What happens to you on those days or weeks when you start feeling a little worse? Your knee, which has always been reliable, or at least semi-reliable, now hurts every morning — before you climb any stairs. Or it’s too painful to reach those high shelves, or hit a golf ball.

What thoughts begin to go through your mind?

For most of us, a setback like increased pain or unexplained symptoms triggers a cascade of worries. Our thoughts begin to take on a life of their own. We see our future unrolling before us: limited mobility and unceasing pain — a difficult life to manage. These images are powerful, and they scare us.

A friend of mine told me a story about something that happened with his niece, Vanessa, an active seven-year-old who loved to make up games and stories. One day she suggested that they imagine they were being chased by polar bears.

“What would you do, Uncle Jack?” she asked.

He said, “I closed my eyes and pictured the bears coming at me. They were huge and menacing. I tried to remember whether you should run or freeze. I felt frantic and wondered if there was a tree I could climb or … maybe they climb trees … and besides, it’s the tundra, there aren’t any trees! I could feel my heart pounding and I opened my eyes wide.

“‘What would you do, Vanessa?’ I asked.

She laughed and said, ‘Uncle Jack, I’d stop pretending!'”

Now that’s what we need to do!

Most of the time our worries are projections into the future of what may happen — they aren’t really happening right now. But our imaginations take a symptom and begin to run a scary scenario. Fear is one of the most powerful emotions we know.

So how do we take our worries and stop them before they balloon into fears that paralyze us or drain our sense of hope and joy?

The first step is to do what Vanessa suggested: recognize that when we feel a stab of pain or a new symptom, it’s just that, in this moment. Just that symptom, nothing more. Notice when you begin to feel scared — are you imagining things that may not happen?

Come into the present moment. That scary picture that your mind conjured is not happening now. Take a breath. Notice what is right around you. What do you see? What do you hear? What is happening? In this moment you are OK. Stay in the present as long as you can. Gently remind yourself to come back to the present when your mind wanders off.

What you do next depends on your temperament. Are you the kind of person who does better when you talk about something with someone you trust? Do you cope by taking action? Do you know how to distract yourself?

When we are frightened, there are many different ways to calm ourselves — but first we recognize that we are feeling afraid, and then check whether there is genuine reason for fear. If there isn’t, then we can gently turn our minds to something else.

The frightening future we are imagining may never come to pass — and we waste so much time and energy on it!

Choosing to practice being in the present can slowly but surely change your attitudes and your mindset — and that contributes to a more enjoyable life right now.