We believe that therapy can benefit everyone and our dynamic team of therapists work with you to take ownership of your life and your therapy. You’re in the driver’s seat and we’re honored to be along for the ride as a guide and support. We work with you to address your challenges and build on your existing strengths to overcome them. It doesn’t matter what your challenge is called, it’s about finding the solution that works for you.
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How do you cope with doctor’s office anxiety? It is very common to feel nervous when going to see the doctor. Whether it is for an annual physical or if you are going in to address specific symptoms, you are out of your normal environment and may be feeling a bit out of control. And if you are going to the doctor in order to find an explanation for symptoms you are having, you may have already tried to self-diagnose through google searches (which usually leads to more stress rather than relief). A combination of feeling out of control and uncertain about the future can lead to a hefty dose of anxiety. Whether you have an anxiety disorder or if a visit to a doctor’s office just makes you feel a bit uneasy, here are some simple strategies to practice at appointments.
While sitting in the waiting room, try to keep yourself distracted and your mind away from negative thoughts. Some negative thoughts that might come up for you may include fortune-telling or catastrophizing, where you are imagining the worst case scenario. Perhaps you are worried about a diagnosis or finding out the results of a test. Engage your mind by overwriting these thoughts with watching TV, reading a magazine, listening to a podcast, or playing a game on your phone. This can also be helpful for while you are getting a shot or having blood taken. Look away from the arm the doctor is working on and read or watch something on your phone to distract you.
Some people find it comforting to bring a loved one to a doctor’s appointment for moral support. They can be there to provide distracting conversation or to talk you through some of your fears. If you don’t have someone to go with you, it is also possible to enlist the support of the office staff. While the nurse is taking your blood you could ask her for reassurance or perhaps to tell you a story in order to help distract from what is happening.
Remind yourself that although you are feeling out of control, you are surrounded by trained medical professionals who are dedicating to maintaining your health and protecting you. Remind yourself that the appointment will soon be over and you can move on with the rest of your day. If you find yourself thinking that you won’t be able to survive the diagnosis, remind yourself that no matter what comes, you are resilient and have the ability to cope with it and address it.
After your appointment, treat yourself to some extra self-care and do something that brings you comfort and peace. Maybe that means going home to watch a movie, taking a nap, going out to eat, or spending some time with a loved one.
Medical appointments are not always easy on our stress levels, so try out these strategies to help alleviate some of the anxiety. The more you practice these skills and expose yourself to what feels anxiety-inducing, the stronger you will feel in your ability to cope.
A central feature of anxiety, especially in Generalized Anxiety Disorder, is an intolerance of uncertainty. We would venture to say that most people don’t particularly enjoy uncertainty—job interviews, upcoming tests, moving—they are all stressful in their very nature because of the uncertainty involved. The difference between a person with an anxiety disorder and one without is that the person who has anxiety is likely to spend a lot more time worrying, trying to control the outcome, seeking reassurance from others, or avoiding the task altogether, than a person who has a greater ability to tolerate uncertainty.
We work with a lot of perfectionists who use worry as their primary coping tool for anxiety and uncertainty. By the time they come to therapy, the worry is usually unpleasant at best, or debilitating at worst, impacting normal levels of functioning and mood. The worry can feel paralyzing and uncontrollable, though underneath these negative aspects of worry, there are usually beliefs that somehow worry will protect them. For example: “If I think about the worst case scenario, then I’m better prepared to handle it.” In order for treatment to be successful, these beliefs must be scrutinized and challenged. I often use a cost-benefit analysis, to help the client tap into their intrinsic motivation to decrease worrying and increase their tolerance for uncertainty.
Another hallmark of an anxiety disorder is focusing on threats rather than safety signals or internal resources to cope. When this happens, the result is a feeling of helplessness, vulnerability, and increased anxiety. When clients feel anxious, they engage in “safety behaviors” in an attempt to take the anxiety away or reduce its intensity, such as drinking before an event or rereading an email five times before sending it.
In therapy, an important step in treating anxiety is to identify which maladaptive safety behaviors the client uses to cope and to then reduce them in order to actually address the anxiety. To make it more concrete, take an example of how a socially anxious client uses avoidance to cope with his fear of uncertainty. The client feels anxious about an upcoming first date and fears that he won’t have anything to talk about (uncertainty) and that his date will think he’s boring (threat), and in order to cope, he worries (safety behavior 1) all day at work, barely able to focus on his tasks, and eventually avoids the date by canceling (safety behavior 2). Unfortunately, these behaviors reinforce that he can’t tolerate uncertainty and strengthens his beliefs about dating as threatening. In therapy, we might use behavioral interventions to help him reduce his avoidance, while also teaching him cognitive skills to cope with and shift his anxious thoughts.
At its core, uncertainty is a central part of our reality, no matter how much we delude ourselves into believing we can control everything. In order to reduce anxiety, worry, and avoidance, a therapist can help clients learn the necessary skills to manage anxiety and ultimately accept uncertainty as a natural part of a life worth living.
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COBB PSYCHOTHERAPY LCSW
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