. While anecdotal reports like the one in the article describe lasting change, controlled studies of brief cognitive prompts over months are scarce. The evidence suggests short‑term reductions in anxiety intensity, but whether the habit sustains without periodic reinforcement remains unclear.
How to try it this week
- Pick a upcoming social situation – a meeting, a coffee with a friend, or a brief phone call.
- Write the two questions on a sticky note or phone reminder.
- Before the event, answer the first question honestly. Note the worst thing you can imagine.
- Immediately follow with “And then what?” Write the concrete next step you would take if that worst thing happened.
- Read the answer aloud to yourself right before you enter the situation.
If the answer feels insufficient – for instance, “I’ll lose my job” – add a practical backup plan (update your résumé, set a budget). The goal is to make the worst outcome feel manageable, not to dismiss genuine concerns.
