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We humans have an almost pathetic desperation for certainty, despite the entirely uncertain world we live in. For some, not to know is excruciating agony. It is why women often spend money on more expensive pregnancy tests that can tell them a day before cheaper brands on the market whether they are pregnant, or a week before their doctor could have told them for free.1
One of the most poignant examples I have ever come across of desperation for certainty was that of a man whom palliative care specialist Rachel Clarke wrote about in her moving book Dear Life. Roger had been terrified ever since he was a child by not knowing when he would die, and had suffered over the years from severe anxiety and depression.
Yet, when he was brought into the hospice, in serious pain, paralysed from the waist down by advanced prostate cancer and with the knowledge that he had just days or weeks to live, he was smiling broadly. Once his pain had been sorted out, he said, “I feel free. This is the first time in my life I have ever felt relaxed. None of my fears bothers me anymore. All the things like the kindness of nurses, a massage in the morning, time with my family — I can just enjoy them without worrying.”2
Anxiety is an obsession with the unknowns of the future (‘Might it?’ ‘Will I?’ ‘What if?’), and it is draining. It stops us from truly living, as was so sadly the case for Roger until his last weeks. I had a client who went through nightly paroxysms of terror at the thought of going to college the next day, although she thoroughly enjoyed her course and the studying. Yet, whenever she actually got herself out and onto the bus, she was absolutely fine. It was as if, having acted on her decision to go, she could relax into the day ahead. But she couldn’t, before our work, use this knowledge to protect herself from the anticipatory agony.
Sometimes it is tunnel vision that prevents us from recognising that we can get through. Another client was suffering panic attacks because she was in the early stages of a freelance project that demanded enormously long hours, stopping her from eating, exercising, and sleeping properly, or keeping up with friends. ‘I can’t live like this!’ she wailed.
We unpacked the problem. She had high motivation for completing the project because it would lead to desirable further work. The job would be over in six months. We rehearsed how she could write off expectations of sane living during this period, grabbing just as much sleep, nutritious food, exercise, and social contact as was possible in the circumstances, knowing there was a clear (and worthwhile) end in sight. Reframing her circumstances in this way stopped the panics.
It makes sense that, when we know the end is in sight, we can pace ourselves better. In an experiment, undergraduates had to complete a complex series of activities, split into 10 blocks of 240 somewhat tedious tasks. Half of the students received regular feedback as to how many blocks they had completed, while the others were told nothing. All were asked, after the third, sixth, and ninth blocks, how tired they were. Those who received the feedback were less tired, performed better, and also took fewer breaks than the others, presumably because they could see the finish line and thus were motivated to carry on, just like my client, instead of feeling swamped.3
But what if we can’t judge, or know, how long we have to keep going? I take inspiration from one of my sons who, when young, participated in the Duke of Edinburgh Award bronze expedition. This entailed covering 15 to 20 miles on foot in heavy boots while carrying a weighty rucksack. The day in question turned out to be blisteringly hot; the rucksacks must have felt colossal, and the kids quickly became tired.
As our son told us later, when they finally reached an outpost where they were given further directions, they eagerly asked, "How far have we come?" convinced that they must be nearly three-quarters of the way there by then. All were crestfallen to discover that they had walked barely a mile.
My son immediately rallied by instructing himself, "Right! Then just put one foot in front of the other, and keep going for as long as it takes."
We are resilient creatures and we can, indeed, keep going for as long as it takes when we set our minds to it. If we can admire the view along the way, better still.
References
1. Niv, Y and Chan, S (2011). On the value of information and other rewards. Nature Neuroscience, 14, 9, 1095–7.
2. Clarke, R (2020). Dear Life: a doctor’s story of love and loss. Little, Brown. London.
3. Katzir, M, Emanuel, A and Liberman, N (2020). Cognitive performance is enhanced if one knows when the task will end. Cognition, doi:10.1016/j.cognition.2020.104189
