Have you ever been afraid of something, before it happened? This intangible feeling of fear is quite common, it is called anticipatory anxiety. For example, you have to go for an MRI and you feel stress before the exam, at the thought of being stuck in the tube. It is therefore the fact ofapprehend a situation with worry, without having experienced it yet. Psychologist Maria Hejnar looks at the mechanisms of this anxiety disorder and offers solutions to free yourself from it.
How does anticipatory anxiety manifest?
“There is a difference between fear, which is rational in the face of a situation, and anxiety, which is the same feeling but has no existing object“, she begins. “It’s like you live with a lion by your side every day, except the lion isn’t actually there.” According to her, anticipatory anxiety could be likened to background noise, as if we were constantly hearing “oh my, this is going to go badly”, before anything has happened. For some, this anxiety is managed, it is not disabling. Before an important event, we are worried, we are apprehensive, but we go anyway. And in others, it grows to the point where it can turn into panic and become paralyzing.
Anticipatory anxiety, when it takes up too much space in individuals who suffer from it, can generate anxiety attacks. Reasoning no longer manages to counter the effects of fear, “patients then lose control”, she notes. Concretely, one may have the impression of finding oneself in an unreal world, of being “depersonalized”, having dizziness, nausea and other digestive disorders, chest pain, a feeling of shortness of breath, palpitations, tremors, heavy sweating, feeling like our legs are going to give out…
When anxiety becomes generalized, it manifests itself as a persistent feeling of insecurity, and “permanent and excessive worry that interferes with daily activities. It can be accompanied by physical symptoms, such as agitation, nervousness, fatigue, difficulty concentrating, muscle tension or sleep problems. Inserm. And Maria Hejnar added: “anxiety can be expressed in different ways, it can turn into phobias, it can lead to somatization“ (having persistent physical symptoms linked to excessive fears).
What causes anticipatory anxiety?
Concretely, anticipatory anxiety is part of a context of more global anxiety. “When there is a little anxiety, it can be a driving force in life. It helps us to anticipate more, it motivates us to work… It’s stimulating and empowering”, explains the psychologist. But when this anxiety is too great, the effect is the opposite, and this is often due to the fact that the individual “lives with a significant lack of internal security“.
The psychologist returns to this feeling and explains that it can come from past traumas, whether big or small. “The feeling of internal security is founded during childhood, it is constituted with the people who take care of us. When an adult is in such insecurity, to the point of living in permanent anxiety, there could have been had a problem at the time of the foundation of this internal security”. She cites sometimes trivial examples: being asked to answer a question on the board and not knowing the answer, others more serious, such as being separated from a parent too early.
The mechanism of anticipatory anxiety
In people who live with this anxiety, a vicious circle sets in. “Typically, what serves as the basis for anticipatory anxiety has happened once. They’ve experienced something and think it’s going to happen again, so they have anticipatory fear,” notes the psychologist. She gives a concrete example: someone who would have experienced anxiety while crossing a bridge by car, and who would since then be afraid to do it again, for fear that the anxiety would resurface. “There are people who make a 100-kilometer detour to avoid crossing a bridge again,” remarks the psychotherapist.
Anticipatory anxiety can lead to seeking avoidance at all costsand go as far as the development of phobias. “But the more we avoid something that scares us, the worse the situation becomes, because the less familiar the thing is, the more frightening it is. We then become prisoners of the phobia and by extension of this anticipatory anxiety.” underlines Maria Hejnar.
What are the solutions to anticipatory anxiety?
Anticipatory anxiety is treated in the same way as generalized anxiety. The objective is to reduce the level of insecurity felt by the patient, via therapy. “When there is really a lot of anxiety and it disrupts daily life, we can introduce cognitive-behavioral therapy (CBT) techniques. We also use relaxation to reduce the general level of anxiety. We teach the patient to know your body and its anxiety reactions, to ensure that they do not become invasive. We also work on the irrational side of fear which has no precise object. The objective is to understand. what are the reasons for this anxietyat large.”