CHAPTER 9

Dealing with Academic Anxiety (General) &

Exam Anxiety (Specific)

You might be surprised to learn that post-graduate students and medical doctors
are not immune from exam anxiety.
Carl’s case:
Carl, a doctor referred by the chief surgeon at his hospital, had failed his surgical
fellowship exams several times. With each failure, he became increasingly anxious
about whether he would pass at the next set of exams. His particular worry was the
viva exam, difficult assessment which required candidates to interview patients and
then be examined by two doctors. Carl's anxiety about his viva exams was so
extreme that it began to adversely affect his daily life and professional practice.
Carl's hands were damp, verging on wet with perspiration when I first met him. He
reported that at 39 years of age with a large family to support, he was faced with
the very real and negative prospect of failing in his career. If he failed his fifth
attempt at the viva exams, he was prepared to leave medicine altogether and look
for a business opportunity elsewhere. He stated quite firmly that if he could not
practice as a surgeon, he would not work in medicine at all.

Academic anxiety:
Academic anxiety can be described as grit in your mental gears. That high-
performance machine (your brain) within your cranium is fuelled and fired up, but
grit in the gears can lower your performance.
Some problems students face in studying and cause anxiety are:
1- Some students when working on an essay, they would sit and wait and wait
before generating sufficient courage (panic?) to get their self-moving.
2- Some students think that their reading and writing skills are inadequate because
`it's been so many years since they've studied'
3- Negative thoughts versus positive thoughts.
4- Fears of failure or of low performance. For example, getting started on major
projects and speaking in class are some of the most common problems experienced
by students.
5- Comparing yourself negatively to your younger classmates whom you see full
of confidence and up-to-date competence in their subject areas.

Anxiety and fear of failure:

Academic anxiety is almost always due to negative thoughts, especially about the
possibility of failure or poor performance. Let's look at speaking in the classroom
for example. It would be safe to say that few if any classrooms hold any life-
threatening risks, yet many students experience feelings of high anxiety when
sitting in their classes. These feelings are fundamentally attributable to negative
thoughts. If these thoughts can be turned around to become either neutral or better
yet, positive, then the student can sit more comfortably in class and learn.
We might look at the anxiety situation as an A, B, C cycle where
A: Represents a negative thought, for example. What if I can't answer a question
correctly?
B: The nervous feelings.
C: The avoidance of the threatening activity — sitting very quietly and
inconspicuously in class.
As the whole system hinges upon A, that's the best place to start in dealing with the
problem.
(Achilles' heel): Being very weak on something.
If classroom speaking is your (Achilles' heel) and you choose the back rows in
class to minimize the chance of being called upon to speak, then look at the types
of thoughts you are entertaining. Yes, you might have had some painful
experiences in the past, such as being embarrassed when struck speechless in front
of the class while trying to present a report. Or, perhaps a teacher ridiculed you in
class because of a particularly poor effort on some project. There's no getting
around these situations — they do hurt. But, it is very important for you to note
that these are historical events and your present classrooms bear no relationship
with them. It is directly up to you to influence the present so that these historical
events are not repeated.
Acknowledge the painful experience from the past, but then add, `I am in control
of my present behavior!' It is up to you to take steps to prevent the anxiety from
recurring. With thorough preparation for your classes, you can assure yourself that
you can handle the classroom situation. You want to put the present situation into a
realistic perspective and certainly not allow yourself to emotionally cringe in the
shadow of some past event. It will take some practice, but putting into direct action
this rational approach to your academic challenges will certainly bear more fruit
than defaulting from trying.

The role of being well prepared:

Preparation is very important. Anxiety about classroom participation breeds upon
uncertainty. If you know that you are not well prepared for a class, a speech or a
project, then it's quite understandable that your mind might be entertaining some
catastrophic thoughts about possible embarrassment or failure. The secret is to be
well prepared so that you have every possible chance of performing to the best of
your ability.

The TUF approach:

Getting tough with yourself is often necessary, but that might sound daunting. As
an alternative, try the TUF approach, where T, U, F stand for (try, use, and fun).
Instead of putting off things and avoiding threatening but harmless situations, get
into the habit of trying particular skills every day.

(TRY)
- If you have had a fear of speaking in class, then practice the skill but in
smaller bites. When you arrive in the classroom, make a point of greeting the
classmates on either side of you. That's speaking in class, but in a less
threatening way.
 - If you know that a topic is going to be discussed tomorrow, then read about
the topic tonight and prepare three questions which you might ask in class. It
takes less courage to ask a question than to offer an answer.
- When the opportunity arises, get straight into action and ask one of the
relevant questions. You'll be surprised how much easier the task is when
you're well prepared and you know what to say. Thus, trying to participate in
class is an important step to overcoming anxiety about classroom discussion.
(USE)
The use part of the formula means literally using the skills frequently to increase
their strength in your behavior. It is well established that skills which are
frequently used will strengthen. Those which are ignored and allowed to become
idle are likely to weaken and possibly disappear. By using these participation skills
most days, you can move from fear to confidence and from hesitation to fluency, a
situation which would be very appealing to most students.

(FUN)
Fun is something we all like and it will certainly lubricate your learning. A former
teaching colleague, once told me that when faced with teaching a difficult concept,
try to turn the learning situation into a game. Games are fun and when students are
having fun, they learn much more easily. When trying to increase your classroom
speaking skills, look for amusing stories and anecdotes which relate to topics being
discussed in class. Practice telling these anecdotes to two or three friends or
perhaps several family members. Enjoy the humorous situation and be prepared to
laugh, especially at yourself. The principle is to start out in a small way and
progress gradually to larger groups.

Learning how to relax:

Some people might say that their anxiety level is just too high to ever expect these
lighter approaches to have any effect. Whether you are an anxious person or not,
relaxation training can produce a very positive result. The following steps should
be practiced twice a day for a period of about three months. After 180 practice
sessions or thereabouts, you will have conditioned yourself to respond to the word,
`relax', with a strong and productive relaxation response.
1- Be sure to practice twice daily, especially on busy days — that's when you will
need the relaxation and benefit most from its effects.
2- Develop the expectation that you will relax, but don't try too hard. Relaxation is
a passive process. In the early practice sessions, your mind will tend to wander off
onto other thoughts. Expect this to happen and when it does, just bring your
attention back onto the relaxation procedure.
3- Find a quiet setting where you will not be disturbed.
4- Make yourself as comfortable as possible. It's best not to lie down in bed as you
are likely to drift off into sleep.
5- Focus upon your breathing. Just breathe comfortably and notice how pleasant it
feels to listen to the air flowing in and out.
6- Over the next ten breaths, count to yourself successively from one to ten as you
breathe in and say `Relax' to yourself as you breathe out. If your mind is still quite
active and strays from the procedure, then trace the numbers in your palm to fix
your mind more strongly onto the relaxation process.
7- Now, concentrate upon the body muscles and move from head down to feet,
relaxing the muscles of your body. Simply focus your attention on the following
muscle groups and then say, `Relax'. Feel the tension flowing out and
systematically relaxing your body. Start by relaxing your forehead and then move
downwards: eyebrows, eyelids, cheeks, mouth, jaws, neck, shoulders, back, upper
and then lower arms, chest, abdomen, thighs, calves, ankles and feet.
8- To deepen the relaxation effect, imagine now that you are descending a staircase
to a warm and quiet beach. As you see yourself stepping slowly downwards from
step to step, associate the familiar feeling of stepping down one step with a
stronger feeling of relaxation. When you reach the bottom of the staircase, see
yourself walking out onto the beach and then stretching out on a beach towel. If
you have difficulty visualizing this scene, ask yourself the following questions.
What do I see? (the blue water, the breaking waves, the yellow-white sand, the
swaying palms); What do I hear? (the breaking waves, the whistling of the gentle
wind in the palm fronds); What do I feel? (the fine texture of the sand, the warmth
of the sun); What do I smell? (the salty aroma in the air, the sweet smell of flower
blossoms); What do I taste? (the salty taste on my lips). By focusing upon your
five senses, you should be able to keep the scene actively in the front of your mind.
9- When fully relaxed, say to yourself: `I can relax my mind and body. I am in
control.'
10- After you have enjoyed the feeling of relaxation for a few minutes, then slowly
count from one to five, open your eyes and come back to your previous state of
functioning. Stay in the same position and then slowly stretch your arms and legs.
11- You can experience a mini-relaxation effect by briefly pausing any time during
your days and taking a comfortably deep breath and then slowly letting the air out
while you say `R-e-l-a-x-x-x' to yourself. To remind yourself to take these brief
breaks, place small stickers with a large R on them on your telephone receiver,
your car dashboard or at any other place where stress can be a problem.

Reducing exam anxiety:

It has been found through controlled research studies that by pairing the relaxation
response to the imagined scenes, it is possible to reduce the anxiety in the real
event. The purpose of this exercise was to provide a series of visual stimuli which
Tony was to imagine while he was relaxed. While you progressed through the
series, you paired increasing relaxation response with the images in the series of
scenes. Here is a sample of some scenes which might be helpful to you.
Scene one
It is Week One of the year and I am sitting in class. The course coordinator is
discussing the syllabus and the various assessment exercises which will determine
the final mark. The final exams are nine months away.
Scene two
It is Week Four and I am sitting at home at my desk looking at the schedule of
papers, tests and exams which are posted on my planning chart. I note that there
are several mid-year exams coming up in about ten weeks.
Scene three
It is Week Seven and I am sitting at my desk preparing for my Mid-Term Exams. I
have covered the material thoroughly and feel confident about my preparation.
Scene four
It is the night before my first mid-term exam and I am lying in bed ready to go to
sleep. My mind is still buzzing with thoughts about the exam. I start the relaxation
series and find myself drifting quickly off to sleep feeling much more calm and
confident about my preparation.
Scene five
It is the week before my final exams. I have been obtaining quite good results
through the year and I want the same trend to continue into the exams. I am
thinking confidently about myself and I am saying, `I can do it!'. I feel much more
confident about my abilities.
Scene six
It is the day of the first final exam and I awake early after a surprisingly sound
sleep. I browse through my notes, knowing that my preparation has been thorough,
except for one topic which I will reinforce now. I feel calm and confident. You will
have noticed that the scenes become more positive in orientation. That is what you
want to build into your responses so that by the time the final exams arrive, you are
feeling calm, confident and in control. I suggest to exam anxious students that they
use those three C's (calm, confident, in control) as prompters for a positive mental
attitude.
In summary, examinations can certainly raise your anxiety level and thus affect
your results unless specific steps are taken. By learning the relaxation procedure
described in this chapter and coupling with it the desensitization steps, you can
lower your anxiety and increase your marks, by up to 30 per cent! Time and
practice are necessary, but that increase in your results makes the small effort well
worthwhile.
Practical exercises:
1- Take the role of the examiner and write your own examination paper. Examine
the syllabus and then write five essay questions which will address the major
concepts dealt with in the syllabus. For short answer and multiple-choice
questions, write three questions of either style immediately following your revision
of the notes from each lecture.
2- Have lunch on a set day each week with a classmate or two and prepare five
questions from the last week's notes for your colleagues to answer. They should
prepare five questions as well and then exchange questions during your quiz/lunch.

3- If past exam papers are available, revise these well before the examination
period and note specifically any similarities in question orientation. Prepare a one-
page summary for essay questions which appear in two or more of the past papers.