By Manny Vazquez, M.S., LMFT, Christian Counselor

Wednesday, September 9, 2026

One of our human frailties is the problem of excessive worry. Many of my clients come to me with severe anxiety over problems in their life. I never judge them for their worry because I have had severe anxiety in my life, so if I judge them, I would have to judge myself.

But what exactly is anxiety? Well, it can take many forms, but one of the common things that we do when we worry is that we ruminate about what if scenarios. I once had a client, a young man who liked to organize events for his family and friends. Once, he and his girlfriend wanted to organize a trip for them and their family and friends. So, they planned the trip, and as is often the case, people were too busy to make the time to spend time with one another, and my client and his girlfriend ended up going on the trip just the two of them.

While they were gone, one of my client’s cousins was struck by a car, and he ended up in the ICU with severe injuries. My client came to session that next week, and he was obviously distraught. He told me that this cousin was supposed to go on the trip with him and his girlfriend, and that if he had gone, he would have never been hit by the car.

I looked at my client and engaged him in supportive talk therapy, encouraging him to restructure his thinking, so that he could let go of the cognitive distortions of what I call what if thinking. I asked him to consider all the different possibilities that could have happened to his cousin. What if he had died, instead of being in the ICU? What if he had gone on the trip and something worse had happened? What if had gone on the trip and nothing happened? I got my client to see that no matter what what if scenario he posited, it did not matter because that was not what happened.

Instead, I reinforced with my client that he needed to consider the reality around him, what I call the what is of life, not the what ifs of what could have happened. The reality was that he had a cousin who needed his love and support. And he had an uncle and an aunt who needed him to come around them and provide them support, as well. Additionally, he had a family who was hurting because their family member was in the hospital. I encouraged my client to use his organizational skills to help his cousin and his family recover from what happened. In other words, I encouraged my client to focus on the reality around him, and I encouraged him to take decisive action to help his cousin and his family through this tragedy. Over the course of the next few weeks, through much prayer and supplication to our Blessed LORD, my client’s cousin slowly recovered from his injuries. He was taken out of ICU, and eventually, he left the hospital.

I remember this client very clearly because what happened to his cousin and his family is something that can happen to anyone of us. And we can all go down the rabbit hole of what if thinking. At one point, after I posited several possibilities of what could have happened, I asked my client how many what if possibilities there actually were. He quickly realized that there were an infinite number of what ifs, and then he realized there was only one what is, which was the reality of what happened. And then, he and his girlfriend and his family rallied around his cousin and their family and figured out how to truly help them.

I’ve always been fascinated by Marvel Comics and DC Comics. I often see the stories in these comics as allegorical of events that happen in real life, albeit with a lot of fantastical attributes. One of the fantasies in these comics is the idea that there are multiple realities. And while these different realities are fun to consider in comic books, in our real life, there is only one reality. And if we start to believe that there are multiple realities in our real universe, we will create anxieties in ourselves that can be very debilitating.

So, in psychotherapy, one of the main things we do as clinicians is to challenge what if thinking. I confront this kind of thinking with what is thinking; in other words, realistic thinking. I strongly encourage my clients to challenge their thinking and to eliminate any what if anxiety with the truth of what is really going on in their lives. This problem of what if thinking is universal for humanity, and if we are honest with ourselves, we have all engaged in it at some point in our lives. And I am just as guilty of it myself. People who have learned that only reality matters in their lives will challenge their thinking, and they will place reality at the forefront of our minds, leaving the what ifs behind. Amen.