“My antidepressant medication has been slowly reduced. I still will not give it up entirely. Perhaps it is my ‘last parent’ or security blanket. Perhaps it is my safety net that I can turn to in time of need. I am learning that I have been standing on my own two feet for a long time and doing quite well. Maybe I do not need a safety net.
“My involvement with Siddha Yoga practices has taught me how to meditate. Every morning, I spend at least ten minutes focusing my breathing and clearing my mind of all thoughts. It is tough to learn and does not happen instantly, but over time I have gotten to the point where I can clear my mind in five minutes and actually not feel anxiety for that time in meditation. I also feel it affects the stress level of the rest of my day in a positive way. My spiritual leader also taught me that ‘We are all alone. God is inside us.” This idea has helped me be less dependent on others.
“After taking a class from a Reiki Master, I learned to perform Reiki on myself. Reiki is the movement of spiritual energy or Qi through the body. It is meditative and whether it is a placebo effect or not, it aids in relieving my stress physically and mentally.
“Finally, one of the most important steps in lessening anxiety over time is positive self-talk. I consciously make an effort to recognize my accomplishments in fighting my anxiety and refuse to beat myself up if I fall short of my own expectations in the battle. I compare how I handled a situation in the present to how I would have handled it a year ago or two years ago and realize how far I have come. I recognize that there is no magic answer or instant fix, but each little step I take further into the battlefield is a win.”
My Opinion of What Helped Matt’s Anxiety
I have seen the simple breathing exercise calm people. However, some of Matt’s physical symptoms of anxiety, particularly those involving his face, were far worse than average. I taught Matt the deep breathing exercise, hoping for the best. After two weeks he returned and told me that he drove a longer distance than usual and his anxiety grew progressively worse with each mile. His lips, the sides of his face and his hands and feet became numb and tingled. Hive-like blotches appeared on his face. He did the deep breathing exercise. After three tries, he looked in the car mirror and the blotches were gone. He was astonished. Seeing this technique work allowed him to have greater trust in therapy and my view of the nature and cause of his anxiety.
When I first saw Matt, I felt that, although he was unhappy, frustrated and had a history of depression, he was no longer clinically depressed. He had GAD and a history of panic disorder. Although his medication was an antidepressant, it was also helpful for insomnia and anxiety. Matt was not wrong when he said that he got increased anxiety, stomach pains and dizziness when he tried to get off his medication (which is known to have withdrawal symptoms). I suggested that we gradually decrease his dosage and place him on an antianxiety medication that would help his anxiety and prevent his panic attacks from returning. It took him five months to try this for the first time.
Matt incorporated yoga, meditation and other alternative therapies as well as spirituality into his treatment plan. He felt that his association with a spiritual leader was very helpful. This involvement allowed him to bring religion back into his life in a way with which he felt comfortable. It gave him something to hold on to during times of stress. He had come back to religion but in his own way.
In therapy we addressed many issues. Matt’s mother and maternal grandmother were both role models who put much emphasis on physical problems and believed that a pill was the answer to everything, even though it sometimes isn’t. This revelation moved Matt to allow me to slowly reduce his antidepressant medication. Matt internalized feelings of anger and guilt and denied his need for support and dependency. All of these issues got in the way in his new relationship with David. As time went by I was able to get him to verbalize these feelings. In any new relationship, we project our early wishes onto the other person just as the client projects them onto the therapist. As we get to know the person better, we start to see flaws and limitations. Gradually, Matt was better able to accept David, “warts and all.”
Therapy helped Matt with his self-esteem and allowed him to feel better about himself. He had a distorted perception of himself, particularly his body image. Some of this was due to the message that he received in childhood that he was “a cross-eyed fat pig.” I helped him reduce feelings of shame and guilt, stay away from self-pity and begin to like himself more. He started a diet. I also helped him see that he did not have to give others so much power over him. As Eleanor Roosevelt said, “No one can make you feel inferior without your consent.”
To reduce his need for control and predictability, I pointed out that his life history showed no evidence of loss of control. There was no family history of psychosis. If anything, his problem was too much control. I tried to teach him that his personality probably would never allow him to lose complete control.
The most significant gain in therapy for Matt was his gradual willingness to travel greater distances, take risks and still feel in control. At first, he traveled to another city to see his lover and visit people in the area. Then, he took another job in a location that was outside of his comfort zone. Finally, with his dependency needs and anxiety in better focus, he was able to leave therapy and take an advanced position in a neighboring state. His anxiety battle had, at last, been partially won.
After several months had passed since I had last spoken to Matt, I called him to check his progress. He seemed happy and confident; his first words were, “I’m doing well. I just graduated from school with a master’s degree in instructional technology. I gave my dissertation presentation in front of thirty people.”
Matt told me that he was still working for the same firm: “It’s been rough—a lot of management changes—but I stuck in there. I am doing consulting work on the side with a young firm. I’m handling stressful situations better. It’s been good, especially with driving. You would be proud. I drive all over now, even across bridges. It’s amazing. At first, I did it with my partner and then started to drive myself. Now I’m cruising on the highway. We are still together. If the fears do come up, I do the breathing exercise. I no longer need to be tethered to home. We will see how it goes from here. My anxiety is manageable. If it does present, I have the tools to handle it and it’s just a bump in the road. Sometimes I just say to myself, what is the worst thing that can happen?”
What surprised me the most was what happened when I read him the first line of his vignette, where he compared his anxiety to a battlefield. Although he remembered writing the words, he could no longer relate to them because so much had changed in his life. I could see that he had come a long way from that insecure, upset and anxious young man whom I had met years ago. I was happy for him.
Refocus. Concentrate on the here and now. Throw away those underlying negative feelings, particularly those from the past. Don’t play the victim. Leave the past behind. Don’t take it all so seriously. Give yourself permission to lighten up, smile and enjoy the moment. You are allowed to relax and have fun. All those bad things happened a long time ago. This is now. You are older, wiser and more in control.
Penny and Susan, two of my clients, are as different as night and day. However, they do share two things in common. They both have GAD and they both had an alcoholic parent who affected their lives and intensified their innate anxiety.
These women are not alone. Alcoholism statistics tell us that seventy-six million people in the United States alone have been exposed to alcohol dependency in the family. More than nine million children live with a parent dependent on alcohol.1 Alcoholism is a disease involving the body, mind and spirit that often reflects psychological stress. This tension can spill over onto the children in the house, creating feelings of fear and insecurity. Children absorb anxiety like a sponge.
Gilda Berger calls alcoholism