Asian male student in orange shirt holding head stressed, looking at notebook

The 3 R's of Overcoming Test Anxiety

Preparing for high-stakes exams such as the SAT or ACT can be stressful, but with a few simple steps, you can transform your stress into a useful motivator.

Almost everyone has experienced the feeling of stress and anxiety that arises prior to a high-stakes test like the ACT, the SAT, and Advanced Placement exams. I often get approached by students who want a “cure” for their test anxiety. I recommend using a method that I call the “3 R’s.” It’s grounded in neuroscience and is simple and effective if practiced regularly. The 3 R’s are skills your brain needs to learn, like riding a bike. You can use the 3 R’s for any form of anxiety, not just the test-taking kind. But first, let’s talk about your anxiety.

The truth about your anxiety

The first thing I tell students looking for the test anxiety cure: Don’t fear the feeling of stress! In moderation, anxiety before an exam is healthy and even helpful—it shows you’re invested in the exam and confirms that you’re human since nearly everyone experiences some form of test anxiety. Think of test anxiety as coffee: in small doses, it can increase the “fight or flight” hormones in your system that give you razor-sharp concentration, peak mental stamina, and the ability to move mountains of information in your mind. However, too much can send your system into overdrive and lead to a jittery, panicked feeling of helplessness that can devastate test performance.  

For students who approach me wanting to maximize their test performance and take charge of their anxiety, I first congratulate them. Mastering your mind and anxiety is the “secret ingredient” of transforming mediocre practice into the most effective practice—whether you’re a student, an athlete, or a performer. Then I suggest the 3 R’s method, as it is perfectly compatible with other medical treatments and diagnoses and has only positive side effects. Remember, if you feel like your anxiety is interfering substantially with your daily life, see your medical provider in addition to trying the 3 R’s to ensure you have enough support.

Related: Alleviating Stress and Anxiety: The Best Advice From Real Students 

Step 1: Recognize your anxiety blueprint

Your anxiety blueprint—how you personally experience stress within your body and mind—is unique to you. Get to know this sensation intimately. How does anxiety manifest in your body? Do you feel nauseous? A tightening in your jaw? Chest pressure? Sweaty palms? This first step involves mastering your anxiety blueprint so you can recognize it immediately. Remember, anxiety can “creep up” unannounced, and before you know it, it’s overtaking your mind and body, causing a full-blown panic spiral. By recognizing your blueprint, you’re taking the first step to mastering your anxiety. From there, you can respond to these uncomfortable sensations in your body by telling yourself that they’re nothing more than your programmed anxiety response.  

Why is this important? Neuroscience tells us that this act of labeling your emotional experiences short-circuits the intensity of your brain’s anxiety response, preventing it from spiraling out of control. When you’re preparing for a high-stakes exam and feel your anxiety manifest, take a few deep breaths and tell yourself, “These sensations are just the way I experience anxiety, that’s all!”

Step 2: Regroup your internalized thoughts

It’s easy for your anxiety to take control of your emotions and actions once it’s triggered. If left unchecked, anxiety overtakes your brain with negativity, which can undermine focus and result in more anxiety. Therefore, once you recognize your symptoms, it’s time to regroup. In this case, regrouping means distancing yourself from the physical sensation taking place. A way to do this is by doing something that tells your body you’re still in charge.

Take control of your thoughts and uncomfortable sensations by reminding yourself that they simply arise from chemicals released in your body after having negative and anxious thoughts. In other words, these anxious feelings stem from thoughts—not “real,” tangible things, like if a hungry bear were right in front of you. Do these common, negative thoughts sound familiar? 

  • “I’m never going to reach my target test score.” 
  • “I’m not going to remember anything come test day.” 
  • “I should’ve studied earlier and harder.”   

These are the kinds of negative ideas that invite anxiety into your system. Regroup by reminding yourself that these thoughts are invisible and can be changed; there’s nothing physically in your way except your mind. Regrouping can shift these negative thoughts and stop the anxiety sensation in its tracks. 

Related: 4 Mindful Ways to Combat Your Test-Taking Anxiety

Step 3: Refocus and repeat

Refocusing is the most powerful step of the 3 R’s, but it also takes the most practice. This step has the effect of reprogramming your mind away from unproductive, negative feelings and thoughts and toward a more positive, calming space. Over time, you’ll train your mind—as you might train a dog to fetch—to form a new response to your stress.

First, spend some time (extensive, quality time!) thinking of a positive phrase, image, or action that’s personally meaningful to you. This thought or activity should evoke positive, calm, and confident feelings in you. Here are some examples of positive statements: 

  • “I’ve worked hard for this, and I’m ready.” 
  • “I’ve done my best, and I’m confident that I can do this.” 
  • “I trust my abilities and skills.”  

For some students, images work well, such as picturing yourself easily answering test questions with confidence. And actions also work to interrupt negative thoughts. Examples include squeezing your hands and releasing the tension or taking three slow, deep breaths with a long exhale. Remember: The positive refocus step should be personal to you, just like your anxiety blueprint. Be sure to choose something that resonates with your values and beliefs.

Why is this step so crucial? Neuroscience shows us that thinking and feeling the sensations of a statement about yourself—as though it’s actually happening and not just your imagination—will, over time, move you toward that positive sensation. This is true even if you don’t fully believe the positive statement at first. Keep repeating it to yourself with sincerity and confidence.

New habits take time

Be patient with yourself and remember that forming new habits takes time. If anxiety and stress play a big role in your life right now, it’ll likely take plenty of practice before you start to see the training response kick in. But the investment of time and practice will be well worth it in terms of your results. For example, the first time you try the 3 R’s cycle, the positive effect might only last for a second before your anxious thoughts and uncomfortable sensations come back. Keep repeating the 3 R’s. Their effectiveness grows with persistence and dedicated practice. Regroup and remind yourself that you—not your negative, intangible thoughts—are in charge of how you feel and respond, then keep refocusing on your positive image, phrase, or action. 

Related: Infographic: Find Your Learning Style and Study Smarter

Prioritize practicing the 3 R’s in your life as much as you focus on studying and taking practice exams. Start months in advance so they become automatic by the time you’re in the examination room. You may find that building this mental and psychological stamina within yourself has the potential to transform your most undesirable and unpleasant feelings into your most treasured test-taking weapon.

For more advice to help you prepare for your standardized tests, check out our Test Prep section—and don’t forget to check our SAT/ACT date wheel to plan your test day! 

Dr. Janani Krishnaswami, MD, MPH, is one of a small group of physicians triple board–certified in preventive medicine, internal medicine, and lifestyle medicine. She practices medicine at Academic Medical Associates and serves as a content author for UWorld’s online tools to prepare for medical exams.

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