“Life is inherently uncertain, and if you have difficulty dealing with that, you will have difficulty dealing with life,” says Michel Dugas, a professor of psychology at the University of Quebec in Outaouais and a leader in the study of uncertainty and mental health.
Tolerating and even delighting in uncertainty doesn’t merely help us to accept life’s unpredictability; it also readies us to learn and adapt. Each day, the brain uses honed mental models about how the world works, which are used to process a shifting environment. When we meet something unexpected, a neural “prediction error” signals a mismatch between what we assumed would occur and what our senses tell us. Yet our uneasy sense of not knowing triggers a host of beneficial neural changes, including heightened attention, bolstered working memory and sensitivity to new information. The brain is preparing to update our knowledge of the world. Uncertainty offers the “opportunity for life to go in different directions,” says Stephanie Gorka of Ohio State University’s College of Medicine, “and that is exciting.”
This is why being open to uncertainty is critical for mental well-being. Pioneering work led by Dr. Dugas (who originated the term “intolerance of uncertainty”) and Nicholas Carleton of the University of Regina in Canada shows that being intolerant of uncertainty is associated with vulnerability to mental health challenges such as anxiety, eating disorders and depression. After more than two decades of spadework, they and their colleagues are beginning to effectively ameliorate such disorders by treating people’s fears of the unknown, or what Dr. Carleton calls the “one fear to rule them all.”
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A recent randomized controlled study led by Dr. Dugas gave 60 people with generalized anxiety disorder 12 individual therapy sessions focused on reducing their aversion to not knowing by challenging them to experience more uncertainty in small doses. In doing so, patients can discover that uncertainty isn’t necessarily synonymous with weakness. For example, a patient who believed that feelings of uncertainty at work stymied her productivity took on new responsibilities and learned that she could be effective in situations filled with unknowns.
In Dr. Dugas’s study, participants who completed the program suffered significantly less depression — gains that held even a year later — and their levels of both worry and anxiety fell to amounts typically experienced by people in the general population.
Another randomized controlled study led by Ivan Molton at the University of Washington gave 75 people with multiple sclerosis, a highly unpredictable condition, seven psychotherapy sessions aimed at helping them accept uncertainty by, for instance, refocusing away from distressing thoughts about this state. According to Dr. Molton, unpublished preliminary results reveal that participants reported feeling more resilient — able to bounce back from adversity — even four months after the program. Further, people’s resilience rose as their tolerance for uncertainty improved.
For Dr. Dugas and others, the future of this work lies beyond just taming our dread of not knowing, as important as that is, and in recognizing that uncertainty can strengthen our thinking. It is, as the National Cancer Institute senior scientist Paul K.J. Han says, “all about resetting our expectations of what knowledge is” and about developing “a culture of uncertainty tolerance,” where the open-mindedness, flexibility and curiosity offered by being unsure are prized. Dr. Han, who studies uncertainty in medicine, is working with Norwegian colleagues to train medical students and physicians to “leverage” uncertainty. For instance, by realizing that there is often no one right answer in medicine, practitioners can begin to investigate multiple sides of a question, harnessing uncertainty to find not merely the first solution but the best one.
Such efforts are increasingly needed in medicine and beyond. Epistemic hubris, or unwarranted certainty, about complex policy issues such as gun control is “common and bipartisan” among U.S. adults, a 2022 study found. Evidence suggests and some leading psychologists believe that uncertainty intolerance is rising. Our devices, with their streams of instant answers, may play a role, as might societal veneration of efficiency.
At heart, being unsure demands a crucial admission: The world is unpredictable, dynamic and flawed — and so are we. It’s an approach that recognizes that the strength of knowledge — and of our own minds — derives from its very mutability. It’s a realm of second chances.
My friend and I talk now, and even share a laugh or two. I have never really learned her true motives for acting as she did, and perhaps never will. I can’t predict if our bond will endure. But I sense that being open to uncertainty during that painful time allowed me to mull possibilities beyond my first assumption that she meant to firmly sever ties. Not knowing was solace and inspiration, a chance to see that resolution may be an unending work in progress in matters of the heart and beyond.