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Wiping Out Worry

🔒 Privacy Note: This worksheet includes some intimate questions. We record your responses only for purposes of emailing you a copy of your responses. We do not retain this information long term, and we never share any of your information — including name, email address, and responses — with anyone else.

The worst thing that could happen if I don’t fall asleep is…

If that does happen, I will have to…

…and it will mean that I am…

How likely is it that the “worst thing” above will happen?

How likely is it that the “worst thing” above will happen?
not very likelyextremely likely

Has that “worst thing” happened before?

Has that “worst thing” happened before?
A
B

What is more likely to happen than that “worst thing”?

You wrote that if that “worst thing” happens, it will mean that you are…

How much do you believe that to be true?

How much do you believe that to be true?
not so muchvery much so

What evidence do you have that you are ?

What evidence do you have that you are not ?


You’re all done!
If you provide an email address, we’ll send you a copy of your responses. It may be helpful to file this away to revisit and reflect on later. We will never share or sell your information.