ANXIETY AND PSYCHOTHERAPY
Anxiety comes in various forms. Sometimes it can be mild and occasional. For some, it can be an ongoing hum --- anywhere from low level unease to panic attacks. All of us can at times experience anxiety over a relationship, money, health, or our work. Alternately, on occasion, anxiety can have more to do with our past. Whatever the reason or causes, first and foremost, anxiety interferes with satisfaction and growth. Some ten to fifteen percent of the population is affected by an anxiety disorder.
When I work with someone who reports being burdened by anxiety, the first thing I do is to understand as fully as possible what the anxiety is like and what sorts of thoughts emerge during these anxious times. Talking about feelings and our history can often lessen the intensity of anxiety. For some people, anti-anxiety medication can be a helpful support. Below are two examples of people I've seen (all identifying information has been changed) and how we worked together to help them manage their anxiety.
Jack, just out of college, came to see me because he was plagued with, as he put it, feeling "lousy" and generally "uncomfortable." He said the reasons behind this came from a variety of sources: his relationship with his girlfriend, problems with his noisy neighbor, his college loans, his brother's too frequent phone calls --- the list went on. Actually, it didn't occur to Jack that what he was feeling was anxiety. Jack wasn't used to connecting very much with his feelings and often was confused about naming his emotions. We spent quite a bit of our time just helping him know what he was feeling, and often it came down to anxiety.
Jack and I then worked on what he initially considered the impossible: sometimes telling certain friends that he felt anxious and needed support and comfort. We also spent many sessions discussing how he could comfort himself when he felt anxious. As Jack said when we were winding down his therapy, "You know, the anxiety never fully goes away, but it's certainly a lot better these days. At least now I'm able to call friends and tell them what's up with me, or sometimes just get myself out of the apartment and go for a long walk or bike ride."
Sara, a 33 year old graphic designer, was quite successful, but often felt anxious that she'd be fired from her job. She knew this didn't make much sense, since she'd worked at her company for six years, and had always had excellent performance reviews. In exploring her childhood, Sarah would describe her highly critical father who regularly expressed irritation and disappointment in her. She often repeated the story of her mom putting Sarah's art work up on their living room wall, and when her father came home from work, he'd tear down her paintings and put them in the basement. Over a period of many months in therapy Sarah got in touch with her hurt, humiliation and anger toward her father. We explored how their relationship currently continued in this demeaning manner when she'd visit the family over holidays.
Sarah slowly came to accept that she could start setting limits with her father and respond to him more self-protectively and assertively. As she initiated these new ways of relating to him, she began to notice that she was becoming more assertive with certain friends who were also highly critical of her. Sarah came to understand that much of her anxiety --- which she'd initially felt related exclusively to her job --- was in fact rooted in deeper fears over her father's critical attitude toward her. And as she continued to assert herself more, she noticed a significant decrease in her anxiety at work.
Anxiety never completely goes away. But the more we understand our own histories and the patterns of adjustments to them that we early on employed, the more we're able to name when we're anxious, the more we're able to get comfort from others and give it to ourselves, the less we feel burdened by anxiety.