Month: February 2024

PPA:

It’s a TLI
PA: It’s also a TLI, or a TLA

I used to do this in the classroom. There were so many abbreviations. In my jargon, a TLA is a three-letter acronym – and also a two-letter acronym. But I know that actually, PPA is not a three-letter acronym. It’s a three-letter initialism.

Acronym

a word (such as NATO, radar, or laser) formed from the initial letter or letters of each of the successive parts or major parts of a compound term

Merriam Webster Dictionary

Initialism

an abbreviation formed from initial letters

Merriam Webster Dictionary

“Okay”, you might say, “Wut’s this all really about?” Well, I thought I might be coining a new acronym/initialism, but once again, Google search saved me from embarrassment.

PPA is an initialism for Pre-Performance Anxiety. According to WebMD, pre-performance anxiety is stress and anxiety about performing in front of people and causes performance anxiety. PA can be considered either an initialism or an acronym since its letters also form a colloquialism for father. Performance Anxiety is also known as stage fright.

Now do you see where I’m headed with this? I now have two performances scheduled for next week. On Thursday I will participate in an open mic at Sidekick Coffee & Books in Iowa City. I recently added this venue after previously committing to the 55+ Connections Lunch at the North Liberty Recreation Center.

I’ve known about the 55+ gig for some time and have been practicing a set of songs that I hope will engage and somehow positively affect the lives of those who attend. Now that the time is near at hand, I find myself second guessing. Are my music and lyrics really “good” enough for public consumption? Is my presentation polished enough to expose myself to scrutiny? Will my aging, stiff fingers work!!!? On the up side, I do think I’ll remember the words.

I am not self-absorbed enough to think I am the only person who experiences performance anxiety (stage fright). I immediately think of my 13-year-old granddaughter who landed a major part in a community theater musical that opens next Friday, the same day as my 55+ performance. Break a leg, E! And there are others in my immediate sphere who have upcoming meetings and interviews who may deal with similar anxieties.

I found an interesting article, Get excited: reappraising pre-performance anxiety as excitement, on the National Library of Medicine website. Just reading the abstract helped me reframe my perspective:

Abstract

Individuals often feel anxious in anticipation of tasks such as speaking in public or meeting with a boss. I find that an overwhelming majority of people believe trying to calm down is the best way to cope with pre-performance anxiety. However, across several studies involving karaoke singing, public speaking, and math performance, I investigate an alternative strategy: reappraising anxiety as excitement. Compared with those who attempt to calm down, individuals who reappraise their anxious arousal as excitement feel more excited and perform better. Individuals can reappraise anxiety as excitement using minimal strategies such as self-talk (e.g., saying “I am excited” out loud) or simple messages (e.g., “get excited”), which lead them to feel more excited, adopt an opportunity mind-set (as opposed to a threat mind-set), and improve their subsequent performance. These findings suggest the importance of arousal congruency during the emotional reappraisal process.

Alison Wood Brooks 
PsycINFO Database Record (c) 2014 APA, all rights reserved

Next week will be a culmination of an extensive period of hoping, dreaming, and preparing that began even before my retirement and Pam’s illness and death. I’ve conveyed many times my desire to “take it on the road” with Pam during our retirement years, using venues as a tour guide for going places and seeing things together. Something we so enjoyed together.

These two gigs also mark the beginning of a new phase of reaching for the dream. Though I have performed at very limited open mic sessions and in front of a friendly audience of family and friends at a church, these are the first true public appearances in front of people whom I don’t know. No one will have heard the songs. No one will know what to expect. At the 55+, I’m not even sure they know that the program is a musician. They only know that there is a program every last Friday of the month.

Success will look like people not walking out during the first song or shortly thereafter. It will look like people looking at me, perhaps nodding with some sort of mutual understanding. Maybe even clapping? Success will catapult me forward in my journey, give me confidence to book other performances, find other ways to get my music out there. Obviously, failure will look and feel quite different.

Therein lies the fear with pre-performance anticipation. I am excited that I have followed through with the commitment to pursue my music. I believe that I have a message of humanness, one that not everyone is willing to share. It happens to be through music. I am fearful that my musical message will not be received, even though those who have listened have encouraged me.

Performance anxiety, stage fright, is another matter. My mouth gets dry, my heart rate goes up (even more than when I just play the songs), and I have trouble staying focused. My eyes and ears seem to work overtime to ferret out any peculiar distracting input, of which there are ample, when one is on stage. Practice, even trying to imagine myself at the venue, helps. Just thinking about looking out over the audience during practice is enough to distract me. Thus, the more I do it, the better I will be able to focus – I hope.

Again, none of this is unique to me. I am sure that many of you can relate at some level. And again, I am just egocentric enough to think it’s worth writing about. That you might enjoy the reading, and maybe get something worthwhile out of it.

By this time next week, all of the anticipation, anxiety, excitement, and of course, the performances will be over. I will have an emotional let down, as I always do. I will review and evaluate the outcome. Then I will pick myself up and figure out the next plan. Yet I have made a greater commitment – to Pam:

I will go on. I will be okay.

Privilege

a right or immunity granted as a peculiar benefit, advantage, or favor : PREROGATIVE

especially : such a right or immunity attached specifically to a position or an office

Merriam Webster Dictionary

As I ponder Webster’s definition of privilege, I’m not sure if it is an accurate reflection of my topic. But I think my discourse does reflect common understanding of the word.

He walked into the dentist's office asking for help with a tooth that, by the way he talked, was clearly causing him discomfort. He explained that he had been to another office that he previously patronized where he was told that they would have to begin a new, complete work-up. Apparently, it had been a while. "Can you help me?", he asked. "I just want help with this tooth right now. I don't want to start with a whole mouth evaluation."

Assured now that this office would not deny him or make him jump through hoops to get immediate relief, he began looking for his dental insurance card to assist with the sign-in process. As he fumbled through a stack of cards in his wallet, he began to explain. "I know it's here somewhere. No, that's for my health insurance. Oh, that one's expired. I know it's here somewhere.

"I'm glad to have insurance", he continued as he fumbled. "The place I work has been laying off. It sounds like more layoffs are coming. Oh, that looks like it. No, that's for prescriptions."

His frayed baseball cap, faded plaid jacket covering a just as faded hoody, well-worn jeans, and scuffed up work boots betrayed his economic status. It certainly was not one of privilege.

While still looking, the assistant was checking the schedule. "I can get you in at 12:30 and it might be a bit sooner. "I don't think I can do that. I have to go to the unemployment office and then get groceries for my mother."

"How about two o'clock? Or two thirty?"

"Well, I'm not sure... Let's just make it for the 12:00. I can just go to the unemployment tomorrow and get the groceries after the appointment. Oh, there it is! I really need to clean out this wallet."

Sitting in the lobby, waiting for the hygienist to call my name for scheduled teeth cleaning, I was aware of the different world this man lived in. I have lived a life of privilege.

Oh, I’ve had my difficult times, economically as well as physically and emotionally. Everyone does. This man, at least from my snap judgmental viewpoint, is living harder times than I.

My father died while I was young. My mother, with four young mouths to feed, had to find a job. She did. But she and my father were really just trying to get ahead in life before he died. Now it was a much larger challenge. I knew times were rough, but didn’t really understand.

But I was young and unaware of how anything in the world works. I was unfazed by economic struggles, even when mom married again. A man in between jobs. That didn’t last too long and as I grew into my tweens and teens, our household was one of upward economic and social mobility. I have benefited from that economic stability throughout my life other than a self-imposed poverty period in my early 20’s.

My father’s death and that poverty did manage to instill in me some empathy for others who are less fortunate. But I did attend an almost all white high school in the suburbs and wasn’t exposed to many alternative cultures until going to college.

So what is this really about? It’s about trekking through my life with some empathy, and a lot of guilt. I am guilty of not being empathetic enough. I am guilty of not doing more to help others in need. I am guilty of judging them by their apparent economic status rather than by their character. I think, because I have been privileged. Although I know such judgements go both ways.

I am thankful for my parents’ hard work to keep me fed and clothed; to provide me with more than my needs, to give me at least some of what I wanted. I am thankful that, at many tipping points in my life, my parents and family have supported me and, possibly most importantly, have provided safe haven when my world was anything but safe. So many around the world don’t have the luxury.

This post is a reminder to all of us that we (you and I) have lived some level of privilege in our lives. Though we might be on varying levels of the economic spectrum, most likely if you are reading this, you are not on the lower end. I dare say that most of you can relate to my empathy, my thankfulness, and my guilt.

Times being what they are, it is difficult to determine how to help. We are deluged with requests for donations in written, online, and multi-media forms. Who can we trust? You already know of some of my choices that include the Arbor Day Foundation, Parkinson’s Foundation, EWALU, Habitat for Humanity, and our local community pantry. Organizations I know first hand, or have researched and trust.

But assuaging guilt goes beyond giving of my fixed income resources. It must include a change in perspective, a change in judgement. I have been working on this for decades now and still have work to do. It must be a conscious effort to recognize biases and prejudices. Then, act in opposition to those preconceived notions. And that I try to do.

Regardless of my ramblings, it is a privilege to be able to share my personal struggles with you. I do hope that the sharing adds value to your lives. You may empathize, you may think I’m out to lunch. But I hope I make you think. That, too, is my privilege.

Iatrophobia

Fear of Doctors

Originally, I planned to write about fear in general. But that subject seemed too broad. I may take it up in multiple posts at some later time.

Cigna Healthcare defines iatrophobia as “…people [who] have such an intense fear of doctors that they are said to have a phobia of doctors. The clinical word for this is, ‘iatrophobia.’” They further define symptoms as follows:

  • You cancel doctor appointments or keep rescheduling them to avoid dealing with the fear; you don’t even get the preventive care and important vaccinations you may need to help stay healthy.
  • Instead of seeing a doctor when you’re sick, you try and self-treat.
  • In advance of a doctor appointment, you are unable to concentrate on anything else, lose sleep, may not eat, or cry at the thought of the upcoming appointment.
  • Do you have a fear of dentists, hospitals, and even sickness or illnesses? Some or all of these other types of fears are commonly combined with a fear of doctors.
Cigna Healthcare

To be fair, Cigna also states from the outset that some level of stress leading up to any type of healthcare visit is normal. Based on the symptoms listed above, I cannot definitively say that I suffer from iatrophobia. However, based on my personal experiences in the past couple years, well, let’s just say, I suffer! I found it interesting that Cigna also suggests working with a therapist to help alleviate the symptoms. Okay. I know that therapists aren’t necessarily doctors. But seriously. When you have this phobia, don’t they count?! (sorry Cynthia 😉 )

About three years ago, I finally went to the dentist due to an ongoing toothache. I hadn’t been for a few years. COVID, and caregiving were great excuses to avoid the dreaded chair. Unfortunately, this pain would no longer wait. I had a cracked tooth, presumably from clenching my jaw as I sleep. I later got a mouth guard to assuage that issue.

So I went through the process of getting a root canal and crown. It was stressful. In addition to my personal angst, Pam’s cognition was deteriorating and, as a result, I had to take her with me, leave her in the waiting room (and give instructions to the front desk assistant) while I went under the drill. But we got through it without a mental breakdown (on my part).

Forward to after Pam’s passing

About this time last year, I had a similar problem on the other end of my lower jaw. A persistent toothache. I knew the symptoms and the process. Still a result of clinching my jaw. Schedule a visit to the dentist, go for a root canal, get the crown. I can handle this. Except this time I was told that there wasn’t enough bone left for a crown and I would have to have the tooth pulled.

Instant anxiety. Another loss trauma. I broke down crying while still in the chair! And, I had to schedule with another oral surgeon to get the procedure. Unfortunately, that meant I had plenty of time to “stew” over the appointment. Mind you, I was in a fragile emotional state, dealing with losing my Pam and trying to get my health and my life on a new trajectory.

I knew I was not in a good place when I went to the appointment that day. The first thing they do when you get in the chair is take your blood pressure. Mine was extremely high. They were almost afraid to do the procedure. Take it again, similar results. And again, just a bit better. I told them that I have the anxiety and elevated blood pressure every time I see a doctor and this is extra stressful. Procedure done. Take blood pressure again. Still very high. Now they were afraid to let me get up. But, having no other symptoms, they let me go.

Over the next few days I knew that my BP was still elevated. Still no symptoms besides a feeling of high anxiety. Got a monitor. Yep, still high. Ended up at the hospital. Everything normal except BP. Long story short, I’m on BP medicine now.

I’m not sure how much of this I have already written. But I came to the realization, somewhat recently, that I was living every day in fear of dying. I’ve been afraid, to an obsessive extent, that if I eat the wrong foods, don’t exercise enough, don’t sleep well, high BP, whatever, I was going to die. It is an irrational fear, due mostly, I think, to watching my Pam deteriorate and die in front of me. It is not abnormal in those who lose a close loved one.

Forward to current events

Well, backing up for a moment. Last year my right thumb began to lock up at the joints. Movement was painful and I lost range of motion and gripping capability to the point that I could hardly hold a guitar pick. Problematic! Over time it eased, and I was able to avoid seeing a doctor.

Last November, my left thumb locked up and it’s been a problem ever since. It has impeded my ability to play guitar to the point where I stopped for days at a time. I’ve tried to work it out on my own and discussed it with family and my chiropractor. She, along with a daughter who knows of such things, suggested that I look into physical therapy.

I have an upcoming performance, the first for a bunch of people I do not know, in a public setting. I’ve been working through the pain and impediment so I can practice in preparation. I finally made the move Wednesday when my chiropractor recommended a specific physical therapy company. I went directly there. They were great and, after a quick referral from my primary care, I had an appointment for Thursday. Now I have a therapy plan and high hopes for long term recovery from tendinitis. I also found out that, at least on my left side, it may be related to issues I’ve been having with my shoulder. So much for fear of doctors.

I’m not sure if I suffer from iatrophobia. I can relate to some of the symptoms. Maybe you have similar issues. Hopefully, with recent success, increased knowledge, and recognition of the normalcy of my experiences, I can better deal with health issues and abandon the fear of eminent death.

Monday I have a teeth cleaning and PT for my thumb. Wednesday, it’s an appointment for my hearing devices and PT. If getting out there and doing it help with overcoming a phobia, I must be on the right path. Hopefully also, with life in general. I guess the moral to the story is, if you have health issues, work with the professionals.