Advertising Anxiety

When working with a client who stutters, we often talk to them about “advertising”. By that, we mean being open about their stutter. Sometimes we’ll have a client go into another therapist’s office and tell them, “I was hoping to talk to you today about stuttering. What do you know about it?” Or they might ask to borrow a stapler, but stutter while they’re doing it (on purpose). Other times they’ll be ready to tell a new adult, “I stutter, and this is what I’m working on.” The idea being that the more they are open about stuttering, the more their own internal stigmas are broken down. Additionally, the more open they are, the less likely they are to have avoidance behaviors (avoiding people, places, and words, because of their stutter).

This is the type of advertising I have learned to do about my anxiety when I’m in a medical setting.

I don’t do well in a doctor’s office of any capacity, and I have recognized that I likely never will be able to be present in those settings without any anxiety. But for many years, this knowledge, this belief of I have panic attacks in medical settings directed my behavior. I was completely out of control – or rather, my anxiety was completely in control.

[Apologies in advance – the next part is gross but hey, it’s all about being real, right?]

For years I passed out every single time that I had blood drawn, or a TB test. But passing out wasn’t the worst part. I knew people who fainted from things like that, and let me tell you, I would’ve paid money to only have fainting be the issue. What would happen to me is that a heavy, hot, feeling of unreal-ness would pass over me. I’d start to get tunnel vision. And then instantly, nausea and an urgent stomachache would follow. My body would go directly into flight-or-fight mode, and shut down, trying to empty. And this meant maybe by vomiting and maybe from my bowels. Well, you can’t really do both at once, or else it’s going to be messy and disgusting. And it’s even messier and more disgusting if it happens in an exam room. So in this split second, I’d realize I needed to bolt to the bathroom before any or all of these things happened. Usually I’d make it to the bathroom, my system would empty in one way or another, and I would pass out on the toilet seat.

Lovely, right?

The memories of these unpleasant panic attacks combined with my pre-existing fear and anxiety about a doctor’s office in general led me into a cycle for years: knowing it would happen, therefore it would, therefore confirming that it happened, therefore knowing it would happen next time, etc. I’d sit in the chair, and wait for the needle, hoping I could fake it this time around, never succeeding.

Until one day about 5 years ago I realized that I didn’t have to be helpless.

I began to advertise.

“I need to lie down when you take my blood,” I started telling the techs. “I am a fainter and do better reclined.”

“I’m going to listen to my ipod while you do that procedure,” I told a dentist.

“I appreciate you telling me exactly what you’re doing while you’re doing it, but can you actually talk to me about anything else instead?” I’d ask the doctor.

“I am about to pass out,” I told a doctor once. “I need to recline and I need something cold for my head.”

“I know you’re not doing an exam today, but I just need to let you know that I tend to get very anxious in medical settings. So if I step out into the hall or something, I’m fine, I just need a minute.” I told a new specialist I was seeing.

“So do you think it’ll snow tomorrow?” I’d ask a technician, not caring about the weather and not knowing if she did, but knowing I needed to distract myself from what was happening.

And it began to work. I had a TB test where I didn’t faint. I had blood drawn where I didn’t pass out. I sat on an exam table without the white-hot unreal fog coming over me. Breaking the cycle, making me believe I could be in control of this.

My expectation was never – and is not today – that I will never have these episodes again. But more that in being up front about it, the fear is out of me and into the world. They know what to expect so there are no surprises if I rush off to the bathroom or suddenly dart out of the room. One lab technician thanked me, saying, “I’m glad you said something. We’d always rather know, just in case.”

I used to not speak up out of – you guessed it – shame. Feeling that I should be able to handle this and it shouldn’t be such a big deal and what was my problem, anyway. But guess where that got me? Correct. Nowhere.

So now, I advertise.

Dispelling a piece of that shame, each time I speak up.

Speech-Language Pathologist. Nature-loving, book-reading, coffee-drinking, mismatched-socks-wearing, Autism-Awesomeness-finder, sensitive-soul Bostonian.


  1. I get anxious when traveling of any kind and the last time I flew I chatted with my seat partner about how I get anxious and we chatted about everything basically the entire time. It really helped to quell my anxiety. Putting it it there takes the surprise/shock factor out for me. I would rather not reveal that I have a weakness but it helps every time I do admit to being anxious.
    And oftentimes, it’s the fear of the panic attack that makes me so anxious. Which is ridiculous in itself but so common I have found.

    1. So common absolutely. Fear of fear, panicking about panic, it just makes it worse. Which is why, I think, when we tell it like it is, we remove that initial judgment and fear and therefore feel stronger and more successful, regardless of what ends up happening.

  2. As someone who has drawn blood believe me the best thing you can do as patient is to be honest and tell us how you feel we do not want to hurt or scare you. Yes advertise sing read a book you are not there to be punished or feel ashamed. Great post

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