It is normal to experience fear and anxiety or anger when something of high importance to you is at risk. Facing a lot of these emotions at once along with other feelings can feel overwhelming. This chapter describes ways to cope with uncertainty, stress, and overwhelm and strong feelings like anxiety and anger.
Coping with Uncertainty
Medical education involves a series of potentially stressful uncertainties. It starts even before entering medical school, with not knowing whether or not your application will be accepted or where. It continues when you are waiting to receive licensing test scores to see if you passed and if your scores are high enough to help you get into the residency training program you desire. In the fourth year, you wait to find out if you will match with the residency program or specialty you want. Unanticipated events like a pandemic create more uncertainties.
Resources on Uncertainty:
Resource 1: The American Psychological Association Help Center shares common ways that uncertainty stresses us and tips for dealing with it. They offer 10 simple steps for facing uncertainties:
- Be kind to yourself
- Reflect on past successes
- Develop new skills
- Limit exposure to news
- Avoid dwelling on things you can’t control
- Take your own advice
- Engage in self-care
- Seek support from those you trust
- Control what you can
- Ask for help
Visit the APA website to learn more about each step: “The great unknown: 10 tips for dealing with the stress of uncertainty.” Updated 8/2620, Created 10/24/17.
The Greater Good offers seven strategies to use when things feel out of control:
- Don’t resist
- Invest in yourself
- Find healthy comfort items
- Don’t believe everything you think
- Pay attention
- Stop looking for someone to rescue you.
- Find meaning in the chaos
Visit the Greater Good website to learn more about each strategy. View Seven_Ways_to_Cope_with_Uncertainty By the Carter C, Greater Good Science Center, a magazine published by U.C. Berkely with a mission of turning “scientific research into stories, tips, and tools for a happier life and a more compassionate society.”
Article: Science Explains Why Uncertainty Is So Hard on Our Brain. This article explains the relationship between the fear of the unknown and anxiety and relates it to what patients go through while waiting for a diagnosis. Interesting tips include doing your worrying in a different chair from the one in which you relax (Heid, 2020). Read this interesting article to find out why.
Coping With Anger and Feeling Overwhelmed
Reviewing statements that change your thinking about the situation to thoughts that will help you better cope can help when faced with strong or stuck unpleasant emotions that are harming your well-being. Try repeating the following to yourself if feeling angry or overwhelmed.
Coping Statements for Anger Management
- It’s not worth getting angry about.
- I will not take it personally.
- I am in charge, not my anger.
- I will breathe slowly until I know what to do.
- Getting angry isn’t going to help.
- I can handle this and stay in control.
- Remember to breathe. Remember to breathe.
- People aren’t against me – they’re for themselves.
Coping Statements for Overwhelming Feelings
- Take a breath.
- Stay focused on the present. What do I need to do right now?
- It will soon be over.
- It’s not the worst thing that could happen.
- One step at a time, until it’s over.
- I don’t need to eliminate stress, just keep it under control.
- Once I label my stress from 1 to 10, I can watch it go down.
External Resource: Managing General Heightened Emotions. A brief pdf for the healthcare community. By Mt. Sinai Medical Center, NY. 2020.
Source: John Lee, Using Coping Cards and Coping Statements to Improve Mental Health. Website: ChooseHelp.com – for mental health and addiction treatment.
Coping with Anxiety
Relaxing Anxiety During Stressful Times. Being Well Podcast Episode #123. By Rick Hanson, Ph.D. Psychology. © Copyright 2020. Drs. Rick Hanson and Forrest Hanson. Includes: Rational, appropriate stress and anxiety, the cost of ‘negative’ emotions, practicing ways to calm stress, accepting some amount of stress, dealing with the bad and turning toward the good, and an exercise for calming and centering. Time: 51 minutes with the time for different subtopics marked.
Highlights of this resource. When feeling stressed:
- Slow down and breathe* and then widen your perspective. Focus on what is true in that broader picture.
- Acknowledge that stress is normal and appropriate in some circumstances. But try not to dwell or get stuck there. Ask yourself, “Am I basically ok at this moment?” Or tell yourself, “I did my best given the circumstances.”
- Deal with the bad, turn to the good, take in the good.
- Accept the limits of your influence AND Find the place where you can have a lot of influence.
- A 5-breath calming practice. Breathing while feeling: your chest, caring, cared about, peaceful, content. Described at minute 38 in the podcast.
Coping with Anxiety A brief pdf with 7 tips for dealing with a wave of anxiety. Written for the Mount Sinai Medical Center, NY healthcare community to help health care providers cope with stress.
The tips include not judging or avoiding your anxious feeling, which may include disappointment, the anticipation of something, or change fatigue. They describe how to check to see what you are worried will happen and how likely that is and several other steps.
A Simple, Brief Stress Management Activity
4 x 4 breathing: A simple, easy-to-remember breathing exercise to disrupt the stress response: Breathe in through your nose slowly to a count of 4, breathe out slowly through your mouth for a count of 4. Repeat 4 times.
Stress Management External Resources
- Medical Student Perspective: Strategies To Prevent Burnout During Medical School – by the American College of Physicians.
- Stress Management – An overview with multiple resources from the American Psychological Association
- Stress Management & the Challenge of Balance – Includes a daily stress record that can be helpful and tips for stress reduction, by Lisa Wallace, Regional Specialist, Human Development and Family Science, U of Missouri Extension.