There are many definitions of uncertainty, capturing its various aspects. Generally speaking, uncertainty refers to a state of not knowing or lacking confidence about the outcome of a particular event, situation, or decision. It involves a sense of ambiguity, unpredictability, or doubt regarding future circumstances or consequences and can manifest in various aspects of life. Generally speaking, it is a condition of human life. Uncertainty can range from mild and temporary to prolonged and overwhelming, depending on the complexity and significance of the situation. If the situation is existentially threatening, perceived uncertainty can be experienced as dramatically disturbing.
Impact of perceived uncertainty on mental health
Perceiving increased uncertainty can contribute to feelings of anxiety, stress, and overwhelm. Uncertainty may also affect decision-making abilities and interpersonal relationships, further impacting mental well-being.
Perceived uncertainty can lead to excessive worry, fear, and apprehension about future events or situations, which are common features of anxiety disorders such as generalised anxiety disorder, panic disorder, and social anxiety disorder. It can also trigger obsessive-compulsive disorder as patients may experience intrusive thoughts and engage in compulsive behaviours as a way to alleviate uncertainty and anxiety. Uncertainty following a traumatic event can contribute to the development of PTSD: uncertainty about safety and security may exacerbate symptoms of hyper-vigilance, avoidance, and re-experiencing trauma. PTSD cannot be diagnosed while people are experiencing trauma, like combat, because the responses that make PTSD pathological in a non-traumatic environment are extremely adaptive in the midst of trauma. Hyper-vigilance or being unable to sleep may save your life if you’re in a war. Pathology is when people return home to safe environments but the safety-seeking behaviours persist. PTSD is not about dangerous things being dangerous; it’s about an inability to perceive safe things as safe.
Perceived uncertainty can lead to excessive worry, fear, and apprehension about future events or situations, which are common features of anxiety disorders such as generalised anxiety disorder, panic disorder, and social anxiety disorder.
Prolonged experiencing of uncertainty about the future, feelings of helplessness, and lack of control can contribute to the development or worsening of depressive symptoms, such as persistent sadness, loss of interest in activities, and feelings of hopelessness.
Uncertain circumstances can trigger adjustment disorders. Uncertainty about the future can exacerbate symptoms, such as anxiety, depression, and u disturbances.
For many autistic individuals, even slight uncertainty is reported to lead to distress and anxiety, which exacerbates difficulties with social interaction. There is a positive association between intolerance of uncertainty and anxiety: higher anxiety is found in individuals who are more intolerant of uncertainty (and vice versa) among people with autism as well as in neurotypical population. That is why intolerance of uncertainty (to be discussed a little bit later) is an appropriate target for intervention in autistic individuals, as it is in neurotypical populations.
The relationship between uncertainty and psychosis is still under-investigated.
The pain of uncertainty
The pain of uncertainty is a well-studied neuropsychological phenomenon; now I am referring to experiment in which researchers attached people to machines that delivered electric shocks. The participants of experiment reported that it is more painful to be uncertain if they may be shocked than it is to be certain that they will be shocked. The truth is that emotions surrounding the uncertainty can be, quite literally, more painful than physical pain.
Because uncertainty can be so painful, the brain tries very hard to avoid it. Extreme safety seeking is core to every form of anxiety: PTSD, social anxiety, generalised anxiety, OCD.
All kinds of hyper-compensation as safety seeking behaviour can be seen as a defence against anxiety. All forms of anxiety - from the mild to the pathological - can be understood as a dysfunctional relationship with certainty.
The behaviours one employs to keep him safe from uncertainty become the very behaviours that injure him.
Tolerating pain of uncertainty
Experiencing uncertainty of quite the same situation can be very individual due to persons’ (in)tolerance of uncertainty.
Tolerance of uncertainty refers to an individual’s ability to withstand and cope with situations characterised by ambiguity, unpredictability, and lack of control. It involves an individual’s capacity to manage feelings of discomfort, anxiety, and distress that arise in response to uncertainty.
People with high tolerance of uncertainty can navigate uncertain situations more effectively, remain calm in the face of ambiguity, and make decisions even when outcomes are unclear. They may be more adaptable, resilient, and open to new experiences. Conversely, individuals with low tolerance of uncertainty may experience heightened levels of anxiety, worry, and fear when faced with uncertain circumstances, leading to avoidance behaviours or difficulty making decisions.
Tolerance of uncertainty is influenced by various modified and unmodified factors, including personality traits, cognitive styles, past experiences, and coping strategies.
Strategies and interventions to decrease intolerance of uncertainty
Several therapeutic techniques are proven to be beneficial for increasing tolerance of uncertainty.
Cognitive restructuring challenge and modify maladaptive thoughts and beliefs about uncertainty so we can learn to tolerate it better. Mindfulness practices can help us cultivate present-moment awareness and acceptance of uncertainty by promoting nonjudgmental awareness of thoughts and emotions. Behavioural experiments involve engaging in activities or behaviours that challenge beliefs about uncertainty and its consequences so one can gather empirical evidence to challenge one’s beliefs and thus increase tolerance of uncertainty. Exposure therapy involves gradually introducing one to feared or uncertain situations in a controlled and supportive environment. Through repeated exposure to uncertain stimuli, we can learn to tolerate discomfort and anxiety and develop more adaptive coping strategies. Learning effective problem-solving skills can help one feel more empowered and in control when faced with uncertain situations by breaking down problems into manageable steps and generating potential solutions. Acceptance and commitment therapy (ACT) focuses on accepting difficult thoughts and feelings while committing to actions aligned with one’s values and goals. By accepting uncertainty as a normal part of life and focusing on taking meaningful actions, we can reduce the impact of intolerance of uncertainty on our well-being. Seeking support from friends, family, or support groups can provide us validation and reassurance that give us courage to move on with our lives in this sometimes unpredictable but beautiful world. □