Out of Control !
One message I have often repeated in my blog and newsletter is that significant anxiety symptoms, especially in the form of panic attacks or obsessive thoughts and compulsive behaviors, often tend to sneak up on their victims. This is why, in my opinion, so many of my clients have said, ” These symptoms just seem to have come from out of the blue ! ”
Well, I truly believe that these symptoms have a cause and therefore need to be treated not just with medications, but with a structured game plan where therapy helps the suffering individual realize and deal with the causes as well as the resulting fears and symptoms.
The symptoms can be very overwhelming to be sure, and the natural want to control those symptoms leads most clients to medications. I fully understand and appreciate that fact. However, medications, although sometimes helpful, may curb or limit the symptoms, but I seriously question that they are actually treating the cause unless there is found a true medical source for those symptoms. Even when there are thyroid issues, hypoglycemia or other conditions that may predispose a person to anxiety symptoms, while those conditions need to be treated medically, I have not found that the panic or OCD stops after such treatment. Make no mistake, if true medical or neurological conditions exist, by all means they should be treated. I have just not found that to be the case for the vast majority of especially the panic attack or OCD clients I have worked with during the past forty years.
As just another yet very vivid example of how anxiety symptoms can mask or distract a person from the true sources for the pain they are feeling, I offer the following :
What I observed of this woman as she sat across from me for the first time was the look of full-blown terror painted on her face and of course her tears of frustration and hopelessness. She was feeling totally out of control physically and emotionally, and her husband sitting next to her felt helpless.
No, her focus was not on her panic attacks which she hardly mentioned. Understandably, she was focused instead on the horrible withdrawal symptoms she was experiencing week after week after she stopped taking Xanax.
She seemed obsessed with making sure I understood that the symptoms she was feeling were real, that she was not making them up, so I just listened at first.
She felt her skin crawling, she could not stay focused on any one thing as her thoughts ran away from her. She physically and mentally felt out of control, and was dwelling on whether she had some kind of brain or nervous system damage due to previously being on Xanax, at 3 mg. a day.
I knew I had to bring her to a point where I could help her to focus on why all this was happening, but that was a challenge as anything I said was not being heard over the dominant fear-based chatter going on in her head. I realized the withdrawal symptoms were real, but her fears and resulting anxiety were making all her symptoms worse.
So after listening to her intently, and showing acknowledgment and respect for all she was going through, I asked her…. ” Why were you put on Xanax, especially that high of a dosage, to begin with ?” She had to collect her thoughts and wipe her tears, and I could see that look on her face that almost cried out, ” What does that matter ? ” However, after a few seconds and with her spouse’s urging, she related a story of being a rather perfectionistic wife, mother and loyal friend who was just helping neighbors through a difficult crisis in their lives when ” this anxiety just came over me ! ” She ended up in the ER, then being seen by the hospital’s house psychiatrist, and was placed on the rather significant dose of Xanax. From that point on, it became all about her unreal feelings while taking the medications, and the horrible withdrawal symptoms once she stopped the meds.
I brought her back around to the reality that, as the doctors had told her, the medications would gradually work their way out of her system, and she should continue working with her PCP regarding her physical symptoms, but that I wanted to refocus on the true source of the anxiety, as her withdrawal symptoms had all but distracted her from the real problem.
So then she listened as I told her about herself, where I described her perfectionistic and caregiving personality which had run unchecked and unbridled for many years leading to her gradually overwhelming herself, and creating anxiety and panic attacks. In essence, I was describing a good person, well-meaning and caring, who was burning the candle at both ends. She sat there acknowledging that yes, she did tend to take on too much, and rarely could say no to anyone’s request for her help. Why not, it felt good to be needed and see herself as useful and well-liked ! How could that be a problem !
I could see her husband’s facial gestures and eye-rolling that all but said that his wife was minimizing the extent to which SHE OVER-EXTENDED herself all the time. She was addicted to pleasing ! However, without boundaries, that need to be needed and fix others had become a self-sabotaging path to disaster. I expressed to her that this is less a disease, and more of a reaction to her habitual, compulsive pattern of overwhelming herself because her very positive personality characteristics had run amok and caused her to unravel.
Once she realized what had happened and truly embraced it, and that took some time and soul-searching, she learned to set healthy limits and boundaries. She learned she was not broken, and that she could be better than she was before, as she could still be who she was, but would make smarter choices. Her pain taught her to take better care of herself. Unfortunately, without pain, she would never have seriously considered change. Would you ?
She had to realize that all she had been through was not a sign of weakness, but a sign that corrections needed to be made where she created a greater balance in her life between being there for others and being there for herself. She was not needy, but she had needs. She was not selfish, but needed to take care of herself. She could be there for others, but knew where to draw the line so that the energy she put into others was better matched with the energy coming back.
Oh, she would still screw up at times and have little setbacks as old habits are hard to break, but she would catch herself and readjust. That’s how it works !
Just a thought or two !
Gene Benedetto, Psychologist / Coach
dba, The Benhaven Group, LLC
On Line Support Group: www.OneStepataTime.com