Book Review: Overcoming Anticipatory Anxiety

Book cooer: Overcoming Anticipatory Anxiety by Sally M. Winston and Martin N. Seif

Overcoming Anticipatory Anxiety by Sally M. Winston and Martin N. Seif uses a cognitive behaviour therapy approach to help readers deal with chronic indecisiveness, avoidance, and catastrophic thinking.

The book begins by explaining what anticipatory anxiety is—the expectation of distress and the push towards avoidance that occurs before you encounter the situation you fear in real life. The authors refer to it as the “third layer” of fear—it’s being afraid of being afraid of being afraid. They explain that sometimes people will refer to this as “free-floating anxiety” when they’re not actually aware of what they’re anticipating.

The book describes how anticipatory anxiety shows up in anxiety disorders and OCD, as well as other conditions like PTSD, mood disorders, and substance use disorders. In generalized anxiety disorder, anticipatory anxiety is the initial what if, which is then followed by thoughts to try to make that anticipatory anxiety go away; however, those subsequent thoughts actually end up reinforcing the anxiety. In OCD, anticipatory anxiety drives the performance of compulsive behaviours. In anxiety disorders and OCD, anticipatory anxiety often sticks around the longest during people’s recovery journeys.

One of the topics covered is chronic indecisiveness, which is presented as a behaviour that can be changed rather than a personality trait. There’s a not-so-fun mental loop where people have anticipatory anxiety so they try to avoid making decisions (the book describes strategies like procrastination and convenient forgetting), but indecision increases anticipatory anxiety. The book explores several issues that can feed into indecisiveness, like FOMO, feeling the need to make the best/right choice, fear of regret, and perfectionism.

There’s a chapter devoted to how anxiety works in our minds and bodies. The authors explain how the amygdala works and why it sends out a lot of false alarms (way back in the day, that would have helped save you from getting eaten). There are also personality traits that people can be genetically predisposed to that make anxiety more of an issue. Because of the way the brain is set up, the feelings you get are basically the same when you’re actually in danger vs. when you’re anxious. I thought the authors did a really good job of explaining this in a way that validated why people feel the way they feel but at the same time giving a solid alternative way of evaluating those feelings.

The book also explores avoidance, pointing out that this removes the possibility of new learning to teach your brain that your catastrophizing isn’t accurate. Also, the more effort you put into trying to remove unwanted thoughts and feelings, the more they stick around.

“Surrender and commit” is presented as the antidote to avoidance. This includes “attending to what is instead of what if,” disentangling yourself from your thinking, and committing to proceeding with either action or choice. I quite liked this line: “problems related to too much thinking are not solved with more thinking.”

The book closes with a chapter on troubleshooting and a chapter that explores what recovery might look like (and what it won’t look like).

I liked this book. I thought the explanations were really effective at conveying why our minds work the way they do. Another thing I liked was that the authors seemed very realistic. There were no flowery promises about strategies that will have you feeling better lickety-split. CBT-based books sometimes annoy me by being overly certain, but this book didn’t have that feel to it. The focus on anticipatory anxiety isn’t something I’ve encountered in other books on anxiety that I’ve read. Overall, I thought it was quite well done.

Overcoming Anticipatory Anxiety is available on Amazon (affiliate link).

I received a reviewer copy from the publisher through Netgalley.

You can find my other reviews on the MH@H book review index or on Goodreads.

23 thoughts on “Book Review: Overcoming Anticipatory Anxiety”

  1. ” CBT-based books sometimes annoy me by being overly certain…” Your analysis could be made into a sticker by publishers and smacked on so many books. I love it.

  2. I can’t remember the last time I finished a book in a week. Probably when I was traveling through Asia in 2013… I love reading, but I fall asleep… That’s why I love blogs haha 😆. Short and punchy!

  3. What would you call anticipatory anxiety that focuses on things that will happen (who will die first, me or my husband) and things that are already on the calendar (like a doctor’s appointment or a meeting with someone, or say a job interview) and a person catastrophizes the outcome(s), in some cases, and in other cases plans for the more predictable outcomes – not knowing which outcome will come first so plans for all possible outcomes? This is my type of anxiety, what keeps me up at night – I rehearse conversations; I make lists and plans for when-if becomes right-now.

  4. Surrender and commit actually for me seems to be a very comforting way to manage that future anxiety. Any time I can out-logic my anxiety in the moment I feel like I can manage it pretty okay. I’m usually opposed to CBT, but it’s definitely got its place! Seems like a book I need to add to the repertoire! Thanks for the review, Ashley 🙂

  5. Very interesting review. I’m going to look into this book. Much of what you highlight here is what I go through with my own anxiety. I think this might be a good next step in bettering myself. It makes more sense than being diagnosed with potentially agoraphobia-type symptoms.

    One commenter above mentioned events on the calendar, and that could not be more true for me. Having anything scheduled is almost debilitating. I feel like I must do it, it must be done, and then the anticipation kills me. I can’t do it. I too plan for multiple outcomes to no avail.

    1. That’s interesting regarding scheduling. My illness tends to lean in the opposite direction. Depression slows my mind down, so putting things on my calendar is a way for me to set it and forget so I don’t have to find the mental energy to keep thing about it.

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