• Mindy Utay


There’s a certain type of anxiety that I am seeing more frequently in my practice. Some patients are extremely uncomfortable with accepting that anxiety is a normal part of life. Their anxiety becomes a separate cause of concern. They worry about feeling worried.

Normal anxiety based on actual conflict, develops into a fear of failure and a sense of hopelessness and feeling overwhelmed. An otherwise well-functioning individual starts to show signs of depression and isolation.

Typically, anxiety is excessive worry about what might happen in the future. For instance, a first-time father is worried about the effect his new baby will have on his marital relationship. A college student is anxious about an upcoming test. A business owner worries about earnings. A single person about meeting someone to love. The anxiety is directed toward an object of concern. 

Anticipatory anxiety, or anxiety about feeling anxious, is excessive focus on the feeling of anxiety. Often these individuals associate anxiety with insecurity or weakness. They are often self-critical and hold themselves to high expectations. Their identity is formed around feelings of competence and self-control. When they feel anxious, they feel alienated from themselves, and become preoccupied with the sensations of anxiety as a problem in itself. A few examples:

A 25 year old woman becomes increasingly focused on her anxiety, so she finds it difficult to sleep at night anticipating that she will feel overwhelmed the next day. She becomes fixated on her feelings, instead of on resolving real life problems that are the source of her anxiety. Instead of working to resolve these issues, she is becoming increasingly anxious and depressed. 

A successful lawyer faces family issues which are interfering with his concentration at work. He begins to feel overwhelmed and afraid that he will lose everything, even though he has successfully handled crises at work and with his family before. His anxiety is creating paralysis, and a fear of failure. He is beginning to engage in self-sabotaging behavior in anticipation that failure is imminent.

A straight-A student describes a sinking feeling at the beginning of each week as she looks ahead to the work she will have to do at school, anticipating that it will be too difficult and her grades will suffer.  Her identity is associated with feelings of competence and achievement. Self-doubt and anxiety, normal reactions to increasing challenges, are causing a crisis of confidence and she is withdrawing from school activities. 

Based on my clinical observations, these tools are successful in changing attitudes and getting people back on track:

  1. Normalize anxiety as a fact of life.  Gain a level of comfort around anxiety as a normal part of life, and not a sign of weakness or failure. Become familiar with how stress feels in the body and learn effective coping strategies. Make stress reduction strategies part of a daily routine. 

  2. Don’t go it alone.  Who doesn’t feel insecure now and then? Anxiety and self-doubt and are normal, but for some people, they are associated with shame and fear of failure and a tendency to withdraw from relationships.  Talk about what is going on. Ask for help and understanding at work and at home, especially when you need to clarify issues or may have trouble meeting certain responsibilities on time. Relationships are built on trust and honesty and develop through open communication over time. 

  3. Reevaluate what is most important to you. Many over-achievers are performance oriented and lose touch with why they work so hard and what their effort is for, or what really matters to them. Refocus on your individual or family goals, set your intentions, and get back in touch with what is meaningful to you. This helps to set priorities when things feel overwhelming, and to decide how much time to spend on a task, and what to focus on and who needs your attention most.

  4. Perfectionism is a buzz-killer. Get to the bottom of what it means to be perfect and why this feels important. Think about early messages around success. Get comfortable with vulnerability and letting go of image or expectations from the past. Learn to lean on others and trust that their interest in you is deeper than your achievements.

Anticipatory anxiety is more typical today as more people feel the need to be “on call” 24/7 and there is less down time and higher demands for success. Stress and anxiety are normal parts of life. Learning coping strategies and reassessing priorities can bring greater wellbeing and satisfaction in life. It can re-energize you to face problems head-on. When you become more comfortable navigating the ups and downs of life you find inner resilience, self-acceptance and a community of support.


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