You know how I so often talk about needing to realize and deal with the source of your anxiety, panic attacks or OCD symptoms, not just the symptoms themselves.
Believe me, I know how frustrating it is to have anxiety symptoms that can control your life. And I know that through the use of exposure therapy, using a very step-by-step process, we can overcome most if not all anxiety symptoms, even though we may need support and guidance to stay on track.
However, I was working with a client who is a good example of why the source [s] for the anxiety or panic need to be dealt with, because the source issues will often double back and stop your progress.
So Shiela had been making great progress. Gradually, she was able to leave her home for greater lengths of time, and go to a variety of destinations with much less anxiety. At our last two sessions, she was so pleased with herself, that she was talking about setting goals to start going to the Roller Skating Rink she use to enjoy years ago. She even talked very briefly about maybe some day she would meet a companion, a guy she could enjoy and do things with.
Then all of a sudden, at the last session, she appeared frustrated and depressed that for about two weeks, her anxiety symptoms had returned and her fears of going out had increased.
She searched for physical reasons why this was happening, and resisted my suggestions that there was a more obvious emotional/psychological cause for her ‘relapse’. As we talked and I reminded her of our last two sessions, it all started to make more sense to her.
She had been so focused on the steps we laid out together to overcome her anxiety, that all her attention was going to the day-by-day plans and progress she was making. However, once she reached a certain level of success, she started to drift with her thoughts to what would happen if she really COULD overcome her anxiety.
She admitted that the evenings were her worst time, while during the day, she was still getting out some with a degree of success. She even shared a contrary experience that when she went to cooking class once or twice in the evenings, she was actually alright and was able to control her anxiety. Those are times when she had learned to focus on something other than how she felt. The bad times were when she was alone at home in the evenings. That is when her thoughts drifted. Reality? Her obvious progress was sparking thoughts of what would happen if she really was able to be free of anxiety. She could then be “normal”! However, normal meant potentially dealing with issues she had not been able to deal with before. Being normal meant dealing with the sources of her anxiety and panic. In relationships, she had made poor choices and decisions. Her lack of self-esteem allowed her to get involved with the wrong guys. She allowed these controlling and manipulative guys to take control of her life. She new it was a bad thing to do. She knew she was not happy, but she was more fearful of being alone. She had wasted years in these abusive relationships.
Now, sensing success in controlling her anxiety symptoms had led her back to thoughts of again, finding herself able to explore new relationships, but having no faith in herself that she would not again make the same bad choices. She feared she would again find herself trapped in an unhealthy, even abusive relationship. She ultimately did not trust herself to make healthy relationship choices.
She had not lost the value of the progress she has made, but now she and I had to truly focus more on her self-esteem issues and practicing making better choices because she deserves to. That is where the real work had to be done.
Gene Benedetto, Psychologist Emeritus