Panic Attacks and Phobias Often a Distraction from the Real Issue !
So often, clients come to me because they are experiencing over-whelming anxiety, even debilitating panic attacks, or phobias that are interfering with their lives. These symptoms I refer to as the Presenting Symptoms.
Of course, once I get a better picture of the client’s personality, I can help him or her develop a game plan to deal with, significantly reduce or eliminate the presenting symptoms, but that is only half the battle. The real issue is WHY he or she is so susceptible to these anxiety symptoms, to the point that they can take over one’s life.
In truth, one of the first things I think about when meeting a new client is, “what is causing this person to feel out of control in some way in their life”. That real issue, the real fear of being, in some perceived way, out of control mostly runs deeper than the phobia or anxiety symptoms being manifested or presented.
But then, I always remind myself that it is the anxiety symptoms that are initially creating pain, and we must bring some understanding and relief of those symptoms before we can deal with the underlying but real issues of control. There is a delicate balance that must be struck in therapy between the presenting symptoms and the underlying fears and issues.
Often, as I am working with a client to set up and carry out a plan to face and take control of the presenting anxiety and symptoms, I will pick up some pretty strong clues as to what is going on beneath the surface.
If you are experiencing significant anxiety, panic attacks , agoraphobia or other phobias, you need to think seriously about the fact that in my experience, there ARE underlying issues which are often not dealt with, and therefore, allow you to remain vulnerable to more symptoms later. Without realizing it consciously, the presenting symptoms may even be a way of avoiding deeper control issues, of distracting yourself from the source issues because those issues may be seen as just to complex, painful or forbidden to deal with.
In today’s mental health climate where therapy is under the pressure of managed care and Insurance company reviews, the real issues are less often uncovered.
So, when I see a client who has been in various therapies for panic and anxiety, and after 30 years has not recovered but in fact has had symptoms return in a more viral form, as in agoraphobia, I know that the root issues that cause her to feel out of control have not been addressed, and the presenting symptoms have taken over her life.
For example, I have seen clients with IBS or digestive problems become phobic about eating in public or going places socially where they fear their symptoms will flair up, only to find that they have underlying insecurities and fears of rejection from childhood that have never been dealt with, so their physical symptoms, though real, are actually stress induced, and unconsciously allow the person the excuse to not venture in to socially threatening situations.
I have seen clients over the years who manifest phobias about being sick, especially vomiting, which have developed into a fear of getting pregnant because of the possibility of becoming nauseous during the initial stages of the pregnancy, or being around infants who get sick and bring germs home from school. Yet, in therapy, we might discover that the phobia, which represents being out of control on one’s bodily functions momentarily, is more a result of a childhood and adolescence where the client felt anger towards herself for always adapting and conforming to the wants and demands of others, as she attempted to gain approval at all costs. As an adult, and without full conscious awareness, she had over-corrected to ensure she was in control. Those fears and feelings of being out of control as a adolescent and adult may have caused her to be ultra sensitive to any perception of her body feeling out of control, as in sickness or vomiting. On top of that, maybe the fear of getting sick allows her to maintain a distance from people in her life, so that prevents her from developing a dependence on people, something she may fear because of the lessons of the past,
When we feel out of control especially when we avoid dealing with issues and conflicts in our lives, and if that pattern of needing approval and acceptance from others becomes a primary way to feel worth and value, we are more vulnerable to anxiety symptoms. When we avoid, we perceive ourselves in a negative light, and we do not trust ourselves. This is damaging to our self-esteem. We become angry with ourselves as we perceive our apparent weakness, which often causes us to avoid that much more. We often continue to have these underlying issues of not feeling in control, especially in our personal lives and relationships. Since the pattern or habit of avoiding persists and we but never deal with the the issues face to face, it can often lead to symbolic issues of not feeling in control such as in some phobias, A lot to think about !
Gene Benedetto, Coach