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Pre-traumatic Stress


Do you ever have those time where you work yourself into a state of stress or panic before something even happens? You go to the doctor and find out something “needs more looking into.” You find out that you scored an interview for your dream job. A pandemic starts, throwing the whole world into a “new normal” that seems unprecedented. These and many other events can cause pre-traumatic stress.


Pre-traumatic stress is the worry, concern, or fear that one feels before a potentially traumatic experience. It’s the anticipation of stress, which causes stress itself. Fortunately, we can deal with pre-traumatic stress using the same model as for dealing with other concerns.


First, let your brain dump all the things – thoughts, fears, worries, terrible scenarios, etc. - onto paper. Allow your brain to go there. Don’t edit or judge at this point. Just put your thoughts on paper where they become actual “things” – sentences on a piece of paper – rather than chaotic thoughts in your mind.


Once your thoughts are on paper, take the time to separate the facts from the rest of the thoughts. Facts are things that can be proven, observed, and that everyone would agree on. “This summer is going to be stressful” may seem like a fact, but it is actually the story you are telling yourself. The facts might be, “I have a family reunion with people I haven’t seen in over a year. I am working from home from 9-5 every day. I have three children who are home during the day while I am working.” Once we can see the facts, we can deal with the rest.

I remember my 7th-grade teacher saying, “The anticipation is better than the event.” The opposite can also be true - the anticipation of something terrible can often be worse than the event. When anticipating a stressful or traumatic experience, you may have a thought like, “I don’t know what is going to happen.” That thought generates fear. When we feel fear, we often take some action to cope with the feeling – watching TV, overeating, doing our work in a state of stress and anxiety, talking about the circumstances negatively or fearfully. Ultimately these actions reinforce the fear. Once we are conscious of what we are doing, we always have a choice. Is fear is the emotion you want to feel?


The truth is that we never know what is going to happen. Having an event occur that brings that reality to the forefront of our minds (i.e., a potentially scary diagnosis, the opportunity of a lifetime, a global catastrophe) does not make the fact that the future is uncertain any more or less real than it was before.


We don’t know what is going to happen.


Although our brains think that worry is necessary and useful with a scary event front and center, it is not. We can be prepared for something, be cautious and judicious without constant worrying.


During this state of pre-traumatic stress, you may be thinking, “I won’t be able to handle it.” A tool to mitigate this thought is to go to the worst-case scenario. You can visualize the worst-case scenario, feel the fear, and imagine how it would be. You can learn that you can “handle it.”


Similarly, I want you to give equal time to the opposite side as well. If you visualize the worst-case scenario – spend the same amount of time imagining the best-case scenario. We don’t know what is going to happen, so either could be equally valid.


Another helpful tool may be to allow seemingly conflicting thoughts and feelings simultaneously – again giving airtime to both sides. While you may be afraid, you may also be brave. You may be both worried and determined. You don’t have to pretend not to be fearful in order to make a difference – that is what courage is.


In pre-traumatic stress, you may need to let the mind go where it wants. It wants to protect you, so it is looking for danger, startling events, and worst-case scenarios. It’s okay to experience that AND to move forward, AND to be brave, AND to imagine the good that could happen.


Remember that pre-traumatic stress is a story we tell ourselves with our thoughts. Since we never know what will happen (even though we go through life acting like we do), we can choose to tell ourselves whatever story we want. It is okay to feel stress, worry, and concern, AND it’s equally okay to feel calm, hopeful, and content. The best part is knowing that you have the tools to handle whatever comes your way.