Some; indeed, many fears are overcome by reasoned argument and explanation. Others lead to “learned avoidance” of whatever forms the focus for our anxiety. And those that we cannot explain away and are unavoidable (though not so severe as to be disabling) we learn simply to thole•. Every one of us is, I suppose, ‘in there’ somewhere, as we catch a glimpse of an important truth, namely that anxiety is an inescapable and in many ways important, indeed essential and even life-preserving element in daily living. Just imagine the potential for disaster inherent in a situation where – let us say – a mother does not feel anxious at the thought of her pre-school age child playing by the side of a busy road.

This then in a nutshell provides us with the essentials about anxiety, forming part as it does of the human condition. By being confronted as most of us are daily with minor fears, worries and concerns, our lives are shaped and styled. Moreover, this plays a major role in determining our priorities, developing learned patterns of responsible behaviour and thus achieving that essential focus for satisfactory continuance, attainment and success. Anxiety then plays an integral part of our overall wellbeing and quality of life.

The problem arises when we are confronted by fears and anxieties, which are i: unavoidable ii: severe to the point of being unbearable and disabling and iii: beyond our capacity to manage or control. We have – let us say – been diagnosed as suffering from a life threatening illness. Moreover, the burden of this sudden and unexpected “bad news” is further compounded by our awareness of the need for treatment in the form of major surgery or chemotherapy or radiotherapy (or all three) which sends us ‘weak at the knees’, merely at the thought of it. Or (where treatment may have already begun) we find that among its unpleasant and noxious side effects is an alarming tendency to play upon and exacerbate or magnify known and established fears, which formerly we seemed able to manage satisfactorily; e.g. agoraphobia, as when we feel “spaced out” or claustrophobia, as when we feel “hemmed in”.

Also we may be aware of the development of new fears, seemingly linked to treatment needs and demands. These may include fear of retching; or needle phobia; or fear of some things – anything – that has to do with surgery or surgical procedures. Moreover – and as we have witnessed in earlier blogs concerning conditioning effects and anti-cancer treatments – former neutral stimuli such as a smell, a sound, or a visual cue may become contiguously (at the same time and in the same place) paired and bonded together. This – as, you will recall, I was at pains to explain earlier – can mean that even when off treatment altogether, a similar smell or sound or whatever, may cause us, in an instant, to retch, actually vomit and/or panic.

Clearly, in such circumstances, our normal learned coping strategies and responses are likely to be wholly inadequate. How should we – can we – begin to relieve, at least some of the burden of their grim threat? (Before we begin to discuss simple but effective ways of shifting the balance somewhat, in favour of coping and self-management, there are further important words, which I might usefully include here about generalized anxiety state, as well as those two very common but potentially disabling manifestations of anxiety, namely panic attacks and phobias. However, the contents of this blog have, in all probability, provided quite enough to take in for the moment. I shall therefore continue the ‘story’ about anxiety over the course of my next two blogs to be written, hopefully, for your support, encouragement, self-management and to assist in the provision of care for someone else in need.