What If I Make It Worse?
You know something needs to change.
Maybe you need to have a difficult conversation. Set a boundary. Make a decision. Try something new. Ask for help. Begin treatment. Stop avoiding something you’ve been afraid to face.
But just as you begin to consider taking action, another thought appears:
“What if I make it worse?”
This is one of the most common fears people describe when they are trying to change something that matters. At first, it sounds reasonable. You are not trying to avoid growth. You are not trying to stay stuck. You are simply trying not to create a bigger problem. But sometimes, the fear of making things worse becomes the very thing that keeps a problem going.
The Need to Know Before Acting
Many people believe they are waiting for the right time, the right wording, the right plan, or the right amount of confidence. But underneath, they may be waiting for something much harder to find: certainty.
They want to know:
“If I bring this up, will it go well?”
“If I set this boundary, will they be upset?”
“If I try something new, will I regret it?”
“If I make a change, will I feel worse?”
The problem is that most meaningful action involves uncertainty.
We usually cannot know ahead of time that a conversation will go well, that a decision will be perfect, that a feeling will pass quickly, or that a change will not create discomfort.
This is where the research on intolerance of uncertainty becomes helpful.
What Is Intolerance of Uncertainty?
Intolerance of uncertainty refers to difficulty tolerating the unknown. It is not simply disliking uncertainty - most people prefer clarity when they can have it.
Intolerance of uncertainty is the tendency to experience uncertainty as stressful, threatening, unacceptable, or unbearable.
It can sound like:
“I want to know what will happen.”
“I can’t relax until I’m sure.”
“If I don’t think this through completely, I’ll make the wrong choice.”
“I want to be prepared for every possible outcome.”
Psychologist Nicholas Carleton has described fear of the unknown as a central feature underlying many forms of anxiety. From this perspective, anxiety is not only about the possibility of a bad outcome. It is also about not knowing what will happen.
For many people, the unknown itself becomes the threat.
What Recent Research Has Found
Recent research continues to describe intolerance of uncertainty as a transdiagnostic factor. This means it appears across many different mental health concerns rather than belonging to only one diagnosis.
A 2023 paper by Morriss and colleagues described intolerance of uncertainty as a risk factor across emotional disorders, including anxiety, depression, obsessive-compulsive disorder, post-traumatic stress, and eating disorders. The authors also found that intolerance of uncertainty does not only heighten fear and anxiety - it may also intensify other negative emotional states and dampen positive emotional states. That means that even a potentially positive change can feel threatening because the outcome is not guaranteed (e.g., a new opportunity may bring excitement, but also dread).
A 2024 study by Breaux and colleagues looked at adults during the COVID-19 pandemic and found that higher intolerance of uncertainty predicted more severe anxiety during a period filled with unknowns. This study is important because it shows how uncertainty can become especially powerful during real-life periods of stress, change, and unpredictability.
Other research has examined whether therapy can reduce intolerance of uncertainty. A 2023 systematic review and meta-analysis by Wilson and colleagues found that psychological treatments for adults with generalized anxiety disorder were effective at reducing intolerance of uncertainty. A 2024 systematic review and meta-analysis by Näsling and colleagues also found that psychotherapy can reduce intolerance of uncertainty, though effects varied depending on the type of comparison condition.
The hopeful message is that difficulty tolerating uncertainty is a pattern that can be understood, practiced with, and changed.
Why “I Don’t Want to Make It Worse” Feels So Convincing
Sometimes pausing before acting is wise. Not every impulse should be followed. Some situations do require thoughtfulness, timing, support, and care.
But there is an important difference between caution and avoidance.
Caution says:
“Let me think carefully and choose a wise next step.”
Avoidance says:
“I need to feel certain that nothing bad will happen before I act.”
Caution leads to preparation and is connected to our values. Avoidance leads to postponement and is organized around fear.
When someone says, “I don’t want to make it worse,” they may be describing a very real fear. But the fear can quietly create an impossible standard:
“I can only act when I know the outcome will be safe.”
Life rarely gives us that level of certainty.
Avoidance Feels Safe in the Short Term
Avoidance often works immediately. If you do not send the message, you do not have to feel the anxiety of waiting for a response. If you do not set the boundary, you do not have to tolerate someone else’s disappointment. If you do not try something new, you do not have to risk failure. In the short term, avoidance reduces distress. That relief is very powerful.
But over time, avoidance unconsciously teaches the brain:
“The only reason I’m okay is because I avoided XYZ.”
AND it prevents new learning.
You never get to discover:
“The feared outcome may not happen.”
“Even if it goes imperfectly, I can respond.”
“I can make a repair.”
“I do not need certainty before taking a meaningful step.”
Avoidance protects you from the immediate feeling, but it often keeps the fear alive.
The Hidden Cost of Waiting
You can think of avoidance as doing nothing and a lot of the time it does not seem like actual choice we are making. Unfortunately, doing nothing still has consequences. The conversation remains unspoken. The decision remains unresolved and the anxiety grows. The relationship pattern continues. The opportunity passes and the person loses more confidence in their ability to act.
This is why “not making it worse” can be misleading. Sometimes inaction does prevent immediate discomfort. But it may also prevent repair, clarity, growth, connection, and relief.
A more useful question may be:
“What is the cost of continuing to avoid this?”
Not as a way to pressure yourself, but as a way to see the whole picture.
Why This Matters for High-Achieving Adults
High-achieving adults often do not experience avoidance as avoidance. They experience it as being careful and patient. They may delay because they want to get it right. They may over-prepare because they do not want to disappoint anyone. They may avoid a difficult conversation because they do not want to hurt someone. They may stay in an unsustainable pattern because changing it feels risky. From the outside, this can look thoughtful and controlled.
Internally, it can feel like being trapped between two fears:
“I can’t keep doing this.”
and
“But a change may make everything worse.”
That is an exhausting place to live.
What Helps?
Working with intolerance of uncertainty does not mean becoming reckless (which is often what most people are afraid will happen). It means learning to take thoughtful action without requiring certainty. This often involves practicing small steps. Not the most terrifying step and not a complete life overhaul. Just the next workable action.
For example:
sending a short message instead of drafting it ten times,
asking one honest question,
setting a small boundary,
making a decision with incomplete information,
allowing someone else to have their own reaction,
The goal is not to eliminate uncertainty. The goal is to build trust in your ability to respond to it.
A Different Question
Instead of asking:
“What if I make it worse?”
you might ask:
“What if avoiding this is keeping it the same?”
Or:
“What would I do if I trusted myself to handle the outcome?”
These questions do not guarantee that everything will go smoothly. They simply make room for a possibility anxiety often hides: You may be more capable of handling uncertainty than you think.
Reflection
As you read this, consider:
Where in my life am I waiting for certainty before acting?
What am I afraid will happen if I take the next step?
Is my hesitation connected to wisdom, or is it connected to avoidance?
What is the cost of continuing to avoid this?
What small step would move me toward clarity, repair, or growth?
What would it mean to trust myself to respond, even if things do not go well?
Research References
Breaux, R., Hallion, L. S., MacNamara, A., & others. (2024). Intolerance of uncertainty as a predictor of anxiety severity and trajectory during the COVID-19 pandemic. Journal of Affective Disorders. doi: 10.1016/j.jad.2024.11.095
Carleton, R. N. (2016). Into the unknown: A review and synthesis of contemporary models involving uncertainty. Journal of Anxiety Disorders, 39, 30–43. doi: 10.1016/j.janxdis.2016.02.007
Gentes, E. L., & Ruscio, A. M. (2011). A meta-analysis of the relation of intolerance of uncertainty to symptoms of generalized anxiety disorder, major depressive disorder, and obsessive-compulsive disorder. Clinical Psychology Review, 31(6), 923–933. doi: 10.1016/j.cpr.2011.05.001
Morriss, J., Saldarini, F., & van Reekum, C. M. (2023). Intolerance of uncertainty heightens negative emotional states and dampens positive emotional states. Frontiers in Psychiatry, 14, 1147970. doi: 10.3389/fpsyt.2023.1147970
Näsling, J., Åström, E., Jacobsson, L., & Ljungberg, J. K. (2024). Effect of psychotherapy on intolerance of uncertainty: A systematic review and meta-analysis. Clinical Psychology & Psychotherapy, 31(4), e3026. doi: 10.1002/cpp.3026
Wilson, E. J., Abbott, M. J., & Norton, A. R. (2023). The impact of psychological treatment on intolerance of uncertainty in generalized anxiety disorder: A systematic review and meta-analysis. Journal of Anxiety Disorders, 96, 102729. doi: 10.1016/j.janxdis.2023.102729
Ready for Support?
If you recognize yourself in these patterns, therapy can help you understand the fears underneath avoidance and begin building a more flexible relationship with uncertainty, action, and change.
EGS Therapy offers in-person therapy in Northfield, Illinois, and virtual therapy throughout Illinois. Serving Northfield, Winnetka, Kenilworth, Wilmette, Northbrook, Glencoe, Glenview, and surrounding North Shore Communities
