Anxiety can be a mild nervous feeling that can actually give us energy, sharpen our thinking, and allow us to move out of our comfort zones to try something different, or it can produce fear and worry, sap our energy, and cause us to withdraw from life. At lower levels, anxiety and excitement can closely resemble one another. Think of getting a promotion, skydiving, buying a home for the first time, or getting married. All four examples can be anxiety-producing and exciting at the same time. However, there is a different kind of anxiety that can go far beyond excitement and send people into a state of panic. This is where catastrophic or negative thinking can bring about unrelenting fear. It is the kind of anxiety that can paralyze a person and shrink one’s world into a prison without walls. When is the time to call a therapist? As always, it should be sooner than later.

Stuck in the Past/ Fearing the Future

When I encounter clients who talk about their anxiety, I find many are either dwelling in the past or trying to predict the future. A lot of people continue to worry about something they said or did, or something a loved one said or did, many years after the situation has passed. They may be stuck in the past and continue to bring up old marital issues, problematic family-of-origin situations, or any other issue they cannot or will not let go of. These folks cannot move forward. They often play the role of victim and martyr. Here are a few examples of someone living in the past:

  • I still cannot get over what you said to my sister last Thanksgiving.
  • I should have known better when I first married you.
  • Are you going to lose this job, too?
  • You remind me of your mother when you do that.
  • I have to keep my eye on you at all times so that you don’t relapse.

Others engage in future worry called the “what-if ’s”:

  • What if I go to the party and see my ex? We have a lot of friends in common.
  • What if I go out to my car and my tire is flat? What will I do?
  • I’m taking my exam next week. What if I don’t pass it?
  • What if it rains on the day of our family barbeque?  
  • What if my mother doesn’t like what I am wearing?

As you can see, we can what-if anything. These folks are trying to predict the future. The negative event hasn’t even happened yet, but people think, “Yeah, but what if it does?” For the record, we can counter that question with another question, “But what if it doesn’t happen?” Makes sense, but there is no stopping people who really want to worry. What people often fail to recognize is if something not in their plans occurs, they, as adults, have the capacity to figure out what to do. We are capable of dealing with any of the scenarios mentioned above and the many other situations that may come up in our lives. Yes, having to change a flat tire is not something anyone wants to do, especially after a long workday, but if it does occur, we have the capacity to deal with it one way or another. We need to trust that we can handle whatever comes our way, whether by ourselves or with the help of others, and know that whatever we encounter will not remain that way for long.

Worrying for Nothing

No one has a “crystal ball” to the future. Anything can happen, and sometimes things just do not go our way. Using the example of the flat tire, 99.9 percent of the time we go to our car, start the engine, and drive away without a second thought. If we worried all day about leaving work only to find a flat tire, we would have worried eight hours of our day for absolutely nothing. Who wants to do that? I don’t.

Now, in that rare .1 percent of the time when we leave work and we do have a flat tire, what do we do? Pronounce that it must be the end of the world and sit in the parking lot and cry? Blame the automobile manufacturer and swear you’ll never buy another one of “those” cars again? Kick the tire until you hurt your foot? That’s not going to get your tire fixed. Fortunately, as adults, we can come up with several solutions to the problem. Some may be more palatable than others depending on the circumstances you find yourself in. Here are some solutions:

  • You can change the tire yourself.
  • If the tire is not entirely flat, you can drive to a service station.
  • Call AAA if you have that service.
  • Call a friend or relative for help.
  • Ask a coworker to assist you.
  • Take a taxi or Uber home and get it fixed the next day.

Those are six solutions, and there may be more, to deal with that .1-percent-of-the-time annoyance no one likes. It simply isn’t worth worrying about the possibility of this rare event for the entire day on the off chance it may happen when we’ve seen that chances are it won’t. It is not worth the energy and time, not to mention that gut-wrenching feeling that comes with worrying all day long for nothing. We can’t predict the future, but worrying about something that hasn’t happened yet is counterproductive.

Here’s another example of trying to predict the future: “What if I don’t pass my licensing exam?” Many people worry like this before an important test of any kind. Although it may be a common occurrence, it does no good to think negative thoughts about your performance days or even hours before the exam. I know people who worried so much about not passing an exam that the built-up anxiety turned out to be the reason they did not get a passing score. Their worry became a self-fulfilling prophecy.

Many people have the knowledge base to pass exams, but in some cases, the anxiety prevents that knowledge from being accessed. Any ability to think and recall effectively is used up by focusing on the anxiety. Below are a few tips to consider prior to taking an exam:

  • Give yourself sufficient time to review any preparatory material.
  • Take a class on sample questions that may be on the exam.
  • Use exercise to help lower anxiety.
  • Get proper rest the day and night before the test.
  • Have something to eat and drink the day of the exam.
  • Go into the test with a positive mindset.
  • Talk to others who have passed the test.  
  • Know that more than likely, you can retake the test if necessary.

As mentioned earlier, a little bit of anxiety can energize us and sharpen our minds, but a lot of anxiety can actually do the opposite. Practice how to gauge where your anxiety level is, like biofeedback, sometime before the exam to try to decide which coping strategies will help lower the stress. 

The above examples were designed to illustrate how negative past thinking and catastrophic future thinking are counterproductive. We cannot change the past nor accurately predict the future. It’s only in the present where reality resides that we can have control over whatever comes our way. 

Excerpt from When to Call a Therapist, Chapter 4, pp. 33-36


  • Robert C. Ciampi, LCSW has worn many “hats” in his professional career: clinician, therapist, supervisor, coach, consultant, and now author. He earned a BA in psychology from Montclair State University and went on for his MSW at Rutgers University, both in New Jersey. After receiving his licensure as a clinical social worker, he worked in community mental health centers and hospitals as a clinician working with individuals with serious and persistent mental illness as well as patients who were dually diagnosed with mental illness and substance abuse. Robert C. Ciampi, LCSW went on to work for a behavioral healthcare consulting firm which helped healthcare facilities reestablish themselves as well as coordinated a program that provided employee assistance help for problems in and out of the workplace. He was also the Director of psychiatric inpatient social work services at the largest hospital in New Jersey. He began a private practice in 2010 which focuses on clients needing assistance with anxiety, depression, anger management, assertiveness training, and other issues. He also sees clients for couples and marital counseling. His practice is in northern New Jersey.