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Anxiety Management Technique: Bookending

Originally used as a tool to help 12-step recovery addicts prevent relapse, bookending involves creating a positive activity on either end of a potentially triggering event. For example, if I know that going to the doctor will cause me to feel panicky (true story), I might “bookend” the visit with something more pleasant. It’s kind of like getting a lollipop at the end of the doctor’s visit—a reward for having survived the challenge. But, perhaps even more importantly, bookending involves a “lollipop” before the appointment even occurs. I say this is the more important bookend because, if I don’t have one in place, more often than not, my dread will overcome me and I will cancel the appointment, thus putting off the anxiety until I reschedule.

So, bookending is a 2-lollipop proposition: one to insure I will go to the doctor, and one to reward me for getting through the anxiety-provoking experience.

Here’s the tricky part: lollipops don’t do it for me. They never have (my dad is a dentist and brainwashed us into believing all that hard sugar and food coloring would cause all of our teeth to instantly disintegrate). So the idea of getting a lollipop after facing my greatest source of anxiety is not very enticing.

Getting a pedicure (is there anything as good as a foot massage?) immediately after a doctor’s appointment, however, is a great bookend as I can spend the entire appointment counting down the minutes until I can sink my feet into that warm, lavender soak. (A pint of Ben and Jerry’s while binge watching Mad Men can also do the trick, if going to the spa is not in the budget.)

The first bookend is not so easy. Obviously, a pre-doctor pedicure would be the least relaxing treatment I could imagine. (I would spend every minute envisioning my reaction when the doc would inevitably give me my horrifying diagnosis, thus guaranteeing I would skip the appointment altogether.) And no amount of sugar would help that particular “medicine” go down.

What seems to work well for me is a phone call to my Anxiety Sister, Mags, who will soothe me and reassure me from the time I get into the car until the nurse calls me into the examination room. (Once, I didn’t hang up until the doctor came in and asked me to put down the phone and get on the table.) As long as I am talking to Mags, I am distracted from my anxiety—at least enough to get me from the parking lot into the waiting room.

Talking to a supportive Anxiety Sister is a wonderful tool to help ease the anxiety that accompanies a triggering event. The next time you have to do something anxiety-provoking, set up a bookend call. It really helps.

Anxiety Sisters don’t go it alone!


  • Sondra
    December 27, 2017

    Good thoughs

  • Kelly Ricci
    December 12, 2020

    I love this group!! My anxiety has been out of control lately!!(dealing w/serious health issues)I enjoy the posts!!

  • ann diesz
    October 18, 2021

    Just knowing that others suffer from anxiety and have panic attacks make me feel better and not alone.

  • Kerri
    November 14, 2021

    Never thought of bookending – thanks for a great tip!

    • Misty Kifer
      March 27, 2022

      I have Been struggling with anxiety around health issues as well. Anxiety always seems to be the worst first thing in the morning. Makes me nauseous at times. Bookending might help with the upcoming doctor appointments.

      • S Bice
        September 19, 2023

        Yes! Mine starts as soon as i wake up in the morning.

  • March 25, 2022

    It’s like you are right in my head. My Anxiety due to health Issues is off the charts. Thank you for your helpfu tips


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