Anxiety causing me to doubt my ability to cope at work

06 March 2012

Hiya Robin

I can’t decide if I’m having a breakthrough or a breakdown at the minute! It involves a story about my latest clinical placement..

basically iv been there for 9 weeks, the first 3 of which i had no official mentor due to my allocated one going off sick. so i got a new one 

I think there is a bit of a personality clash between us – she is very loud and outspoken/sociable where as I’m pretty quiet and like to get on with my work. 

To cut a long story short – she said that she wasn’t happy to ‘pass’ me on the placement as there ‘was something she couldn’t put her finger on’ – apparently I’m not as up to scratch as other students? She said it wasn’t my knowledge base, but more my ‘professionalism’ in the sense that I had left a skill until the last minute to complete.

To cut a long story short, my personal tutor had to get involved. She told me off for not being as organised as I could be – granted – and she asked if my anxiety was affecting my performance, as ”this happened last year when you were poorly” (when I had not yet learnt of CBT etc and thought I was dying lol) 

I have told her about my anxiety – and she has had it herself! Anyway I told her that I felt I had actually made some progress whilst on the postnatal ward. She kept referring to me as being “ill” and “poorly” with anxiety – I wanted to scream at her! lol. She started asking me if I would like 6 months off to “get better”  – I said no as I felt I am capable of achieving the ‘learning plan’ they will put in to place when I go back for a further 4 weeks to the postnatal ward for reassessment

Then the doubts started to creep in – what if I’m imagining my progress… what if I SHOULD take time off… what if I won’t be able to cope as a midwife…. these people don’t think I’m capable… etc

In a way I am pleased with how I am coping – catching and identifying negative thoughts about this situation etc. But a small part of me is thinking ‘what if this course really is hindering my recovery from anxiety at the moment?’ If anything I think repeated exposure is doing me good – like you were saying there is lots to practice with – and I feel I coped with the emergency the other day better than previous times. But I am cautious of stressing my body ‘too much’

It’s funny at the minute – I’m sort of at the stage where I’m challenging anxiety and when I succeed I think “is this IT? I understand it now – symptom, instant panic, constant checking in etc and how it affects thoughts and feelings – I think to myself, surely it isn’t this simple, I’ve been duped by THIS all along? lol. Fear is such a good bluffer

I’m listening to a lot of Alan Watts at the minute – very insightful! and a lot of what he says can be related to what I have learnt from CBT 🙂

Sorry for the huge email!



sorry for the delay – moving house so up to my eyes

Trust me – you ARE getting this – you ARE improving – you WILL get past this completely

but it does take time

whatever you are doing can not stop that progress – and you can’t stress your body too much – you have panic – not stress – you misinterpret and catastrophise and get caught in the cycle of fear

but you ARE changing that and you CAN do it in this course

just do it and even if it doesn’t work out this time – do it again

remember that OTHER PEOPLE ALSO HAVE PROBLEMS with these placements – for many reasons – they may just not be good at it – they may be anxious – they may have relationship problems – they may be out partying too much

it happens

and other people clash with other people for all sorts of reasons

try not to forget that this IS normal

don’t add it to the list of misinterpretation and catastrophisation 

It sounds like she just has a ‘bossy’ type personality –  so if you didn’t do something on time I could see that she might react that way – with anyone – anxiety or no anxiety

what I am trying to say is don’t put this all down to your panic – and don’t think that all this will make your panic worse

it’s just not an easy thing to have to deal with – for anyone

In fact you do deal with a LOT more than most people – you don’t realise just how NOT anxious you are – many people can’t even get out of bed in the mornings

You are doing fine 🙂

Stick with it – take it on the chin and keep trying

don’t let it shake you out of your progress

You will get there


12 Mar 2012

Hiya Robin

thanks 🙂 hope the move is going well!

you’re right – I think I have been attributing everything to anxiety/panic and forgetting sometimes that other people would feel the same

It’s probably how I make the world such a scary place – relating EVERYTHING to fear and drama because of something ‘wrong with me’

I’m being strict with myself today and making sure I watch some of the CBT videos – its amazing how much better they can make me feel!! because some days, I just resort to ‘muddling through’ even if I’m particularly anxious, and I’ll visit the nomorepanic forum – it’s like a bad habit/reflex!! I don’t know why I do it, I think it’s because its ‘reassuring’ to see that other people feel the same.

But it doesn’t help – I guess that is to do with basically being surrounded by people stuck in their cycles, who end up triggering my fight or flight response because I can empathise with them too easily

So – I’m going to make sure I refer back to the CBT books and complete my panic diaries!! The difficulty I’m having at the minute is like I’ve mentioned before, not having panic attacks as such but more varying levels of constant anxiety. I’m presuming this is anticipatory anxiety, as my thoughts are ‘theres something wrong with my body that its trying to tell me’ ‘i’m suddenly going to fit’ etc. 

Am I right in thinking it’s the MEMORY of feeling so scared (before CBT/I realised what was happening) that scares me? I’m sure you’ve mentioned this before. Basically, I think it’s the fact when I am nervous I remember how I felt the first few times it happened – and worry that I’m going to feel like that again, even though I now know what to do – its like I don’t trust myself never to be that scared again? 

It feels too good to be true that I will ever be free of anxiety, which is another thought holding me back. It’s the constant little butterflies/ tight chest that make me feel there is something wrong with my body as it’s virtually ALWAYS there – like a permanent uneasiness – but I guess thats to do with all the tension and adrenaline, and me constantly ‘checking in’ on it that keeps it going. I find this the hardest part to accept

Also, I need to work more on putting my fears in to perspective – instead of being reassured that my symptoms aren’t a heart attack, I think a long the lines of “well it isn’t a heart attack today, but what WOULD a heart attack feel like, isn’t it awful that human beings have to suffer such things, I wonder how I feel when I DO have a heart attack when I’m old, I bet I’ll have one, lots of people do….” lol!

I’m working on the mindfulness and meditation also – I find this incredibly difficult at the minute but I will persevere!



That’s great – you are getting it now – especially if you are prepared to accept that sometimes in life people do get ill – it’s normal and so is the fact that many don’t – but in the end we all die – that’s life – and if we trust that overall ‘life’ wants what is best for us most of the time then ‘dying’ will be part of that

I spent a long time sitting contemplating my worst fears and allowing them to exist and it really did help

not dwelling on them and worrying but simply accepting that sometimes life is like that and that ultimately most people SO cope in some way of other

yes – it is DEFINITELY memory

if you got amnesia and totally forgot that you had panic – then fear of future panic wouldn’t happen

but also it’s a ‘physical’ memory

If we get attacked by a dog the body reacts with fight or flight – and from then on our BODY will react very quickly if we see another scary dog – sometimes faster than our thoughts

the GOOD news is however that it’s not the TRIGGER – or the fight or flight that is the problem

it’s what we do AFTER that – the misinterpretation and catastrophisation

that is the ONLY problem

fight or flight is not pleasant – but that’s it – it’s not dangerous either

even panic is not dangerous either – but if we get into the cycle it’s just a pain in the neck

so ALLOW the memory to trigger fight or flight – you may not have much choice in that

that’s FINE

but as SOON as you realise you have been triggered then CATCH it – SMILE – let go – practice and let it all do it’s thing and die down


24 Apr 2012


Hi Robin

just wanted to add to the previous email – sorry for spam! lol

I received my results yesterday – b12 level has come up very well  (from 75 to 667! normal range: 200-900) so I am pleased about that.  

Also my folate level was good (showing the veg intake has been a success! lol) However, my ferritin (iron level) stores were at the very low end of normal (16 : range 11-250) and from what I gather,  anything less than 50 can make you feel unwell and symptomatic of anaemia.

To cut the medical jargon short – this result has made me question a lot of ‘episodes’ and symptoms I have been having with regards to panic and anxiety. I knew all along I needed to improve my diet but I think it’s contributed more than I thought? So I am a little surprised and worried about how long my body has been in this ‘state’, wondering about whether chicken or egg came first!!

I’m fairly sure my first panic attack was one of a mistake with wind and chest pain, but the resultant anxiety states must have depleted my reserves, together with the stress of the course and poor diet (this is what i have been rationalising to myself)

However at the minute, I’m waiting to go to the doctors to get some iron tablets prescribed to boost my stores – which will be great – but I’m currently feeling a bit panicky/anxious about my confidence in using the CBT  approach to calm myself – it’s as if now i believe all along my body really WAS saying “hey somethings up!!”  when i panicked or felt strange therefore i find it hard to ‘rationalise’ when I feel a little dizzy, shaky or short of breath as these are all signs and symptoms of anaemia also.

I have been trying my best but still feeling a little miserable with it. I guess the only thing I can do is to keep eating well  (Even more so) and start these tablets and hopefully I’ll see an improvement!

Just need to stop catastrophising until then lol

Thanks for listening 🙂




Keep in mind that CBT never suggests that one should not go to the doctor to uncover genuine physical ailments or to check if we are getting the right nutrients and so on – in fact CBT encourages you to do so

but trust me – regardless of whether or not our body needs better food or medicine we CAN still ADD panic on top of everything else

I have seen people with health anxiety who get completely terrified when they have a cold or flu – where other people might just feel like rubbish but not catastrophise

You mentioned anemia – let’s say someone who never suffered from anxiety or panic got symptoms of anemia

They will go to the doctor and get sorted out – but they won’t go into ‘panic’ about it

People with health anxiety catastrophise so much they DO trigger fight or flight which adds many more symptoms – or increases whatever symptoms are there already

anyway – this is easy to test

when the new food/meds etc help to sort out actual physical symptoms you can see if afterwards you never get anxious again

It might help to repeat to yourself that many many people who don’t have health anxiety can have the EXACT same physical complaints but they don’t get hyper anxious or panic

I say this not to make you feel bad but so that you realise that it IS possible FOR YOU ALSO to have health problems (like all of us) without added anxiety

It is not a law that health problems MUST cause anxiety

Those of us who have suffered anxiety have got caught up in cycles of fear that CAN be changed

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