For years I have sat with anxious patients in my office mired by “what if” thinking. Their worried thoughts about every possible scenario of having a panic attack can cripple them. I have labeled this anticipatory anxiety and explained how this thinking could trigger anxiety symptoms like heart palpitations, trembling, dizziness, shortness of breath, and more. I teach mindfulness mediation and the importance of focusing on the present instead of the “what if” filled future. These tools, coupled with deep breathing and other coping skills like guided imagery, have helped many patients lessen panic attacks and anxiety symptoms.
In a previous blog, I wrote about the many losses people experienced related to the pandemic and briefly alluded to the loss of things like weddings and upcoming graduation ceremonies. What I had not fully realized at that time was that these types of losses created an ongoing situation where people lost most opportunities to experience anticipatory joy. It has been challenging to plan things like vacations or weddings or other joyous occasions with any confidence. This has created a loss of things to look forward to. It’s not surprising that this has been adding to what is depressing for people these past months. We need things, especially positive things, to look forward to.
In a 2015 study, Christian Waugh, Ph.D., found that “having things to look forward to is a major coping strategy. It helps us recover and adapt to stressors.” He described how this happens via several avenues. He shared when you have positive things to look forward to, you have less room for negative thinking, and you can be energized and motivated by that thinking. You probably felt this way in planning a trip in the past. It may have given you a well-needed break to look forward to. For years, research (2007) has shown that just planning and anticipating something like a vacation creates happiness.
Waugh noted that while “anticipation is very important, positive anticipation is something that goes away when people are depressed.” It is also challenging to have when people feel uncertain – as most of us have since the beginning of the pandemic. I encourage patients to practice using smaller ways to experience positive anticipation (planning a Zoom gathering, or a virtual tour of a museum or country you have wanted to visit, baking/buying a cake for an occasion) as a way to keep a depressed mood at bay. Do not abandon these, but I think it may be time to practice more positive anticipation again as we draw closer to post-pandemic life.
Many patients in line for the vaccine are feeling unprepared to “re-enter” their lives again. Sometimes they think this way because life circumstances have changed. Sometimes, they are “out of practice” with old behaviors, whether in the workplace or socially. No matter how many more months we have to weather this pandemic, it could help to have more thinking that involves positive anticipation.
Think about the many details of a trip or celebration. Practice visualizing yourself doing things you have missed (eating at restaurants, visiting with friends or family members). It may feel strange. If the thoughts you have about the future are not productive or in the direction of positive anticipation, go back to rooting yourself in the moment and just stay with that until you can try to practice positive anticipation again. It will come. Be patient with yourself and with the change that is on the horizon.
Van Boven, Leaf, and Ashworth, Laurence. “Looking Forward, Looking Back: Anticipation Is More Evocative Than Retrospection.” Journal of Experimental Psychology, vol. 136, no. 2, 2007, pp 289-300
Waugh, Christian et al. The impact of anticipating positive events on responses to stress.” Journal of Experimental Social Psychology, vol. 58, May 2015, pp.11-22