The 5 W’s and the H: Anxiety Edition 

Do you remember when you learned how to write? Not just how to form letters or spell words, but how to write an essay or an article or a story? I distinctly remember a poster hung high on the wall in my classroom in 3rd grade that said something like: 

When you Write, remember the 5 W’s and the H! 

Who is the story about? 

What is the main character doing? 

When did the story take place? 

Where did the story take place? 

Why did the action happen? 

How was the action done? 

Even as an adult I have to admit that it’s a pretty handy way to make sure you’re giving the reader all the necessary information. It works when you’re giving information about an event or a situation or telling a story, and it’s a good way to make sure that whoever reads your article will understand enough of what’s going on to feel fully informed.  

But I’m not here to give you a writing lesson (although, if that’s something you need, I’m your girl). Because the 5 W’s and the H are also a great way to gather information, particularly when you’re preparing to explain something clearly. In this case, I am thinking specifically about how you might want to describe your concerns or symptoms to a doctor or therapist.  

I know firsthand that seeing a doctor for the first time can induce anxiety all on its own, and when you’re coming in with a complaint, seeking help with a mental or physical symptom that you can’t control on your own, it’s really easy to worry about whether you’ll be understood. And if you’ve never had to try to get help for a problem that is both invisible and hard to describe, let me tell you, that situation presents a whole new type of anxiety all on its own. You’ve got, at best, about 30 minutes to tell a doctor about some undesirable thing that your body is doing in such a way that the doctor can understand what you’re describing, give it a name, and provide a treatment. If you don’t explain it well enough you could end up with the wrong treatment, the wrong medicine, or even getting expensive testing done that doesn’t help your pain or your bank account. 

One way that you can be sure to utilize a short appointment well is to make sure you give the “reader,” in this scenario this is the doctor/therapist/coach/teacher, complete, factual information before you tell her what you or your friend or your mom think it might be. And this is why my 3rd grade teacher (Hi Mrs. Kressin!) taught me that the 5 W’s and the H can help me communicate.  

So, for example, let’s say that you’re going to see a counselor at your church because you’ve been feeling nervous and worried about an upcoming move to a city you don’t know much about. For me, the temptation would be to go into the appointment ready to tell the counselor all the good reasons I have for being anxious about it. This would include a lot of “what if’s”.  

  • What if I can’t find my way around? 
  • What if there’s no churches nearby? 
  • What if my car breaks down and I don’t have anyone who can come pick me up? 
  • What if I move and then realize I can’t do this job?  

All of those worries are perfectly valid, and as the wife of an active duty officer in the Navy, I can assure you that they are all worth consideration prior to a major move. But, while these questions and worries may demonstrate your anxiety to the therapist, they don’t help her nail down what is triggering your anxiety. To put it another way, your worries about the future don’t tell her why this particular change is more problematic for you, and how she can help you address the real problem. Because, while all of those concerns are definitely real and important, your counselor isn’t there to help you navigate around a new city or find a car insurance policy that includes roadside assistance. She’s there to help you stop worrying about those things. 

This is where your 3rd grade teacher can help.  

Using the 5 W’s and the H, you can prepare for your session with the counselor by providing facts to answer each of those questions. For example: 

  • Who you are.  

While she’ll need to know your demographic information, it will help if you can tell her briefly about what made you decide to make this move to this particular place, despite your trepidation about it. Is this your chance to move forward in your industry? Is this city somewhere you’ve always wanted to live? Do you have friends or a significant other there? Is it cheaper to live there than where you live now? If you’ve made the decision to make this big change even though you’re afraid to, there must be something that is motivating you, a reason you want to do this, despite the anxiety and fear you’re feeling right now.  

  • What you’re worried about.  

Many times, when we seek help from a therapist or counselor, we don’t go into the first appointment knowing precisely why we’re feeling what we’re feeling. Sure, you’re worried about moving and you have reasons to be, but something about this change in particular is scaring you enough that you made an appointment with a counselor, and it will help to have a little more insight into what’s so special about this situation. This is where you want to dig into some of the ugly things you’ve experienced in the past. Maybe you moved around a lot when you were a kid and never stayed anywhere long enough to feel at home. Maybe you lived in a different city a few years ago, and it was a terrible place to be. Maybe you’ve got a niche hobby that you really love, but it will be a lot harder to do in an urban setting. The idea here is that, if you know or can make a reasonable guess about at least one aspect of your fears, your counselor can help you plan how to move forward despite that concern.  

  • When the fear began. 

Did you start worrying as soon as you were told you would be moving, or did the worries sneak in more slowly and gradually overwhelm you? Was there something specific that you read or that someone told you that gave you second thoughts about moving? Or is it that this move is a mandatory relocation, and you have no choice in the matter? The storyline of events that led up to the decision (or mandate) to move could very easily be part of your fear.  

  • Where were you when you recognized the anxiety? 

In this case you’re not just looking for a location, such as “at home.” The question of where can help you and your counselor examine whether environmental factors are a part of your worries. For example, if you were having Sunday dinner with your parents, was there something that came up in a conversation that gave you second thoughts? Maybe your dad just retired and was disappointed that you wouldn’t be able to visit as often, or your mom is having medical problems. Your location when you first remember feeling this way isn’t necessarily a contributing factor, but recalling the situation and scenario surrounding a moment of anxiety can help your counselor address your concerns more directly. 

  • Why you’re worried or anxious. 

Even if you don’t think you know why you’re worried, a counselor may ask you to take a guess based on what you know about yourself from the past. Most people are quite aware of what makes them tick, and chances are you’ve been asking yourself this question leading up to your appointment anyway. So, even if it seems like you’re pulling a potential connection out of the air, take a stab at your reasons for being concerned enough about yourself to see a counselor.  

  • How you feel when you feel anxious. 

This can (and really should) include physical reactions to your worries, like sweating, a sudden rush of energy, racing thoughts, irritability, and having trouble concentrating. You may only notice these things when you are making decisions and preparations for the move, or you may be experiencing them almost all the time. For me, for example, one big sign of out-of-control anxiety is the energy rush. Years ago my family and I hosted an event at our house, and even though this was a happy occasion, I was anxious weeks in advance, so much so that I cleaned every inch of a pretty large house multiple times, rushing to find every dusty inch of the baseboards, every toddler handprint left on the walls. It was madness. When the whole thing was over I think I slept for a week.  

While I will always tell someone that if he/she is at all wondering if a therapist or counselor could help her feel better, she should try it, it’s important to get as much out of each appointment as you can. First-time appointments with a new or new-to-you therapist can end up getting bogged down in background information and getting-to-know-you conversation, and then just like that, your 50 minutes is up and you haven’t even addressed the reason you came. If you come to your appointment having already searched your heart and mind and body to understand how you’re feeling and why, a trained therapist can take that information and help you find a working solution for managing your fears.