Dealing with Anxiety While Taking Tests

Guided imagery, visualization, mental rehearsal or other such techniques can maximize the efficiency and effectiveness of your studying.  In a world where school performance and success is measured in tenths of a point, most students will use every possible training technique at hand.
Guided Imagery might be one way to gain that very slim margin.

Curiously, many high school and college students perform their best during studying and/or or practice tests, then find that they choke during the actual test.  If this happens there are some simple steps to be taken to overcome such anxiety.

Choking is described as a decrease in performance due to too much perceived stress.  It should be kept in mind that stress lives only in our mind and in the way we interpret a situation.   Ultimately, it is not the external situation that causes stress, but the way we think about that event that creates feelings of stress, anxiety and fear.

For students who choke during test taking it is important to understand that they can control the thoughts they have regarding the test - thoughts of self-doubt, failure and a lack of confidence in their ability.  And past failure after failure often breeds feelings of anxiety, nervousness, and tension going forward.

Tips That Can Help

Before any test remember that pre-test jitters are normal and accept them. Don't fight the nervous energy.  Don't misinterpret it by thinking that it is fear.  That adrenaline rush felt is normal and it is part of our body's natural preparation for any stressful event in our lives.  Once the student begins focusing on the test at hand that feeling will subside - as it always does.

Prepare both mentally and physically by getting a good night’s sleep the night before, and by arriving for the test with plenty of time, so you aren't rushed - which only increases your stress.  Allow a few minutes to visualize  yourself doing everything right.  Breathe easy, close your eyes and
use mental imagery to visualize performing well.   This positive self-talk can change your attitude – and that can change everything.

Focus on the test at hand rather than the outcome.  Stay present in the moment and avoid thinking too far into the test or thinking about the final grade/score.   If thinking of negative thoughts or negative self-talk comes, stop and focus only on breathing. 

Finally, during the test, act like you don't care about the outcome.  See the test for what it is; just one of a long series of events in your life, not the definition of who you are.

Test anxiety can be dealt with.  Call Coach Mickey to experience guided imagery for test anxiety – 714.743.5612 or TXT anytime.

WHAT IS GUIDED IMAGERY?

Many people routinely use guided imagery as part of a healthful lifestyle. There are stories and examples of how such techniques provide not only a competitive edge, but a renewed mental awareness and sense of well-being.   And further down this page clinical research finding are provided which confirms the benefits of using guided imagery to achieve desired academic and athletic performance outcomes.

Guided imagery has also been called visualization, mental rehearsal, mediation, and a variety of other things -- no matter the term, the basic techniques and concepts are the same.  Generally speaking, guided imagery is the process of creating a mental image, or intention, of what person wants to happen or feel.

A student can use this technique to 'intend' an outcome of a test or school project. By imagining a scene, complete with images of a previous best performance or a future desired outcome, the student is instructed to simply 'step into' that feeling. While imagining these scenarios, the student will try to imagine the detail and the way it feels to perform in the desired way.

These scenarios can include any of the senses. They can be visual (images and pictures) kinesthetic (how the body feels) or auditory (the roar of the crowd).  Using the mind, the student can call up these images over and over, enhancing the skill through repetition or rehearsal, similar to physical practice.

With mental rehearsal, minds and bodies become trained to actually perform the skill imagined. Research is finding that both physical and psychological reactions in certain situations can be improved with visualization. Such repeated imagery can build both experience and confidence in a student’s ability to perform certain skills under pressure, or in a variety of possible situations. The most effective visualization techniques result in a very vivid experience in which the student has complete control over a successful performance and a belief in this new 'self.'

For one-on-one help call 714.743.5612 or TXT and ask for Coach Mickey.  For more in depth information on guided imagery, please visit Dr. Mickey's guided imagery website; Guided Imagery For Healing

RESEARCH FINDINGS USING GUIDED IMAGERY FOR ANXIETY

July, 2006

Prevalence and Costs

Anxiety disorders are the most common psychiatric condition in the United States, affecting 40 million people annually (NIHM, 2006). In the annual reporting period of 1997-1998, anxiety was responsible for 12.3 million office visits, up from 9.5 million in 1985 (Harmon, Rollman, et al, 2002). 1996, anxiety disorders cost the US economy over $46.6 billion in direct and indirect costs (NCHS, 1997).

What is Anxiety?

Anxiety disorders is an umbrella term used to describe a wide diversity of psychological conditions. The two major anxiety disorders are Generalized Anxiety Disorders (GAD) and Panic Disorders. Others include Post-Traumatic Stress Disorders (PTSD), phobias, separation anxiety, performance anxiety, and Obsessive-Compulsive Disorders (OCD).

All of these conditions are marked by feelings of apprehension, tension, or uneasiness which can range from mild to incapacitating. Physical symptoms can include stress, palpitations, and sweating. The severity of these symptoms can vary. No single cause seems to be responsible for anxiety disorders. Both psychological and physical causes are usually involved. Genetics can also play a role.

Medical Treatment of Anxiety

Treatment depends on the precise anxiety disorder. Serotonin-reuptake inhibitors (SSRIs) are the most frequent initial medications prescribed. Other medications include benzodiazepines, trycyclics (if depression is also involved), MAO inhibitors (for OCD), beta-blockers (for phobias), and clonidine (for PTSD).

Non-pharmacologic treatment including imagery

The most effective approach is cognitive-behavior therapy (CBT). It is usually combined with medication.

Mind-body approaches have proven effective in cases of situational anxiety, such as test-taking (Wachelka and Katz, 1999), fear of flying (Aitken and Benson, 1984), undergoing surgery (Saadat, Drummond-Lewis, et al, 2006; Simmons, Chabal, et al, 2004; Tusek, Church, et al, 1997; Tusek, Cwynar, 1999); and in dealing with illnesses or conditions such as heart trouble (van Dixhoorn & White, 2005; Vila, Benedicto, et al, 2005), cancer (Deng & Cassileth, 2005; Hidderley & Holt, 2004), infertility (Chan, Ng, et al, 2006), pregnancy (Bastani, Hidarnia, et al, 2005; Rees, 1995; Teixeira, Martin, et al, 2005), and childbirth (Almeida, de Sousa, et al, 2005).

Many medical studies confirm the effectiveness of CBT for anxiety disorders (Borkoved & Ruscio, 2001; Butler, Fennell, et al, 1991; Lenz & Demal, 2000; Silverman, Kurtines, et al, 1999; Toren, Wolmer, et al, 2000). CBT can sometimes be so effective that it can replace medication in treating the symptoms of OCD and PTSD (Basco, Glickman, et al, 2000).

Studies also confirm the effectiveness of the mind-body techniques of guided imagery (Rees, 1995; Tusek, Cwynar & Cosgrove, 1999), relaxation (Aitken & Benson, 1984; Eppley, Abrams & Shear, 1989; Mathew, Ho, et al, 1981; Pender, 1985; Wachelka & Katz, 1999; Weber, 1996), hypnosis (Ashton, Whitworth, et al, 1997; Bryant, Moulds, et al, 2005; Benson, Frankel, et al, 1978; Davidson, Farnbach & Richardson, 1978; Stetter, Walter, et al, 1994), meditation (Finucane & Mercer, 2006; Kabat-Zinn, Massion, et al, 1992; Reibel, Greeson, et al, 2001), autogenic training (Hidderley and Holt, 2004; Jorm, Christensen, et al, 2004) and biofeedback (Clark & Hirschman, 1990; Rice, Blanchard & Purcell, 1993).

CBT and/or mind-body therapies have been effective in all types of anxiety disorders and across all age ranges (Barrett, 1998; Barrett, Duffy, et al, 2001; Barrowclough, King, et al, 2001; Craske MG, Golinelli, et al, 2005; Kendall & Southam-Gerow, 1996; Klinger, Bouchard, et al., 2005; Otto & Smits, 2004; Rayburn & Otto, 2003; Stanley, Beck, et al, 2003), and patients reported feeling more in control of their lives (Pender, 1985; Weinman, Semuch, et al, 1983), even when delivery is computer-assisted (Kenardy, Dow, et al, 2003).

These positive benefits have been sustained in follow-ups as long as six years (Barrett; Barrowclough, King et al; Kenardy, Robinson, et al, 2005; Kendall and Southam-Gerrow). In a study of over 1000 patients, behavioral medicine (relaxation response, cognitive restructuring, exercise, and nutrition) was able to significantly reduce anxiety as well as its medical symptoms (Nakao, Fricchione, et al, 2001). A biofeedback study of 45 people with GAD showed “significant reduction” in one measure of anxiety and its physical and psychological symptoms (Rice, Blanchard and Purcell, 1993).

Herbert Benson, a researcher famous for his studies on relaxation, and his colleagues, reported the effectiveness of meditation-based relaxation and self-hypnosis in the treatment of anxiety (Benson, Frankel, et al, 1978). A study of people with OCD showed that mental imagery could be used successfully to “freeze” the anxiety trigger in order to reduce fear and avoidance behavior in subjects (Riskind, Wheeler & Picerno, 1997). Self-help audiotapes and/or multimedia self-help programs have also been effective (Davidson, Farnbach & Richardson, 1978; Finch, Lambert & Brown, 2000).

Reviews of the literature confirm that all forms of CBT are “likely to provide some benefit for adults” (Rodebaugh, Holoway, and Heimberg, 2004), with relaxation techniques having the strongest evidence for generalized anxiety, panic disorders, dental phobia, and test anxiety, and autogenic training and meditation having some evidence to support their effectiness for generalized anxiety (Jorm, Christensen, et al, 2004).

Studies confirm physiological changes occur after using mind body techniques. After using relaxation training, one small study showed that subjects’ anxiety and platelet MAO levels were significantly lower (Mathew, Ho, et al, 1981), while in another study, subjects’ salivary cortisol levels were greatly reduced and salivary immunoglobulin A (sigA) levels significantly increased (Pawlow and Jones, 2005). Another 2005 study confirmed both physiological and psychological changes (Tafet, Feder, et al, 2005).

Conclusion

A program that includes imagery, relaxation, and behavioral changes can be a low cost, effective way for patients to actively participate in managing the symptoms of anxiety disorders.

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