Intervention tidbit #6: Anxiety

A woman in her early thirties has continuous anxiety, often “like an out-of-body experience.”  “I break out crying hysterically, more in the evenings as it gets darker.”  She has a solid marriage, a baby who’s just left nursing, is a well established middle-school teacher.  She is in constant fear and smiles – a rigid but pleasing and infectious smile – most of the hour, every session.

I’d like to fire any therapist, endorsing the here-and-now, who believes that mindfulness, reframing, de-catastrophizing self-talk, rationality, autogenic relaxation or regulated breathing would help this woman’s problem, even come up to its ankles.  Open your eyes and see the past:

She was the disliked stepchild of her aunt.  She was almost three years old when her mother died.  The aunt was a raging Histrionic who broke tree branches on her head, “screamed and threw things” if there was one lower grade in a superb report card.  Age ten, she had become characterologically a vigilant and tiptoeing and strategizing girl, manipulating remote factors, distracting her aunt’s mind away from her crazy thoughts and punishments.

The girl never expressed a thing, never breathed a word of anger or unhappiness.  Childhood-to-adolescence became a play of fake smiles and life, a secondary circle of existence orbiting her scorched world.

By age thirty she had never said a single word of anger or grievance or serious feeling to anyone.  She emailed her friends and husband because she couldn’t talk to them, still lived the play-act with her stepmother.  She sat ten minutes, twenty minutes in silence in therapy, and no word could come out, week after week.

Strength-based, here-and-now therapists, picture someone holding in mountainous anguish her whole life, walking on with it, smiling over it, speaking pre-made lessons through it in her classes.  Always having used the mind to figure out escapes and the best unreality for the moment.  There was one thing she needed in our therapy – to find her tongue, her words; meaning: the strength to exist, the strength to be devastated.  Anxiety ends when it turns to grief-rage and tears, that finally water her scorched home world.