Nothing to Worry About: A Clinical Note on Examination Anxiety

With some frequency, one hears about the following experience from a patient (or recalls it from one's own past). There is about to be an examination of some importance or an interview for a significant job in the offing. The person to be examined confides (or even complains about) a pessimistic outlook to a friend who then says, "You have nothing to worry about!" This comment usually reassures briefly, only to be followed by an increase in anxiety, accompanied by irritation and the thought, "That's easy for you to say! You have already passed the exam [been accepted for admission, etc.]." The person is left with a heightened feeling of pessimism about the examination or interview and disappointment, even cynicism, over the friend's "reassurance." The expression of apprehension is almost always made to someone who qualifies both as a friend and as one who previously has succeeded at such a trial. In the instances with which I am familiar, the individuals knew full well (or at least fully expected) that their plaint would bring forth the response, "You have nothing to worry about!"

The partial analysis of a dream afforded insight into this fairly typical mechanism. The patient, a married scientist in his middle twenties, had been in treatment for some time. Although he was successful in his occupation and had achieved some minor recognition, he had never obtained the advanced degree usual in his field. At the time he reported the following dream he had applied to two prestigious graduate schools. He had gone