Anticipatory Anxiety and Negative Fantasies

You are going under the surgeon’s knife.  You are meeting with a potential new client. You’re starting on a new drug regimen. You’re driving through uncharted territory. What could possibly go wrong?


One of the things I’ve picked up as both a project manager and a Stage Four cancer patient is a newfound sense of serious anticipatory anxiety. Any time there are changes or new aspects to our lives, we have an opportunity to either revel in anticipation or wallow in it. I never really thought of myself as a Nervous Nellie (one of my mom’s terms), but I’m learning. Change inevitably includes some measure of the unknown, and it’s up to us as to how we react to it. 

When I was first getting sick three years ago, it was new to me. I could envision the Grim Reaper right around the corner. When I had my first ablation therapy, I feared it could be the painful approach of the remainder of my short life. When I went through radiation therapy, I dreaded the idea of isolating myself from everyone so that they wouldn’t be irradiated (and yet my doctor wasn’t worried about my level of exposure).

So along comes someone with your next event. Some of us have a nasty habit (rooted in some experience) of taking the opportunity to crawl into a black hole and fantasize negatively about how horribly this could all turn out. I’m guilty as charged. In order to survive this, we need to be honest with ourselves about the nature of our imaginings as just what they are—fantasies.

Lesson Learned: The first thing I had to do was to sort out my imagination from reality. For my fears, I quickly learned how much control I had over the situation. I hated ablation therapy. So I quit. I’d rather have my cancer than go through that on a regular basis. (And radiation and chemo have now worked wonders). You have the ability to just say “no.” I didn’t have that ability when going through the initial (very uncomfortable) round of that therapy, but as soon as it was over, I could see the light at the end of the tunnel.  If you know when you’re going to regain control, even if you don’t have it at a given point in time, that’s a comfort that can help to quickly put the anxieties in check. 

How do you do that? BEFORE you engage in any behavior that’s causing dread, know thy offramps.  If you know when and how you can get out of the situation, it’s far less dire or threatening.

In social situations, I can build up anticipatory anxiety in no time. The new client might not like me. The dinner might make me physically ill.  I can go from zero to sixty on the anxiety meter just invoking the obvious.

Lesson Learned: I actually had both of those situations in recent weeks. The meeting with the new client was scheduled for one hour. Can you handle yourself socially for an hour?  I think most of us can. And if they don’t like you? You’ll have an idea on how your personality type wasn’t a good match. (BTW, the meeting went famously, and I’m looking forward to a future with a new client). And as for the dinner and my delicate stomach? We didn’t go. It was to be an extended event (5-hours-plus), and I knew my stomach wasn’t up to that, even with outstanding anti-nausea meds.  Turns out it was a good call, as a friend of ours who went wound up where I had feared I’d be.  (That’s important. If there’s proof you are/were right, cling to that.  Sometimes, anxiety is your body’s early warning system).

In all of these instances, it’s important to remember that others are there with us. They may be there physically to support us.  And if they’re not, we need to ask them to consider being our physical support system. Every time I’m with someone I trust in a waiting room (most often, my wife), I feel a lot less anxious about it. And it matters if they’re there metaphorically. My wife is getting eye surgery soon. She’s anxious. I have the joy of reminding her that 3.7 million Americans undergo that surgery every year.  It’s one of the most common, successful surgeries on the planet. That’s a cheering section the size of the population of the city of Los Angeles.

Trust is the enemy of anxiety. The more we can do to find those we trust, the more we can do to stem those negative fantasies that invade our day-to-day.


Carl Pritchard, PMP, PMI-RMP is a nervous Nellie (sometimes), who is having a very good day.  He’s surrounded by those he trusts from his family, his church, and his friends (professional and personal).  He is blessed, and welcomes your e-mails with questions or comments at