Spinning Wheels and Winding Up: The Amplifying Nature of Anticipatory Stress

“Here’s a pamphlet.  This contains everything you need to know so whatever you do, don’t look up anything else.” 

I came to see this physician assistant for some numbness and discomfort in my fingers that I had been experiencing for a few months.  A few minutes into the appointment, she gave me a referral for an electromyography along with the pamphlet and that firm but concerned warning.  “I’m telling you, just don’t Google ‘EMG’ and you’ll be fine.  Trust me.”  

One might think she essentially handed me a big red button with “DO NOT PUSH” embossed on it for safekeeping for the next few weeks.  But I actually took her advice, made the EMG appointment, tossed the pamphlet, and went on with my life.  Maybe I was thrilled at being given permission to do one less thing, maybe my rusty bucket of care sprung another leak with age, but I actually did what I was told and dismissed my curiosity.  

Fast forward to the day and I’m taking in the sterile aroma of hospital soap and rustling exam table paper through a backless paisley gown and pants.  Next to me was a collection of pristine but beige computer equipment and wire clusters straight out of a lab in the 80’s. A light, rapid knock and the neurologist walked in, quickly and politely introduced himself, and got to work as he descended on a castered stool.  He untangled some wires and brandished what appeared to be a portable tesla coil and a bandoleer of stick-on electrodes. In the meantime, he explained that he was going to use all this equipment to measure the speed and magnitude through which electrical signals can be transmitted across various points along my arms.  What I heard was that he was going to shock me for the next few minutes.  Medical euphemisms don’t fool me. 

The procedure went on like a series of knee-jerk tests on my arms, but using an Atari and a Geiger counter instead of a rubber mallet.

The highlight of the spa treatment was having a thick needle probe plunged into the side of my neck and being instructed to relax as it was used to capture increasingly powerful electrical currents from my wrists.  No problem, I’ll just mindfully bask in the present moment.  Twenty minutes of involuntary movement eventually revealed that everything was pretty much working as well as it should, but I needed to improve my posture.  Judgment is a painful but thankfully cheap result. 

Throughout the process I indulged in my nervous habit of engaging in relentlessly persistent, increasingly personal small talk with my captive tormentor. I learned that this procedure famously caused debilitating terror in his patients.  He described a patient he had just the day before, a generally healthy college student that had a complete meltdown as soon as he walked in the room.  Tears were common across gender, age, and cultural background.  He wearily lamented being the cause of extreme levels of distress so frequently. 

Now, what may impress you is just how poorly I tolerate pain and discomfort.  Apparently us younger-to-middle-aged men are the worst at this, and I willingly confess my contribution to the stereotype.  But I survived the EMG just fine.  The needle in my neck was a bit much, and the simmering, popping sensation of electricity running through my body was new and unpleasant but sufferable.  So how was I able to happily ramble throughout my procedure when so many other patients broke down before getting started? 

The difference was I heeded the advice of my referrer and spared myself the anticipation. 

The internet offers an endless buffet of horribles specifically catering to your current flavor of fear.  Many of my neurologist’s patients went all out in exploring worst case scenarios, adverse outcomes, and tales of outlier experiences.  They experienced a hundred imagined EMGs that were a hundred times worse than the real deal before they stepped foot into the clinic, and they reacted accordingly when they were finally confronted with the event. 

THE IMPACT OF ANTICIPATORY STRESS

What does this have to do with you?  Consider the ambiguity and uncertainty you experience in your personal and professional lives.  The extent to which you are expected to pre-emptively divine future outcomes and select the right approach among a plurality of viable in-game and metagame strategies.  The unpredictability of communications, issues, and reactions from clients, colleagues, and everyone else.  Do you have enough resources to tackle everything on your plate on time?  

All of these issues relate to things that have yet to happen. 

Anticipatory stress or anticipatory anxiety is what we experience at the prospect of a challenging or unfamiliar situation in the future.  When we are aware of the possibility of experiencing, doing, or receiving something that we perceive as unpleasant or threatening, we worry about it.  We consider what it will actually be like, whether we have what we need to overcome it, and all of the potential consequences.  And due to the way we are built, we mentally and physically react as though each conjured threat is actually occurring when it comes to mind.  And we pay the price for it each time. 

Much of the motivation behind this response stems from a belief that if we worry about it now, the actual event will not be as painful.  If I mentally prepare myself up until the moment, it won’t catch me off guard, right?  However, as we saw with my neurologist’s patients, this mindset can have an amplifying effect that ultimately makes an otherwise tolerable event unbearable. The fear itself becomes the threat to be managed.

To be fair, we are programmed to respond to uncertainty and ambiguity in this way for a good reason.  When we feel uncertain about the future, it means we do not have a ready response that will ensure a positive outcome.  The resulting worry, stress, and anxiety motivates us to identify problems and pursue protective measures in advance to reduce the likelihood of harm.  It makes us uncomfortable in order to make us want to protect ourselves, which is a good thing. 

But where we get into trouble is when there is nothing to be done and we worry anyway. 

What was said was said, what was filed was filed, what was done was done.  But we continue to ruminate–all the things we could have done, wishing that some fact or circumstance was different, imagining all the ways things will play out.  Then we jump as our phone buzzes with a new notification.   

We also do this when there are in fact still things to be done, but for whatever reason we are not in position to do them. It’s after midnight and you’re in bed staring at the ceiling.  Or you’re preoccupied while out to dinner with your partner and friends.  Or silently brooding at your kid’s soccer game.  In these instances, you continue to pay the price to no advantage.  You’re not present in the moment and you chew up resources in the meantime. 

Multitasking as far as our focus goes is a myth. 

While we can literally work on multiple tasks at the same time, doing so comes at the expense of our attention.  When we switch cognitive tasks, the first task leaves behind an attention residue that clouds our ability to focus on the new task.  So whether the new task involves another case or engaging in recreation, what becomes a priority is managing our attention and making a clean cognitive break with things that are not in our control.  

HOW TO MANAGE ANTICIPATORY STRESS

For my clients that struggle with anticipatory stress, my go-to recommendation is to first determine whether there is anything that can be done to reduce the risk of a negative outcome, and if so, whether they are currently in a position to do those things.  If the answer to both queries is affirmative, the issue becomes one of motivation and execution.  This is your opportunity to leverage that anxiety to improve your odds. However, if the answer to either of those questions is no–for example because they are currently sitting in my therapy room–the question becomes how do I effectively manage this anticipatory stress? 

A first strategy for managing anticipatory stress is to give yourself permission to indulge in procrastination.

Put that worry off for later.  Procrastination effectively delegates a current responsibility to your future self, giving your present self an immediate sense of relief.  That responsibility is no longer your problem. Procrastination is usually something we associate with laziness or dereliction of duty, but we have already determined that there is nothing to be done right now. So indulge in some fully justified procrastination and choose to give yourself permission to put off that worry until you can actually act on it. 

A second strategy is more spiritual but with a cognitive basis, and that is to transfer the responsibility elsewhere altogether.

Whether you believe in one or more deities, the laws of science and physics, or the collective powers of the universe as a whole, the reality is that our lives are the sum output of an incredibly complex system of forces.  Most of which are well beyond your control.  To implement this strategy, close your eyes and visualize the responsibility underlying your anticipatory stress as a weight on your shoulders, a pit in your stomach, or a burden in your hands.  Now imagine handing off that responsibility to your omnipotent being and entrusting them with the outcome.  Recognize that the uncertainty and that outcome is no longer up to you, but to the powers that be.  It always has been, and always will be.  Then open your eyes and get cracking on something in your control, like living in the present moment. 

If you need help with this, we’d be glad to hear from you for anxiety counseling support.