Anxiety and living with uncertainty

  1. There are many potential areas of uncertainty in genetics that tend to diminish a sense of control over
    events and life. Anxiety and fear are often the result, or may be exacerbated.
  2. Potential areas of genetic uncertainty include:
  3. An increased chance (risk) of occurrence of a genetic condition
  4. An increased risk of a pregnancy affected by a chromosome abnormality
  5. A risk that future pregnancies will be affected by a genetic condition
  6. Clinical identification of a child with unusual physical features but no definite diagnosis
  7. The diagnosis in a child of a condition where the level of ability and future health may be unknown
  8. An increased risk of developing a condition at some time in the future
  9. In an attempt to obtain certainty, people may be motivated to search the Internet, visit many doctors, travel overseas for medical advice, and question the expertise of the original doctor.
  10. Family members may expect a genetic consultation or diagnosis to resolve uncertainty and decrease
    anxiety. This expectation is not always realistic and may lead to new uncertainties.
  11. Counselling for anxiety and uncertainty may be facilitated by:
  12. Discussing the individual’s expectations prior to tests being conducted
  13. Enabling the individuals to verbalise their concerns and fears. This can assist them to identify the
    underlying source of their anxiety
  14. Discussing past experiences that involved uncertainty and their resolution
  15. Being self-aware. Anxious individuals can unconsciously ‘transfer’ their feelings of anxiety and
    helplessness to the practitioner (transference). Practitioners need to be aware that their own feelings
    may reflect the emotional state of their patient
  16. Avoiding false reassurance or expectations
  17. Avoiding jargon
  18. Discussing the individual’s expectations of a referral (eg to a clinical geneticist)
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