Are you afraid of what the future holds? Are you often worried or plagued by anxiety? If this sounds like you, you are far from alone.
We get a lot of comments and messages from students who are worried about the future, and this fear causes them to struggle to make decisions.
Whether you’re stressed about an upcoming exam, worried about whether or not you’ll get into medical school, or overwhelmed by an aspect of your life, there’s actually quite a bit you can do to overcome these feelings. In this article, we cover six actionable strategies you can use to manage your fears.
1 | Acknowledge Your Feelings
First off, you have to acknowledge your feelings and state of mind. So many of us ignore warning signs from both our body and mind because we don’t want to admit how we’re feeling.
But this only pushes away the problem. Ignoring how you feel over and over again will result in an emotional reckoning at some point or another. You simply can’t keep everything bottled in forever, and if you try to, eventually, it will boil to the surface, and it could be at a pretty inopportune time. You could blow up at a friend or barista or send a rude, impulsive email to a professor—none of which will do anything to dispel your anxiety.
If you’re worried about something or suffering from anxiety, acknowledge to yourself that you feel this way so that you can begin to pinpoint the source. Understanding where these feelings are coming from is the first step to working through your fears.
If you’re worried about an upcoming test, ask yourself why, and turn to the facts. Are you worried because it’s an important test, or are you worried because you haven’t adequately prepared for the test? If you’re worried about whether or not you’ll get into medical school, is it because you objectively have a weak application and are not prepared to apply, or are you experiencing an attack of imposter syndrome?
Acknowledging your feelings is the first step toward working through them in a healthy and productive way.
2 | Understand Your Circle of Control
Next, put your worries and fears into perspective by understanding your circle of control. There are so many aspects of your life that you have no control over, and while that may seem even more scary at first, understanding what you can and can’t control is incredibly empowering.
You learn what to focus on and what to let go of so that you apply your energy to the areas of your life you can actually impact.
Things that are out of your control include:
- What other people say,
- What other people do,
- What other people think,
- Traffic,
- How a book, show, or movie ends,
- The weather,
- And when you need to poop
You can’t control how a piece of fiction ends, so what use is it to get upset about it? You can’t control what people think or how they behave, so don’t try to. And you certainly can’t control the weather or when you have to go to the bathroom.
That doesn’t mean you should just let life happen to you. In fact, the opposite is true. You can make the very most of every aspect of your life you do have control over.
Things that are within your circle of control include:
- What you do,
- What you say,
- How you react,
- How you spend your time,
- Who you spend your time with, and
- What you buy
When you focus on what you can control versus what you can’t, you’re able to let the uncontrollable roll off of you.
You don’t need to worry about whether or not it will rain. If it’s going to rain, it’s going to rain, you can’t change that, but you can control your own actions, reactions, and preparedness. If you hate the rain, carry an umbrella. If you know eating at Chipotle sends you running to the bathroom, don’t eat there. Or, at the very least, don’t eat there before an interview or date.
If you’re worried about an upcoming test, focus on what you can do about it. You control how much you prepare for the test. You can’t change the traffic you might hit on the way, but you can plan to arrive early so that what’s out of your control isn’t a factor.
3 | Talk It Through
Next, sometimes the best thing you can do is to talk it through with a trusted friend or mentor. Too often, human beings, and especially medical students and doctors, do not open up about our negative feelings for fear we’ll be judged.
There is a great deal of stigma around mental health and seeking help in the medical community, which is quite ironic considering our shared medical education and chosen vocation to heal others. We cover this topic in a previous video on the stigma of mental health for med students and doctors. Link in the description.
But despite the irony, it’s true. We don’t want to admit anything that could be seen as weakness, so we keep negative emotions to ourselves, further damaging our mental and physical health in the process.
However, talking with someone and asking for help not only requires tremendous bravery, but it shows a great deal of maturity. Don’t lose sight of this.
Everyone gets scared and everyone has their own worries and insecurities—you’re no different. Talking about your fears relinquishes their control over you, as you can break them down and analyze where they’re coming from rather than letting them fester. Sometimes just releasing them into the air allows you to see how small or irrational they really are.
Open up to someone you trust who has the capacity to listen to you. If a friend is in the middle of studying for an important exam, they won’t be able to give you the time and energy you need.
Before diving into a deep conversation, be sure to ask the person if they have the time and are willing to listen. But don’t let this step hold you back; if you have something weighing on you, the people closest to you will make time for you if they know it’s important.
The longer you keep your fears inside, the more powerful they get. Talk it through with someone you trust to gain a different perspective.
4 | Practice Intentional Breathing
The fourth strategy is to practice intentional breathing.
When we get stressed or scared, our fight-or-flight response is triggered, which sets off a chain reaction in our bodies. Our pupils dilate to let more light in so that we can better see the danger, our body starts sweating to cool itself, our muscles tense, blood is diverted from our digestive tract, causing it to feel uncomfortable, and our breath becomes fast and shallow to improve oxygenation in preparation to fight or flee.
These physiologic responses were essential for our ancestors, who frequently had to outrun predators or catch their own prey. However, they do little for us when we’re about to give a speech or take an important test.
We won’t be running or fighting, but our body still believes it needs more oxygen, so we take more breaths. This expels much more CO2, and when our oxygen and carbon dioxide levels become imbalanced, we need to restore balance by slowing down our breathing.
It might sound overly simplistic, but the basic act of breathing slowly and intentionally can do wonders for fear and anxiety. The body influences the mind, and the mind influences the body. It’s a two-way interaction.
There are myriad breathing exercises out there, so we’ll only mention a couple. 4-7-8 breathing was developed by Dr. Andrew Weil and is based on the pranayama breathing exercise practiced during yoga.
Start by finding a comfortable place to sit and keeping your back straight. Next, place your tongue against the back of your top front teeth and keep it there. Then, exhale completely around your tongue. This will make a whoosh sound. Next, press your lips together and inhale through your nose for four seconds. Hold your breath for seven seconds. Exhale through your mouth and make the whoosh sound for eight seconds. Then repeat this process three more times.
This will activate your parasympathetic nervous system, which controls your body’s relaxation and rest response and offsets your sympathetic nervous system, which controls your body’s stress response. Do this exercise whenever you start to feel stressed or scared. The more you practice it, the more effective it will be.
Another popular breathing technique is box breathing, also known as 4 by 4 breathing. It’s used by Navy SEALS as a quick and effective way to control their nervous system to maintain calm and focus on the battlefield.
It works like this. First, inhale through your nose for four seconds. Hold that breath at the top for four seconds. Exhale through your mouth for four seconds. Hold that exhale at the bottom for four seconds. Then repeat the process four times. This is another effective way to activate your parasympathetic nervous system and offset your sympathetic nervous system.
Other breathing exercises include Wim Hof, diaphragmatic breathing, coherent breathing, and Bhramari.
It doesn’t matter so much what exercise you choose as they all work to achieve a similar end result. The next time you feel stressed or scared, breathe slowly and intentionally to restore your sense of calm as well as your ability to focus.
5 | Fear-Setting Exercise
Next, let’s look at the bigger picture fears that may be haunting you. Tim Ferriss has a great exercise for not only tackling your fear but using that fear as a tool to help guide your decisions. It’s called fear-setting, and it’s one of the processes I used when deciding whether or not to quit clinical medicine. More on my personal process on the Kevin Jubbal MD channel.
The exercise is comprised of three pages and can take up to a couple of hours to complete, so we’ll only cover the basics here.
It begins with a simple “What if I…” question with the headings: DEFINE, PREVENT, and REPAIR.
In the first column, DEFINE your nightmare. Write down all of the worst things that could happen if you follow through on what you’re afraid of. Be as detailed as possible.
The fear could be giving a speech, telling someone how you feel about them, ending a relationship, or asking for a raise. For example, if you fear moving to a new city for school, define what you’re specifically afraid of. You might not make any friends. You might get lost because you don’t know your way around. You might miss out on family gatherings at home.
Next, PREVENT. What could you do to prevent these terrible outcomes from happening? How can you decrease the likelihood of your worst case scenarios? Continuing with the same example, you could participate in orientation events to ensure you meet new people right away. You could go on a city tour to learn more about the neighborhood. You could arrange weekly Zoom calls or game nights with your friends and family back home.
Next, REPAIR. If the worst case you outlined under DEFINE were to happen, what could you do to repair the damage, and who can you ask for help? If you don’t make any friends, you can be more intentional about participating in school clubs, teams, and activism groups to meet people. If you get lost in the city or on campus, you can pull up a map or ask someone for directions. If you become homesick and miss your family back home, you can pay to visit them over a weekend or ask them to visit you for a pick-me-up.
It is helpful to think: Has anyone else in the history of time who is less intelligent and less driven than you figured this out? Has anyone else struggled to make friends or fit in before you? The answer is absolutely.
On the next page, it’s time to conservatively look at the benefits. What might the benefits of an attempt or partial success be? Moving to a new city for school will help you learn more about the world, it’s a chance to meet new friends and mentors, and it will push you outside of your comfort zone to build your resilience.
The last page is the Cost of Inaction assessment. What are the costs emotionally, physically, and financially for not acting. Don’t only consider the downsides—what happiness or success are you denying yourself with your lack of action? If you don’t take action, what will your life look like in 6 months, 1 year, and 3 years?
What is the cost of the status quo?
Label these from a 1 to 10 minimal to maximum impact. On a scale of 1 to 10, what is the cost of inaction?
Do the same for the benefits you previously outlined. On a scale of 1 to 10, how would these outcomes, whether it’s increased confidence, new relationships, or lifelong memories, positively impact your life?
What out of 10 are you risking, and what out of 10 are you gaining? In many cases, people find the reward far outweighs the potential risk.
To learn more about Tim Ferriss’s fear-setting exercise, check out his video and blog on the process—link in the description.
What in your life are you putting off because you’re afraid? Typically, what we’re most afraid of is also the thing we most need to do. Ask yourself: “What are you waiting for?”
If your answer is “it’s not the right time,” what you’re really saying is you’re afraid, just like everyone else. The fear setting exercise helps you realize how repairable your end of the world scenarios are and evaluate the true cost of not acting.
6 | Build Your Discomfort Tolerance
Lastly, intentionally build your tolerance for discomfort. While some people are more naturally resilient than others, resilience is absolutely something you can build. The more you take action and push yourself outside of your comfort zone, the more experiences and skills you accrue, which helps to limit your fears and build your confidence. You begin to understand that no matter what life throws at you, you can overcome it.
Often, the best action you can take to overcome your fears is to expose yourself to them. If you constantly avoid your fears, you’ll grow to believe you’re not tough enough to face them. You won’t feel confident or resilient, and soon enough, you won’t feel capable. Any form of discomfort will feel like too much to bear.
But the more discomfort and the more of your fears you expose yourself to, the more you can grow to be comfortable being uncomfortable. This is an invaluable skill that will benefit all aspects of your life.
Instead of trying to hide or escape from your discomfort, practice mindfulness. Look at your fears and your anxiety from a third person perspective so that you can observe your feelings with curiosity instead of judgment. This diminishes their power and hold over you. Isn’t it interesting you’re feeling this way? What could be causing it? The next time you feel all tied up inside from nerves, try to reframe it as excitement. The sensations are quite close already.
Start small and take baby steps. If you’re afraid of public speaking, for example, go to a karaoke bar and sing one song, sign up for an improv class, or raise your hand in class to answer questions in front of your peers.
Another great way to intentionally become comfortable with being uncomfortable is exercise. There’s no way around it, vigorous exercise and endurance training is tough. And that’s the whole point. Push your limits to show yourself how much you can endure.
This endurance and perseverance will translate over into other aspects of your life.
There’s a quote by Jerzy Gregorek, a four time world champion weightlifter. He says, “Easy choices, hard life. Hard choices, easy life.”
For many of us, being afraid and in a constant state of worry comes from a lack of confidence. When we believe that we can’t do things or that we’re not good enough, these feelings seep into all aspects of our lives. The best way to combat worry and self-doubt is by proving to yourself you are competent and capable, and you do this one step at a time by forcibly putting yourself out there and challenging yourself to try new things.
How much more self-confidence would you have if you knew how to change a tire, play guitar, or cook a badass pasta dish?
This month, I challenge you to take a step outside your comfort zone by trying something new. Intentionally build your resiliency, confidence, and sense of self-worth. You’ll never completely dispel every fear or worry, but you’ll have the confidence to tackle them head-on and use your fear to your advantage.
If your current fears are about how to apply to medical school and whether or not you’ll get accepted, the tools and resources at medschoolinsiders.com can help. We have a huge library of guides on our blog, as well as a number of online courses, application consulting, and tutoring services to help you become the most capable version of yourself.
If you enjoyed this video, check out our self-improvement playlist right up here.
Much love, and I’ll see you in the next one.
