Career advice

The anxiety demon: how to let go of ‘what if’

How do you deal with the constant fear of ‘doing something wrong’? By focusing on the present and breaking the cycle of negative thoughts that feed anxiety.

How do you deal with the constant fear of ‘doing something wrong’? By focusing on the present and breaking the cycle of negative thoughts that feed anxiety

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Ruminating over what might have happened (if you hadn’t spotted patient X was trying to get out of bed) or worrying about what may happen in the future (I’m so tired – what happens if I make an error with medication) can become an addictive pattern that will leave you anxious and exhausted.

Steven Seay, a psychologist who specialises in treating anxiety, uses the analogy of trying to fill a colander with water to describe how futile constant ‘what if’ questioning is. ‘You can spend time doing it, but it’s never going to get you anywhere,’ he says. So, using this imagery, how can you redirect the water (your energy) so that you are nurturing, not draining, yourself?

Limits of coping

It is natural to feel a degree of apprehension about following procedures and avoiding clinical errors.

Remember that not all anxiety is bad, and when kept under control it can help to sharpen your performance. The trick is to know what level you can cope with and recognise when your anxious thinking or behaviours are getting out of control (constant ruminations, planning for all eventualities, insomnia, mood changes).

Strategies to try

Once you have this level of awareness try adopting some of these self-help strategies:

  • Learn to tolerate uncertainty: patients’ conditions can change rapidly, and while you can learn to hone your clinical observation skills you cannot predict everything. Similarly, on a personal level it is impossible to know what lies ahead, so try to let go of over-planning. Using past experiences, try to develop confidence in your ability to cope with whatever comes your way.
  • Stay in the present: if you are constantly thinking about ‘what if’ scenarios you are either living in the past or the future. Consciously re-directing your energy to what is happening right now can help to break this cycle. Sometimes having a focal point, such as feeling your breathing or mentally scanning your body, can help but it takes practice. Try getting into the habit of using a relaxation or mindfulness app.
  • Talk your way out of it: if you notice that you are back on the ‘what if’ cycle try repeating a positive affirmation or mantra. Or you can change the words to a popular song to hum in your head, for example ‘hello anxiety, my old friend. I’ve come to talk with you again.’ What you are aiming to do is redirect your attention so that such thoughts lose their grip over you.
  • Seek support: uncontrolled anxiety can be crippling, but it is treatable. There is no shame in admitting you need help, so be brave and take the first step by talking to someone you can trust.

Mandy Day-Calder is a freelance writer and life/health coach

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