Friday, December 15, 2006

On Being Late for Appointments

Did I run late today? Is that what's going on here? Well...

That'd be pretty rude, right?

But it does happen to everyone, and when it happens, those of us who respect others and their time, who sees time as a valuable commodity, will feel some stress, even distress when running behind the clock.

Anxiety disordered patients have the most trouble when this happens, when they're running late. People with anxiety disorders can feel highly anxious, even have panic attacks at the very thought of inconveniencing others.

But anyone, really, can be late.

Once you're late it's a little too late to have started out earlier. I tell people who are chronically late that they need to either set their clocks ahead or start out an hour (a full hour!) earlier for appointments. Both systems tend to work.

But say it's too late for preventive strategies, too late to test out new behaviors. It's too late, you're late. What do you do?

How do you control your anxiety? How do you keep that pulse down?

Like today, since I know you're wondering, I was running late for my 11:45 appointment. AND I was riding my bike to the office, meaning I'd have to compensate for things like wind. Plus I'd have to add time to change my clothes upon arrival. The wind, as luck would not have it, was in my face, slowing me down.

What I'll do in this case is damage control, of course. I call the person I'm inconveniencing. They can power trip me all they want about it, I don't care, I've screwed up. I'm at a disadvantage.

Once a person runs late, everything shifts in the power tripping. I always respect people who don't hold it against me, you know? Those who don't take advantage of an advantage.

But I've found that when I'm running late, calling makes a big difference. It says I care and gives me a chance to apologize profusely, also allows the other person to use the time more productively.

If you adopt that strategy call as soon as you realize you're not going to make it on time. And apologize a lot.

You do it before you get into the car and have to fumble for a cell phone in traffic, or in cases like mine, before you hop on a bike and look like a person with schizophrenia in the winter.

(Listen. The bike paths were clear, the sun was shining. What was I to do, drive?)

So calling ahead is a good thing, even if it opens up the possibility of more anxiety if you don't connect. But that's the price you pay, isn't it, for screwing up? (poor time management could have been avoided, face it, if I just hadn't. . .)

I'm thinking if you're like me and anxious when running late, it's because you don't want to hurt that person's feelings. You don't want the person you're keeping in limbo to feel rejected, angry, resentful, slighted, narcissistically injured, like you placed him low on your list.

If you're late for an appointment, lunch date, job interview, sales meeting, birthday party, just about anything, it's possible you'll ruffle a few feathers. And who needs that. I hate ruffling. People have it tough enough as it is.

Anyway, I picture the person waiting for me feeling mixed emotions, none of them good, maybe even feeling relief at the thought of me not making it. Some people don't even care when I'm late, I'm convinced. Therapy can be hard.

But if you try to let yourself off the hook by focusing on positive thoughts, like people will be relieved if you don't show or won't care, be aware that the other thoughts, the more negatative ones about how badly you've hurt their feelings, or how unprofessional or callous you look, will creep in and pollute those nifty rationalizations.

That's the problem with intellectualizing. You can't get away from so many possibilities and variables once you start thinking.

Lucky for you, there IS a quick and easy solution, a tried and true TherapyDoc Intervention that has worked for almost everyone in my sample, i.e., those in my practice for whom anxiety over lateness had been a problem, probably a tiny fraction of a few thousand patients spread over 25 years, and me.

It's denial.

Now I know I've said that denial is the most immature, primative of our defenses, and it's true. But it does work here up to the moment of truth.

You say to yourself, I am not late until I'm late.

What does that mean?

If it is 11:30 and you think it will take you yet another 30 minutes to get to an 11:45 appointment, rationally, you're late. But in my world, in real time, you are not yet late. It is only 11:30. The appointment is at 11:45. You really are not late, not yet. For all you know the person you are to meet will call within the next fifteen minutes to tell you that he or she is running late. Or cancelling.

Get it? You're not late until you're late.

If the appointment is for 11:45 and it is 11:46, then you're late. THEN you have to begin to worry about your relationship. You have just stolen a minute of that person's time. You're a thief.

This is not a good feeling, and obviously can be avoided with a little planning and less puttering, eating, or Spider Solitaire.


Yup. I was. Anticipating that, I left that message on the patient's cell phone apologizing. I was indeed, 4 minutes late. We had a deal, however. All of my patients know that I'll wait 15 minutes for them if they're late, and they have agreed to extend me the same courtesy. But it's not something I make a habit of doing and I discourage lateness.

The crazy thing is that it seems that whenever I'm late, the patient is late, too! The patient can be later than me! Then I have to make the moral/ethical decision: Do I lie and say I'd been waiting for them when I haven't? That's that power tripping thing I referred to above.

I'm a social worker, so no, I wouldn't do that. We're a pretty honest bunch. I'll for sure say, Oh, I was late, too. It worked out just fine, right? (smile). That's so intimate, by the way, being honest.

Today? I was blown off altogether, which is why you get to see this post. It's why that mantra works so well, too. Saying "I'm not late until I'm late" may feel like denial, but psychologically I feel that beating myself up over an event that hasn't happened yet is a waste of emotional energy. It's silly. Being late won't matter if the other person isn't waiting for you. Other variables do affect most outcomes. Others are often late, too.

This whole rationale, by the way, applies to all anticipatory anxiety. Why worry about an event that hasn't and very well may not happen?

I'm not saying you should be late intentionally or shouldn't worry at all. We have to stoke the fires of arousal SOMEHOW.

But you shouldn't ignore punctuality assuming that others will be late, or that they will blow you off, or that they keep what is often affectionately referred to as "Jewish time" or "Irish time". In these cultural "times" the thinking is that being fifteen minutes to a half hour late is normal and okay, which it might be in some crowds where everyone knows the rules. The idea there is that everyone should be adapting to an unwritten, covert rule about punctuality being over-rated and abnormal, culturally awry.

To me, fighting anticipatory anxiety, quieting yourself down by staying rational is the key. And quit the early self-flagellation. You'll have time, believe me, to regret the error or your ways later on, at show time.

Repeat after me.

I'm not late until I'm late. I'm not late until I'm late. I'm not late until I'm late. I'm not late until I'm late.

Then check your watch and get moving. Maybe you can salvage the relationship. Maybe not.

Copyright 2006, Therapy Doc


bjurstrom said...

Dear Doc,
I hope that I'm not late with Happy Holiday. As always great reading and yes keep riding--this has been excellent bike riding weather for December.

Anonymous said...

Very interesting post. Punctuality is a big thing for me. Recently I realized I was going to be late for a therapy session and I flipped out, practically killing myself on the freeway trying to get there faster. Of course then we spent much of the next session looking at my anxiety. Sure, being on time is important to me and that's fine. But why did I think that being late one time would be such a catastrophe and grounds for wiping out years of punctuality? Why do I think that one slip will absolutely define me for life?

therapydoc said...

Makes no sense, right?

Unless you know a little about how the brain works.

It's all about us having been little and having had seemingly BIG parents. When we did something wrong we paved a really strong neurological path between authority and fear.

And rightly so. Then.

But the problem is that our brains continue to use the same pathways unless we take charge and create new ones.

That's what all that cognitive mumbo jumbo is about. The brain has billions of neurons waiting to connect. When you write you're creating new pathways with every couple of words, every sentence requires new neurological activity.

That's why creativity is good for depression, any brain activity has the potential to unlock seratonin.

So anytime we're stuck with that feeling in the gut about facing authority figures we have to think differently.

We're all grown up now.

That's pretty much it in a nutshell. Thanks for asking.

I like that so much I think I'll post it.

Holly Schwendiman said...

This one struck a chord with me - on both sides! Great advice BTW, something I tend to do often is borrow trouble and believe if I'm not 3-5 minutes early to something I'm late. ;o) I remember the days in the salon and how hard it would be when that first appointment came late - it threw every other one late no matter how hard you'd try to compensate - you just can't rush a good haircut, but I hated the pressure of dealing with that thought. If you're the client and the first on the list of a full schedule, it is really appreciated when you show up on time. ;o)

Holly's Corner

Anonymous said...

I too, hate to be late and I have very little paitence waiting for someone who is late.
I also subscribe to the thought that better late then never, and better to take your time and arive alive. I think the difference is between occasionaly being late and habitualy being late. Being on time or being late is a habit. If you can always be 10 minutes late, then you can change that behavior and always be 15 minutes early.
I do love your advice, you are not late until you are late, and you may find out that the other person was late or grateful that you were late so that they had time to take care of something that "just came up".
The key is good planning, however we all know that there are many factors that can derail our plan that we could not anticipate.

Cham said...

This is one of my problems- I totally flip out when we are going to be late for something...I think for me its sort of a rudeness thing, I feel like if I come late it's just SO rude and makes me crazy (And dovid crazier). I guess also a responsibility thing? I guess I see lateness as irresponsible. Anywho glad to see other people have this problem with anxiety and lateness--this is like group therapy:-) I feel better already. Have a great Chanukah!

Anonymous said...

Doc, You've never once been late, okay?

therapydoc said...

When it works, it works.

therapydoc said...

Oh for sure once.

Fallen said...

I really like the advice you gave... Now I have to keep telling myself "You're not late until you're late."

Punctuality is a big thing for me, whether it's me or someone else. I always thought it was just because I am a control freak and maybe that is part of it. I do get bent out of shape with things I can't control and really do need to learn how to relax.

If I think I am going to be late for work that usually means my ride has either forgotten me or is late. So suddenly I'm disappointed that they have let me down, angry with them, and anxious about the fact I might be late (after all I'm not late yet). Yes there are times when I am late for work but there are other times when I am anxious for nothing and make it there on time. The problem is that by then I am so worked up that it takes probably 2-3 hours for the anxiety to dissipate and the muscles to relax again.

As you said you could be wasting a lot of energy needlessly. I'm all for denial. So "You're not late until you're late."

Rob at Kintropy said...

Thanks for the post: sense of time and lateness are interesting points-of-view topics, I think.

Sense of time is itself relative and most of my relatives have no sense of time ;-) Quite irritating when I'm a bit obsessive about schedules and time and tasks, but I've learned to build filters that help me switch gears and interact with the world as-it-is rather than the world as my-mind-expects-it-to-be.

Ellie said...

Hi TherapyDoc - I endorse your Call when you are going to be late/not late until you are late method.
I've always been a tardy person - the class Dean sent me to detention for a week because I was late so many days sophomore year of HS. He said I would be late for my own funeral!
I had a heart attack this year, not funeral-worthy but let's say I have an idea of how I might die.
I cannot STAND to be late anymore. I get to therapy appt 15-20 early due to dropping off my kids. Met a new SpecialistT this week, had to drive 25 miles at rush hour. She was 10 min late to an intro session, a referral from a long-time colleague. She did not apologize, said we did get a late start but not to worry I'll get my full 45 min.
To 2ndT: Seriously, when I am the first appt of the day, DO NOT show up late without calling like TherapyDoc. You know the number of the receptionist, and she knows I am sitting there waiting for you.
thanks for listening

therapydoc said...

The whole idea that someone's time is worth more than someone else's time bothers me a lot.