Anticipatory anxiety: symptoms and solutions to unfounded fears – Online Psychologists

David still trembles, sitting on the couch in my office, when he tells me “I was home alone, finishing getting ready. I had arranged to meet my girlfriend at eight o'clock; we had to go to a formal dinner with our parents. While I was putting on my watch, I automatically looked at the time. It was eight ten and Marta hadn't arrived.

At that moment, without expecting it, I began to think that Marta must have had an accident on her way back and that as soon as they called, it would be the police who would ask me to go and identify her and… please, I thought so many things in one minute, my heart skipped a beat and began to pound, I had to take off my tie because I was sweating profusely, I began to choke and feel unsteady, as if my vision was becoming blurred, I was convinced that I was going to go crazy… another shock came thirty seconds later when the bell rang and Marta came in smiling and apologising for being late…

«What happened to me? How can I control it? Because it has happened to me before, will I ever be cured?»

What happened to David is a fairly typical situation that also happens to many other patients and which we call anxiety although, in this case, we will give it a “surname”: anticipatory. As we have already seen in previous articles in Psychiawe call anxiety to a positive and natural response of the organism that serves to defend itself from a threatwhether real or perceived. Only if certain activation thresholds are exceeded does anxiety become a pathological response, which manifests itself in panic attacks, leaving a high residual part which is usually somatized in the organism causing psychophysiological symptoms, which is when we say that the body hurts, since it does so in a totally non-specific, vague way, affecting various organs and systems.

Anticipation is related to imagining the future. When David looks at the time and sees that ten minutes have passed since his date with his girlfriend, he begins to think about what could have happened to him. He anticipates that something horrible must have happened to him. that has caused him not to be there at eight o'clock, as agreed. Later, he imagines himself in the situation of his worst expectations being fulfilled and everything that he must go through. While he thinks this, his heart beats very fast, his breathing is shallow and rapid, the sensations that lead to a panic attack begin. Therefore, as we see, the main function of anxiety is to mobilize the organism against possible threats, real or perceived. However, when we talk about anticipatory anxietyits function is activate the body before this possible danger occurs. That is, it warns us. In other words, “he who warns, is not a traitor”… although too often what happens is that the danger is non-existent.

Anticipatory anxiety is a cognitive evaluation process that, taking into account experience, among other issues, predicts the consequences that a given event (Marta's delay, in the example) produces in the patient's behavior (David, in this case).

Anticipation also produces a motivational effect. According to Bandura (1986) «anticipatory thoughts that do not exceed the limits of reality have a functional value because they motivate the development of competencies and action plans.» Anticipation is part of the action since it is both a regulatory and inductive factor of behavior and emotions.

Thought has an important capacity for physiological self-activation of emotion. Anticipations of threats, harm or damage generate anxiety. These perceived thoughts, which does not mean that they are unreal, can be as activating as the actual events themselves. It is then that the lungs, heart, stomach and muscles do not know what is happening and, therefore, do not make any decision that implies an action on their part. It is the higher nervous centres, the cerebral cortex, especially, but not only, that presuppose our reality, correctly or incorrectly, as well as how it is affecting us and make decisions about what we can do. Therefore, a psychophysiological response is produced that will allow the organism to respond.

The importance of anticipatory anxiety cannot be underestimated since, contrary to what some may think, This is a real problem that produces absolutely real symptoms.. When the mind expects the worst (“Marta must have had an accident”), the body prepares to receive the emotional impact of news that it will not receive (but it does not know it yet, therefore, tension, tachycardia…) and the worry (“she is 10 minutes late and it is not usual for her, on such an important day”), is interpreted by the body as a dangerous situation. If this way of thinking becomes habitual, the disorder tends to become chronic.

On the other hand, in addition to making you feel distressed, Anxiety can play with your moodmaking you feel angry, confused, hopeless, irritable or sad, which can end up affecting your ability to concentrate and make decisions.

Physical symptoms of anticipatory anxiety include:

The physical symptoms of anticipatory anxiety can be very intense, which makes the person think that they are having a heart attack. This is because they are first panic attack It is usually sudden and unexpected, but it changes the patient's entire perception. After having one, they begin to feel constant anticipatory anxiety, due to the fear of having a second one, in the same way that it happens to patients who suffer from phobias or specific anxiety.

In general, we can say that there are three types of treatment: psychotherapy, pharmacological or a combination of bothWe will talk about them a little later. The most important thing is that both specific and anticipatory anxiety can be treated.

However, many of the tips given for treating specific anxiety also work for anticipatory anxiety. Here are some tips to keep in mind:

1. Change your thinking. Anticipatory anxiety is a catastrophic or negative interpretation of an unknown outcome. Learn to allow for positive interpretations. In other words, change your self-fulfilling prophecy thinking (i.e. predictions that cause something to happen in our minds or, in other words, we put a stumbling block in our path) to realistic thinking (if something is, it is).

2. Physical exercise. Because it has undeniable benefits, on several levels. It distracts, helps burn calories, relaxes you and releases the extra adrenaline that is produced when you get anxious.

3. Distract yourselfFinding a pleasant activity can reduce anxiety because it occupies your mind, for example: reading a book, going for a walk, going to the movies, among others.

4. Learn relaxation techniques. There are relaxation, breathing, visualization, imagination, mindfulness techniques that you can only practice with your psychologist and you will be able to reduce your level of anticipatory anxiety. With the right exercises, you can even learn to calm an anxiety attack.

Regarding the formal treatment of anticipatory anxiety, the use of anti-anxiety medications to treat anxiety which can be very useful to relieve symptoms in the short term. However – and as we said in a previous post – there is a growing trend true addiction to psychotropic drugs with few benefits and many side effects, some of which are dangerous to health.

Psychotherapy, for its part, has proven to be quite effective.especially cognitive-behavioral therapy, which helps, above all, to change thought patterns, which is the key point to overcome anticipatory anxiety.

To do this, he uses various techniques such as: stopping his thoughts, being in contact with the here and now, visualizing the confrontation with feared situations or finding out what part is real and what is unreal in his anticipations of future events.

And that is precisely what it is all about. If you are a person who constantly worries about what will happen in the future, whether it is an upcoming activity or your own future, you are possibly suffering from a anticipatory anxiety disorder which is related to the intolerance to uncertainty and the need for control. Therefore, it is associated with situations in which the person has high expectations about their own performance.

The person recurrently repeats catastrophic scenarios in his mind in which everything goes wrong. In other words, he has a negative thought, repeated continuously, which favors the appearance of self-fulfilling prophecies or predictions that cause something to happen. As we said a little earlier, they are the stone that we put on ourselves to trip over.

1. Stop the vicious cycle of negative emotions. Almost every thought produces an emotion. Therefore, if we fill our minds with catastrophic ideas, we will be very anxious. So, to interrupt anticipatory anxiety it is necessary to discover the negative emotions that it produces and calm them. For example: breathe deeply and relax. When you feel that you have control over your emotions again, you can analyze the situation rationally.

2. Discover negative thoughts. What are you thinking? You can write it down on paper. You will realize…